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Sample records for non-school influences poor

  1. Non-School Influences and Educational Disadvantage: Pre and Post-natal Nutritional Deprivation

    Science.gov (United States)

    Doll, Russell C.

    1973-01-01

    Deals with pre and post-natal malnutrition and its possible influence on the child, focusing on these points: How wide-spread and severe is the malnutrition? What might be the effects of the malnutrition at certain critical points in development? (Author/JM)

  2. Influencing pro-poor telecommunication policies in Asia | IDRC ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    2016-06-10

    Jun 10, 2016 ... The survey also revealed that the poorer the people, the larger the share ... CEO of LIRNEasia, the Sri Lanka-based think tank which conducted the study. ... has also been successful in influencing pro-poor telecommunication ...

  3. Influencing pro-poor telecommunication policies in Asia | CRDI ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    10 juin 2016 ... A study on mobile phone use by the poor has resulted in the cancellation of a plan to tax mobile usage in Bangladesh. Surveys on mobile expenditures in several South Asian countries found that nearly half of the poor people in Bangladesh own a mobile phone. Ownership rates are even higher in ...

  4. Iliac artery stenting in patients with poor distal runoff: Influence of concomitant infrainguinal arterial reconstruction.

    Science.gov (United States)

    Timaran, Carlos H; Ohki, Takao; Gargiulo, Nicholas J; Veith, Frank J; Stevens, Scott L; Freeman, Michael B; Goldman, Mitchell H

    2003-09-01

    Inadequate infrainguinal runoff is considered an important risk factor for iliac stent failure. However, the influence of concomitant infrainguinal arterial reconstruction (CIAR) on iliac stent patency is unknown. This study evaluated the influence of CIAR on outcome of iliac angioplasty and stenting (IAS) in patients with poor distal runoff. Over 5 years (1996 to 2001), 68 IAS procedures (78 stents) were performed in 62 patients with poor distal runoff (angiographic runoff score >or=5). The SVS/AAVS reporting standards were followed to define outcome variables and risk factors. Data were analyzed with both univariate analysis (Kaplan-Meier method [K-M]) and regression analysis (Cox proportional hazards model). Indications for iliac artery stenting were disabling claudication (59%) and limb salvage (41%). Of the 68 procedures, IAS with CIAR was performed in 31 patients (46%), and IAS alone was performed in 37 patients (54%). Patients undergoing IAS with CIAR were older (P =.03) and had more extensive and multifocal iliac artery occlusive disease, with more TASC (TransAtlantic Inter-Society Consensus) type C lesions (P =.03), compared with patients undergoing IAS alone. No other significant differences in risk factors were noted. Runoff scores between patients undergoing IAS with CIAR and those undergoing IAS alone were not significantly different (median runoff scores, 6 [range, 5-8] and 7 [range, 5-9], respectively; P =.77). Primary stent patency rate at 1, 3, and 5 years was 87%, 54%, and 42%, respectively, for patients undergoing IAS with CIAR, and was 76%, 66%, and 55%, respectively, for patients undergoing IAS. Univariate analysis revealed that primary stent patency rate was not significantly different between the 2 groups (K-M, log-rank test, P =.81). Primary graft patency rate for CIAR was 81%, 52%, and 46% at 1, 3, and 5 years, respectively. Performing CIAR did not affect primary iliac stent patency (relative risk, 1.1; 95% confidence interval, 0.49-2.47; P

  5. Whistleblowing: what influences nurses' decisions on whether to report poor practice?

    Science.gov (United States)

    Gallagher, Ann

    Several recent high profile examples demonstrate that nurses fear and have reason to fear the consequences of reporting poor practice. This article examines the ethical issues surrounding whistleblowing, discussing in detail the reasons for and against reporting concerns about poor practice, and how nurses can be supported to do this.

  6. A qualitative study of the influence of poor dental aesthetics on the lives of young adults.

    Science.gov (United States)

    Josefsson, Eva; Lindsten, Rune; Hallberg, Lillemor R-M

    2010-01-01

    Although many countries offer some publicly funded orthodontic treatment for children, not all conditions receive treatment and some adolescents enter adulthood with persisting poor dental aesthetics or malocclusions. The aim of this study was to generate a theory highlighting the main concerns of young adults, either native-born or of immigrant background, with poor dental aesthetics and the measures they adopt to manage their condition in everyday life. A qualitative method, classic grounded theory, was applied in order to generate a substantive theory highlighting the main concerns and managing mechanisms of 13 strategically selected 19- and 20-year-olds with poor dental aesthetics. Open interviews were conducted with each participant, the topics covering different aspects of social and dental conditions. A core category and three conceptual categories were generated. The core category was labelled "Being under the pressure of social norms" and was related to categories explaining three different ways in which these young adults handle their main concern: (1) avoiding showing their teeth; (2) minimizing the importance of appearance; and (3) seeking orthodontic treatment. The theory offers the potential for improved understanding of young adults who, despite poor dental aesthetics, are managing well with life, and also of those who have not adjusted well. In early adolescence it may be problematic to make decisions about orthodontic treatment. Undisclosed dental fear can be an important barrier. Some of the young adults in the present study would probably benefit from treatment.

  7. Research review: maternal prenatal distress and poor nutrition - mutually influencing risk factors affecting infant neurocognitive development.

    Science.gov (United States)

    Monk, Catherine; Georgieff, Michael K; Osterholm, Erin A

    2013-02-01

    Accumulating data from animal and human studies indicate that the prenatal environment plays a significant role in shaping children's neurocognitive development. Clinical, epidemiologic, and basic science research suggests that two experiences relatively common in pregnancy - an unhealthy maternal diet and psychosocial distress - significantly affect children's future neurodevelopment. These prenatal experiences exert their influence in the context of one another and yet, almost uniformly, are studied independently. In this review, we suggest that studying neurocognitive development in children in relation to both prenatal exposures is ecologically most relevant, and methodologically most sound. To support this approach, we selectively review two research topics that demonstrate the need for dual exposure studies, including exemplar findings on (a) the associations between pregnant women's inadequate maternal intake of key nutrients - protein, fat, iron, zinc, and choline - as well as distress in relation to overlapping effects on children's neurocognitive development; and (b) cross-talk between the biology of stress and nutrition that can amplify each experience for the mother and fetus,. We also consider obstacles to this kind of study design, such as questions of statistical methods for 'disentangling' the exposure effects, and aim to provide some answers. Studies that specifically include both exposures in their design can begin to determine the relative and/or synergistic impact of these prenatal experiences on developmental trajectories - and thereby contribute most fully to the understanding of the early origins of health and disease. © 2012 The Author. Journal of Child Psychology and Psychiatry © 2012 Association for Child and Adolescent Mental Health.

  8. Maternal prenatal distress and poor nutrition – mutually influencing risk factors affecting infant neurocognitive development

    Science.gov (United States)

    Monk, Catherine; Georgieff, Michael K.; Osterholm, Erin A.

    2012-01-01

    Background Accumulating data from animal and human studies indicate that the prenatal environment plays a significant role in shaping children’s neurocognitive development. Clinical, epidemiologic, and basic science research suggests that two experiences relatively common in pregnancy — an unhealthy maternal diet and psychosocial distress — significantly affect children’s future neurodevelopment. These prenatal experiences exert their influence in the context of one another and yet, almost uniformly, are studied independently. Scope and Method of Review In this review, we suggest that studying neurocognitive development in children in relation to both prenatal exposures is ecologically most relevant, and methodologically most sound. To support this approach, we selectively review two research topics that demonstrate the need for dual exposure studies, including exemplar findings on (1) the associations between pregnant women’s inadequate maternal intake of key nutrients – protein, fat, iron, zinc, and choline – as well as distress in relation to overlapping effects on children’s neurocognitive development; and (2) cross-talk between the biology of stress and nutrition that can amplify each experience for the mother and fetus,. We also consider obstacles to this kind of study design, such as questions of statistical methods for ‘disentangling’ the exposure effects, and aim to provide some answers. Conclusion Studies that specifically include both exposures in their design can begin to determine the relative and/or synergistic impact of these prenatal experiences on developmental trajectories — and thereby contribute most fully to the understanding of the early origins of health and disease. PMID:23039359

  9. Interpersonal communication as an agent of normative influence: a mixed method study among the urban poor in India.

    Science.gov (United States)

    Rimal, Rajiv N; Sripad, Pooja; Speizer, Ilene S; Calhoun, Lisa M

    2015-08-12

    Although social norms are thought to play an important role in couples' reproductive decisions, only limited theoretical or empirical guidance exists on how the underlying process works. Using the theory of normative social behavior (TNSB), through a mixed-method design, we investigated the role played by injunctive norms and interpersonal discussion in the relationship between descriptive norms and use of modern contraceptive methods among the urban poor in India. Data from a household survey (N = 11,811) were used to test the underlying theoretical propositions, and focus group interviews among men and women were then conducted to obtain more in-depth knowledge about decision-making processes related to modern contraceptive use. Spousal influence and interpersonal communication emerged as key factors in decision-making, waning in the later years of marriage, and they also moderated the influence of descriptive norms on behaviors. Norms around contraceptive use, which varied by parity, are rapidly changing with the country's urbanization and increased access to health information. Open interpersonal discussion, community norms, and perspectives are integral in enabling women and couples to use modern family planning to meet their current fertility desires and warrant sensitivity in the design of family planning policy and programs.

  10. Influence of Interleukin-1 Beta on Platelet-Poor Plasma Clot Formation: A Potential Impact on Early Bone Healing.

    Directory of Open Access Journals (Sweden)

    Xin Wang

    Full Text Available Hematoma quality (especially the fibrin matrix plays an important role in the bone healing process. Here, we investigated the effect of interleukin-1 beta (IL-1β on fibrin clot formation from platelet-poor plasma (PPP.Five-milliliter of rat whole-blood samples were collected from the hepatic portal vein. All blood samples were firstly standardized via a thrombelastograph (TEG, blood cell count, and the measurement of fibrinogen concentration. PPP was prepared by collecting the top two-fifths of the plasma after centrifugation under 400 × g for 10 min at 20°C. The effects of IL-1β cytokines on artificial fibrin clot formation from PPP solutions were determined by scanning electronic microscopy (SEM, confocal microscopy (CM, turbidity, and clot lysis assays.The lag time for protofibril formation was markedly shortened in the IL-1β treatment groups (243.8 ± 76.85 in the 50 pg/mL of IL-1β and 97.5 ± 19.36 in the 500 pg/mL of IL-1β compared to the control group without IL-1β (543.8 ± 205.8. Maximal turbidity was observed in the control group. IL-1β (500 pg/mL treatment significantly decreased fiber diameters resulting in smaller pore sizes and increased density of the fibrin clot structure formed from PPP (P < 0.05. The clot lysis assay revealed that 500 pg/mL IL-1β induced a lower susceptibility to dissolution due to the formation of thinner and denser fibers.IL-1β can significantly influence PPP fibrin clot structure, which may affect the early bone healing process.

  11. Influence of neutrophile granulocyte/lymphocyte ratio (NLR on poor prognosis of elderly AECOPD patients during hospital stay

    Directory of Open Access Journals (Sweden)

    Jian-Rong Cui

    2016-01-01

    Full Text Available Objective: To discuss the influence of neutrophile granulocyte/lymphocyte ratio(NLR to the poor prognosis of elderly AECOPD patients during the stay in hospital. Method: A total of 133 cases elderly patients with AECOPD admitted in our hospital from March 2013 to September 2014 were selected, and divided them into death group (31 cases and survival group (102 cases according to in-hospital death occurrence; To compare the on admission general clinical data, therapy method, lung function, blood routine examination [white blood cell count (WBC, neutrophile granulocyte/lymphocyte ratio(NLR], C-reactive protein (CRP, blood gas analysis and blood biochemical indexes in both groups, and drew ROC curve for a analysis of the clinical value of NLR in the prediction of death. Results: Among 133 cases of elderly AECOPD patients: the proportion of combined pulmonary heart disease and mechanical ventilation in death group was higher than that in survival group, PaCO2, WBC count, neutrophil count, NLR, CRP level in death group was higher, but lymphocyte count, serum albumin(ALB in death group was lower; multiple logistic regression analysis showed that NLR presented independent positive correlation with the in-hospital death in elderly AECOPD patients; ROC curve analysis showed that the ROCAUC of NLR to the inhospital death in elderly AECOPD patients was 0.787, the best diagnostic node value was 7.3, sensitivity and specificity were 77.4% and 74.5% respectively; bounded by NLR(7.3, divided patients into NLR≥7.3 group and NLR<7.3 group, hospital stays, CRP level and mortality in NLR≥7.3 group were higher than that in NLR<7.3 group. Conclusion: NLR was the high risk factor of the in-hospital death in elderly AECOPD patients, early detection of NLR level had a certain difference to the evaluation for short-term prognosis of elderly AECOPD patients and guide treatment.

  12. CERN as a Non-School Resource for Science Education

    CERN Document Server

    Ellis, Jonathan Richard

    2000-01-01

    As a large international research laboratory, CERN feels it has a special responsibility for outreach, and has many activities directed towards schools, including organized visits, an on-site museum, hands-on experiments, a Summer intern programme for high-school teachers, lecture series and webcasts. Ongoing activities and future plans are reviewed, and some ideas stimulated by this workshop are offered concerning the relevance of CERN's experience to Asia, and the particular contribution that CERN can make as a non-school resource for science education.

  13. Influence of residual catalyst on the properties of conjugated polyphenylenevinylene materials: Palladium nanoparticles and poor electrical performance

    DEFF Research Database (Denmark)

    Krebs, Frederik C; Nyberg, R.B.; Jørgensen, M.

    2004-01-01

    polymer material prepared by two different routes: the palladium route and the condensation route. The performance in a device application of the two polymer materials was, however, very different, and the palladium route was demonstrated to give poor films with low breakdown voltages and short circuits....

  14. Impact of dental fear on oral health-related quality of life among school going and non-school going children in Udaipur city: A cross-sectional study

    Directory of Open Access Journals (Sweden)

    Akanksha Goyal

    2014-01-01

    Full Text Available Aim: To assess the impact of dental fear on different domains of oral health-related quality of life (OHRQoL among school going and non-school going children in the Indian scenario. Materials and Methods: The study sample consisted of 279 school children and 257 non-school going children thus making a total sample of 536 children. The sampling frame comprised of 12-15-year-old children attending two upper primary public schools and non-school going children working at shops or not working in Udaipur city, India. Information on dental fear and OHRQoL was obtained by personal interviews by a single trained and calibrated examiner through a structured questionnaire. Intercooled STATA version 9.2 was employed to perform statistical analysis. The level of significance was set at 5%. Results: Mean dental fear scores among school going (35.41 [11.79] and non-school going (47.59 [3.80] children revealed that dental fear was significantly (P ≤ 0.05 higher among non-school going than among school going children. In school going children, the likelihood of having poor oral symptoms, functional limitation and poorer social and emotional well being were significantly (P ≤ 0.05 lesser as compared with non-school going children. Conclusions: Fear has a significant impact on different domains of OHRQoL, except emotional well being, among non-school going children.

  15. The influence of travel time on emergency obstetric care seeking behavior in the urban poor of Bangladesh: a GIS study.

    Science.gov (United States)

    Panciera, Rocco; Khan, Akib; Rizvi, Syed Jafar Raza; Ahmed, Shakil; Ahmed, Tanvir; Islam, Rubana; Adams, Alayne M

    2016-08-22

    Availability of Emergency Obstetric Care (EmOC) is crucial to avert maternal death due to life-threatening complications potentially arising during delivery. Research on the determinants of utilization of EmOC has neglected urban settings, where traffic congestion can pose a significant barrier to the access of EmOC facilities, particularly for the urban poor due to costly and limited transportation options. This study investigates the impact of travel time to EmOC facilities on the utilization of facility-based delivery services among mothers living in urban poor settlements in Sylhet, Bangladesh. A cross-sectional EmOC health-seeking behavior survey from 39 poor urban clusters was geo-spatially linked to a comprehensive geo-referenced dataset of EmOC facility locations. Geo-spatial techniques and logistic regression were then applied to quantify the impact of travel time on place of delivery (EmOC facility or home), while controlling for confounding socio-cultural and economic factors. Increasing travel time to the nearest EmOC facility is found to act as a strong deterrent to seeking care for the urban poor in Sylhet. Logistic regression results indicate that a 5-min increase in travel time to the nearest EmOC facility is associated with a 30 % decrease (0.655 odds ratio, 95 % CI: 0.529-0.811) in the likelihood of delivery at an EmOC facility rather than at home. Moreover, the impact of travel time varies substantially between public, NGO and private facilities. A 5-min increase in travel time from a private EmOC facility is associated with a 32.9 % decrease in the likelihood of delivering at a private facility, while for public and Non-Government Organizations (NGO) EmOC facilities, the impact is lower (28.2 and 28.6 % decrease respectively). Other strong determinants of delivery at an EmOC facility are the use of antenatal care and mother's formal education, while Muslim mothers are found to be more likely to deliver at home. Geospatial evidence points to

  16. Influence of gender roles and rising food prices on poor, pregnant women's eating and food provisioning practices in Dhaka, Bangladesh.

    Science.gov (United States)

    Levay, Adrienne V; Mumtaz, Zubia; Faiz Rashid, Sabina; Willows, Noreen

    2013-09-26

    Maternal malnutrition in Bangladesh is a persistent health issue and is the product of a number of complex factors, including adherence to food 'taboos' and a patriarchal gender order that limits women's mobility and decision-making. The recent global food price crisis is also negatively impacting poor pregnant women's access to food. It is believed that those who are most acutely affected by rising food prices are the urban poor. While there is an abundance of useful quantitative research centered on maternal nutrition and food insecurity measurements in Bangladesh, missing is an understanding of how food insecurity is experienced by people who are most vulnerable, the urban ultra-poor. In particular, little is known of the lived experience of food insecurity among pregnant women in this context. This research investigated these lived experiences by exploring food provisioning strategies of urban, ultra-poor, pregnant women. This knowledge is important as discussions surrounding the creation of new development goals are currently underway. Using a focused-ethnographic approach, household food provisioning experiences were explored. Data from participant observation, a focus group discussion and semi-structured interviews were collected in an urban slum in Dhaka, Bangladesh. Interviews were undertaken with 28 participants including 12 pregnant women and new mothers, two husbands, nine non-pregnant women, and five health care workers. The key findings are: 1) women were aware of the importance of good nutrition and demonstrated accurate, biomedically-based knowledge of healthy eating practices during pregnancy; 2) the normative gender rules that have traditionally constrained women's access to nutritional resources are relaxing in the urban setting; however 3) women are challenged in accessing adequate quality and quantities of food due to the increase in food prices at the market. Rising food prices and resultant food insecurity due to insufficient incomes are

  17. The Influence of Family Socialisation on the Success of Girls from Poor Urban Communities in Brazil at School

    Science.gov (United States)

    Carvalho, Marília

    2015-01-01

    The principle focus of this article is to understand the influence of socialisation in the family on the success of girls at school. Eight low-income families with children of both sexes in the city of São Paulo, Brazil were studied through interviews and observation methods. It was found that socialisation in the family favoured in girls, and not…

  18. Influence of Poor Oral Health on Physical Frailty: A Population-Based Cohort Study of Older British Men.

    Science.gov (United States)

    Ramsay, Sheena E; Papachristou, Efstathios; Watt, Richard G; Tsakos, Georgios; Lennon, Lucy T; Papacosta, A Olia; Moynihan, Paula; Sayer, Avan A; Whincup, Peter H; Wannamethee, S Goya

    2018-03-01

    To investigate the associations between objective and subjective measures of oral health and incident physical frailty. Cross-sectional and longitudinal study with 3 years of follow-up using data from the British Regional Heart Study. General practices in 24 British towns. Community-dwelling men aged 71 to 92 (N = 1,622). Objective assessments of oral health included tooth count and periodontal disease. Self-reported oral health measures included overall self-rated oral health; dry mouth symptoms; sensitivity to hot, cold, and sweet; and perceived difficulty eating. Frailty was defined using the Fried phenotype as having 3 or more of weight loss, grip strength, exhaustion, slow walking speed, and low physical activity. Incident frailty was assessed after 3 years of follow-up in 2014. Three hundred three (19%) men were frail at baseline (aged 71-92). Having fewer than 21 teeth, complete tooth loss, fair to poor self-rated oral health, difficulty eating, dry mouth, and more oral health problems were associated with greater likelihood of being frail. Of 1,284 men followed for 3 years, 107 (10%) became frail. The risk of incident frailty was higher in participants who were edentulous (odds ratio (OR) = 1.90, 95% confidence interval (CI) = 1.03-3.52); had 3 or more dry mouth symptoms (OR = 2.03, 95% CI = 1.18-3.48); and had 1 (OR = 2.34, 95% CI = 1.18-4.64), 2 (OR = 2.30, 95% CI = 1.09-4.84), or 3 or more (OR = 2.72, 95% CI = 1.11-6.64) oral health problems after adjustment for age, smoking, social class, history of cardiovascular disease or diabetes mellitus, and medications related to dry mouth. The presence of oral health problems was associated with greater risks of being frail and developing frailty in older age. The identification and management of poor oral health in older people could be important in preventing frailty. © 2017 The Authors The Journal of the American Geriatrics Society published by Wiley Periodicals, Inc. on behalf of The American Geriatrics

  19. Provider performance in treating poor patients--factors influencing prescribing practices in lao PDR: a cross-sectional study.

    Science.gov (United States)

    Syhakhang, Lamphone; Soukaloun, Douangdao; Tomson, Göran; Petzold, Max; Rehnberg, Clas; Wahlström, Rolf

    2011-01-06

    Out-of-pocket payments make up about 80% of medical care spending at hospitals in Laos, thereby putting poor households at risk of catastrophic health expenditure. Social security schemes in the form of community-based health insurance and health equity funds have been introduced in some parts of the country. Drug and Therapeutics Committees (DTCs) have been established to ensure rational use of drugs and improve quality of care. The objective was to assess the appropriateness and expenditure for treatment for poor patients by health care providers at hospitals in three selected provinces of Laos and to explore associated factors. Cross-sectional study using four tracer conditions. Structured interviews with 828 in-patients at twelve provincial and district hospitals on the subject of insurance protection, income and expenditures for treatment, including informal payment. Evaluation of each patient's medical record for appropriateness of drug use using a checklist of treatment guidelines (maximum score=10). No significant difference in appropriateness of care for patients at different income levels, but higher expenditures for patients with the highest income level. The score for appropriate drug use in insured patients was significantly higher than uninsured patients (5.9 vs. 4.9), and the length of stay in days significantly shorter (2.7 vs. 3.7). Insured patients paid significantly less than uninsured patients, both for medicines (USD 14.8 vs. 43.9) and diagnostic tests (USD 5.9 vs. 9.2). On the contrary the score for appropriateness of drug use in patients making informal payments was significantly lower than patients not making informal payments (3.5 vs. 5.1), and the length of stay significantly longer (6.8 vs. 3.2), while expenditures were significantly higher both for medicines (USD 124.5 vs. 28.8) and diagnostic tests (USD 14.1 vs. 7.7). The lower expenditure for insured patients can help reduce the number of households experiencing catastrophic health

  20. Provider performance in treating poor patients - factors influencing prescribing practices in lao PDR: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Petzold Max

    2011-01-01

    Full Text Available Abstract Background Out-of-pocket payments make up about 80% of medical care spending at hospitals in Laos, thereby putting poor households at risk of catastrophic health expenditure. Social security schemes in the form of community-based health insurance and health equity funds have been introduced in some parts of the country. Drug and Therapeutics Committees (DTCs have been established to ensure rational use of drugs and improve quality of care. The objective was to assess the appropriateness and expenditure for treatment for poor patients by health care providers at hospitals in three selected provinces of Laos and to explore associated factors. Methods Cross-sectional study using four tracer conditions. Structured interviews with 828 in-patients at twelve provincial and district hospitals on the subject of insurance protection, income and expenditures for treatment, including informal payment. Evaluation of each patient's medical record for appropriateness of drug use using a checklist of treatment guidelines (maximum score = 10. Results No significant difference in appropriateness of care for patients at different income levels, but higher expenditures for patients with the highest income level. The score for appropriate drug use in insured patients was significantly higher than uninsured patients (5.9 vs. 4.9, and the length of stay in days significantly shorter (2.7 vs. 3.7. Insured patients paid significantly less than uninsured patients, both for medicines (USD 14.8 vs. 43.9 and diagnostic tests (USD 5.9 vs. 9.2. On the contrary the score for appropriateness of drug use in patients making informal payments was significantly lower than patients not making informal payments (3.5 vs. 5.1, and the length of stay significantly longer (6.8 vs. 3.2, while expenditures were significantly higher both for medicines (USD 124.5 vs. 28.8 and diagnostic tests (USD 14.1 vs. 7.7. Conclusions The lower expenditure for insured patients can help reduce

  1. Real-time investigations of the influence of sodium on the properties of Cu-poor prepared CuInS{sub 2} thin films

    Energy Technology Data Exchange (ETDEWEB)

    Rudigier, E.; Pietzker, Ch.; Wimbor, M.; Luck, I.; Klaer, J.; Scheer, R.; Barcones, B.; Jawhari Colin, T.; Alvarez-Garcia, J.; Perez-Rodriguez, A.; Romano-Rodriguez, A

    2003-05-01

    The influence of sodium on the growth path and the properties of Cu-poor prepared CuInS{sub 2} (CIS) thin films is investigated. In situ experiments of X-ray diffraction and Raman spectroscopy reveal a different growth path when sodium is incorporated. A delay of the CIS formation has been found as well as a different contribution of the resulting phases in the layer like the In-S alloy is now supposed to be located nearer the surface. Sodium doping results in a remarkable increase in the lateral conductivity and the cell efficiency of CuInS{sub 2} based solar cells.

  2. “Not on the agenda”: A qualitative study of influences on health services use among poor young women who use drugs in Cape Town, South Africa

    Science.gov (United States)

    Myers, Bronwyn; Carney, Tara; Wechsberg, Wendee M.

    2016-01-01

    Background Poor young women who use alcohol and other drugs (AODs) in Cape Town, South Africa, need access to health services to prevent HIV. Efforts to link young women to services are hampered by limited information on what influences service initiation. We explored perceptions of factors that influence poor AOD-using young women’s use of health services. Methods We conducted four focus groups with young women (aged 16 to 21) who used AODs and were recruited from two township communities in Cape Town. We also conducted 14 in-depth interviews with health and social welfare service planners and providers. Discussion topics included young women’s use of health services and perceived influences on service use. Qualitative data were analysed using a framework approach. Results The findings highlighted structural, contextual, and systemic influences on the use of health services by young women who use AODs. First, young women were absent from the health agenda, which had an impact on the provision of women-specific services. Resource constraints and gender inequality were thought to contribute to this absence. Second, gender inequality and stigma toward young women who used AODs led to their social exclusion from education and employment opportunities and health care. Third, community poverty resulted in the emergence of perverse social capital and social disorder that limited social support for treatment. Fourth, the health care system was unresponsive to the multiple service needs of these young women. Conclusion To reach young women who use AODs, interventions need to take cognisance of young women’s risk environment and health systems need to adapt to respond better to their needs. For these interventions to be effective, gender must be placed on the policy agenda. PMID:26797188

  3. "Not on the agenda": A qualitative study of influences on health services use among poor young women who use drugs in Cape Town, South Africa.

    Science.gov (United States)

    Myers, Bronwyn; Carney, Tara; Wechsberg, Wendee M

    2016-04-01

    Poor young women who use alcohol and other drugs (AODs) in Cape Town, South Africa, need access to health services to prevent HIV. Efforts to link young women to services are hampered by limited information on what influences service initiation. We explored perceptions of factors that influence poor AOD-using young women's use of health services. We conducted four focus groups with young women (aged 16-21) who used AODs and were recruited from two township communities in Cape Town. We also conducted 14 in-depth interviews with health and social welfare service planners and providers. Discussion topics included young women's use of health services and perceived influences on service use. Qualitative data were analysed using a framework approach. The findings highlighted structural, contextual, and systemic influences on the use of health services by young women who use AODs. First, young women were absent from the health agenda, which had an impact on the provision of women-specific services. Resource constraints and gender inequality were thought to contribute to this absence. Second, gender inequality and stigma toward young women who used AODs led to their social exclusion from education and employment opportunities and health care. Third, community poverty resulted in the emergence of perverse social capital and social disorder that limited social support for treatment. Fourth, the health care system was unresponsive to the multiple service needs of these young women. To reach young women who use AODs, interventions need to take cognisance of young women's risk environment and health systems need to adapt to respond better to their needs. For these interventions to be effective, gender must be placed on the policy agenda. Copyright © 2016 Elsevier B.V. All rights reserved.

  4. Coverage and Influencing Determinants of Influenza Vaccination in Elderly Patients in a Country with a Poor Vaccination Implementation

    Directory of Open Access Journals (Sweden)

    Maria Ganczak

    2017-06-01

    Full Text Available The seasonal influenza vaccination uptake of the elderly in Poland is one of the lowest in Europe. Objective: to assess the vaccination coverage and influencing determinants in patients ≥65 years of age. Methods: A cross-sectional study was conducted (November 2015–April 2016 among consecutive patients admitted to a municipal hospital located in the city of Szczecin, North-west Poland. Patients completed researcher-administered, anonymous questionnaires on socio- demographic data/factors related to the vaccination. Results: The response rate: 92.0%. Among 230 patients (79.6% women, median of age 69 years, range 65–89 who agreed to participate, 34.8% (95% Confidence Interval: 28.6–41.0% were vaccinated. About 15.7% of respondents had not previously heard about the vaccination; 41.3% of those who stated they were vaccinated or planned on being vaccinated the following year, compared to 19.3% of respondents who stated they were not currently vaccinated (p < 0.001. A multivariable regression analysis revealed that patient factors, such as younger age (Odds Ratio, OR = 7.69, living in the urban area (OR = 7.69, having comorbidities (OR = 2.70, having a vaccinated family member (OR = 3.57, and being informed about vaccination (OR = 5.00 were each associated with greater odds of being immunized. Willingness for vaccination the next year was strongly associated (OR = 8.59 with vaccination status. Conclusions: The influenza vaccination uptake in the elderly population in Poland is disturbingly low. Improved education strategies are needed to increase the uptake. Vaccinated respondents are more likely to plan on being vaccinated the following year. Future interventions related to maximizing vaccination coverage should be more tailored, focusing especially on older patients living in rural areas.

  5. Integrating petrography, mineralogy and hydrochemistry to constrain the influence and distribution of groundwater contributions to baseflow in poorly productive aquifers: insights from Gortinlieve catchment, Co. Donegal, NW Ireland.

    Science.gov (United States)

    Caulfield, John; Chelliah, Merlyn; Comte, Jean-Christophe; Cassidy, Rachel; Flynn, Raymond

    2014-12-01

    Identifying groundwater contributions to baseflow forms an essential part of surface water body characterisation. The Gortinlieve catchment (5 km(2)) comprises a headwater stream network of the Carrigans River, itself a tributary of the River Foyle, NW Ireland. The bedrock comprises poorly productive metasediments that are characterised by fracture porosity. We present the findings of a multi-disciplinary study that integrates new hydrochemical and mineralogical investigations with existing hydraulic, geophysical and structural data to identify the scales of groundwater flow and the nature of groundwater/bedrock interaction (chemical denudation). At the catchment scale, the development of deep weathering profiles is controlled by NE-SW regional scale fracture zones associated with mountain building during the Grampian orogeny. In-situ chemical denudation of mineral phases is controlled by micro- to meso-scale fractures related to Alpine compression during Palaeocene to Oligocene times. The alteration of primary muscovite, chlorite (clinochlore) and albite along the surfaces of these small-scale fractures has resulted in the precipitation of illite, montmorillonite and illite-montmorillonite clay admixtures. The interconnected but discontinuous nature of these small-scale structures highlights the role of larger scale faults and fissures in the supply and transportation of weathering solutions to/from the sites of mineral weathering. The dissolution of primarily mineral phases releases the major ions Mg, Ca and HCO3 that are shown to subsequently form the chemical makeup of groundwaters. Borehole groundwater and stream baseflow hydrochemical data are used to constrain the depths of groundwater flow pathways influencing the chemistry of surface waters throughout the stream profile. The results show that it is predominantly the lower part of the catchment, which receives inputs from catchment/regional scale groundwater flow, that is found to contribute to the

  6. Influence of Language and Culture in the Primary Care of Spanish-Speaking Latino Adults with Poorly Controlled Diabetes: A Qualitative Study.

    Science.gov (United States)

    Zamudio, Cindy D; Sanchez, Gabriela; Altschuler, Andrea; Grant, Richard W

    2017-01-01

    We examined the role of language and culture in the interactions between Spanish-speaking Latino patients with poorly controlled diabetes - a fast-growing population in the United States - and their primary care providers. We conducted four focus groups with 36 non-US born Spanish-speaking patients with elevated HbA1c. Participants were insured health plan members with either English-speaking (2 groups) or Spanish-speaking (2 groups) primary care providers. Moderated discussions focused on visit preparation, communication during visit, and role of other care team members. Key themes derived from these discussions were then linked to corresponding Latino cultural constructs. Patients had a mean age of 57.9 (±11.2) years and last measured HbA1c was 8.6% (1.5%). Two communication-related themes (reluctance to switch providers and use of intermediaries) and two visit-related themes (provider-driven visit agendas and problem-based visits) emerged from our analyses. These themes reflected the cultural constructs of confianza (trust), familismo (family), respeto (deference), and simpatía (harmonious relationship). Trust in the patient-provider relationship led many participants to remain with English-speaking providers who treated them well. Patients with either language concordant and discordant providers reported reliance on family or other intermediaries to close communication gaps. Deference to physician expertise and authority led to visit expectations that it is the doctor's job to know what to ask and that visits were intended to address specific, often symptom-driven problems. Spanish-speaking Latino patients' cultural expectations play an important role in framing their primary care interactions. Recognizing culturally influenced visit expectations is an important step toward improving patient-provider communication.

  7. Hemoglobin status of non-school going adolescent girls in three districts of Orissa, India.

    Science.gov (United States)

    Bulliyy, Gandham; Mallick, Gitanjali; Sethy, Girija Sankar; Kar, Santanu Kumar

    2007-01-01

    Anemia is a major public health problem in young children and pregnant women in SouthEast Asia, but a paucity of data on anemia in adolescent girls in India. Studies are lacking on the entire non-school going adolescent population. To determine the prevalence of anemia in non-school going adolescent girls and the association between hemoglobin (Hb) concentration and socioeconomic and nutritional factors. A cross-sectional community study conducted on a sample of 1937 healthy adolescent girls aged 11-19 years from three districts of Orissa, India. Sample size was determined using a probability proportionate to size cluster sampling. The adolescent girls were interviewed and anthropometric measurements were collected. The Hb estimation was carried out in capillary blood samples using the cyanmethemoglobin method. Anemia and nutritional status were evaluated according to standard procedures. The mean Hb concentration was 9.7 +/- 1.4 g/dL (range, 4.5-13.4 g/dL). Of the total adolescent girls, 1869 (96.5%) were anemic (Hb education levels of girls and their parents' family income, body mass index, and mid-upper arm circumference. This study revealed that prevalence of anemia was extremely high in non-school going adolescent girls (most were moderately anemic) and stressed the need for more research and public health interventions.

  8. Social support and mastery influence the association between stress and poor physical health in parents caring for children with developmental disabilities.

    Science.gov (United States)

    Cantwell, Joanne; Muldoon, Orla T; Gallagher, Stephen

    2014-09-01

    To date, much of the research linking the stress of caring for children with developmental disabilities (e.g. Autism & Down syndrome) with parental health outcomes have tended to concentrate on mental health with less attention paid to the physical health consequences. Thus, this study sought to explore the psychosocial predictors of poor physical health in these caring parents. One hundred and sixty-seven parents (109 caregivers and 58 control parents) completed measures of stress, child problem behaviours, social support, mastery and physical health. Parents of children with developmental disabilities had poorer physical health compared to control parents. Stress and mastery, but not social support and problem behaviours, were significant predictors of poor physical health within caring parents for children with developmental disabilities. However, the association between mastery and physical health was mediated by perceived stress such that those parents who were higher on mastery reported less stress and better physical health; furthermore, the association between stress and physical health was moderated by social support; those parents high on social support and low in stress had better physical health. These results indicate that the paths between psychosocial factors and poor physical health in the caring parents are working synergistically rather than in isolation. They also underscore the importance of providing multi-component interventions that offer a variety of psychosocial resources to meet the precise needs of the parents. Copyright © 2014 Elsevier Ltd. All rights reserved.

  9. Influence of gender roles and rising food prices on poor, pregnant women’s eating and food provisioning practices in Dhaka, Bangladesh

    Science.gov (United States)

    2013-01-01

    Background Maternal malnutrition in Bangladesh is a persistent health issue and is the product of a number of complex factors, including adherence to food 'taboos’ and a patriarchal gender order that limits women’s mobility and decision-making. The recent global food price crisis is also negatively impacting poor pregnant women’s access to food. It is believed that those who are most acutely affected by rising food prices are the urban poor. While there is an abundance of useful quantitative research centered on maternal nutrition and food insecurity measurements in Bangladesh, missing is an understanding of how food insecurity is experienced by people who are most vulnerable, the urban ultra-poor. In particular, little is known of the lived experience of food insecurity among pregnant women in this context. This research investigated these lived experiences by exploring food provisioning strategies of urban, ultra-poor, pregnant women. This knowledge is important as discussions surrounding the creation of new development goals are currently underway. Methods Using a focused-ethnographic approach, household food provisioning experiences were explored. Data from participant observation, a focus group discussion and semi-structured interviews were collected in an urban slum in Dhaka, Bangladesh. Interviews were undertaken with 28 participants including 12 pregnant women and new mothers, two husbands, nine non-pregnant women, and five health care workers. Results The key findings are: 1) women were aware of the importance of good nutrition and demonstrated accurate, biomedically-based knowledge of healthy eating practices during pregnancy; 2) the normative gender rules that have traditionally constrained women’s access to nutritional resources are relaxing in the urban setting; however 3) women are challenged in accessing adequate quality and quantities of food due to the increase in food prices at the market. Conclusions Rising food prices and resultant food

  10. Exploitation of 3D face-centered cubic mesoporous silica as a carrier for a poorly water soluble drug: influence of pore size on release rate.

    Science.gov (United States)

    Zhu, Wenquan; Wan, Long; Zhang, Chen; Gao, Yikun; Zheng, Xin; Jiang, Tongying; Wang, Siling

    2014-01-01

    The purposes of the present work were to explore the potential application of 3D face-centered cubic mesoporous silica (FMS) with pore size of 16.0nm as a delivery system for poorly soluble drugs and investigate the effect of pore size on the dissolution rate. FMS with different pore sizes (16.0, 6.9 and 3.7nm) was successfully synthesized by using Pluronic block co-polymer F127 as a template and adjusting the reaction temperatures. Celecoxib (CEL), which is a BCS class II drug, was used as a model drug and loaded into FMS with different pore sizes by the solvent deposition method at a drug-silica ratio of 1:4. Characterization using scanning electron microscopy (SEM), transmission electron microscopy (TEM), Fourier transformation infrared spectroscopy (FT-IR), thermogravimetric analysis (TGA), nitrogen adsorption, X-ray diffraction (XRD), and differential scanning calorimetry (DSC) was used to systematically investigate the drug loading process. The results obtained showed that CEL was in a non-crystalline state after incorporation of CEL into the pores of FMS-15 with pore size of 16.0nm. In vitro dissolution was carried out to demonstrate the effects of FMS with different pore sizes on the release of CEL. The results obtained indicated that the dissolution rate of CEL from FMS-15 was significantly enhanced compared with pure CEL. This could be explained by supposing that CEL encountered less diffusion resistance and its crystallinity decreased due to the large pore size of 16.0nm and the nanopore channels of FMS-15. Moreover, drug loading and pore size both play an important role in enhancing the dissolution properties for the poorly water-soluble drugs. As the pore size between 3.7 and 16.0nm increased, the dissolution rate of CEL from FMS gradually increased. © 2013.

  11. The Influence of Malnutrition and Micronutrient Status on Anemic Risk in Children under 3 Years Old in Poor Areas in China

    Science.gov (United States)

    Wang, Jie; Wang, Hui; Chang, Suying; Zhao, Liyun; Fu, Ping; Yu, Wentao; Man, Qingqing; Scherpbier, Robert; Pan, Lili; Duan, Yifan; Yin, Shi-an

    2015-01-01

    Background Malnutrition and anemia affect large numbers of young children living in poor areas of China. Multi-micronutrient deficiencies may be related to the prevalence of anemia in different populations, and identifying the risk factors that render children susceptible to anemia is the first step in combating anemia effectively. Methods In this cross-sectional study, a total of 1370 children under 3 years old were selected based on probability proportional to size sampling principles from poor counties of China. Basic characteristics data were collected by questionnaire; then anthropometrics and hemoglobin were measured in the field and anemia prevalence evaluated. Venous blood was drawn from children aged 12–35 months (N = 553) to evaluate micronutrient status. Logistic regression was used to identify the risk factors for children’s anemia. Results Among children aged 0–35 months, the prevalence of stunting, low body weight and wasting was 17.5%, 8.6% and 5.1%, respectively, and 25.6% of the children were affected by anemia, with more anemic infants and younger children than older children (P children aged 12–35 months affected by iron deficiency, vitamin D deficiency, folic acid deficiency and vitamin B12 deficiency, respectively. For children aged 0–11 months who were breastfed, the mothers’ anemic status was the only factor associated with the child’s anemia (OR = 2.6; 95% CI: 1.2–5.4, P children aged 12–35 months, multivariate logistic regression indicated that anemia was significantly associated with iron and vitamin B12 deficiency (OR = 5.3; 95% CI: 1.9–14.5, P anemia was higher in children under 2 years old and requires urgent intervention. An effective intervention strategy should include iron and vitamin B12 supplements, improving dietary diversity and controlling breastfeeding mothers' anemia. PMID:26488490

  12. Exploitation of 3D face-centered cubic mesoporous silica as a carrier for a poorly water soluble drug: Influence of pore size on release rate

    Energy Technology Data Exchange (ETDEWEB)

    Zhu, Wenquan; Wan, Long; Zhang, Chen; Gao, Yikun; Zheng, Xin; Jiang, Tongying; Wang, Siling, E-mail: silingwang@syphu.edu.cn

    2014-01-01

    The purposes of the present work were to explore the potential application of 3D face-centered cubic mesoporous silica (FMS) with pore size of 16.0 nm as a delivery system for poorly soluble drugs and investigate the effect of pore size on the dissolution rate. FMS with different pore sizes (16.0, 6.9 and 3.7 nm) was successfully synthesized by using Pluronic block co-polymer F127 as a template and adjusting the reaction temperatures. Celecoxib (CEL), which is a BCS class II drug, was used as a model drug and loaded into FMS with different pore sizes by the solvent deposition method at a drug–silica ratio of 1:4. Characterization using scanning electron microscopy (SEM), transmission electron microscopy (TEM), Fourier transformation infrared spectroscopy (FT-IR), thermogravimetric analysis (TGA), nitrogen adsorption, X-ray diffraction (XRD), and differential scanning calorimetry (DSC) was used to systematically investigate the drug loading process. The results obtained showed that CEL was in a non-crystalline state after incorporation of CEL into the pores of FMS-15 with pore size of 16.0 nm. In vitro dissolution was carried out to demonstrate the effects of FMS with different pore sizes on the release of CEL. The results obtained indicated that the dissolution rate of CEL from FMS-15 was significantly enhanced compared with pure CEL. This could be explained by supposing that CEL encountered less diffusion resistance and its crystallinity decreased due to the large pore size of 16.0 nm and the nanopore channels of FMS-15. Moreover, drug loading and pore size both play an important role in enhancing the dissolution properties for the poorly water-soluble drugs. As the pore size between 3.7 and 16.0 nm increased, the dissolution rate of CEL from FMS gradually increased. - Highlights: • Exploitation of 3D cubic mesoporous silica (16 nm) as a carrier was completed. • The release rate of CEL increased on increasing the pore size of carriers. • The crystallinity

  13. Inference in `poor` languages

    Energy Technology Data Exchange (ETDEWEB)

    Petrov, S.

    1996-10-01

    Languages with a solvable implication problem but without complete and consistent systems of inference rules (`poor` languages) are considered. The problem of existence of finite complete and consistent inference rule system for a ``poor`` language is stated independently of the language or rules syntax. Several properties of the problem arc proved. An application of results to the language of join dependencies is given.

  14. Exploiting the Poor

    DEFF Research Database (Denmark)

    Kamp Justesen, Mogens; Bjørnskov, Christian

    2014-01-01

    While extant research has focused on the causes and consequences of corruption at the macro-level, less effort has been devoted to understanding the micro-foundation of corruption. We argue that poor people are more likely to be victims of corrupt behavior by street-level bureaucrats as the poor...... often rely heavily on services provided by governments. We test this proposition using micro-level survey data from the Afrobaromenter. Multilevel regressions across 18 countries show that poor people are much more prone to experience having to pay bribes to government officials....

  15. Accounting for the Poor

    OpenAIRE

    Robert M. Townsend

    2013-01-01

    Economists and other social scientists have long tried to understand the nature of poverty and how poor people make decisions. For example, T.W. Schultz, a Nobel Laureate, former professor of economics at the University of Chicago, and former president of the American Economic Association, spent his career working in development and agricultural economics. In his 1980 Nobel Prize acceptance speech, Schultz suggests that there is some accounting for the behavior of the poor in agriculture. "Fa...

  16. 9. Poor medication

    African Journals Online (AJOL)

    Sitwala

    Majority (60%) of the patients were reviewed at least twice in the last 6 months at the time of the interview. 195 (83%) patients reported that drugs prescribed were not available at the hospital pharmacy, but 186 (79%) of. Factors Associated With Poor Medication Adherence. In Hypertensive Patients In Lusaka, Zambia. 1,4. 1.

  17. Savings for the Poor

    OpenAIRE

    Ignacio Mas

    2010-01-01

    This paper reviews the relevance of formal financial services – in particular, savings – to poor people, the economic factors that have hindered the mass-scale delivery of such services in developing countries, and the technology-based opportunities that exist today to make massive gains in financial inclusion. It also highlights the benefits to government from universal financial access, as well as the key policy enablers that would need to be put in place to allow the necessary innovati...

  18. Poorly Differentiated Thyroid Carcinoma.

    Science.gov (United States)

    Setia, Namrata; Barletta, Justine A

    2014-12-01

    Poorly differentiated thyroid carcinoma (PDTC) has been recognized for the past 30 years as an entity showing intermediate differentiation and clinical behavior between well-differentiated thyroid carcinomas (ie, papillary thyroid carcinoma and follicular thyroid carcinoma) and anaplastic thyroid carcinoma; however, there has been considerable controversy around the definition of PDTC. In this review, the evolution in the definition of PDTC, current diagnostic criteria, differential diagnoses, potentially helpful immunohistochemical studies, and molecular alterations are discussed with the aim of highlighting where the diagnosis of PDTC currently stands. Published by Elsevier Inc.

  19. [Poor insight and psychosis].

    Science.gov (United States)

    Giotakos, O

    2017-01-01

    A variety of phenomena might be considered as reflecting impaired insight in psychosis, like failure to recognize signs, symptoms or disease, failure to derive appropriate cognitive representations, despite recognition of the disease, and misattribution of the source or cause of the disease. The unawareness of tardive dyskinesia symptoms in schizophrenic patients points that self-awareness deficits in schizophrenia may be domain specific. Poor insight is an independent phenomenological and a prevalent feature in psychotic disorders in general, and in schizophrenia in particular, but we don't know yet if delusions in schizophrenia are the result of an entirely normal attempt to account for abnormal perceptual experiences or a product of abnormal experience but of normal reasoning. The theoretical approaches regarding impaired insight include the disturbed perceptual input, the impaired linkage between thought and emotion and the breakdown of the process of self-monitoring and error checking. The inability to distinguish between internally and externally generated mental events has been described by the metarepresentation theory. This theory includes the awareness of ones' goals, which leads to disorders of willed action, the awareness of intention, which leads to movement disorders, and the awareness of intentions of others, which leads to paranoid delusions. The theory of metarepresentation implies mainly output mechanisms, like the frontal cortex, while the input mechanism implies posterior brain systems, including the parietal lobe. There are many similarities between the disturbances of awareness seen in schizophrenia and those seen as a result of known neurological impairment. Neuropsychological models of impaired insight typically attribute the disturbance to any of a variety of core deficits in the processing of information. In this respect, lack of insight is on conceptual par with alogia, apraxia or aphasia in reflecting disturbed cognitive processing. In

  20. The 'poor man's laryngogram'

    International Nuclear Information System (INIS)

    Bartelt, D.

    1991-01-01

    This paper is reassessment of an old method improved by well-directed application of well-known maneuvers of laryngo-pharyngeal function. Although not as visually attractive as a dedicated laryngogram (now hardly ever requested), it does render similarly reliable diagnostic information, which, supported, as occasionally necessary, by conventional tomography, can even surpass that given by the older technique. Its main advantage lies in providing cheap, quick, noninvasive studies with minimal descomfort for the patient. Should further investigation be necessary, for analysis of deep extension, modern cross-sectional imaging methods (especially MR) far surpass even dedicated laryngography in diagnostic value and can be based adequately on 'poor mans's laryngography'. Ways in which this method may be optimised, especially those involving laryngopharyngeal function, are briefly presented - with emphasis on relevant practical aspects - as are normal and abnormal findings. (orig.) [de

  1. REMO poor man's reanalysis

    Science.gov (United States)

    Ries, H.; Moseley, C.; Haensler, A.

    2012-04-01

    Reanalyses depict the state of the atmosphere as a best fit in space and time of many atmospheric observations in a physically consistent way. By essentially solving the data assimilation problem in a very accurate manner, reanalysis results can be used as reference for model evaluation procedures and as forcing data sets for different model applications. However, the spatial resolution of the most common and accepted reanalysis data sets (e.g. JRA25, ERA-Interim) ranges from approximately 124 km to 80 km. This resolution is too coarse to simulate certain small scale processes often associated with extreme events. In addition, many models need higher resolved forcing data ( e.g. land-surface models, tools for identifying and assessing hydrological extremes). Therefore we downscaled the ERA-Interim reanalysis over the EURO-CORDEX-Domain for the time period 1989 to 2008 to a horizontal resolution of approximately 12 km. The downscaling is performed by nudging REMO-simulations to lower and lateral boundary conditions of the reanalysis, and by re-initializing the model every 24 hours ("REMO in forecast mode"). In this study the three following questions will be addressed: 1.) Does the REMO poor man's reanalysis meet the needs (accuracy, extreme value distribution) in validation and forcing? 2.) What lessons can be learned about the model used for downscaling? As REMO is used as a pure downscaling procedure, any systematic deviations from ERA-Interim result from poor process modelling but not from predictability limitations. 3.) How much small scale information generated by the downscaling model is lost with frequent initializations? A comparison to a simulation that is performed in climate mode will be presented.

  2. Poor housing quality: Prevalence and health effects.

    Science.gov (United States)

    Baker, Emma; Lester, Laurence H; Bentley, Rebecca; Beer, Andrew

    2016-01-01

    Housing is a central component of productive, healthy, and meaningful lives, and a principle social determinant of health and well-being. Surprisingly, though, evidence on the ways that housing influences health in Australia is poorly developed. This stems largely from the fact that the majority of the population are accommodated in good quality housing. The dominance of a "good housing paradigm" means that households living in poor quality and unhealthy housing are doubly disadvantaged-by the quality of their housing and because policy makers in Australia do not acknowledge the health effects of housing. In this article, we examine the relationship between health outcomes and quality of housing. We base our analysis on data from the Household Income and Labour Dynamics in Australia (HILDA) survey, a panel dataset that is representative across Australia. We find a sizeable, policy-important, and to date under-acknowledged cohort of Australians whose health is influenced by poor-condition dwellings.

  3. Poor expectations of knee replacement benefit are associated with modifiable psychological factors and influence the decision to have surgery: A cross-sectional and longitudinal study of a community-based sample.

    Science.gov (United States)

    Riddle, Daniel L; Golladay, Gregory J; Hayes, Amanda; Ghomrawi, Hassan M K

    2017-03-01

    Total knee arthroplasty (TKA) is a highly effective surgery, but is underutilized by some patient groups. This study determined factors associated with a person's expectations with respect to pain and walking function following a TKA procedure, should they elect to undergo a TKA. A total of 3542 people were studied with or at risk of knee osteoarthritis and enrolled in the community-based Osteoarthritis Initiative (OAI). Multivariable logistic regression analyses identified demographic, socioeconomic, osteoarthritis-related, joint replacement awareness, and psychological correlates as poor outcome expectations. Logistic regression determined if outcome expectation was associated with future knee arthroplasty utilization. Approximately 25% of the sample expected a poor outcome. Several factors were associated with poor pain outcome expectation, with the most powerful being African American race (Odds Ratio (OR)=2.11, 95% CI=1.69, 2.64) and an interaction between clinical depression symptoms and pain catastrophizing (OR=3.17, 95% CI=2.26, 4.44 when both were coded 'yes'). Whether a person had knee OA did not affect expectations. Pain outcome expectations were strongly associated with future TKA utilization (OR=4.9, 95% CI=2.2, 11.1). A variety of modifiable psychological factors impact people's expectations of the extent of pain and walking difficulty following a potential future TKA. Expectations strongly predict future TKA utilization. Given the high prevalence of knee osteoarthritis, mass media educational interventions for the population may assist in better aligning expectations with evidence-based knee arthroplasty outcomes and lead to more appropriate utilization of an effective procedure. Copyright © 2016 Elsevier B.V. All rights reserved.

  4. Are the energy poor also income poor? Evidence from India

    International Nuclear Information System (INIS)

    Khandker, Shahidur R.; Barnes, Douglas F.; Samad, Hussain A.

    2012-01-01

    The energy poverty line is defined as the threshold point at which energy consumption begins to rise with increases in household income. This approach is applied to cross-sectional data from a comprehensive 2005 household survey representative of both urban and rural India. The objective is to determine if the energy poor are also income poor and whether and how energy policies help reduce energy poverty, independent of income. The findings suggest that in rural areas some 57% of households are energy poor, versus 22% that are income poor. But in urban areas the energy poverty rate is 28% compared to 20% that are income poor. That is, energy policies are expected to play some roles in mitigating energy poverty. We find that reducing energy poverty requires not only support for rural electrification, but also more use of modern cooking fuels such as LPG. While income growth matters, a combination of energy related programs can play an independent and substantial role in reducing energy poverty. - Highlights: ► This paper applies a new approach to measuring energy poverty to rural and urban India. ► It also compares and contrasts income poverty with energy poverty in the context of India. ► Findings suggest that income poverty tracks energy poverty in urban India, but not in rural India. ► Income growth is very important in reducing energy poverty. ► In addition, access to and reliability of modern sources (electricity, LPG) are also helpful.

  5. Access to energy for the poor

    International Nuclear Information System (INIS)

    Huntjens, E.; Van Bussel, F.; Raats, M.

    2005-01-01

    Paper dealing with the topic E nergy consumption and economic development (in developed / wealthy and undeveloped / poor regions; energy price, social influence and energy efficiency. 'Brothers and sisters, I want to tell you this. The greatest thing on earth is to have the love of God in your heart, and the next greatest thing is to have electricity in your house.' In the early 1940s a farmer, who had just been connected to the electric grid, gave witness in a rural church in the United States of America(author)

  6. Mental Health Service Use in Schools and Non-School-Based Outpatient Settings: Comparing Predictors of Service Use.

    Science.gov (United States)

    Langer, David A; Wood, Jeffrey J; Wood, Patricia A; Garland, Ann F; Landsverk, John; Hough, Richard L

    2015-09-01

    Researchers have consistently documented a gap between the large number of US youth meeting criteria for a mental health disorder with significant associated impairment, and the comparatively few youth receiving services. School-based mental health care may address the need-services gap by offering services more equitably to youth in need, irrespective of family economic resources, availability of transportation, and other factors that can impede access to community clinics. However, diagnoses alone do not fully capture the severity of an individual's mental health status and need for services. Studying service use only in relation to diagnoses may restrict our understanding of the degree to which service use is reflective of service need, and inhibit our ability to compare school and non-school-based outpatient settings on their responsiveness to service need. The present study evaluated predictors of mental health service use in school- and community-based settings for youth who had had an active case in one of two public sectors of care, comparing empirically-derived dimensional measurements of youth mental health service need and impairment ratings against non-need variables (e.g., ethnicity, income). Three dimensions of youth mental health service need were identified. Mental health service need and non-need variables each played a significant predictive role. Parent-rated impairment was the strongest need-based predictor of service use across settings. The impact of non-need variables varied by service setting, with parental income having a particularly noticeable effect on school-based services. Across time, preceding service use and impairment each significantly predicted future service use.

  7. Testosterone for Poor Ovarian Responders

    DEFF Research Database (Denmark)

    Polyzos, Nikolaos P; Davis, Susan R; Drakopoulos, Panagiotis

    2016-01-01

    Testosterone, an androgen that directly binds to the androgen receptor, has been shown in previous small randomized controlled trials to increase the reproductive outcomes of poor ovarian responders. In most of these studies, transdermal testosterone in relatively high doses was administered before...... ovarian stimulation with a duration varying from 5 to 21 days. Nevertheless, the key question to be asked is whether, based on ovarian physiology and testosterone pharmacokinetics, a short course of testosterone administration of more than 10 mg could be expected to have any beneficial effect...... stages. In addition, extreme testosterone excess is not only likely to induce adverse events but has also the potential to be ineffective and even detrimental. Thus, evidence from clinical studies is not enough to either "reopen" or "close" the "androgen chapter" in poor responders, mainly because...

  8. All Work and No Play? The Effects of Ability Sorting on Students’ Non-school Inputs, Time Use, and Grade Anxiety

    OpenAIRE

    Liang Choon Wang

    2014-01-01

    How students’ non-school inputs respond to ability grouping may explain the currently mixed findings in the literature about the impacts of tracking. Using data from South Korea, where students are randomized into middle schools under the country’s equalization policy, but sorted into different high schools on the basis of achievement in some non-equalization policy areas, I find that under ability sorting, students’ demand for private tutoring, self-study time, and grade anxiety levels are l...

  9. Energy poor or fuel poor: What are the differences?

    International Nuclear Information System (INIS)

    Li, Kang; Lloyd, Bob; Liang, Xiao-Jie; Wei, Yi-Ming

    2014-01-01

    Energy poverty and fuel poverty are descriptors of problems of households' energy consumption, they are both distinct problems and have been addressed by many researchers, organizations and governments. Cross use of the terms of energy poverty and fuel poverty in published papers is common. As an accurate descriptor is the presupposition of research and policy development, especially for those who just started to pay attention to this issue, this paper compares the definitions, research priorities, status quo, and problems of these two concepts, and summarizes the relationship between them. The paper suggests that only when the research targets are households who are living in a cold climate and have difficulty in getting access to electricity or modern cooking facilities, and in supplying indoor heating with appropriate cost, the concepts of energy poverty and fuel poverty have the chance to be broadened and mutually integrated. - Highlights: • Address energy poverty and fuel poverty simultaneously. • Compare energy poverty and fuel poverty from 4 perspectives. • Summarize the relationship between energy poverty and fuel poverty. • Divide energy poor and fuel poor into three categories

  10. Poorly studied phenomena in geoelectrics

    Directory of Open Access Journals (Sweden)

    В. С. Могилатов

    2016-12-01

    Full Text Available Undoubtedly, modern geoelectric technologies emerge in the result of the development of traditional approaches and techniques. However of more interest is the appearance of completely new technologies based on new effects and new models of interaction of geological medium and electromagnetic field. The author does not commit to indicate principally new directions, but only wants to discuss some poorly known facts from the theory and practice of geoelectrics. The outcome of this study could be considered attracting the attention of experts to non-traditional signals in geoelectrics. The reviewed phenomena of interest, not fully implemented in practice in the author’s opinion, are field split into two polarizations: transverse electric (the ТЕ-field and transverse magnetic (the ТМ-field, then some poorly known properties of ТМ-field, the role of bias currents, the anisotropy of horizontal resistances, the role of geomagnetic field in geoelectric sounding, the unique resolution of CSEM (Controlled Source Electro-Magnetic techniques at sea.

  11. Serving the world's poor, profitably.

    Science.gov (United States)

    Prahalad, C K; Hammond, Allen

    2002-09-01

    By stimulating commerce and development at the bottom of the economic pyramid, multi-nationals could radically improve the lives of billions of people and help create a more stable, less dangerous world. Achieving this goal does not require MNCs to spearhead global social-development initiatives for charitable purposes. They need only act in their own self-interest. How? The authors lay out the business case for entering the world's poorest markets. Fully 65% of the world's population earns less than $2,000 per year--that's 4 billion people. But despite the vastness of this market, it remains largely untapped. The reluctance to invest is easy to understand, but it is, by and large, based on outdated assumptions of the developing world. While individual incomes may be low, the aggregate buying power of poor communities is actually quite large, representing a substantial market in many countries for what some might consider luxury goods like satellite television and phone services. Prices, and margins, are often much higher in poor neighborhoods than in their middle-class counterparts. And new technologies are already steadily reducing the effects of corruption, illiteracy, inadequate infrastructure, and other such barriers. Because these markets are in the earliest stages of economic development, revenue growth for multi-nationals entering them can be extremely rapid. MNCs can also lower costs, not only through low-cost labor but by transferring operating efficiencies and innovations developed to serve their existing operations. Certainly, succeeding in such markets requires MNCs to think creatively. The biggest change, though, has to come from executives: Unless business leaders confront their own preconceptions--particularly about the value of high-volume, low-margin businesses--companies are unlikely to master the challenges or reap the rewards of these developing markets.

  12. Does Maternal Employment Influence Poor Children's Social Development?

    Science.gov (United States)

    Fuller, Bruce; Caspary, Gretchen; Kagan, Sharon Lynn; Gauthier, Christiane; Hnang, Danny Shih-Cheng; Carroll, Judith; McCarthy, Jan

    2002-01-01

    This study examined the relation between young children's social development and maternal employment among women who entered welfare-to-work programs. Structural equation models provided evidence that indicators of economic security, such as food security and job quality indicators, but not recent employment per se, operated through parenting…

  13. Influencing pro-poor telecommunications policy in Latin America ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    2016-06-24

    Jun 24, 2016 ... Research conducted by DIRSI (Regional Dialogue on the Information ... In Brazil, DIRSI research findings were taken up in the design of the National ... Involving urban communities in controlling dengue fever in Latin America.

  14. Pro Poor Growth in Cameroon

    Directory of Open Access Journals (Sweden)

    Samuel Fambon

    2017-06-01

    Full Text Available The purpose of this paper is to analyze the relationship between economic growth, poverty and income distribution in Cameroon, using both the data derived from three Cameroonian household surveys and the Poverty Equivalent Growth Rate (PEGR methodology developed by Kakwani et al. (2004, The study found that economic growth in Cameroon was pro poor over the period 1996–2007, which suggests that instead of increasing the economic growth rate alone, the poverty equivalent growth rate should also be maximized to achieve the poverty reduction objective, meaning that on the one hand, the growth rate should be boosted, and on the other, the distribution of income should also be concurrently improved. A decomposition of changes in poverty using the Kakwani (1997 approach reveal that the growth component dominates the redistribution component in the reduction of poverty. This suggests that the fall in absolute poverty over the survey period may be attributed to an increase in average household income, and not to the redistributive policies of the government.

  15. How poor are women in rural India?

    Science.gov (United States)

    Rajuladevi, A K

    1992-07-01

    The assessment of poor women in India as dependent and exploited regardless of poverty focused strategies is reflected in this review of relevant literature. The scholarly approaches to the problems of poor women involve redirection and expansion of resources to women (increase bank credit) through policy and institutional changes, and involve improving women's welfare through changes in class and gender hierarchies; both pertain to restructuring power groups. A little ascribed to belief is that the organization of women's numbers will empower women; the constraints are stated. There is also some argument over whether to design women-specific programs or integrate women into existing programs; some examples are given of successes and difficulties. The regionalization of poverty in eastern and central India is discussed. The growth of the poor has been among the landless, wage-dependent households. 9.6% of households (7.5 million) are headed by women. Women work fewer hours and at lower wage scales and have fewer employment opportunities. Lower earnings are coupled with differentials in demand for female and male labor in agriculture and a crowded labor market. There is a concentration of women in less visible, nonmonetary subsistence production and domestic work. Women are undercounted in employment studies. Women predominate in agricultural activity. Women's status is influenced by economic status, caste, and ethnic background. Domestic work increases status for women and households. The poorer households have greater labor force participation, particularly as wage laborers rather than unpaid family workers. Regional factors affecting rural household strategies are factors affecting the economy (topography, rainfall, climate) and the degree of development, plus sociocultural variables (kinship and religious beliefs which affect the social domain of women), and the degree of dependence on hired vs. family labor. There are sharp contrasts in the value and survival

  16. Pro-poor growth and gender inequality

    OpenAIRE

    Klasen, Stephan

    2006-01-01

    This paper examines to what extent gender gaps in education, health, employment, productive assets and inputs can affect pro poor growth (in the sense of increasing monetary incomes of the poor). After discussing serious methodological problems with examining gender issues in the context of an income-based pro-poor growth framework, the paper considers theory and evidence on the impact of gender inequality on pro poor growth. While there is a considerable literature suggesting negative impact...

  17. Relationship between craniomandibular disorders and poor posture.

    Science.gov (United States)

    Nicolakis, P; Nicolakis, M; Piehslinger, E; Ebenbichler, G; Vachuda, M; Kirtley, C; Fialka-Moser, V

    2000-04-01

    The purpose of this research was to show that a relationship between craniomandibular disorders (CMD) and postural abnormalities has been repeatedly postulated, but still remains unproven. This study was intended to test this hypothesis. Twenty-five CMD patients (mean age 28.2 years) were compared with 25 gender and age matched controls (mean age 28.3 years) in a controlled, investigator-blinded trial. Twelve postural and ten muscle function parameters were examined. Measurements were separated into three subgroups, consisting of those variables associated with the cervical region, the trunk in the frontal plane, and the trunk in the sagittal plane. Within these subgroups, there was significantly more dysfunction in the patients, compared to control subjects (Mann-Whitney U test p Postural and muscle function abnormalities appeared to be more common in the CMD group. Since there is evidence of the mutual influence of posture and the craniomandibular system, control of body posture in CMD patients is recommended, especially if they do not respond to splint therapy. Whether poor posture is the reason or the result of CMD cannot be distinguished by the data presented here.

  18. What characterizes persons with poor mental health?

    DEFF Research Database (Denmark)

    Christensen, Anne Illemann; Davidsen, Michael; Kjøller, Mette

    2014-01-01

    analysed by means of logistic regression models. Results: Men and women with poor mental health are characterized by being single, having a long-term illness, not being able to rely on help from others in case of illness and by feeling that family and friends demand too much of them. Men with poor mental...... health were further characterized by being a heavy smoker, and having a BMI below 25. Women with poor mental health were further characterized by being 16-44 years old and sedentary in leisure time. CONCLUSIONS THE PREVALENCE OF POOR MENTAL HEALTH IS HIGHER AMONG WOMEN THAN MEN, AND DIFFERENT FACTORS...... CHARACTERIZE MEN AND WOMEN WITH POOR MENTAL HEALTH THE PRESENT FINDINGS SUPPORT THE NOTION THAT BOTH SOCIO-DEMOGRAPHICS AND LIFESTYLE FACTORS ARE INDEPENDENTLY RELATED WITH POOR MENTAL HEALTH WE SUGGEST TAKING INTO ACCOUNT ALL THESE AREAS OF LIFE WHEN PLANNING ACTIVITIES TO PREVENT POOR MENTAL HEALTH AND WHEN...

  19. The impact of non-financial and financial encouragements on participation in non school-based human papillomavirus vaccination: a retrospective cohort study.

    Science.gov (United States)

    Lefevere, Eva; Hens, Niel; De Smet, Frank; Beutels, Philippe

    2016-04-01

    Adolescent vaccination coverage under a system of non school-based vaccination is likely to be suboptimal, but might be increased by targeted encouragement campaigns. We analysed the effect on human papillomavirus (HPV) vaccination initiation by girls aged 12-18 of two campaigns set up in Flanders (Belgium) in 2007 and 2009: a personal information campaign and a combined personal information and financial incentive campaign. We analysed (objective) data on HPV vaccination behaviour from the National Alliance of Christian Mutualities (NACM), Flanders' largest sickness fund. We used z-scores to compare the monthly proportion of girls initiating HPV vaccination over time between carefully selected intervention and control groups. Separate analyses were done for older and younger girls. Total sample sizes of the intervention (control) groups were 221 (243) for the personal information campaign and 629 (5,322) for the combined personal information and financial incentive campaign. The personal information campaign significantly increased vaccination initiation, with older girls reacting faster. One year after the campaign the percentages of vaccination initiation for the oldest girls were 64.6 and 42.8 % in the intervention and control group, respectively (z = 3.35, p = 0.0008); for the youngest girls the percentages were 78.4 and 68.1 % (z = 1.71, p = 0.09). The combined personal information and financial incentive campaign increased vaccination initiation among certain age groups. One year after the campaign the difference in percentage points for HPV vaccination initiation between intervention and control groups varied between 18.5 % (z = 3.65, p = 0.0002) and 5.1 % (z = 1.12, p = 0.26). Under a non school-based vaccination system, personal information and removing out-of-pocket costs had a significant positive effect on HPV vaccination initiation, although the effect substantially varied in magnitude. Overall, the obtained vaccination rates remained far below those

  20. Nanosuspension Technology for Solubilizing Poorly Soluble Drugs

    OpenAIRE

    Deoli Mukesh

    2012-01-01

    Poor water solubility for many drugs and drug candidates remains a major obstacle to their development and clinical application. It is estimated that around 40% of drugs in the pipeline cannot be delivered through the preferred route or in some cases, at all owing to poor water solubility. Conventional formulations to improve solubility suffer from low bioavailability and poor pharmacokinetics, with some carriers rendering systemic toxicities (e.g. Cremophor1 EL). To date, nanoscale systems f...

  1. Poor motor skills: a risk marker for bully victimization.

    Science.gov (United States)

    Bejerot, Susanne; Plenty, Stephanie; Humble, Alice; Humble, Mats B

    2013-01-01

    Children who are clumsy are often bullied. Nevertheless, motor skills have been overlooked in research on bullying victimization. A total of 2,730 Swedish adults (83% females) responded to retrospective questions on bullying, their talents in physical education (i.e., coordination and balls skills) and school academics. Poor talents were used as indicators of poor gross motor skills and poor academic skills. A subset of participants also provided information on educational level in adulthood, childhood obesity, belonging to an ethic minority in school and socioeconomic status relative to schoolmates. A total of 29.4% of adults reported being bullied in school, and 18.4% reported having below average gross motor skills. Of those with below average motor skills, 48.6% were bullied in school. Below average motor skills in childhood were associated with an increased risk (OR 3.01 [95% CI: 1.97-4.60]) of being bullied, even after adjusting for the influence of lower socioeconomic status, poor academic performance, being overweight, and being a bully. Higher odds for bully victimization were also associated with lower socioeconomic status (OR 2.29 [95% CI: 1.45-3.63]), being overweight (OR 1.71 [95% CI: 1.18-2.47]) and being a bully (OR 2.18 [95% CI: 1.53-3.11]). The findings indicate that poor gross motor skills constitute a robust risk-marker for vulnerability for bully victimization. © 2013 The Authors. Aggressive Behavior Published by Wiley-Blackwell.

  2. Using Qualitative Methods with Poor Children in Urban Ethiopia: Opportunities & Challenges

    Science.gov (United States)

    Tekola, Bethlehem; Griffin, Christine; Camfield, Laura

    2009-01-01

    This paper discusses the advantages and challenges of using qualitative methods to elicit poor children's perspectives about threats and positive influences on their wellbeing. It draws on research carried out by the author on the subjective experiences of poor children in Addis Ababa, the capital of Ethiopia in terms of their understandings of…

  3. Use of modern contraception by the poor is falling behind.

    Directory of Open Access Journals (Sweden)

    Emmanuela Gakidou

    2007-02-01

    Full Text Available The widespread increase in the use of contraception, due to multiple factors including improved access to modern contraception, is one of the most dramatic social transformations of the past fifty years. This study explores whether the global progress in the use of modern contraceptives has also benefited the poorest.Demographic and Health Surveys from 55 developing countries were analyzed using wealth indices that allow the identification of the absolute poor within each country. This article explores the macro level determinants of the differences in the use of modern contraceptives between the poor and the national averages of several countries. Despite increases in national averages, use of modern contraception by the absolute poor remains low. South and Southeast Asia have relatively high rates of modern contraception in the absolute poor, on average 17% higher than in Latin America. Over time the gaps in use persist and are increasing. Latin America exhibits significantly larger gaps in use between the poor and the averages, while gaps in sub-Saharan Africa are on average smaller by 15.8% and in Southeast Asia by 11.6%.The secular trend of increasing rates of modern contraceptive use has not resulted in a decrease of the gap in use for those living in absolute poverty. Countries with large economic inequalities also exhibit large inequalities in modern contraceptive use. In addition to macro level factors that influence contraceptive use, such as economic development and provision of reproductive health services, there are strong regional variations, with sub-Saharan Africa exhibiting the lowest national rates of use, South and Southeast Asia the highest use among the poor, and Latin America the largest inequalities in use.

  4. Mongo Beti's The Poor Christ of Bomba

    African Journals Online (AJOL)

    2016-03-28

    Mar 28, 2016 ... discovered the Harlem Renaissance Movement or New Negro Movement ... Beti picks up as a subject for his satire in The Poor Christ of Bomba. ..... slave driver, and the indigenous man into an instrument of production” (6).

  5. Where are the poor in International Economics?

    OpenAIRE

    Luis Carvalho; Aurora A.C. Teixeira

    2011-01-01

    Despite the fact that a very significant proportion of the human population is living with financial difficulties and other constraints typical of poverty, scientific studies in the areas of Economics and especially in International Economics that address the issue of poverty and of poor countries are very few. Using bibliometric techniques, we measured the attention paid by authors from the field of International Economics to poverty and poor countries. To this end, we sorted and analyzed al...

  6. Hydrogen-Poor Core-Collapse Supernovae

    Science.gov (United States)

    Pian, Elena; Mazzali, Paolo A.

    Hydrogen-poor core-collapse supernovae (SNe) signal the explosive death of stars more massive than the progenitors of hydrogen-rich core-collapse supernovae, i.e., approximately in the range 15-50 M⊙ in main sequence. Since hydrogen-poor core-collapse supernovae include those that accompany gamma-ray bursts (GRBs), which were all rigorously identified with type Ic supernovae, their explosion energies cover almost two decades. The light curves and spectra are consequently very heterogeneous and often bear the signature of an asymmetric, i.e., aspherical, explosion. Asphericity is best traced by early-time (within days of the explosion) optical spectropolarimetry and by late-epoch (more than ˜ 100 days after explosion) low-resolution spectroscopy. While the relationship between hydrogen-poor core-collapse supernovae to hydrogen-poor super-luminous supernovae is not understood, a known case of association between an ultra-long gamma-ray burst and a very luminous hydrogen-poor supernova may help unraveling the connection. This is tantalizingly pointing to a magnetar powering source for both phenomena, although this scenario is still highly speculative. Host galaxies of hydrogen-poor supernovae are always star forming; in those of completely stripped supernovae and gamma-ray burst supernovae, the spatial distribution of the explosions follows the blue/ultraviolet light, with a correlation that is more than linear.

  7. Dehydroepiandrosterone (DHEA) supplementation and IVF outcome in poor responders.

    Science.gov (United States)

    Triantafyllidou, Olga; Sigalos, George; Vlahos, Nikos

    2017-06-01

    Ovarian stimulation of poor ovarian responders still remains a challenging issue. The incidence of poor responders among infertile women is reported in 9-24% IVF cycles and is associated with very low clinical pregnancy rates. Different treatments have been reported in the literature in an attempt to identify the best stimulation protocol for those patients. Administration of dehydroepiandrosterone acetate (DHEA) was suggested as a promising treatment. It is well known that androgens can influence ovarian follicular growth, augment steroidogenesis, promote follicular recruitment and increase the number of primary and pre-antral follicles. The purpose of this review is to evaluate the effect of DHEA supplementation on women with diminished ovarian reserve. Because of the uncertainty of published data, we suggest that well-designed multicentre RCTs are required to provide more insight on the effectiveness of DHEA. The absence of significant side effects should not be considered as an argument to support DHEA treatment.

  8. The poorly explored impact of uncontrolled asthma

    DEFF Research Database (Denmark)

    O'Byrne, Paul M; Pedersen, Søren; Schatz, Michael

    2013-01-01

    The goal of asthma management is to achieve disease control; however, despite the availability of effective and safe medications, for many patients asthma remains uncontrolled. One reason for this is the fear of long-term side effects from the regular use of inhaled corticosteroids (ICSs). Adverse...... effects of poorly controlled asthma (for example, obesity, pneumonia, and risks to the fetus) can be perceived as side effects of ICSs. Poorly controlled asthma adversely affects children's cardiovascular fitness, while children with well-controlled asthma perform at the same level as their peers....... Children with uncontrolled asthma also have a higher frequency of obesity than children with controlled asthma. Stress can affect asthma control, and children with poorly controlled asthma are more likely to have learning disabilities compared with those with good control. In adults, focused attention...

  9. Is American business working for the poor?

    Science.gov (United States)

    Bane, M J; Ellwood, D T

    1991-01-01

    At first glance, poverty seems to have little to do with business. When most people--managers included--think about poverty, they assume that people are poor because they are isolated from the mainstream economy, not productive participants in it. But according to Harvard University professors Mary Jo Bane and David Ellwood, this is a misleading image of the true face of poverty in the United States today. Most poor adults--and a full 90% of poor children--live in families where work is the norm, not the exception. Poor people often work or want to work. But at the low-wage end of the American economy, having a job is no guarantee of avoiding poverty. Poverty is a business issue, then, because the American poor are part of the American work force. And this poses a problem for managers. In a more competitive and fast-changing economic environment, the performance of companies increasingly depends on the capabilities of their employees. In response to this human-resource challenge, more and more managers are embracing the language of "empowerment". And yet how can low-wage employees believe empowerment when their experience of work is, quite literally, impoverishment? It is unlikely that American companies can create the work force of the future with the poverty policies of the past. Fortunately, there are some simple policy mechanisms that can assist the working poor without putting an undue burden on business. Enacting them, however, requires managers to see poverty policy as one part of a national human-resource strategy that links the strategic concerns of companies to a broad social agenda.

  10. Who speaks for the poor (question mark)

    International Nuclear Information System (INIS)

    Wyatt, Alan

    1981-01-01

    Nuclear energy benefits the poor, because it alleviates a shortage of petroleum. Less-developed countries suffer directly from a shortage of petroleum; also petroleum is necessary to raise food in the developed countries for export to the less-developed countries. (L.L.)

  11. Text comprehension strategy instruction with poor readers

    NARCIS (Netherlands)

    Van den Bos, K.P.; Aarnoudse, C.C.; Brand-Gruwel, S.

    1998-01-01

    The goal of this study was to investigate the effects of teaching text comprehension strategies to children with decoding and reading comprehension problems and with a poor or normal listening ability. Two experiments are reported. Four text comprehension strategies, viz., question generation,

  12. University Students with Poor Reading Comprehension

    Science.gov (United States)

    Georgiou, George K.; Das, J. P.

    2015-01-01

    The present study aimed to examine the nature of the working memory and general cognitive ability deficits experienced by university students with a specific reading comprehension deficit. A total of 32 university students with poor reading comprehension but average word-reading skills and 60 age-word-matched controls with no comprehension…

  13. Adult Literacy and the Poor Farming People.

    Science.gov (United States)

    Mathur, J. C.

    1978-01-01

    In discussing Rafe-uz-Zaman's essay on adult literacy and national development (see v9, n1 of this journal), the author cites examples to support his thesis that mass literacy campaigns in predominately agricultural countries can be successful only if there is simultaneous undertaking of economic development programs focused on the rural poor. (MF)

  14. Planning Behaviour in Good and Poor Readers

    Science.gov (United States)

    Mahapatra, Shamita

    2016-01-01

    A group of 50 good readers and a group of 50 poor readers of Grade 5 matched for age and intelligence and selected on the basis of their proficiency in reading comprehension were tested for their competence in word reading and the process of planning at three different levels, namely, perceptual, memory and conceptual in order to study the…

  15. Getting to Know L2 Poor Comprehenders

    Science.gov (United States)

    Zoghi, Masoud; Mustapha, Ramlee; Maasum, Tengku Nor Rizan BT Tengku Mohamad

    2011-01-01

    Among the plethora of studies conducted thus far to explore the factors affecting EFL reading effectiveness, scant attention seems to be paid to the why of poor reading comprehension of most EFL learners. In this regard, the present article capitalized on qualitative research on a small scale, for the purpose of addressing the not-so-often debated…

  16. Dealing with living in poor neighbourhoods

    NARCIS (Netherlands)

    Kleinhans, R.; Van der Land, M.; Doff, W.

    2010-01-01

    In this prologue to the special issue, the guest editors place the contributions in the context of current debates on living in concentrated poverty neighbourhoods. These debates concern two broad categories of residents: poor households that are assisted to move from concentrations of poverty to

  17. Correcting Poor Posture without Awareness or Willpower

    Science.gov (United States)

    Wernik, Uri

    2012-01-01

    In this article, a new technique for correcting poor posture is presented. Rather than intentionally increasing awareness or mobilizing willpower to correct posture, this approach offers a game using randomly drawn cards with easy daily assignments. A case using the technique is presented to emphasize the subjective experience of living with poor…

  18. Poor migrants in Bandung: settlement and employment

    NARCIS (Netherlands)

    Bruinessen, M.M. van

    1989-01-01

    Sukapakir is the real but appropriate name of a poor urban kampung in southwestern Bandung. It is one of the most densely populated neighbourhoods of the town now, although some forty years ago it was still a largely rural district. On the fringes of Sukapakir, one finds even today a few sawah

  19. Child spacing and contraception among the poor in Zambia

    Directory of Open Access Journals (Sweden)

    Vijayan K Pillai

    2010-03-01

    Full Text Available Vijayan K Pillai1, Rashmi Gupta21School of Social Work, University of Texas at Arlington, Arlington, TX, USA; 2Department of Social Work, San Francisco State University, San Francisco, CA, USAAbstract: For decades, family planning programs have targeted women in developing countries. These programs bestow a great deal of autonomy on women with respect to fertility decision making. It is well known that a number of close relatives in multigenerational and extended family systems influence women’s fertility decisions with respect to child spacing and contraceptive use. One approach toward a systematic study of fertility decision making is to explicitly consider the husband’s influences on fertility decision making. This study examines the effects of a selected number of factors on the desired birth interval lengths. We interviewed husbands and wives separately from 165 randomly selected households from two poor neighborhoods in the city of Kitwe, Zambia. Three ordinal birth interval groups were obtained for both husbands and wives separately. The effect of selected factors on the likelihood of influencing the three groups was examined using ordinal logistic regression methods. Data from husbands and wives were analyzed separately. Qualitative methods such as semistructured interviews were used to gather extensive information on the various factors that husbands and wives perceive to influence their child spacing decisions. We found differences in accounts with respect to child spacing between husbands and wives, likely due to a lack of communication. A gender-sensitive approach is necessary to promote spacing methods among poor couples in Zambia.Keywords: child spacing, contraceptive use, correspondence analysis, couple decision making

  20. Parenting Efficacy and the Early School Adjustment of Poor and Near-Poor Black Children

    Science.gov (United States)

    Jackson, Aurora P.; Choi, Jeong-Kyun; Bentler, Peter M.

    2009-01-01

    This short-term longitudinal study investigates whether maternal educational attainment, maternal employment status, and family income affect African American children's behavioral and cognitive functioning over time through their impacts on mothers' psychological functioning and parenting efficacy in a sample of 100 poor and near-poor single…

  1. From non school-based, co-payment to school-based, free Human Papillomavirus vaccination in Flanders (Belgium): A retrospective cohort study describing vaccination coverage, age-specific coverage and socio-economic inequalities

    OpenAIRE

    Lefevere, Eva; Theeten, Heidi; Hens, Niel; De Smet, Frank; Top, Geert; Van Damme, Pierre

    2015-01-01

    School-based, free HPV vaccination for girls in the first year of secondary school was introduced in Flanders (Belgium) in 2010. Before that, non school-based, co-payment vaccination for girls aged 12-18 was in place. We compared vaccination coverage, age-specific coverage and socio-economic inequalities in coverage -3 important parameters contributing to the effectiveness of the vaccination programs - under both vaccination systems. We used retrospective administrative data from different so...

  2. Poor Semen Quality Predicts Increased Mortality

    DEFF Research Database (Denmark)

    Jensen, Tina Kold; Bostofte, Erik; Jacobsen, Rune

    Objective: Over recent decades a possible decrease in semen quality and an increase in the incidence of testicular cancer have been reported. In addition, men with poor semen quality have been reported to be at increased risk of developing testicular cancer whereas the risk of other cancers...... is not increased. The long-term survival of men with poor semen quality is, however, unknown. We therefore studied the associations between semen characteristics and subsequent mortality. Back to Top Material and Methods: The Copenhagen Sperm Analysis Laboratory is one of several public semen analysis laboratories...... in Denmark and examines semen samples mostly from men in the area of Copenhagen. Men are referred to the clinic by general practitioners and urologists, and the investigations are paid for through the public health system. A total of 34.442 men had a semen analysis done at the laboratory during 1963 to 1995...

  3. Current stress and poor oral health

    OpenAIRE

    Vasiliou, A.; Shankardass, K.; Nisenbaum, R.; Qui?onez, C.

    2016-01-01

    Background Psychological stress appears to contribute to poor oral health systemically in combination with other chronic diseases. Few studies directly examine this relationship. Methods Data from a cross-sectional study of 2,412 participants between the ages of 25?64 years old living in the City of Toronto between 2009 and 2012 were used to examine the relationship between current stress and two self-rated oral health outcomes (general oral health and oral pain). Dental care utilization and ...

  4. Stereotactic Radiosurgery for Poor Performance Status Patients

    Energy Technology Data Exchange (ETDEWEB)

    Kubicek, Gregory J., E-mail: kubicek-gregory@cooperhealth.edu [Department of Radiation Oncology, Cooper University Hospital, Camden, New Jersey (United States); Turtz, Alan [Department of Neurological Surgery, Cooper University Hospital, Camden, New Jersey (United States); Xue, Jinyu; Patel, Ashish; Richards, Gregory; LaCouture, Tamara [Department of Radiation Oncology, Cooper University Hospital, Camden, New Jersey (United States); Cappelli, Louis; Diestelkamp, Tim [Rowan Graduate School, Camden, New Jersey (United States); Saraiya, Piya [Department of Diagnostic Radiology, Cooper University Hospital, Camden, New Jersey (United States); Bexon, Anne [Department of Neurological Surgery, Cooper University Hospital, Camden, New Jersey (United States); Lerman, Nati [Department of Medical Oncology, Cooper University Hospital, Camden, New Jersey (United States); Goldman, Howard Warren [Department of Neurological Surgery, Cooper University Hospital, Camden, New Jersey (United States)

    2016-07-01

    Purpose: Patients with poor performance status (PS), usually defined as a Karnofsky Performance Status of 60 or less, were not eligible for randomized stereotactic radiosurgery (SRS) studies, and many guidelines suggest that whole-brain radiation therapy (WBRT) is the most appropriate treatment for poor PS patients. Methods and Materials: In this retrospective review of our SRS database, we identified 36 patients with PS of 60 or less treated with SRS for central nervous system (CNS) metastatic disease. PS, as defined by the Karnofsky Performance Status, was 60 (27 patients), 50 (8 patients), or 40 (1 patient). The median number of CNS lesions treated was 3. Results: Median overall survival (OS) was 7.2 months (range, 0.73-25.6 months). Fifteen patients (41%) were alive at 6 months, and 6 patients (16.6%) were alive at 1 year. There was no difference in OS in patients who underwent previous WBRT. There were no local failures or cases of radiation toxicity. Distant CNS failures were seen in 9 patients (25%). Conclusions: Our patients with poor PS had reasonable median OS and relatively low distant CNS failure rates. Patients in this patient population may be ideal candidates for SRS compared with WBRT given the low incidence of distant failure over their remaining lives and the favorable logistics of single-fraction treatment for these patients with debility and their caregivers.

  5. Diaspora, dispute and diffusion: bringing professional values to the punitive culture of the Poor Law.

    Science.gov (United States)

    Kirby, Stephanie

    2004-09-01

    From the 1870s to the 1920s Poor Law institutions in England developed from destinations of last resort to significant providers of health-care. As part of this process a general professionalisation of Poor Law work took place. The change was facilitated by wider social, philosophical and political influences in nineteenth century England. The introduction of trained nurses into the Poor Law was part of a diaspora of both ideas and people from voluntary institutions and organisations. Unrecognised in 1834, nurses eventually became the most numerous class of workhouse officers. This was not accomplished without dispute and acrimony. As a group and as individuals nurses were often at the centre of disputes. Utilising a social history framework and drawing on contemporary written sources, including Poor Law and nursing journals, this paper highlights the role played by Poor Law nurses in the diffusion of values and attitudes that helped to transform the workhouse regime from one of punishment to therapy.

  6. A 'Scottish Poor Law of Lunacy'? Poor Law, Lunacy Law and Scotland's parochial asylums.

    Science.gov (United States)

    Farquharson, Lauren

    2017-03-01

    Scotland's parochial asylums are unfamiliar institutional spaces. Representing the concrete manifestation of the collision between two spheres of legislation, the Poor Law and the Lunacy Law, six such asylums were constructed in the latter half of the nineteenth century. These sites expressed the enduring mandate of the Scottish Poor Law 1845 over the domain of 'madness'. They were institutions whose very existence was fashioned at the directive of the local arm of the Poor Law, the parochial board, and they constituted a continuing 'Scottish Poor Law of Lunacy'. Their origins and operation significantly subverted the intentions and objectives of the Lunacy Act 1857, the aim of which had been to institute a public district asylum network with nationwide coverage.

  7. Current stress and poor oral health.

    Science.gov (United States)

    Vasiliou, A; Shankardass, K; Nisenbaum, R; Quiñonez, C

    2016-09-02

    Psychological stress appears to contribute to poor oral health systemically in combination with other chronic diseases. Few studies directly examine this relationship. Data from a cross-sectional study of 2,412 participants between the ages of 25-64 years old living in the City of Toronto between 2009 and 2012 were used to examine the relationship between current stress and two self-rated oral health outcomes (general oral health and oral pain). Dental care utilization and access to dental insurance were examined as effect modifiers. A positive relationship between current stress and poor oral health was observed for both outcomes (oral pain coefficient 0.32, 95 % CI 0.26-0.38; general oral health coefficient 0.28, 95 % CI 0.19-0.36). Effects on oral pain were stronger for the uninsured, while effects on general oral health were stronger with decreasing socioeconomic position. Our findings suggest that individuals with greater perceived stress also report poorer oral health, and that this relationship is modified by dental insurance and socioeconomic position. These findings warrant a greater focus on the role of psychological stress in the development of oral disease, including how perceived stress contributes to health inequities in self-reported oral health status. Patients experiencing stressful lives may differentially require closer monitoring and more vigilant maintenance of their oral health, above and beyond that which is needed to achieve a state of health in the oral environment of less stressed individuals. There may be health promoting effects of addressing psychosocial concerns related to dental care - particularly for the poor and uninsured.

  8. EXTREMELY METAL-POOR GALAXIES: THE ENVIRONMENT

    Energy Technology Data Exchange (ETDEWEB)

    Filho, M. E. [Universidad de Las Palmas de Gran Canaria–Universidad de La Laguna, CIE Canarias: Tri-Continental Atlantic Campus, Canary Islands (Spain); Almeida, J. Sánchez; Muñoz-Tuñón, C. [Instituto Astrofísica de Canarias, E-38200 La Laguna, Tenerife (Spain); Nuza, S. E.; Kitaura, F.; Heß, S., E-mail: mfilho@astro.up.pt [Leibniz-Institut für Astrophysik Potsdam (AIP), An der Sternwarte 16, D-14482 Potsdam (Germany)

    2015-04-01

    We have analyzed bibliographical observational data and theoretical predictions, in order to probe the environment in which extremely metal-poor dwarf galaxies (XMPs) reside. We have assessed the H i component and its relation to the optical galaxy, the cosmic web type (voids, sheets, filaments and knots), the overdensity parameter and analyzed the nearest galaxy neighbors. The aim is to understand the role of interactions and cosmological accretion flows in the XMP observational properties, particularly the triggering and feeding of the star formation. We find that XMPs behave similarly to Blue Compact Dwarfs; they preferably populate low-density environments in the local universe: ∼60% occupy underdense regions, and ∼75% reside in voids and sheets. This is more extreme than the distribution of irregular galaxies, and in contrast to those regions preferred by elliptical galaxies (knots and filaments). We further find results consistent with previous observations; while the environment does determine the fraction of a certain galaxy type, it does not determine the overall observational properties. With the exception of five documented cases (four sources with companions and one recent merger), XMPs do not generally show signatures of major mergers and interactions; we find only one XMP with a companion galaxy within a distance of 100 kpc, and the H i gas in XMPs is typically well-behaved, demonstrating asymmetries mostly in the outskirts. We conclude that metal-poor accretion flows may be driving the XMP evolution. Such cosmological accretion could explain all the major XMP observational properties: isolation, lack of interaction/merger signatures, asymmetric optical morphology, large amounts of unsettled, metal-poor H i gas, metallicity inhomogeneities, and large specific star formation.

  9. Justice, Work, and the Ghetto Poor

    OpenAIRE

    Shelby, Tommie

    2012-01-01

    In view of the explanatory significance of joblessness, some social scientists, policymakers,and commentators have advocated strong measures to ensure that the ghetto poor work, includingmandating work as a condition of receiving welfare benefits. Indeed, across the ideological po-litical spectrum, work is often seen as a moral or civic duty and as a necessary basis for personaldignity. And this normative stance is now instantiated in federal and state law, from the tax schemeto public benefits....

  10. Bureaucracy and Pro-poor Change

    OpenAIRE

    Ali Cheema; Asad Sayeed

    2006-01-01

    Based on the premise that a functioning state is a necessary pre-requisite for pro-poor change, it is critical to investigate the role of the bureaucracy as a key catalyst in this process. Weber (1968) ascribes bureaucracies to be anchors of the modern nation state as their conduct is based on rational-legal norms. Bureaucracies, according to this ideal type, temper the populist urges of politicians who wish to execute policy unencumbered by rules and procedures. State success or failure in m...

  11. Association of diarrhoea, poor hygiene and poor social conditions in childhood with blood pressure in adulthood.

    Science.gov (United States)

    Kauhanen, L; Lynch, J W; Lakka, H-M; Kauhanen, J; Smith, G D

    2010-05-01

    Previous research has suggested that dehydration in infancy may lead to high blood pressure in later life because of sodium retention. The purpose of this study was to examine the effect of poor hygiene of the child, poor social and poor housing conditions at home and diarrhoea in childhood as proxies for dehydration on high blood pressure in later life. Data were from a subset of participants in the Kuopio Ischaemic Heart Disease Risk Factor Study, a population-based cohort study in eastern Finland. Information on childhood factors was collected from school health records (n=952), from the 1930s to the 1950s. Adult data were obtained from baseline examinations of the Kuopio Ischaemic Heart Disease Risk Factor Study cohort (n=2682) in 1984-1989. Men who had poor hygiene in childhood had on average 4.07 mm Hg (95% CI 0.53 to 7.61) higher systolic blood pressure than men who had good or satisfactory hygiene in childhood in the age-adjusted analysis. Reports of diarrhoea were not associated with adult blood pressure. The authors' findings suggest that poor hygiene and living in poor social conditions in childhood are associated with higher systolic blood pressure in adulthood. Reported childhood diarrhoea did not explain the link between hygiene and high blood pressure in adulthood.

  12. Education of quality to the poor

    Directory of Open Access Journals (Sweden)

    H.M. van der Merwe

    2011-09-01

    Full Text Available Quality education often eludes South African learners from poverty- stricken environments. There are, however, some notable exceptions. This article looks at how quality education based on social capital is provided to the poor. The author reports on a qualitative investigation based on both focus group and individual interviews conducted at a resource-poor KwaZulu- Natal school serving learners from Grade R to 9. The findings show that quality education at the research site relates to the moral agency of the school principal and teaching staff. Through their ethics of being and doing, the school principal and teaching staff ensure that sufficient resources, sound home-school relations, and a high premium on moral values result in a receptive learner corps. This environment encourages these learners to act with diligence, honesty, politeness, respect and service to the community. The findings contribute to research that maintains that quality education is indicative of the school principal and teachers‟ ethics of being and of doing.

  13. Alleviating energy poverty for the world's poor

    International Nuclear Information System (INIS)

    Sagar, Ambuj D.

    2005-01-01

    Improving energy services for poor households in developing countries remains one of the most pressing challenges facing the development community. The dependence of these households on traditional forms of energy leads to significant health impacts as well as other major disbenefits, yet there has been little progress in meeting this challenge. This viewpoint argues for an 'energy-poverty alleviation' fund to help provide modern energy services to these households. It also proposes an approach through which to create such a fund, namely by introducing an incremental levy on petroleum. Notably, this scheme does not need a global agreement since a levy could be introduced by major oil-exporting countries. The implementation of this mechanism would result in a climate-friendly outcome (even before taking into account the elimination of products of incomplete combustion resulting from the traditional household use of biomass-based fuels) while providing immense socio-economic benefits to the world's poor. Such an approach would allow significant progress on the sustainable development front while reducing global greenhouse gas emissions, and therefore is very much consistent with the United Nations Framework Convention on Climate Change

  14. Crisis and Communication among Rural Poor People

    Directory of Open Access Journals (Sweden)

    Agus Ganjar Runtiko

    2015-07-01

    Full Text Available The effect of the crisis is often multiple on people in rural poverty that secluded and away from the reach of government. Main factor cannot be ignored in crisis is communication. Prolonged crisis will occur when the channels of communication in society clogged. This study establishes three specific targets: (1 To obtain a comprehensive overview of the rural poor people’s knowledge about the crisis and the potential impact, (2 To discover crisis problems faced by the rural people poor, (3 To enlist communication problems in a crisis situation. This study used a qualitative method with a case study approach. Research data collect by conducting FGD of 40 informants selected based on purposive sampling, furthermore eight people were interviewed in depth, plus other supporting informant. The results of the research show people on those two locations have understood the crisis based on their experience of dealing with it. They believe the economic crisis as the first aspect that must be resolved. The completion of crisis should consider indigenous wisdom to avoid a new crisis.

  15. Poor Response to Periodontal Treatment May Predict Future Cardiovascular Disease.

    Science.gov (United States)

    Holmlund, A; Lampa, E; Lind, L

    2017-07-01

    Periodontal disease has been associated with cardiovascular disease (CVD), but whether the response to the treatment of periodontal disease affects this association has not been investigated in any large prospective study. Periodontal data obtained at baseline and 1 y after treatment were available in 5,297 individuals with remaining teeth who were treated at a specialized clinic for periodontal disease. Poor response to treatment was defined as having >10% sites with probing pocket depth >4 mm deep and bleeding on probing at ≥20% of the sites 1 y after active treatment. Fatal/nonfatal incidence rate of CVD (composite end point of myocardial infarction, stroke, and heart failure) was obtained from the Swedish cause-of-death and hospital discharge registers. Poisson regression analysis was performed to analyze future risk of CVD. During a median follow-up of 16.8 y (89,719 person-years at risk), those individuals who did not respond well to treatment (13.8% of the sample) had an increased incidence of CVD ( n = 870) when compared with responders (23.6 vs. 15.3%, P 4 mm, and number of teeth, the incidence rate ratio for CVD among poor responders was 1.28 (95% CI, 1.07 to 1.53; P = 0.007) as opposed to good responders. The incidence rate ratio among poor responders increased to 1.39 (95% CI, 1.13 to 1.73; P = 0.002) for those with the most remaining teeth. Individuals who did not respond well to periodontal treatment had an increased risk for future CVD, indicating that successful periodontal treatment might influence progression of subclinical CVD.

  16. Irradiation-induced dimensional changes of poorly crystalline carbons

    International Nuclear Information System (INIS)

    Bullock, R.E.

    1979-01-01

    Data are presented on irradiation-induced changes of poorly crystalline carbons at high temperatures(>900 0 C). The materials surveyed include: (1) carbon fibers, (2) glassy carbons, (3) carbonaceous matrix materials for HTGR fuel rods and (4) pyrocarbons. The materials are listed in order of increasing stability, with maximum strains ranging from more than 50% for fibers to less than 10% for pyrocarbons. Dimensional changes of highly anisotropic carbon fibers appear to be sensitive to irradiation temperature, as slightly anisotropic pyrocarbons are, whereas temperature seems to have little influence on the behavior of isotropic glassy carbons over the range from 600 to 1350 0 C. Dimensional changes for graphite-filled matrix materials were roughly isotropic on the average and did not seem to be strongly temperature dependent for the lower fluences investigated. Increased graphite filler lowered volumetric dimensional changes of the matrix in agreement with a rule-of-mixtures relationship between change components for the filler and the less-stable binder phases. Instabilities of all of the poorly crystalline materials were generally greater than those for more crystalline carbons under the same conditions, including highly orientated graphites that approximate single-crystal behavior. (author)

  17. Hardship financing of healthcare among rural poor in Orissa, India.

    Science.gov (United States)

    Binnendijk, Erika; Koren, Ruth; Dror, David M

    2012-01-27

    This study examines health-related "hardship financing" in order to get better insights on how poor households finance their out-of-pocket healthcare costs. We define hardship financing as having to borrow money with interest or to sell assets to pay out-of-pocket healthcare costs. Using survey data of 5,383 low-income households in Orissa, one of the poorest states of India, we investigate factors influencing the risk of hardship financing with the use of a logistic regression. Overall, about 25% of the households (that had any healthcare cost) reported hardship financing during the year preceding the survey. Among households that experienced a hospitalization, this percentage was nearly 40%, but even among households with outpatient or maternity-related care around 25% experienced hardship financing.Hardship financing is explained not merely by the wealth of the household (measured by assets) or how much is spent out-of-pocket on healthcare costs, but also by when the payment occurs, its frequency and its duration (e.g. more severe in cases of chronic illnesses). The location where a household resides remains a major predictor of the likelihood to have hardship financing despite all other household features included in the model. Rural poor households are subjected to considerable and protracted financial hardship due to the indirect and longer-term deleterious effects of how they cope with out-of-pocket healthcare costs. The social network that households can access influences exposure to hardship financing. Our findings point to the need to develop a policy solution that would limit that exposure both in quantum and in time. We therefore conclude that policy interventions aiming to ensure health-related financial protection would have to demonstrate that they have reduced the frequency and the volume of hardship financing.

  18. Hardship financing of healthcare among rural poor in Orissa, India

    Directory of Open Access Journals (Sweden)

    Binnendijk Erika

    2012-01-01

    Full Text Available Abstract Background This study examines health-related "hardship financing" in order to get better insights on how poor households finance their out-of-pocket healthcare costs. We define hardship financing as having to borrow money with interest or to sell assets to pay out-of-pocket healthcare costs. Methods Using survey data of 5,383 low-income households in Orissa, one of the poorest states of India, we investigate factors influencing the risk of hardship financing with the use of a logistic regression. Results Overall, about 25% of the households (that had any healthcare cost reported hardship financing during the year preceding the survey. Among households that experienced a hospitalization, this percentage was nearly 40%, but even among households with outpatient or maternity-related care around 25% experienced hardship financing. Hardship financing is explained not merely by the wealth of the household (measured by assets or how much is spent out-of-pocket on healthcare costs, but also by when the payment occurs, its frequency and its duration (e.g. more severe in cases of chronic illnesses. The location where a household resides remains a major predictor of the likelihood to have hardship financing despite all other household features included in the model. Conclusions Rural poor households are subjected to considerable and protracted financial hardship due to the indirect and longer-term deleterious effects of how they cope with out-of-pocket healthcare costs. The social network that households can access influences exposure to hardship financing. Our findings point to the need to develop a policy solution that would limit that exposure both in quantum and in time. We therefore conclude that policy interventions aiming to ensure health-related financial protection would have to demonstrate that they have reduced the frequency and the volume of hardship financing.

  19. Detonation velocity in poorly mixed gas mixtures

    Science.gov (United States)

    Prokhorov, E. S.

    2017-10-01

    The technique for computation of the average velocity of plane detonation wave front in poorly mixed mixture of gaseous hydrocarbon fuel and oxygen is proposed. Here it is assumed that along the direction of detonation propagation the chemical composition of the mixture has periodic fluctuations caused, for example, by layered stratification of gas charge. The technique is based on the analysis of functional dependence of ideal (Chapman-Jouget) detonation velocity on mole fraction (with respect to molar concentration) of the fuel. It is shown that the average velocity of detonation can be significantly (by more than 10%) less than the velocity of ideal detonation. The dependence that permits to estimate the degree of mixing of gas mixture basing on the measurements of average detonation velocity is established.

  20. The Nordic version of working poor

    DEFF Research Database (Denmark)

    Ilsøe, Anna

    The development of service economies in the Western world has led to a debate on the quality of new service jobs as many are low-wage jobs with poor working conditions and career opportunities (Westergaard-Nielsen 2008; Gautié & Schmitt 2009; Kalleberg 2011). Empirical and theoretical work has...... from the European Labour Force Survey it is examined how low wage service work has developed in the private sector in the three countries since 2000 and which segments that can be identified. Data is drawn from the last quarter of 2000 (before the economic boom), 2007 (before the financial crisis....../restaurants, as the majority of low-wage private service workers in Denmark, Norway and Sweden work in these sectors (Bosch & Lehndorff 2005). We compare developments in the three countries to identify similar and different segments that have emerged over the past 15 years. Finally, the paper discusses findings in relation...

  1. Sensorimotor Mismapping in Poor-pitch Singing.

    Science.gov (United States)

    He, Hao; Zhang, Wei-Dong

    2017-09-01

    This study proposes that there are two types of sensorimotor mismapping in poor-pitch singing: erroneous mapping and no mapping. We created operational definitions for the two types of mismapping based on the precision of pitch-matching and predicted that in the two types of mismapping, phonation differs in terms of accuracy and the dependence on the articulation consistency between the target and the intended vocal action. The study aimed to test this hypothesis by examining the reliability and criterion-related validity of the operational definitions. A within-subject design was used in this study. Thirty-two participants identified as poor-pitch singers were instructed to vocally imitate pure tones and to imitate their own vocal recordings with the same articulation as self-targets and with different articulation from self-targets. Definitions of the types of mismapping were demonstrated to be reliable with the split-half approach and to have good criterion-related validity with findings that pitch-matching with no mapping was less accurate and more dependent on the articulation consistency between the target and the intended vocal action than pitch-matching with erroneous mapping was. Furthermore, the precision of pitch-matching was positively associated with its accuracy and its dependence on articulation consistency when mismapping was analyzed on a continuum. Additionally, the data indicated that the self-imitation advantage was a function of articulation consistency. Types of sensorimotor mismapping lead to pitch-matching that differs in accuracy and its dependence on the articulation consistency between the target and the intended vocal action. Additionally, articulation consistency produces the self-advantage. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  2. Management of poor quality irrigation water

    International Nuclear Information System (INIS)

    Change, M.H.; Leghari, A.M.; Sipio, Q.A.

    2000-01-01

    The effect of poor quality drainage effluent on moderately saline sodic, medium textured soil at different growth stages of wheat and cotton is reported. The irrigation treatments were: I) All canal irrigations, II) one irrigation of 75 mm with saline drainage effluent (EC = 3 dS m1) after four weeks sowing of the crop, III) one irrigation of 75 mm with saline drainage effluent after seven weeks sowing of the crop, and IV) one irrigation of 75 mm with saline drainage effluent after ten weeks sowing of the crop. The treatments receiving saline water gave significant decrease in crop yields as compared to canal irrigation treatment. The higher yield of wheat and seed cotton was recorded T1 followed by T2, T3 and T4. The trend of produce was T1< T2< T3< T4 respectively. Electrical conductivity of the soil (Ece) in T1 was decreased and in other three treatments was increased, whereas, pH decreased in T1 and T2. The SAR of soil decreased in all the treatments as compared with initial values. Treatment receiving an irrigation with saline water after four weeks of sowing (T2) was better in reducing soil salinity as compared to treatments receiving such water after 7 or 10 weeks os sowing. Poor quality water (EC = 3 d Sm/sup -1/) can be managed for irrigation after four weeks of swing of crops provided certain soil and water management practices like good seed bed preparation and proper drainage measures are adopted. (author)

  3. Specific food preferences of older adults with a poor appetite. A forced-choice test conducted in various care settings

    NARCIS (Netherlands)

    van der Meij, B.S.; Wijnhoven, H.A.H.; Finlayson, G.S.; Oosten, B.S.H.; Visser, M.

    2015-01-01

    A poor appetite in older adults is an important determinant of reduced food intake and undernutrition. Food preferences may influence food intake. The aim of this study was to investigate food preferences of older adults with a poor appetite and compare these with preferences of older adults with a

  4. "Managing" the poor: neoliberalism, Medicaid HMOs and the triumph of consumerism among the poor.

    Science.gov (United States)

    Maskovsky, J

    2000-10-01

    In order to explore the contradictions of neoliberal health policy, this article examines Medicaid managed care in Philadelphia. At the federal and state levels, government is increasingly promoting private-sector market-based strategies over policies formerly associated with the welfare state, arguing that the former are the most effective means of achieving economic growth and guaranteeing social welfare. A prime example of this shift, Medicaid managed care is a policy by which states contract with private-sector health maintenance organizations to provide health coverage to the poor. Drawing on ethnographic and historical data, this paper shows how Pennsylvania's Medicaid managed care program has created access barriers for poor Philadelphians. It also illustrates how ideologies that justify this policy shift serve to mask its detrimental effects on the poor. By contrasting the state's consumerist model with one group's protest efforts, this article calls into question the neoliberal ideology that undergirds health and welfare "reform."

  5. Poor mental health status and aggression are associated with poor driving behavior among male traffic offenders

    Directory of Open Access Journals (Sweden)

    Abdoli N

    2015-08-01

    Full Text Available Nasrin Abdoli,1,2 Vahid Farnia,3 Ali Delavar,4 Alirez Esmaeili,5 Fariborz Dortaj,4 Noorali Farrokhi,4 Majid Karami,6 Jalal Shakeri,3 Edith Holsboer-Trachsler,7 Serge Brand7,8 1International University of Imam Reza, Mashhad, 2Kermanshah University of Medical Sciences, Kermanshah, 3Substance Abuse Prevention Research Center, Psychiatry Department, Kermanshah University of Medical Sciences, Kermanshah, 4Allameh Tabataba’i University, Tehran, 5Police University, Tehran, 6Baharestan Research Center, Kermanshah Transportation Terminal, Kermanshah, Iran, 7Center for Affective, Stress and Sleep Disorders, Psychiatric Clinics of the University of Basel, Basel, 8Department of Sport and Health Science, Sport Science Section, University of Basel, Basel, Switzerland Background: In Iran, traffic accidents and deaths from traffic accidents are among the highest in the world, and generally driver behavior rather than either technical failures or environmental conditions are responsible for traffic accidents. In the present study, we explored the extent to which aggressive traits, health status, and sociodemographic variables explain driving behavior among Iranian male traffic offenders. Method: A total of 443 male driving offenders (mean age: M =31.40 years, standard deviation =9.56 from Kermanshah (Iran took part in the study. Participants completed a questionnaire booklet covering sociodemographic variables, traits of aggression, health status, and driving behavior. Results: Poor health status, such as symptoms of depression, anxiety, insomnia, and social dysfunction, and also higher levels of trait aggression explained poor driving behavior. Multiple regressions indicated that poor health status, but not aggression, independently predicted poor driving behavior. Conclusion: Results suggest that health status concerns are associated with poor driving behavior. Prevention and intervention might therefore focus on drivers reporting poor mental health status

  6. Analytical review based on statistics on good and poor financial performance of LPD in Bangli regency.

    Science.gov (United States)

    Yasa, I. B. A.; Parnata, I. K.; Susilawati, N. L. N. A. S.

    2018-01-01

    This study aims to apply analytical review model to analyze the influence of GCG, accounting conservatism, financial distress models and company size on good and poor financial performance of LPD in Bangli Regency. Ordinal regression analysis is used to perform analytical review, so that obtained the influence and relationship between variables to be considered further audit. Respondents in this study were LPDs in Bangli Regency, which amounted to 159 LPDs of that number 100 LPDs were determined as randomly selected samples. The test results found GCG and company size have a significant effect on both the good and poor financial performance, while the conservatism and financial distress model has no significant effect. The influence of the four variables on the overall financial performance of 58.8%, while the remaining 41.2% influenced by other variables. Size, FDM and accounting conservatism are variables, which are further recommended to be audited.

  7. Poor people and poor fields? : integrating legumes for smallholder soil fertility management in Chisepo, central Malawi

    NARCIS (Netherlands)

    Kamanga, B.

    2011-01-01

    Soil infertility undermines the agriculture-based livelihoods in Malawi, where it is blamed for poor crop yields and the creation of cycles of poverty. Although technologies and management strategies have been developed to reverse the decline in soil fertility, they are under-used by smallholder

  8. Isolated microalbuminuria indicates a poor medical prognosis.

    Science.gov (United States)

    Scheven, Lieneke; Van der Velde, Marije; Lambers Heerspink, Hiddo J; De Jong, Paul E; Gansevoort, Ron T

    2013-07-01

    Microalbuminuria is often regarded as a sign of end-organ damage due to diabetes and/or hypertension, and as such to be associated with an increased risk for cardiovascular events. It has been questioned whether isolated microalbuminuria, that is microalbuminuria in the absence of a cardiovascular disease (CVD) history, hypertension and diabetes has clinical relevance. Included were 8356 subjects who participated in the first four screening rounds of the PREVEND study, a prospective, community-based, observational cohort study. Isolated microalbuminuria was defined as microalbuminuria (30-300 mg/24 h), in the absence of a CVD history, hypertension (blood pressuredefinition of isolated microalbuminuria, in which 2250 person-years of follow-up were available. In subjects with isolated microalbuminuria, the incidence rates of cardiovascular events and mortality, hypertension and diabetes were 15.3, 28.9 and 8.9 per 1000 person-year follow-up, respectively. Subjects with isolated microalbuminuria had an increased risk for cardiovascular events and mortality [crude HR 2.23 (1.63-3.07); Phypertension [OR 1.95 (1.47-2.59); Phypertension and/or diabetes. This increased risk remained significant after adjustment for age and gender. The relative risk held by isolated microalbuminuria was similar to the relative risk held by microalbuminuria in subjects that did have a CVD history, hypertension and/or diabetes. Isolated microalbuminuria indicates a poor prognosis and warrants medical attention.

  9. Poorly Understood Aspects of Striated Muscle Contraction

    Directory of Open Access Journals (Sweden)

    Alf Månsson

    2015-01-01

    Full Text Available Muscle contraction results from cyclic interactions between the contractile proteins myosin and actin, driven by the turnover of adenosine triphosphate (ATP. Despite intense studies, several molecular events in the contraction process are poorly understood, including the relationship between force-generation and phosphate-release in the ATP-turnover. Different aspects of the force-generating transition are reflected in the changes in tension development by muscle cells, myofibrils and single molecules upon changes in temperature, altered phosphate concentration, or length perturbations. It has been notoriously difficult to explain all these events within a given theoretical framework and to unequivocally correlate observed events with the atomic structures of the myosin motor. Other incompletely understood issues include the role of the two heads of myosin II and structural changes in the actin filaments as well as the importance of the three-dimensional order. We here review these issues in relation to controversies regarding basic physiological properties of striated muscle. We also briefly consider actomyosin mutation effects in cardiac and skeletal muscle function and the possibility to treat these defects by drugs.

  10. Poor, Old “Physical Education”

    Directory of Open Access Journals (Sweden)

    Earle F. Zeigler

    2014-01-01

    Full Text Available The field of physical activity (and related health education (“poor, old ‘PE’” needs to assert its "will to win" more vigorously then ever before. Scholarly and scientific investigation of the past 60 years since Sputnik was launched in 1957 has identified a wide variety of findings proving that a quality program can provide highly important benefits to the growing child and youth. Societal developments, including other curricular demands, have undoubtedly created uneasiness within the overall field of education. In North America the time and attention devoted to the relatively few involved in external highly competitive sport for the few has been a negative factor. At the same time intramural athletics for the large majority of children and youth has not been available to the extent it should be. There is now doubt as to the field’s ability to achieve high status within education. Therefore, we must pledge ourselves to make still greater efforts to become vibrant and stirring through absolute dedication and commitment in our professional endeavors. Ours is a high calling since we seek to improve the quality of life for all people on earth through the finest type of human motor performance in exercise, sport, and related expressive movement.

  11. FACTORS ASSOCIATED WITH POOR GLYCEMIC CONTROL AMONG TYPE 2 DIABETES MELLITUS IN INDONESIA

    Directory of Open Access Journals (Sweden)

    Rian Adi Pamungkas

    2017-07-01

    Full Text Available Background: Type 2 Diabetes mellitus becomes the public health problem in the wide world. Reasons for poor glycemic control in Type 2 diabetes are complex. Objective: To determine factors contributed to poor glycemic control among Indonesian patients with Type 2 Diabetes Methods: This was a cross sectional regression study. There were 70 respondents selected using purposive sampling. Pre-structured questionnaires were used to measure socio demographic, clinical characteristics, self-care management behaviors, medication adherence, barriers to adherence, and family support. Data were analyzed using chi-square and binary logistic regression. Results: Poor glycemic control was defined as HbA1c ≥7% or FBG ≥200 mg/dl. Findings of this study reported that 83% patients had or FBG ≥200 mg/dl, which confirmed as poor glycemic control. Logistic regression showed that increasing duration of diabetes (> 5 years, non-adherence to dietary behaviors recommendation through selecting healthy diet, arranging a meal plan, recognizing the amount calorie needs, managing dietary behaviors challenges, medication adherence, and family support were significantly influence poor glycemic control with increased odds ratio scores. Conclusion: The proportion of patients with poor glycemic control was raised. Increasing duration of diabetes, non- adherence to medication and dietary behaviors management, and lack of family support were associated with poor glycemic control. Thus, integration of diabetes self-management program with social support is needed to deal with patients’ need to achieve the great benefits in diabetes care.

  12. Making law work for the poor

    Energy Technology Data Exchange (ETDEWEB)

    Cotula, Lorenzo

    2005-11-15

    To many, law – the systems of binding rules governing human relations – seems remote from the reality of daily struggle in poor and marginalised communities around the world. Yet, directly or indirectly, legal rules shape the way we behave in our everyday life, and contribute to organise social and economic relations (from commercial codes to EC 'freedom-of-movement' treaty provisions to welfare state legislation). Since the 1960s, development agencies have supported law reform processes in developing countries. Interest in law reform was recently revived by the recognition of the importance of institutional frameworks for social change ('New Institutional Economics'), and by the attention paid by several development agencies to concepts like good governance and the rule of law. Earlier emphasis on 'legal transplants' and naive assumptions about the way the law operates have given way to a better understanding of the complex nature of processes of legal and socio-economic change. Drawing on three examples, this paper explores the extent to which legal tools can contribute to improve the lives of poorer groups in both developing and developed countries; the conditions under which this is possible; and the constraints that such tools face in the pursuit of this aim. The paper aims to spark reflection and debate on these issues – not to come up with definitive answers. It is likely to be of interest for development lawyers, development practitioners working at a macro-planning level, and researchers. As for development practitioners, the paper sets out the case for taking law seriously as a tool for positive change. As for development lawyers, it argues that designing and implementing legal interventions that deliver that positive change is function not only of sound legal thinking, but also of a solid understanding of power relations and other social, cultural, political and economic factors that affect the way the law operates in

  13. Poor livestock keepers: ecosystem-poverty-health interactions.

    Science.gov (United States)

    Grace, Delia; Lindahl, Johanna; Wanyoike, Francis; Bett, Bernard; Randolph, Tom; Rich, Karl M

    2017-07-19

    Humans have never been healthier, wealthier or more numerous. Yet, present success may be at the cost of future prosperity and in some places, especially in sub-Saharan Africa, poverty persists. Livestock keepers, especially pastoralists, are over-represented among the poor. Poverty has been mainly attributed to a lack of access, whether to goods, education or enabling institutions. More recent insights suggest ecosystems may influence poverty and the self-reinforcing mechanisms that constitute poverty traps in more subtle ways. The plausibility of zoonoses as poverty traps is strengthened by landmark studies on disease burden in recent years. While in theory, endemic zoonoses are best controlled in the animal host, in practice, communities are often left to manage disease themselves, with the focus on treatment rather than prevention. We illustrate this with results from a survey on health costs in a pastoral ecosystem. Epidemic zoonoses are more likely to elicit official responses, but these can have unintended consequences that deepen poverty traps. In this context, a systems understanding of disease control can lead to more effective and pro-poor disease management. We illustrate this with an example of how a system dynamics model can help optimize responses to Rift Valley fever outbreaks in Kenya by giving decision makers real-time access to the costs of the delay in vaccinating. In conclusion, a broader, more ecological understanding of poverty and of the appropriate responses to the diseases of poverty can contribute to improved livelihoods for livestock keepers in Africa.This article is part of the themed issue 'One Health for a changing world: zoonoses, ecosystems and human well-being'. © 2017 The Authors.

  14. Drug-like properties and the causes of poor solubility and poor permeability.

    Science.gov (United States)

    Lipinski, C A

    2000-01-01

    There are currently about 10000 drug-like compounds. These are sparsely, rather than uniformly, distributed through chemistry space. True diversity does not exist in experimental combinatorial chemistry screening libraries. Absorption, distribution, metabolism, and excretion (ADME) and chemical reactivity-related toxicity is low, while biological receptor activity is higher dimensional in chemistry space, and this is partly explainable by evolutionary pressures on ADME to deal with endobiotics and exobiotics. ADME is hard to predict for large data sets because current ADME experimental screens are multi-mechanisms, and predictions get worse as more data accumulates. Currently, screening for biological receptor activity precedes or is concurrent with screening for properties related to "drugability." In the future, "drugability" screening may precede biological receptor activity screening. The level of permeability or solubility needed for oral absorption is related to potency. The relative importance of poor solubility and poor permeability towards the problem of poor oral absorption depends on the research approach used for lead generation. A "rational drug design" approach as exemplified by Merck advanced clinical candidates leads to time-dependent higher molecular weight, higher H-bonding properties, unchanged lipophilicity, and, hence, poorer permeability. A high throughput screening (HTS)-based approach as exemplified by unpublished data on Pfizer (Groton, CT) early candidates leads to higher molecular weight, unchanged H-bonding properties, higher lipophilicity, and, hence, poorer aqueous solubility.

  15. Cervical vertebrae maturation method morphologic criteria: poor reproducibility.

    Science.gov (United States)

    Nestman, Trenton S; Marshall, Steven D; Qian, Fang; Holton, Nathan; Franciscus, Robert G; Southard, Thomas E

    2011-08-01

    The cervical vertebrae maturation (CVM) method has been advocated as a predictor of peak mandibular growth. A careful review of the literature showed potential methodologic errors that might influence the high reported reproducibility of the CVM method, and we recently established that the reproducibility of the CVM method was poor when these potential errors were eliminated. The purpose of this study was to further investigate the reproducibility of the individual vertebral patterns. In other words, the purpose was to determine which of the individual CVM vertebral patterns could be classified reliably and which could not. Ten practicing orthodontists, trained in the CVM method, evaluated the morphology of cervical vertebrae C2 through C4 from 30 cephalometric radiographs using questions based on the CVM method. The Fleiss kappa statistic was used to assess interobserver agreement when evaluating each cervical vertebrae morphology question for each subject. The Kendall coefficient of concordance was used to assess the level of interobserver agreement when determining a "derived CVM stage" for each subject. Interobserver agreement was high for assessment of the lower borders of C2, C3, and C4 that were either flat or curved in the CVM method, but interobserver agreement was low for assessment of the vertebral bodies of C3 and C4 when they were either trapezoidal, rectangular horizontal, square, or rectangular vertical; this led to the overall poor reproducibility of the CVM method. These findings were reflected in the Fleiss kappa statistic. Furthermore, nearly 30% of the time, individual morphologic criteria could not be combined to generate a final CVM stage because of incompatible responses to the 5 questions. Intraobserver agreement in this study was only 62%, on average, when the inconclusive stagings were excluded as disagreements. Intraobserver agreement was worse (44%) when the inconclusive stagings were included as disagreements. For the group of subjects

  16. Towards overcoming poor readership and building reading culture ...

    African Journals Online (AJOL)

    Towards overcoming poor readership and building reading culture of in schools. ... of this paper is to find strategies that can overcome poor readership in schools. ... Keywords: English First Additional Language, Writing Skills, Spelling Errors, ...

  17. Causes and consequences of poor reading habit on primary school ...

    African Journals Online (AJOL)

    Causes and consequences of poor reading habit on primary school pupils in Enugu urban. ... Moreover, they noticed that poor reading habit negatively affect pupils' educational achievement. The researchers ... AJOL African Journals Online.

  18. Standard & Poor's kulupäid ei kummarda / Raivo Raigna

    Index Scriptorium Estoniae

    Raigna, Raivo

    2006-01-01

    Rahvusvaheline reitinguagentuur Standard & Poor's hoiatas, et ilma rahanduslike reformideta hakkab Eesti rahvastiku vananemine avaldama tugevat survet avaliku sektori rahandusele ja ühtlasi riigi reitingule. Standard & Poor'si nn. mustast stsenaariumist, pakutud lahendusest

  19. Contributing Factors to Poor Service Delivery by Administrative ...

    African Journals Online (AJOL)

    Poor service delivery by local government is crippling South African businesses .... main categories: one focuses on an employee's internal attributes (content ... admitted that their attitude to work was adversely affected by the poor quality.

  20. Information Lives of the Poor: Fighting poverty with technology ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    2016-05-05

    May 5, 2016 ... ... access to information and communication technologies (ICTs) in the ... the developing-country poor are using modern communication tools. ... Policy impacts ... A study on mobile phone use by the poor has resulted in the ...

  1. Advertising and the Poor. Journalism Monographs Number Seventy-Five.

    Science.gov (United States)

    Bowen, Lawrence

    This monograph examines the impact of media advertising on the poor. The first half of the report discusses research on the conceptual styles of the poor, mass communication among the poor, and advertising and the low-income consumer. The second half describes the methodology and results of a study of the advertising evaluation capacity and…

  2. Decomposing the Gap in Childhood Undernutrition between Poor and Non–Poor in Urban India, 2005–06

    Science.gov (United States)

    Kumar, Abhishek; Singh, Aditya

    2013-01-01

    Background Despite the growing evidence from other developing countries, intra-urban inequality in childhood undernutrition is poorly researched in India. Additionally, the factors contributing to the poor/non-poor gap in childhood undernutrition have not been explored. This study aims to quantify the contribution of factors that explain the poor/non-poor gap in underweight, stunting, and wasting among children aged less than five years in urban India. Methods We used cross-sectional data from the third round of the National Family Health Survey conducted during 2005–06. Descriptive statistics were used to understand the gap in childhood undernutrition between the urban poor and non-poor, and across the selected covariates. Blinder–Oaxaca decomposition technique was used to explain the factors contributing to the average gap in undernutrition between poor and non-poor children in urban India. Result Considerable proportions of urban children were found to be underweight (33%), stunted (40%), and wasted (17%) in 2005–06. The undernutrition gap between the poor and non-poor was stark in urban India. For all the three indicators, the main contributing factors were underutilization of health care services, poor body mass index of the mothers, and lower level of parental education among those living in poverty. Conclusions The findings indicate that children belonging to poor households are undernourished due to limited use of health care services, poor health of mothers, and poor educational status of their parents. Based on the findings the study suggests that improving the public services such as basic health care and the education level of the mothers among urban poor can ameliorate the negative impact of poverty on childhood undernutrition. PMID:23734231

  3. Decomposing the gap in childhood undernutrition between poor and non-poor in urban India, 2005-06.

    Science.gov (United States)

    Kumar, Abhishek; Singh, Aditya

    2013-01-01

    Despite the growing evidence from other developing countries, intra-urban inequality in childhood undernutrition is poorly researched in India. Additionally, the factors contributing to the poor/non-poor gap in childhood undernutrition have not been explored. This study aims to quantify the contribution of factors that explain the poor/non-poor gap in underweight, stunting, and wasting among children aged less than five years in urban India. We used cross-sectional data from the third round of the National Family Health Survey conducted during 2005-06. Descriptive statistics were used to understand the gap in childhood undernutrition between the urban poor and non-poor, and across the selected covariates. Blinder-Oaxaca decomposition technique was used to explain the factors contributing to the average gap in undernutrition between poor and non-poor children in urban India. Considerable proportions of urban children were found to be underweight (33%), stunted (40%), and wasted (17%) in 2005-06. The undernutrition gap between the poor and non-poor was stark in urban India. For all the three indicators, the main contributing factors were underutilization of health care services, poor body mass index of the mothers, and lower level of parental education among those living in poverty. The findings indicate that children belonging to poor households are undernourished due to limited use of health care services, poor health of mothers, and poor educational status of their parents. Based on the findings the study suggests that improving the public services such as basic health care and the education level of the mothers among urban poor can ameliorate the negative impact of poverty on childhood undernutrition.

  4. Becoming a caregiver: attachment theory and poorly performing doctors.

    Science.gov (United States)

    Adshead, Gwen

    2010-02-01

    In this paper, I review a theoretical paradigm (attachment theory) which facilitates an understanding of how human care-giving and care-eliciting behaviours develop and are maintained over the lifespan. I argue that this paradigm has particular utility in: (i) the training of doctors; (ii) understanding why some doctors and medical students experience high levels of stress, and (iii) developing interventions to help those who struggle to manage high levels of work-related stress. I carried out a review of key texts and previously published studies of attachment styles in caregivers. Large-scale epidemiological studies, using valid and reliable measures, show that insecure attachment styles are found in a proportion of normal populations of both males and females. Insecure attachment is associated with impaired stress management and subtle deficits in care-giving sensitivity. It is reasonable to assume that a proportion of students entering medical training and doctors with performance problems may have insecure attachment styles which influence how they approach their training experience and how they manage occupational stress. Attachment theory is a useful paradigm for thinking about training as a professional caregiver. Insecure early attachment experiences may be a risk factor for poor stress management in some medical students and doctors who are exposed to increasing demands as carers. These findings lead to suggestions for possible research and support interventions.

  5. Inequity and health. Is malnutrition really caused by poor nutrition?

    Science.gov (United States)

    Bharmal, F Y

    2000-08-01

    To look at inequities leading to malnutrition and from the wider picture to find root causes and deal with them in order to alleviate malnutrition. Literature review. The health of the population is adversely affected by the inequities in the country. Women and children being most vulnerable are worst affected. The prevalence of Protein Energy Malnutrition (P.E.M.) in children under five years of age is 51 percent. Such a magnitude of malnutrition in a country, where availability of food per capita is more than adequate, points towards the fact that the inequities within the country are at the root of the problem. Poor income is not the only predictor of malnutrition, gender, urban-rural differences in access, utilization and quality of health care also influence health. In addition, there are some underlying factors such as illiteracy, unawareness of the mother about healthy behaviors, lack of decision-making power of women, along with deep-rooted cultural values of a patriarchal system. Malnutrition is caused by a multitude of factors, some of which are biological, others are environmental, cultural or social. Education of the invisible half of the population, who actually look after the children and the family, is an important strategy to alleviate this problem.

  6. Factors associated with poor sleep quality in women with cancer

    Directory of Open Access Journals (Sweden)

    Thalyta Cristina Mansano-Schlosser

    Full Text Available ABSTRACT Objectives: to analyze the factors associated with poor sleep quality, its characteristics and components in women with breast cancer prior to surgery for removing the tumor and throughout the follow-up. Method: longitudinal study in a teaching hospital, with a sample of 102 women. The following were used: a questionnaire for sociodemographic and clinical characterization, the Pittsburgh Sleep Quality Index; the Beck Depression Inventory; and the Herth Hope Scale. Data collection covered from prior to the surgery for removal of the tumor (T0 to T1, on average 3.2 months; T2, on average 6.1 months; and T3, on average 12.4 months. Descriptive statistics and the Generalized Estimating Equations model were used. Results: depression and pain contributed to the increase in the score of the Pittsburgh Sleep Quality Index, and hope, to the reduction of the score - independently - throughout follow-up. Sleep disturbances were the component with the highest score throughout follow-up. Conclusion: the presence of depression and pain, prior to the surgery, contributed to the increase in the global score of the Pittsburgh Sleep Quality Index, which indicates worse quality of sleep throughout follow-up; greater hope, in its turn, influenced the reduction of the score of the Pittsburgh Sleep Quality Index.

  7. Poor energy poor: Energy saving obligations, distributional effects, and the malfunction of the priority group

    International Nuclear Information System (INIS)

    Moser, Simon

    2013-01-01

    The European Union’s Energy Efficiency Directive forces the Member States to install energy efficiency obligation schemes. In a first step, this paper identifies the distributional effects caused by this policy instrument which occur when energy efficiency measures are implemented (phase of delivery) and when its costs are passed on to the society (phase of financing). In the phase of delivery, suppliers prefer to implement measures at the property of those customers which enable them to minimise their costs, i.e. enterprises with large energy savings potentials and high-income households who can contribute a greater share of the costs. In the phase of financing, distributional effects occur when the costs of the scheme are passed on from the obliged suppliers to their customers, primarily affecting less competitive customers, i.e. households and small enterprises. In the British scheme, the so-called priority group was installed in order to decrease distributional effects and to support energy poor households. In a second step, this paper evaluates approaches to reduce energy poverty and indicates ineffectiveness, high transaction costs and incoherency with the aims of the obligation scheme. Alternative approaches to tackle energy poverty are briefly described. - Highlights: • The paper discusses distributional effects of energy efficiency obligations. • Significant distributional effects occur when measures are implemented. • Significant distributional effects occur when costs are passed on to the customers. • Suppliers face problems to identify energy poor households. • The priority group contradicts the scheme’s intention of cost minimisation

  8. Beyond liposomes: Recent advances on lipid based nanostructures for poorly soluble/poorly permeable drug delivery.

    Science.gov (United States)

    Teixeira, M C; Carbone, C; Souto, E B

    2017-10-01

    Solid lipid nanoparticle (SLN), nanostructured lipid carriers (NLC) and hybrid nanoparticles, have gained increasing interest as drug delivery systems because of their potential to load and release drugs from the Biopharmaceutical classification system (BCS) of class II (low solubility and high permeability) and of class IV (low solubility and low permeability). Lipid properties (e.g. high solubilizing potential, biocompatibility, biotolerability, biodegradability and distinct route of absorption) contribute for the improvement of the bioavailability of these drugs for a set of administration routes. Their interest continues to grow, as translated by the number of patents being field worldwide. This paper discusses the recent advances on the use of SLN, NLC and lipid-polymer hybrid nanoparticles for the loading of lipophilic, poorly water-soluble and poorly permeable drugs, being developed for oral, topical, parenteral and ocular administration, also discussing the industrial applications of these systems. A review of the patents filled between 2014 and 2017, concerning the original inventions of lipid nanocarriers, is also provided. Copyright © 2017 Elsevier Ltd. All rights reserved.

  9. Poor working conditions and work stress among Canadian sex workers.

    Science.gov (United States)

    Duff, P; Sou, J; Chapman, J; Dobrer, S; Braschel, M; Goldenberg, S; Shannon, K

    2017-10-01

    While sex work is often considered the world's oldest profession, there remains a dearth of research on work stress among sex workers (SWs) in occupational health epidemiological literature. A better understanding of the drivers of work stress among SWs is needed to inform sex work policy, workplace models and standards. To examine the factors that influence work stress among SWs in Metro Vancouver. Analyses drew from a longitudinal cohort of SWs, known as An Evaluation of Sex Workers' Health Access (AESHA) (2010-14). A modified standardized 'work stress' scale, multivariable linear regression with generalized estimating equations was used to longitudinally examine the factors associated with work stress. In multivariable analysis, poor working conditions were associated with increased work stress and included workplace physical/sexual violence (β = 0.18; 95% confidence interval (CI) 0.06, 0.29), displacement due to police (β = 0.26; 95% CI 0.14, 0.38), working in public spaces (β = 0.73; 95% CI 0.61, 0.84). Older (β = -0.02; 95% CI -0.03, -0.01) and Indigenous SWs experienced lower work stress (β = -0.25; 95% CI -0.43, -0.08), whereas non-injection (β = 0.32; 95% CI 0.14, 0.49) and injection drug users (β = 0.17; 95% CI 0.03, 0.31) had higher work stress. Vancouver-based SWs' work stress was largely shaped by poor work conditions, such as violence, policing, lack of safe workspaces. There is a need to move away from criminalized approaches which shape unsafe work conditions and increase work stress for SWs. Policies that promote SWs' access to the same occupational health, safety and human rights standards as workers in other labour sectors are also needed. © The Author 2017. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com

  10. Outcome of poor response Paediatric AML using early SCT

    DEFF Research Database (Denmark)

    Wareham, Neval E; Heilmann, Carsten; Abrahamsson, Jonas

    2013-01-01

    ) or > 5% blasts after AM (n = 14, refractory disease). Poor response patients received intensively timed induction and proceeded to SCT when a donor was available. RESULTS: Thirty-one of 267 evaluable patients (12%) had a poor response. SCT was performed in 25; using matched unrelated donors in 13......BACKGROUND: Children with poor response acute myeloid leukaemia (AML) generally have a very poor outcome. Allogeneic stem cell transplantation (SCT) is often recommended for these children but the benefit is unclear. The aim of this study was to investigate survival for poor response AML patients...... treated with SCT. MATERIAL AND METHODS: Treatment was given according to the NOPHO-AML 2004 protocol. All patients received AIET (Cytarabine, Idarubicin, Etoposide, Thioguanine) and AM (Cytarabine, Mitoxantrone) as induction. We included poor response defined as > 15% blasts on day 15 after AIET (n = 17...

  11. Industrial Catching Up in the Poor Periphery 1870-1975

    OpenAIRE

    Jeffrey G. Williamson

    2011-01-01

    This paper documents industrial output and labor productivity growth around the poor periphery 1870-1975 (Latin America, the European periphery, the Middle East, South Asia, Southeast Asia and East Asia). Intensive and extensive industrial growth accelerated there over this critical century. The precocious poor periphery leaders underwent a surge and more poor countries joined their club. Furthermore, by the interwar the majority were catching up on Germany, the US and the UK, a process that ...

  12. Poverty, growth, inequality and pro-poor factors : new evidence from macro data

    OpenAIRE

    Amini, Chiara; Dal Bianco, Silvia

    2016-01-01

    Does economic growth reduce poverty? If so, by how much? How economic inequality affects poverty? Does the responsiveness of poverty to growth and inequality depend on initial poverty and inequality? How do pro-poor policies influence the poverty-growth-inequality nexus? \\ud \\ud This paper provides novel quantitative answers to such questions. In particular, the System Generalised Method of Moments estimator is employed to estimate the intertwined relation between poverty, growth, inequality ...

  13. Blaming the helpers: the marginalization of teachers and parents of the urban poor.

    Science.gov (United States)

    Farber, B A; Azar, S T

    1999-10-01

    The nature and origins of the current tendency toward disparaging parents and teachers of the urban poor are examined. It is suggested that the influence of parents and teachers must be understood in the context of multiple intervening variables. Several explanations are offered for the phenomenon of blame, including the fact that women constitute the great majority of teachers and are often the primary agents of parenting.

  14. The Influence of Affordable Daycare on Women's Empowerment in ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    The Influence of Affordable Daycare on Women's Empowerment in India ... services for the poor likely contribute to gender inequality by restricting women's educational ... a state that performs poorly in terms of women's empowerment in India.

  15. [Poor, propertyless and pregnant: classification of women's status by country].

    Science.gov (United States)

    1988-12-01

    A new study called "Poor, propertyless, and pregnant" that classified the condition of women in 99 countries found women in Sweden, Finland, and the US to enjoy the best legal and social conditions and the greatest degree of equality with men. The worst discrimination against women occurred in Bangladesh, Mali, Afghanistan, North Yemen, Pakistan, Nigeria, and Saudi Arabia. Women do not have complete equality with men in any country. But over 60% of the world's female population lives in countries where extensive poverty and sexual discrimination have created conditions of deprivation. One of the principal mechanisms that negatively influences the condition of women is early procreation; early and frequent childbirth obliterates women's chances for education and paid employment. Feminization of poverty is becoming universal, largely because a growing proportion of households are headed by women with dependent children. In developed and developing countries alike, working women with families work a double day. Although the struggle for legal and social equality for women takes different forms in different countries, certain basic measures can be applied by all governments. Reforms are needed to give women access to more remunerative jobs, equal property rights, and access to credit. Greater investments are needed in reproductive health and in education and training for women. Governments, employers, and husbands should recognize the social value of childbirth and child rearing. The study is divided into 5 sections, each of which has 4 series of data, so that each country is evaluated on 20 variables. The 5 sections are health, nuptiality and children, education, economic participation, and social equality. In most developed countries women live an average of 7 years longer than men, but in developing countries the difference is only 2 years. Complications of pregnancy and childbirth cause the deaths of over 500,000 women each year and affect another 5 million, mostly

  16. A influência da desnutrição na utilização de ventilação mecânica em crianças admitidas em UTI pediátrica The influence of poor nutrition on the necessity of mechanical ventilation among children admitted to the Pediatric Intensive Care Unit

    Directory of Open Access Journals (Sweden)

    Elaine Martins Mota

    2002-04-01

    -nificativamente pela presença de desnutrição.Conclusões: em nosso estudo, tivemos oportunidade de documentar que a presença de desnutrição em crianças menores de 4 anos admitidas em UTI pediátrica representa um fator decisivo na sua evolução, aumentando significativamente a necessidade de ventilação mecânica, o tempo de ventilação e o tempo de permanência em UTI pediátrica.Objective: to determine the relation between children's nutritional status when they are admitted to the Pediatric Intensive Care Unit, the necessity and length of mechanical ventilation and the mortality rate. Methods: a cohort study was conducted between July 1st, 1995 and June 30th, 1996. This study involved all children (28 days old to 48 months old admitted to the pediatric intensive care unit of Hospital São Lucas, who stayed there longer than 8 hours. Exclusion criteria were complex cardiac disease, admission to the pediatric intensive care unit for elective procedure (regardless of pediatric intensive care unit admission criteria or elective mechanical ventilation (cardiac, thoracic or other postoperative period. The staff responsible for the daily data collection were not involved with patient care or assistance decisions. On the day of admission to the pediatric intensive care unit, patients were evaluated regarding their nutritional status through the z score and the severity of the disease using the Pediatric Risk Mortality score. Demographic data, necessity and length of mechanical ventilation as well as main diagnosis and evolution of each patient were evaluated every day.Results: malnourishment increased significantly the need for mechanical ventilation, especially when associated with (a age under one year old (RR= 2.4; 1.4-3.8; (b children admitted to the pediatric intensive care unit with low Pediatric Risk Mortality score (less than 10 (RR=2.5; 1.3-4.7; (c presence of respiratory disease (RR=2.1; 1.3-4.7. Otherwise, malnourishment did not show any influence on the mortality rate

  17. A comparison of the language skills of ELLs and monolinguals who are poor decoders, poor comprehenders, or normal readers.

    Science.gov (United States)

    Geva, Esther; Massey-Garrison, Angela

    2013-01-01

    The overall objective of this article is to examine how oral language abilities relate to reading profiles in English language learners (ELLs) and English as a first language (EL1) learners, and the extent of similarities and differences between ELLs and EL1s in three reading subgroups: normal readers, poor decoders, and poor comprehenders. The study included 100 ELLs and 50 EL1s in Grade 5. The effect of language group (ELL/EL1) and reading group on cognitive and linguistic skills was examined. Except for vocabulary, there was no language group effect on any measure. However, within ELL and EL1 alike, significant differences were found between reading groups: Normal readers outperformed the two other groups on all the oral language measures. Distinct cognitive and linguistic profiles were associated with poor decoders and poor comprehenders, regardless of language group. The ELL and EL1 poor decoders outperformed the poor comprehenders on listening comprehension and inferencing. The poor decoders displayed phonological-based weaknesses, whereas the poor comprehenders displayed a more generalized language processing weakness that is nonphonological in nature. Regardless of language status, students with poor decoding or comprehension problems display difficulties with various aspects of language.

  18. Analysis of Poor Performance of Senior Secondary Students in ...

    African Journals Online (AJOL)

    This study investigated the poor performance of students in Chemistry. The widespread poor performance and the negative attitudes towards chemistry of secondary school students have been largely ascribed to teaching problems. A random sample of 109 students from St Pius X College Bodo City was used. The research ...

  19. Finance for the Poor: An Assessment of the Performance of ...

    African Journals Online (AJOL)

    The introduction of microfinance in the Nigerian financial system is an attempt to provide the poor with access to micro-financial services. Micro-banks that are supposed to provide these services are faced with many challenges. Among these are: inability to reach a greater number of the poor; funding of commercial sectors ...

  20. Outcome of poor response paediatric AML using early SCT.

    Science.gov (United States)

    Wareham, Neval E; Heilmann, Carsten; Abrahamsson, Jonas; Forestier, Erik; Gustafsson, Britt; Ha, Shau-Yin; Heldrup, Jesper; Jahnukainen, Kirsi; Jónsson, Ólafur G; Lausen, Birgitte; Palle, Josefine; Zeller, Bernward; Hasle, Henrik

    2013-03-01

    Children with poor response acute myeloid leukaemia (AML) generally have a very poor outcome. Allogeneic stem cell transplantation (SCT) is often recommended for these children but the benefit is unclear. The aim of this study was to investigate survival for poor response AML patients treated with SCT. Treatment was given according to the NOPHO-AML 2004 protocol. All patients received AIET (Cytarabine, Idarubicin, Etoposide, Thioguanine) and AM (Cytarabine, Mitoxantrone) as induction. We included poor response defined as > 15% blasts on day 15 after AIET (n = 17) or > 5% blasts after AM (n = 14, refractory disease). Poor response patients received intensively timed induction and proceeded to SCT when a donor was available. Thirty-one of 267 evaluable patients (12%) had a poor response. SCT was performed in 25; using matched unrelated donors in 13, matched sibling donors in 6, cord blood donor in 4, and haploidentical donor in two. The median follow-up for the 31 poor responding patients was 2.6 years (range 0.4 - 8.1 years) and 3-year probability of survival 70% (95% CI 59-77%). The poor responders in the NOPHO-AML 2004 protocol had a favourable prognosis treated with time-intensive induction followed by SCT. © 2012 John Wiley & Sons A/S.

  1. Factors associated with high school learners' poor performance: a ...

    African Journals Online (AJOL)

    This study, using a non-experimental, exploratory and descriptive method, established learners' and educators' views about factors that contribute to poor performance in mathematics and physical science. Participants were purposefully selected from seven schools with poor pass rates in District 3 of Tshwane North.

  2. Globalisation And The Poor Nations | Maku | Journal of Research in ...

    African Journals Online (AJOL)

    The paper reviews some definition of globalization, presents the real picture of the general economic welfare of poor nation in the era of intensive globalsiation and proffer policy recommendation on the strategies the poor nations can adopt to integrate fully and derive the immense benefits from globalization process.

  3. Mandated empowerment: handing antipoverty policy back to the poor?

    Science.gov (United States)

    Banerjee, Abhijit V; Duflo, Esther

    2008-01-01

    The current trend in antipoverty policy emphasizes mandated empowerment: the poor are being handed the responsibility for making things better for themselves, largely without being asked whether this is what they want. Beneficiary control is now being built into public service delivery, while microcredit and small business promotion are seen as better ways to help the poor. The clear presumption is that the poor are both able and happy to exercise these new powers. This essay uses two examples to raise questions about these strategies. The first example is about entrepreneurship among the poor. Using data from a number of countries, we argue that there is no evidence that the median poor entrepreneur is trying his best to expand his existing businesses, even if we take into account the many constraints he faces. While many poor people own businesses, this seems to be more a survival strategy than something they want to do. The second example comes from an evaluation of a program in India that aims to involve poor rural parents in improving local public schools. The data suggest that despite being informed that they now have both the right to intervene in the school and access to funds for that purpose, and despite being made aware of how little the children were learning, parents opt to not get involved. Both examples raise concerns about committing ourselves entirely to antipoverty strategies that rely on the poor doing a lot of the work.

  4. Distinguishing between Poor/Dysfunctional Parenting and Child Emotional Maltreatment

    Science.gov (United States)

    Wolfe, David A.; McIsaac, Caroline

    2011-01-01

    Objective: This paper was intended to distinguish between poor parenting and child emotional maltreatment (CEM), to inform child welfare and public health policymakers of the need for differentiated responses. Methods: Scientific literature was integrated with current practice and assumptions relating to poor/dysfunctional parenting and child…

  5. Energy sector reform, energy transitions and the poor in Africa

    International Nuclear Information System (INIS)

    Prasad, Gisela

    2008-01-01

    There is little systematic information about the impact of energy sector reform on all sources and methods of energy utilised or potentially utilised by the poor. It is not sufficiently known what fuels the poor use, if a larger range of fuels becomes available and affordable and if barriers to access and consumption are reduced. A detailed assessment is presented for four countries, three in Africa (Botswana, Ghana and Senegal) and for comparison one in Latin America (Honduras), of steps taken to reform the energy sector and their effect on various groups of poor households. The paper analyses the pattern of energy supply to, and use by, poor households and explores the link-or its absence-to energy policy. We investigate what works for the poor and which type of reforms and implementation are effective and lead to a transition to more efficient and clean fuels from which the poor benefit. Energy sector reforms when adjusted to the specific conditions of the poor have a positive impact on access and use of clean, safe and efficient fuels. The poor are using gradually less wood as cooking fuel. Gas and kerosene are made more widely available through market liberalisation and subsidy in the particular case of Senegal. Electricity access and use is generally promoted or subsidised through changes in payment conditions and lifeline tariffs

  6. Energy sector reform, energy transitions and the poor in Africa

    Energy Technology Data Exchange (ETDEWEB)

    Prasad, Gisela [Energy Research Centre, University of Cape Town, Private Bag, Rondebosch 7701 (South Africa)

    2008-08-15

    There is little systematic information about the impact of energy sector reform on all sources and methods of energy utilised or potentially utilised by the poor. It is not sufficiently known what fuels the poor use, if a larger range of fuels becomes available and affordable and if barriers to access and consumption are reduced. A detailed assessment is presented for four countries, three in Africa (Botswana, Ghana and Senegal) and for comparison one in Latin America (Honduras), of steps taken to reform the energy sector and their effect on various groups of poor households. The paper analyses the pattern of energy supply to, and use by, poor households and explores the link - or its absence - to energy policy. We investigate what works for the poor and which type of reforms and implementation are effective and lead to a transition to more efficient and clean fuels from which the poor benefit. Energy sector reforms when adjusted to the specific conditions of the poor have a positive impact on access and use of clean, safe and efficient fuels. The poor are using gradually less wood as cooking fuel. Gas and kerosene are made more widely available through market liberalisation and subsidy in the particular case of Senegal. Electricity access and use is generally promoted or subsidised through changes in payment conditions and lifeline tariffs. (author)

  7. Expanding Access to Insurance by the Poor : Policy, Regulation and ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Expanding Access to Insurance by the Poor : Policy, Regulation and Supervision of Micro Insurance. This project aims to facilitate poor people's access to insurance products and services as a means of addressing their vulnerability to risk. It will do so by carrying out case studies in five countries. Potential candidates ...

  8. Rich Man, Poor Man: Developmental Differences in Attributions and Perceptions

    Science.gov (United States)

    Sigelman, Carol K.

    2012-01-01

    In an examination guided by cognitive developmental and attribution theory of how explanations of wealth and poverty and perceptions of rich and poor people change with age and are interrelated, 6-, 10-, and 14-year-olds (N = 88) were asked for their causal attributions and trait judgments concerning a rich man and a poor man. First graders, like…

  9. Education reduces the effects of genetic susceptibilities to poor physical health.

    Science.gov (United States)

    Johnson, Wendy; Kyvik, Kirsten Ohm; Mortensen, Erik L; Skytthe, Axel; Batty, G David; Deary, Ian J

    2010-04-01

    Greater education is associated with better physical health. This has been of great concern to public health officials. Most demonstrations show that education influences mean levels of health. Little is known about the influence of education on variance in health status, or about how this influence may impact the underlying genetic and environmental sources of health problems. This study explored these influences. In a 2002 postal questionnaire, 21 522 members of same-sex pairs in the Danish Twin Registry born between 1931 and 1982 reported physical health in the 12-item Short Form Health Survey. We used quantitative genetic models to examine how genetic and environmental variance in physical health differed with level of education, adjusting for birth-year effects. and Conclusions As expected, greater education was associated with better physical health. Greater education was also associated with smaller variance in health status. In both sexes, 2 standard deviations (SDs) above mean educational level, variance in physical health was only about half that among those 2 SDs below. This was because fewer highly educated people reported poor health. There was less total variance in health primarily because there was less genetic variance. Education apparently reduced expression of genetic susceptibilities to poor health. The patterns of genetic and environmental correlations suggested that this might take place because more educated people manage their environments to protect their health. If so, fostering the personal charactieristics associated with educational attainment could be important in reducing the education-health gradient.

  10. From non school-based, co-payment to school-based, free Human Papillomavirus vaccination in Flanders (Belgium): a retrospective cohort study describing vaccination coverage, age-specific coverage and socio-economic inequalities.

    Science.gov (United States)

    Lefevere, Eva; Theeten, Heidi; Hens, Niel; De Smet, Frank; Top, Geert; Van Damme, Pierre

    2015-09-22

    School-based, free HPV vaccination for girls in the first year of secondary school was introduced in Flanders (Belgium) in 2010. Before that, non school-based, co-payment vaccination for girls aged 12-18 was in place. We compared vaccination coverage, age-specific coverage and socio-economic inequalities in coverage - 3 important parameters contributing to the effectiveness of the vaccination programs - under both vaccination systems. We used retrospective administrative data from different sources. Our sample consisted of all female members of the National Alliance of Christian Mutualities born in 1995, 1996, 1998 or 1999 (N=66,664). For each vaccination system we described the cumulative proportion HPV vaccination initiation and completion over time. We used life table analysis to calculate age-specific rates of HPV vaccination initiation and completion. Analyses were done separately for higher income and low income groups. Under non school-based, co-payment vaccination the proportions HPV vaccination initiation and completion slowly rose over time. By age 17, the proportion HPV vaccination initiation/completion was 0.75 (95% CI 0.74-076)/0.66 (95% CI 0.65-0.67). The median age at vaccination initiation/completion was 14.4 years (95% CI 14.4-14.5)/15.4 years (95% CI 15.3-15.4). Socio-economic inequalities in coverage widened over time and with age. Under school-based, free vaccination rates of HPV vaccination initiation were substantially higher. By age 14,the proportion HPV vaccination initiation/completion was 0.90 (95% CI 0.90-0.90)/0.87 (95% CI 0.87-0.88). The median age at vaccination initiation/completion was 12.7 years (95% CI 12.7-12.7)/13.3 years (95% CI 13.3-13.3). Socio-economic inequalities in coverage and in age-specific coverage were substantially smaller. Copyright © 2015. Published by Elsevier Ltd.

  11. School and Parental Influences on Sociopolitical Development among Poor Adolescents of Color

    Science.gov (United States)

    Diemer, Matthew A.; Hsieh, Chueh-an; Pan, Tianshu

    2009-01-01

    Sociopolitical development represents a motivation to reduce sociopolitical inequity, a healthy sense of the self, and perceived agency in the context of structural oppression. Sociopolitical development has been associated with progress in career development, school engagement, and healthier sexual behavior among oppressed and marginalized…

  12. Ruprecht 106 - A young metal-poor Galactic globular cluster

    International Nuclear Information System (INIS)

    Buonanno, R.; Buscema, G.; Fusi Pecci, F.; Richer, H.B.; Fahlman, G.G.

    1990-01-01

    The first CCD photometric survey in the Galactic globular cluster Ruprecht 106 has been performed. The results show that Ruprecht 106 is a metal-poor cluster with (Fe/H) about -2 located at about 25 kpc from the Galactic center. A sizable, high centrally concentrated population of blue stragglers was detected. Significant differences in the positions of the turnoffs in the color-magnitude diagram are found compared to those in metal-poor clusters. The cluster appears younger than other typical metal-poor Galactic globulars by about 4-5 Gyr; if true, this object would represent the first direct proof of the existence of a significant age spread among old, very metal-poor clusters. 51 refs

  13. Cost Analysis of Poor Quality Using a Software Simulation

    Directory of Open Access Journals (Sweden)

    Jana Fabianová

    2017-02-01

    Full Text Available The issues of quality, cost of poor quality and factors affecting quality are crucial to maintaining a competitiveness regarding to business activities. Use of software applications and computer simulation enables more effective quality management. Simulation tools offer incorporating the variability of more variables in experiments and evaluating their common impact on the final output. The article presents a case study focused on the possibility of using computer simulation Monte Carlo in the field of quality management. Two approaches for determining the cost of poor quality are introduced here. One from retrospective scope of view, where the cost of poor quality and production process are calculated based on historical data. The second approach uses the probabilistic characteristics of the input variables by means of simulation, and reflects as a perspective view of the costs of poor quality. Simulation output in the form of a tornado and sensitivity charts complement the risk analysis.

  14. URBAN PRO-POOR REGISTRATIONS: COMPLEX-SIMPLE

    African Journals Online (AJOL)

    New Win User

    registrations for the poor and low-literate / corporate social responsibility); ..... legal textbooks, statutory texts, case law texts, customary texts (from a largely ...... by speaking directly to the prosecutor, or an academic who specialises in ethics.

  15. Mechanisms for oral absorption of poorly water-soluble compounds

    DEFF Research Database (Denmark)

    Lind, Marianne Ladegaard

    Abstract A large part of the new drug candidates discovered by the pharmaceutical industry have poor solubility in aqueous media. The preferred route of drug administration is the oral route, but for these poorly water-soluble drug candidates the oral bioavailability can be low and variable. Often......, phospholipids) and exogenous surfactants used in pharmaceutical formulations on the oral absorption of poorly water-soluble drug substances. Three different models were used for this purpose. The first model was the in vitro Caco-2 cell model. Simulated intestinal fluids which did not decrease cellular...... products are important for the solubilization of poorly water-soluble drug substances and thus absorption. The second model used was the lipoprotein secreting Caco-2 cell model, which was used to simulate intestinal lymphatic transport in vitro. Various simulated intestinal fluids were composed...

  16. Detection of plane, poorly oriented wide flaws using focused transducers

    International Nuclear Information System (INIS)

    Vadder, D. de; Azou, P.; Bastien, P.; Saglio, R.

    1976-01-01

    The detection of plane, poorly oriented, wide flaws by ultrasonic non destructive testing is distinctly improved when using focused transducers. An increased echo can be obtained crossing the defect limit [fr

  17. Management of aplastic anaemia in pregnancy in a resource poor ...

    African Journals Online (AJOL)

    Management of aplastic anaemia in pregnancy in a resource poor centre. ... This is case of a 37 year old Nigerian woman G6P0+5managed with repeated blood ... aplastic anaemia following presentation with weakness and gingival bleeds.

  18. Poor access to basic services | IDRC - International Development ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    2015-10-28

    Oct 28, 2015 ... Poor access to basic services can foster competition and fuel conflict between groups. ... Make clean water, sanitation, electricity, and other services accessible ... Poverty, inequality, and violence in urban India: Towards more ...

  19. Expanding Access to Insurance by the Poor : Policy, Regulation and ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    This project aims to facilitate poor people's access to insurance products and ... Potential candidates include China, Colombia, India, Indonesia, Mali and South ... IDRC congratulates first cohort of Women in Climate Change Science Fellows.

  20. Satisfaction with Life Amongst the Urban Poor: Empirical Results from South Africa

    Directory of Open Access Journals (Sweden)

    Chengedzai Mafini

    2016-10-01

    Full Text Available Satisfaction with life is a dynamic factor which merits ongoing research takes into consideration all contextual influences. This study assessed the influence of four economic factors, namely employment status, rural/urban residence, public service delivery and poverty on satisfaction with life amongst the urban poor in South Africa. Although satisfaction with life is a well-research concept in most environments, no consensus exists on the results, which prompts the need for continuous research. A survey design was adopted involving 402 purposively selected residents of Sebokeng Township in Gauteng Province. Regression analysis revealed that employment status, public service delivery and poverty significantly predicted satisfaction with life. Residing in the rural areas was statistically insignificant. The study provides current insights on the association between economic factors and satisfaction with life amongst poor people in urban societies. The study may be used by governments in developing countries to develop policies for improving the socio-economic well-being of poor societies.

  1. Explaining the role of proximate determinants on fertility decline among poor and non-poor in Asian countries.

    Directory of Open Access Journals (Sweden)

    Nabanita Majumder

    Full Text Available We examined the overall contributions of the poor and non-poor in fertility decline across the Asian countries. Further, we analyzed the direct and indirect factors that determine the reproductive behaviour of two distinct population sub-groups.Data from several new rounds of DHS surveys are available over the past few years. The DHS provides cross-nationally comparable and useful data on fertility, family planning, maternal and child health along with the other information. Six selected Asian countries namely: Bangladesh, India, Indonesia, Nepal, Philippines, and Vietnam are considered for the purpose of the study. Three rounds of DHS surveys for each country (except Vietnam are considered in the present study.Economic status is measured by computing a "wealth index", i.e. a composite indicator constructed by aggregating data on asset ownership and housing characteristics using principal components analysis (PCA. Computed household wealth index has been broken into three equal parts (33.3 percent each and the lowest and the highest 33.3 percent is considered as poor and non-poor respectively. The Bongaarts model was employed to quantify the contribution of each of the proximate determinants of fertility among poor and non-poor women.Fertility reduction across all population subgroups is now an established fact despite the diversity in the level of socio-economic development in Asian countries. It is clear from the analysis that fertility has declined irrespective of economic status at varying degrees within and across the countries which can be attributed to the increasing level of contraceptive use especially among poor women. Over the period of time changing marriage pattern and induced abortion are playing an important role in reducing fertility among poor women.Fertility decline among majority of the poor women across the Asian countries is accompanied by high prevalence of contraceptive use followed by changing marriage pattern and induced

  2. Circulating carnosine dipeptidase 1 associates with weight loss and poor prognosis in gastrointestinal cancer.

    Directory of Open Access Journals (Sweden)

    Peter Arner

    Full Text Available Cancer cachexia (CC is linked to poor prognosis. Although the mechanisms promoting this condition are not known, several circulating proteins have been proposed to contribute. We analyzed the plasma proteome in cancer subjects in order to identify factors associated with cachexia.Plasma was obtained from a screening cohort of 59 patients, newly diagnosed with suspected gastrointestinal cancer, with (n = 32 or without (n = 27 cachexia. Samples were subjected to proteomic profiling using 760 antibodies (targeting 698 individual proteins from the Human Protein Atlas project. The main findings were validated in a cohort of 93 patients with verified and advanced pancreas cancer.Only six proteins displayed differential plasma levels in the screening cohort. Among these, Carnosine Dipeptidase 1 (CNDP1 was confirmed by sandwich immunoassay to be lower in CC (p = 0.008. In both cohorts, low CNDP1 levels were associated with markers of poor prognosis including weight loss, malnutrition, lipid breakdown, low circulating albumin/IGF1 levels and poor quality of life. Eleven of the subjects in the discovery cohort were finally diagnosed with non-malignant disease but omitting these subjects from the analyses did not have any major influence on the results.In gastrointestinal cancer, reduced plasma levels of CNDP1 associate with signs of catabolism and poor outcome. These results, together with recently published data demonstrating lower circulating CNDP1 in subjects with glioblastoma and metastatic prostate cancer, suggest that CNDP1 may constitute a marker of aggressive cancer and CC.

  3. Inference in {open_quotes}poor{close_quotes} languages

    Energy Technology Data Exchange (ETDEWEB)

    Petrov, S. [Oak Ridge National Lab., TN (United States)

    1996-12-31

    Languages with a solvable implication problem but without complete and consistent systems of inference rules ({open_quote}poor{close_quote} languages) are considered. The problem of existence of a finite, complete, and consistent inference rule system for a {open_quotes}poor{close_quotes} language is stated independently of the language or the rule syntax. Several properties of the problem are proved. An application of the results to the language of join dependencies is given.

  4. Pro-poor health policies in poverty reduction strategies.

    Science.gov (United States)

    Laterveer, Leontien; Niessen, Louis W; Yazbeck, Abdo S

    2003-06-01

    Since 1999, the International Monetary Fund and World Bank have required low-income countries soliciting for debt relief and financial support to prepare a Poverty Reduction Strategy Paper (PRSP). The objective of this study is to arrive at a systematic assessment of the extent to which the first batch of interim PRSPs actually addresses the health of the poor and vulnerable. A literature study was used to design and test a semi-quantitative approach to assess the pro-poor focus of health policies in national documents. The approach was applied to the existing interim proposals for 23 Highly Indebted Poor Countries. Results show that a majority of proposals lack country-specific data on the distribution and composition of the burden of disease, a clear identification of health system constraints and an assessment of the impact of health services on the population. More importantly, they make little effort to analyze these issues in relation to the poor. Furthermore, only a small group explicitly includes the interests of the poor in health policy design. Attention to policies aiming at enhancing equity in public health spending is even more limited. Few papers that include expenditure proposals also show pro-poor focused health budgets. We conclude that our systematic assessment of a new international development policy instrument, PRSP, raises strong concerns about the attributed role of health in development and the limited emphasis on the poor, the supposed primary beneficiaries of this instrument. There is a need and an opportunity for the international development community to provide assistance and inputs as poor countries shift their policy thinking from an interim stage to fully developed national policies. This paper presents a menu of analytical and policy options that can be pursued.

  5. Technologies of identification under the Old Poor Law\\ud

    OpenAIRE

    Hindle, Steve

    2006-01-01

    In this important article Steve Hindle, the leading historian of the local state and the pre-1834 Poor Law, considers the different ways in which parish and township authorities labelled and identified paupers. His paper is closely based upon the lecture which he gave to the British Association for Local History in June 2006. Steve Hindle gives an accessible and comprehensive explanation of the background and rationale for the various ways in which the poor could be categorised, and discusses...

  6. Rich or poor: Who should pay higher tax rates?

    Science.gov (United States)

    Murilo Castro de Oliveira, Paulo

    2017-08-01

    A dynamic agent model is introduced with an annual random wealth multiplicative process followed by taxes paid according to a linear wealth-dependent tax rate. If poor agents pay higher tax rates than rich agents, eventually all wealth becomes concentrated in the hands of a single agent. By contrast, if poor agents are subject to lower tax rates, the economic collective process continues forever.

  7. Who Cares for the Poor in Europe? Micro and Macro Determinants for Alleviating Poverty in 15 European Countries

    NARCIS (Netherlands)

    Scheepers, Peer; Grotenhuis, Manfred te

    2005-01-01

    The present study aims to answer research questions on people’s willingness to donate money to help alleviate poverty. First, what are the individual (or micro) determinants and state-level (macro) determinants of welfare states that influence people’s willingness to donate money to the poor?

  8. Psychosocial work environment and depressive symptoms among US workers: comparing working poor and working non-poor.

    Science.gov (United States)

    Simmons, Leigh Ann; Swanberg, Jennifer E

    2009-08-01

    The psychosocial work environment has been associated with mental health outcomes; however, little research has examined this relationship for low-wage workers. The purpose of this study was to investigate the relationship between psychosocial job characteristics and depressive symptoms for US workers using an expanded model of job quality. Data were from the 2002 National Study of the Changing Workforce, a nationally representative study of wage and salaried workers in the US. Working poor was defined as households earning working poor employees, job insecurity was the single significant correlate of depressive symptoms after controlling for other demographic and work environment variables. For working non-poor employees, high psychological demands and low supervisor and coworker support were associated with depressive symptoms. Findings suggest all jobs do not equally affect employees' depressive symptoms. Implications for research that may improve the mental health of the working poor in the US are presented.

  9. Reading comprehension and expressive writing: a comparison between good and poor comprehenders.

    Science.gov (United States)

    Carretti, Barbara; Re, Anna Maria; Arfè, Barbara

    2013-01-01

    This study investigated expressive writing in 8- to 10-year-old children with different levels of reading comprehension. Poor and good comprehenders were presented with three expressive writing tasks where the modality (pictorial vs. verbal) and the text genre (narrative vs. descriptive) varied. Results showed that poor comprehenders' performance was minimally influenced by the modality of the prompt. In fact, their performance was generally worse than that of good comprehenders and affected by the text genre, as the quality of their narratives was generally lower than that of good comprehenders. However, in the descriptive text condition, their performance was comparable to that of good comprehenders. One can conclude that their problems depend on the characteristics of the narrative text where coherence and causality are important elements.

  10. Individual and community factors associated with geographic clusters of poor HIV care retention and poor viral suppression.

    Science.gov (United States)

    Eberhart, Michael G; Yehia, Baligh R; Hillier, Amy; Voytek, Chelsea D; Fiore, Danielle J; Blank, Michael; Frank, Ian; Metzger, David S; Brady, Kathleen A

    2015-05-01

    Previous analyses identified specific geographic areas in Philadelphia (hotspots) associated with negative outcomes along the HIV care continuum. We examined individual and community factors associated with residing in these hotspots. Retrospective cohort of 1404 persons newly diagnosed with HIV in 2008-2009 followed for 24 months after linkage to care. Multivariable regression examined associations between individual (age, sex, race/ethnicity, HIV transmission risk, and insurance status) and community (economic deprivation, distance to care, access to public transit, and access to pharmacy services) factors and the outcomes: residence in a hotspot associated with poor retention-in-care and residence in a hotspot associated with poor viral suppression. In total, 24.4% and 13.7% of persons resided in hotspots associated with poor retention and poor viral suppression, respectively. For persons residing in poor retention hotspots, 28.3% were retained in care compared with 40.4% of those residing outside hotspots (P care, and longer distance to pharmacies. Factors significantly associated with residence in poor viral suppression hotspots included female sex, higher economic deprivation, and shorter distance to pharmacies. Individual and community-level associations with geographic hotspots may inform both content and delivery strategies for interventions designed to improve retention-in-care and viral suppression.

  11. Mapping onto Eq-5 D for patients in poor health

    Directory of Open Access Journals (Sweden)

    Brazier John E

    2010-11-01

    Full Text Available Abstract Background An increasing amount of studies report mapping algorithms which predict EQ-5 D utility values using disease specific non-preference-based measures. Yet many mapping algorithms have been found to systematically overpredict EQ-5 D utility values for patients in poor health. Currently there are no guidelines on how to deal with this problem. This paper is concerned with the question of why overestimation of EQ-5 D utility values occurs for patients in poor health, and explores possible solutions. Method Three existing datasets are used to estimate mapping algorithms and assess existing mapping algorithms from the literature mapping the cancer-specific EORTC-QLQ C-30 and the arthritis-specific Health Assessment Questionnaire (HAQ onto the EQ-5 D. Separate mapping algorithms are estimated for poor health states. Poor health states are defined using a cut-off point for QLQ-C30 and HAQ, which is determined using association with EQ-5 D values. Results All mapping algorithms suffer from overprediction of utility values for patients in poor health. The large decrement of reporting 'extreme problems' in the EQ-5 D tariff, few observations with the most severe level in any EQ-5 D dimension and many observations at the least severe level in any EQ-5 D dimension led to a bimodal distribution of EQ-5 D index values, which is related to the overprediction of utility values for patients in poor health. Separate algorithms are here proposed to predict utility values for patients in poor health, where these are selected using cut-off points for HAQ-DI (> 2.0 and QLQ C-30 ( Conclusion Mapping algorithms overpredict utility values for patients in poor health but are used in cost-effectiveness analyses nonetheless. Guidelines can be developed on when the use of a mapping algorithms is inappropriate, for instance through the identification of cut-off points. Cut-off points on a disease specific questionnaire can be identified through association

  12. Association of poor childhood fear conditioning and adult crime.

    Science.gov (United States)

    Gao, Yu; Raine, Adrian; Venables, Peter H; Dawson, Michael E; Mednick, Sarnoff A

    2010-01-01

    Amygdala dysfunction is theorized to give rise to poor fear conditioning, which in turn predisposes to crime, but it is not known whether poor conditioning precedes criminal offending. This study prospectively assessed whether poor fear conditioning early in life predisposes to adult crime in a large cohort. Electrodermal fear conditioning was assessed in a cohort of 1,795 children at age 3, and registration for criminal offending was ascertained at age 23. In a case-control design, 137 cohort members with a criminal record were matched on gender, ethnicity, and social adversity with 274 noncriminal comparison members. Statistical analyses compared childhood fear conditioning for the two groups. Criminal offenders showed significantly reduced electrodermal fear conditioning at age 3 compared to matched comparison subjects. Poor fear conditioning at age 3 predisposes to crime at age 23. Poor fear conditioning early in life implicates amygdala and ventral prefrontal cortex dysfunction and a lack of fear of socializing punishments in children who grow up to become criminals. These findings are consistent with a neurodevelopmental contribution to crime causation.

  13. Food beliefs and practices in urban poor communities in Accra: implications for health interventions.

    Science.gov (United States)

    Boatemaa, Sandra; Badasu, Delali Margaret; de-Graft Aikins, Ama

    2018-04-02

    Poor communities in low and middle income countries are reported to experience a higher burden of chronic non-communicable diseases (NCDs) and nutrition-related NCDs. Interventions that build on lay perspectives of risk are recommended. The objective of this study was to examine lay understanding of healthy and unhealthy food practices, factors that influence food choices and the implications for developing population health interventions in three urban poor communities in Accra, Ghana. Thirty lay adults were recruited and interviewed in two poor urban communities in Accra. The interviews were audio-taped, transcribed and analysed thematically. The analysis was guided by the socio-ecological model which focuses on the intrapersonal, interpersonal, community, structural and policy levels of social organisation. Food was perceived as an edible natural resource, and healthy in its raw state. A food item retained its natural, healthy properties or became unhealthy depending on how it was prepared (e.g. frying vs boiling) and consumed (e.g. early or late in the day). These food beliefs reflected broader social food norms in the community and incorporated ideas aligned with standard expert dietary guidelines. Healthy cooking was perceived as the ability to select good ingredients, use appropriate cooking methods, and maintain food hygiene. Healthy eating was defined in three ways: 1) eating the right meals; 2) eating the right quantity; and 3) eating at the right time. Factors that influenced food choice included finances, physical and psychological state, significant others and community resources. The findings suggest that beliefs about healthy and unhealthy food practices are rooted in multi-level factors, including individual experience, family dynamics and community factors. The factors influencing food choices are also multilevel. The implications of the findings for the design and content of dietary and health interventions are discussed.

  14. Identification of poorly crystalline scorodite in uranium mill tailings

    International Nuclear Information System (INIS)

    Frey, R.; Rowson, J.; Hughes, K.; Rinas, C.; Warner, J.

    2010-01-01

    The McClean Lake mill, located in northern Saskatchewan, processes a variety of uranium ore bodies to produce yellowcake. A by-product of this process is an acidic waste solution enriched in arsenic, referred to as raffinate. The raffinate waste stream is treated in the tailings preparation circuit, where arsenic is precipitated as a poorly crystalline scorodite phase. Raffinate neutralization studies have successfully identified poorly crystalline scorodite using XRD, SEM, EM, XANES and EXAFS methods, but to date, scorodite has not been successfully identified within the whole tailing solids. During the summer of 2008, a drilling program sampled the in situ tailings within the McClean Lake tailings management facility. Samples from this drilling campaign were sent to the Canadian Light Source Inc. for EXAFS analysis. The sample spectra positively identify a poorly crystalline scorodite phase within the McClean tailings management facility. (author)

  15. Channels for change: private water and the urban poor

    Energy Technology Data Exchange (ETDEWEB)

    Lynch, Matthew; Matthews, Petter; Ryan-Collins, Lily [Engineers Against Poverty (United Kingdom)

    2010-05-15

    For the rapidly urbanising developing world, safe and affordable water is key to health and livelihoods, as well as meeting the Millennium Development Goals. But providing it demands innovative models. Where the context allows and the approach is appropriate, private sector involvement can generate win-win outcomes. Poor people can gain access to high-quality, affordable services, and companies can gain access to new and profitable business opportunities. Two examples of innovative 'private' water suppliers are the Manila Water Company's Water for the Poor Communities (TPSB) programme, and the Water & Sanitation for the Urban Poor (WSUP) partnership. Both have a multisector approach to service expansion and provision, including partnerships with local authorities; strong community involvement in selecting, designing and operating options; appropriate service levels to reduce costs; and a flexible range of services. Many elements of these models are also replicable.

  16. Is Globalization Good for the Poor? A Reply to Pogge

    DEFF Research Database (Denmark)

    Sønderholm, Jørn; Lydholm, Henrik

    2016-01-01

    an economic polarization between the wealthiest and poorest people of the world, is not, we contend, something that in itself offers strong support for his view that the global institutional order is a significant cause of this economic polarization. We believe that Pogge overemphasizes the impact......In an article from 2011, Thomas Pogge asks if globalization is good for the world’s poor. Pogge answers in the negative. As important evidence for the view that the globalization period has not been good for the world’s poor, Pogge cites a dataset provided by Branko Milanović (CUNY......). In this article, we do not take issue with Pogge’s definition of “globalization”, “the world’s poor” or with the veracity of the empirical data he refers to in articulating and defending his view about globalization and the world’s poor. However, Pogge’s reference to a dataset showing that there has been...

  17. Predictors of dental care utilization among working poor Canadians.

    Science.gov (United States)

    Muirhead, V E; Quiñonez, C; Figueiredo, R; Locker, D

    2009-06-01

    This study used the Gelberg-Andersen Behavioral Model for Vulnerable Populations to identify predictors of dental care utilization by working poor Canadians. A cross-sectional stratified sampling study design and telephone survey methodology was used to collect data from a nationally representative sample of 1049 working poor individuals aged 18 to 64 years. Working poor persons worked > or = 20 h a week, were not full-time students and had annual family incomes 1 year ago: male gender (OR = 1.63; P = 0.005), aged 25-34 years (OR = 2.05; P = 0.02), paying for dental care with cash or credit (OR = 2.31; P credit (OR = 2.71; P demand for economically constrained adults.

  18. Poor care and the professional duty of the registered nurse.

    Science.gov (United States)

    Gamble, Clair; Ion, Robin

    2017-04-28

    Concerns have been raised in recent years about standards of care in the UK. Notable failures have been identified in the care of vulnerable older adults. This article identifies and discusses some logical steps which might be taken to minimise the risk of individual and systemic care failure in settings for older adults. These steps include frank discussion about ageism to promote empowerment and respect for older people; ensuring robust policies are in place that support and encourage the reporting of poor care; and ensuring that registered practitioners are aware of their accountability for their actions and also their omissions should they witness poor care. In addition to reducing the risk of poor care, these steps could contribute to having a more confident, competent and empowered workforce.

  19. Elucidating poor decision-making in a rat gambling task.

    Directory of Open Access Journals (Sweden)

    Marion Rivalan

    Full Text Available Although poor decision-making is a hallmark of psychiatric conditions such as attention deficit/hyperactivity disorder, pathological gambling or substance abuse, a fraction of healthy individuals exhibit similar poor decision-making performances in everyday life and specific laboratory tasks such as the Iowa Gambling Task. These particular individuals may provide information on risk factors or common endophenotypes of these mental disorders. In a rodent version of the Iowa gambling task--the Rat Gambling Task (RGT, we identified a population of poor decision makers, and assessed how these rats scored for several behavioral traits relevant to executive disorders: risk taking, reward seeking, behavioral inflexibility, and several aspects of impulsivity. First, we found that poor decision-making could not be well predicted by single behavioral and cognitive characteristics when considered separately. By contrast, a combination of independent traits in the same individual, namely risk taking, reward seeking, behavioral inflexibility, as well as motor impulsivity, was highly predictive of poor decision-making. Second, using a reinforcement-learning model of the RGT, we confirmed that only the combination of extreme scores on these traits could induce maladaptive decision-making. Third, the model suggested that a combination of these behavioral traits results in an inaccurate representation of rewards and penalties and inefficient learning of the environment. Poor decision-making appears as a consequence of the over-valuation of high-reward-high-risk options in the task. Such a specific psychological profile could greatly impair clinically healthy individuals in decision-making tasks and may predispose to mental disorders with similar symptoms.

  20. Echoic memory processes in good and poor readers.

    Science.gov (United States)

    Sipe, S; Engle, R W

    1986-07-01

    Four experiments were conducted to determine whether echoic memory plays a role in differences between good and poor readers. The first two experiments used a suffix procedure in which the subject is read a list of digits with either a tone control or the word go appended to the list. For lists that exceeded the length of the subjects memory span by one digit (i.e., that avoided ceiling effects), the poor readers showed a larger decrement in the suffix condition than did the good readers. The third experiment was directed at the question of whether the duration of echoic memory is different for good and poor readers. Children shadowed words presented to one ear at a rate determined to give 75-85% shadowing accuracy. The items presented to the nonattended ear were words and an occasional digit. At various intervals after the presentation of the digit, a light signaled that the subject was to cease shadowing and attempt to recall any digit that had occurred in the nonattended ear recently. Whereas good and poor readers recalled the digit equally if tested immediately after presentation, the poor readers showed a faster decline in recall of the digit as retention interval increased. A fourth experiment was conducted to determine whether the differences in echoic memory were specific to speech stimuli or occurred at a more basic level of aural persistence. Bursts of white noise were separated by 9-400 ms of silence and the subject was to say whether there were one or two sounds presented. There were no differences in detectability functions for good and poor readers.

  1. Expanding Access to Pro-Poor Energy Services in Nigeria

    Energy Technology Data Exchange (ETDEWEB)

    Eleri, Ewah Otu; Ugwu, Okechukwu; Onuvae, Precious

    2012-10-15

    Nigeria experiences a remarkable paradox -- the abundance of energy resources and widespread energy poverty. Only about 40% of the population has access to the country’s grid electricity. About 72% of the population depends on traditional fuelwood for cooking. Despite this, government financing of energy services that benefits majority of Nigeria’s population has been grossly inadequate. Private sector investments and donor support have not fared better. This paper examines the current level of energy poverty in Nigeria. It analyses the level of government, private sector and donor funding for energy services that benefit the poor. It further reviews international best practices in expanding access for pro poor energy services. The paper finds a significant decline in political interest for expanding electricity services to rural areas. Even though ambitious policy reforms have commenced, agreed programmes are not implemented effectively. Not only are investments in rural electrification in decline, there is no history of annual budgeting for cooking energy programmes. The paper recommends a number of action points for expanding access to energy services that benefit the poor. These include the development and launching of a new national rural electrification strategy; establishment of a national cooking energy programme; and the development of clear policy incentives to support private sector investment in energy services for the poor. It calls on the Nigerian Central Bank of Nigeria to set aside 10% of the existing power intervention fund for pro poor energy financing; and the Nigerian Electricity Regulatory Commission to establish a clear framework for the utilization of the Consumer Assistance Fund. Other recommendations include the use of a proportion of the Ecological Fund to finance cooking energy; establishment of a donor’s platform on pro poor energy; and the mobilization of civil society in providing community-level energy services.

  2. Nanonization strategies for poorly water-soluble drugs.

    Science.gov (United States)

    Chen, Huabing; Khemtong, Chalermchai; Yang, Xiangliang; Chang, Xueling; Gao, Jinming

    2011-04-01

    Poor water solubility for many drugs and drug candidates remains a major obstacle to their development and clinical application. Conventional formulations to improve solubility suffer from low bioavailability and poor pharmacokinetics, with some carriers rendering systemic toxicities (e.g. Cremophor(®) EL). In this review, several major nanonization techniques that seek to overcome these limitations for drug solubilization are presented. Strategies including drug nanocrystals, nanoemulsions and polymeric micelles are reviewed. Finally, perspectives on existing challenges and future opportunities are highlighted. Published by Elsevier Ltd.

  3. On Poor Separation in Magnetically Driven Shock Tube

    DEFF Research Database (Denmark)

    Chang, C.T.

    1973-01-01

    Observations made at steady-state running conditions in a magnetically driven shock tube, with parallel-plate electrodes, showed that for a given discharge voltage, sufficient separation between the shock and the current-sheet occurred only at relatively high discharge pressures. As a comparison......, poor separations were also noted in conventional diaphragm-type shock tubes running at low initial pressures. It is demonstrated that the observed poor separation can be explained by a mass leakage, instead of through the wall boundary layer, but through the current-sheet itself....

  4. Turning a Poor Ion Channel into a Good Pump

    Science.gov (United States)

    Astumian, Dean

    2003-05-01

    We consider a membrane protein that can exist in two configurations, either one of which acts as a poor ion channel, allowing ions to slowly leak across the membrane from high to low elctrochemical potential. We show that random external fluctuations can provide the energy to turn this poor channel into a good pump that drives ion transport from low to high electrochemical potential. We discuss this result in terms of a gambling analogy, and point to possible implications for fields as far ranging as population biology, economics, and actuarial science.

  5. Renewable energies and the poor: niche or nexus?

    International Nuclear Information System (INIS)

    Bhattacharyya, Subhes C.

    2006-01-01

    Renewable energies are considered as an essential element of any strategy for sustainable energy development. The poor in the developing world without access to modern energies are regarded as a major market for renewable energies. This short paper attempts to analyse whether such a niche is backed by any economic logic and whether renewable energy and the poor nexus could be a strategy for success. The paper suggests that contrary to the common belief, the economic logic behind the niche is unsound and that the nexus is not a recipe for success

  6. Motivação para aprender música em espaços escolares e não-escolares/Motivation to learn music in school and non-school contexts

    Directory of Open Access Journals (Sweden)

    Cristina Cereser

    2009-10-01

    Full Text Available Este artigo apresenta o resultado da amostra brasileira da pesquisa internacional intitulada “Os significados da música para crianças e adolescentes em atividades musicais escolares e não-escolares”. Essa pesquisa teve o objetivo de investigar a importância e o significado atribuído pelos alunos às atividades musicais desenvolvidas em ambientes escolares e não-escolares. O método consistiu em um survey envolvendo 21.975 alunos de oito países (Brasil, China, Coreia do Sul, Estados Unidos, Finlândia, Hong Kong, Israel e México, cujo questionário foi concebido sob a ótica do modelo de expectativa e valor de Eccles e Wigfield. No Brasil, fizeram parte da amostra 1848 alunos da 6a série do ensino fundamental à 3a série do ensino médio, de 11 cidades do Estado do Rio Grande do Sul. O instrumento de coleta de dados foi um questionário sobre o perfil dos alunos e suas opiniões quanto ao interesse, importância, dificuldade, utilidade, senso de competência e senso de confiança em relação às disciplinas Artes, Ciências, Educação Física, Matemática, Português e Música. Os dados foram tratados por análise de variância (ANOVA. Os resultados do Brasil apontam que o grau de interesse, importância e utilidade da Música aumenta à medida que os estudantes brasileiros pertencem a séries mais avançadas, em sentido oposto ao observado na maioria dos outros países. This article presents the results of the Brazilian study within the international research entitled “Meanings of music for students in school-based and non-school musical activities”. This research aimed at investigating the importance and the meaning assigned by students to musical activities developed in school and non-school contexts. The method consisted of a survey involving 21,975 students from eight countries (Brazil, China, Finland, Hong Kong, Israel, Mexico, South Korea and United States of America, which questionnaire was grounded on the Eccles and

  7. Poor sleep quality in patients with multiple sclerosis : gender differences

    NARCIS (Netherlands)

    Vitkova, Marianna; Rosenberger, Jaroslav; Gdovinova, Zuzana; Szilasiova, Jarmila; Mikula, Pavol; Groothoff, Johan W.; Reijneveld, Sijmen A.; van Dijk, Jitse P.

    2016-01-01

    Objectives Most of the psychological and physical factors associated with poor sleep quality in patients with multiple sclerosis (MS) have a different prevalence in women and men, but whether or not these factors contribute differently to sleep quality in women and men with MS remains unclear. The

  8. Treatment non-adherence among patients with poorly controlled ...

    African Journals Online (AJOL)

    2014-03-01

    Mar 1, 2014 ... Background: Poor adherence to prescribed therapy among patients with chronic diseases is a growing concern which un- dermines the ... consent was obtained from individual patient to signi- .... and SRMAS in binary categories of adherence versus ..... United Kingdom Prospective Diabetes Study Group.

  9. Poor Pregnancy Outcomes among Adolecents in South Nyanza ...

    African Journals Online (AJOL)

    In this paper, we examine factor associated with poor pregnancy outcomes among teenagers in South Nyanza region of Kenya. The analysis is based on a recent WHO funded study on Adolescent safe motherhood in the region, which involved a survey of 1247 adolescents aged 12-19 and in-depth interviews with 39 of the ...

  10. Carbon-enhanced metal-poor stars in dwarf galaxies

    NARCIS (Netherlands)

    Salvadori, Stefania; Skúladóttir, Ása; Tolstoy, Eline

    2015-01-01

    We investigate the frequency and origin of carbon-enhanced metal-poor (CEMP) stars in Local Group dwarf galaxies by means of a statistical, data-calibrated cosmological model for the hierarchical build-up of the Milky Way and its dwarf satellites. The model self-consistently explains the variation

  11. The effect of Rational Emotive Behaviour Therapy (REBT) on poor ...

    African Journals Online (AJOL)

    Research has identified Poor study habits as one of the key factors responsible for this high rate of failure and widespread examination malpractice among students. REBT is a cognitive behavior therapy that deals with modifying maladjusted behavior that has to do with a faulty belief system. The purpose of this study is to ...

  12. Aggregate packing characteristics of good and poor performing asphalt mixes

    CSIR Research Space (South Africa)

    Denneman, E

    2007-07-01

    Full Text Available The aggregate structure of the compacted mix is a determining factor for the performance of Hot-Mix Asphalt (HMA). In this paper, the grading characteristics of good and poor performing HMA mixes are explored using the concepts of the Bailey method...

  13. Verbal Processing Reaction Times in "Normal" and "Poor" Readers.

    Science.gov (United States)

    Culbertson, Jack; And Others

    After it had been determined that reaction time (RT) was a sensitive measure of hemispheric dominance in a verbal task performed by normal adult readers, the reaction times of three groups of subjects (20 normal reading college students, 12 normal reading third graders and 11 poor reading grade school students) were compared. Ss were exposed to…

  14. Do Poor Readers Feel Angry, Sad, and Unpopular?

    Science.gov (United States)

    Morgan, Paul L.; Farkas, George; Wu, Qiong

    2012-01-01

    We investigated whether being poorly skilled in reading contributes to children's reported feelings of anger, distractibility, anxiety, sadness, loneliness, and social isolation. Data were analyzed from a longitudinal subsample of children (N = 3,308) participating in the Early Childhood Longitudinal Study-Kindergarten Cohort. Multilevel logistic…

  15. Associations between insomnia, sleep duration and poor work ability.

    Science.gov (United States)

    Lian, Yulong; Xiao, Jing; Liu, Yan; Ning, Li; Guan, Suzhen; Ge, Hua; Li, Fuye; Liu, Jiwen

    2015-01-01

    The aim of this study was to examine the independent and joint effect of insomnia and objective sleep duration on poor work ability. In this cross-sectional study, a total of 2820 Chinese manufacturing workers were categorized as insomnia patients and individuals with normal sleeping pattern by interview according to DSM-IV criteria. Sleep duration was classified into four categories: ≥7h, 6-7h, 5-6h, and Work ability was assessed using the Chinese Work Ability Index (WAI) questionnaire. Regression analysis examined the independent and joint association of sleep duration and insomnia with poor work ability, after adjusting for various confounding factors. Insomnia and objective short sleep duration were both independently associated with poor work ability. Compared with the normal sleeping and ≥7h sleep duration group, the highest risk of poor work ability was in the insomnia patients with work ability. Objective sleep duration should be taken into consideration when assessing the work ability of people with insomnia. Copyright © 2014 Elsevier Inc. All rights reserved.

  16. Chemical Abundances of Metal-poor stars in Dwarf Galaxies

    NARCIS (Netherlands)

    Venn, Kim A.; Jablonka, Pascale; Hill, Vanessa; Starkenburg, Else; Lemasle, Bertrand; Shetrone, Matthew; Irwin, Mike; Norris, John; Yong, David; Gilmore, Gerry; Salvadori, Stephania; Skuladottir, Asa; Tolstoy, Eline; Bragaglia, A.; Arnaboldi, M.; Rejkuba, M.; Romano, D.

    2016-01-01

    Stars in low-mass dwarf galaxies show a larger range in their chemical properties than those in the Milky Way halo. The slower star formation efficiency make dwarf galaxies ideal systems for testing nucleosynthetic yields. Not only are alpha-poor stars found at lower metallicities, and a higher

  17. Poor Reading Culture: A Barrier to Students' Patronage of Libraries ...

    African Journals Online (AJOL)

    FIRST LADY

    show that computer and other media, harsh economic reality, societal demand for materialism, inadequate library materials among others are causes of poor reading culture of students in secondary schools. .... foundation of elementary education. ... play in the social, economic and technological development of any country.

  18. Poor Facial Affect Recognition among Boys with Duchenne Muscular Dystrophy

    Science.gov (United States)

    Hinton, V. J.; Fee, R. J.; De Vivo, D. C.; Goldstein, E.

    2007-01-01

    Children with Duchenne or Becker muscular dystrophy (MD) have delayed language and poor social skills and some meet criteria for Pervasive Developmental Disorder, yet they are identified by molecular, rather than behavioral, characteristics. To determine whether comprehension of facial affect is compromised in boys with MD, children were given a…

  19. Providing choice for poor farmers: Harsha de Silva (Sri Lanka ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    The work we are doing is really cutting-edge. Through this research we are talking about creating choices for farmers, giving them power using mobile phones as a tool. We just completed an extensive and comprehensive study of how 10 000 poor people use ICTs in Pakistan, India, Sri Lanka, Bangladesh, Thailand, and ...

  20. Targeting micro-credits to poor household enterprises in Ecuador

    NARCIS (Netherlands)

    Hidalgo, D.; Oosterbeek, H.

    2008-01-01

    In 2007 the government of Ecuador launched a micro-credit program for enterprises run by poor households. The program was targeted to households at the bottom two quintiles in the wealth distribution. This paper uses data collected prior to the start of the program to examine whether the

  1. Creating Work Opportunities for the Poor through Home Community ...

    African Journals Online (AJOL)

    This article seeks to investigate how Home Community Based Care (HCBC) is used as a strategy to create work opportunities for the poor. Quantitative and qualitative data from 65 HCBC organisations with three years of active involvement in HCBC that are funded by the Department of Health was collected. This was done ...

  2. PRO-POOR TOURISM POTENTIALS OF GHANA The Contribution ...

    African Journals Online (AJOL)

    Apusigah

    Dept. of Ecotourism and Environmental Management ... The potential of the tourism and hospitality sector as a poverty reduction tool, specifically ... concept is not just a state of affairs but an unacceptable state of affairs, ... A case of SMEs offering employment is the Okavango ..... strategies; making tourism work for the poor.

  3. Urban trees and the risk of poor birth outcomes

    Science.gov (United States)

    Geoffrey H. Donovan; Yvonne L. Michael; David T. Butry; Amy D. Sullivan; John M. Chase

    2011-01-01

    This paper investigated whether greater tree-canopy cover is associated with reduced risk of poor birth outcomes in Portland, Oregon. Residential addresses were geocoded and linked to classified-aerial imagery to calculate tree-canopy cover in 50, 100, and 200 m buffers around each home in our sample (n=5696). Detailed data on maternal characteristics and additional...

  4. Evidence for Opportunity Cost Neglect in the Poor

    NARCIS (Netherlands)

    Plantinga, Arnoud; Krijnen, Job M.T.; Zeelenberg, Marcel; Breugelmans, Seger M.

    2018-01-01

    People often neglect opportunity costs: They do not fully take into account forgone alternatives outside of a particular choice set. Several scholars have suggested that poor people should be more likely to spontaneously consider opportunity costs, because budget constraints should lead to an

  5. Evidence for opportunity cost neglect in the poor

    NARCIS (Netherlands)

    Plantinga, A.; Krijnen, J.M.T.; Zeelenberg, M.; Breugelmans, S.M.

    2018-01-01

    People often neglect opportunity costs: They do not fully take into account forgone alternatives outside of a particular choice set. Several scholars have suggested that poor people should be more likely to spontaneously consider opportunity costs, because budget constraints should lead to an

  6. Automated processing of leucocyte-poor platelet concentrates.

    Science.gov (United States)

    Tandy, N P; Seghatchian, M J; Bessos, H

    1992-10-01

    In view of transfusion reactions and alloimmunization associated with leucocyte contamination of platelet concentrates (PC), there is a general move towards the production of leuco-poor PC. This goal is currently pursued by the production of various PC using buffy coat and apheresis techniques. Although there is no overall consensus on the meaning of 'leuco-poor', by assuming that this refers to a level of 5-50 x 10(7) leucocytes per PC, we were able to make comparisons with available systems used in Europe. In addition to platelet and white cell counts, other markers of PC quality were assessed in some cases. These included traditional markers (such as hypotonic stress response, pH, and lactate and beta-thromboglobulin levels) and newer markers (such as glycocalicin and plasma von Willebrand factor levels). Our preliminary results showed appreciable differences in platelet and white cell content of PC prepared by various types of apheresis equipment. Appreciable differences in the quality of stored PC were also observed between routine PC (non-leuco-poor and buffy coat and apheresed PC (leuco-poor).

  7. Carbon-enhanced metal-poor stars and thermohaline mixing

    NARCIS (Netherlands)

    Stancliffe, R.J.; Glebbeek, E.; Izzard, R.G.; Pols, O.R.

    2007-01-01

    One possible scenario for the formation of carbon-enhanced metal-poor stars is the accretion of carbon-rich material from a binary companion which may no longer visible. It is generally assumed that the accreted material remains on the surface of the star and does not mix with the interior until

  8. Jesus: Born Poor or Rich? | Osai | African Research Review

    African Journals Online (AJOL)

    The paper concludes that, like tailoring, smith, masonry etc. carpentry was part of a guild that only those with means practiced in Judaea of that epoch and, therefore Joseph was not poor; that Joachim, the maternal grandfather of Jesus, was a wealthy descendant of the royal house of David; that Joseph had the means to ...

  9. Common Characteristics of Good and Poorly Performing AC Pavements

    Science.gov (United States)

    1999-12-01

    This report documents the analysis and findings of a study to identify the site conditions and design/construction features of : flexible pavements that lead to good performance and those that lead to poor performance. Data from the Long Term Pavemen...

  10. Common Characteristics of Good and Poorly Performing PCC Pavements

    Science.gov (United States)

    1998-01-01

    This report documents the analysis and findings of a study to identify the site conditions and design/construction features of concrete pavements (JPCP, JRCP, CRCP) that lead to good performance and those that lead to poor performance. Data from Long...

  11. The Heavily Indebted Poor Countries (HIPC) Initiative Fund Micro ...

    African Journals Online (AJOL)

    Since Ghana opted for the HIPC debt relief initiative and reached the completion point in June 2004 the country has received several billions of money into the HIPC account at the Bank of Ghana. Part of the funds has been given out in the form of micro-credit to poor households to help reduce their poverty situation.

  12. Clofarabine in the treatment of poor risk acute myeloid leukaemia.

    LENUS (Irish Health Repository)

    Krawczyk, Janusz

    2010-09-01

    Clofarabine is a second generation nucleoside analogue. It inhibits DNA repair and activates the mitochondrial apoptotic pathway leading to cell death. In vitro clofarabine has demonstrated synergy with daunorubicin and Ara-C and in phase II clinical trials has shown promising activity in poor risk Acute myeloid leukaemia (AML) patients. In our institution over a 24 month period 22 AML patients (11 M, 11 F) with poor risk features, deemed unsuitable for standard therapy, were treated with clofarabine, alone (eight patients) or in combination (14 patients) for up to three cycles of treatment. The median age was 67.5 years (24-76) with 16 patients > 60 years. At the time of treatment 18 patients had active AML. Four patients intolerant of standard induction received clofarabine as consolidation. The overall response rate (ORR) for the 18 patients with active AML was 61%, nine patients (50%) achieving a complete response (CR). Induction and consolidation were well tolerated with no unexpected toxicities. Predictably, all patients developed grade 4 neutropenia but the median duration was only 20 days (17-120). Induction mortality was acceptable at 17%. In conclusion, clofarabine (alone or in combination) is active in poor risk AML with an acceptable safety profile and should be considered a potential option in poor risk AML patients.

  13. Poor vision, refractive errors and barriers to treatment among ...

    African Journals Online (AJOL)

    Poor vision, refractive errors and barriers to treatment among commercial vehicle drivers in the Cape Coast municipality. ... were also administered to the participants to collect demographic data, history of driving and RTAs and utilization of eye care services as well as identification of the colours of the traffic light. Results: A ...

  14. Clinical Features and the Factors Associated with Poor Outcome of ...

    African Journals Online (AJOL)

    Clinical Features and the Factors Associated with Poor Outcome of. Measles Patients at Queen Elizabeth Central Hospital. Robin L Broadhead. Paul Courtright. Lincy Misoya. Affiliation: 1. Department of Paediatrics College of. Medicine University of Malawi. 2. International Eye FoundatiQn. 3. Department of Paediatrics ...

  15. Cystic poorly differentiated nephroblastoma: A case report and ...

    African Journals Online (AJOL)

    M.O. Odubanjo

    Abstract. Background: Cystic poorly differentiated nephroblastoma (CPDN) is a rare variant of nephroblastoma which follows a benign clinical course. Case diagnosis/treatment: In this report, we document a case of CPDN in a 2 year old boy who pre- sented with recurrent gross painless hematuria and progressive ...

  16. Brief Report: Platelet-Poor Plasma Serotonin in Autism

    Science.gov (United States)

    Anderson, George M.; Hertzig, Margaret E.; McBride, P. A.

    2012-01-01

    Possible explanations for the well-replicated platelet hyperserotonemia of autism include an alteration in the platelet's handling of serotonin (5-hydroxyserotonin, 5-HT) or an increased exposure of the platelet to 5-HT. Measurement of platelet-poor plasma (PPP) levels of 5-HT appears to provide the best available index of in vivo exposure of the…

  17. Three-dimensional models of metal-poor stars

    International Nuclear Information System (INIS)

    Collet, R

    2008-01-01

    I present here the main results of recent realistic, three-dimensional (3D), hydrodynamical simulations of convection at the surface of metal-poor red giant stars. I discuss the application of these convection simulations as time-dependent, 3D, hydrodynamical model atmospheres to spectral line formation calculations and abundance analyses. The impact of 3D models on derived elemental abundances is investigated by means of a differential comparison of the line strengths predicted in 3D under the assumption of local thermodynamic equilibrium (LTE) with the results of analogous line formation calculations performed with classical, 1D, hydrostatic model atmospheres. The low surface temperatures encountered in the upper photospheric layers of 3D model atmospheres of very metal-poor stars cause spectral lines of neutral metals and molecules to appear stronger in 3D than in 1D calculations. Hence, 3D elemental abundances derived from such lines are significantly lower than estimated by analyses with 1D models. In particular, differential 3D-1D LTE abundances for C, N and O derived from CH, NH and OH lines are found to be in the range -0.5 to - 1 dex. Large negative differential 3D-1D corrections to the Fe abundance are also computed for weak low-excitation Fe i lines. The application of metal-poor 3D models to the spectroscopic analysis of extremely iron-poor halo stars is discussed.

  18. Poor Reading Culture: A Barrier to Students' Patronage of Libraries ...

    African Journals Online (AJOL)

    The paper examined poor reading culture: A barrier to students' patronage of Selected Secondary School Libraries in Ado Ekiti Local Government Area of Ekiti State. The design for the study is descriptive survey which utilizes questionnaire to collect data. Oral interview was also conducted. Tables and simple percentages ...

  19. LH Pretreatment as a Novel Strategy for Poor Responders

    Directory of Open Access Journals (Sweden)

    Anna Pia Ferraretti

    2014-01-01

    Full Text Available Introduction. Poor response to ovarian stimulation is still a major problem in IVF. The study presents a new stimulation protocol evaluated in a suppopulation of very difficult young poor ovarian responders. Material and Methods. The study consists in two sections. The first includes data from a randomized controlled study involving forty-three young patients with a poor ovarian response in at least two previous cycles (intended as cycle cancellation or with ≤3 collected oocytes. Patients were randomized in two groups: group A (control received FSH (400 IU/day, while group B received the new stimulation protocol consisting in a sequential association of 150 IU r-LH for 4 days followed by 400 IU r-FSH/after downregulation with daily GnRh agonist. The second includes data from the overall results in 65 patients treated with the new protocol compared to their previous performance with conventional cycles (historical control. Results. Both in the RCT and in the historical control study, LH pretreatment was able to decrease the cancellation rate, to improve the in vitro performance, and to significantly increase the live birth rates. Conclusions. LH pretreatment improved oocyte quantity and quality in young repeated poor responders selected in accordance with the Bologna criteria.

  20. Poor physician performance in the Netherlands: characteristics, causes, and prevalence.

    NARCIS (Netherlands)

    Goor, M.M.P.G. van den; Wagner, C.; Lombarts, K.M.J.M.H.

    2015-01-01

    Introduction: Poor physician performance has a profound impact on patient safety and society's trust in the health care system. The attention that this topic has received in the media suggests that it is a large-scale issue. However, research about physician performance is still scant; there is

  1. Contributing factors to poor service delivery by administrative ...

    African Journals Online (AJOL)

    This article reports on a study that was conducted among non-managerial administrative employees in the public sector in Gauteng. The researchers attempted to determine the effect of specified job factors on the wellbeing and service delivery of these employees. Poor service delivery in the country triggered the research.

  2. Metformin in gestational diabetes mellitus: predictors of poor response.

    Science.gov (United States)

    Gante, Inês; Melo, Luís; Dores, Jorge; Ruas, Luísa; Almeida, Maria do Céu

    2018-01-01

    Metformin can be regarded as a first-line treatment in gestational diabetes mellitus (GDM) due to its safety and effectiveness. However, a proportion of women do not achieve adequate glycemic control with metformin alone. We aim to identify predictors of this poor response to metformin. Retrospective multicentre cohort study of women with GDM who started metformin as first-line treatment. The assessed cohort was divided into a metformin group and metformin plus insulin group. Biometric and demographic characteristics, glycemic control data, obstetric, neonatal and postpartum outcomes were compared between groups and analysed in order to identify predictors of poor response to metformin. Data were analysed using STATA, version 13.1. Of the 388 women enrolled in the study, 135 (34.8%) required additional insulin therapy to achieve the glycemic targets. Higher age (aOR: 1.08 (1.03-1.13), P  = 0.003), higher pre-pregnancy body mass index (BMI) (1.06 (1.02-1.10), P  = 0.003) and earlier introduction of metformin (0.89 (0.85-0.94), P  metformin, insulin supplementation was not associated with poor neonatal outcomes. Higher age, higher pre-pregnancy BMI and earlier introduction of metformin could be used as predictors of poor response to metformin. © 2018 European Society of Endocrinology.

  3. Poor glass-forming ability of Fe-based alloys

    DEFF Research Database (Denmark)

    Zheng, H.J.; Hu, L.N.; Zhao, X.

    2017-01-01

    processes. By using the concept of fluid cluster and supercooled liquid fragility in metallic liquids, it has been found that this dynamic transition makes the Fe-based supercooled liquids become more unstable, which leads to the poor GFA of Fe-based alloys. Further, it has been found that the degree...

  4. Hardship financing of healthcare among rural poor in Orissa, India

    NARCIS (Netherlands)

    E. Binnendijk (Erica); R. Koren (Ruth); D.M. Dror (David)

    2012-01-01

    textabstractBackground: This study examines health-related "hardship financing" in order to get better insights on how poor households finance their out-of-pocket healthcare costs. We define hardship financing as having to borrow money with interest or to sell assets to pay out-of-pocket healthcare

  5. Between less eligibility and the NHS: the changing place of poor law hospitals in England and Wales, 1929-39.

    Science.gov (United States)

    Levene, Alysa

    2009-01-01

    In 1929, the Local Government Act broke up the apparatus of the Poor Law Guardians and Unions, and transferred responsibility for the care of the poor to local councils. In theory, the period between the passing of the Act and the formation of the National Health Service witnessed a large-scale reclassification of the sick poor as patients rather than paupers. In reality, as this investigation of contemporary judgements of hospital quality and bed and staff numbers in English and Welsh county boroughs shows, the national picture was very varied at the local level. Local and sometimes regional traditions of care, finance and council priorities had a large influence on the ongoing development of a unified medical service which included the poor. In the best case scenario, hospitals were classified by patient type, and the principle of 'less eligibility' was discarded. Elsewhere, economic status continued to direct medical treatment, but in almost all cases, the chronic and elderly poor were more likely to remain in low-quality and unmodernized buildings than the acutely sick. The investigation highlights the disjuncture between the changed vision for the sick poor and its patchy enforcement on the ground.

  6. Semantic and phonological coding in poor and normal readers.

    Science.gov (United States)

    Vellutino, F R; Scanlon, D M; Spearing, D

    1995-02-01

    Three studies were conducted evaluating semantic and phonological coding deficits as alternative explanations of reading disability. In the first study, poor and normal readers in second and sixth grade were compared on various tests evaluating semantic development as well as on tests evaluating rapid naming and pseudoword decoding as independent measures of phonological coding ability. In a second study, the same subjects were given verbal memory and visual-verbal learning tasks using high and low meaning words as verbal stimuli and Chinese ideographs as visual stimuli. On the semantic tasks, poor readers performed below the level of the normal readers only at the sixth grade level, but, on the rapid naming and pseudoword learning tasks, they performed below the normal readers at the second as well as at the sixth grade level. On both the verbal memory and visual-verbal learning tasks, performance in poor readers approximated that of normal readers when the word stimuli were high in meaning but not when they were low in meaning. These patterns were essentially replicated in a third study that used some of the same semantic and phonological measures used in the first experiment, and verbal memory and visual-verbal learning tasks that employed word lists and visual stimuli (novel alphabetic characters) that more closely approximated those used in learning to read. It was concluded that semantic coding deficits are an unlikely cause of reading difficulties in most poor readers at the beginning stages of reading skills acquisition, but accrue as a consequence of prolonged reading difficulties in older readers. It was also concluded that phonological coding deficits are a probable cause of reading difficulties in most poor readers.

  7. Preoperative psychosocial risk factors for poor outcomes at 1 and 5 years after total knee replacement.

    Science.gov (United States)

    Wylde, Vikki; Trela-Larsen, Lea; Whitehouse, Michael R; Blom, Ashley W

    2017-10-01

    Background and purpose - Psychosocial factors are important risk factors for poor outcomes in the first year after total knee replacement (TKR), however their impact on long-term outcomes is unclear. We aimed to identify preoperative psychosocial risk factors for poor outcomes at 1 year and 5 years after TKR. Patients and methods - 266 patients were recruited prior to TKR surgery. Knee pain and function were assessed preoperatively and at 1 and 5 years postoperative using the WOMAC Pain score, WOMAC Function score and American Knee Society Score (AKSS) Knee score. Preoperative depression, anxiety, catastrophizing, pain self-efficacy and social support were assessed. Statistical analyses involved multiple linear regression and mixed effect linear regression. Results - Higher anxiety was a risk factor for worse pain at 1 year postoperative. No psychosocial factors were associated with any outcomes at 5 years postoperative. Analysis of change over time found that patients with higher pain self-efficacy had lower preoperative pain and experienced less improvement in pain up to 1 year postoperative. Higher pain self-efficacy was associated with less improvement in the AKSS up to 1 year postoperative but more improvement between 1 and 5 years postoperative. Interpretation - Preoperative anxiety was found to influence pain at 1 year after TKR. However, none of the psychosocial variables were risk factors for a poor outcome at 5 years post-operative, suggesting that the negative effects of anxiety on outcome do not persist in the longer-term.

  8. Poor Sleep and Its Relation to Impulsivity in Patients with Antisocial or Borderline Personality Disorders.

    Science.gov (United States)

    Van Veen, M M; Karsten, J; Lancel, M

    2017-01-01

    Studies investigating sleep and personality disorders consistently demonstrate a relation between personality disorders characterized by behavioral disinhibition and/or emotional dysregulation (traditionally termed cluster B personality disorders) and poor sleep. This finding is in line with previous studies associating insomnia with impulsive behavior, since this is a core characteristic of both antisocial and borderline personality disorder. The current study investigates a group (n = 112) of forensic psychiatric inpatients with antisocial or borderline personality disorder or traits thereof. Subjective sleep characteristics and impulsivity were assessed with the Pittsburgh Sleep Quality Index, the Sleep Diagnosis List, and the Barratt Impulsiveness Scale, respectively. More than half of the patients (53.6%) report poor sleep quality and 22.3% appears to suffer from severe chronic insomnia. Both poor sleep quality and chronic insomnia are significantly associated with self-reported impulsivity, in particular with attentional impulsiveness. This association was not significantly influenced by comorbid disorders. Actively treating sleep problems in these patients may not only improve sleep quality, mental health, and physical well-being, but may also have impact on impulsivity-related health risks by increasing self-control.

  9. Influences of working conditions on the performance of sign ...

    African Journals Online (AJOL)

    Findings showed that poor working conditions such as delay in promotion and salary payment and unattractive office accommodation have significant adverse influence on working performance of both teachers and interpreters. Teachers significantly felt the disturbing influence of poor working conditions on their job ...

  10. Factors associated with poor sleep quality in women with cancer.

    Science.gov (United States)

    Mansano-Schlosser, Thalyta Cristina; Ceolim, Maria Filomena

    2017-03-02

    to analyze the factors associated with poor sleep quality, its characteristics and components in women with breast cancer prior to surgery for removing the tumor and throughout the follow-up. longitudinal study in a teaching hospital, with a sample of 102 women. The following were used: a questionnaire for sociodemographic and clinical characterization, the Pittsburgh Sleep Quality Index; the Beck Depression Inventory; and the Herth Hope Scale. Data collection covered from prior to the surgery for removal of the tumor (T0) to T1, on average 3.2 months; T2, on average 6.1 months; and T3, on average 12.4 months. Descriptive statistics and the Generalized Estimating Equations model were used. depression and pain contributed to the increase in the score of the Pittsburgh Sleep Quality Index, and hope, to the reduction of the score - independently - throughout follow-up. Sleep disturbances were the component with the highest score throughout follow-up. the presence of depression and pain, prior to the surgery, contributed to the increase in the global score of the Pittsburgh Sleep Quality Index, which indicates worse quality of sleep throughout follow-up; greater hope, in its turn, influenced the reduction of the score of the Pittsburgh Sleep Quality Index. analizar los factores asociados a la mala calidad del sueño, sus características y componentes en mujeres con cáncer de mama, antes de la cirugía de retirada del tumor y a lo largo del seguimiento. estudio longitudinal, en hospital universitario con muestra de 102 mujeres. Fueron utilizados: un cuestionario de caracterización sociodemográfica y clínica; el Índice de Calidad del Sueño de Pittsburgh; el Inventario de Depresión de Beck; y la Escala de Esperanza de Herth. La recolección comprendió los momentos: antes de la cirugía de retirada del tumor (T0), en (T1) en promedio 3,2 meses, en (T2) en promedio 6,1 meses y en (T3) en promedio 12,4 meses. Se utilizó estadística descriptiva y el modelo de

  11. Changes in utilization of health services among poor and rural residents in Uganda: are reforms benefitting the poor?

    Science.gov (United States)

    Pariyo, George W; Ekirapa-Kiracho, Elizabeth; Okui, Olico; Rahman, Mohammed Hafizur; Peterson, Stefan; Bishai, David M; Lucas, Henry; Peters, David H

    2009-11-12

    Uganda implemented health sector reforms to make services more accessible to the population. An assessment of the likely impact of these reforms is important for informing policy. This paper describes the changes in utilization of health services that occurred among the poor and those in rural areas between 2002/3 and 2005/6 and associated factors. Secondary data analysis was done using the socio-economic component of the Uganda National Household Surveys 2002/03 and 2005/06. The poor were identified from wealth quintiles constructed using an asset based index derived from Principal Components Analysis (PCA). The probability of choice of health care provider was assessed using multinomial logistic regression and multi-level statistical models. The odds of not seeking care in 2005/6 were 1.79 times higher than in 2002/3 (OR = 1.79; 95% CI 1.65 - 1.94). The rural population experienced a 43% reduction in the risk of not seeking care because of poor geographical access (OR = 0.57; 95% CI 0.48 - 0.67). The risk of not seeking care due to high costs did not change significantly. Private for profit providers (PFP) were the major providers of services in 2002/3 and 2005/6. Using PFP as base category, respondents were more likely to have used private not for profit (PNFP) in 2005/6 than in 2002/3 (OR = 2.15; 95% CI 1.58 - 2.92), and also more likely to use public facilities in 2005/6 than 2002/3 (OR = 1.31; 95% CI 1.15 - 1.48). The most poor, females, rural residents, and those from elderly headed households were more likely to use public facilities relative to PFP. Although overall utilization of public and PNFP services by rural and poor populations had increased, PFP remained the major source of care. The odds of not seeking care due to distance decreased in rural areas but cost continued to be an important barrier to seeking health services for residents from poor, rural, and elderly headed households. Policy makers should consider targeting subsidies to the poor and

  12. Changes in utilization of health services among poor and rural residents in Uganda: are reforms benefitting the poor?

    Directory of Open Access Journals (Sweden)

    Bishai David M

    2009-11-01

    Full Text Available Abstract Background Uganda implemented health sector reforms to make services more accessible to the population. An assessment of the likely impact of these reforms is important for informing policy. This paper describes the changes in utilization of health services that occurred among the poor and those in rural areas between 2002/3 and 2005/6 and associated factors. Methods Secondary data analysis was done using the socio-economic component of the Uganda National Household Surveys 2002/03 and 2005/06. The poor were identified from wealth quintiles constructed using an asset based index derived from Principal Components Analysis (PCA. The probability of choice of health care provider was assessed using multinomial logistic regression and multi-level statistical models. Results The odds of not seeking care in 2005/6 were 1.79 times higher than in 2002/3 (OR = 1.79; 95% CI 1.65 - 1.94. The rural population experienced a 43% reduction in the risk of not seeking care because of poor geographical access (OR = 0.57; 95% CI 0.48 - 0.67. The risk of not seeking care due to high costs did not change significantly. Private for profit providers (PFP were the major providers of services in 2002/3 and 2005/6. Using PFP as base category, respondents were more likely to have used private not for profit (PNFP in 2005/6 than in 2002/3 (OR = 2.15; 95% CI 1.58 - 2.92, and also more likely to use public facilities in 2005/6 than 2002/3 (OR = 1.31; 95% CI 1.15 - 1.48. The most poor, females, rural residents, and those from elderly headed households were more likely to use public facilities relative to PFP. Conclusion Although overall utilization of public and PNFP services by rural and poor populations had increased, PFP remained the major source of care. The odds of not seeking care due to distance decreased in rural areas but cost continued to be an important barrier to seeking health services for residents from poor, rural, and elderly headed households. Policy

  13. The best and brightest metal-poor stars

    Energy Technology Data Exchange (ETDEWEB)

    Schlaufman, Kevin C.; Casey, Andrew R., E-mail: kschlauf@mit.edu, E-mail: arc@ast.cam.ac.uk [Kavli Institute for Astrophysics and Space Research, Massachusetts Institute of Technology, Cambridge, MA 02139 (United States)

    2014-12-10

    The chemical abundances of large samples of extremely metal-poor (EMP) stars can be used to investigate metal-free stellar populations, supernovae, and nucleosynthesis as well as the formation and galactic chemical evolution of the Milky Way and its progenitor halos. However, current progress on the study of EMP stars is being limited by their faint apparent magnitudes. The acquisition of high signal-to-noise spectra for faint EMP stars requires a major telescope time commitment, making the construction of large samples of EMP star abundances prohibitively expensive. We have developed a new, efficient selection that uses only public, all-sky APASS optical, 2MASS near-infrared, and WISE mid-infrared photometry to identify bright metal-poor star candidates through their lack of molecular absorption near 4.6 microns. We have used our selection to identify 11,916 metal-poor star candidates with V < 14, increasing the number of publicly available candidates by more than a factor of five in this magnitude range. Their bright apparent magnitudes have greatly eased high-resolution follow-up observations that have identified seven previously unknown stars with [Fe/H] ≲ –3.0. Our follow-up campaign has revealed that 3.8{sub −1.1}{sup +1.3}% of our candidates have [Fe/H] ≲ –3.0 and 32.5{sub −2.9}{sup +3.0}% have –3.0 ≲ [Fe/H] ≲ –2.0. The bulge is the most likely location of any existing Galactic Population III stars, and an infrared-only variant of our selection is well suited to the identification of metal-poor stars in the bulge. Indeed, two of our confirmed metal-poor stars with [Fe/H] ≲ –2.7 are within about 2 kpc of the Galactic center. They are among the most metal-poor stars known in the bulge.

  14. Is poor mental health a risk factor for retirement? Findings from a longitudinal population survey.

    Science.gov (United States)

    Olesen, Sarah C; Butterworth, Peter; Rodgers, Bryan

    2012-05-01

    Poor mental health may influence people's decisions about, and ability to, keep working into later adulthood. The identification of factors that drive retirement provides valuable information for policymakers attempting to mitigate the effects of population ageing. This study examined whether mental health predicts subsequent retirement in a general population sample, and whether this association varied with the timing of retirement. Longitudinal data from 2,803 people aged 45-75 years were drawn from five waves of the Household Income and Labour Dynamics in Australia (HILDA) survey. Discrete-time survival analyses were used to estimate the association between mental health and retirement. Mental health was measured using the Mental Health Index (MHI-5). The relative influences of other health, social, financial, and work-related predictors of retirement were considered to determine the unique contribution of mental health to retirement behaviour. Poor mental health was associated with higher rates of retirement in men (hazard rate ratio, HRR 1.19, 95% CI 1.01-1.29), and workforce exit more generally in women (HRR 1.14, 95% CI 1.07-1.22). These associations varied with the timing of retirement and were driven by early retirees specifically. Physical functioning, income, social activity, job conditions (including job stress for women and job control for men), and aspects of job satisfaction also predicted subsequent retirement. Poor mental and physical health predict workforce departure in mid-to-late adulthood, particularly early retirement. Strategies to accommodate health conditions in the workplace may reduce rates of early retirement and encourage people to remain at work into later adulthood.

  15. Domestic food preparation practices: a review of the reasons for poor home hygiene practices.

    Science.gov (United States)

    Al-Sakkaf, Ali

    2015-09-01

    New Zealand has a much higher rate of reported campylobacteriosis cases than the rest of the developed world. It has been suggested that New Zealanders have worse home hygiene practices during food preparation than the citizens of other developed countries. Thus, it is necessary to recognize and understand the reasons for consumer's poor practices in order to help develop a more effective message to improve New Zealanders' practices in the domestic environment. This could in turn lead to a reduction in the number of campylobacteriosis cases. The objective is to review cited literature on consumer practices which is related to food poisoning and to attempt to list the factors related to poor consumer practice. There are many internationally identifiable reasons for the poor practices of consumers. These reasons include psychological, demographic and socioeconomic variables; personal interest in new information; prior knowledge; cultural influence; educational background; perception of risk, control and liability; and attitude towards the addressed practices or hazards. The results have indicated that 'optimistic bias', the 'illusion of control', habits and lack of knowledge concerning food safety during domestic food preparation are prevalent among consumers. The research indicated the influence of demographic factors (age, gender, level of education, income, work hours, race, location, culture), as they play a potential role in determining domestic food safety behaviour. It appears that all these factors are applicable for New Zealand consumers and should be addressed in any future education strategy aimed at improving New Zealanders' food handling practices. © The Author (2013). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  16. Low GILT expression is associated with poor patient survival in diffuse large B-cell lymphoma

    Directory of Open Access Journals (Sweden)

    Hannah ePhipps-Yonas

    2013-12-01

    Full Text Available The MHC class II-restricted antigen processing pathway presents antigenic peptides acquired in the endocytic route for the activation of CD4+ T cells. Multiple cancers express MHC class II, which may influence the anti-tumor immune response and patient outcome. Low MHC class II expression is associated with poor survival in diffuse large B-cell lymphoma (DLBCL, the most common form of aggressive non-Hodgkin lymphoma. Therefore, we investigated whether gamma-interferon-inducible lysosomal thiol reductase (GILT, an upstream component of the MHC class II-restricted antigen processing pathway that is not regulated by the transcription factor class II transactivator, may be important in DLBCL biology. GILT reduces protein disulfide bonds in the endocytic compartment, exposing additional epitopes for MHC class II binding and facilitating antigen presentation. In each of four independent gene expression profiling cohorts with a total of 585 DLBCL patients, low GILT expression was significantly associated with poor overall survival. In contrast, low expression of a classical MHC class II gene, HLA-DRA, was associated with poor survival in one of four cohorts. The association of low GILT expression with poor survival was independent of established clinical and molecular prognostic factors, the International Prognostic Index and the cell of origin classification, respectively. Immunohistochemical analysis of GILT expression in 96 DLBCL cases demonstrated variation in GILT protein expression within tumor cells which correlated strongly with GILT mRNA expression. These studies identify a novel association between GILT expression and clinical outcome in lymphoma. Our findings underscore the role of antigen processing in DLBCL and suggest that molecules targeting this pathway warrant investigation as potential therapeutics.

  17. Intimate partner violence and poor mental health among Thai women residing in Sweden.

    Science.gov (United States)

    Fernbrant, Cecilia; Emmelin, Maria; Essén, Birgitta; Östergren, Per-Olof; Cantor-Graae, Elizabeth

    2014-01-01

    The current aim is to examine the prevalence of intimate partner violence (IPV) among Thai women residing in Sweden and its association with mental health. We also investigate the potential influence of social isolation and social capital regarding the association between IPV and mental health outcome. A public health questionnaire in Thai was distributed by post to the entire population of Thai women, aged 18-64, residing in two regions in Sweden since 2006. Items included aspects related to IPV (physical/sexual/emotional), sociodemographic background, physical health, mental health (GHQ-12), social isolation, and social capital (i.e. social trust/participation). The response rate was 62.3% (n=804). Prevalence of lifetime reported IPV was 22.1%, with 20.5% by a previous partner and 6.7% by a current partner. Previous IPV exposure was significantly related to current IPV exposure, and all IPV exposure measures were significantly related to poor mental health. However, Thai women experiencing IPV by a current partner were more at risk for poor mental health than Thai women with previous or without any experience of IPV. Also, among all women exposed to IPV, those with trust in others and without exposure to social isolation seemed to have partial protection against the adverse mental health consequences associated with IPV. Most Thai women had never been exposed to IPV, and after migrating to Sweden, women had lower IPV exposure than in Thailand. However, the increased risk for poor mental health among those Thai women exposed to IPV suggests the need for supportive measures and targeted interventions to prevent further injuries and adverse health consequences. Although poor mental health in Thai women represents an obstacle for integration, the potential resilience indicated in the group with high social trust and without exposure to social isolation suggests that such aspects be included in the program designed to facilitate integration.

  18. Poor sleep quality is associated with a negative cognitive bias and decreased sustained attention.

    Science.gov (United States)

    Gobin, Christina M; Banks, Jonathan B; Fins, Ana I; Tartar, Jaime L

    2015-10-01

    Poor sleep quality has been demonstrated to diminish cognitive performance, impair psychosocial functioning and alter the perception of stress. At present, however, there is little understanding of how sleep quality affects emotion processing. The aim of the present study was to determine the extent to which sleep quality, measured through the Pittsburg Sleep Quality Index, influences affective symptoms as well as the interaction between stress and performance on an emotional memory test and sustained attention task. To that end, 154 undergraduate students (mean age: 21.27 years, standard deviation = 4.03) completed a series of measures, including the Pittsburg Sleep Quality Index, the Sustained Attention to Response Task, an emotion picture recognition task and affective symptom questionnaires following either a control or physical stress manipulation, the cold pressor test. As sleep quality and psychosocial functioning differ among chronotypes, we also included chronotype and time of day as variables of interest to ensure that the effects of sleep quality on the emotional and non-emotional tasks were not attributed to these related factors. We found that poor sleep quality is related to greater depressive symptoms, anxiety and mood disturbances. While an overall relationship between global Pittsburg Sleep Quality Index score and emotion and attention measures was not supported, poor sleep quality, as an independent component, was associated with better memory for negative stimuli and a deficit in sustained attention to non-emotional stimuli. Importantly, these effects were not sensitive to stress, chronotype or time of day. Combined, these results suggest that individuals with poor sleep quality show an increase in affective symptomatology as well as a negative cognitive bias with a concomitant decrease in sustained attention to non-emotional stimuli. © 2015 European Sleep Research Society.

  19. Urachal tumour: case report of a poorly understood carcinoma

    Directory of Open Access Journals (Sweden)

    Vallarino Luigi

    2009-11-01

    Full Text Available Abstract Background Urachal carcinoma is an uncommon neoplasm associated with poor prognosis. Case presentation A 45-year-old man was admitted with complaints of abdominal pain and pollakisuria. A soft mass was palpable under his navel. TC-scan revealed a 11 × 6 cm tumor, which was composed of a cystic lesion arising from the urachus and a solid mass component at the urinary bladder dome. The tumor was removed surgically. Histological examination detected poor-differentiated adenocarcinoma, which had invaded the urinary bladder. The patient has been followed up without recurrence for 6 months. Conclusion The urachus is the embryological remnant of urogenital sinus and allantois. Involution usually happens before birth and urachus is present as a median umbilical ligament. The pathogenesis of urachal tumours is not fully understood. Surgery is the treatment of choice and role of adjuvant treatment is not clearly understood.

  20. Evidence for Opportunity Cost Neglect in the Poor.

    Science.gov (United States)

    Plantinga, Arnoud; Krijnen, Job M T; Zeelenberg, Marcel; Breugelmans, Seger M

    2018-01-01

    People often neglect opportunity costs: They do not fully take into account forgone alternatives outside of a particular choice set. Several scholars have suggested that poor people should be more likely to spontaneously consider opportunity costs, because budget constraints should lead to an increased focus on trade-offs. We did not find support for this hypothesis in five high-powered experiments (total N = 2325). The experiments used different products (both material and experiential) with both high and low prices (from $8.50 to $249.99) and different methods of reminding participants of opportunity costs. High-income and low-income participants showed an equally strong decrease in willingness to buy when reminded of opportunity costs, implying that both the rich and the poor neglect opportunity costs. © 2017 The Authors Journal of Behavioral Decision Making Published by John Wiley & Sons Ltd.

  1. Solubilization of poorly water-soluble drugs using solid dispersions.

    Science.gov (United States)

    Tran, Thao T-D; Tran, Phuong H-L; Khanh, Tran N; Van, Toi V; Lee, Beom-Jin

    2013-08-01

    Many new drugs have been discovered in pharmaceutical industry and exposed their surprised potential therapeutic effects. Unfortunately, these drugs possess low absorption and bioavailability since their solubility limitation in water. Solid dispersion (SD) is the current technique gaining so many attractions from scientists due to its effect on improving solubility and dissolution rate of poorly water-soluble drugs. A number of patents including the most recent inventions have been undertaken in this review to address various respects of this strategy in solubilization of poorly watersoluble drugs including type of carriers, preparation methods and view of technologies used to detect SD properties and mechanisms with the aim to accomplish a SD not only effective on enhanced bioavailability but also overcome difficulties associated with stability and production. Future prospects are as well discussed with an only hope that many developments and researches in this field will be successfully reached and contributed to commercial use for treatment as much as possible.

  2. Clinical management of poor adherence to CPAP: motivational enhancement.

    Science.gov (United States)

    Aloia, Mark S; Arnedt, J Todd; Riggs, Raine L; Hecht, Jacki; Borrelli, Belinda

    2004-01-01

    Adherence to continuous positive airway pressure (CPAP) in patients with sleep apnea hypopnea syndrome (SAHS) is poor. Previous studies have attempted to identify specific barriers to treatment, but none has identified the sole cause for the problem. We outline a behavioral approach to the problem of CPAP adherence that is based on the theories of the transtheoretical model and social cognitive theory. We used these theories to guide the development of an intervention based on the methods of motivational interviewing. We present our motivational enhancement therapy for CPAP (ME-CPAP) here, with some brief pilot data to show its efficacy. Finally, we outline some strengths and weaknesses of taking a behavior change approach to the problem of poor CPAP adherence.

  3. Delineation of geological facies from poorly differentiated data

    Energy Technology Data Exchange (ETDEWEB)

    Wohlberg, Brendt [Los Alamos National Laboratory; Tartakovsky, Daniel [UCSC

    2008-01-01

    The ability to delineate geologic facies and to estima.te their properties from sparse data is essential for modeling physical and biochemical processes occurring in the 'ubsurface. If such data are poorly differentiated, this challcnrring task is complicated further by the absence of a clear distinction between different hydrofacies even at locations where data. are available. vVe consider three alt mative approaches for analysis of poorly differentiated data: a k-means clU!:iterinrr algorithm, an expectation-maximization algorithm, and a minimum-variance algorithm. Two distinct synthetically generated geological settings are used to r:tnalyze the ability of these algorithmti to as ign accurately the membership of such data in a given geologic facies. On average, the minimum-variance algorithm provides a more robust p rformance than its two counterparts and when combined with a nearest-neighbor algorithm, it also yields the most accurate reconstruction of the boundaries between the facies.

  4. Seeking a preferential option for the rural poor in Chile

    Directory of Open Access Journals (Sweden)

    Edward Dew

    2006-01-01

    Full Text Available From colonial times well into the twentieth century (and, unfortunately, even beyond the man/land relationship in Latin America has been markedly unjust. Small numbers of families have owned large tracts of the best land, while large numbers of poor families have struggled with tiny plots of marginal land or labored on the estates of the rich. Chile was no exception to this pattern. Thus, its experiment with land reform in the 1960s and 1970s, the setback of reform under the military in the 1970s and 1980s, and the resumption of reform under democrats in the 1990s, may provide lessons for the rest of Latin America. Is a preferential option for the rural poor still possible in a neoliberal economic system? In Chile, the answer is a qualified “yes”

  5. Challenges in managing postpartum hemorrhage in resource-poor countries.

    Science.gov (United States)

    Karoshi, Mahantesh; Keith, Louis

    2009-06-01

    Managing postpartum hemorrhage depends in part on having a prepared mind, a complement of trained coworkers, and full access to modern therapies. The last 2 components are rare in resource-poor areas and their absence may be accentuated by climatic instability and lack of basic transportation. Greater use of the active management of third stage of labor and administration of misoprostol by nontrained birth attendants will provide beneficial reductions in hemorrhage rates in resource-poor areas. Additional improvements depend on increasing public awareness, facilitating existing nongovernmental organizations in their community-related, upgrading training of traditional birth attendants, and providing cell phone communication to workers in remote areas, in addition to providing better access to blood.

  6. On social inequality: Analyzing the rich-poor disparity

    Science.gov (United States)

    Eliazar, Iddo; Cohen, Morrel H.

    2014-05-01

    From the Old Testament to the Communist Manifesto, and from the French Revolution to the Occupy Wall Street protests, social inequality has always been at the focal point of public debate, as well as a major driver of political change. Although being of prime interest since Biblical times, the scientific investigation of the distributions of wealth and income in human societies began only at the close of the nineteenth century, and was pioneered by Pareto, Lorenz, Gini, and Pietra. The methodologies introduced by these trailblazing scholars form the bedrock of the contemporary science of social inequality. Based on this bedrock we present a new quantitative approach to the analysis of wealth and income distributions, which sets its spotlight on the most heated facet of the current global debate on social inequality-the rich-poor disparity. Our approach offers researchers highly applicable quantitative tools to empirically track and statistically analyze the growing gap between the rich and the poor.

  7. Health indicators associated with poor sleep quality among university students

    Directory of Open Access Journals (Sweden)

    Márcio Flávio Moura de Araújo

    Full Text Available Objective To associate the sleep quality of Brazilian undergraduate students with health indicators. Method A cross-sectional study was developed with a random sample of 662 undergraduate students from Fortaleza, Brazil. The demographic data, Pittsburgh Sleep Quality Index and health data indicators (smoking, alcoholism, sedentary lifestyle, nutritional condition and serum cholesterol were collected through a self-administered questionnaire. Blood was collected at a clinical laboratory. In order to estimate the size of the associations, a Poisson Regression was used. Results For students who are daily smokers, the occurrence of poor sleep was higher than in non-smokers (p<0.001. Prevalence rate values were nevertheless close to 1. Conclusion The likelihood of poor sleep is almost the same in smokers and in alcoholics.

  8. POOR TEXTURAL IMAGE MATCHING BASED ON GRAPH THEORY

    Directory of Open Access Journals (Sweden)

    S. Chen

    2016-06-01

    Full Text Available Image matching lies at the heart of photogrammetry and computer vision. For poor textural images, the matching result is affected by low contrast, repetitive patterns, discontinuity or occlusion, few or homogeneous textures. Recently, graph matching became popular for its integration of geometric and radiometric information. Focused on poor textural image matching problem, it is proposed an edge-weight strategy to improve graph matching algorithm. A series of experiments have been conducted including 4 typical landscapes: Forest, desert, farmland, and urban areas. And it is experimentally found that our new algorithm achieves better performance. Compared to SIFT, doubled corresponding points were acquired, and the overall recall rate reached up to 68%, which verifies the feasibility and effectiveness of the algorithm.

  9. Formulation of poorly water-soluble Gemfibrozil applying power ultrasound.

    Science.gov (United States)

    Ambrus, R; Naghipour Amirzadi, N; Aigner, Z; Szabó-Révész, P

    2012-03-01

    The dissolution properties of a drug and its release from the dosage form have a basic impact on its bioavailability. Solubility problems are a major challenge for the pharmaceutical industry as concerns the development of new pharmaceutical products. Formulation problems may possibly be overcome by modification of particle size and morphology. The application of power ultrasound is a novel possibility in drug formulation. This article reports on solvent diffusion and melt emulsification, as new methods supplemented with drying in the field of sonocrystallization of poorly water-soluble Gemfibrozil. During thermoanalytical characterization, a modified structure was detected. The specific surface area of the drug was increased following particle size reduction and the poor wettability properties could also be improved. The dissolution rate was therefore significantly increased. Copyright © 2011 Elsevier B.V. All rights reserved.

  10. Beyond "banking for the poor": credit mechanisms and women's empowerment.

    Science.gov (United States)

    Albee, A

    1996-10-01

    This article describes some strengths and limitations of credit programs for women in developing countries. It is urged that development planners recognize the importance of the selection of the type of credit mechanism in the long term. Ethical issues should be decided upon before the credit mechanism is operable. Organizations should make clear what level of commitment there is to empower borrowers. Most organizations give loans to women and assume empowerment will take place without devising strategies to ensure empowerment. Credit mechanisms include credit for the poor and credit by the poor. A sound financial portfolio and 100% repayment are not the appropriate criteria for securing the empowerment of women. Empowerment of women is related to "building the capacity of borrowers to manage and control decision making." UNICEF's framework of gender equality and women's empowerment identifies levels of empowerment as "welfare, access, conscientisation, participation, and control." Development planners should be aware that provision of credit also has the potential to increase a poor family's debt. Delinquency may be hidden by overlapping loans that trap borrowers. Fewer installment payments increase the chances of a debt trap. Reducing the number of installments may reduce administrative costs and conform to production processes, but may also lead to a debt trap. There is now considerable emphasis on investing in low-income women entrepreneurs as a highly efficient means of achieving social and economic objectives. Credit programs aim to support the growth of small, self-sustaining businesses, to improve women's opportunities, and to provide alternatives to exploitation by local money-lenders. This article describes the following credit mechanisms: bank guarantee systems, government credit schemes, intermediary projects, direct lending projects, banks for the poor, credit unions, and village-based banks.

  11. GE PETtrace RF power failures related to poor power quality

    OpenAIRE

    Bender, B. R.; Erdahl, C. E.; Dick, D. W.

    2015-01-01

    Introduction Anyone who has ever overseen the installation of a new cyclotron is aware of the importance of addressing the numerous vendor-supplied site specifications prior to its arrival. If the site is not adequately prepared, the facility may face project cost overruns, poor cyclotron performance and unintended maintenance costs. Once a facility has identified the space, providing sufficient power is the next step. Every cyclotron vendor will provide you with a set of power specificati...

  12. Stellar Archaeology -- Exploring the Universe with Metal-Poor Stars

    OpenAIRE

    Frebel, Anna

    2010-01-01

    The abundance patterns of the most metal-poor stars in the Galactic halo and small dwarf galaxies provide us with a wealth of information about the early Universe. In particular, these old survivors allow us to study the nature of the first stars and supernovae, the relevant nucleosynthesis processes responsible for the formation and evolution of the elements, early star- and galaxy formation processes, as well as the assembly process of the stellar halo from dwarf galaxies a long time ago. T...

  13. Globalization of food and agriculture and the poor:

    OpenAIRE

    von Braun, Joachim; Díaz-Bonilla, Eugenio

    2008-01-01

    The economic impact of globalization, particularly on poverty, and the changes in agri-food markets have received much attention in recent years. However, the intersection of these two trends has been neglected. The present volume fills this gap by focusing on the way globalization of agri-food systems affects the world's poor and its impact on food and nutrition security in developing countries. Rather than offering a single policy prescription or simplistic messages about globalization bein...

  14. Novel liquid application systems for poorly soluble drugs

    OpenAIRE

    Luschmann, Christoph Roman

    2015-01-01

    This thesis was focused on the development of efficient novel liquid formulations for poorly water soluble drugs for the treatment of inflammatory ophthalmic diseases. With Restasis® there is currently only one drug product approved by the FDA, in the US only, for the treatment of dry eye syndrome. It still suffers from low bioavailability, bad biocompatibility and thus a low patient compliance, as well as cumbersome manufacturing. Hence, there is a tremendous lack in the options for a causal...

  15. EDUCATION AND FAMILY INCOME: CAN POOR CHILDREN SIGNAL THEIR TALENT?

    OpenAIRE

    Gonzalo Olcina Vauteren; Luisa Escriche

    2006-01-01

    The aim of this paper is to explain how financial constraints and family background characteristics affect the signalling educational investments of individuals born in low-income families. We show that talented students who are poor are unable to signal their talent, as the maximum level of education they can attain may also be achieved by less talented students who are rich. Under this approach, a de-crease in inequalities across generations cannot be expected. The paper also shows that an ...

  16. Issues of poor rural self-employed women.

    Science.gov (United States)

    Jumani, U

    1994-01-01

    Most Indian women are low income and self-employed, but women's studies have not focused on this large population. In order to fill in the gap in the literature on women's employment in India, a study was conducted in 1985 among 800 women from 5 "talukas" in Ahmedabad district. This article describes the common social and economic issues faced by poor, rural, self-employed women. Most of the sample belong to lower caste groups. The caste system contributed largely to their poverty, exploitation, and lack of access to facilities. The Harijans are treated the worst and many villages consider them untouchables. The Vaghris and the Dehgam are considered low caste but not untouchables. These groups are not treated much better than the Harijans. Relations between various castes are often strained. In many villages access to information about government programs is controlled by the Sarpanch and Talati and denied to the lower castes. Women's division of labor is determined by caste. The response to the demands of survival among low-income women is to adopt a "contingency" approach to life. These women are mobile, travel with few belongings, and seek shelter anywhere. Children are not sent to school. Many are untrained even in a caste-based occupation. The poor are generally landless and without assets. Work skills are acquired from family or neighbors. Women and poor people lack access to loans and lack awareness of detailed procedures. Cash payment does not usually go to women. Women work in caste-based occupations in addition to two or three seasonal agricultural labor jobs. Development programs do not address the current situation of the poor.

  17. Fundamental aspects of solid dispersion technology for poorly soluble drugs

    Directory of Open Access Journals (Sweden)

    Yanbin Huang

    2014-02-01

    Full Text Available The solid dispersion has become an established solubilization technology for poorly water soluble drugs. Since a solid dispersion is basically a drug–polymer two-component system, the drug–polymer interaction is the determining factor in its design and performance. In this review, we summarize our current understanding of solid dispersions both in the solid state and in dissolution, emphasizing the fundamental aspects of this important technology.

  18. Diffusion of novel healthcare technologies to resource poor settings.

    Science.gov (United States)

    Malkin, Robert; von Oldenburg Beer, Kim

    2013-09-01

    A new product has completed clinical trials in a distant, resource poor hospital using a few dozen prototypes. The data looks great. The novel medical device solves a widely felt problem. The next goal is to integrate the device into the country's healthcare system and spread the device to other countries. But how? In order to be widely used, the device must be manufactured and distributed. One option is to license the intellectual property (IP) to an interested third party, if one can be found. However, it is possible to manage the manufacturing and distribution without licensing. There are at least two common means for manufacturing a novel medical device targeted to resource poor settings: (a) formal (contract) manufacturing and (b) informal (local) manufacturing. There are three primary routes to diffusion of novel medical devices in the developing world: (1) local distributors (2) direct international sales and (3) international donations. Perhaps surprisingly, the least effective mechanism is direct importation through donation. The most successful mechanism, the method used by nearly all working medical devices in resource-poor settings, is the use of contract manufacturing and a local distributor. This article is written for the biomedical innovator and entrepreneur who wishes to make a novel healthcare technology or product available and accessible to healthcare providers and patients in the developing world. There are very few documented cases and little formal research in this area. To this end, this article describes and explores the manufacturing and distribution options in order to provide insights into when and how each can be applied to scale up a novel technology to make a difference in a resource poor setting.

  19. Fiscal policy, inequality, and the poor in the developing world

    OpenAIRE

    Lustig, Nora

    2016-01-01

    Using comparable fiscal incidence analysis, this paper examines the impact of fiscal policy on inequality and poverty in 25 countries for around 2010. Success in fiscal redistribution is driven primarily by redistributive effort (share of social spending to GDP in each country) and the extent to which transfers/subsidies are targeted at the poor and direct taxes targeted at the rich. While fiscal policy always reduces inequality, this is not the case with poverty. Fiscal policy increases pove...

  20. Poorly Controlled Homocystinuria: A Rare Cause of Ischemic Priapism?

    OpenAIRE

    Mark Johnson, BSc, MBChB; Elaine Murphy, MRCP, FRCPath; Amr Raheem, MB BCh, PhD; David Ralph, BSc, MS FRCS(Urol)

    2018-01-01

    We report on the 1st case of ischemic priapism secondary to poorly controlled homocystinuria. Homocystinuria is a rare, autosomal recessive, inherited disorder of metabolism that is caused by a deficiency of cystathionine synthase, leading to marked hyperhomocysteinemia. Arterial and/or venous thromboemboli are a major cause of mortality and morbidity in patients with homocystinuria. Untreated patients have a 50% chance of having a vascular event by 30 years of age. Increased homocysteine lev...

  1. Poor Oral Hygiene and Middle Ear Infections: Any Relationship?

    OpenAIRE

    Esra, Eryaman; Banu, Oter Ilhan; Erdinc, Aydin

    2013-01-01

    The purpose of this study is to evaluate the relationship between poor oral hygiene and middle ear infections. 59 children between 3–12 age intervals were included in this study. The ears were examined by microscope. The findings were marked according to Kempthorne clinical scale and tympanograms were performed. For data analysis of dental caries, dft and DMFT indexes were used in accordance with WHO (World Health Organization) criteria for oral health surveys. The oral hygiene status was det...

  2. Metering: EU policy and implications for fuel poor households

    International Nuclear Information System (INIS)

    Darby, Sarah J.

    2012-01-01

    Fuel poverty is a function of household energy consumption, income, and the cost of delivered energy. The paper discusses ways in which current EU policy on the development of ‘smart’ metering could affect fuel poor households. The main focus is on developments in electricity metering and the development of ‘active demand’ and smart grids, so that demand can be matched closely with available supply. Advances in metering and related technologies open the way to time-of-use charging, easier switching between suppliers and between credit payment and prepayment, direct load control of some end-uses by the utility, greater scope for microgeneration, and improved consumption feedback for customers. These options open up both uncertainties and risks. The paper offers definitions and discussion of various functions of smart metering, summarizes the EU policy background, and considers some possible equity implications of rolling out a new generation of meters. There follows an assessment of potential implications to the fuel poor of changes to metering, based on a review of the literature on energy feedback, tariffing, and supplier–customer relationships. Much of the discussion is based on the UK experience, with examples from other EU member states and, where appropriate, from other parts of the world. - Highlights: ► Smart meters are part of general upgrading of electricity and gas networks. ► EU policy is to roll out the meters to 80%+ of the population by 2020. ► Improved feedback and prepayment metering may benefit the fuel poor. ► Remote disconnection and data privacy are issues for all consumers. ► We need careful assessment of potential gains and losses to the fuel poor.

  3. Understanding Preclerkship Medical Students' Poor Performance in Prescription Writing.

    Science.gov (United States)

    James, Henry; Al Khaja, Khalid A J; Tayem, Yasin I; Veeramuthu, Sindhan; Sequeira, Reginald P

    2016-05-01

    This study aimed to explore reasons for poor performance in prescription writing stations of the objective structured practical examination (OSPE) and absenteeism in prescription writing sessions among preclerkship medical students at the Arabian Gulf University (AGU) in Manama, Bahrain. This descriptive study was carried out between September 2014 and June 2015 among 157 preclerkship medical students at AGU. Data were collected using focus group discussions and a questionnaire with closed- and open-ended items. All 157 students participated in the study (response rate: 100.0%). The most frequently cited reasons for poor performance in OSPE stations were an inability to select the correct drugs (79.6%), treatment duration (69.4%), drug quantity (69.4%) and drug formulation (68.2%). Additionally, students reported inadequate time for completing the stations (68.8%). During focus group discussions, students reported other reasons for poor performance, including examination stress and the difficulty of the stations. Absenteeism was attributed to the length of each session (55.4%), lack of interest (50.3%), reliance on peers for information (48.4%) and optional attendance policies (47.1%). Repetitive material, large group sessions, unmet student expectations and the proximity of the sessions to summative examinations were also indicated to contribute to absenteeism according to open-ended responses or focus group discussions. This study suggests that AGU medical students perform poorly in prescription writing OSPE stations because of inadequate clinical pharmacology knowledge. Participation in prescription writing sessions needs to be enhanced by addressing the concerns identified in this study. Strategies to improve attendance and performance should take into account the learner-teacher relationship.

  4. Three-dimensional models of metal-poor stars

    OpenAIRE

    Collet, R.

    2008-01-01

    I present here the main results of recent realistic, 3D, hydrodynamical simulations of convection at the surface of metal-poor red giant stars. I discuss the application of these convection simulations as time-dependent, 3D, hydrodynamical model atmospheres to spectral line formation calculations and abundance analyses. The impact of 3D models on derived elemental abundances is investigated by means of a differential comparison of the line strengths predicted in 3D under the assumption of loc...

  5. Indoor air quality for poor families: new evidence from Bangladesh

    OpenAIRE

    Dasgupta, Susmita; Huq, Mainul; Khaliquzzaman, M.; Pandey, Kiran; Wheeler, David

    2004-01-01

    Indoor air pollution (IAP) from cooking and heating is estimated to kill a million children annually in developing countries. To promote a better understanding of IAP, the authors investigate the determinants of IAP in Bangladesh using the latest air monitoring technology and a national household survey. The study concludes that IAP is dangerously high for many poor families in Bangladesh. Concentrations of respirable airborne particulates(PM10) 300 ug/m3 or greater are common in the sample, ...

  6. Understanding Preclerkship Medical Students’ Poor Performance in Prescription Writing

    Directory of Open Access Journals (Sweden)

    Henry James

    2016-05-01

    Full Text Available Objectives: This study aimed to explore reasons for poor performance in prescription writing stations of the objective structured practical examination (OSPE and absenteeism in prescription writing sessions among preclerkship medical students at the Arabian Gulf University (AGU in Manama, Bahrain. Methods: This descriptive study was carried out between September 2014 and June 2015 among 157 preclerkship medical students at AGU. Data were collected using focus group discussions and a questionnaire with closed- and open-ended items. Results: All 157 students participated in the study (response rate: 100.0%. The most frequently cited reasons for poor performance in OSPE stations were an inability to select the correct drugs (79.6%, treatment duration (69.4%, drug quantity (69.4% and drug formulation (68.2%. Additionally, students reported inadequate time for completing the stations (68.8%. During focus group discussions, students reported other reasons for poor performance, including examination stress and the difficulty of the stations. Absenteeism was attributed to the length of each session (55.4%, lack of interest (50.3%, reliance on peers for information (48.4% and optional attendance policies (47.1%. Repetitive material, large group sessions, unmet student expectations and the proximity of the sessions to summative examinations were also indicated to contribute to absenteeism according to open-ended responses or focus group discussions. Conclusion: This study suggests that AGU medical students perform poorly in prescription writing OSPE stations because of inadequate clinical pharmacology knowledge. Participation in prescription writing sessions needs to be enhanced by addressing the concerns identified in this study. Strategies to improve attendance and performance should take into account the learner-teacher relationship.

  7. Public funding of abortions and abortion counseling for poor women.

    Science.gov (United States)

    Edwards, R B

    1997-01-01

    This essay seeks to reveal the weakness in arguments against public funding of abortions and abortion counseling in the US based on economic, ethico-religious, anti-racist, and logical-consistency objections and to show that public funding of abortion is strongly supported by appeals to basic human rights, to freedom of speech, to informed consent, to protection from great harm, to justice, and to equal protection under the law. The first part of the article presents the case against public funding with detailed considerations of the economic argument, the ethico/religious argument, the argument that such funding supports racist genocide or eugenic quality control, and arguments that a logical inconsistency exists between the principles used to justify the legalization of abortions and arguments for public funding. The second part of the article presents the case for public funding by discussing the spending of public funds on morally offensive programs, arguments for public funding of abortion counseling for the poor, and arguments for public funding of abortions for the poor. It is concluded that it is morally unacceptable and rationally unjustifiable to refuse to expend public funds for abortions for low income women, because after all most money for legal abortions for the poor comes from welfare payments made to women. If conservative forces want to insure that no public funds pay for abortions, they must stop all welfare payments to pregnant women.

  8. Dendritic brushes under theta and poor solvent conditions

    Science.gov (United States)

    Gergidis, Leonidas N.; Kalogirou, Andreas; Charalambopoulos, Antonios; Vlahos, Costas

    2013-07-01

    The effects of solvent quality on the internal stratification of polymer brushes formed by dendron polymers up to third generation were studied by means of molecular dynamics simulations with Langevin thermostat. The distributions of polymer units, of the free ends, the radii of gyration, and the back folding probabilities of the dendritic spacers were studied at the macroscopic states of theta and poor solvent. For high grafting densities we observed a small decrease in the height of the brush as the solvent quality decreases. The internal stratification in theta solvent was similar to the one we found in good solvent, with two and in some cases three kinds of populations containing short dendrons with weakly extended spacers, intermediate-height dendrons, and tall dendrons with highly stretched spacers. The differences increase as the grafting density decreases and single dendron populations were evident in theta and poor solvent. In poor solvent at low grafting densities, solvent micelles, polymeric pinned lamellae, spherical and single chain collapsed micelles were observed. The scaling dependence of the height of the dendritic brush at high density brushes for both solvents was found to be in agreement with existing analytical results.

  9. The sorption of silver by poorly crystallized manganese oxides

    Science.gov (United States)

    Anderson, B.J.; Jenne, E.A.; Chao, T.T.

    1973-01-01

    The sorption of silver by poorly crystallized manganese oxides was studied using synthesized samples of three members of the manganous manganite (birnessite) group, of different chemical composition and crystallinity, and a poorly organized ??-MnO2. All four oxides sorbed significant quantities of silver. The manganous manganites showed the greatest sorption (up to 0.5 moles silver/mole MnOx at pH 7) while the ??-MnO2 showed the least (0.3 moles silver/ mole MnOx at pH 7). Sorption of silver was adequately described by the Langmuir equation over a considerable concentration range. The relationship failed at low pH values and high equilibrium silver concentrations. The sorption capacity showed a direct relationship with pH. However, the rate of increase of sorption capacity decreased at the higher pH values. Silver sorption maxima. were not directly related to surface area but appeared to vary with the amount of occluded sodium and potassium present in the manganese oxide. The important processes involved in the uptake of silver by the four poorly crystallized manganese oxides ara considered to be surface exchange for manganese, potassium and sodium as well as exchange for structural manganese, potassium and sodium. ?? 1973.

  10. Residential Electrostatic Precipitator - Performance at efficient and poor combustion conditions

    Energy Technology Data Exchange (ETDEWEB)

    Baefver, Linda; Yngvesson, Johan; Niklasson, Fredrik

    2012-07-01

    The performance of a pilot residential electrostatic precipitator R{sub E}SP (Applied Plasma Physics AS), was investigated at laboratory. Measurements of TSP (Total Suspended Particles), content of organic and elemental carbon, and mass size distribution of particles upstream and downstream of ESP were performed. Values for PM1 (particles < 1 {mu}m) were calculated from the particle size distributions. Concentrations and size distributions with respect to particle numbers were measured in separate tests. Gas concentrations, temperatures and boiler parameters were also measured. The TSP concentrations upstream of the R{sub E}SP were varied in range of 15-390 mg/m{sub N}{sup 3}. Up to concentrations of about 300 mg/m{sub N}{sup 3}, the TSP-concentrations out from the ESP were less than 20 mg/m{sub N}{sup 3}, which is well below the German emission limit for wood stoves. The removal efficiencies with respect to mass were about 87% at efficient combustion and 93% at poor combustion. Corresponding values with respect to number concentrations were about 97% at efficient combustion and almost 99% at poor combustion. The better performance at poor combustion may be explained by lower flue gas temperature, leading to longer residence time in the ESP. High removal efficiencies were also found with respect to particulate organic and elemental carbon.

  11. A tiered analytical approach for investigating poor quality emergency contraceptives.

    Directory of Open Access Journals (Sweden)

    María Eugenia Monge

    Full Text Available Reproductive health has been deleteriously affected by poor quality medicines. Emergency contraceptive pills (ECPs are an important birth control method that women can use after unprotected coitus for reducing the risk of pregnancy. In response to the detection of poor quality ECPs commercially available in the Peruvian market we developed a tiered multi-platform analytical strategy. In a survey to assess ECP medicine quality in Peru, 7 out of 25 different batches showed inadequate release of levonorgestrel by dissolution testing or improper amounts of active ingredient. One batch was found to contain a wrong active ingredient, with no detectable levonorgestrel. By combining ultrahigh performance liquid chromatography-ion mobility spectrometry-mass spectrometry (UHPLC-IMS-MS and direct analysis in real time MS (DART-MS the unknown compound was identified as the antibiotic sulfamethoxazole. Quantitation by UHPLC-triple quadrupole tandem MS (QqQ-MS/MS indicated that the wrong ingredient was present in the ECP sample at levels which could have significant physiological effects. Further chemical characterization of the poor quality ECP samples included the identification of the excipients by 2D Diffusion-Ordered Nuclear Magnetic Resonance Spectroscopy (DOSY 1H NMR indicating the presence of lactose and magnesium stearate.

  12. Oxygen and iron abundances in two metal-poor dwarfs

    Science.gov (United States)

    Spiesman, William J.; Wallerstein, George

    1991-11-01

    Oxygen abundances from the O I line at 6300 A in two metal-poor K dwarfs, HD 25329 and HD 134440, are derived. The spectra were obtained with the KPNO 4-m echelle spectrograph and long camera, yielding a resolution of 32,000 and an S/N of about 125. Model atmospheres with Te of 4770 were appropriate to both stars, whose metallicities were found to be -1.74 and -1.43 for HD 25329 and HD 134440, respectively. These oxygen abundances are 0.3 and 0.4 for the two stars. From the resolution an S/N a 3(sigma) upper limit of 0.8 is derived for each star, which may be combined into an upper limit of O/Fe of 0.6 for a generic K dwarf with Fe/H of 1.6. These values are more in line with O/Fe as seen in similarly metal-poor red giant than those reported in metal-poor subdwarfs by Abia and Rebolo (1989).

  13. Poorly Differentiated Squamous Cell Carcinoma Arising in Tattooed Skin

    Science.gov (United States)

    Sarma, Deba P.; Dentlinger, Renee B.; Forystek, Amanda M.; Stevens, Todd; Huerter, Christopher

    2010-01-01

    Introduction. Tattoos have increasingly become accepted by mainstream Western society. As a result, the incidence of tattoo-associated dermatoses is on the rise. The presence of a poorly differentiated squamous cell carcinoma in an old tattooed skin is of interest as it has not been previously documented. Case Presentation. A 79-year-old white homeless man of European descent presented to the dermatology clinic with a painless raised nodule on his left forearm arising in a tattooed area. A biopsy of the lesion revealed a poorly differentiated squamous cell carcinoma infiltrating into a tattoo. The lesion was completely excised and the patient remains disease-free one year later. Conclusion. All previous reports of squamous cell carcinomas arising in tattoos have been well-differentiated low-grade type or keratoacanthoma-type and are considered to be coincidental rather than related to any carcinogenic effect of the tattoo pigments. Tattoo-associated poorly differentiated invasive carcinoma appears to be extremely rare. PMID:21274289

  14. Poorly Differentiated Squamous Cell Carcinoma Arising in Tattooed Skin

    Directory of Open Access Journals (Sweden)

    Deba P. Sarma

    2010-01-01

    Full Text Available Introduction. Tattoos have increasingly become accepted by mainstream Western society. As a result, the incidence of tattoo-associated dermatoses is on the rise. The presence of a poorly differentiated squamous cell carcinoma in an old tattooed skin is of interest as it has not been previously documented. Case Presentation. A 79-year-old white homeless man of European descent presented to the dermatology clinic with a painless raised nodule on his left forearm arising in a tattooed area. A biopsy of the lesion revealed a poorly differentiated squamous cell carcinoma infiltrating into a tattoo. The lesion was completely excised and the patient remains disease-free one year later. Conclusion. All previous reports of squamous cell carcinomas arising in tattoos have been well-differentiated low-grade type or keratoacanthoma-type and are considered to be coincidental rather than related to any carcinogenic effect of the tattoo pigments. Tattoo-associated poorly differentiated invasive carcinoma appears to be extremely rare.

  15. Paediatric Palliative Care in Resource-Poor Countries

    Directory of Open Access Journals (Sweden)

    Julia Downing

    2018-02-01

    Full Text Available There is a great need for paediatric palliative care (PPC services globally, but access to services is lacking in many parts of the world, particularly in resource-poor settings. Globally it is estimated that 21.6 million children need access to palliative care, with 8.2 needing specialist services. PC has been identified as important within the global health agenda e.g., within universal health coverage, and a recent Lancet commission report recognised the need for PPC. However, a variety of challenges have been identified to PPC development globally such as: access to treatment, access to medications such as oral morphine, opiophobia, a lack of trained health and social care professionals, a lack of PPC policies and a lack of awareness about PPC. These challenges can be overcome utilising a variety of strategies including advocacy and public awareness, education, access to medications, implementation and research. Examples will be discussed impacting on the provision of PPC in resource-poor settings. High-quality PPC service provision can be provided with resource-poor settings, and there is an urgent need to scale up affordable, accessible, and quality PPC services globally to ensure that all children needing palliative care can access it.

  16. A study of poor insight in social anxiety disorder.

    Science.gov (United States)

    Vigne, Paula; de Menezes, Gabriela B; Harrison, Ben J; Fontenelle, Leonardo F

    2014-11-30

    We investigated levels of insight among patients with Social Anxiety Disorder (SAD) as compared to patients with Obsessive-Compulsive Disorder (OCD) and evaluated whether levels of insight in SAD were related to specific sociodemographic and/or clinical features. Thirty-seven SAD patients and 51 OCD patients attending a tertiary obsessive-compulsive and anxiety disorders clinic were assessed with a sociodemographic and clinical questionnaire, a structured diagnostic interview, the Brown Assessment of Beliefs Scale (BABS), the Social Phobia Inventory (SPIN), the Beck Depression Inventory (BDI), the Sheehan Disability Scale (SDS), and the Treatment Adherence Survey-patient version (TAS-P). According to the BABS, SAD patients exhibited insight levels that were as low as those exhibited by OCD patients, with up to 29.7% of them being described as "poor insight" SAD. Although poor insight SAD patients were more frequently married, less depressed and displayed a statistical trend towards greater rates of early drop-out from cognitive-behavioral therapy, their insight levels were not associated with other variables of interest, including sex, age, employment, age at onset, duration of illness, associated psychiatric disorders, SPIN and SDS scores. Patients with poor insight SAD might perceive their symptoms as being less distressful and thus report fewer depressive symptoms and high rates of treatment non-adherence. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  17. Achieving the same for less: improving mood depletes blood glucose for people with poor (but not good) emotion control.

    Science.gov (United States)

    Niven, Karen; Totterdell, Peter; Miles, Eleanor; Webb, Thomas L; Sheeran, Paschal

    2013-01-01

    Previous studies have found that acts of self-control like emotion regulation deplete blood glucose levels. The present experiment investigated the hypothesis that the extent to which people's blood glucose levels decline during emotion regulation attempts is influenced by whether they believe themselves to be good or poor at emotion control. We found that although good and poor emotion regulators were equally able to achieve positive and negative moods, the blood glucose of poor emotion regulators was reduced after performing an affect-improving task, whereas the blood glucose of good emotion regulators remained unchanged. As evidence suggests that glucose is a limited energy resource upon which self-control relies, the implication is that good emotion regulators are able to achieve the same positive mood with less cost to their self-regulatory resource. Thus, depletion may not be an inevitable consequence of engaging in emotion regulation.

  18. Anti-osteoporotic therapy in Denmark-predictors and demographics of poor refill compliance and poor persistence

    DEFF Research Database (Denmark)

    Hansen, C; Pedersen, Birthe D.; Konradsen, H

    2013-01-01

    In this study of 100,949 new users of oral bisphosphonates age ≥35 years, "early quitters" were found to differ from others with poor refill compliance in terms of socioeconomic, demographic, and treatment-related characteristics. New risk factors for poor compliance and persistence were identified...... quitters" were associated with high household income, subjects' age 71.9-79 years, living in the countryside or village, prior treatment with analgesics and anti-parkinson drugs, and dementia. Differences concerning decreased risk of "early quitters" were associated with male, living in an apartment......, children living at home, living close to a university hospital, anti-osteoporotic therapy other than alendronate, number of drugs especially above three, pulmonary disease, collagen disease. CONCLUSION: The results suggest a need for improved support for patients to facilitate the interpretation...

  19. Neonatal stroke causes poor midline motor behaviors and poor fine and gross motor skills during early infancy.

    Science.gov (United States)

    Chen, Chao-Ying; Lo, Warren D; Heathcock, Jill C

    2013-03-01

    Upper extremity movements, midline behaviors, fine, and gross motor skills are frequently impaired in hemiparesis and cerebral palsy. We investigated midline toy exploration and fine and gross motor skills in infants at risk for hemiplegic cerebral palsy. Eight infants with neonatal stroke (NS) and thirteen infants with typical development (TD) were assessed from 2 to 7 months of age. The following variables were analyzed: percentage of time in midline and fine and gross motor scores on the Bayley Scales of Infant Development (BSID-III). Infants with neonatal stroke demonstrated poor performance in midline behaviors and fine and gross motor scores on the BSID-III. These results suggest that infants with NS have poor midline behaviors and motor skill development early in infancy. Copyright © 2012 Elsevier Ltd. All rights reserved.

  20. Poor understanding of marketing principles has led to poor marketing management performance: Consideration of four marketing myths.

    OpenAIRE

    Pickton, David W.; Wright, Sheila

    2000-01-01

    Marketing is accused of poor management practice. This paper argues that this is grounded in a confusion of marketing thinking and marketing action which results from widely held beliefs and myths that surround the marketing management process, making it difficult for marketing to develop as a coherent management discipline and profession. Barriers to its successful implementation are created at both strategic and tactical levels. The paper presents an exploration of four myths which are oft...

  1. Specific food preferences of older adults with a poor appetite. A forced-choice test conducted in various care settings.

    Science.gov (United States)

    van der Meij, Barbara S; Wijnhoven, Hanneke A H; Finlayson, Graham S; Oosten, Babette S H; Visser, Marjolein

    2015-07-01

    A poor appetite in older adults is an important determinant of reduced food intake and undernutrition. Food preferences may influence food intake. The aim of this study was to investigate food preferences of older adults with a poor appetite and compare these with preferences of older adults with a good appetite. Older adults (n = 349, aged 65-101 years) in nursing/residential care homes, hospitals or at home receiving home care participated in a computer-based forced-choice food preference assessment. Self-reported appetite in the past week was classified as 'good' or 'poor' using a validated instrument. Food preferences were determined by counting the relative frequency of choices for food images according to 11 dichotomous categories: high/low 1) protein; 2) fat; 3) carbohydrates; 4) fiber; 5) variation; and 6) animal/vegetarian proteins; 7) sweet/savory taste; 8) solid/liquid texture; 9) dairy/non-dairy; with/without 10) sauce or 11) color variation. Specific food preferences in participants with a poor appetite were identified by one-sample t-tests comparing frequencies to the expected value of 48. Preference differences between those with a good and a poor appetite were analyzed using GLM adjusting for confounders. The results showed that older adults with a poor appetite (n = 113; 32.4%) preferred variation (51.6 vs. 48, P food preferences. Their preference for variation differs from those with a good appetite. These results may be used to develop meals that are preferred by older adults with poor appetite in order to increase food intake and prevent undernutrition. Copyright © 2015 Elsevier Ltd. All rights reserved.

  2. Improved simulation of poorly drained forests using Biome-BGC.

    Science.gov (United States)

    Bond-Lamberty, Ben; Gower, Stith T; Ahl, Douglas E

    2007-05-01

    Forested wetlands and peatlands are important in boreal and terrestrial biogeochemical cycling, but most general-purpose forest process models are designed and parameterized for upland systems. We describe changes made to Biome-BGC, an ecophysiological process model, that improve its ability to simulate poorly drained forests. Model changes allowed for: (1) lateral water inflow from a surrounding watershed, and variable surface and subsurface drainage; (2) adverse effects of anoxic soil on decomposition and nutrient mineralization; (3) closure of leaf stomata in flooded soils; and (4) growth of nonvascular plants (i.e., bryophytes). Bryophytes were treated as ectohydric broadleaf evergreen plants with zero stomatal conductance, whose cuticular conductance to CO(2) was dependent on plant water content. Individual model changes were parameterized with published data, and ecosystem-level model performance was assessed by comparing simulated output to field data from the northern BOREAS site in Manitoba, Canada. The simulation of the poorly drained forest model exhibited reduced decomposition and vascular plant growth (-90%) compared with that of the well-drained forest model; the integrated bryophyte photosynthetic response accorded well with published data. Simulated net primary production, biomass and soil carbon accumulation broadly agreed with field measurements, although simulated net primary production was higher than observed data in well-drained stands. Simulated net primary production in the poorly drained forest was most sensitive to oxygen restriction on soil processes, and secondarily to stomatal closure in flooded conditions. The modified Biome-BGC remains unable to simulate true wetlands that are subject to prolonged flooding, because it does not track organic soil formation, water table changes, soil redox potential or anaerobic processes.

  3. Carbon-enhanced metal-poor stars in dwarf galaxies

    OpenAIRE

    Salvadori, Stefania; Skuladottir, Asa; Tolstoy, Eline

    2015-01-01

    We investigate the frequency and origin of carbon-enhanced metal-poor (CEMP) stars in Local Group dwarf galaxies by means of a statistical, data-calibrated cosmological model for the hierarchical build-up of the Milky Way and its dwarf satellites. The model self-consistently explains the variation with dwarf galaxy luminosity of the observed: i) frequency and [Fe/H] range of CEMP stars; ii) metallicity distribution functions; iii) star formation histories. We show that if primordial faint sup...

  4. Solid Phospholipid Dispersions for Oral Delivery of Poorly Soluble Drugs

    DEFF Research Database (Denmark)

    Fong, Sophia Yui Kau; Martins, Susana A. M.; Brandl, Martin

    2016-01-01

    Celecoxib (CXB) is a Biopharmaceutical Classification System class II drug in which its oral bioavailability is limited by poor aqueous solubility. Although a range of formulations aiming to increase the solubility of CXB have been developed, it is not completely understood, whether (1) an increase...... the importance of evaluating both, solubility and permeability, and the use of biorelevant medium for testing the candidate-enabling performance of liposomal formulations. Mechanisms at molecular level that may explain the effect of PL formulations on the permeability of CXB are also discussed....

  5. [Health consequences of smoking electronic cigarettes are poorly described].

    Science.gov (United States)

    Tøttenborg, Sandra Søgaard; Holm, Astrid Ledgaard; Wibholm, Niels Christoffer; Lange, Peter

    2014-09-01

    Despite increasing popularity, health consequences of vaping (smoking electronic cigarettes, e-cigarettes) are poorly described. Few studies suggest that vaping has less deleterious effects on lung function than smoking conventional cigarettes. One large study found that e-cigarettes were as efficient as nicotine patches in smoking cessation. The long-term consequences of vaping are however unknown and while some experts are open towards e-cigarettes as a safer way of satisfying nicotine addiction, others worry that vaping in addition to presenting a health hazard may lead to an increased number of smokers of conventional cigarettes.

  6. Sulphur in the metal poor globular cluster NGC 6397

    Science.gov (United States)

    Koch, A.; Caffau, E.

    2011-10-01

    Sulphur (S) is a non-refractory α-element that is not locked into dust grains in the interstellar medium. Thus no correction to the measured, interstellar sulphur abundance is needed and it can be readily compared to the S content in stellar photospheres. Here we present the first measurement of sulphur in the metal poor globular cluster (GC) NGC 6397, as detected in a MIKE/Magellan high signal-to-noise, high-resolution spectrum of one red giant star. While abundance ratios of sulphur are available for a larger number of Galactic stars down to an [Fe/H] of ~ -3.5 dex, no measurements in globular clusters more metal poor than -1.5 dex have been reported so far. We find aNLTE, 3-D abundance ratio of [S/Fe] = +0.52 ± 0.20 (stat.) ± 0.08 (sys.), based on theS I, Multiplet 1 line at 9212.8 Å. This value is consistent with a Galactic halo plateau as typical of other α-elements in GCs and field stars, but we cannot rule out its membership with a second branch of increasing [S/Fe] with decreasing [Fe/H], claimed in the literature, which leads to a large scatter at metallicities around - 2 dex. The [S/Mg] and [S/Ca] ratios in this star are compatible with a Solar value to within the (large) uncertainties. Despite the very large scatter in these ratios across Galactic stars between literature samples, this indicates that sulphur traces the chemical imprints of the other α-elements in metal poor GCs. Combined with its moderate sodium abundance ([S/Na]NLTE = 0.48), the [S/Fe] ratio in this GC extends a global, positive S-Na correlation that is not seen in field stars and might indicate that proton-capture reactions contributed to the production of sulphur in the (metal poor) early GC environments. This paper includes data gathered with the 6.5 m Magellan Telescopes located at Las Campanas Observatory, Chile.

  7. Contrast Enhancement in Poor Visibility Conditions Using Guided Filtering

    Directory of Open Access Journals (Sweden)

    D

    2013-06-01

    Full Text Available In this paper, extraction of atmospheric veil is proposed to enhance the contrast of the images captured under poor visibility conditions. The method based on guided filtering can accurately recover hidden edges, maintain structural similarity (SSIM to input image and it is effective for both color and gray level images. The proposed algorithm works without prior information about the scene and its complexity is linear function of the input image size. Experimental comparisons with state of the art algorithms demonstrate that our approach can significantly enhance the contrast and restore the visibility in fine details.

  8. 2020 Focus briefs on the world's poor and hungry people:

    OpenAIRE

    IFPRI

    2007-01-01

    Contents: 1.The Changing Profile of Poverty in the World/Shaohua Chen and Martin Ravallion. 2.Characteristics and Causes of Severe Poverty and Hunger/Akhter U. Ahmed, Ruth Vargas Hill, Lisa C. Smith, and Tim Frankenberger. 3.The Poorest and Hungry: Looking Below the Line/Akhter U. Ahmed, Ruth Vargas Hill, and Doris M. Wiesmann. 4.Mapping Where the Poor Live/Todd Benson, Michael Epprecht, and Nicholas Minot 5.Child Malnutrition in India and China/Peter Svedberg. 6.Poverty and the Globalization...

  9. Application of the Lifshitz Theory to Poor Conductors

    International Nuclear Information System (INIS)

    Svetovoy, Vitaly B.

    2008-01-01

    The Lifshitz formula for dispersive forces is generalized to the materials, which cannot be described with the local dielectric response. The principal nonlocality of poor conductors is related to the finite screening length of the penetrating field and collisional relaxation; at low temperatures the role of collisions plays the Landau damping. Spatial dispersion makes the theory self-consistent. Our predictions are compared with the recent experiment. It is demonstrated that at low temperatures Casimir-Lifshitz entropy disappears as T in the case of degenerate plasma and as T 2 for the nondegenerate one

  10. Dextromethorphan in Cough Syrup: The Poor Man’s Psychosis

    OpenAIRE

    Martinak, Bridgette; Bolis, Ramy A.; Black, Jeffrey Ryne; Fargason, Rachel E.; Birur, Badari

    2017-01-01

    Dextromethorphan (3-methoxy-N-methylmorphinan), also known as “DXM” and “the poor man’s PCP,” is a synthetically produced drug that is available in more than 140 over-the-counter cough and cold preparations. Dextromethorphan (DXM) has overtaken codeine as the most widely used cough suppressant due to its availability, efficacy, and safety profile at directed doses. However, DXM is subject to abuse. When consumed at inappropriately high doses (over 1500 mg/day), DXM can induce a state of psych...

  11. [Effect of poor dietary behaviors on the overweight and obesity of school-aged children].

    Science.gov (United States)

    Xue, Yong; Yun, Chen; Zhao, Ai; Wang, Peiyu; Zhang, Yumei; Mu, Zhishen

    2014-09-01

    To explore the rate of overweight and obesity, and the association between unhealthy dietary behaviors and overweight and obesity among Chinese school-aged children from 9 areas. By multiple stage stratified cluster sampling, 814 children aged 7 - 12 years old were chosen, provided with questionnaire and anthropometric measurements. According to the definition from Working Group on Obesity in China, children,were divided into different group, univariate logistic regression and multivariate logistic regression were used to analyze the associations between unhealthy dietary behaviors and overweight and obesity. The rates of overweight and obesity of school-aged children were 22. 88% and 9. 90%, respectively. The rates were higher in urban areas, and second-tier cities were similar with first-tier city. Influence factor analysis revealed skipping breakfast behavior was the influence factor (OR =1. 65, Pchildren’s overweight and obesity has been an increasingly serious health problem, which were correlated with genetic factor, environmental factor, and dietary behaviors and so on, poor dietary behavior might be influence factor for overweight and obesity, so it is necessary to provide earlier intervention strategies for parents to promote children’s good dietary habits.

  12. Poor textural image tie point matching via graph theory

    Science.gov (United States)

    Yuan, Xiuxiao; Chen, Shiyu; Yuan, Wei; Cai, Yang

    2017-07-01

    Feature matching aims to find corresponding points to serve as tie points between images. Robust matching is still a challenging task when input images are characterized by low contrast or contain repetitive patterns, occlusions, or homogeneous textures. In this paper, a novel feature matching algorithm based on graph theory is proposed. This algorithm integrates both geometric and radiometric constraints into an edge-weighted (EW) affinity tensor. Tie points are then obtained by high-order graph matching. Four pairs of poor textural images covering forests, deserts, bare lands, and urban areas are tested. For comparison, three state-of-the-art matching techniques, namely, scale-invariant feature transform (SIFT), speeded up robust features (SURF), and features from accelerated segment test (FAST), are also used. The experimental results show that the matching recall obtained by SIFT, SURF, and FAST varies from 0 to 35% in different types of poor textures. However, through the integration of both geometry and radiometry and the EW strategy, the recall obtained by the proposed algorithm is better than 50% in all four image pairs. The better matching recall improves the number of correct matches, dispersion, and positional accuracy.

  13. Poor sleep quality affects spatial orientation in virtual environments

    Directory of Open Access Journals (Sweden)

    Silvana Valera

    2016-07-01

    Full Text Available Sleep is well known to have a significant impact on learning and memory. Specifically, studies adopting an experimentally induced sleep loss protocol in healthy individuals have provided evidence that the consolidation of spatial memories, as acquired through navigating and orienteering in spatial surroundings, is negatively affected by total sleep loss. Here, we used both objective and subjective measures to characterize individuals' quality of sleep, and grouped participants into either a poor (insomnia-like or normal (control sleep quality group. We asked participants to solve a wayfinding task in a virtual environment, and scored their performance by measuring the time spent to reach a target location and the number of wayfinding errors made while navigating. We found that participants with poor sleep quality were slower and more error-prone than controls in solving the task. These findings provide novel evidence that pre-existing sleep deficiencies in otherwise healthy individuals affects negatively the ability to learn novel routes, and suggest that sleep quality should be accounted for among healthy individuals performing experimental spatial orientation tasks in virtual environments.

  14. LITHIUM ABUNDANCES OF EXTREMELY METAL-POOR TURNOFF STARS

    International Nuclear Information System (INIS)

    Aoki, Wako; Inoue, Susumu; Barklem, Paul S.; Beers, Timothy C.; Christlieb, Norbert; Perez, Ana E. GarcIa; Norris, John E.; Carollo, Daniela

    2009-01-01

    We have determined Li abundances for eleven metal-poor turnoff stars, among which eight have [Fe/H] <-3, based on LTE analyses of high-resolution spectra obtained with the High Dispersion Spectrograph on the Subaru Telescope. The Li abundances for four of these eight stars are determined for the first time by this study. Effective temperatures are determined by a profile analysis of Hα and Hβ. While seven stars have Li abundances as high as the Spite Plateau value, the remaining four objects with [Fe/H] <-3 have A(Li) =log (Li/H)+ 12 ∼< 2.0, confirming the existence of extremely metal-poor (EMP) turnoff stars having low Li abundances, as reported by previous work. The average of the Li abundances for stars with [Fe/H]<-3 is lower by 0.2 dex than that of the stars with higher metallicity. No clear constraint on the metallicity dependence or scatter of the Li abundances is derived from our measurements for the stars with [Fe/H]<-3. Correlations of the Li abundance with effective temperatures, with abundances of Na, Mg, and Sr, and with the kinematical properties are investigated, but no clear correlation is seen in the EMP star sample.

  15. Poor outcome in radiation-induced constrictive pericarditis

    International Nuclear Information System (INIS)

    Karram, T.; Rinkevitch, D.; Markiewicz, W.

    1993-01-01

    The purpose was to compare the outcome of patients with radiation-induced constrictive pericarditis versus patients with constiction due to another etiology. Twenty patients with constrictive pericarditis were seen during 1975-1986 at a single medical center. Six had radiation-induced constrictive pericarditis (Group A). The etiology was idiopathic in ten subjects and secondary to carcinomatous encasement, chronic renal failure, purulent infection and tuberculosis in one patient each (Group B, N = 14). Meang age was 53.4 ± 15.5 years. Extensive pericardiectomy was performed in 3/6 Group A and 13/14 Group B patients. All Group A patients died, 4 weeks - 11 years post-diagnosis (median = 10 months). Two Group A patients died suddenly, one died post-operatively of respiratory failure, another of pneumonia and two of recurrent carcinoma. Thirteen Group B patients are alive (median follow-up = 72 months). The only death in this group was due to metastatic cancer. The poor outcome with radiation-induced constriction is probably multi-factorial. Poor surgical outcome is to be expected in patients with evidence of recurrent tumor, high-dose irradiation, pulmonary fibrosis or associated radiation-induced myocardinal, valvular or coronary damage

  16. Work stress, poor recovery and burnout in teachers.

    Science.gov (United States)

    Gluschkoff, K; Elovainio, M; Kinnunen, U; Mullola, S; Hintsanen, M; Keltikangas-Järvinen, L; Hintsa, T

    2016-10-01

    Both work stress and poor recovery have been shown to contribute to the development of burnout. However, the role of recovery as a mediating mechanism that links work stress to burnout has not been sufficiently addressed in research. To examine recovery as a mediator in the relationship between work stress and burnout among teachers. A cross-sectional study of Finnish primary school teachers, in whom burnout was measured with the Maslach Burnout Inventory-General Survey and work stress was conceptualized using the effort-reward imbalance (ERI) model. Recovery was measured with the Recovery Experience Questionnaire and the Jenkins Sleep Problems Scale. Multiple linear regression analyses and bootstrap mediation analyses adjusted for age, gender and total working hours were performed. Among the 76 study subjects, high ERI was associated with burnout and its dimensions of exhaustion, cynicism and reduced professional efficacy. Poor recovery experiences, in terms of low relaxation during leisure time, partially mediated the relationship between ERI and reduced professional efficacy. Sleep problems, in the form of non-restorative sleep, partially mediated the relationship between ERI and both burnout and exhaustion. Supporting a balance between effort and reward at work may enhance leisure time recovery and improve sleep quality, as well as help to reduce burnout rates. © The Author 2016. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  17. Investigation on Strengthening Approaches Adopted for Poorly Detailed RC Corbels

    Directory of Open Access Journals (Sweden)

    Ram Chandra Neupane

    2017-05-01

    Full Text Available Poor detailing of the position of bearing pad over reinforced concrete (RC corbel may lead to premature failure, which is undesired and structurally vulnerable. An appropriate retrofitting solution is necessary to ensure the functionality of such RC corbels. Considering the growing popularity of external carbon fiber-reinforced polymer (CFRP in retrofitting, this research examines the effectiveness of an externally wrapped unidirectional CFRP sheet and compares its performance against traditional retrofitting methods. Moreover, it is intended to fulfill the lack of extensive research on external CFRP application for corbel strengthening. A total of eight medium-scale corbel specimens were tested on vertical load. Observed premature failure due to placing the bearing pad near the edge of corbel was verified and the effectiveness of the proposed structural strengthening solutions was studied. Experimental results show that although the loading capacity of the damaged corbel due to the poor detailing of bearing pad position could not be fully recovered, the external CFRP wrapping method demonstrated superior performance over RC jacketing and was able to prevent localized failure. Further study based on non-linear 3D finite element analysis (FEA was carried out to identify the governing parameters of each retrofitting solution. Numerical studies suggested important parameters of various retrofitting alternatives for higher capacity assurance.

  18. Diagnosis of a Poorly Performing Liquid Hydrogen Bulk Storage Sphere

    Science.gov (United States)

    Krenn, Angela G.

    2011-01-01

    There are two 850,000 gallon Liquid Hydrogen (LH2) storage spheres used to support the Space Shuttle Program; one residing at Launch Pad A and the other at Launch Pad B. The LH2 Sphere at Pad B has had a high boiloff rate since being brought into service in the 1960's. The daily commodity loss was estimated to be approximately double that of the Pad A sphere, and well above the minimum required by the sphere's specification. Additionally, after being re-painted in the late 1990's a "cold spot" appeared on the outer sphere which resulted in a poor paint bond, and mold formation. Thermography was used to characterize the area, and the boiloff rate was continually evaluated. All evidence suggested that the high boiloff rate was caused by an excessive heat leak into the inner sphere due to an insulation void in the annulus. Pad B was recently taken out of Space Shuttle program service which provided a unique opportunity to diagnose the sphere's poor performance. The sphere was drained and inerted, and then opened from the annular relief device on the top where a series of boroscoping operations were accomplished. Boroscoping revealed a large Perlite insulation void in the region of the sphere where the cold spot was apparent. Perlite was then trucked in and off-loaded into the annular void region until the annulus was full. The sphere has not yet been brought back into service.

  19. Do horses with poor welfare show `pessimistic' cognitive biases?

    Science.gov (United States)

    Henry, S.; Fureix, C.; Rowberry, R.; Bateson, M.; Hausberger, M.

    2017-02-01

    This field study tested the hypothesis that domestic horses living under putatively challenging-to-welfare conditions (for example involving social, spatial, feeding constraints) would present signs of poor welfare and co-occurring pessimistic judgement biases. Our subjects were 34 horses who had been housed for over 3 years in either restricted riding school situations ( e.g. kept in single boxes, with limited roughage, ridden by inexperienced riders; N = 25) or under more naturalistic conditions ( e.g. access to free-range, kept in stable social groups, leisure riding; N = 9). The horses' welfare was assessed by recording health-related, behavioural and postural indicators. Additionally, after learning a location task to discriminate a bucket containing either edible food (`positive' location) or unpalatable food (`negative' location), the horses were presented with a bucket located near the positive position, near the negative position and halfway between the positive and negative positions to assess their judgement biases. The riding school horses displayed the highest levels of behavioural and health-related problems and a pessimistic judgment bias, whereas the horses living under more naturalistic conditions displayed indications of good welfare and an optimistic bias. Moreover, pessimistic bias data strongly correlated with poor welfare data. This suggests that a lowered mood impacts a non-human species' perception of its environment and highlights cognitive biases as an appropriate tool to assess the impact of chronic living conditions on horse welfare.

  20. Do horses with poor welfare show 'pessimistic' cognitive biases?

    Science.gov (United States)

    Henry, S; Fureix, C; Rowberry, R; Bateson, M; Hausberger, M

    2017-02-01

    This field study tested the hypothesis that domestic horses living under putatively challenging-to-welfare conditions (for example involving social, spatial, feeding constraints) would present signs of poor welfare and co-occurring pessimistic judgement biases. Our subjects were 34 horses who had been housed for over 3 years in either restricted riding school situations (e.g. kept in single boxes, with limited roughage, ridden by inexperienced riders; N = 25) or under more naturalistic conditions (e.g. access to free-range, kept in stable social groups, leisure riding; N = 9). The horses' welfare was assessed by recording health-related, behavioural and postural indicators. Additionally, after learning a location task to discriminate a bucket containing either edible food ('positive' location) or unpalatable food ('negative' location), the horses were presented with a bucket located near the positive position, near the negative position and halfway between the positive and negative positions to assess their judgement biases. The riding school horses displayed the highest levels of behavioural and health-related problems and a pessimistic judgment bias, whereas the horses living under more naturalistic conditions displayed indications of good welfare and an optimistic bias. Moreover, pessimistic bias data strongly correlated with poor welfare data. This suggests that a lowered mood impacts a non-human species' perception of its environment and highlights cognitive biases as an appropriate tool to assess the impact of chronic living conditions on horse welfare.

  1. Energy, equity and the future of the fuel poor

    International Nuclear Information System (INIS)

    Roberts, Simon

    2008-01-01

    A warm and adequately-lit home is considered a basic need, together with access to energy-consuming appliances ranging from a fridge to a TV. An underlying tenet of sustainable energy is that such basic needs should be affordably met. Yet low incomes, energy-inefficient housing and appliances and high energy costs mean that roughly 10 per cent of UK households, many of them elderly or with young children, fail to attain this basic standard. These households, which would need to spend more than 10 per cent of their income to attain adequate energy services, are officially defined as 'fuel poor'. Their cold, poorly equipped homes lead to chronic cold-related health conditions, exacerbate social isolation, and may undermine educational achievement. In addition, rural areas have a disproportionately high incidence of fuel poverty. This Review examines the current distribution of energy consumption, its social impacts, and the opportunities to address fuel poverty through improvements to the housing stock. It will then consider potential future developments

  2. Poor program's progress: the unanticipated politics of Medicaid policy.

    Science.gov (United States)

    Brown, Lawrence D; Sparer, Michael S

    2003-01-01

    Advocates of U.S. national health insurance tend to share an image that highlights universal standards of coverage, social insurance financing, and national administration--in short, the basic features of Medicare. Such an approach is said to be good (equitable and efficient) policy and equally good politics. Medicaid, by contrast, is often taken to exemplify poor policy and poorer politics: means-tested eligibility, general revenue financing, and federal/state administration, which encourage inequities and disparities of care. This stark juxtaposition fails, however, to address important counterintuitive elements in the political evolution of these programs. Medicare's benefits and beneficiaries have stayed disturbingly stable, but Medicaid's relatively broad benefits have held firm, and its categories of beneficiaries have expanded. Repeated alarms about "bankruptcy" have undermined confidence in Medicare's trust funding, while Medicaid's claims on the taxpayer's dollar have worn well. Medicare's national administration has avoided disparities, but at the price of sacrificing state and local flexibility that can ease such "reforms" as the introduction of managed care. That Medicaid has fared better than a "poor people's program" supposedly could has provocative implications for health reform debates.

  3. Poor outcome in radiation-induced constrictive pericarditis

    Energy Technology Data Exchange (ETDEWEB)

    Karram, T.; Rinkevitch, D.; Markiewicz, W. (Technion Medical School, Haifa (Israel))

    1993-01-15

    The purpose was to compare the outcome of patients with radiation-induced constrictive pericarditis versus patients with constiction due to another etiology. Twenty patients with constrictive pericarditis were seen during 1975-1986 at a single medical center. Six had radiation-induced constrictive pericarditis (Group A). The etiology was idiopathic in ten subjects and secondary to carcinomatous encasement, chronic renal failure, purulent infection and tuberculosis in one patient each (Group B, N = 14). Meang age was 53.4 [+-] 15.5 years. Extensive pericardiectomy was performed in 3/6 Group A and 13/14 Group B patients. All Group A patients died, 4 weeks - 11 years post-diagnosis (median = 10 months). Two Group A patients died suddenly, one died post-operatively of respiratory failure, another of pneumonia and two of recurrent carcinoma. Thirteen Group B patients are alive (median follow-up = 72 months). The only death in this group was due to metastatic cancer. The poor outcome with radiation-induced constriction is probably multi-factorial. Poor surgical outcome is to be expected in patients with evidence of recurrent tumor, high-dose irradiation, pulmonary fibrosis or associated radiation-induced myocardinal, valvular or coronary damage.

  4. WTO accepts rules limiting medicine exports to poor countries.

    Science.gov (United States)

    James, John S

    2003-09-12

    In a controversial decision on August 30, 2003, the World Trade Organization agreed to complex rules limiting the export of medications to developing countries. Reaction to the decision so far has shown a complete disconnect between trade delegates and the WTO, both of which praise the new rules as a humanitarian advance, and those working in treatment access in poor countries, who believe that they will effectively block treatment from reaching many who need it. We have prepared a background paper that analyzes this decision and its implications and offers the opinions of key figures on both sides of the debate. It is clear that the rules were largely written for and probably by the proprietary pharmaceutical industry, and imposed on the countries in the WTO mainly by the United States. The basic conflict is that this industry does not want the development of international trade in low-cost generic copies of its patented medicines--not even for poor countries, where little or no market exists. Yet millions of people die each year without medication for treatable conditions such as AIDS, and drug pricing remains one of several major obstacles to controlling global epidemics.

  5. Overcoming the Obstacle of Poor Knowledge in Proving Geometry Tasks

    Directory of Open Access Journals (Sweden)

    Zlatan Magajna

    2013-12-01

    Full Text Available Proving in school geometry is not just about validating the truth of a claim. In the school setting, the main function of the proof is to convince someone that a claim is true by providing an explanation. Students consider proving to be difficult; in fact, they find the very concept of proof demanding. Proving a claim in planar geometry involves several processes, the most salient being visual observation and deductive argumentation. These two processes are interwoven, but often poor observation hinders deductive argumentation. In the present article, we consider the possibility of overcoming the obstacle of a student’s poor observation by making use of computer-aided observation with appropriate software. We present the results of two small-scale research projects, both of which indicate that students are able to work out considerably more deductions if computer-aided observation is used. Not all students use computer-aided observation effectively in proving tasks: some find an exhaustive computer-provided list of properties confusing and are not able to choose the properties that are relevant to the task.

  6. Insurance premiums and insurance coverage of near-poor children.

    Science.gov (United States)

    Hadley, Jack; Reschovsky, James D; Cunningham, Peter; Kenney, Genevieve; Dubay, Lisa

    States increasingly are using premiums for near-poor children in their public insurance programs (Medicaid/SCHIP) to limit private insurance crowd-out and constrain program costs. Using national data from four rounds of the Community Tracking Study Household Surveys spanning the seven years from 1996 to 2003, this study estimates a multinomial logistic regression model examining how public and private insurance premiums affect insurance coverage outcomes (Medicaid/SCHIP coverage, private coverage, and no coverage). Higher public premiums are significantly associated with a lower probability of public coverage and higher probabilities of private coverage and uninsurance; higher private premiums are significantly related to a lower probability of private coverage and higher probabilities of public coverage and uninsurance. The results imply that uninsurance rates will rise if both public and private premiums increase, and suggest that states that impose or increase public insurance premiums for near-poor children will succeed in discouraging crowd-out of private insurance, but at the expense of higher rates of uninsurance. Sustained increases in private insurance premiums will continue to create enrollment pressures on state insurance programs for children.

  7. Integration of immigrants into a new culture is related to poor sleep quality.

    Science.gov (United States)

    Voss, Ursula; Tuin, Inka

    2008-08-10

    This article reports on the relationship between cultural influences on life style, coping style, and sleep in a sample of female Portuguese immigrants living in Germany. Sleep quality is known to be poorer in women than in men, yet little is known about mediating psychological and sociological variables such as stress and coping with stressful life circumstances. Migration constitutes a particularly difficult life circumstance for women if it involves differing role conceptions in the country of origin and the emigrant country. The study investigated sleep quality, coping styles and level of integration in a sample of Portuguese (N = 48) and Moroccan (N = 64) immigrant women who took part in a structured personal interview. Sleep quality was poor in 54% of Portuguese and 39% of Moroccan women, which strongly exceeds reports of sleep complaints in epidemiologic studies of sleep quality in German women. Reports of poor sleep were associated with the degree of adoption of a German life style. Women who had integrated more into German society slept worse than less integrated women in both samples, suggesting that non-integration serves a protective function. An unusually large proportion of women preferred an information-seeking (monitoring) coping style and adaptive coping. Poor sleep was related to high monitoring in the Portuguese but not the Moroccan sample. Sleep quality appears to be severely affected in women with a migration background. Our data suggest that non-integration may be less stressful than integration. This result points to possible benefits of non-integration. The high preference for an information-seeking coping style may be related to the process of migration, representing the attempt at regaining control over an uncontrollable and stressful life situation.

  8. Environmental impacts of alternative agricultural uses of poorly drained farm land in Ireland.

    Science.gov (United States)

    Sharma, Pooja; Humphreys, James; Holden, Nicholas M

    2018-05-07

    Abolition of the milk quota in the European Union and favourable market conditions have stimulated the expansion of the dairy sector in Ireland, causing more milk to be produced from poorly drained land. This work evaluated the environmental impacts of alternative agricultural uses for poorly drained farm land in Ireland using life cycle assessment (LCA). The avoided burden of the displaced product was used to calculate the net environmental consequences in the context of regional or global markets. The impact categories evaluated were climate change, eutrophication and acidification, all expressed per hectare of land for the alternative land uses, which were pasture-based milk, suckler beef and lowland sheep production and coniferous forestry. Beef had the lowest net climate change impact with global marginal and average product substitution while sheep had the lowest net climate change impact with European displaced product. For net eutrophication and acidification, dairy had the lowest impacts with European and global average displaced product. With global marginal displaced product, forestry had the lowest net eutrophication impact and sheep had the lowest net acidification impact. From an Irish perspective, forestry would generate the lowest environmental impacts and would also increase soil carbon stock, but this was not the best land use option from global perspective. Overall it can be concluded that a pasture based dairy or sheep system would have the greatest net global impact reduction (i.e. greatest global benefit) as land use options for farms with poorly drained soils. Prioritizing climate change, suckler beef system would perhaps be more favourable. It is clear that the choice of the displaced regional or global co-product from the market has a great influence on the results and there is a need to consider more detailed consumption modelling to better understand the substitution process. Copyright © 2018 Elsevier B.V. All rights reserved.

  9. Food provisioning experiences of ultra poor female heads of household living in Bangladesh.

    Science.gov (United States)

    McIntyre, Lynn; Rondeau, Krista; Kirkpatrick, Sharon; Hatfield, Jennifer; Islam, Khaled Shamsul; Huda, Syed Nazmul

    2011-03-01

    Ultra poor women in Bangladesh are especially vulnerable to poverty and food insecurity, and they have generally been excluded from recent improvements in hunger and poverty rates in the country. An examination of the food provisioning narratives of 43 ultra poor female heads of household in Bangladesh was conducted in order to deepen understanding of this obstacle to the country's achievement of the First Millennium Development Goal. All participants were the household's sole income provider, had dependent children, and earned less than $1 USD per day. Women were purposively selected based on occupational group, context, and personal characteristics. Ethnographic interviews were conducted in January and February, 2008. Analysis of women's accounts of their daily food routine revealed chronic and pervasive food insecurity punctuated by acute episodes of absolute food deprivation that resulted from seasonal fluctuations in earnings, rising food prices, illness disrupting work, and healthcare costs. Women's accounts of their daily food provisioning experiences suggested compromises in, and trade-offs between, multiple basic needs as a result of inadequate income. Women were further constrained by social norms and gender roles that influenced their ability to work outside the home. Our method of inquiry led us to construct an organizing framework that extends knowledge of ultra poor women in Bangladesh's complex and multi-sphered experience of poverty and food insecurity. Based on these findings, we propose a strategy called whole person development (WPD), which seeks small adjustments to services, programs, and policies based on leverage points identified through in-depth narratives. Copyright © 2011 Elsevier Ltd. All rights reserved.

  10. Care seeking for maternal health: challenges remain for poor women

    African Journals Online (AJOL)

    Data were analysed using Nudist software. Important findings: The location of childbirth involves retaining control of the process and outcome, and securing a safe delivery. The pregnant woman is influenced by her attendants; families only seek care for complications if local or herbal, remedies and prayer are defeated.

  11. Coercion, autonomy, and the preferential option for the poor in the ethics of organ transplantation.

    Science.gov (United States)

    Jaycox, Michael P

    2012-12-01

    The debate concerning whether to legalize and regulate the global market in human organs is hindered by a lack of adequate bioethical language. The author argues that the preferential option for the poor, a theological category, can provide the grounding for an inductive moral epistemology adequate for reforming the use of culturally Western bioethical language. He proposes that the traditional, Western concept of bioethical coercion ought to be modified and expanded because the conditions of the market system, as viewed from the perspective of organ vendors systemically deprived of access to sufficient resources, are sufficiently exploitative as to diminish the possibility of these vendors giving informed consent. Moreover, empirical studies conducted by professionals in medicine, sociology, psychiatry, economics, and medical anthropology continue to contribute support to the growing interdisciplinary consensus that functionally coercive structural factors exert the most significant influence upon a vendor's decision to sell an organ within any market, regardless of legality or degree of regulation. Therefore any proposal to legalize and regulate the organ market remains patently unethical because doing so would likely function to constrain further the agency of poor potential vendors. © 2012 Blackwell Publishing Ltd.

  12. Lower crustal strength controls on melting and type of oceanization at magma-poor margins

    Science.gov (United States)

    Ros, E.; Perez-Gussinye, M.; Araujo, M. N.; Thoaldo Romeiro, M.; Andres-Martinez, M.; Morgan, J. P.

    2017-12-01

    Geodynamical models have been widely used to explain the variability in the architectonical style of conjugate rifted margins as a combination of lithospheric deformation modes, which are strongly influenced by lower crustal strength. We use 2D numerical models to show that the lower crustal strength also plays a key role on the onset and amount of melting and serpentinization during continental rifting. The relative timing between melting and serpentinization onsets controls whether the continent-ocean transition (COT) of margins will be predominantly magmatic or will mainly consist of exhumed and serpentinized mantle. Based on our results for magma-poor continental rifting, we propose a genetic link between margin architecture and COT styles that can be used as an additional tool to help interpret and understand the processes leading to margin formation. Our results show that strong lower crusts and very slow extension velocities (architecture of the magma-poor section of the South Atlantic, we suggest that the COT of the northern sector, Camamu-Gabon basins, is more likely to consist of exhumed mantle with intruded magmatism, while to the South, the Camamu-Kwanza and North Santos-South Kwanza conjugates, may be better characterized by a predominantly magmatic COT.

  13. Comparative Research of Residents’ Effect Perception and Participation Capacity and Willingness on Pro-poor Tourism

    Institute of Scientific and Technical Information of China (English)

    Guoqing; HUANG; Hong; SHU

    2014-01-01

    In this article,comparative research on residents’ effect perception,participation capacity and willingness on Pro-poor Tourism( PPT) is given based on the questionnaire carried out in Wulong County and Fengjie County in Three Gorges Area,Chongqing,China. Some technologies,such as SPSS 13. 0,ANOVA and T-test are applied to analyze the data and results show Wulong residents’ perception behavior is better than that of Fengjie residents. Moreover,the residents with different demographic characteristics have different participation behavior.Finally,multiple regression analysis is applied to identify the key factors influencing residents’ perception behavior,that is participation willingness and positive economic effect perception,positive social and cultural effect perception and participation capacity.

  14. Effect of the surfactant on the availability of piroxicam as a poorly hydrosoluble drug from suppositories.

    Science.gov (United States)

    Dal Zorro, M; Franceschinis, E; Punchina, A; Realdon, N

    2012-01-01

    The use of surfactants in suppository formulations has been suggested to improve availability of poorly soluble drugs. In the present study, different kinds of surfactants have been investigated to clarify the influence on piroxicam release from suppositories formulated with both lipophilic and hydrophilic bases. Two hydrophilic glucose-derivate surfactants, and a polyoxylglyceride amphiphilic surfactant, all with high HLB values, were investigated for their use in improving drug availability. The two glucose derivate surfactants reduced drug availability from both lipophilic suppositories and hydrophilic formulations, according to longer disintegration times and drug micellization. The more complex surfactant, a lauroyl macrogolglyceride, showed an increase in piroxicam availability from lipophilic suppositories at the higher tested concentrations (15% and 20%). Otherwise, when used in hydrophilic formulations, it was less effective in promoting drug release and even reduced drug availability.

  15. Removal of pollutants from poor quality coals by pyrolysis

    Directory of Open Access Journals (Sweden)

    Natas Panagiotis

    2006-01-01

    Full Text Available Combustion of poor quality coals and wastes is used today worldwide for energy production. However, this entails significant environmental risks due to the presence of polluting compounds in them, i. e. S, N, Hg, and Cl. In the complex environment of combustion these substances are forming conventional (i. e. SOx, NOx and toxic (PCDD/Fs pollutants, while, the highly toxic Hg is volatilized in the gas phase mainly as elemental mercury. Aiming to meet the recently adopted strict environmental standards, and the need of affordable in cost clean power production, a preventive fuels pre-treatment technique, based on low temperature carbonization, has been tested. Clean coals were produced from two poor quality Greek coals (Ptolemais and Megalopolis and an Australian coal sample, in a lab-scale fixed bed reactor under helium atmosphere and ambient pressure. The effect of carbonization temperature (200-900 °C and residence time (5-120 minutes on the properties of the chars, obtained after pyrolysis, was investigated. Special attention was paid to the removal of pollutants such as S, N, Hg, and Cl. To account for possible mineral matter effects, mainly on sulphur removal, tests were also performed with demineralized coal. Reactivity variation of produced clean coals was evaluated by performing non-isothermal combustion tests in a TA Q600 thermo gravimetric analyzer. Results showed that the low temperature carbonization technique might contribute to clean coal production by effectively removing the major part of the existing polluting compounds contained in coal. Therefore, depending on coal type, nitrogen, mercury, and chlorine abatement continuously increases with temperature, while sulphur removal seems to reach a plateau above 500-600 °C. More-over, the prolongation of carbonization time above 20 minutes does not affect the elemental conversion of the pollutants and carbonization at 500-600 °C for ~20 minutes may be considered sufficient for clean

  16. Factors associated with persistent poorly controlled diabetes mellitus: clues to improving management in patients with resistant poor control.

    Science.gov (United States)

    Crowley, Matthew J; Holleman, Rob; Klamerus, Mandi L; Bosworth, Hayden B; Edelman, David; Heisler, Michele

    2014-12-01

    Patients with persistent poorly controlled diabetes mellitus (PPDM), defined as an uninterrupted hemoglobin A1c >8.0% for ≥1 year despite standard care, are at high risk for complications. Additional research to define patient factors associated with PPDM could suggest barriers to improvement in this group and inform the development of targeted strategies to address these patients' resistant diabetes. We analyzed patients with type 2 diabetes from a multi-site randomized trial. We characterized patients with PPDM relative to other patients using detailed survey data and multivariable modeling. Of 963 patients, 118 (12%) had PPDM, 265 (28%) were intermittently poorly controlled, and 580 (60%) were well-controlled. Patients with PPDM had younger age, earlier diabetes diagnosis, insulin use, higher antihypertensive burden, higher low-density lipoprotein cholesterol, and lower statin use relative to well-controlled patients. Among patients with objective adherence data (Veterans Affairs patients), a larger oral diabetes medication refill gap was associated with PPDM. Strategies are needed to target-specific barriers to improvement among patients whose diabetes is resistant to standard diabetes care. Our data suggest that strategies for targeting PPDM should accommodate younger patients' lifestyles, include medication management for insulin titration and comorbid disease conditions, and address barriers to self-management adherence. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  17. β-Cyclodextrin-dextran polymers for the solubilization of poorly soluble drugs.

    Science.gov (United States)

    di Cagno, Massimiliano; Terndrup Nielsen, Thorbjørn; Lambertsen Larsen, Kim; Kuntsche, Judith; Bauer-Brandl, Annette

    2014-07-01

    The aim of this study was to assess the potential of novel β-cyclodextrin (βCD)-dextran polymers for drug delivery. The size distribution of βCD-dextrans (for eventual parenteral administration), the influence of the dextran backbones on the stability of the βCD/drug complex, the solubilization efficiency of poorly soluble drugs and drug release properties were investigated. Size analysis of different βCD-dextrans was measured by size exclusion chromatography (SEC) and asymmetrical flow field-flow fractionation (AF4). Stability of drug/βCD-dextrans was assessed by isothermal titration calorimetry (ITC) and molar enthalpies of complexation and equilibrium constants compared to some commercially available βCD derivatives. For evaluation of the solubilization efficiency, phase-solubility diagrams were made employing hydrocortisone (HC) as a model of poorly soluble drugs, whereas reverse dialysis was used to detect potential drug supersaturation (increased molecularly dissolved drug concentration) as well as controlled release effects. Results indicate that all investigated βCD-polymers are of appropriate sizes for parenteral administration. Thermodynamic results demonstrate that the presence of the dextran backbone structure does not affect the stability of the βCD/drug complex, compared to native βCD and commercially available derivatives. Solubility studies evidence higher solubilizing abilities of these new polymers in comparison to commercially available βCDs, but no supersaturation states were induced. Moreover, drug release studies evidenced that diffusion of HC was influenced by the solubilization induced by the βCD-derivatives. Copyright © 2014 Elsevier B.V. All rights reserved.

  18. DIETARY SODIUM ADHERENCE IS POOR IN CHRONIC HEART FAILURE PATIENTS

    Science.gov (United States)

    Basuray, Anupam; Dolansky, Mary; Josephson, Richard; Sattar, Abdus; Grady, Ellen M.; Vehovec, Anton; Gunstad, John; Redle, Joseph; Fang, James; Hughes, Joel W.

    2015-01-01

    Background We sought to determine the rates and predictors of dietary sodium restriction, while evaluating the reliability of the 24-hour urine collection as a tool to estimate dietary sodium intake in heart failure (HF) patients. Methods and Results We evaluated the 24-hour urinary sodium excretion of 305 outpatients with HF and reduced ejection fraction who were educated on following a sodium diet. The mean sodium excretion using a single sample from each participant was 3.15 ± 1.58 grams, and 23% were adherent to the sodium excretion of 3.21 ± 1.20 grams and lower adherence rates to the sodium and creatinine showed poor reproducibility between samples. Conclusions In this chronic HF population, sodium consumption probably exceeds recommended amounts, particularly in men and those with higher BMI. Urine analyses were not highly reproducible, suggesting variation in both diet and urine collection. PMID:25576680

  19. Depleted depletion drives polymer swelling in poor solvent mixtures.

    Science.gov (United States)

    Mukherji, Debashish; Marques, Carlos M; Stuehn, Torsten; Kremer, Kurt

    2017-11-09

    Establishing a link between macromolecular conformation and microscopic interaction is a key to understand properties of polymer solutions and for designing technologically relevant "smart" polymers. Here, polymer solvation in solvent mixtures strike as paradoxical phenomena. For example, when adding polymers to a solvent, such that all particle interactions are repulsive, polymer chains can collapse due to increased monomer-solvent repulsion. This depletion induced monomer-monomer attraction is well known from colloidal stability. A typical example is poly(methyl methacrylate) (PMMA) in water or small alcohols. While polymer collapse in a single poor solvent is well understood, the observed polymer swelling in mixtures of two repulsive solvents is surprising. By combining simulations and theoretical concepts known from polymer physics and colloidal science, we unveil the microscopic, generic origin of this collapse-swelling-collapse behavior. We show that this phenomenon naturally emerges at constant pressure when an appropriate balance of entropically driven depletion interactions is achieved.

  20. Medical diagnosis in resource-poor tropical countries.

    Science.gov (United States)

    Ramos-Rincón, J M; Cuadros-González, J; Malmierca-Corral, E; de Górgolas-Hernández, M

    2015-01-01

    When working in healthcare centers in developing countries where diagnostic resources are limited, clinical skills are of considerable importance. This study presents the diagnostic tools available in resource-poor areas. Anamnesis and physical examination are key components for reaching a correct diagnosis. The laboratory has at its disposal hemograms, basic blood chemistry and urinalysis. The available basic microbiological tests are the study of fresh feces, smears for malaria, direct smears for bacilli in sputum and Gram staining of clinical exudates. Basic radiography of the chest, abdomen, bones and soft tissues are of considerable usefulness but are not available in all centers. Ultrasonography can be of considerable usefulness due to its simplicity and versatility. The diagnosis in low resource conditions should sharpen our clinical skills and should be supported by the use of additional basic tests. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

  1. Lipid nanoparticles for administration of poorly water soluble neuroactive drugs.

    Science.gov (United States)

    Esposito, Elisabetta; Drechsler, Markus; Mariani, Paolo; Carducci, Federica; Servadio, Michela; Melancia, Francesca; Ratano, Patrizia; Campolongo, Patrizia; Trezza, Viviana; Cortesi, Rita; Nastruzzi, Claudio

    2017-09-01

    This study describes the potential of solid lipid nanoparticles and nanostructured lipid carriers as nano-formulations to administer to the central nervous system poorly water soluble drugs. Different neuroactive drugs, i.e. dimethylfumarate, retinyl palmitate, progesterone and the endocannabinoid hydrolysis inhibitor URB597 have been studied. Lipid nanoparticles constituted of tristearin or tristearin in association with gliceryl monoolein were produced. The nanoencapsulation strategy allowed to obtain biocompatible and non-toxic vehicles, able to increase the solubility of the considered neuroactive drugs. To improve URB597 targeting to the brain, stealth nanoparticles were produced modifying the SLN surface with polysorbate 80. A behavioural study was conducted in rats to test the ability of SLN containing URB597 given by intranasal administration to alter behaviours relevant to psychiatric disorders. URB597 maintained its activity after nanoencapsulation, suggesting the possibility to propose this kind of vehicle as alternative to unphysiological mixtures usually employed for animal and clinical studies.

  2. Sustainable development in an N-rich/n-poor world.

    Science.gov (United States)

    Perrings, Charles; Kinzig, Ann; Halkos, George

    2014-11-01

    Sustainable development requires that per capita inclusive wealth-produced, human, and natural capital-does not decline over time. We investigate the impact of changes in nitrogen on inclusive wealth. There are two sides to the nitrogen problem. Excess use of nitrogen in some places gives rise to N-pollution, which can cause environmental damage. Insufficient replacement of nitrogen in other places gives rise to N-depletion, or loss of nutrient stocks. Neither is explicitly accounted for in current wealth measures, but both affect wealth. We calculate an index of net N-replacement, and investigate its relationship to wealth. In countries with low levels of relative N-loss, we find that the uncompensated loss of soil nitrogen in poorer countries is associated with declining rates of growth of inclusive per capita wealth. What is less intuitive is that increasing fertilizer application in both rich and poor countries can increase per capita inclusive wealth.

  3. Do health systems delay the treatment of poor children?

    DEFF Research Database (Denmark)

    Samuelsen, Helle; Tersbøl, Britt Pinkowski; Mbuyita, Selemani Said

    2013-01-01

    Child mortality remains one of the major public-health problems in Tanzania. Delays in receiving and accessing adequate care contribute to these high rates. The literature on public health often focuses on the role of mothers in delaying treatment, suggesting that they contact the health system too...... late and that they prefer to treat their children at home, a perspective often echoed by health workers. Using the three-delay methodology, this study focus on the third phase of the model, exploring the delays experienced in receiving adequate care when mothers with a sick child contact a health......-care facility. The overall objective is to analyse specific structural factors embedded in everyday practices at health facilities in a district in Tanzania which cause delays in the treatment of poor children and to discuss possible changes to institutions and social technologies....

  4. Ethical review boards are poor advocates for patient perspectives

    DEFF Research Database (Denmark)

    Masterton, Malin; Renberg, Tobias; Hansson, Mats G

    2014-01-01

    is to evaluate the risk−benefits of research, which are ultimately grounded in attitudes and values. From focus-group interviews with patients suffering from chronic inflammatory diseases, a postal questionnaire was developed and sent to patient members of the Swedish Rheumatism Association (n = 1195) and to all...... ERB board members in Sweden (N = 583). Response rates were 65 percent and the surveys were conducted in Jan−May 2011. Agreement across the groups included priority for medical research on diagnostic and early detection of disease. A key difference was expert and lay ERB members giving higher priority...... to basic research/research on lifestyle and prevention (primarily benefiting future patients), whereas patients prioritized research on daily function. On this significant point, lay members did not share the opinion of this patient group, indicating that they may be poor representatives for patients...

  5. HIV and Pregnancy in Resource-Poor Settings

    Science.gov (United States)

    Tang, Jennifer; Nour, Nawal M

    2010-01-01

    There are 33.4 million people living with human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome. Globally, HIV/AIDS is the leading cause of death among women of reproductive age. In the United States and other developed countries, aggressive efforts to treat HIV-positive pregnant women with highly active antiretroviral therapy have decreased the maternal-to-child transmission (MTCT) from over 20% to less than 2%. However, in resource-poor settings, access to antiretroviral therapy (ART) is not readily available, and perinatal transmission rates remain as high as 45%. Women are at greater risk of heterosexual transmission of HIV, which is compounded by lack of condom use, imbalance of social power, and the high fertility rate. Prevention programs are needed to empower and educate women and engender community awareness for condom use. Prenatal screening and treatment, intrapartum ART, and postpartum prophylaxis must be made available to all women and children to prevent MTCT. PMID:20842284

  6. Certified Basic Life Support Instructors Assess Cardiopulmonary Resuscitation Skills Poorly

    DEFF Research Database (Denmark)

    Hansen, Camilla; Rasmussen, Stinne E; Kristensen, Mette Amalie

    2016-01-01

    Introduction: High-quality cardiopulmonary resuscitation (CPR) improves survival from cardiac arrest. During basic life support (BLS) training, instructors assess CPR skills to enhance learning outcome. Emergency department staff and senior residents have been shown to assess chest compression...... quality poorly. Currently no studies have evaluated CPR assessment among certified BLS instructors. The aim of this study was to investigate certified BLS instructors’ assessment of chest compressions and rescue breathing.Methods: Data were collected at BLS courses for medical students at Aarhus...... of CPR skills may be beneficial to ensure high-quality learning outcome.Author Disclosures: C. Hansen: None. S.E. Rasmussen: None. M.A. Nebsbjerg: None. M. Stærk: None. B. Løfgren: None....

  7. Food as pharma: marketing nutraceuticals to India's rural poor.

    Science.gov (United States)

    Street, Alice

    2015-05-27

    This commentary sketches out the politics of the expansion of affordable, fast-moving nutraceutical products into rural India, with a focus on fortified foods and beverages. It examines the relationships between industry, government and humanitarian organisations that are being forged alongside the development of markets for nutraceuticals; the production of evidence and the harnessing of science to support nutraceutical companies' claims; the ways in which nutraceuticals are being marketed and distributed in rural areas; and the concepts of health and well-being that are being promulgated through those marketing campaigns. Lastly, it asks what kinds of impact fast-moving nutraceuticals are likely to have on the lives of India's rural poor. It concludes by questioning how smooth a transition to nutraceutical consumption Big Food marketing strategies can really facilitate and how readily low-income families seeking to feed their families and safeguard health will actually adopt concepts of wellness and internalise micro-nutrient associated risks.

  8. Microcontainers - an oral drug delivery system for poorly soluble drugs

    DEFF Research Database (Denmark)

    Nielsen, Line Hagner; Petersen, Ritika Singh; Marizza, Paolo

    In oral delivery, it can sometimes be necessary to employ drug delivery systems to achieve targeted delivery to the intestine. Microcontainers are polymeric, cylindrical devices in the micrometer size range (Figure 1), and are suggested as a promising oral drug delivery system [1],[2]. The purpose...... of these studies was to fabricate microcontainers in either SU-8 or biodegradable poly-L-lactic acid (PLLA), and fill the microcontainers with poorly soluble drugs. Furthermore, the application of the microcontainers as an oral drug delivery system was investigated in terms of release, in situ intestinal perfusion...... medium at pH 6.5 was observed. In situ intestinal perfusions were performed in rats of the Eudragit-coated ASSF-filled microcontainers and compared to a furosemide solution. At the end of the study, the small intestine was harvested from the rat and imaged under a light microscope. The absorption rate...

  9. Heavy elements abundances in metal-poor stars

    International Nuclear Information System (INIS)

    Magain, P.; Jehin, E.; Neuforge, C.; Noels, A.

    1998-01-01

    A sample of 21 metal-poor stars have been analysed on the basis of high resolution and high signal-to-noise spectra. Correlations between relative abundances of 16 elements have been studied, with a special emphasis on the neutron-capture ones. This analysis reveals the existence of two sub-populations of field halo stars, namely Pop IIa and Pop IIb. They differ by the behaviour of the s-process elements versus the α and r-process elements. We suggest a scenario of formation of these stars, which closely relates the field halo stars to the evolution of globular clusters. The two sub-populations would have evaporated the clusters during two different stages of their chemical evolution

  10. Contrast thresholds for component motion with full and poor attention.

    Science.gov (United States)

    Tsuchiya, Naotsugu; Braun, Jochen

    2007-02-12

    We compare luminance-contrast-masking thresholds for fully and poorly attended stimuli, controlling attention with a demanding concurrent task. We use dynamic displays composed of discrete spatiotemporal wavelets, comparing three conditions ("single," "parallel," and "random"). In contrast to static displays, we do not find that attention modulates the "dipper" regime for masks of low luminance contrast. Nor does attention alter direction-selective masking by multiple wavelets moving in random directions, a condition designed to isolate effects on component motion. However, direction-selective masking by multiple wavelets moving in parallel is significantly reduced by attention. As the latter condition is expected to excite both component and pattern motion mechanisms, this implies that attention may alter the visual representation of pattern motion. In addition, attention exhibits its well-known effect of reducing lateral masking between nearby spatiotemporal wavelets.

  11. Indoor air quality for poor families: new evidence from Bangladesh.

    Science.gov (United States)

    Dasgupta, S; Huq, M; Khaliquzzaman, M; Pandey, K; Wheeler, D

    2006-12-01

    Poor households in Bangladesh depend heavily on wood, dung and other biomass fuels for cooking. This paper provides a detailed analysis of the implications for indoor air pollution (IAP), drawing on new 24-h monitoring data for respirable airborne particulates (PM10). A stratified sample of 236 households was selected in Dhaka and Narayanganj, with a particular focus on fuel use, cooking locations, structural materials, ventilation practices, and other potential determinants of exposure to IAP. At each household, PM10 concentrations in the kitchen and living room were monitored for a 24-h period during December, 2003-February, 2004. Concentrations of 300 microg/m3 or greater are common in our sample, implying widespread exposure to a serious health hazard. A regression analysis for these 236 households was then conducted to explore the relationships between PM10 concentrations, fuel choices and a large set of variables that describe household cooking and ventilation practices, structure characteristics and building materials. As expected, our econometric results indicate that fuel choice significantly affects indoor pollution levels: natural gas and kerosene are significantly cleaner than biomass fuels. However, household-specific factors apparently matter more than fuel choice in determining PM10 concentrations. In some biomass-burning households, concentrations are scarcely higher than in households that use natural gas. Our results suggest that cross-household variation is strongly affected by structural arrangements: cooking locations, construction materials, and ventilation practices. A large variation in PM10 was also found during the 24-h cycle within households. For example, within the 'dirtiest' firewood-using household in our sample, readings over the 24-h cycle vary from 68 to 4864 microg/m3. Such variation occurs because houses can recycle air very quickly in Bangladesh. After the midday meal, when ventilation is common, air quality in many houses goes

  12. Poor Sleep Is Related to Lower Emotional Competence Among Adolescents.

    Science.gov (United States)

    Brand, Serge; Kirov, Roumen; Kalak, Nadeem; Gerber, Markus; Schmidt, Norman B; Lemola, Sakari; Correll, Christoph U; Holsboer-Trachsler, Edith

    2016-01-01

    The aim of the present study was to explore the association between subjective insomnia and self-reported emotional competence in areas such as regulating and perceiving one's own emotions and empathy, in a sample of adolescents. Gender differences were also explored. 366 adolescents in 10th to 12th grade (mean age: M = 16.9 years) took part in this cross-sectional study. They completed questionnaires related to emotional competencies, empathy, and sleep. Higher scores for insomnia were associated with lower scores for some aspects of emotional competence and empathy. Compared to males, females generally had higher scores for emotional competence. Poor sleep as subjectively experienced among adolescents is associated with specific impairments in emotional competence and empathy. Gender-related patterns were also observed.

  13. Childhood maltreatment and adulthood poor sleep quality: a longitudinal study.

    Science.gov (United States)

    Abajobir, Amanuel A; Kisely, Steve; Williams, Gail; Strathearn, Lane; Najman, Jake M

    2017-08-01

    Available evidence from cross-sectional studies suggests that childhood maltreatment may be associated with a range of sleep disorders. However, these studies have not controlled for potential individual-, familial- and environmental-level confounders. To determine the association between childhood maltreatment and lower sleep quality after adjusting for potential confounders. Data for the present study were obtained from a pre-birth cohort study of 3778 young adults (52.6% female) of the Mater Hospital-University of Queensland Study of Pregnancy follow up at a mean age of 20.6 years. The Mater Hospital-University of Queensland Study of Pregnancy is a prospective Australian pre-birth cohort study of mothers consecutively recruited during their first obstetric clinic visit at Brisbane's Mater Hospital in 1981-1983. Participants completed the Pittsburgh Sleep Quality Index at the 21-year follow up. We linked this dataset to agency-recorded substantiated cases of childhood maltreatment. A series of separate logistic regression models was used to test whether childhood maltreatment predicted lower sleep quality after adjustment for selected confounders. Substantiated physical abuse significantly predicted lower sleep quality in males. Single and multiple forms of childhood maltreatment, including age of maltreatment and number of substantiations, did not predict lower sleep quality in either gender in both crude and adjusted models. Not being married, living in a residential problem area, cigarette smoking and internalising were significantly associated with lower sleep quality in a fully adjusted model for the male-female combined sample. Childhood maltreatment does not appear to predict young adult poor sleep quality, with the exception of physical abuse for males. While childhood maltreatment has been found to predict a range of mental health problems, childhood maltreatment does not appear to predict sleep problems occurring in young adults. Poor sleep quality was

  14. Defining poor and optimum performance in an IVF programme.

    Science.gov (United States)

    Castilla, Jose A; Hernandez, Juana; Cabello, Yolanda; Lafuente, Alejandro; Pajuelo, Nuria; Marqueta, Javier; Coroleu, Buenaventura

    2008-01-01

    At present there is considerable interest in healthcare administration, among professionals and among the general public concerning the quality of programmes of assisted reproduction. There exist various methods for comparing and analysing the results of clinical activity, with graphical methods being the most commonly used for this purpose. As yet, there is no general consensus as to how the poor performance (PP) or optimum performance (OP) of assisted reproductive technologies should be defined. Data from the IVF/ICSI register of the Spanish Fertility Society were used to compare and analyse different definitions of PP or OP. The primary variable best reflecting the quality of an IVF/ICSI programme was taken to be the percentage of singleton births per IVF/ICSI cycle initiated. Of the 75 infertility clinics that took part in the SEF-2003 survey, data on births were provided by 58. A total of 25 462 cycles were analysed. The following graphical classification methods were used: ranking of the proportion of singleton births per cycles started in each centre (league table), Shewhart control charts, funnel plots, best and worst-case scenarios and state of the art methods. The clinics classified as producing PP or OP varied considerably depending on the classification method used. Only three were rated as providing 'PP' or 'OP' by all methods, unanimously. Another four clinics were classified as 'poor' or 'optimum' by all the methods except one. On interpreting the results derived from IVF/ICSI centres, it is essential to take into account the characteristics of the method used for this purpose.

  15. Low Level Waste Conceptual Design Adaption to Poor Geological Conditions

    International Nuclear Information System (INIS)

    Bell, J.; Drimmer, D.; Giovannini, A.; Manfroy, P.; Maquet, F.; Schittekat, J.; Van Cotthem, A.; Van Echelpoel, E.

    2002-01-01

    Since the early eighties, several studies have been carried out in Belgium with respect to a repository for the final disposal of low-level radioactive waste (LLW). In 1998, the Belgian Government decided to restrict future investigations to the four existing nuclear sites in Belgium or sites that might show interest. So far, only two existing nuclear sites have been thoroughly investigated from a geological and hydrogeological point of view. These sites are located in the North-East (Mol-Dessel) and in the mid part (Fleurus-Farciennes) of the country. Both sites have the disadvantage of presenting poor geological and hydrogeological conditions, which are rather unfavorable to accommodate a surface disposal facility for LLW. The underground of the Mol-Dessel site consists of neogene sand layers of about 180 m thick which cover a 100 meters thick clay layer. These neogene sands contain, at 20 m depth, a thin clayey layer. The groundwater level is quite close to the surface (0-2m) and finally, the topography is almost totally flat. The upper layer of the Fleurus-Farciennes site consists of 10 m silt with poor geomechanical characteristics, overlying sands (only a few meters thick) and Westphalian shales between 15 and 20 m depth. The Westphalian shales are tectonized and strongly weathered. In the past, coal seams were mined out. This activity induced locally important surface subsidence. For both nuclear sites that were investigated, a conceptual design was made that could allow any unfavorable geological or hydrogeological conditions of the site to be overcome. In Fleurus-Farciennes, for instance, the proposed conceptual design of the repository is quite original. It is composed of a shallow, buried concrete cylinder, surrounded by an accessible concrete ring, which allows permanent inspection and control during the whole lifetime of the repository. Stability and drainage systems should be independent of potential differential settlements an d subsidences

  16. Financing off-grid sustainable energy access for the poor

    International Nuclear Information System (INIS)

    Glemarec, Yannick

    2012-01-01

    This paper examines the role of public instruments in promoting private finance to achieve off-grid sustainable energy access. Renewable energy technologies are increasingly becoming the cheapest solutions for off-grid energy access. The dramatic uptake of mobile phones in developing countries shows how quickly decentralized services can develop on a commercial basis under the right conditions, and raises the prospect that private finance could also drive decentralized energy access for the poor. Indeed, there are already a number of instances of clean energy solutions – such as solar portable lights, household biogas units or solar home systems – that have managed to scale-up through leveraging private finance. However, the experience gained from first-generation market development projects show that, in almost all cases, significant public resources have been necessary to increase the affordability of clean energy technologies, provide access to financing for the poor, and remove non-economic barriers. Such public interventions may be funded by international public finance, domestic budgets and carbon finance. Despite mounting fiscal constraints facing governments worldwide, the emergence of new sources of climate finance and the political momentum in support of energy subsidy reforms, as well as new programming modalities, offer opportunities to leverage additional resources to achieve universal energy access by 2030. - Highlights: ► Renewable energy is increasingly the cheapest solution for off-grid energy access. ► Universal access to energy now depends less on technology and more business models. ► Substantial public finance will still be required to support universal energy access.

  17. Factors associated with poor outcomes of continuous renal replacement therapy.

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    Chih-Chin Kao

    Full Text Available Continuous renal replacement therapy (CRRT is one of the dialysis modalities for critically ill patients. Despite intensive dialysis care, a high mortality rate is found in these patients. Our objective was to investigate the factors associated with poor outcomes in these patients. We conducted a retrospective cohort study using the National Health Insurance Research Database. Records of critically ill patients who received CRRT between 2007 and 2011 were retrieved, and the patients were categorized into two groups: those with acute kidney injury (AKI and those with history of end-stage renal disease (ESRD. Our primary and secondary outcomes were in-hospital mortality and long-term survival and non-renal recovery (long-term dialysis dependence, respectively, in the AKI group. We enrolled 15,453 patients, with 13,204 and 2249 in the AKI and ESRD groups, respectively. Overall, 66.5% patients died during hospitalization. In-hospital mortality did not differ significantly between groups (adjusted odds ratio, 0.93; 95% CI, 0.84-1.02. Age, chronic liver disease, and cancer history were identified as independent risk factors for in-hospital mortality in both groups. Hypertension was associated with higher risk of in-hospital mortality in patients with AKI. Age, coronary artery disease, and admission to the medical intensive care unit (MICU were risk factors for long-term dialysis dependence in patients with AKI. Patients with AKI and ESRD have similarly poor outcomes after CRRT. Older age and presence of chronic liver disease and cancer were associated with higher mortality. Older age, presence of coronary artery disease, and admission to MICU were associated with lower renal recovery rate in patients with AKI.

  18. Improvement of poor subgrade soils using cement kiln dust

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    Ahmed Mancy Mosa

    2017-12-01

    Full Text Available Construction of pavements layers on subgrade with excellent to good properties reduces the thickness of the layers and consequently reduces the initial and maintenance cost of highways and vice versa. However, construction of pavements on poor subgrade is unavoidable due to several constrains. Improvement of subgrade properties using traditional additives such as lime and Portland cement adds supplementary costs. Therefore, using by-products in this domain involves technical, economic, and environmental advantages. Cement kiln dust (CKD is generated in huge quantities as a by-product material in Portland cement plants. Therefore, it can be considered as an excellent alternative in this domain. In Iraq, Portland cement plants generate about 350000 tons of CKD annually which is available for free. Therefore, Iraq can be adopted as a case study. This paper covers using CKD to improve the properties of poor subgrade soils based on series of California Bearing Ration (CBR tests on sets of untreated samples and samples treated with different doses of CKD in combination with different curing periods to investigate their effects on soil properties. The results exhibited that adding 20% of CKD with curing for 14 days increases the CBR value from 3.4% for untreated soil to 48% for treated soil; it, also, decreases the swelling ratio. To determine the effects of using this dose under the mentioned curing period on the designed thicknesses of pavements layers, a case study was adopted. The case study results exhibited that treatment of the subgrade soil by 20% of CKD with curing for 14 days reduces the cost of the pavements by $25.875 per square meter.

  19. Origin of poor doping efficiency in solution processed organic semiconductors.

    Science.gov (United States)

    Jha, Ajay; Duan, Hong-Guang; Tiwari, Vandana; Thorwart, Michael; Miller, R J Dwayne

    2018-05-21

    Doping is an extremely important process where intentional insertion of impurities in semiconductors controls their electronic properties. In organic semiconductors, one of the convenient, but inefficient, ways of doping is the spin casting of a precursor mixture of components in solution, followed by solvent evaporation. Active control over this process holds the key to significant improvements over current poor doping efficiencies. Yet, an optimized control can only come from a detailed understanding of electronic interactions responsible for the low doping efficiencies. Here, we use two-dimensional nonlinear optical spectroscopy to examine these interactions in the course of the doping process by probing the solution mixture of doped organic semiconductors. A dopant accepts an electron from the semiconductor and the two ions form a duplex of interacting charges known as ion-pair complexes. Well-resolved off-diagonal peaks in the two-dimensional spectra clearly demonstrate the electronic connectivity among the ions in solution. This electronic interaction represents a well resolved electrostatically bound state, as opposed to a random distribution of ions. We developed a theoretical model to recover the experimental data, which reveals an unexpectedly strong electronic coupling of ∼250 cm -1 with an intermolecular distance of ∼4.5 Å between ions in solution, which is approximately the expected distance in processed films. The fact that this relationship persists from solution to the processed film gives direct evidence that Coulomb interactions are retained from the precursor solution to the processed films. This memory effect renders the charge carriers equally bound also in the film and, hence, results in poor doping efficiencies. This new insight will help pave the way towards rational tailoring of the electronic interactions to improve doping efficiencies in processed organic semiconductor thin films.

  20. Main causes of poor welfare in intensively reared dairy cows

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    Fabio Abeni

    2010-01-01

    Full Text Available The aim of this review is to summarise the main causes of poor welfare in intensively reared dairy cows. Intensive farming systems are considered, both from a structural and a managerial point of view, for their constraints that may limit animal welfare: possible physical activity; acceptable interactions with humans and other animals; feeding and watering, protection from climate, parasites, and diseases. The dairy farms managed according to the organic rules do not always guarantee, per se, better welfare conditions; organic or low input dairy farming needs to consider the right interaction among cattle breed and herd management, focusing on the actual quality of feedstuffs meet face cow requirements. The considered structural aspects evidence how special care must be given to the rest area (straw yard or cubicle; to the floors that should be not too hard or abrasive and not slippery; to the cubicle bedding material to ensure hygiene, softness, and dryness; to the feeding (and watering area to reduce conflicts; to a microclimate control system, to avoid heat stress during summer time. The importance of proper management for animal welfare is evidenced for buildings and equipment, to have clean and comfortable stables and well functioning milking machines; nutritive and storage quality of feeds; diet suitability (energy, protein, physically efficient fibre, buffers etc., in the different phases of a dairy cow’s life (dry period, close-up, transition, and lactation; feed distribution (frequency and time, and 24h availability. Special attention has to be paid to the social aspects, regarding both animal competition (stocking density, group size, and human/animal interactions (methods of management and manipulation. The interaction between welfare and health requires special attention. Poor welfare can cause immune depression, thus increasing the risk of disease. In turn, any disease that causes an inflammatory response may determine depression

  1. Maternal care practices among the ultra poor households in rural Bangladesh: a qualitative exploratory study

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    Choudhury Nuzhat

    2011-03-01

    pregnancy and post-partum period. Women usually failed to go to the healthcare providers for illnesses in the post-partum period. Conclusion This study shows that cultural beliefs and norms have a strong influence on maternal care practices among the ultra poor households, and override the beneficial economic effects from livelihood support intervention. Some of these practices, often compromised by various taboos and beliefs, may become harmful at times. Health behavior education in this livelihood support program can be carefully tailored to local cultural beliefs to achieve better maternal outcomes.

  2. Discovery of a Metal-Poor Little Cub

    Science.gov (United States)

    Kohler, Susanna

    2017-09-01

    The discovery of an extremely metal-poor star-forming galaxy in our local universe, dubbed Little Cub, is providing astronomers with front-row seats to the quenching of a near-pristine galaxy.SDSS image of NGC 3359 (left) and Little Cub (right), with overlying contours displaying the location of hydrogen gas. Little Cubs (also shown in the inset) stellar mass lies in the blue contour of the right-hand side. The outer white contours show the extended gas of the galaxy, likely dragged out as a tidal tail by Little Cubs interaction with NGC 3359. [Hsyu et al. 2017]The Hunt for Metal-Poor GalaxiesLow-metallicity, star-forming galaxies can show us the conditions under which the first stars formed. The galaxies with the lowest metallicities, however, also tend to be those with the lowest luminosities making them difficult to detect. Though we know that there should be many low-mass, low-luminosity, low-metallicity galaxies in the universe, weve detected very few of them nearby.In an effort to track down more of these metal-poor galaxies, a team of scientists led by Tiffany Hsyu (University of California Santa Cruz) searched through Sloan Digital Sky Survey data, looking for small galaxies with the correct photometric color to qualify a candidate blue compact dwarfs, a type of small, low-luminosity, star-forming galaxy that is often low-metallicity.Hsyu and collaborators identified more than 2,500 candidate blue compact dwarfs, and next set about obtaining follow-up spectroscopy for many of the candidates from the Keck and Lick Observatories. Though this project is still underway, around 100 new blue compact dwarfs have already been identified via the spectroscopy, including one of particular interest: the Little Cub.Little CubThis tiny star-forming galaxy gained its nickname from its location in the constellation Ursa Major. Little Cub is perhaps 50 or 60 million light-years away, and Hsyu and collaborators find it to be one of the lowest-metallicity star

  3. Poor self-control and harsh punishment in childhood prospectively predict borderline personality symptoms in adolescent girls.

    Science.gov (United States)

    Hallquist, Michael N; Hipwell, Alison E; Stepp, Stephanie D

    2015-08-01

    Developmental theories of borderline personality disorder (BPD) propose that harsh, invalidating parenting of a child with poor self-control and heightened negative emotionality often leads to a coercive cycle of parent-child transactions that increase risk for BPD symptoms such as emotion dysregulation. Although parenting practices and child temperament have previously been linked with BPD, less is known about the prospective influences of caregiver and child characteristics. Using annual longitudinal data from the Pittsburgh Girls Study (n = 2,450), our study examined how reciprocal influences among harsh parenting, self-control, and negative emotionality between ages 5 and 14 predicted the development of BPD symptoms in adolescent girls ages 14 to 17. Consistent with developmental theories, we found that harsh punishment, poor self-control, and negative emotionality predicted BPD symptom severity at age 14. Only worsening self-control between ages 12 and 14, however, predicted growth in BPD symptoms from 14 to 17. Furthermore, the effects of harsh punishment and poor self-control on age 14 BPD symptoms were partially mediated by their earlier reciprocal effects on each other between ages 5 and 14. Our findings underscore the need to address both child and parental contributions to dysfunctional transactions in order to stem the development of BPD symptoms. Moreover, problems with self-regulation in early adolescence may indicate heightened risk for subsequent BPD. Altogether, these results increase our understanding of developmental trajectories associated with BPD symptoms in adolescent girls. (c) 2015 APA, all rights reserved).

  4. Prevalence and risk factors of poor sleep quality among Inner Mongolia Medical University students: A cross-sectional survey.

    Science.gov (United States)

    Wang, Lan; Qin, Peng; Zhao, Yunshan; Duan, Shengyun; Zhang, Qing; Liu, Ying; Hu, Yueling; Sun, Juan

    2016-10-30

    Medical students face new challenges at the beginning of college life, such as being responsible for oneself, an unfamiliar environment, social obligations, and academic stress, all of which influence or even heavily change their sleep quality and life, leading to sleep-related problems to some degree. This study investigated the relationship between sleep quality and behavior among students at the Inner Mongolia Medical University in China. Self-administered questionnaires were used to collect information on sociodemographic characteristics and lifestyle habits. The Pittsburgh Sleep Quality Index was also used. A total of 6044 and 6085 students completed the questionnaires in 2011 and 2013. According to the index, 27.8% (1694) of students had poor sleep quality with major risk factors being poor academic performance and interpersonal relationships in 2013. Among others, regular exercise less than three times a week, skipping breakfast, and studying in higher grades were associated with poor sleep quality. These results will help university administrators understand the risk factors of poor sleep quality among students, which can be improved through individual efforts, and provide adequate counseling and systematic education to improve their behavior and lifestyle. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  5. Significance of excipients to enhance the bioavailability of poorly water-soluble drugs in oral solid dosage forms: A Review

    Science.gov (United States)

    Vadlamudi, Manoj Kumar; Dhanaraj, Sangeetha

    2017-11-01

    Nowadays most of the drug substances are coming into the innovation pipeline with poor water solubility. Here, the influence of excipients will play a significant role to improve the dissolution of poorly aqueous soluble compounds. The drug substance needs to be dissolved in gastric fluids to get the better absorption and bioavailability of an orally administered drug. Dissolution is the rate-controlling stage for drugs which controls the rate and degree of absorption. Usually, poorly soluble oral administrated drugs show a slower dissolution rate, inconsistent and incomplete absorption which can lead to lower bioavailability. The low aqueous solubility of BCS class II and IV drugs is a major challenge in the drug development and delivery process. Several technologies have been used in an attempt to progress the bioavailability of poorly water-soluble drug compounds which include solid dispersions, lipid-based formulations, micronization, solvent evaporation, co-precipitation, ordered mixing, liquid-solid compacts, solvent deposition inclusion complexation, and steam aided granulation. In fact, most of the technologies require excipient as a carrier which plays a significant role in improving the bioavailability using Hypromellose acetate succinate, Cyclodextrin, Povidone, Copovidone, Hydroxypropyl cellulose, Hydroxypropyl methylcellulose, Crospovidone, Starch, Dimethylacetamide, Polyethylene glycol, Sodium lauryl sulfate, Polysorbate, Poloxamer. Mesoporous silica and so on. This review deliberates about the excipients significance on bioavailability enhancement of drug products in a single platform along with pragmatically proved applications so that user can able to select the right excipients as per the molecule.

  6. Students’ and Teachers’ Perceptions of Factors Leading to Poor Clinical Skill Development in Medical Education: A Descriptive Study

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    Chatterjee Nandini

    2015-01-01

    Full Text Available Background. Our study was taken up to explore the possible factors influencing poor performance of undergraduate students in clinical skill demonstration. Aims. Identification of factors leading to poor clinical skill development in undergraduate medical students. Settings and Design. This is an observational study. Methods and Material. The study population comprised the undergraduate students and teachers of the Department of Medicine. All were provided with structured questionnaires who responded anonymously which were then interpreted with the help of software statistical calculator. Results. Of the 145 students, only 57 (39.3% actually attended medicine ward. The major factors that the students reported were large groups of students around a patient (94.74%  ± 4.67, inadequacy of information in books of clinical medicine (78.9%  ± 8.53, overcrowded unclean wards (73.7%  ± 9.2, lack of practice of clinical methods at home (50.8%  ± 10.4, and timing of classes (42.1%  ± 10.3. Teachers cited poor attendance of students to wards (76.2%  ± 17.1, poor condition of wards and lack of separate enclosures to teach (100%, and large groups around a single patient (66.67%  ± 17.9. Conclusions. Absenteeism of students, overcrowding of wards, and lack of uniformity of study materials were prime factors.

  7. The Shape of Extremely Metal-Poor Galaxies

    Science.gov (United States)

    Putko, Joseph; Sánchez Almeida, Jorge; Muñoz-Tuñón, Casiana; Elmegreen, Bruce; Elmegreen, Debra

    2018-01-01

    This work is the first study on the 3D shape of starbursting extremely metal-poor galaxies (XMPs; a galaxy is said to be an XMP if its ionized gas-phase metallicity is less than 1/10 the solar value). A few hundred XMPs have been identified in the local universe primarily through mining the spectroscopic catalog of the Sloan Digital Sky Survey (SDSS), and follow-up observations have shown that metallicity drops significantly at the starburst (compared to the quiescent component of the galaxy). As the timescale for gas mixing is short, the metal-poor gas triggering the starburst must have been accreted recently. This is strong observational evidence for the cold flow accretion predicted by cosmological models of galaxy formation, and, in this respect, XMPs seem to be the best local analogs of the very first galaxies.The ellipsoidal shape of a class of galaxies can be inferred from the observed axial ratio (q) distribution (q = minor axis/major axis) of a large sample of randomly-oriented galaxies. Fitting ellipses to 200 XMPs using r-band SDSS images, we observe that the axial ratio distribution falls off at q ~0.8, and we determine that these falloffs are not due to biases in the data. The falloff at low axial ratio indicates that the XMPs are thick for their size, and the falloff at high axial ratio suggests the vast majority of XMPs are triaxial. We also observe that smaller XMPs are thicker in proportion to their size, and it is expected that for decreasing galaxy size the ratio of random to rotational motions increases, which correlates with increasing relative thickness. The XMPs are low-redshift dwarf galaxies dominated by dark matter, and our results are compatible with simulations that have shown dark matter halos to be triaxial, with triaxial stellar distributions for low-mass galaxies and with triaxiality increasing over time. We will offer precise constraints on the 3D shape of XMPs via Bayesian analysis of our observed axial ratio distribution.This work

  8. Unusual dewetting of thin polymer films in liquid media containing a poor solvent and a nonsolvent.

    Science.gov (United States)

    Xu, Lin; Sharma, Ashutosh; Joo, Sang Woo; Liu, Hui; Shi, Tongfei

    2014-12-16

    We investigate the control of pattern size and kinetics in spontaneous dewetting of thin polymer films (polystyrene) that are stable to thermal annealing by annealing in a poor solvent (acetone)/nonsolvent (ethanol or n-hexane) liquid mixture. Dewetting occurs by the formation and growth of circular holes that coalesce to form droplets. The influence of the nature and the volume fraction of the nonsolvents on the contact angle of polymer droplets, number density of holes, and the kinetics of holes formation and growth is studied. Addition of ethanol greatly increases the hole density and slows down the kinetics substantially, while affecting only a small change in wettability. n-Hexane addition shows an interesting nonmonotonic response in decreasing the hole density and contact angle in the volume fraction range of 0-0.3 but an opposite effect beyond that. Although the two nonsolvents chosen cannot by themselves induce dewetting, their relative affinity for the solid substrate vis-à-vis acetone can strongly influence the observed dewetting scenarios that are not understood by the existing theoretical considerations. n-Hexane, for example, has great affinity for silicon substrate. In addition to the changes in wettability, viscosity, and film interfacial tension engendered by the nonsolvents, the possibility of the formation of adsorbed liquid layers at the substrate-polymer interface, which can modify the interfacial friction and slippage, needs to be considered.

  9. Interaction of some essential amino acids with synthesized poorly crystalline hydroxyapatite

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    A. El Rhilassi

    2016-09-01

    Full Text Available This study focused on the release of two essential amino acids, l-lysine and dl-leucine, previously adsorbed onto poorly crystalline hydroxyapatite of Ca/P = 1.59, synthesis by precipitation methods. The composition of the calcium-deficient hydroxyapatite (CDHA is chemically and structurally similar to the bone mineral. Their surface reactivity is indeed linked to the existence of hydrated surface particles (HPO42- and Ca2+. The adsorption kinetics is very fast while the release kinetics is relatively slow. The adsorption rate reached approximately 70%, but the release rate did not exceed 12%. The chemical composition of solution has an influence on the release processes. The presence of phosphate ions favored the release of amino acids, while the calcium ions inhibited it. Also, the release process is slightly influenced by Ra (ml/mg ratio and incubation temperature of the medium. The charged –COO− and NH3+ of amino acids are the strongest groups that interact with the surface of hydroxyapatite, the adsorption is mainly due to the electrostatic interaction between the groups –COO− of amino acids and calcium Ca2+ ions of the hydroxyapatite. dl-Leucine (non-polar and l-Lysine (polar–basic interact with the hydroxyapatite surface in the zwitterionic and cationic forms, respectively. The study of interactions between amino acids and hydroxyapatite is carried out in vitro by using UV–vis and infrared spectroscopy IR techniques.

  10. The development of the food barn in achieving food security of poor household in Wonogiri Regency

    Science.gov (United States)

    Suminah

    2018-03-01

    Food barn has function as food stock which managed by households both individually and collectively. It has important role in food security. This study aims to determine the factors that influence the development of food barns, and formulate alternative strategies in the development of food barns in Wonogiri regency. The samples of this research were determined by random sampling. The data collection technique was done by interview, field observation and focus group discussion (FGD). The data analysis was done quantitatively with multiple regression, and qualitative information. The results showed that the age of respondents included in the category of middle age, their level of education was mostly from elementary school, most of their occupation were farmers, they had narrow knowledge of land management, and their income was around 1-2 million rupiah/month. In fact, the perception of food barns, institutional regulation of food barns, and the Economic institutions of food barn have a positive significant influence toward food barn development, filling the food barn and institutional capacity of food barn groups in realizing the food security of poor household in Wonogiri Regency. In food barn development, there are positive and clear perceptions of the food barn, institutional regulations. It indicates that significant as well as the economic institution of food barn are needed so that the food security can be realized.

  11. Poor Consumer Comprehension and Plan Selection Inconsistencies Under the 2016 Choice Architecture

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    Annabel Z. Wang BA

    2017-06-01

    Full Text Available Background: Many health policy experts have endorsed insurance competition as a way to reduce the cost and improve the quality of medical care. In line with this approach, health insurance exchanges, such as HealthCare.gov , allow consumers to compare insurance plans online. Since the 2013 rollout of HealthCare.gov , administrators have added features intended to help consumers better understand and compare insurance plans. Although well-intentioned, changes to exchange websites affect the context in which consumers view plans, or choice architecture, which may impede their ability to choose plans that best fit their needs at the lowest cost. Methods: By simulating the 2016 HealthCare.gov enrollment experience in an online sample of 374 American adults, we examined comprehension and choice of HealthCare.gov plans under its choice architecture. Results: We found room for improvement in plan comprehension, with higher rates of misunderstanding among participants with poor math skills ( P 0.9. Limitations: Participants were drawn from a general population sample. The study does not assess for all possible plan choice influencers, such as provider networks, brand recognition, or help from others. Conclusions: Our findings suggest two areas of improvement for exchanges: first, the remaining gap in consumer plan comprehension and, second, the apparent influence of sorting order—and likely other choice architecture elements—on plan choice. Our findings inform strategies for exchange administrators to help consumers understand and select plans that better fit their needs.

  12. Urban marginality, religious liminality, and the black poor

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    R. Drew Smith

    2015-11-01

    Full Text Available While many persons within westernised or westernising nations such as the United States of America and South Africa continue to place importance on matters of faith, a growing number of those persons approach matters of faith informally rather than formally and individually rather than institutionally. The implications of this are that among 21st century populations informal religious formation may be as important as or more important than the formation taking place via formal religious channels. A central emphasis of this article is that this is especially true among more socially marginalised populations, not simply because they may not enjoy the same level of access to formal institutions, but also because they may regard those institutions as spiritually and culturally restrictive and exclusionary. The contributions of the article are, firstly, its use of original and unique survey data generated from neighbourhood studies the author directed in low-income contexts within several U.S. cities and within Pretoria, South Africa, and, secondly, its analysis of informal ways the urban poor engage Christian ideas and practices − an aspect of urban religion that has not received adequate scholarly attention.

  13. Minimal NOx emission by Lysinibacillus sphaericus in nutrient poor soil

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    Melissa Sánchez

    2018-06-01

    Full Text Available The aim of this study was to determine whether nitrogen dioxide emissions by Lysinibacillus sphaericus exist in nutrient poor soil. First, we evaluated the presence of two genes involved in denitrification (nosF and nosD by PCR screening of five strains of L. sphaericus (III (37, OT4b.49, OT4b.25, OT4b.31 and CBAM5. We then applied a bacterial consortium made up by L. sphaericus III (37 and OT4b.49 into closed microcosms of soil and with minimum salts medium (MSM supplemented with ammonia to measure the concentration of produced nitrogen dioxide over time. The assays with closed microcosms showed a minimum level of nitrogen dioxide over time. The nosF and nosD primers amplified the expected fragment for the five strains and the sequenced nosF and nosD PCR product showed an ATPase domain and a copper-binding domain respectively, which was consistent with the function of these genes. The basal emission of nitrogen dioxide by L. sphaericus in soil is coupled to its ability to enhance the nitrogen bioavailability for soils deficient in nutrients. Therefore, our results indicate that this microorganism can be considered as a good candidate to validate the low emission of NOx in field and in the future as an alternative for biofertilization.

  14. Poor flight performance in deep-diving cormorants.

    Science.gov (United States)

    Watanabe, Yuuki Y; Takahashi, Akinori; Sato, Katsufumi; Viviant, Morgane; Bost, Charles-André

    2011-02-01

    Aerial flight and breath-hold diving present conflicting morphological and physiological demands, and hence diving seabirds capable of flight are expected to face evolutionary trade-offs regarding locomotory performances. We tested whether Kerguelen shags Phalacrocorax verrucosus, which are remarkable divers, have poor flight capability using newly developed tags that recorded their flight air speed (the first direct measurement for wild birds) with propeller sensors, flight duration, GPS position and depth during foraging trips. Flight air speed (mean 12.7 m s(-1)) was close to the speed that minimizes power requirement, rather than energy expenditure per distance, when existing aerodynamic models were applied. Flights were short (mean 92 s), with a mean summed duration of only 24 min day(-1). Shags sometimes stayed at the sea surface without diving between flights, even on the way back to the colony, and surface durations increased with the preceding flight durations; these observations suggest that shags rested after flights. Our results indicate that their flight performance is physiologically limited, presumably compromised by their great diving capability (max. depth 94 m, duration 306 s) through their morphological adaptations for diving, including large body mass (enabling a large oxygen store), small flight muscles (to allow for large leg muscles for underwater propulsion) and short wings (to decrease air volume in the feathers and hence buoyancy). The compromise between flight and diving, as well as the local bathymetry, shape the three-dimensional foraging range (<26 km horizontally, <94 m vertically) in this bottom-feeding cormorant.

  15. Defining the conformational features of anchorless, poorly neuroinvasive prions.

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    Cyrus Bett

    Full Text Available Infectious prions cause diverse clinical signs and form an extraordinary range of structures, from amorphous aggregates to fibrils. How the conformation of a prion dictates the disease phenotype remains unclear. Mice expressing GPI-anchorless or GPI-anchored prion protein exposed to the same infectious prion develop fibrillar or nonfibrillar aggregates, respectively, and show a striking divergence in the disease pathogenesis. To better understand how a prion's physical properties govern the pathogenesis, infectious anchorless prions were passaged in mice expressing anchorless prion protein and the resulting prions were biochemically characterized. Serial passage of anchorless prions led to a significant decrease in the incubation period to terminal disease and altered the biochemical properties, consistent with a transmission barrier effect. After an intraperitoneal exposure, anchorless prions were only weakly neuroinvasive, as prion plaques rarely occurred in the brain yet were abundant in extracerebral sites such as heart and adipose tissue. Anchorless prions consistently showed very high stability in chaotropes or when heated in SDS, and were highly resistant to enzyme digestion. Consistent with the results in mice, anchorless prions from a human patient were also highly stable in chaotropes. These findings reveal that anchorless prions consist of fibrillar and highly stable conformers. The additional finding from our group and others that both anchorless and anchored prion fibrils are poorly neuroinvasive strengthens the hypothesis that a fibrillar prion structure impedes efficient CNS invasion.

  16. The rich and the poor: A note on countries’ classification

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    Gianni Vaggi

    2017-03-01

    Full Text Available With respect to the official thresholds of development in terms of GNI per capita, all developing countries have made remarkable progress; between 1987 and 2015 the number of Low Income Countries has decreased from 42 to 31, while that of High Income Countries has increased from 25 to 79. This rosy picture is largely due to the specific way in which the thresholds have been updated. This paper revises the thresholds according to the increase in the world income per capita during those 28 years. The revised thresholds give a less optimistic description of the economic improvements that occurred during these 28 years, but they provide a better classification of the changes in relative income per capita levels. According to the World Bank’s classification, middle-income countries host the majority of the poor. With the methodology proposed in this paper this is still true, but only because India marginally belongs to the LMICs group. The paper discusses the implication of the proposed thresholds for the extreme poverty line, which in 2015 has been updated to 1.90 US$ a day at 2011 Purchasing Power Parity prices.

  17. Sialolithiasis and Poorly Controlled Type 2 Diabetes Mellitus

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    Agoeng Tjahjani Sarwono

    2015-10-01

    Full Text Available Sialolithiasis is a common disease of the submandibular glands or its duct but rare in parotids of patients, especially in male adults. The accessory of salivary glands are small, unsheathed masses with a small canaliculi. The irritant factors might be due to inflammation of the inner layer of the canaliculi, that often concomitant to saliva stasis. This process leads to development of calculus that it is related to secretive specificity of the submandibular gland. The essential factor for its calcification is the stagnation of secretory matieral rich in calcium. The accumulation of this material would cause swelling, further obstruction and atrophy until there is widespread inflammation that has been termed sialadenitis. Diabetes mellitus is one of the medically compromised diseases. Although there are many assocaiations between diabetes mellitus and oral health, lack of investigation in this area has been done to study salivary gland alterations. Many diabetic patient complained xerostomia, a decreasing salivary flow and enlargement of the parotid gland due to a compensatory mechanism to xerostomia that has been termed sialadenosis. This review article summarized that there is no relationship between sialolithiasis and poorly controlled type 2 diabetes mellitus.

  18. Dark matter CMB constraints and likelihoods for poor particle physicists

    Energy Technology Data Exchange (ETDEWEB)

    Cline, James M.; Scott, Pat, E-mail: jcline@physics.mcgill.ca, E-mail: patscott@physics.mcgill.ca [Department of Physics, McGill University, 3600 rue University, Montréal, QC, H3A 2T8 (Canada)

    2013-03-01

    The cosmic microwave background provides constraints on the annihilation and decay of light dark matter at redshifts between 100 and 1000, the strength of which depends upon the fraction of energy ending up in the form of electrons and photons. The resulting constraints are usually presented for a limited selection of annihilation and decay channels. Here we provide constraints on the annihilation cross section and decay rate, at discrete values of the dark matter mass m{sub χ}, for all the annihilation and decay channels whose secondary spectra have been computed using PYTHIA in arXiv:1012.4515 (''PPPC 4 DM ID: a poor particle physicist cookbook for dark matter indirect detection''), namely e, μ, τ, V → e, V → μ, V → τ, u, d s, c, b, t, γ, g, W, Z and h. By interpolating in mass, these can be used to find the CMB constraints and likelihood functions from WMAP7 and Planck for a wide range of dark matter models, including those with annihilation or decay into a linear combination of different channels.

  19. Dark matter CMB constraints and likelihoods for poor particle physicists

    International Nuclear Information System (INIS)

    Cline, James M.; Scott, Pat

    2013-01-01

    The cosmic microwave background provides constraints on the annihilation and decay of light dark matter at redshifts between 100 and 1000, the strength of which depends upon the fraction of energy ending up in the form of electrons and photons. The resulting constraints are usually presented for a limited selection of annihilation and decay channels. Here we provide constraints on the annihilation cross section and decay rate, at discrete values of the dark matter mass m χ , for all the annihilation and decay channels whose secondary spectra have been computed using PYTHIA in arXiv:1012.4515 (''PPPC 4 DM ID: a poor particle physicist cookbook for dark matter indirect detection''), namely e, μ, τ, V → e, V → μ, V → τ, u, d s, c, b, t, γ, g, W, Z and h. By interpolating in mass, these can be used to find the CMB constraints and likelihood functions from WMAP7 and Planck for a wide range of dark matter models, including those with annihilation or decay into a linear combination of different channels

  20. Strategies to advance vaccine technologies for resource-poor settings.

    Science.gov (United States)

    Kristensen, Debra; Chen, Dexiang

    2013-04-18

    New vaccine platform and delivery technologies that can have significant positive impacts on the effectiveness, acceptability, and safety of immunizations in developing countries are increasingly available. Although donor support for vaccine technology development is strong, the uptake of proven technologies by the vaccine industry and demand for them by purchasers continues to lag. This article explains the challenges and opportunities associated with accelerating the availability of innovative and beneficial vaccine technologies to meet critical needs in resource-poor settings over the next decade. Progress will require increased dialog between the public and private sectors around vaccine product attributes; establishment of specifications for vaccines that mirror programmatic needs; stronger encouragement of vaccine developers to consider novel technologies early in the product development process; broader facilitation of research and access to technologies through the formation of centers of excellence; the basing of vaccine purchase decisions on immunization systems costs rather than price per dose alone; possible subsidization of early technology adoption costs for vaccine producers that take on the risks of new technologies of importance to the public sector; and the provision of data to purchasers, better enabling them to make informed decisions that take into account the value of specific product attributes. Copyright © 2012 Elsevier Ltd. All rights reserved.

  1. Acrophialophora, a Poorly Known Fungus with Clinical Significance

    Science.gov (United States)

    Sandoval-Denis, Marcelo; Sutton, Deanna A.; Wiederhold, Nathan P.; Guarro, Josep

    2015-01-01

    Acrophialophora fusispora is an emerging opportunistic fungus capable of causing human infections. The taxonomy of the genus is not yet resolved and, in order to facilitate identification of clinical specimens, we have studied a set of clinical and environmental Acrophialophora isolates by morphological and molecular analyses. This set included the available type strains of Acrophialophora species and similar fungi, some of which were considered by various authors to be synonyms of A. fusispora. Sequence analysis of the large subunit (LSU) and internal transcribed spacer (ITS) regions of the nuclear ribosomal DNA and a fragment of the β-tubulin (Tub) gene revealed that Acrophialophora belongs in the family Chaetomiaceae and comprises three different species, i.e., A. fusispora, Acrophialophora levis, and Acrophialophora seudatica; the latter was previously included in the genus Ampullifera. The most prevalent species among clinical isolates was A. levis (72.7%), followed by A. fusispora (27.3%), both of which were isolated mostly from respiratory specimens (72.7%), as well as subcutaneous and corneal tissue samples. In general, of the eight antifungal drugs tested, voriconazole had the greatest in vitro activity, while all other agents showed poor in vitro activity against these fungi. PMID:25716450

  2. Predictors of Poor Prognosis in Aluminum Phosphide Intoxication

    Directory of Open Access Journals (Sweden)

    Fakhredin Taghaddosi Nejad

    2012-05-01

    Full Text Available Background: Aluminum phosphide as a fumigant is extensively used for wheat preservation from rodents and bugs especially in silos worldwide. There is increasing number of acute intoxication with this potentially lethal compound because of its easy availability. We have tried to locate predictors of poor prognosis in patients with aluminum phosphide intoxication in order to find patients who need more strict medical cares. Methods: All cases of aluminum phosphide intoxication that had been referred to our hospital during April 2008 to March 2010 were studied by their medical dossiers. Pertinent data including vital signs, demographic features, clinical and lab findings, and incidence of any complication were collected and analyzed by the relevant statistical methods. Results: Sixty seven cases of aluminum phosphide intoxication were included in the study. 44.8% of them were male. 97% of cases were suicidal. Mean amount of ingestion was 1.23+/- 0.71 tablets. Mortality rate was 41.8%. ECG abnormality and need for mechanical ventilation had negative relation with outcome. Conclusion: Correlation between some findings and complications with outcome in aluminum phosphide intoxication can be used as guidance for risk assessment and treatment planning in the patients.

  3. Treatment of chancroid in resource-poor countries.

    Science.gov (United States)

    Annan, Naa Torshie; Lewis, David A

    2005-04-01

    Chancroid, formerly a major cause of the genital ulcer disease syndrome, remains an important cofactor in both the transmission and acquisition of HIV-1 infection. Those countries with the greatest burden of HIV also have some of the highest prevalence rates of chancroid worldwide. The diagnosis of chancroid, caused by the fastidious bacterium Haemophilus ducreyi, is both expensive and difficult in many resource-poor areas. These areas of the world use syndromic management to treat genital ulcers and such an approach has proven effective in reducing rates of bacterial genital ulcer diseases. There are currently inexpensive and effective single-dose therapies available to treat chancroid. Single-dose regimens, given at first presentation, improve compliance and reduce the risk of sexually transmitted infections. Bacterial resistance to several antimicrobial agents has increased over the years and remains a continued threat to effective antimicrobial therapy. Follow-up of cases, and partner notification and treatment is carried out to limit reinfection and onward transmission of chancroid. Patients with coexistent HIV may be particularly at risk of failing single-dose therapy and should therefore be reviewed wherever possible.

  4. Poor agreement between operators on grading of the placenta.

    LENUS (Irish Health Repository)

    Moran, M

    2011-01-01

    Abnormal placental grading is associated with poor pregnancy outcome. The aim of this study was to measure intra- and interobserver variability in placental grading. Five expert sonographers independently graded 90 images on two occasions, each viewing separated by 1 week. A number of measures were employed to standardise assessment and minimise potential for variation: prior agreement was established between observers on the classifications for placental grading; a controlled viewing laboratory was used for all viewings; ambient lighting was optimal and monitors were calibrated to the GSDF standard. Kappa (κ) analysis was used to measure observer agreement. Substantial variations between individuals\\' scores were observed. A mean κ-value of 0.34 (range from 0.19 to 0.50) indicated fair interobserver agreement over the two occasions and only nine of the 90 images were graded the same by all five observers. Intraobserver agreement had a moderate mean κ-value of 0.52, with individual comparisons ranging from 0.45 to 0.66. This study demonstrates that, despite standardised viewing conditions, Grannum grading of the placenta is not a reliable technique even among expert observers. The need for new methods to assess placental health is required and work is ongoing to develop 2D and 3D software-based methods.

  5. Telemedicine for Epilepsy Support in Resource-poor Settings

    Directory of Open Access Journals (Sweden)

    Victor ePatterson

    2014-08-01

    Full Text Available The ProblemEpilepsy is a common disease worldwide causing significant physical and social. disability. It is one of the most treatable neurological diseases. Yet in rural, poorer countries like much of India and Nepal most people with epilepsy are not on any treatment often because they cannot access doctors. Conventional ApproachesIt is being appreciated that perhaps doctors are not the solution and that enabling health workers to treat epilepsy may be better. Few details however have been put forward about how that might be achieved.Thinking differentlyUntreated epilepsy should be considered a public health problem like HIV/AIDS, the various steps needed for treatment identified and solutions found. Telemedicine ApproachesTelemedicine might contribute to two steps - diagnosis and review. A tool which enables non-doctors to diagnose episodes as epileptic has been developed as a mobile phone app and has good applicability, sensitivity and specificity for the diagnosis. There are a number of ways in which the use of phone review or SMS can improve management.ConclusionsTelemedicine, as part of a public health program, can potentially help the millions of people in the resource-poor world with untreated epilepsy.

  6. Saving maternal lives in resource-poor settings: facing reality.

    Science.gov (United States)

    Prata, Ndola; Sreenivas, Amita; Vahidnia, Farnaz; Potts, Malcolm

    2009-02-01

    Evaluate safe-motherhood interventions suitable for resource-poor settings that can be implemented with current resources. Literature review to identify interventions that require minimal treatment/infrastructure and are not dependent on skilled providers. Simulations were run to assess the potential number of maternal lives that could be saved through intervention implementation according to potential program impact. Regional and country level estimates are provided as examples of settings that would most benefit from proposed interventions. Three interventions were identified: (i) improve access to contraception; (ii) increase efforts to reduce deaths from unsafe abortion; and (iii) increase access to misoprostol to control postpartum hemorrhage (including for home births). The combined effect of postpartum hemorrhage and unsafe abortion prevention would result in the greatest gains in maternal deaths averted. Bold new initiatives are needed to achieve the Millennium Development Goal of reducing maternal mortality by three-quarters. Ninety-nine percent of maternal deaths occur in developing countries and the majority of these women deliver alone, or with a traditional birth attendant. It is time for maternal health program planners to reprioritize interventions in the face of human and financial resource constraints. The three proposed interventions address the largest part of the maternal health burden.

  7. Dextromethorphan in Cough Syrup: The Poor Man's Psychosis.

    Science.gov (United States)

    Martinak, Bridgette; Bolis, Ramy A; Black, Jeffrey Ryne; Fargason, Rachel E; Birur, Badari

    2017-09-15

    Dextromethorphan (3-methoxy-N-methylmorphinan), also known as "DXM" and "the poor man's PCP," is a synthetically produced drug that is available in more than 140 over-the-counter cough and cold preparations. Dextromethorphan (DXM) has overtaken codeine as the most widely used cough suppressant due to its availability, efficacy, and safety profile at directed doses. However, DXM is subject to abuse. When consumed at inappropriately high doses (over 1500 mg/day), DXM can induce a state of psychosis characterized by Phencyclidine (PCP)-like psychological symptoms, including delusions, hallucinations, and paranoia. We report a noteworthy case of severe dextromethorphan use disorder with dextromethorphan-induced psychotic disorder in a 40-year-old Caucasian female, whose symptoms remitted only following treatment with a combination of an antipsychotic and mood stabilizer. While some states have begun to limit the quantity of DXM sold or restrict sales to individuals over 18-years of age, there is currently no federal ban or restriction on DXM. Abuse of DXM, a readily available and typically inexpensive agent that is not detected on a standard urine drug screen, may be an under-recognized cause of substance-induced psychosis. It is imperative that clinicians are aware of the potential psychiatric sequelae of recreational DXM use.

  8. Dextromethorphan in Cough Syrup: The Poor Man’s Psychosis

    Science.gov (United States)

    Martinak, Bridgette; Bolis, Ramy A.; Black, Jeffrey Ryne; Fargason, Rachel E.; Birur, Badari

    2017-01-01

    Dextromethorphan (3-methoxy-N-methylmorphinan), also known as “DXM” and “the poor man’s PCP,” is a synthetically produced drug that is available in more than 140 over-the-counter cough and cold preparations. Dextromethorphan (DXM) has overtaken codeine as the most widely used cough suppressant due to its availability, efficacy, and safety profile at directed doses. However, DXM is subject to abuse. When consumed at inappropriately high doses (over 1500 mg/day), DXM can induce a state of psychosis characterized by Phencyclidine (PCP)-like psychological symptoms, including delusions, hallucinations, and paranoia. We report a noteworthy case of severe dextromethorphan use disorder with dextromethorphan-induced psychotic disorder in a 40-year-old Caucasian female, whose symptoms remitted only following treatment with a combination of an antipsychotic and mood stabilizer. While some states have begun to limit the quantity of DXM sold or restrict sales to individuals over 18-years of age, there is currently no federal ban or restriction on DXM. Abuse of DXM, a readily available and typically inexpensive agent that is not detected on a standard urine drug screen, may be an under-recognized cause of substance-induced psychosis. It is imperative that clinicians are aware of the potential psychiatric sequelae of recreational DXM use. PMID:28936010

  9. Searching for dust around hyper metal poor stars

    International Nuclear Information System (INIS)

    Venn, Kim A.; Divell, Mike; Starkenburg, Else; Puzia, Thomas H.; Côté, Stephanie; Lambert, David L.

    2014-01-01

    We examine the mid-infrared fluxes and spectral energy distributions for stars with iron abundances [Fe/H] <–5, and other metal-poor stars, to eliminate the possibility that their low metallicities are related to the depletion of elements onto dust grains in the formation of a debris disk. Six out of seven stars examined here show no mid-IR excesses. These non-detections rule out many types of circumstellar disks, e.g., a warm debris disk (T ≤ 290 K), or debris disks with inner radii ≤1 AU, such as those associated with the chemically peculiar post-asymptotic giant branch spectroscopic binaries and RV Tau variables. However, we cannot rule out cooler debris disks, nor those with lower flux ratios to their host stars due to, e.g., a smaller disk mass, a larger inner disk radius, an absence of small grains, or even a multicomponent structure, as often found with the chemically peculiar Lambda Bootis stars. The only exception is HE0107-5240, for which a small mid-IR excess near 10 μm is detected at the 2σ level; if the excess is real and associated with this star, it may indicate the presence of (recent) dust-gas winnowing or a binary system.

  10. Searching for dust around hyper metal poor stars

    Energy Technology Data Exchange (ETDEWEB)

    Venn, Kim A.; Divell, Mike; Starkenburg, Else [Department of Physics and Astronomy, University of Victoria, 3800 Finnerty Road, Victoria, BC, V8P 5C2 (Canada); Puzia, Thomas H. [Institute of Astrophysics, Pontificia Universidad Catolica de Chile, Av. Vicuna Mackenna 4860, 7820436 Macul, Santiago (Chile); Côté, Stephanie [NRC Herzberg Institute of Astrophysics, 5071 West Saanich Road, Victoria, BC, V9E 2E7 (Canada); Lambert, David L., E-mail: kvenn@uvic.ca [McDonald Observatory and the Department of Astronomy, University of Texas at Austin, RLM 15.308, Austin, TX 78712 (United States)

    2014-08-20

    We examine the mid-infrared fluxes and spectral energy distributions for stars with iron abundances [Fe/H] <–5, and other metal-poor stars, to eliminate the possibility that their low metallicities are related to the depletion of elements onto dust grains in the formation of a debris disk. Six out of seven stars examined here show no mid-IR excesses. These non-detections rule out many types of circumstellar disks, e.g., a warm debris disk (T ≤ 290 K), or debris disks with inner radii ≤1 AU, such as those associated with the chemically peculiar post-asymptotic giant branch spectroscopic binaries and RV Tau variables. However, we cannot rule out cooler debris disks, nor those with lower flux ratios to their host stars due to, e.g., a smaller disk mass, a larger inner disk radius, an absence of small grains, or even a multicomponent structure, as often found with the chemically peculiar Lambda Bootis stars. The only exception is HE0107-5240, for which a small mid-IR excess near 10 μm is detected at the 2σ level; if the excess is real and associated with this star, it may indicate the presence of (recent) dust-gas winnowing or a binary system.

  11. Nocturnal motor activity in fibromyalgia patients with poor sleep quality.

    Science.gov (United States)

    Hyyppä, M T; Kronholm, E

    1995-01-01

    Nocturnal motor activity was examined in long-term rehabilitation patients complaining of poor sleep and having fibromyalgia syndrome (N = 24) or other musculoskeletal disorders (N = 60) and compared with that in 91 healthy controls drawn from a random community sample. Self-reports on sleep complaints and habits were collected. The frequency of nocturnal body movements, the "apnoea" index and ratio of "quiet sleep" to total time in bed were measured using the Static Charge Sensitive Bed (SCSB) (BioMatt). As a group, patients with fibromyalgia syndrome did not differ from patients with other musculoskeletal disorders or from healthy controls in their nocturnal motor activity. The "apnoea" index was a little higher in the fibromyalgia group than in the healthy control group but did not differ from that of the group of other musculoskeletal patients. Further multivariate analyses adjusted for age, BMI, medication and "apnoea" index did not support the assumption that an increased nocturnal motor activity characterizes patients with fibromyalgia syndrome.

  12. Impact of Economic Crisis to Family Planning Realination on Poor Household in Banjarsari District, Surakarta

    Directory of Open Access Journals (Sweden)

    Wahyuni Apri Astuti

    2016-07-01

    Full Text Available This study is carried out in Nusukan, Banjarsari, Surakarta. The problems that are related to economic crisis in Indonesia are the supply of contraception, the weakening of people purchasing power so they influence the realization of family planning program. The goals of the study are: to know the supply of contraception for poor household, to study the influence of the effect of economic crisis for the participant of family planning, to study the change of birth control and its effective strategy and to know the quality of family planning service. The data are collected using observation, and questionnaire. The study takes the area in which it has more productive couple, the percentage of poor families and the prosperous families I that belong to productive couple whose age 20 to 49 years old, at least they have two children, and participant of family planning or ever followed it. The result of the study shows that 82% respondents can get contraception easily before and at economic crisis. It is one of the important factors, for which the participant of family planning is still high. Although the economic crisis influences the price of contraception and family Income, it does not affect the participant of family planning. 87% respondents participate actively the family planning. This shows that the people have realized the importance of family planning program. There is an impact of economic crisis for the change of the ways of birth control. 38% respondents have changed over their strategy from modern to traditional contraception and the contrary, and from modern contraception to the other one. Some of them are abstention. The level of the people adaptation is high enough. They use various ways to prevent of being pregnant. 92% respondents do not want to be pregnant. If it happens an unwanted pregnancy, 15% of the respondents will abort their pregnancy. This is the challenge for the officers and the government to supply safe and accurate

  13. DEK protein overexpression predicts poor prognosis in pancreatic ductal adenocarcinoma.

    Science.gov (United States)

    Sun, Jie; Bi, Fangfang; Yang, Yang; Zhang, Yuan; Jin, Aihua; Li, Jinzi; Lin, Zhenhua

    2017-02-01

    DEK, a transcription factor, is involved in mRNA splicing, transcriptional control, cell division and differentiation. Recent studies suggest that DEK overexpression can promote tumorigenesis in a wide range of cancer cell types. However, little is known concerning the status of DEK in pancreatic ductal adenocarcinoma (PDAC). Based on the microarray data from Gene Expression Omnibus (GEO), the expression levels of DEK mRNA in PDAC tissues were significantly higher than levels in the adjacent non-tumor tissues. To explore the clinical features of DEK overexpression in PDAC, 87 PDAC and 52 normal pancreas tissues were selected for immunoenzyme staining of the DEK protein. Localization of the DEK protein was detected in PANC-1 pancreatic cancer cells using immunofluorescence (IF) staining. The correlations between DEK overexpression and the clinical features of PDAC were evaluated using the Chi-squared (χ2) and Fisher's exact tests. The survival rates were calculated by the Kaplan-Meier method, and the relationship between prognostic factors and patient survival was also analyzed by the Cox proportional hazard models. The expression levels of DEK mRNA in PDAC tissues were significantly higher than that in the adjacent non‑tumor tissues. The DEK protein showed a primarily nuclear staining pattern in PDAC. The positive rate of the DEK protein was 52.9% (46/87) in PDAC, which was significantly higher than that in the adjacent normal pancreatic tissues (7.7%, 4/52). DEK overexpression in PDAC was correlated with tumor size, histological grade, tumor‑node‑metastasis (TNM) stage and overall survival (OS) rates. In addition, multivariate analysis demonstrated that DEK overexpression was an independent prognostic factor along with histological grade and TNM stage in patients with PDAC. In conclusion, DEK overexpression is associated with PDAC progression and may be a potential biomarker for poor prognostic evaluation in PDAC.

  14. Poor knowledge and faulty thinking regarding hemolysis and potassium elevation.

    Science.gov (United States)

    Hawkins, Robert C

    2005-01-01

    A questionnaire to assess knowledge of the expected elevation in serum K measurement with different grades of hemolysis was administered to medical technologists working in biochemistry laboratories, hospital physicians and nurses. The questions involved different grades of hemolysis (mild, 1.0, moderate, 2.5 and severe, 5.0 g/L) and different final K measurements (2.9, 4.0, 5.2 and 8.2 mmol/L). Subjects estimated the K concentration in a non-hemolyzed sample for each scenario. Adjustment values (difference between final hemolyzed K concentration and subject's response) were calculated. For the 132 respondees, the mean correct score was 1.7/12. Mean adjustment values were: mild, 0.43 mmol/L (K 2.9), 0.55 (4.0), 0.88 (5.2) and 1.53 (8.2); moderate, 0.85 (2.9), 0.92 (4.0), 1.33 (5.2) and 2.50 (8.2); and severe, 0.93 (2.9), 1.48 (4.0), 1.96 (5.2), 2.96 (8.2). Correct adjustments were: mild, 0.28; moderate, 0.70; and severe, 1.40 mmol/L. Healthcare staff overestimated the effect of hemolysis on potassium measurement and used an incorrect proportional adjustment approach to the problem. Such poor knowledge and faulty thinking could lead to diagnostic delays or misdiagnoses. There is potential for such faulty thinking in all areas of laboratory medicine, and laboratories should review their educational responsibilities and reporting practices in light of this.

  15. [Congenital anomalies of poor prognosis. Genetics Consensus Committee].

    Science.gov (United States)

    Pardo Vargas, Rosa A; Aracena, Mariana; Aravena, Teresa; Cares, Carolina; Cortés, Fanny; Faundes, Víctor; Mellado, Cecilia; Passalacqua, Cristóbal; Sanz, Patricia; Castillo Taucher, Silvia

    The Genetic Branch of the Chilean Society of Paediatrics, given the draft Law governing the decriminalisation of abortion on three grounds, focusing on the second ground, which considers the "embryo or foetus suffering from a congenital structural anomaly or a genetic disorder incompatible with life outside the womb", met to discuss the scientific evidence according to which congenital anomalies (CA) may be included in this draft law. Experts in clinical genetics focused on 10 CA, reviewed the literature evidence, and met to discuss it. It was agreed not to use the term "incompatible with life outside the womb", as there are exceptions and longer survivals, and change to "congenital anomaly of poor prognosis (CAPP)". Ten CA were evaluated: serious defects of neural tube closure: anencephaly, iniencephaly and craniorachischisis, pulmonary hypoplasia, acardiac foetus, ectopia cordis, non-mosaic triploidy, "limb body wall" complex, "body stalk" anomaly, trisomy 13, trisomy 18, and bilateral renal agenesis. Findings on the prevalence, natural history, prenatal diagnostic methods, survival, and reported cases of prolonged survival were analysed. Post-natal survival, existence of treatments, and outcomes, as well as natural history without intervention, were taken into account in classifying a CA as a CAPP. A CAPP would be: anencephaly, severe pulmonary hypoplasia, acardiac foetus, cervical ectopia cordis, non-mosaic triploidy, limb body wall complex, body stalk anomaly, non-mosaic trisomy 13, non-mosaic trisomy 18, and bilateral renal agenesis. For their diagnosis, it is required that all pregnant women have access to assessments by foetal anatomy ultrasound and occasionally MRI, and cytogenetic and molecular testing. Copyright © 2016 Sociedad Chilena de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

  16. The frontotemporal syndrome of ALS is associated with poor survival.

    Science.gov (United States)

    Govaarts, Rosanne; Beeldman, Emma; Kampelmacher, Mike J; van Tol, Marie-Jose; van den Berg, Leonard H; van der Kooi, Anneke J; Wijkstra, Peter J; Zijnen-Suyker, Marianne; Cobben, Nicolle A M; Schmand, Ben A; de Haan, Rob J; de Visser, Marianne; Raaphorst, Joost

    2016-12-01

    Thirty percent of ALS patients have a frontotemporal syndrome (FS), defined as behavioral changes or cognitive impairment. Despite previous studies, there are no firm conclusions on the effect of the FS on survival and the use of non-invasive ventilation (NIV) in ALS. We examined the effect of the FS on survival and the start and duration of NIV in ALS. Behavioral changes were defined as >22 points on the ALS-Frontotemporal-Dementia-Questionnaire or ≥3 points on ≥2 items of the Neuropsychiatric Inventory. Cognitive impairment was defined as below the fifth percentile on ≥2 tests of executive function, memory or language. Classic ALS was defined as ALS without the frontotemporal syndrome. We performed survival analyses from symptom onset and time from NIV initiation, respectively, to death. The impact of the explanatory variables on survival and NIV initiation were examined using Cox proportional hazards models. We included 110 ALS patients (76 men) with a mean age of 62 years. Median survival time was 4.3 years (95 % CI 3.53-5.13). Forty-seven patients (43 %) had an FS. Factors associated with shorter survival were FS, bulbar onset, older age at onset, short time to diagnosis and a C9orf72 repeat expansion. The adjusted hazard ratio (HR) for the FS was 2.29 (95 % CI 1.44-3.65, p NIV initiation (adjusted HR 2.70, 95 % CI 1.04-4.67, p = 0.04). In conclusion, there is an association between the frontotemporal syndrome and poor survival in ALS, which remains present after initiation of NIV.

  17. Reduction of cost of poor quality in nuclear fuel manufacturing

    International Nuclear Information System (INIS)

    Holmqvist, B.

    2000-01-01

    Within ABB reduction of Cost of Poor Quality (COPQ) has become an important process to focus quality improvement initiatives on bottom-line results. The process leads to improved bottom-line results, through cost savings, but it also leads to quality improvements in our processes, products and services. The traditional way of measuring and controlling COPQ in the production workshops is not enough. It is of vital importance to include other non-value creating costs as well, both internally, e.g. in the engineering work, and externally, in delivered products and purchased goods. ABB Atom has since a number of years used the COPQ process in the various steps of nuclear fuel manufacturing. The definition has been expanded to cover, for instance: Scrap, rework and deviations; Margin slippage; Warranty costs; Lack of supplier performance; Excess and obsolete inventory. Each of the COPQ elements has a responsible 'owner' within the management of the Nuclear Fuel Division. The owners form a COPQ task force, which is responsible for analyzing results, setting goals and initiating improvement actions. The COPQ result is updated each month and is presented to all employees in several ways, such as Intranet. For the various COPQ elements improvement initiatives have been implemented. The presentation will describe some of them, such as reduction of: Scrap, rework and deviations through a process with zero defect meetings, high level of process automation, statistical methods; Margin slippage through business process re-engineering; Warranty costs through an improved design review process and expanded testing of new products; Costs for lack in supplier performance through a new concept for supplier QA/QC. It is our strong belief that both ABB Atom and our Customers will benefit from the COPQ process since it leads to a higher quality for nuclear fuel and control rods and facilitates lower product prices. (author)

  18. Citrobacter Peritoneal Dialysis Peritonitis: Rare Occurrence with Poor Outcomes

    Science.gov (United States)

    Chao, Chia-Ter; Lee, Szu-Ying; Yang, Wei-Shun; Chen, Huei-Wen; Fang, Cheng-Chung; Yen, Chung-Jen; Chiang, Chih-Kang; Hung, Kuan-Yu; Huang, Jenq-Wen

    2013-01-01

    Introduction: Non-Pseudomonas gram-negative bacteria are responsible for an increasing proportion of cases of peritoneal dialysis (PD)-related peritonitis. The role of Citrobacter species in the etiology of PD-related peritonitis is often underestimated. In the present study, we aimed to describe the clinical features, laboratory findings, and short- and long-term outcomes in PD-related peritonitis caused by Citrobacter. Methods: A retrospective review of all episodes of PD-related peritonitis caused by Citrobacter from a single center between 1990 and 2010 was performed. Clinical features, microbiological data, and outcomes of these episodes were analyzed. Results: Citrobacter species was responsible for 11 PD-related episodes (1.8% of all peritonitis episodes) in 8 patients. Citrobacter freundii was the most common etiologic species (73%), and mixed growth was found in the other 3 episodes (27%). Approximately half (46%) of the episodes were associated with constipation and/or diarrhea. Of the Citrobacter isolates from all episodes, 54% were resistant to cefazolin, and only 18% were susceptible to cefmetazole. All isolates were susceptible to ceftazidime, cefepime, carbapenem, and aminoglycosides. More than half of the patients (54%) were hospitalized for index peritonitis, and 27% of the episodes involved a change in antibiotic medication. One patient had relapsing peritonitis caused by C. koseri (9%). The mortality rate of PD-related peritonitis caused by Citrobacter was 18%, and 89% of surviving patients developed technique failure requiring a modality switch after an average of 12 months of follow-up (range 1.2-31.2 months). Conclusion: PD-related peritonitis caused by Citrobacter is associated with poor outcomes, including high rates of antibiotic resistance, a high mortality rate, and a high rate of technique failure among survivors during the follow-up period. PMID:23869184

  19. Characteristics of adolescents with poor mental health after bariatric surgery.

    Science.gov (United States)

    Järvholm, Kajsa; Karlsson, Jan; Olbers, Torsten; Peltonen, Markku; Marcus, Claude; Dahlgren, Jovanna; Gronowitz, Eva; Johnsson, Per; Flodmark, Carl-Erik

    2016-05-01

    About 20% of adolescents experience substantial mental health problems after bariatric surgery. The aim of this study was to explore differences between adolescents with poor mental health (PMH) 2 years after surgery and those with average/good mental health. Three university hospitals in Sweden. Mental health and health-related quality of life were assessed in 82 of 88 adolescents (mean age: 16.8 yr, 67% female) at baseline and 1 and 2 years after laparoscopic gastric bypass. Possible associations among mental health, weight, and biochemical outcomes were explored. Two years after surgery 16 (20%) adolescents were identified as having PMH. More symptoms of anxiety and depression and worse mental health at baseline significantly predicted PMH 2 years later. The decline in mental health for the PMH group happened mainly during the second year after surgery. Suicidal ideation was reported in 14% of the total sample 2 years postsurgery and was more frequent in the PMH group. Weight outcomes between groups were comparable at all time points, and physical health was equally improved 2 years after surgery. Although adolescents with PMH after surgery lose as much weight and have similar improvements in physical health compared with other adolescents, special attention should be given to adolescents who report mental health problems at baseline and follow-up, especially during the second year after gastric bypass. The high prevalence of suicidal ideation in adolescents 2 years after bariatric surgery is another indication that longer follow-up is necessary. Copyright © 2016 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

  20. Identifying poor performance among doctors in NHS organizations.

    Science.gov (United States)

    Locke, Rachel; Scallan, Samantha; Leach, Camilla; Rickenbach, Mark

    2013-10-01

    To account for the means by which poor performance among career doctors is identified by National Health Service organizations, whether the tools are considered effective and how these processes may be strengthened in the light of revalidation and the requirement for doctors to demonstrate their fitness to practice. This study sought to look beyond the 'doctor as individual'; as well as considering the typical approaches to managing the practice of an individual, the systems within which the doctor is working were reviewed, as these are also relevant to standards of performance. A qualitative review was undertaken consisting of a literature review of current practice, a policy review of current documentation from 15 trusts in one deanery locality, and 14 semi-structured interviews with respondents with an overview of processes in use. The framework for the analysis of the data considered tools at three levels: individual, team and organizational. Tools are, in the main, reactive--with an individual focus. They rely on colleagues and others to speak out, so their effectiveness is hindered by a reluctance to do so. Tools can lack an evidence base for their use, and there is limited linking of data across contexts and tools. There is more work to be done in evaluating current tools and developing stronger processes. Linkage between data sources needs to be improved and proactive tools at the organizational level need further development to help with the early identification of performance issues. This would also assist in balancing a wider systems approach with a current over emphasis on individual doctors. © 2012 John Wiley & Sons Ltd.

  1. At Work..., and Poor? A Look at the Czech Working Poor Population in the Living Conditions Survey (EU-SILC

    Directory of Open Access Journals (Sweden)

    Sarka Sustova

    2013-03-01

    Full Text Available The main aim of the article is to analyse the working poor employees and their household's social situation in the national income and living conditions survey (EU-SILC. The analysis starts with the definition of the two main groups of employees according to the number of months spent in the full-time employment - those working whole year and those employed for 6 to 11 months. Poverty in earned income concept is used to evaluate poverty at individual level, confronting employee's income with single person household poverty line benchmark. The study then moves to the household level poverty measure based on household's disposable equivalised income. When shifting from the individual income to the household's one the economies of scale represented by an implicit or explicit equivalence scale used in the construction of the household poverty measure play a crucial role. Therefore, attention is paid to the comparison of poverty level based on equivalised disposable income using equivalence scales and per-capita income. At the end, material deprivation of different subgroups of employees according to their poverty status is examined.

  2. Poorly-differentiated colorectal neuroendocrine tumour: CT differentiation from well-differentiated neuroendocrine tumour and poorly-differentiated adenocarcinomas

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Ji Hee [Seoul National University Hospital, Department of Radiology, Seoul (Korea, Republic of); Kim, Se Hyung [Seoul National University Hospital, Department of Radiology, Seoul (Korea, Republic of); Seoul National University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Han, Joon Koo [Seoul National University Hospital, Department of Radiology, Seoul (Korea, Republic of); Seoul National University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Seoul National University Medical Research Center, Institute of Radiation Medicine, Seoul (Korea, Republic of)

    2017-09-15

    The differentiation of poorly-differentiated neuroendocrine tumours (PD-NETs), well-differentiated NETs (WD-NETs), and adenocarcinomas (ADCs) is important due to different management options and prognoses. This study is to find the differential CT features of colorectal PD-NETs from WD-NETs and ADCs. CT features of 25 colorectal WD-NETs, 36 PD-NETs, and 36 ADCs were retrospectively reviewed. Significant variables were assessed using univariate and multivariate analyses. Receiver operating characteristics analysis determined the optimal cut-off value of tumour and lymph node (LN) size. Large size, rectum location, ulceroinfiltrative morphology without intact overlying mucosa, heterogeneous attenuation with necrosis, presence of ≥3 enlarged LNs, and metastasis were significant variables to differentiate PD-NETs from WD-NETs (P < 0.05). High attenuation on arterial phase, persistently high enhancement pattern, presence of ≥6 enlarged LNs, large LN size, and wash-in/wash-out enhancement pattern of liver metastasis were significant variables to differentiate PD-NETs from ADCs (P < 0.05). Compared to WD-NETs, colorectal PD-NETs are usually large, heterogeneous, and ulceroinfiltrative mass without intact overlying mucosa involving enlarged LNs and metastasis. High attenuation on arterial phase, presence of enlarged LNs with larger size and greater number, and wash-in/wash-out enhancement pattern of liver metastasis can be useful CT discriminators of PD-NETs from ADCs. (orig.)

  3. Nutritional quality of two cyanobacteria : How rich is 'poor' food?

    DEFF Research Database (Denmark)

    Schmidt, K.; Jonasdottir, Sigrun

    1997-01-01

    Cyanobacteria have often been described to be nutritionally inadequate and to interfere with zooplankton feeding. In laboratory experiments we offered 2 cyanobacteria, a unicellular Microcystis aeruginosa strain and the filamentous Nodularia sprumigena, to the calanoid copepod Acartia tonsa...... as the sole diet and in food mixtures with the nutritious diatom Thalassiosira weissflogii. Egg production was used as criterion of food quality. The use of cyanobacteria alone was an insufficient diet. However, with increasing additions of M. aeruginosa and N. spumigena to the diatom, different effects were...... observed. Large additions of cyanobacteria resulted in lower egg production and often in elevated mortality of the females, but small additions of M. aeruginosa caused an increase of about 25 % in egg production compared to a pure diatom diet. The influence of similar low concentrations of N. spumigena...

  4. Building social networks for maternal and newborn health in poor urban settlements: a cross-sectional study in Bangladesh.

    Science.gov (United States)

    Adams, Alayne M; Nababan, Herfina Y; Hanifi, S M Manzoor Ahmed

    2015-01-01

    The beneficial influence of social networks on health and wellbeing is well-established. In poor urban settlements in Bangladesh, BRAC's Manoshi programme trains community health workers (CHWs) to support women through pregnancy, delivery and postpartum periods. This paper test the hypothesis that the introduction of CHWs as weak ties into the social networks of Manoshi members mediates improvements in maternal and neonatal health (MNH) best practices by providing support, facilitating ideational change, connecting mother to resources, and strengthening or countering the influence of strong ties. 1000 women who had given birth in the last three months were identified and interviewed as part of ongoing monitoring of 5 poor urban settlements in Dhaka, Bangladesh. A social networks questionnaire was administered which elicited women's perceived networks around pregnancy, delivery and post-partum periods. Mediation analysis was performed to test the hypothesis that penetration of Manoshi CHWs into women's perceived networks has a beneficial effect on MNH best practises. The presence and influence of Manoshi CHWs in women's networks significantly mediated the effect of Manoshi membership on MNH best practices. Respondents who were Manoshi members and who listed Manoshi CHWs as part of their support networks were significantly more likely to deliver with a trained birth attendant (OR 3.61; 95%CI 2.36-5.51), to use postnatal care (OR 3.09; 95%CI 1.83-5.22), and to give colostrum to their newborn (OR 7.51; 95%CI 3.51-16.05). Manoshi has succeeded in penetrating the perceived pregnancy, delivery and post-partum networks of poor urban women through the introduction of trained CHWs. Study findings demonstrate the benefits of moving beyond urban health care delivery models that concentrate on the provision of clinical services by medical providers, to an approach that nurtures the power of social networks as a means to support the poorest and most marginalized in changing

  5. Building social networks for maternal and newborn health in poor urban settlements: a cross-sectional study in Bangladesh.

    Directory of Open Access Journals (Sweden)

    Alayne M Adams

    Full Text Available The beneficial influence of social networks on health and wellbeing is well-established. In poor urban settlements in Bangladesh, BRAC's Manoshi programme trains community health workers (CHWs to support women through pregnancy, delivery and postpartum periods. This paper test the hypothesis that the introduction of CHWs as weak ties into the social networks of Manoshi members mediates improvements in maternal and neonatal health (MNH best practices by providing support, facilitating ideational change, connecting mother to resources, and strengthening or countering the influence of strong ties.1000 women who had given birth in the last three months were identified and interviewed as part of ongoing monitoring of 5 poor urban settlements in Dhaka, Bangladesh. A social networks questionnaire was administered which elicited women's perceived networks around pregnancy, delivery and post-partum periods. Mediation analysis was performed to test the hypothesis that penetration of Manoshi CHWs into women's perceived networks has a beneficial effect on MNH best practises.The presence and influence of Manoshi CHWs in women's networks significantly mediated the effect of Manoshi membership on MNH best practices. Respondents who were Manoshi members and who listed Manoshi CHWs as part of their support networks were significantly more likely to deliver with a trained birth attendant (OR 3.61; 95%CI 2.36-5.51, to use postnatal care (OR 3.09; 95%CI 1.83-5.22, and to give colostrum to their newborn (OR 7.51; 95%CI 3.51-16.05.Manoshi has succeeded in penetrating the perceived pregnancy, delivery and post-partum networks of poor urban women through the introduction of trained CHWs. Study findings demonstrate the benefits of moving beyond urban health care delivery models that concentrate on the provision of clinical services by medical providers, to an approach that nurtures the power of social networks as a means to support the poorest and most marginalized in

  6. Quality of life from the perspective of the palliative care patient in a resource-poor community in South Africa.

    Science.gov (United States)

    Jansen van Rensburg, Jacoba J M; Maree, Johanna E; van Belkum, Corrien

    2013-02-01

    Quality of life is an ill-defined term, as it means different things to different people. Quality of life has been well researched, especially with respect to people with cancer, but not necessarily from the perspective of the patient, and also, not in Third World, resource-poor countries. The objective of this study was to explore quality of life from the perspective of palliative care patients managed at a palliative care clinic serving a resource-poor community in Tshwane, South Africa. An exploratory, qualitative phenomenological study was conducted. The target population for this study was all patients managed at a palliative care clinic serving a resource-poor community in Tshwane. Self-report data were gathered by means of in-depth interviews. The data were analyzed using a template analysis style as well as content analysis using open coding. Data analysis was done concurrently with data gathering. Data saturation was reached after 10 interviews (n = 10). Three themes arose from the data: factors that had a positive influence on quality of life, factors that had a negative influence on quality of life, and experience of quality of life. Work played the most important role in quality of life whereas only one participant linked symptom control with quality of life. Experiencing symptoms, rejection, and stigmatization had a negative influence on quality of life. Friends and religion played a significant role and added to quality of life. Life was a daily struggle for survival. Poverty was so overwhelming that quality of life was primarily measured in terms of the ability to buy food and other basic commodities.

  7. Decomposing the gap in missed opportunities for vaccination between poor and non-poor in sub-Saharan Africa: A multicountry analyses.

    Science.gov (United States)

    Ndwandwe, Duduzile; Uthman, Olalekan A; Adamu, Abdu; Sambala, Evanson Z; Wiyeh, Alison B; Olukade, Tawa; Bishwajit, Ghose; Yaya, Sanni; Okwo-Bele, Jean-Marie; Wiysonge, Charles S

    2018-04-24

    Understanding the gaps in missed opportunities for vaccination (MOV) between poor and non-poor in sub-Saharan Africa (SSA) would enable an understanding of factors associated with interventions for improving immunisation coverage to achieving universal childhood immunisation. We aimed to conduct a multicountry analyses to decompose the gap in MOV between poor and non-poor in SSA. We used cross-sectional data from 35 Demographic and Health Surveys in SSA conducted between 2007 and 2016. Descriptive statistics used to understand the gap in MOV between the urban poor and non-poor, and across the selected covariates. Out of the 35 countries included in this analysis, 19 countries showed pro-poor inequality, 5 showed pro-non-poor inequality and remaining 11 countries showed no statistically significant inequality. Among the countries with statistically significant pro-illiterate inequality, the risk difference ranged from 4.2% in DR Congo to 20.1% in Kenya. Important factors responsible for the inequality varied across countries. In Madagascar, the largest contributors to inequality in MOV were media access, number of under-five children, and maternal education. However, in Liberia media access narrowed inequality in MOV between poor and non-poor households. The findings indicate that in most SSA countries, children belonging to poor households are most likely to have MOV and that socio-economic inequality in is determined not only by health system functions, but also by factors beyond the scope of health authorities and care delivery system. The findings suggest the need for addressing social determinants of health.

  8. Rapamycin Rescues the Poor Developmental Capacity of Aged Porcine Oocytes

    Directory of Open Access Journals (Sweden)

    Seung Eun Lee

    2014-05-01

    Full Text Available Unfertilized oocytes age inevitably after ovulation, which limits their fertilizable life span and embryonic development. Rapamycin affects mammalian target of rapamycin (mTOR expression and cytoskeleton reorganization during oocyte meiotic maturation. The goal of this study was to examine the effects of rapamycin treatment on aged porcine oocytes and their in vitro development. Rapamycin treatment of aged oocytes for 24 h (68 h in vitro maturation [IVM]; 44 h+10 μM rapamycin/24 h, 47.52±5.68 or control oocytes (44 h IVM; 42.14±4.40 significantly increased the development rate and total cell number compared with untreated aged oocytes (68 h IVM, 22.04±5.68 (p<0.05. Rapamycin treatment of aged IVM oocytes for 24 h also rescued aberrant spindle organization and chromosomal misalignment, blocked the decrease in the level of phosphorylated-p44/42 mitogen-activated protein kinase (MAPK, and increased the mRNA expression of cytoplasmic maturation factor genes (MOS, BMP15, GDF9, and CCNB1 compared with untreated, 24 h-aged IVM oocytes (p<0.05. Furthermore, rapamycin treatment of aged oocytes decreased reactive oxygen species (ROS activity and DNA fragmentation (p<0.05, and downregulated the mRNA expression of mTOR compared with control or untreated aged oocytes. By contrast, rapamycin treatment of aged oocytes increased mitochondrial localization (p<0.05 and upregulated the mRNA expression of autophagy (BECN1, ATG7, MAP1LC3B, ATG12, GABARAP, and GABARAPL1, anti-apoptosis (BCL2L1 and BIRC5; p<0.05, and development (NANOG and SOX2; p<0.05 genes, but it did not affect the mRNA expression of pro-apoptosis genes (FAS and CASP3 compared with the control. This study demonstrates that rapamycin treatment can rescue the poor developmental capacity of aged porcine oocytes.

  9. Radiotherapy for superficial esophageal cancer of poor risk patients

    International Nuclear Information System (INIS)

    Kagami, Yoshikazu; Ikeda, Hiroshi; Murayama, Shigeyuki; Yamaguchi, Hajime; Tachimori, Yuji; Kato, Hoichi; Watanabe, Hiroshi; Tokuue, Kouichi; Sumi, Minako; Kawashima, Mitsuhiko; Imai, Atsushi; Nakayama, Shuji

    1997-01-01

    Purpose/Objective: The reported incidence of superficial esophageal cancer (SEC) has steadily increased in Japan as result of endoscopic examination has been become common. In Japan, treatment of SEC is endoscopical mucosal resection (EMR) for mucosal cancer or esophagectomy with 3 fields lymph nodes resection for submucosal cancer. Radiotherapy is little place for the management of SEC. Because of some reasons, we treated patients with SEC by radiotherapy alternative to surgery. Purpose of this report is to evaluate efficacy of radiotherapy for SEC. Methods and Materials: Between 1989 to 1996, eighteen patients with SEC were treated with radiotherapy at our hospital. Reasons of radiotherapy that was chosen as the primary methods of treatment were refusal of surgery in one patient, poor medical condition in 4 patients and double primary cancer in 13 patients (head and neck: 11, simultaneously: 11). No patients had indication of EMR. Diagnosis was made by endoscopy and radiography. Some patients were examined with endoscopic ultrasound. Two patients (11.1%) had tumor limited to the mucosa and 16 patients (88.9%) had tumor invaded the submucosa. Seven of these tumors (38.9%) were multicentric. All patients had squamous cell carcinoma. There were 17 male patients and one female patient. The age range was 49 years to 87 years with a median of 62 years. Stage of all patients was T1N0M0 according to UICC staging system. Ten patients underwent external radiotherapy (Ex) (50 Gy - 66 Gy) alone and 8 patients did both Ex and intracavitary radiotherapy (IC) (30-60 Gy of Ex with 5-15 Gy of IC). No patients received chemotherapy. Duration of follow-up was 6 months to 96 months with a median of 30 months. Results: The overall survival rate was 55.9% in 3-year and 14% in 5-year, and the cause-specific 5-year survival rate was 100%. Causes of death were malignant tumor other than esophageal cancer in 4 patients, intercurrent disease other than malignant tumor in 3 patients and no

  10. Factors associated with poor outcome for aneurysmal subarachnoid haemorrhage in a series of 334 patients.

    Science.gov (United States)

    Rivero Rodríguez, D; Scherle Matamoros, C; Fernández Cúe, L; Miranda Hernández, J L; Pernas Sánchez, Y; Pérez Nellar, J

    This study evaluates care-related sociodemographic, clinical, and imaging factors and influences associated with outcome at discharge in patients with aneurismal subarachnoid haemorrhage. Retrospective cohort study in 334 patients treated at Hospital Hermanos Ameijeiras in Havana, Cuba between October 2005 and June 2014. Logistic regression analysis determined that the following factors were associated with higher risk of poor outcome: age older than 65 years (OR 3.51, 95% CI 1.79-5.7, P=.031), female sex (OR 2.17, 95% CI 1.22-3.84, P=.0067), systolic hypertension (OR 4.82, 95% CI 2.27-9.8, P=.0001), and hyperglycaemia at admission (OR 3.93, 95% CI 2.10-7.53, P=.0003). Certain complications were also associated with poor prognosis, including respiratory infection (OR 2.73, 95% CI 1.27-5.85, P=.0085), electrolyte disturbances (OR 3.33, 95% CI 1.33-8.28, P=.0073), hydrocephalus (OR 2.21, 95% CI 1.05-4.63, P=.0039), rebleeding (OR 16.50, 95% CI 8.24-41.24, P=.0000), symptomatic vasospasm (OR 19.00, 95% CI 8.86-41.24, P=.0000), cerebral ischaemia (OR 3.82, 95% CI 1.87-7.80, P=.000) and multiplex rebleeding (OR 6.69, 95% CI 1.35-36.39, P=.0019). Grades of iii and iv on the World Federation of Neurological Surgeons (OR 2.09, 95% CI 1.12-3.91, P=.0021) and Fisher scales (OR 5.18, 95% CI 2.65-10.29, P=.0008) were also related to poor outcome. Outcome of aneurysmal subarachnoid haemorrhage was related to age, sex, clinical status at admission to the stroke unit, imaging findings according to the Fisher scale, blood pressure, glycaemia and such complications as electrolyte disturbances, hydrocephalus, rebleeding, and multiplex rebleeding. Copyright © 2014 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

  11. Muscle Oxygen Supply Impairment during Exercise in Poorly Controlled Type 1 Diabetes

    Science.gov (United States)

    TAGOUGUI, SEMAH; LECLAIR, ERWAN; FONTAINE, PIERRE; MATRAN, RÉGIS; MARAIS, GAELLE; AUCOUTURIER, JULIEN; DESCATOIRE, AURÉLIEN; VAMBERGUE, ANNE; OUSSAIDENE, KAHINA; BAQUET, GEORGES; HEYMAN, ELSA

    2015-01-01

    ABSTRACT Purpose Aerobic fitness, as reflected by maximal oxygen (O2) uptake (V˙O2max), is impaired in poorly controlled patients with type 1 diabetes. The mechanisms underlying this impairment remain to be explored. This study sought to investigate whether type 1 diabetes and high levels of glycated hemoglobin (HbA1c) influence O2 supply including O2 delivery and release to active muscles during maximal exercise. Methods Two groups of patients with uncomplicated type 1 diabetes (T1D-A, n = 11, with adequate glycemic control, HbA1c 8%) were compared with healthy controls (CON-A, n = 11; CON-I, n = 12, respectively) matched for physical activity and body composition. Subjects performed exhaustive incremental exercise to determine V˙O2max. Throughout the exercise, near-infrared spectroscopy allowed investigation of changes in oxyhemoglobin, deoxyhemoglobin, and total hemoglobin in the vastus lateralis. Venous and arterialized capillary blood was sampled during exercise to assess arterial O2 transport and factors able to shift the oxyhemoglobin dissociation curve. Results Arterial O2 content was comparable between groups. However, changes in total hemoglobin (i.e., muscle blood volume) was significantly lower in T1D-I compared with that in CON-I. T1D-I also had impaired changes in deoxyhemoglobin levels and increase during high-intensity exercise despite normal erythrocyte 2,3-diphosphoglycerate levels. Finally, V˙O2max was lower in T1D-I compared with that in CON-I. No differences were observed between T1D-A and CON-A. Conclusions Poorly controlled patients displayed lower V˙O2max and blunted muscle deoxyhemoglobin increase. The latter supports the hypotheses of increase in O2 affinity induced by hemoglobin glycation and/or of a disturbed balance between nutritive and nonnutritive muscle blood flow. Furthermore, reduced exercise muscle blood volume in poorly controlled patients may warn clinicians of microvascular dysfunction occurring even before overt

  12. PS1-10bzj: A FAST, HYDROGEN-POOR SUPERLUMINOUS SUPERNOVA IN A METAL-POOR HOST GALAXY

    Energy Technology Data Exchange (ETDEWEB)

    Lunnan, R.; Chornock, R.; Berger, E.; Milisavljevic, D.; Drout, M.; Sanders, N. E.; Challis, P. M.; Czekala, I.; Foley, R. J.; Fong, W.; Kirshner, R. P.; Leibler, C.; Marion, G. H.; Narayan, G. [Harvard-Smithsonian Center for Astrophysics, 60 Garden St., Cambridge, MA 02138 (United States); Huber, M. E. [Institute for Astronomy, University of Hawaii, 2680 Woodlawn Drive, Honolulu, HI 96822 (United States); McCrum, M.; Smartt, S. J. [Astrophysics Research Centre, School of Mathematics and Physics, Queen' s University Belfast, Belfast BT7 1NN (United Kingdom); Rest, A. [Space Telescope Science Institute, 3700 San Martin Dr., Baltimore, MD 21218 (United States); Roth, K. C. [Gemini Observatory, 670 N. Aohoku Place, Hilo, HI 96720 (United States); Scolnic, D., E-mail: rlunnan@cfa.harvard.edu [Department of Physics and Astronomy, Johns Hopkins University, 3400 North Charles Street, Baltimore, MD 21218 (United States); and others

    2013-07-10

    We present observations and analysis of PS1-10bzj, a superluminous supernova (SLSN) discovered in the Pan-STARRS Medium Deep Survey at a redshift z = 0.650. Spectroscopically, PS1-10bzj is similar to the hydrogen-poor SLSNe 2005ap and SCP 06F6, though with a steeper rise and lower peak luminosity (M{sub bol} {approx_equal} -21.4 mag) than previous events. We construct a bolometric light curve, and show that while PS1-10bzj's energetics were less extreme than previous events, its luminosity still cannot be explained by radioactive nickel decay alone. We explore both a magnetar spin-down and circumstellar interaction scenario and find that either can fit the data. PS1-10bzj is located in the Extended Chandra Deep Field South and the host galaxy is imaged in a number of surveys, including with the Hubble Space Telescope. The host is a compact dwarf galaxy (M{sub B} Almost-Equal-To -18 mag, diameter {approx}< 800 pc), with a low stellar mass (M{sub *} Almost-Equal-To 2.4 Multiplication-Sign 10{sup 7} M{sub Sun }), young stellar population ({tau}{sub *} Almost-Equal-To 5 Myr), and a star formation rate of {approx}2-3 M{sub Sun} yr{sup -1}. The specific star formation rate is the highest seen in an SLSN host so far ({approx}100 Gyr{sup -1}). We detect the [O III] {lambda}4363 line, and find a low metallicity: 12 + (O/H) = 7.8 {+-} 0.2 ({approx_equal} 0.1 Z{sub Sun }). Together, this indicates that at least some of the progenitors of SLSNe come from young, low-metallicity populations.

  13. Characteristics of energy access to the poor and to impoverished regions in India

    International Nuclear Information System (INIS)

    Kemmler, A.

    2007-01-01

    have higher levels of education, better sanitation facilities, and greater access to tap water; their houses are in better condition; and they have a higher daily caloric intake. For this reason, energy measures may form a practical basis for a proxy indicator of poverty, as the use of energy indicators is not restricted to environmental and economical issues but is significant for social issues as well. Although energy development is closely related to measures that focus on basic human needs, a single energy-based indicator cannot grasp the multidimensional quality of poverty. Energy is a factor in fulfilling each of these needs, but the extent of these needs is not completely captured by measuring energy poverty alone. Therefore, while access adjusted useful energy correlates fairly well with most of the analysed poverty dimensions, it is only a rough approximation for poverty. The relationship between energy and poverty, however, is a reciprocal one. Improving the poors' access to modern energy sources can make an important difference to their welfare and can be a catalyst for human development: specifically, electricity may be an important trigger for development. Yet, there are still about 450 million people in India without access to electricity. In this way, one observes remarkable regional differences in the electrification rate. These observed regional disparities in electrification can be explained by a combination of factors that influence both village and household electrification. While the geographic endowment of a region was found to be relevant for village electrification, this was not the case for household electrification. A panel data analysis shows further that having a high proportion of agricultural area has a positive effect on a village's electrification rate, while an unfavourable settlement structure and a large state area constrain its electrification rate. In particular, the existence of small but numerous villages seems to correspond to

  14. Characteristics of energy access to the poor and to impoverished regions in India[Dissertation 17033

    Energy Technology Data Exchange (ETDEWEB)

    Kemmler, A.

    2007-07-01

    therein have higher levels of education, better sanitation facilities, and greater access to tap water; their houses are in better condition; and they have a higher daily caloric intake. For this reason, energy measures may form a practical basis for a proxy indicator of poverty, as the use of energy indicators is not restricted to environmental and economical issues but is significant for social issues as well. Although energy development is closely related to measures that focus on basic human needs, a single energy-based indicator cannot grasp the multidimensional quality of poverty. Energy is a factor in fulfilling each of these needs, but the extent of these needs is not completely captured by measuring energy poverty alone. Therefore, while access adjusted useful energy correlates fairly well with most of the analysed poverty dimensions, it is only a rough approximation for poverty. The relationship between energy and poverty, however, is a reciprocal one. Improving the poors' access to modern energy sources can make an important difference to their welfare and can be a catalyst for human development: specifically, electricity may be an important trigger for development. Yet, there are still about 450 million people in India without access to electricity. In this way, one observes remarkable regional differences in the electrification rate. These observed regional disparities in electrification can be explained by a combination of factors that influence both village and household electrification. While the geographic endowment of a region was found to be relevant for village electrification, this was not the case for household electrification. A panel data analysis shows further that having a high proportion of agricultural area has a positive effect on a village's electrification rate, while an unfavourable settlement structure and a large state area constrain its electrification rate. In particular, the existence of small but numerous villages seems to

  15. Subgrouping Poor Readers on the Basis of Individual Differences in Reading-Related Abilities

    OpenAIRE

    Catts, Hugh W.; Hogan, Tiffany; Fey, Marc E.

    2003-01-01

    The present study investigated the use of the Reading Component Model to subgroup poor readers. A large sample of poor readers was identified in second grade and subgrouped on the basis of relative strengths and weaknesses in word recognition and listening comprehension. Although homogeneous subgroups were not identified, poor readers could be classified into four subgroups that differed significantly in reading-related abilities. Further analyses showed that poor readers' strengths and weakn...

  16. Poor School Performance: Contributing Factors and Consequences, with Emphasis on the Nonwhite Child.

    Science.gov (United States)

    Gwinn, Diane G.

    Research on poor school performance--with emphasis on the nonwhite child--is discussed in terms of differences children bring to school, the school process, and consequences of poor school performance. Individual factors related to poor achievement are noted to include membership in a disadvantaged minority group, broken homes and absent fathers,…

  17. Pro-Poor Tourism: Putting Poverty At The Heart Of The Tourism Agenda

    OpenAIRE

    Ashley, Caroline; Boyd, Charlotte; Goodwin, Harold

    2000-01-01

    This paper examines how tourism affects the livelihoods of the poor and how positive impacts can be enhanced. In doing so, it assesses the relevance of tourism to the poverty agenda, and the factors that encourage or constrain economic participation of the poor in the industry. In conclusion it outlines strategies for promoting pro-poor tourism.

  18. Low self-concept in poor readers: prevalence, heterogeneity, and risk.

    Science.gov (United States)

    McArthur, Genevieve; Castles, Anne; Kohnen, Saskia; Banales, Erin

    2016-01-01

    There is evidence that poor readers are at increased risk for various types of low self-concept-particularly academic self-concept. However, this evidence ignores the heterogeneous nature of poor readers, and hence the likelihood that not all poor readers have low self-concept. The aim of this study was to better understand which types of poor readers have low self-concept. We tested 77 children with poor reading for their age for four types of self-concept, four types of reading, three types of spoken language, and two types of attention. We found that poor readers with poor attention had low academic self-concept, while poor readers with poor spoken language had low general self-concept in addition to low academic self-concept. In contrast, poor readers with typical spoken language and attention did not have low self-concept of any type. We also discovered that academic self-concept was reliably associated with reading and receptive spoken vocabulary, and that general self-concept was reliably associated with spoken vocabulary. These outcomes suggest that poor readers with multiple impairments in reading, language, and attention are at higher risk for low academic and general self-concept, and hence need to be assessed for self-concept in clinical practice. Our results also highlight the need for further investigation into the heterogeneous nature of self-concept in poor readers.

  19. Low self-concept in poor readers: prevalence, heterogeneity, and risk

    Science.gov (United States)

    Castles, Anne; Kohnen, Saskia; Banales, Erin

    2016-01-01

    There is evidence that poor readers are at increased risk for various types of low self-concept—particularly academic self-concept. However, this evidence ignores the heterogeneous nature of poor readers, and hence the likelihood that not all poor readers have low self-concept. The aim of this study was to better understand which types of poor readers have low self-concept. We tested 77 children with poor reading for their age for four types of self-concept, four types of reading, three types of spoken language, and two types of attention. We found that poor readers with poor attention had low academic self-concept, while poor readers with poor spoken language had low general self-concept in addition to low academic self-concept. In contrast, poor readers with typical spoken language and attention did not have low self-concept of any type. We also discovered that academic self-concept was reliably associated with reading and receptive spoken vocabulary, and that general self-concept was reliably associated with spoken vocabulary. These outcomes suggest that poor readers with multiple impairments in reading, language, and attention are at higher risk for low academic and general self-concept, and hence need to be assessed for self-concept in clinical practice. Our results also highlight the need for further investigation into the heterogeneous nature of self-concept in poor readers. PMID:27867764

  20. Risk Factors of Poor Prognosis after Whiplash Injury

    Directory of Open Access Journals (Sweden)

    Samy Suissa

    2003-01-01

    and symptoms that were found to be independently associated with a slower recovery from whiplash, besides female gender and older age, were neck pain on palpation; muscle pain; pain or numbness radiating from neck to arms, hands or shoulders; and headache. Together, the presence of all these factors in females aged 60 predicted a median recovery time of 262 days, compared with 17 days for younger males aged 20 who do not have any of these factors. In contrast, using the Quebec classification of signs and symptoms, the median recovery time varied from 17 to 123 days. We conclude that several socio-demographic and crash-related factors, as well as several signs and symptoms, including a combination of specific musculoskeletal and neurological ones that whiplash patients present with, are predictive of a longer recovery period. These patients should be targeted for an early intervention programme aimed at managing whiplash patients with a poor prognosis.

  1. Association of poor metabolizers of cytochrome P450 2C19 with head and neck cancer and poor treatment response

    Energy Technology Data Exchange (ETDEWEB)

    Yadav, Sunishtha S.; Ruwali, Munindra; Shah, Parag P. [Developmental Toxicology Division, Indian Institute of Toxicology Research, CSIR P.O. Box 80, M.G. Marg, Lucknow 226001 (India); Mathur, Neeraj [Environmental Epidemiology Division, Indian Institute of Toxicology Research, CSIR P.O. Box 80, M.G. Marg, Lucknow 226001 (India); Singh, Ram L. [Department of Biochemistry, Dr. R.M.L. Awadh University, Faizabad 224 001, U.P. (India); Pant, Mohan C. [Department of Radiotherapy, C.S.M. Medical University, Shahmina Road, Lucknow 226 001 (India); Parmar, Devendra [Developmental Toxicology Division, Indian Institute of Toxicology Research, CSIR P.O. Box 80, M.G. Marg, Lucknow 226001 (India)], E-mail: parmar_devendra@hotmail.com

    2008-09-26

    A case-control study consisting of 300 patients and an equal number of healthy controls was carried out to investigate the association of polymorphism in cytochrome P450 2C19 (CYP2C19), which results in poor and extensive metabolizers (PMs and EMs) genotypes, with squamous cell carcinoma of head and neck (HNSCC) and treatment response in patients receiving combination of chemo-radiotherapy. A higher frequency of CYP2C19*2 variants was observed in the cases resulting in significantly higher risk to HNSCC (Ad OR 3.36, 95% CI 1.94-5.82, p-value < 0.05). The PM genotype of CYP2C19*3 was also found to be slightly increased in the cases, though the increase in risk was not significant when analyzed by multivariate logistic regression model. Tobacco chewing amongst the cases resulted in almost 13-fold increase in the risk with CYP2C19*2 (OR: 12.39) and 3-fold with CYP2C19*3 genotype (OR: 2.90) when compared to the tobacco chewers amongst the controls. Likewise, cigarette smoking in the cases increased the risk approximately 9-fold and 3-fold with CYP2C19*2 (OR: 8.93) and CYP2C19*3 (OR: 2.18) genotypes respectively when compared to smokers amongst the controls. Similar increase in risk was associated with alcohol use amongst the cases carrying variant genotypes of CYP2C19*2 (OR: 7.75) or CYP2C19*3 (OR: 2.60), demonstrating the importance of gene-environment interaction in modifying susceptibility to HNSCC. Interestingly, patients with PMs of CYP2C19 (CYP2C19*2 and CYP2C19*3) exhibited little response to the respective chemotherapy than the patients carrying wild-type genotype demonstrating that functional enzyme deficiencies due to polymorphism in CYPs may not only be important in modifying the susceptibility to HNSCC but also in determining chemotherapeutic response.

  2. Reactive Strength Index: A Poor Indicator of Reactive Strength?

    Science.gov (United States)

    Healy, Robin; Kenny, Ian; Harrison, Drew

    2017-11-28

    The primary aim was to assess the relationships between reactive strength measures and associated kinematic and kinetic performance variables achieved during drop jumps. A secondary aim was to highlight issues with the use of reactive strength measures as performance indicators. Twenty eight national and international level sprinters, consisting of fourteen men and women, participated in this cross-sectional analysis. Athletes performed drop jumps from a 0.3 m box onto a force platform with dependent variables contact time (CT), landing time (TLand), push-off time (TPush), flight time (FT), jump height (JH), reactive strength index (RSI, calculated as JH / CT), reactive strength ratio (RSR, calculated as FT / CT) and vertical leg spring stiffness (Kvert) recorded. Pearson's correlation test found very high to near perfect relationships between RSI and RSR (r = 0.91 to 0.97), with mixed relationships found between RSI, RSR and the key performance variables, (Men: r = -0.86 to -0.71 between RSI/RSR and CT, r = 0.80 to 0.92 between RSI/RSR and JH; Women: r = -0.85 to -0.56 between RSR and CT, r = 0.71 between RSI and JH). This study demonstrates that the method of assessing reactive strength (RSI versus RSR) may be influenced by the performance strategies adopted i.e. whether an athlete achieves their best reactive strength scores via low CTs, high JHs or a combination. Coaches are advised to limit the variability in performance strategies by implementing upper and / or lower CT thresholds to accurately compare performances between individuals.

  3. Methodological aspects of serosurveillance in resource-poor settings.

    Science.gov (United States)

    Sternberg Lewerin, Susanna; Wolff, Cecilia; Masembe, Charles; Ståhl, Karl; Boqvist, Sofia; Franko, Mikael Andersson

    2018-01-01

    Animal production is important for the agricultural economy in low-income countries, but is threatened by infectious diseases. Serosurveys are conducted for different reasons such as disease detection, risk factor studies, disease monitoring and establishing disease-free status. Most reports on such serosurveys include some discussion about methodological constraints but still, by necessity, rely on serological results for case definition. This study uses a cross-sectional serosurvey for foot-and-mouth disease (FMD), Rift Valley fever (RVF) and contagious bovine pleuropneumonia (CBPP) in cattle in three districts in Western Uganda to illustrate the limitations of this approach, addressing the questions of what flaws can be expected in sampling and diagnostics and how these influence the results. The target was to collect blood samples from 60 cattle herds per district. To reflect the recent infection history of the herd, young animals (two to five years) were prioritised. The farmers were interviewed about management, cattle trade, cattle health and vaccination. Commercial ELISAs were used for serological analyses: for CBPP the IDEXX CBPP Mycoplasma mycoides subspecies mycoides antibody test kit, for RVF the ID Screen Rift Valley Fever competitive ELISA, and for FMD the PrioCHECK FMDV NS. Apparent prevalence, true prevalence and associations with herd characteristics were assessed. The sampling plans could not be entirely fulfilled, nor the number of tests run in the laboratory. There were reactors to all three diseases with an apparent prevalence of approximately 30 per cent for CBPP, 6 per cent for RVF and 7 per cent for FMD. Calculation of true prevalence based on test sensitivity and specificity resulted in a slightly higher prevalence figure for CBPP and lower figures for RVF and FMD. The study illustrates the importance of considering diagnostic test performance when interpreting results from serosurveys, and the challenge of representative sampling and

  4. Are You Your Friends’ Friend? Poor Perception of Friendship Ties Limits the Ability to Promote Behavioral Change

    Science.gov (United States)

    Almaatouq, Abdullah; Radaelli, Laura; Pentland, Alex; Shmueli, Erez

    2016-01-01

    Persuasion is at the core of norm creation, emergence of collective action, and solutions to ‘tragedy of the commons’ problems. In this paper, we show that the directionality of friendship ties affect the extent to which individuals can influence the behavior of each other. Moreover, we find that people are typically poor at perceiving the directionality of their friendship ties and that this can significantly limit their ability to engage in cooperative arrangements. This could lead to failures in establishing compatible norms, acting together, finding compromise solutions, and persuading others to act. We then suggest strategies to overcome this limitation by using two topological characteristics of the perceived friendship network. The findings of this paper have significant consequences for designing interventions that seek to harness social influence for collective action. PMID:27002530

  5. Are You Your Friends' Friend? Poor Perception of Friendship Ties Limits the Ability to Promote Behavioral Change.

    Science.gov (United States)

    Almaatouq, Abdullah; Radaelli, Laura; Pentland, Alex; Shmueli, Erez

    2016-01-01

    Persuasion is at the core of norm creation, emergence of collective action, and solutions to 'tragedy of the commons' problems. In this paper, we show that the directionality of friendship ties affect the extent to which individuals can influence the behavior of each other. Moreover, we find that people are typically poor at perceiving the directionality of their friendship ties and that this can significantly limit their ability to engage in cooperative arrangements. This could lead to failures in establishing compatible norms, acting together, finding compromise solutions, and persuading others to act. We then suggest strategies to overcome this limitation by using two topological characteristics of the perceived friendship network. The findings of this paper have significant consequences for designing interventions that seek to harness social influence for collective action.

  6. Factors Influencing Smallholder Farmers Participation in IFAD ...

    African Journals Online (AJOL)

    USER

    2015-02-02

    Feb 2, 2015 ... This study assessed Factors Influencing smallholder farmers' ... percent of the population engaged in agricultural activities as a career and ... that the major source of income of the poor is agriculture and ... shown that farmers have different reasons for participation in agricultural ... 30 Dan gamau 534. 30.

  7. THE INFLUENCE OF VARIOUS PRODUCTION PROCESSES ON ...

    African Journals Online (AJOL)

    mally poor competitors. Hence Baltzer (1969) maintains ... pork, russian and vienna sausages were included in this survey. An investigation of the possible influence of microbial levels of nteat products on shelf life and con- sumer health should .... Results and Discussion. A survey of the slaughter process at a bacon fac-.

  8. Towards improved solubility of poorly water-soluble drugs: cryogenic co-grinding of piroxicam with carrier polymers.

    Science.gov (United States)

    Penkina, Anna; Semjonov, Kristian; Hakola, Maija; Vuorinen, Sirpa; Repo, Timo; Yliruusi, Jouko; Aruväli, Jaan; Kogermann, Karin; Veski, Peep; Heinämäki, Jyrki

    2016-01-01

    Amorphous solid dispersions (SDs) open up exciting opportunities in formulating poorly water-soluble active pharmaceutical ingredients (APIs). In the present study, novel catalytic pretreated softwood cellulose (CPSC) and polyvinylpyrrolidone (PVP) were investigated as carrier polymers for preparing and stabilizing cryogenic co-ground SDs of poorly water-soluble piroxicam (PRX). CPSC was isolated from pine wood (Pinus sylvestris). Raman and Fourier transform infrared (FTIR) spectroscopy, X-ray powder diffraction (XRPD) and differential scanning calorimetry (DSC) were used for characterizing the solid-state changes and drug-polymer interactions. High-resolution scanning electron microscope (SEM) was used to analyze the particle size and surface morphology of starting materials and final cryogenic co-ground SDs. In addition, the molecular aspects of drug-polymer interactions and stabilization mechanisms are presented. The results showed that the carrier polymer influenced both the degree of amorphization of PRX and stabilization against crystallization. The cryogenic co-ground SDs prepared from PVP showed an enhanced dissolution rate of PRX, while the corresponding SDs prepared from CPSC exhibited a clear sustained release behavior. In conclusion, cryogenic co-grinding provides a versatile method for preparing amorphous SDs of poorly water-soluble APIs. The solid-state stability and dissolution behavior of such co-ground SDs are to a great extent dependent on the carrier polymer used.

  9. Associations between the structural and functional aspects of social relations and poor mental health: a cross-sectional register study

    Directory of Open Access Journals (Sweden)

    Lise Røntved Hansen

    2017-11-01

    Full Text Available Abstract Background Social relations influence mental health through different pathways. To capture the complexity of social relations, it is beneficial to consider both the structural (e.g., reachability of social network and social integration and functional (e.g., instrumental and emotional support aspects of the concept. Both aspects are rarely investigated simultaneously. This study aimed to examine the association between the structural and functional aspects of social relations and poor mental health. Methods The study was designed as a cross-sectional register study. We used data on mental health and social relations from 15,839 individuals aged 16–92 years with a mean age of 49.0 years (SD 17.9 who responded to The North Denmark Region Health Survey 2013 among residents in Northern Jutland, Denmark. The 12-Item Short-Form Health Survey measured mental health; a cut-off point of 44.5 was used to dichotomize participants into poor and good mental health. The categorization of social relations was inspired by Berkman et al.’s conceptual model of social relations and health. The analyses were performed with survey logistic regression. Results We found that 21.6% (n = 3422 of participants reported poor mental health, and 59% (n = 2020 of these were women. Being in contact with family and friends less than once a month statistically significantly increased the risk for poor mental health (Family OR = 1.78, 95% CI = 1.51–2.10 and Friends OR = 2.65, 95% CI = 2.30–3.06. The individuals who were not in contact with their network as often as they liked had a significantly higher risk for poor mental health (OR = 2.40, 95% CI = 2.20–2.62. Lack of instrumental support was associated with a higher risk for poor mental health (OR = 2.81, 95% CI = 2.26–3.48. We found an interaction between age and emotional support; the youngest population had the highest risk for poor mental health when they did not have access to

  10. Associations between the structural and functional aspects of social relations and poor mental health: a cross-sectional register study.

    Science.gov (United States)

    Hansen, Lise Røntved; Pedersen, Stinna Bibi; Overgaard, Charlotte; Torp-Pedersen, Christian; Ullits, Line Rosenkilde

    2017-11-03

    Social relations influence mental health through different pathways. To capture the complexity of social relations, it is beneficial to consider both the structural (e.g., reachability of social network and social integration) and functional (e.g., instrumental and emotional support) aspects of the concept. Both aspects are rarely investigated simultaneously. This study aimed to examine the association between the structural and functional aspects of social relations and poor mental health. The study was designed as a cross-sectional register study. We used data on mental health and social relations from 15,839 individuals aged 16-92 years with a mean age of 49.0 years (SD 17.9) who responded to The North Denmark Region Health Survey 2013 among residents in Northern Jutland, Denmark. The 12-Item Short-Form Health Survey measured mental health; a cut-off point of 44.5 was used to dichotomize participants into poor and good mental health. The categorization of social relations was inspired by Berkman et al.'s conceptual model of social relations and health. The analyses were performed with survey logistic regression. We found that 21.6% (n = 3422) of participants reported poor mental health, and 59% (n = 2020) of these were women. Being in contact with family and friends less than once a month statistically significantly increased the risk for poor mental health (Family OR = 1.78, 95% CI = 1.51-2.10 and Friends OR = 2.65, 95% CI = 2.30-3.06). The individuals who were not in contact with their network as often as they liked had a significantly higher risk for poor mental health (OR = 2.40, 95% CI = 2.20-2.62). Lack of instrumental support was associated with a higher risk for poor mental health (OR = 2.81, 95% CI = 2.26-3.48). We found an interaction between age and emotional support; the youngest population had the highest risk for poor mental health when they did not have access to emotional support (Young OR = 5.26, 95% CI = 3

  11. Internet use, browsing, and the urban poor: implications for cancer control.

    Science.gov (United States)

    Viswanath, K; McCloud, Rachel; Minsky, Sara; Puleo, Elaine; Kontos, Emily; Bigman-Galimore, Cabral; Rudd, Rima; Emmons, Karen M

    2013-12-01

    Despite the growing penetration of the Internet, little is known about the usage and browsing patterns of those in poverty. We report on a randomized controlled trial that sheds light on the Internet use and browsing patterns among the urban poor. The data come from 312 participants in Boston, Massachusetts, from Click to Connect, a study that examined the impact of an intervention that provided computers, Internet, and training to people from lower socioeconomic position (SEP). Data were gathered through pre- and posttest surveys and Internet use tracking software that generated approximately 13 million network activity files and more than 5.5 million records. Internet use increased among intervention participants, with most of their time spent on social and participatory media sites or Internet portals. Differential patterns of use by gender and race/ethnicity were observed. Purposive searching for health information was low among all participants. Most of the visits to health-related sites were to local hospitals' sites suggesting the influence of possible preexisting relationships and trust. Social networking sites were frequently visited, with three sites enjoying similar popularity among all groups. Our data show that the availability of Internet can lead to significant increase in its use among low SEP groups. Low SEP members used the Internet for participation and engagement, but the sites visited differed by group. Harnessing the power of social networking sites and shareware sites may be a way to increase access to health information.

  12. Novel electrosprayed nanospherules for enhanced aqueous solubility and oral bioavailability of poorly water-soluble fenofibrate.

    Science.gov (United States)

    Yousaf, Abid Mehmood; Mustapha, Omer; Kim, Dong Wuk; Kim, Dong Shik; Kim, Kyeong Soo; Jin, Sung Giu; Yong, Chul Soon; Youn, Yu Seok; Oh, Yu-Kyoung; Kim, Jong Oh; Choi, Han-Gon

    2016-01-01

    The purpose of the present research was to develop a novel electrosprayed nanospherule providing the most optimized aqueous solubility and oral bioavailability for poorly water-soluble fenofibrate. Numerous fenofibrate-loaded electrosprayed nanospherules were prepared with polyvinylpyrrolidone (PVP) and Labrafil(®) M 2125 as carriers using the electrospray technique, and the effect of the carriers on drug solubility and solvation was assessed. The solid state characterization of an optimized formulation was conducted by scanning electron microscopy, powder X-ray diffraction, differential scanning calorimetry, and Fourier transform infrared spectroscopic analyses. Oral bioavailability in rats was also evaluated for the formulation of an optimized nanospherule in comparison with free drug and a conventional fenofibrate-loaded solid dispersion. All of the electrosprayed nanospherule formulations had remarkably enhanced aqueous solubility and dissolution compared with free drug. Moreover, Labrafil M 2125, a surfactant, had a positive influence on the solubility and dissolution of the drug in the electrosprayed nanospherule. Increases were observed as the PVP/drug ratio increased to 4:1, but higher ratios gave no significant increases. In particular, an electrosprayed nanospherule composed of fenofibrate, PVP, and Labrafil M 2125 at the weight ratio of 1:4:0.5 resulted in a particle size of water-soluble fenofibrate.

  13. Amphiphilic polymeric micelles as the nanocarrier for peroral delivery of poorly soluble anticancer drugs.

    Science.gov (United States)

    Tian, Ye; Mao, Shirui

    2012-06-01

    Many amphiphilic copolymers have recently been synthesized as novel promising micellar carriers for the delivery of poorly water-soluble anticancer drugs. Studies on the formulation and oral delivery of such micelles have demonstrated their efficacy in enhancing drug uptake and absorption, and exhibit prolonged circulation time in vitro and in vivo. In this review, literature on hydrophobic modifications of several hydrophilic polymers, including polyethylene glycol, chitosan, hyaluronic acid, pluronic and tocopheryl polyethylene glycol succinate, is summarized. Parameters influencing the properties of polymeric micelles for oral chemotherapy are discussed and strategies to overcome main barriers for polymeric micelles peroral absorption are proposed. During the design of polymeric micelles for peroral chemotherapy, selecting or synthesizing copolymers with good compatibility with the drug is an effective strategy to increase drug loading and encapsulation efficiency. Stability of the micelles can be improved in different ways. It is recommended to take permeability, mucoadhesion, sustained release, and P-glycoprotein inhibition into consideration during copolymer preparation or to consider adding some excipients in the formulation. Furthermore, both the copolymer structure and drug loading methods should be controlled in order to get micelles with appropriate particle size for better absorption.

  14. The Plumbing of Land Surface Models: Is Poor Performance a Result of Methodology or Data Quality?

    Science.gov (United States)

    Haughton, Ned; Abramowitz, Gab; Pitman, Andy J.; Or, Dani; Best, Martin J.; Johnson, Helen R.; Balsamo, Gianpaolo; Boone, Aaron; Cuntz, Matthais; Decharme, Bertrand; hide

    2016-01-01

    The PALS Land sUrface Model Benchmarking Evaluation pRoject (PLUMBER) illustrated the value of prescribing a priori performance targets in model intercomparisons. It showed that the performance of turbulent energy flux predictions from different land surface models, at a broad range of flux tower sites using common evaluation metrics, was on average worse than relatively simple empirical models. For sensible heat fluxes, all land surface models were outperformed by a linear regression against downward shortwave radiation. For latent heat flux, all land surface models were outperformed by a regression against downward shortwave, surface air temperature and relative humidity. These results are explored here in greater detail and possible causes are investigated. We examine whether particular metrics or sites unduly influence the collated results, whether results change according to time-scale aggregation and whether a lack of energy conservation in fluxtower data gives the empirical models an unfair advantage in the intercomparison. We demonstrate that energy conservation in the observational data is not responsible for these results. We also show that the partitioning between sensible and latent heat fluxes in LSMs, rather than the calculation of available energy, is the cause of the original findings. Finally, we present evidence suggesting that the nature of this partitioning problem is likely shared among all contributing LSMs. While we do not find a single candidate explanation forwhy land surface models perform poorly relative to empirical benchmarks in PLUMBER, we do exclude multiple possible explanations and provide guidance on where future research should focus.

  15. Nonword repetition in children with cochlear implants: a potential clinical marker of poor language acquisition.

    Science.gov (United States)

    Nittrouer, Susan; Caldwell-Tarr, Amanda; Sansom, Emily; Twersky, Jill; Lowenstein, Joanna H

    2014-11-01

    Cochlear implants (CIs) can facilitate the acquisition of spoken language for deaf children, but challenges remain. Language skills dependent on phonological sensitivity are most at risk for these children, so having an effective way to diagnose problems at this level would be of value for school speech-language pathologists. The goal of this study was to assess whether a nonword repetition (NWR) task could serve that purpose. Participants were 104 second graders: 49 with normal hearing (NH) and 55 with CIs. In addition to NWR, children were tested on 10 measures involving phonological awareness and processing, serial recall of words, vocabulary, reading, and grammar. Children with CIs performed more poorly than children with NH on NWR, and sensitivity to phonological structure alone explained that performance for children in both groups. For children with CIs, 2 audiological factors positively influenced outcomes on NWR: being identified with hearing loss at a younger age and having experience with wearing a hearing aid on the unimplanted ear at the time of receiving a 1st CI. NWR scores were better able to rule out than to rule in such language deficits. Well-designed NWR tasks could have clinical utility in assessments of language acquisition for school-age children with CIs.

  16. Businessmen v. Investigators: who is responsible for the Poor Russian Investment Climate?

    Directory of Open Access Journals (Sweden)

    Dmitry Gololobov

    2014-01-01

    Full Text Available This article aims to examine the extent to which Russian investigations into economic and financial crimes are influenced by such factors as systemic problems with Russian gatekeepers, the absence of a formal corporate whistle-blowing mechanism and the continuous abuse of the law by the Russian business community. The traditional critical approach to the quality and effectiveness of Russian economic and financial investigations does not produce positive results and needs to be reformulated by considering the opinions of entrepreneurs. The author considers that forcing Russian entrepreneurs, regardless of the size of their business, to comply with Russian laws and regulations may be a more efficient way to develop the business environment than attempting to gradually improve the Russian judicial system. It is also hardly possible to expect the Russian investigatory bodies to investigate what are effectively complex economic and financial crimes in the almost complete absence of a developed whistle-blowing culture. Such a culture has greatly contributed to the success of widely-publicised corporate and financial investigations in the United States and Europe. The poor development of the culture of Russian gatekeepers and the corresponding regulatory environment is one more significant factor that permanently undermines the effectiveness of economic investigations and damages the investment climate.

  17. Triaxial Compression Testing of Multicomponent Geomaterials from Quartz-Poor (Syenitic Systems

    Directory of Open Access Journals (Sweden)

    Krmíček Lukáš

    2017-12-01

    Full Text Available This paper focuses on mafic microgranular enclaves enclosed in quartz-poor igneous rocks and their effect on strength properties of the rock massif. The study examines host rock–enclave multicomponent geomaterials from enclave-bearing syenitic rocks from the Třebíč Massif exposed in the Královec quarry near Jaroměřice nad Rokytnou in the Czech Republic. A series of laboratory tests were performed to describe strength properties of individual constituents of the multicomponent geomaterials. We mainly focused on triaxial compression tests, however, rebound hardness, uniaxial compressive strength and indirect tensile strength were determined as well. The obtained results indicate that enclaves and even the contact zones between the enclaves and host rocks do not have any negative influence on the rock strength. In contrast, enclaves represent “stress concentrators” within such multicomponent systems. Strength properties of various multicomponent geomaterials are practically an unexplored topic in the field of rocks mechanics and future studies are needed to establish a robust database describing the behaviour of such geocomposites.

  18. Collective attention and stock prices: evidence from Google Trends data on Standard and Poor's 100.

    Directory of Open Access Journals (Sweden)

    Raphael H Heiberger

    Full Text Available Today´s connected world allows people to gather information in shorter intervals than ever before, widely monitored by massive online data sources. As a dramatic economic event, recent financial crisis increased public interest for large companies considerably. In this paper, we exploit this change in information gathering behavior by utilizing Google query volumes as a "bad news" indicator for each corporation listed in the Standard and Poor´s 100 index. Our results provide not only an investment strategy that gains particularly in times of financial turmoil and extensive losses by other market participants, but reveal new sectoral patterns between mass online behavior and (bearish stock market movements. Based on collective attention shifts in search queries for individual companies, hence, these findings can help to identify early warning signs of financial systemic risk. However, our disaggregated data also illustrate the need for further efforts to understand the influence of collective attention shifts on financial behavior in times of regular market activities with less tremendous changes in search volumes.

  19. Collective attention and stock prices: evidence from Google Trends data on Standard and Poor's 100.

    Science.gov (United States)

    Heiberger, Raphael H

    2015-01-01

    Today´s connected world allows people to gather information in shorter intervals than ever before, widely monitored by massive online data sources. As a dramatic economic event, recent financial crisis increased public interest for large companies considerably. In this paper, we exploit this change in information gathering behavior by utilizing Google query volumes as a "bad news" indicator for each corporation listed in the Standard and Poor´s 100 index. Our results provide not only an investment strategy that gains particularly in times of financial turmoil and extensive losses by other market participants, but reveal new sectoral patterns between mass online behavior and (bearish) stock market movements. Based on collective attention shifts in search queries for individual companies, hence, these findings can help to identify early warning signs of financial systemic risk. However, our disaggregated data also illustrate the need for further efforts to understand the influence of collective attention shifts on financial behavior in times of regular market activities with less tremendous changes in search volumes.

  20. Collective Attention and Stock Prices: Evidence from Google Trends Data on Standard and Poor's 100

    Science.gov (United States)

    Heiberger, Raphael H.

    2015-01-01

    Today´s connected world allows people to gather information in shorter intervals than ever before, widely monitored by massive online data sources. As a dramatic economic event, recent financial crisis increased public interest for large companies considerably. In this paper, we exploit this change in information gathering behavior by utilizing Google query volumes as a "bad news" indicator for each corporation listed in the Standard and Poor´s 100 index. Our results provide not only an investment strategy that gains particularly in times of financial turmoil and extensive losses by other market participants, but reveal new sectoral patterns between mass online behavior and (bearish) stock market movements. Based on collective attention shifts in search queries for individual companies, hence, these findings can help to identify early warning signs of financial systemic risk. However, our disaggregated data also illustrate the need for further efforts to understand the influence of collective attention shifts on financial behavior in times of regular market activities with less tremendous changes in search volumes. PMID:26258498

  1. Research Review: Maternal Prenatal Distress and Poor Nutrition--Mutually Influencing Risk Factors Affecting Infant Neurocognitive Development

    Science.gov (United States)

    Monk, Catherine; Georgieff, Michael K.; Osterholm, Erin A.

    2013-01-01

    Background: Accumulating data from animal and human studies indicate that the prenatal environment plays a significant role in shaping children's neurocognitive development. Clinical, epidemiologic, and basic science research suggests that two experiences relatively common in pregnancy--an unhealthy maternal diet and psychosocial…

  2. Did poor eyesight influence Goya's late works? Medicine and art history in search for an interpretation of Goya's late paintings.

    Science.gov (United States)

    Pérez-Trullén, José M; Ascaso, Francisco J; Auría, María J

    2018-04-15

    The aim of this article is to 'determine' the scope of Goya's eyesight difficulties and assess the extent to which those difficulties might explain his style of painting in the last years of his life. We analyse the correspondence and late works of the Aragonese painter Francisco de Goya y Lucientes (1746-1828), who has been admired for his use of colour, his energetic loose brushstrokes, his disregard for details and his bold compositions, as well as for his different artistic styles throughout his life. The evolution of Goya's style of painting in his later works seems to have been the consequence of an eyesight condition, probably age-related cataracts at an advanced stage. The faded dark backgrounds, which become blurred with the silhouette of the person portrayed, could indicate a certain degree of eye strain. This can be traced in all these works, but is especially evident in the unfinished portrait of Pío de Molina (1827-1828), as well as in the portraits of Mariano Goya, the artist's grandson (1827), and Jacques Galos (1826). It has been considered that the late and isolated Goya's sight problems were a belated consequence of his severe illness of 1792. Nevertheless, in our opinion, this is a simplistic explanation and, given the painter's age, it is logical to presume that their cause could be age-related lens opacities. This article argues that medicine may become a subsidiary science to art history, as it can provide empirical evidence of the way painters' illnesses may have a strong impact on their artworks. © 2018 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  3. Influence of dirt, age and poor aim on glare and illumination intensities of car headlamps in practice

    NARCIS (Netherlands)

    Alferdinck, J.W.A.M.; Padmos, P.

    1987-01-01

    Luminous intensities of dipped car headlamps in directions of the eyes of drivers of oncoming cars (glare intensity) and the right roadside (illumination intensity) were measured (404 cars). The often too high glare intensities are mainly due to dirt and lamp age; the often too low illumination

  4. THE INFLUENCE OF THE CONTENT OF ALUMINIUM ON THE BIOCENOSIS OF THE WATERS OF LAKES WITH POORLY URBANIZED RECEPTION BASINS

    Directory of Open Access Journals (Sweden)

    Jacek Kubiak

    2014-10-01

    Full Text Available The article presents the research results of the content of aluminium in the waters of the largest lakes situated in the reception basin of the Tywa river. The general content of aluminium and its form: dissolved and non-dissolved was examined. The general content of aluminium in those waters varied from 5.3 to 98.9 μg/l, while the content of dissolved aluminium varied from 3.0 to 57.0 and its non-dissolved form from 1.0 to 54.0 μg/l. The average concentration of the content of aluminium in the waters of examined lakes was similar; Dłużec lake – 42.9, Strzeszowskie lake – 39.2, Dołgie lake 45.7, Swobnickie lake 41.4 μg/l. The prevailing form of aluminium in the examined bodies of water was the dissolved form. The greatest amounts of that metal in waters of the examined lakes were present in autumn and spring, and the smallest amounts in summer and winter, the tendency concerned the entire content of aluminium and its non-dissolved form. The dissolved form of aluminium in the waters of examined lakes was present in the largest amounts in winter (on average – 17.4 μg/l, in the smallest amounts in spring (14.0 μg/l, this seasonal diversity – was weakly marked. The existing concentration of aluminium is typical of non-polluted surface waters, and with the stated reaction and the content of sulfurs, carbonates and chlorides in the examined waters, they were not toxic to the biocenosis.

  5. Factors associated with poor sleep during menopause: results from the Midlife Women's Health Study.

    Science.gov (United States)

    Smith, Rebecca L; Flaws, Jodi A; Mahoney, Megan M

    2018-05-01

    Poor sleep is one of the most common problems reported during menopause, and is known to vary throughout the menopause transition. The objective of this study was to describe the dynamics of poor sleep among participants of the Midlife Women's Health Study and to identify risk factors associated with poor sleep during the menopausal transition. Annual responses to surveys that included questions about the frequency of sleep disturbances and insomnia were analyzed to determine the likelihood of persistent poor sleep throughout the menopausal transition and the correlation of responses to the different sleep-related questions, including frequency of restless sleep during the first year of the study. Responses to questions about a large number of potential risk factors were used to identify risk factors for poor sleep. Poor sleep in premenopause was not predictive of poor sleep in perimenopause, and poor sleep in perimenopause was not predictive of poor sleep in postmenopause. Frequencies of each of the measures of poor sleep were highly correlated. For all sleep outcomes, high frequency of depression was related to a high frequency of poor sleep. Vasomotor symptoms were also significantly related with a higher frequency of all poor sleep outcomes. A history of smoking was also associated with higher frequencies of insomnia and sleep disturbances. The risk factors identified for poor sleep, depression and vasomotor symptoms, were consistently associated with poor sleep throughout the menopausal transition. The likelihood of these risk factors changed from premenopause, through perimenopause, and into postmenopause, however, which could explain changes in sleep difficulties across the menopausal transition. Treatment of these risk factors should be considered when addressing sleep difficulties in menopausal women. Copyright © 2018 Elsevier B.V. All rights reserved.

  6. Poor health and loneliness in later life: the role of depressive symptoms, social resources, and rural environments.

    Science.gov (United States)

    Burholt, Vanessa; Scharf, Thomas

    2014-03-01

    We draw on cognitive discrepancy theory to hypothesize and test a pathway from poor health to loneliness in later life. We hypothesize that poor health will have a negative influence on social participation and social resources, and these factors will mediate between health and loneliness. We hypothesize that rural environments will amplify any difficulties associated with social participation or accessing social resources and that depression will moderate how intensely people react to levels of social contact and support. We conceptualize a mediation model and a moderated-mediation model. Nationally representative data on older people living in the Republic of Ireland are used to validate the hypothesized pathways. In the mediation model, health has a significant indirect effect on loneliness through the mediating variables social resources and social participation. In the moderated-mediation model, rurality moderates the pathway between health and social resources but not social participation. Depressive symptoms moderate the effect of social resources on loneliness but not social participation. The results provide further credence to cognitive discrepancy theory, suggesting that depressive symptoms influence cognitive processes, interfering with judgments about the adequacy of social interaction. The theory is extended by demonstrating the impact of the environment on loneliness.

  7. The prevalence and determinants of poor glycemic control among adults with type 2 diabetes mellitus in Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Alzaheb RA

    2018-01-01

    Full Text Available Riyadh A Alzaheb,1 Abdullah H Altemani2 1Department of Clinical Nutrition, Faculty of Applied Medical Sciences, 2Department of Family and Community Medicine, Faculty of Medicine, University of Tabuk, Tabuk, Saudi Arabia Background: Although the prevalence of type 2 diabetes mellitus (T2DM is rising sharply in Saudi Arabia, data on glycemic control, crucial to reducing diabetes mellitus complications, remain scarce. This study therefore investigated glycemic control status and the factors influencing poor glycemic control among adult T2DM patients in Saudi Arabia.Methods: This cross-sectional study examined 423 T2DM patients at a diabetic center in Tabuk, Saudi Arabia between September 2016 and July 2017. Glycemic levels were measured via fasting blood glucose (FBG levels, and “poor glycemic control” was defined as FBG >130 mg/dL. Poor glycemic control’s risk factors were identified using a logistic regression.Results: In the sample, 74.9% of the patients had poor blood glycemic control. Logistic regression revealed that T2DM patients had an increased chance of poorly controlled diabetes if they had family histories of diabetes (adjusted odds ratio [AOR] =7.38, 95% CI 4.09–13.31, longer diabetic durations (AOR =2.33, 95% CI 1.14–4.78 for 5–10 years and AOR =5.19, 95% CI 2.50–10.69 for >10 years, insufficient physical exercise (AOR =19.02, 95% CI 6.23–58.06, or were overweight (AOR =3.79, 95% CI 2.00–7.18, or obese (AOR =5.35, 95% CI 2.72–12.59.Conclusion: A high proportion of the sampled patients had poor glycemic control, therefore, health care professionals should manage the associated risk factors to limit disease complications and improve the health of patients with diabetes. Keywords: type 2 diabetes, glycemic control, Saudi Arabia

  8. Effect of exposure to good vs poor medical trainee performance on attending physician ratings of subsequent performances.

    Science.gov (United States)

    Yeates, Peter; O'Neill, Paul; Mann, Karen; Eva, Kevin W

    2012-12-05

    Competency-based models of education require assessments to be based on individuals' capacity to perform, yet the nature of human judgment may fundamentally limit the extent to which such assessment is accurately possible. To determine whether recent observations of the Mini Clinical Evaluation Exercise (Mini-CEX) performance of postgraduate year 1 physicians influence raters' scores of subsequent performances, consistent with either anchoring bias (scores biased similar to previous experience) or contrast bias (scores biased away from previous experience). Internet-based randomized, blinded experiment using videos of Mini-CEX assessments of postgraduate year 1 trainees interviewing new internal medicine patients. Participants were 41 attending physicians from England and Wales experienced with the Mini-CEX, with 20 watching and scoring 3 good trainee performances and 21 watching and scoring 3 poor performances. All then watched and scored the same 3 borderline video performances. The study was completed between July and November 2011. The primary outcome was scores assigned to the borderline videos, using a 6-point Likert scale (anchors included: 1, well below expectations; 3, borderline; 6, well above expectations). Associations were tested in a multivariable analysis that included participants' sex, years of practice, and the stringency index (within-group z score of initial 3 ratings). The mean rating scores assigned by physicians who viewed borderline video performances following exposure to good performances was 2.7 (95% CI, 2.4-3.0) vs 3.4 (95% CI, 3.1-3.7) following exposure to poor performances (difference of 0.67 [95% CI, 0.28-1.07]; P = .001). Borderline videos were categorized as consistent with failing scores in 33 of 60 assessments (55%) in those exposed to good performances and in 15 of 63 assessments (24%) in those exposed to poor performances (P performances compared with 25 of 63 assessments (39.5%) in those exposed to poor performances (P poor

  9. Can microcredit help improve the health of poor women? Some findings from a cross-sectional study in Kerala, India.

    Science.gov (United States)

    Mohindra, Ks; Haddad, Slim; Narayana, D

    2008-01-10

    This study examines associations between female participation in a microcredit program in India, known as self help groups (SHGs), and women's health in the south Indian state of Kerala. Because SHGs do not have a formal health program, this provides a unique opportunity to assess whether SHG participation influences women's health via the social determinants of health. This cross-sectional study used special survey data collected in 2003 from one Panchayat (territorial decentralized unit). Information was collected on women's characteristics, health determinants (exclusion to health care, exposure to health risks, decision-making agency), and health achievements (self assessed health, markers of mental health). The study sample included 928 non elderly poor women. The primary finding is that compared to non-participants living in a household without a SHG member, the odds of facing exclusion is significantly lower among early joiners, women who were members for more than 2 years (OR = 0.58, CI = 0.41-0.80), late joiners, members for 2 years and less (OR = 0.60, CI = 0.39-0.94), and non-participants who live in a household with a SHG member (OR = 0.53, CI = 0.32-0.90). We also found that after controlling for key women's characteristics, early joiners of a SHG are less likely to report emotional stress and poor life satisfaction compared to non-members (OR = 0.52, CI = 0.30-0.93; OR = 0.32, CI = 0.14-0.71). No associations were found between SHG participation and self assessed health or exposure to health risks. The relationship between SHG participation and decision-making agency is unclear. Microcredit is not a panacea, but could help to improve the health of poor women by addressing certain issues relevant to the context. In Kerala, SHG participation can help protect poor women against exclusion to health care and possibly aid in promoting their mental health.

  10. Poor comprehenders in the classroom: teacher ratings of behavior in children with poor reading comprehension and its relationship with individual differences in working memory.

    Science.gov (United States)

    Pimperton, Hannah; Nation, Kate

    2014-01-01

    Differing etiological explanations have been proposed to account for poor comprehenders' difficulties with reading comprehension, with some researchers emphasizing working memory deficits and others arguing for oral language weaknesses playing a key causal role. The authors contrasted these two theoretical accounts using data obtained from direct measures of working memory and from teacher ratings of poor comprehenders' behavior in the classroom. At the group level, poor comprehenders showed weaknesses on verbal but not nonverbal working memory tasks, in keeping with the "language account." However, they also showed evidence of elevated levels of problem behaviors specifically associated with working memory deficits. Further analysis revealed that these group differences in working-memory-related problem behaviors were carried by a small subgroup of poor comprehenders who also displayed domain-general (verbal and nonverbal) working memory problems, argued to be reflective of "genuine" underlying working memory deficits.

  11. Cultural influences behind cholera transmission in the Far North ...

    African Journals Online (AJOL)

    Introduction: in recent years, the Far North Region of Cameroon has experienced serious and recurrent cholera outbreaks. Yet, understanding of cultural influences on outbreaks and spread remain poorly understood. This qualitative study explored cultural influences on cholera exposure in this region. Methods: interviews ...

  12. Novel electrosprayed nanospherules for enhanced aqueous solubility and oral bioavailability of poorly water-soluble fenofibrate

    Directory of Open Access Journals (Sweden)

    Yousaf AM

    2016-01-01

    Full Text Available Abid Mehmood Yousaf,1,2 Omer Mustapha,1 Dong Wuk Kim,1 Dong Shik Kim,1 Kyeong Soo Kim,1 Sung Giu Jin,1 Chul Soon Yong,3 Yu Seok Youn,4 Yu-Kyoung Oh,5 Jong Oh Kim,3 Han-Gon Choi1 1College of Pharmacy and Institute of Pharmaceutical Science and Technology, Hanyang University, Ansan, Gyeonggi, South Korea; 2Faculty of Pharmacy, University of Central Punjab, Johar, Lahore, Pakistan; 3College of Pharmacy, Yeungnam University, Gyongsan, North Gyeongsang, 4School of Pharmacy, Sungkyunkwan University, Suwon, Gyeonggi, 5College of Pharmacy, Seoul National University, Seoul, South Korea Purpose: The purpose of the present research was to develop a novel electrosprayed nanospherule providing the most optimized aqueous solubility and oral bioavailability for poorly water-soluble fenofibrate.Methods: Numerous fenofibrate-loaded electrosprayed nanospherules were prepared with polyvinylpyrrolidone (PVP and Labrafil® M 2125 as carriers using the electrospray technique, and the effect of the carriers on drug solubility and solvation was assessed. The solid state characterization of an optimized formulation was conducted by scanning electron microscopy, powder X-ray diffraction, differential scanning calorimetry, and Fourier transform infrared spectroscopic analyses. Oral bioavailability in rats was also evaluated for the formulation of an optimized nanospherule in comparison with free drug and a conventional fenofibrate-loaded solid dispersion.Results: All of the electrosprayed nanospherule formulations had remarkably enhanced aqueous solubility and dissolution compared with free drug. Moreover, Labrafil M 2125, a surfactant, had a positive influence on the solubility and dissolution of the drug in the electrosprayed nanospherule. Increases were observed as the PVP/drug ratio increased to 4:1, but higher ratios gave no significant increases. In particular, an electrosprayed nanospherule composed of fenofibrate, PVP, and Labrafil M 2125 at the weight ratio of 1

  13. Human performance breakdowns are rarely accidents: they are usually very poor choices with disastrous results

    International Nuclear Information System (INIS)

    Besco, Robert O.

    2004-01-01

    When human error is involved in the error chain of accidents in complex systems, the causes of the errors are very seldom the result of: - a random slip,; - one inadvertent oversight,; - a single unintended action,; - one mis-perceived event,; - simple mal-performance of a complex action, or; - a poor training program for the human operators. Invariably, the cause of the break down is in a very poor conscious choice by someone from the operator back through system designer, the supervision, management and leadership through the entire organization. Usually the operator bears the burden of the blame and is either rebuked, retrained or replaced. In systems such as commercial aviation, complex manufacturing systems, power plants, process control systems, information-processing systems and communications networks, the replacement or retraining of individuals or even classes of individuals usually does not result in any long-term improvement of the safety or effectiveness of the system. What is needed is a system that identifies the reasons why the operators made the errors. Further a system is needed that can recommend what can be done to improve the future performance within the system. The professional performance analysis system (PPAS) has been developed and applied to more than 50 major aircraft accidents in the past 30 years. The PPAS is a direct outgrowth of the human performance analysis system developed by Robert Mager over 45 years ago. The PPAS system is applied after a complete and unbiased definition and description of the events of the accident or incident has been developed by the teams of accident investigation and accident reconstruction professionals. The PPAS then uses a systematic protocol and algorithm to determine the reasons as to why the humans committed the errors or why they performed at subnormal performance levels. This process is based on quantitative behavioral science principles and findings that have been demonstrated valid for many

  14. Improving Flood Prediction By the Assimilation of Satellite Soil Moisture in Poorly Monitored Catchments.

    Science.gov (United States)

    Alvarez-Garreton, C. D.; Ryu, D.; Western, A. W.; Crow, W. T.; Su, C. H.; Robertson, D. E.

    2014-12-01

    Flood prediction in poorly monitored catchments is among the greatest challenges faced by hydrologists. To address this challenge, an increasing number of studies in the last decade have explored methods to integrate various existing observations from ground and satellites. One approach in particular, is the assimilation of satellite soil moisture (SM-DA) into rainfall-runoff models. The rationale is that satellite soil moisture (SSM) can be used to correct model soil water states, enabling more accurate prediction of catchment response to precipitation and thus better streamflow. However, there is still no consensus on the most effective SM-DA scheme and how this might depend on catchment scale, climate characteristics, runoff mechanisms, model and SSM products used, etc. In this work, an operational SM-DA scheme was set up in the poorly monitored, large (>40,000 km2), semi-arid Warrego catchment situated in eastern Australia. We assimilated passive and active SSM products into the probability distributed model (PDM) using an ensemble Kalman filter. We explored factors influencing the SM-DA framework, including relatively new techniques to remove model-observation bias, estimate observation errors and represent model errors. Furthermore, we explored the advantages of accounting for the spatial distribution of forcing and channel routing processes within the catchment by implementing and comparing lumped and semi-distributed model setups. Flood prediction is improved by SM-DA (Figure), with a 30% reduction of the average root-mean-squared difference of the ensemble prediction, a 20% reduction of the false alarm ratio and a 40% increase of the ensemble mean Nash-Sutcliffe efficiency. SM-DA skill does not significantly change with different observation error assumptions, but the skill strongly depends on the observational bias correction technique used, and more importantly, on the performance of the open-loop model before assimilation. Our findings imply that proper

  15. Aripiprazole augmentation in poor insight obsessive-compulsive disorder: a case report

    Directory of Open Access Journals (Sweden)

    Vinciguerra Valentina

    2008-12-01

    Full Text Available Abstract Background Obsessive-compulsive disorder is associated with a relevant impairment in social and interpersonal functioning and severe disability. This seems to be particularly true for the poor insight subtype, characterised by a lack of consciousness of illness and, consequently, compliance with treatment. Poor responsiveness to serotonergic drugs in poor insight obsessive-compulsive patients may also require an augmentation therapy with atypical antipsychotics. Methods We reviewed a case in which a patient with a long history of poor insight obsessive-compulsive disorder was treated with a high dosage of serotonin reuptake inhibitors. Results The treatment resulted in a poor outcome. This patient was therefore augmentated with aripiprazole. Conclusion Doctors should consider aripiprazole as a possible augmentation strategy for serotonergic poor responder obsessive-compulsive patients, but further research on these subjects is needed.

  16. The specific role of inhibition in reading comprehension in good and poor comprehenders.

    Science.gov (United States)

    Borella, Erika; Carretti, Barbara; Pelegrina, Santiago

    2010-01-01

    Difficulties in inhibitory processes have been shown to characterize the performance of poor comprehenders. However, the inhibitory inefficiency of poor comprehenders is most often assessed by their resistance to proactive interference, that is, the ability to suppress off-goal task information from working memory (WM). In two studies tasks assessing resistance to proactive interference (intrusion errors), response to distracters (Text With Distracters task) and prepotent response inhibition (Stroop and Hayling tests), along with WM measures, were administered to children aged 10 to 11, both good and poor comprehenders. The aim of the study was to specifically determine whether general or specific inhibitory factors affect poor comprehenders' reading difficulties. Results showed that poor comprehenders, compared to good ones, are impaired in WM tasks and in inhibitory tasks that assess resistance to proactive interference. This suggests that reading comprehension difficulties of poor comprehenders are related to specific inhibitory problems.

  17. Using the community pharmacy to identify patients at risk of poor asthma control and factors which contribute to this poor control.

    Science.gov (United States)

    Armour, Carol L; Lemay, Kate; Saini, Bandana; Reddel, Helen K; Bosnic-Anticevich, Sinthia Z; Smith, Lorraine D; Burton, Deborah; Song, Yun Ju Christine; Alles, Marie Chehani; Stewart, Kay; Emmerton, Lynne; Krass, Ines

    2011-11-01

    Although asthma can be well controlled by appropriate medication delivered in an appropriate way at an appropriate time, there is evidence that management is often suboptimal. This results in poor asthma control, poor quality of life, and significant morbidity. The objective of this study was to describe a population recruited in community pharmacy identified by trained community pharmacists as being at risk for poor asthma outcomes and to identify factors associated with poor asthma control. It used a cross-sectional design in 96 pharmacies in metropolitan and regional New South Wales, Victoria, Queensland, and Australian Capital Territory in Australia. Community pharmacists with specialized asthma training enrolled 570 patients aged ≥18 years with doctor-diagnosed asthma who were considered at risk of poor asthma outcomes and then conducted a comprehensive asthma assessment. In this assessment, asthma control was classified using a symptom and activity tool based on self-reported frequency of symptoms during the previous month and categorized as poor, fair, or good. Asthma history was discussed, and lung function and inhaler technique were also assessed by the pharmacist. Medication use/adherence was recorded from both pharmacy records and the Brief Medication Questionnaire (BMQ). The symptom and activity tool identified that 437 (77%) recruited patients had poor asthma control. Of the 570 patients, 117 (21%) smoked, 108 (19%) had an action plan, 372 (69%) used combination of inhaled corticosteroid (ICS)/long-acting β(2)-agonist (LABA) medications, and only 17-28% (depending on device) used their inhaler device correctly. In terms of adherence, 90% had their ICS or ICS/LABA dispensed <6 times in the previous 6 months, which is inconsistent with regular use; this low adherence was confirmed from the BMQ scores. A logistic regression model showed that patients who smoked had incorrect inhaler technique or low adherence (assessed by either dispensing history or

  18. Self-disorders and Schizophrenia: A Phenomenological Reappraisal of Poor Insight and Noncompliance

    OpenAIRE

    Henriksen, Mads G.; Parnas, Josef

    2013-01-01

    Poor insight into illness is considered the primary cause of treatment noncompliance in schizophrenia. In this article, we critically discuss the predominant conceptual accounts of poor insight, which consider it as an ineffective self-reflection, caused either by psychological defenses or impaired metacognition. We argue that these accounts are at odds with the phenomenology of schizophrenia, and we propose a novel account of poor insight. We suggest that the reason why schizophrenia patient...

  19. POOR PROGRESS STUDENTS IN LEARNING MATHEMATICS AS SOCIAL AND PSYCHOLOGICAL-PEDAGOGICAL PROBLEM

    OpenAIRE

    Vladimir Tatochenko; Andrii Shypko

    2016-01-01

    The article is devoted to theoretical substantiation of modern methodical system of Mathematics teaching of poor progressing secondary school pupils. A systematic approach to the study of psycho-pedagogical determinants of poor progress of pupils in math was implemented. The dynamic of interfunctional relationship of structure of educational and informative sphere of poor progressing pupils in mathematics was disclosed and scientific understanding of this process was expanded. The introducti...

  20. Determinants of poor 6-min walking distance in patients with COPD: the ECLIPSE cohort

    DEFF Research Database (Denmark)

    Spruit, Martijn A; Watkins, Michael L; Edwards, Lisa D

    2010-01-01

    >/=2) are significant clinical determinants of poor 6MWD performance (poor 6MWD are complex and depend on both physical (both pulmonary and non-pulmonary factors) and psychological factors as evaluated from a large multinational cohort of well......BACKGROUND: The 6-min walking test (6MWT) is widely used to assess exercise tolerance in patients with chronic obstructive pulmonary disease (COPD). Given the prognostic significance of the 6MWT, it is important to identify why some COPD patients perform poorly in terms of this outcome. We aimed...... to identify clinical determinants of a poor 6-min walking distance (

  1. The Institutional Logic of Images of the Poor and Welfare Recipients

    DEFF Research Database (Denmark)

    Larsen, Christian Albrekt

    The article investigates how the poor and welfare recipients are depicted in British, Danish and Swedish newspapers. The study was inspired by American media studies that have documented a negative stereotypic way of portraying the poor and welfare recipients; especially in the case...... they are African-Americans. The article argues that there is an institutional welfare-regime logic behind the way the poor and welfare recipients are depicted in the mass media. It is not only a matter of race. This argument is substantiated by showing that the poor and welfare recipients are a) also depicted...

  2. Factors affecting the implementation of health legislation and its impact on the rural poor in China: a case study of implementation of the maternal and infant health care law in two poor counties.

    Science.gov (United States)

    Tolhurst, Rachel; Zhang, Tuohong; Yang, Hui; Gao, Jun; Tang, Shenglan

    2004-01-01

    This paper presents and discusses a case study of health legislation in China. In the transition to a market economy, legislation has been developed to offset the weakening in the central planning mechanism and political control that have historically influenced the behaviour of institutions and individuals in the Ministry of Health. There has been relatively little empirical examination of the implementation and impact of legislation as a tool for influencing health service provision in low-income countries. The study aimed to contribute towards filling this gap by exploring the factors affecting the implementation and impact of the Maternal and Infant Health Care Law, through a case study of two poor, rural counties in Chongqing municipality, China. The study found that key local actors perceive health legislation to be an important tool for safeguarding access to essential health care. However, the implementation of health legislation is inevitably a political process. The study illustrates the difficulties involved in efforts to influence provider behaviour through a national level legislative framework in a situation of decentralization of control over those providers, due to extreme regional variation in economic situations and limited resource inputs from the centre. Lessons are drawn for Chinese and international policy makers.

  3. Brief report: Poor self-regulation as a predictor of individual differences in adaptive functioning in young children with autism spectrum disorder.

    Science.gov (United States)

    Uljarević, Mirko; Hedley, Darren; Nevill, Rose; Evans, David W; Cai, Ru Ying; Butter, Eric; Mulick, James A

    2018-04-06

    The present study examined the link between poor self-regulation (measured by the child behavior checklist dysregulated profile [DP]) and core autism symptoms, as well as with developmental level, in a sample of 107 children with autism spectrum disorder (ASD) aged 19-46 months. We further examined the utility of DP in predicting individual differences in adaptive functioning, relative to the influence of ASD severity, chronological age (CA), and developmental level. Poor self-regulation was unrelated to CA, developmental level, and severity of ADOS-2 restricted and repetitive behaviors, but was associated with lower ADOS-2 social affect severity. Hierarchical regression identified poor self-regulation as a unique independent predictor of adaptive behavior, with more severe dysregulation predicting poorer adaptive functioning. Results highlight the importance of early identification of deficits in self-regulation, and more specifically, of the utility of DP, when designing individually tailored treatments for young children with ASD. Autism Res 2018. © 2018 International Society for Autism Research, Wiley Periodicals, Inc. This study explored the relationship between poor self-regulation and age, verbal and non-verbal developmental level, severity of autism symptoms and adaptive functioning in 107 children with autism under 4 years of age. Poor self-regulation was unrelated to age, developmental level, and severity of restricted and repetitive behaviors but was associated with lower social affect severity. Importantly, more severe self-regulation deficits predicted poorer adaptive functioning. © 2018 International Society for Autism Research, Wiley Periodicals, Inc.

  4. Effectiveness of Zakat-based Programs on Poverty Alleviation and Economic Empowerment of Poor Women: A Case Study of Bangladesh

    Directory of Open Access Journals (Sweden)

    Fahami Muhammad Anis

    2016-02-01

    Full Text Available Among the many problems facing Bangladesh, poverty remains a key problem affecting millions of lives. During the past few decades, many initiatives have been implemented such as microcredit and cash transfer programs, yet the results seemed to be ambiguous. New frontiers are now sought to find new sources of finance which could offer a more effective and sustainable solution to the root cause of the poverty problem. Considering the idea of entrepreneurship and group-based development approach of microcredit, a zakat-based development approach was initiated in Bangladesh at a private level by an organization called Center for Zakat Management (CZM for poverty alleviation and sustainable economic empowerment targeting poor women in rural areas. This paper aims to assess the effectiveness of the CZM efforts in utilizing zakat funds for promoting entrepreneurship among poor rural women. Focusing on the case of Bangladesh, this study assesses the effectiveness of zakat on aspects such as income, house hold expense and fixed asset accumulation of the poor client based on the “before and after” approach. Groups comprising of poor individuals and families are given equity capital/seed money and are encouraged to embark on small businesses according to their own liking. The groups are supervised for a period of a minimum of three years to ensure all individuals within the group are able to continue with their activities and ultimately, free themselves from the shackles of poverty and graduate into sustainable livelihood. Results indicate a significant nominal and real increase in average monthly income, increase in fixed assets and an increase in monthly average household expenditure before and after receiving zakat money. Results also demonstrate factors such as age of the entrepreneur, family size, type of business involved and the amount of zakat received to have a strong influence in determining the success of women entrepreneurs. Education level

  5. EFFECTIVENESS OF ZAKAT-BASED PROGRAMS ON POVERTY ALLEVIATION AND ECONOMIC EMPOWERMENT OF POOR WOMEN: A CASE STUDY OF BANGLADESH

    Directory of Open Access Journals (Sweden)

    Fahami Muhammad Anis

    2016-02-01

    Full Text Available Among the many problems facing Bangladesh, poverty remains a key problem affecting millions of lives. During the past few decades, many initiatives have been implemented such as microcredit and cash transfer programs, yet the results seemed to be ambiguous. New frontiers are now sought to find new sources of finance which could offer a more effective and sustainable solution to the root cause of the poverty problem. Considering the idea of entrepreneurship and group-based development approach of microcredit, a zakat-based development approach was initiated in Bangladesh at a private level by an organization called Center for Zakat Management (CZM for poverty alleviation and sustainable economic empowerment targeting poor women in rural areas. This paper aims to assess the effectiveness of the CZM efforts in utilizing zakat funds for promoting entrepreneurship among poor rural women. Focusing on the case of Bangladesh, this study assesses the effectiveness of zakat on aspects such as income, house hold expense and fixed asset accumulation of the poor client based on the “before and after” approach. Groups comprising of poor individuals and families are given equity capital/seed money and are encouraged to embark on small businesses according to their own liking. The groups are supervised for a period of a minimum of three years to ensure all individuals within the group are able to continue with their activities and ultimately, free themselves from the shackles of poverty and graduate into sustainable livelihood. Results indicate a significant nominal and real increase in average monthly income, increase in fixed assets and an increase in monthly average household expenditure before and after receiving zakat money. Results also demonstrate factors such as age of the entrepreneur, family size, type of business involved and the amount of zakat received to have a strong influence in determining the success of women entrepreneurs. Education level

  6. [Exogenous luteinizing hormone for assisted reproduction techniques in poor response patients].

    Science.gov (United States)

    Spremović-Radjenović, Svetlana; Gudović, Aleksandra; Lazović, Gordana

    2010-07-01

    Two gonadotrophins, two cell theory refers to necessity of both gonadotrophin activities for theca and granulose cells steroidogenesis of dominant follicle. The aim of this study was to determine the influence of recombinant LH in women qualified as poor responders in the first assisted reproduction procedure (IVF), on fertility results, expressed as percentage of clinical pregnancies. The study included 12 women, 35 years and older who were their own controls. The next trial of IVF was with the same dose of recombinant FSH and GnRH agonist, and with the same, long protocol. Recombinant LH was added in the dose of 75 IU from the 2nd to 7th day of the cycle, and 150 IU from the 8th day of the cycle to the aspiration of oocytes. Within the two different protocols: there was no significant difference between LH concentration in 8th and 12th day of cycle; there was no significant difference between E2 concentration on day 2nd and day 8th; there was a significant difference between E2 concentrations on day 12th; endometrial thickness was not significantly different on the day of aspiration, neither was the number of follicles and embryos. In the two patients, clinical pregnancy was detected (pregnancy rate 17%), and they delivered in term. So, a statistically significant difference between the two protocols was in the rate of clinical pregnancies. The patients with low response to a long protocol in IVF procedures had significantly better results according to the clinical pregnancy rate when the recombinant LH was added to recombinant FSH in the stimulation protocol.

  7. Osteopontin Involves Cisplatin Resistance and Poor Prognosis in Oral Squamous Cell Carcinoma

    Directory of Open Access Journals (Sweden)

    Sheng-Dean Luo

    2015-01-01

    Full Text Available Background. Osteopontin (OPN is a multifunctional cytokine involved in cell survival, migration, and adhesion. However, its role in chemosensitivity in locally advanced oral squamous cell carcinoma (OSCC in humans has not yet been investigated. Methods. We enrolled 121 patients with locally advanced stage IVA/B OSCC receiving cisplatin-based IC followed by CCRT from January 1, 2006, through January 1, 2012. Immunohistochemistry was used to assess OPN expression in OSCC patients’ biopsy specimens from paraffin blocks before treatment. In addition, MTT/colony formation assay was used to estimate the influence of OPN in an oral cancer cell line treated with cisplatin. Results. Of the 121 patients, 94 had positive OPN findings and 52 responded to IC followed by CCRT. Positive osteopontin immunostaining also correlated significantly with positive N status/TNM stage/male gender and smoking. Univariate analyses showed that patients whose tumors had a low expression of OPN were more likely to respond to chemotherapy and have a significantly better OS than those whose tumors had a high expression of OPN. Multivariate analysis revealed that prolonged survival was independently predicted for patients with stage IVA disease, negative lymph nodes, and negative expressions of OPN and for those who received chemotherapy with Docetaxel/cisplatin/fluorouracil (TPF. An oral cancer line stimulated with OPN exhibited a dose-dependent resistance to cisplatin treatment. Conversely, endogenous OPN depletion by OPN-mediated shRNA increased sensitivity to cisplatin. Conclusions. A positive expression of OPN predicts a poor response and survival in patients with locally advanced stage IVA/B OSCC treated with cisplatin-based IC followed by CCRT.

  8. Ostracism Reduces Reliance on Poor Advice from Others during Decision Making.

    Science.gov (United States)

    Byrne, Kaileigh A; Tibbett, Thomas P; Laserna, Lauren N; Carter-Sowell, Adrienne R; Worthy, Darrell A

    2016-10-01

    Decision-making is rarely context-free, and often both social information and non-social information are weighed into one's decisions. Incorporating information into a decision can be influenced by previous experiences. Ostracism has extensive effects, including taxing cognitive resources and increasing social monitoring. In decision-making situations, individuals are often faced with both objective and social information and must choose which information to include or filter out. How will ostracism affect the reliance on objective and social information during decision-making? Participants ( N =245) in Experiment 1 were randomly assigned to be included or ostracized in a standardized, group task. They then performed a dynamic decision-making task that involved the presentation of either non-social (i.e. biased reward feedback) or social (i.e., poor advice from a previous participant) misleading information. In Experiment 2, participants ( N =105) completed either the ostracism non-social condition or social misleading information condition with explicit instructions stating that the advice given was from an individual who did not partake in the group task. Ostracized individuals relied more on non-social misleading information and performed worse than included individuals. However, ostracized individuals discounted misleading social information and outperformed included individuals. Results of Experiment 2 replicated the findings of Experiment 1. Across two experiments, ostracized individuals were more critical of advice from others, both individuals who may have ostracized them and unrelated individuals. In other words, compared to included individuals, ostracized individuals underweighted advice from another individual, but overweighted non-social information during decision-making. We conclude that when deceptive objective information is present, ostracism results in disadvantageous decision-making.

  9. KDM2B overexpression correlates with poor prognosis and regulates glioma cell growth

    Directory of Open Access Journals (Sweden)

    Wang Y

    2018-01-01

    Full Text Available Yiwei Wang,1 Jin Zang,1 Dongyong Zhang,2 Zhenxiang Sun,1 Bo Qiu,2 Xiaojie Wang1 1Department of Human Anatomy, Shenyang Medical College, Huanggu District, Shenyang City, 2Department of Neurosurgery, First Affiliated Hospital of China Medical University, Heping District, Shenyang City, Liaoning Province, ChinaBackground: Gliomas are one of the most lethal cancers in the human central nervous system. Despite clinical treatment advancements, the prognosis of patients with glioma remains poor. KDM2B is a histone lysine demethylase, which has been observed in multiple tumors. But the concrete role of KDM2B in gliomas remains to be further illustrated.Methods: The KDM2B expression in gliomas was detected with immunohistochemistry and Western blot assay. Furthermore, knockdown of KDM2B in U87 and U251 glioma cell lines, the proliferation capacity was evaluated by cell viability assay, colon formation assay and flow cytometry in vitro. Western blot assay was used to analyze the p21, EZH2 and cyclinD1 changes followed by knockdown of KDM2B.Results: KDM2B was upregulated in tissues of glioma patients, and the expression was correlated to cancer progression. Downregulation of KDM2B in U87 and U251 glioma cell lines inhibited cell proliferation and arrested cell cycle in G0/G1 phase. In addition, silencing KDM2B promoted the upregulation of p21 while reduced the expression of EZH2 and cyclinD1.Conclusion: Taken together, our results revealed that KDM2B might influence gliomas growth and act as a novel therapeutic target for glioma patients.Keywords: EZH2, glioma, KDM2B, P21

  10. Determination System Of Food Vouchers For the Poor Based On Fuzzy C-Means Method

    Science.gov (United States)

    Anamisa, D. R.; Yusuf, M.; Syakur, M. A.

    2018-01-01

    Food vouchers are government programs to tackle the poverty of rural communities. This program aims to help the poor group in getting enough food and nutrients from carbohydrates. There are several factors that influence to receive the food voucher, such as: job, monthly income, Taxes, electricity bill, size of house, number of family member, education certificate and amount of rice consumption every week. In the execution for the distribution of vouchers is often a lot of problems, such as: the distribution of food vouchers has been misdirected and someone who receives is still subjective. Some of the solutions to decision making have not been done. The research aims to calculating the change of each partition matrix and each cluster using Fuzzy C-Means method. Hopefully this research makes contribution by providing higher result using Fuzzy C-Means comparing to other method for this case study. In this research, decision making is done by using Fuzzy C-Means method. The Fuzzy C-Means method is a clustering method that has an organized and scattered cluster structure with regular patterns on two-dimensional datasets. Furthermore, Fuzzy C-Means method used for calculates the change of each partition matrix. Each cluster will be sorted by the proximity of the data element to the centroid of the cluster to get the ranking. Various trials were conducted for grouping and ranking of proposed data that received food vouchers based on the quota of each village. This testing by Fuzzy C-Means method, is developed and abled for determining the recipient of the food voucher with satisfaction results. Fulfillment of the recipient of the food voucher is 80% to 90% and this testing using data of 115 Family Card from 6 Villages. The quality of success affected, has been using the number of iteration factors is 20 and the number of clusters is 3

  11. [Patients with subarachnoid haemorrhage in poor grade neurological status: Study of prognostic factors].

    Science.gov (United States)

    Sosa-Pérez, Coralia; Morera-Molina, Jesús; Espino-Postigo, Carlos; Jiménez-O'Shanahan, Aruma

    2015-01-01

    To evaluate and predict factors influencing prognosis and/or clinical outcome at 6 months in patients with spontaneous subarachnoid haemorrhage, World Federation of Neurosurgical Societies (WFNS) grades iv and v. This was a retrospective study of a consecutive series of 394 patients admitted to our hospital with clinical and radiological diagnosis of spontaneous subarachnoid haemorrhage, from 1 January 1999 to 30 June 2009. We selected 121 patients who met the criteria of being in WFNS grades iv or v before treatment; 3 patients were excluded due to loss of tracking. The outcome variable was assessed 6 months after the event using the Glasgow Outcome Scale. A P value<.05 was considered statistically significant. One hundred and twenty-one patients were included in the statistical analysis. The average age of the patients in the series was 54 years (14-92). Patients who had a mean Glasgow Coma Scale lower than 7 points (P<.0001), those who were grade v (P<.0001) in the pre-treatment WFNS scale and those with pupillary disorder (P=.002) had a worse clinical outcome. Likewise, those with associated intraparenchymal hematoma (P=.020) and those not receiving any treatment (P=.020) were also associated with a poor clinical outcome. These results were statistically significant. Patients admitted with a WFNS grade v and/or presenting pupil disorder and/or intraparenchymal hematoma were associated with worse clinical outcomes. Copyright © 2014 Sociedad Española de Neurocirugía. Published by Elsevier España. All rights reserved.

  12. Displaced trochanteric fragments lead to poor functional outcome in pertrochanteric fractures treated by cephalomedullary nails.

    Science.gov (United States)

    Studer, Patrick; Suhm, Norbert; Wang, Qing; Rosenthal, Rachel; Saleh, Hatem Al-Fadel; Jakob, Marcel

    2015-12-01

    The importance of the greater trochanter and its attached abductor muscles for physiological gait is well accepted. However the influence of a displaced greater trochanter fracture after a pertrochanteric fracture is unknown. The aim of this study is to determine if there is an association between the greater trochanter position and the level of patient mobility following internal fixation of pertrochanteric fractures. One hundred and thirty-three consecutive elderly patients with a median age of 85 (interquartile range [IQR] 79-91) years, who were treated for pertrochanteric fractures at a level I trauma centre, were recruited. AO 31 A3.1 and A3.2 fracture types were excluded from the statistical analysis. Patient mobility was prospectively assessed before the fracture and one year following fracture treatment using the Parker mobility score. In a multivariable analysis, the influence of a displaced greater trochanter on patient mobility at one-year follow-up was assessed. The analysis was adjusted for age, gender, body mass index, Charlson comorbidity index, AO fracture classification, varus-/valgus malposition of the neck-shaft fragments, and Parker mobility score before fracture. Post-operative X-rays were available in 125 patients, out of which 66 (53%) patients were identified with a displaced or migrated greater trochanter. One year mortality rate was 22% (n=27). In the 82 patients who had functional assessment one year post-operatively, the median Parker mobility score before fracture and at one-year follow-up was 7 (IQR 4-9) and 7 (IQR 3-9) in patients without, and 7 (IQR 4-9) and 3 (IQR 2-5) in patients with a displaced greater trochanter. In multivariable analysis, a displaced greater trochanter was significantly associated with a lower Parker mobility score (-1.74, 95% confidence interval -2.37, -1.12, pfractures with a cephalomedullary nail is associated with a poor functional outcome. Greater attention to achieve adequate reduction and stabilisation

  13. Poor Performance in Mathematics: Is There a Basis for a Self-Worth Explanation for Women?

    Science.gov (United States)

    Thompson, Ted; Dinnel, Dale L.

    2007-01-01

    The self-worth theory of achievement motivation holds that in situations in which poor performance is likely to reveal low ability, certain students (known as self-worth protective students) intentionally withdraw effort in order to avoid the negative implications of poor performance in terms of damage to self-worth. In this study, evidence of…

  14. Intimate Partner Violence among General and Urban Poor Populations in Kathmandu, Nepal

    Science.gov (United States)

    Oshiro, Azusa; Poudyal, Amod K.; Poudel, Krishna C.; Jimba, Masamine; Hokama, Tomiko

    2011-01-01

    Comparative studies are lacking on intimate partner violence (IPV) between urban poor and general populations. The objective of this study is to identify the prevalence and risk factors of physical IPV among the general and poor populations in urban Nepal. A cross-sectional study was conducted by structured questionnaire interview. Participants…

  15. Persistent poor glycaemic control in adult Type 1 diabetes. A closer look at the problem

    NARCIS (Netherlands)

    DeVries, J. H.; Snoek, F. J.; Heine, R. J.

    2004-01-01

    Around 25% of the adult Type 1 diabetes population is in persistent poor glycaemic control and thus at increased risk of developing microvascular complications. We here discuss correlates of long-standing poor glycaemic control and review the efficacy of clinical strategies designed to overcome

  16. Is It Lateralization, Processing Strategies, or Both That Distinguishes Good And Poor Readers?

    Science.gov (United States)

    Watson, E. Selman; Engle, Randall W.

    1982-01-01

    Two experiments investigated whether poor readers eventually establish a dichotic right ear advantage as predicted by a maturational lag theory. The first studied developmental differences in dichotic listening for normal and poor readers when the order of reporting simultaneously presented items was unconstrained; the second controlled for order…

  17. The Political Economy Of Pro-Poor Development: The Case Of ...

    African Journals Online (AJOL)

    The Political Economy Of Pro-Poor Development: The Case Of Ghana's Poverty Reduction Strategies. ... The eradication of poverty, and hence also sustainable growth, can only be achieved through the engagement of poor people in the development processes which affect their lives. This makes domestic policy ownership ...

  18. [Excessive Daytime Sleepiness, Poor Quality Sleep, and Low Academic Performance in Medical Students].

    Science.gov (United States)

    Machado-Duque, Manuel Enrique; Echeverri Chabur, Jorge Enrique; Machado-Alba, Jorge Enrique

    2015-01-01

    Quality of sleep and excessive daytime sleepiness (EDS) affect cognitive ability and performance of medical students. This study attempts to determine the prevalence of EDS, sleep quality, and assess their association with poor academic performance in this population. A descriptive, observational study was conducted on a random sample of 217 medical students from the Universidad Tecnológica de Pereira, who completed the Pittsburgh Sleep Quality Index (PSQI) questionnaire and the Epworth sleepiness scale. Sociodemographic, clinic and academic variables were also measured. Multivariate analyses for poor academic performance were performed. The included students had a mean age of 21.7±3.3 years, of whom 59.4% were men. Almost half (49.8%) had EDS criteria, and 79.3% were poor sleepers (PSQI ≥ 5), while 43.3% had poor academic performance during the last semester. The bivariate analysis showed that having used tobacco or alcohol until intoxicated, fairly bad subjective sleep quality, sleep efficiency < 65%, and being a poor sleeper were associated with increased risk of low performance. Sleep efficiency < 65% was statistically associated with poor academic performance (P=.024; OR = 4.23; 95% CI, 1.12-15.42) in the multivariate analysis. A poor sleep quality determined by low efficiency was related to poor academic achievement at the end of semester in medical students. Copyright © 2015 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  19. Inclusive growth versus pro-poor growth: Implications for tourism development

    NARCIS (Netherlands)

    Bakker, Martine; Messerli, H.R.

    2017-01-01

    Inclusive growth and pro-poor growth are terms embraced but not fully understood in the tourism community. This paper discusses the main concepts of inclusive growth and their implication for tourism development across the developing world. Is inclusive growth simply another term for pro-poor in

  20. How Do Fluent and Poor Readers' Endurance Differ in Reading?

    Science.gov (United States)

    Bastug, Muhammet; Keskin, Hasan Kagan; Akyol, Mustafa

    2017-01-01

    It was observed in this research how endurance status of fluent readers and poor readers changed as the text became longer. 40 students of the primary school 4th-grade, 20 were fluent readers and other 20 were poor readers, participated in the research. A narrative text was utilised in the data collection process. Students' oral readings were…

  1. Poor Appetite and Dietary Intake in Community-Dwelling Older Adults

    NARCIS (Netherlands)

    van der Meij, Barbara S; Wijnhoven, Hanneke A H; Lee, Jung S; Houston, Denise K; Hue, Trisha; Harris, Tamara B; Kritchevsky, Stephen B; Newman, Anne B; Visser, Marjolein

    2017-01-01

    BACKGROUND/OBJECTIVES: Poor appetite in older adults leads to sub-optimal food intake and increases the risk of undernutrition. The impact of poor appetite on food intake in older adults is unknown. The aim of this study was to examine the differences in food intake among older community-dwelling

  2. The Strengths of Poor Families. Research Brief. Publication #2009-26

    Science.gov (United States)

    Valladares, Sherylls; Moore, Kristin Anderson

    2009-01-01

    In the minds of many people, poor families equal problem families. Indeed, that perception is not surprising, giving compelling evidence of the harsh effects that poverty can have on family life and child well-being. However, far less attention has been paid to the strengths that many poor families have and the characteristics that they may share…

  3. Functional gastrointestinal disorders among adolescents with poor sleep: a school-based study in Shanghai, China.

    Science.gov (United States)

    Zhou, Hui-Qing; Yao, Min; Chen, Guang-Yu; Ding, Xiao-Dong; Chen, Yan-Ping; Li, Ding-Guo

    2012-12-01

    This study aimed to determine whether functional gastrointestinal disorders are more common among adolescents with self-reported poor sleep. Junior middle school and senior high school students (n = 1,362) were recruited from schools in Shanghai. Students completed two questionnaires: the questionnaire for irritable bowel syndrome (IBS) in adolescents and the Pittsburgh Sleep Quality Index. The prevalence of poor sleep was 34.29% [95% confidence interval (CI) = 31.77-36.81] and there was no significant difference between genders (P = 0.991). The tendency towards poor sleep increased with age, with age group yielding a significant effect (P = 0.001). In junior middle school and senior high school students, the propensity towards poor sleep was 30.10% (95% CI = 27.08-33.12%) and 42.11% (95% CI = 37.67-46.55%), respectively. Among students with poor sleep, the prevalence of IBS was 19.70% (95% CI = 16.09-23.31). After adjusting for age, sex, night pain, and psychological factors, IBS was significantly more common in students with poor sleep (odds ratio = 1.92; 95% CI = 1.07-2.58). We conclude that IBS is prevalent in students with poor sleep. Poor sleep was independently associated with IBS among adolescents in Shanghai China.

  4. Interventions and gaps in the process of cushioning the urban poor ...

    African Journals Online (AJOL)

    Interventions and gaps in the process of cushioning the urban poor in Malawi. Felix Kakowa. Abstract. Over the years, Malawi has implemented a number of programmes aimed at cushioning the urban poor in the wake of rapid urbanization, growth of the informal sector and mushrooming squatter settlements. However ...

  5. Assessing stocks in data-poor African fisheries: a case study on the ...

    African Journals Online (AJOL)

    Assessing stocks in data-poor African fisheries: a case study on the white grouper Epinephelus aeneus of Mauritania. ... African Journal of Marine Science ... The lack of reliable stock assessment for numerous exploited stocks in West Africa often results from poor-quality data, high multi-specificity of captures, and the ...

  6. impact of waste disposal on health of a poor urban community

    African Journals Online (AJOL)

    2004-08-08

    Aug 8, 2004 ... and local authorities' policies of hostilities and eviction of poor urban informal settlers(7). This study assessed the human excreta and waste disposal facilities and their health implications among residents of the poor urban settlement of Epworth a few kilometers south east of Harare, Zimbabwe's capital city.

  7. Developmental Trajectories for Children With Dyslexia and Low IQ Poor Readers

    Science.gov (United States)

    2016-01-01

    Reading difficulties are found in children with both high and low IQ and it is now clear that both groups exhibit difficulties in phonological processing. Here, we apply the developmental trajectories approach, a new methodology developed for studying language and cognitive impairments in developmental disorders, to both poor reader groups. The trajectory methodology enables identification of atypical versus delayed development in datasets gathered using group matching designs. Regarding the cognitive predictors of reading, which here are phonological awareness, phonological short-term memory (PSTM) and rapid automatized naming (RAN), the method showed that trajectories for the two groups diverged markedly. Children with dyslexia showed atypical development in phonological awareness, while low IQ poor readers showed developmental delay. Low IQ poor readers showed atypical PSTM and RAN development, but children with dyslexia showed developmental delay. These divergent trajectories may have important ramifications for supporting each type of poor reader, although all poor readers showed weakness in all areas. Regarding auditory processing, the developmental trajectories were very similar for the two poor reader groups. However, children with dyslexia demonstrated developmental delay for auditory discrimination of Duration, while the low IQ children showed atypical development on this measure. The data show that, regardless of IQ, poor readers have developmental trajectories that differ from typically developing children. The trajectories approach enables differences in trajectory classification to be identified across poor reader group, as well as specifying the individual nature of these trajectories. PMID:27110928

  8. Getting to grips with poor comprehenders: stability of group membership across test conditions

    DEFF Research Database (Denmark)

    Daugaard, Hanne Trebbien; Oakhill, Jane V.; Elbro, Carsten

    Reliable identification of poor comprehenders is difficult because reading comprehension tests do not measure the same thing (Keenan et al., 2014). In addition to different contents, differences in how the same test is administered may also cause instability of the definition of poor comprehenders....

  9. Variety within a cooked meal increases meal energy intake in older women with a poor appetite

    NARCIS (Netherlands)

    Wijnhoven, Hanneke Ah; van der Meij, Barbara S; Visser, Marjolein

    2015-01-01

    BACKGROUND: Effective strategies to increase dietary intake in older persons with a poor appetite are needed. Previous studies have shown that increasing diet variety may increase dietary intake. This has not been tested in older adults with a poor appetite. OBJECTIVE: We investigated if an

  10. The Role of Training in Reducing Poverty: The Case of the Ultra-Poor in Bangladesh

    Science.gov (United States)

    Khan, Mohammad Aktaruzzaman; Ali, Anees Janee

    2014-01-01

    Although microcredit is considered the main vehicle for increasing the income of the poor and alleviating poverty in Bangladesh, it is now well recognised that more than this is needed to reach the ultra poor in rural areas. Consequently, almost half of the Bangladesh population is in some way linked to non-governmental organizations' development…

  11. The (Possible) Function of the Beatitude of the Poor in the Context of ...

    African Journals Online (AJOL)

    The article focuses on the beatitude of the poor in the social and religious context of historical Jesus. The original version of this makarism has to be seen as a religious statement which is not meant as a program of social reform. Yet it has political and socio-ethical implications as it connects the poor with God and his ...

  12. Patterns of absolute and relative pro-poor growth in Cameroon ...

    African Journals Online (AJOL)

    Our findings should provide input to policy debate aimed at fostering pro-poor growth and redistributive policies in the context of designing poverty alleviation strategies, the enhancement of participatory approaches in the development of poverty strategies and the encouragement of broad-based pro-poor growth strategies ...

  13. The President's Veto of the Minimum Wage Bill: Impact on Poor and Minority Workers.

    Science.gov (United States)

    Shapiro, Isaac

    Restoration of an adequate minimum wage remains a critical ingredient in efforts to provide income security for poor and minority workers. The experience of recent years indicates that work does not provide economic security for many poor, Black, and Hispanic workers. National and minority unemployment rates have dropped during the economic…

  14. Does Human Capital Investment Impact the Earning Mobility of the Near Poor?

    Science.gov (United States)

    Karasik, Bradley

    2012-01-01

    This secondary analysis of the earning mobility of the near poor examined the impact of human capital investment on the earning mobility of the near poor between 2005 and 2009. The theory framing this study is Human Capital Theory (Shultz, 1961). Other demographic and socioeconomic variables were included in this study to further explore factors…

  15. From Data-Poor to Data-Rich : System Dynamics in the Era of Big Data

    NARCIS (Netherlands)

    Pruyt, E.

    2014-01-01

    Although SD modeling is sometimes called theory-rich data-poor modeling, it does not mean SD modeling should per definition be data-poor. SD software packages allow one to get data from, and write simulation runs to, databases. Moreover, data is also sometimes used in SD to calibrate parameters or

  16. From magma-poor Ocean Continent Transitions to steady state oceanic spreading: the balance between tectonic and magmatic processes

    Science.gov (United States)

    Gillard, Morgane; Manatschal, Gianreto; Autin, Julia; Decarlis, Alessandro; Sauter, Daniel

    2016-04-01

    spreading center. The interest of that definition is that it does not restrain the term oceanic crust to a basement composition and consequently does not exclude the creation of magma-poor oceanic crust, as observed at slow spreading ridges for example. Indeed, the initiation of steady state oceanic spreading is not necessarily magmatic (e.g. some segments of the Australian-Antarctic margins). In this case, drifting is accommodated by mantle exhumation. However, in this magma-poor transition, and without clear markers of a gradual increase of magmatism, it thus appears difficult to clearly differentiate an exhumed OCT basement and an exhumed oceanic basement. Some theoretical differences can be nevertheless considered: exhumed OCT basement should display a chemical evolution toward the ocean from a subcontinental to an oceanic signature. Moreover, extensional detachment faults are probably long-lived due to the poor influence of the asthenosphere at this stage. On the contrary, exhumed oceanic basement should only display an oceanic signature. In this case, extensional detachment faults are certainly short-lived, due to the strong influence of the asthenosphere, which tends to quickly re-localize the deformation above the spreading center.

  17. The development of infants' use of property-poor sounds to individuate objects.

    Science.gov (United States)

    Wilcox, Teresa; Smith, Tracy R

    2010-12-01

    There is evidence that infants as young as 4.5 months use property-rich but not property-poor sounds as the basis for individuating objects (Wilcox, Woods, Tuggy, & Napoli, 2006). The current research sought to identify the age at which infants demonstrate the capacity to use property-poor sounds. Using the task of Wilcox et al., infants aged 7 and 9 months were tested. The results revealed that 9- but not 7-month-olds demonstrated sensitivity to property-poor sounds (electronic tones) in an object individuation task. Additional results confirmed that the younger infants were sensitive to property-rich sounds (rattle sounds). These are the first positive results obtained with property-poor sounds in infants and lay the foundation for future research to identify the underlying basis for the developmental hierarchy favoring property-rich over property-poor sounds and possible mechanisms for change. Copyright © 2010 Elsevier Inc. All rights reserved.

  18. Can a poverty-reducing and progressive tax and transfer system hurt the poor?

    Science.gov (United States)

    Higgins, Sean; Lustig, Nora

    2016-09-01

    To analyze anti-poverty policies in tandem with the taxes used to pay for them, comparisons of poverty before and after taxes and transfers are often used. We show that these comparisons, as well as measures of horizontal equity and progressivity, can fail to capture an important aspect: that a substantial proportion of the poor are made poorer (or non-poor made poor) by the tax and transfer system. We illustrate with data from seventeen developing countries: in fifteen, the fiscal system is poverty-reducing and progressive, but in ten of these at least one-quarter of the poor pay more in taxes than they receive in transfers. We call this fiscal impoverishment, and axiomatically derive a measure of its extent. An analogous measure of fiscal gains of the poor is also derived, and we show that changes in the poverty gap can be decomposed into our axiomatic measures of fiscal impoverishment and gains.

  19. Evidence for deficits in the temporal attention span of poor readers.

    Science.gov (United States)

    Visser, Troy A W

    2014-01-01

    While poor reading is often associated with phonological deficits, many studies suggest that visual processing might also be impaired. In particular, recent research has indicated that poor readers show impaired spatial visual attention spans in partial and whole report tasks. Given the similarities between competition-based accounts for reduced visual attention span and similar explanations for impairments in sequential object processing, the present work examined whether poor readers show deficits in their "temporal attention span"--that is, their ability to rapidly and accurately process sequences of consecutive target items. Poor and normal readers monitored a sequential stream of visual items for two (TT condition) or three (TTT condition) consecutive target digits. Target identification was examined using both unconditional and conditional measures of accuracy in order to gauge the overall likelihood of identifying a target and the likelihood of identifying a target given successful identification of previous items. Compared to normal readers, poor readers showed small but consistent deficits in identification across targets whether unconditional or conditional accuracy was used. Additionally, in the TTT condition, final-target conditional accuracy was poorer than unconditional accuracy, particularly for poor readers, suggesting a substantial cost arising from processing the previous two targets that was not present in normal readers. Mirroring the differences found between poor and normal readers in spatial visual attention span, the present findings suggest two principal differences between the temporal attention spans of poor and normal readers. First, the consistent pattern of reduced performance across targets suggests increased competition amongst items within the same span for poor readers. Second, the steeper decline in final target performance amongst poor readers in the TTT condition suggests a reduction in the extent of their temporal attention

  20. Evidence for deficits in the temporal attention span of poor readers.

    Directory of Open Access Journals (Sweden)

    Troy A W Visser

    Full Text Available While poor reading is often associated with phonological deficits, many studies suggest that visual processing might also be impaired. In particular, recent research has indicated that poor readers show impaired spatial visual attention spans in partial and whole report tasks. Given the similarities between competition-based accounts for reduced visual attention span and similar explanations for impairments in sequential object processing, the present work examined whether poor readers show deficits in their "temporal attention span"--that is, their ability to rapidly and accurately process sequences of consecutive target items.Poor and normal readers monitored a sequential stream of visual items for two (TT condition or three (TTT condition consecutive target digits. Target identification was examined using both unconditional and conditional measures of accuracy in order to gauge the overall likelihood of identifying a target and the likelihood of identifying a target given successful identification of previous items. Compared to normal readers, poor readers showed small but consistent deficits in identification across targets whether unconditional or conditional accuracy was used. Additionally, in the TTT condition, final-target conditional accuracy was poorer than unconditional accuracy, particularly for poor readers, suggesting a substantial cost arising from processing the previous two targets that was not present in normal readers.Mirroring the differences found between poor and normal readers in spatial visual attention span, the present findings suggest two principal differences between the temporal attention spans of poor and normal readers. First, the consistent pattern of reduced performance across targets suggests increased competition amongst items within the same span for poor readers. Second, the steeper decline in final target performance amongst poor readers in the TTT condition suggests a reduction in the extent of their

  1. Channelling urban modernity to sustainable pro-poor tourism development in Indonesia

    Science.gov (United States)

    Prasetyanti, R.

    2017-06-01

    Sustainable urban planning and development requires not only a fast-growing economic growth and modernity, but also social equity and environmental sustainability. Meanwhile, the global goals of sustainable development have fascinatingly set a promising urban development future by enhancing ecology based pro-poor policy program. Apparently, pro-poor development agenda has led to the notion of pro-poor tourism as part of urban development strategies on poverty alleviation. This research presents Jakarta Hidden Tour and Kampung Warna-warni as certain cases of pro-poor tourism in Indonesia. By the emergence of criticism on “pro-growth” paradigm, the critical analysis of this research focuses on the scenario of sustainable pro-poor tourism through eco-cultural based Kampung-Tour development. In accordance, debates and dilemma have been continuously arising as pros and cons regarding the ethical issues of poverty alleviation based Kampung-Tour development. Nevertheless, this paper tries to redefine Slum Kampung as potential; the writer wildly offers a concept of poverty alleviation by reinventing pro-poor tourism strategy; revitalizing slum site to eco-cultural based pro-poor tourism development as an embodiment of a sustainable urban development. By holding system thinking analysis as research method, sustainable pro-poor tourism highlights the urgency community based tourism and eco-tourism so that poverty alleviation based tourism can be tangibly perceived by the poor. In this sense, good local governance and public private partnership must be enhanced, it is due to, like any other development projects; sustainable pro-poor tourism needs a strong political commitment to alleviate urban poverty, as well as to pursue a better future of sustainable nation.

  2. Multilayer encapsulated mesoporous silica nanospheres as an oral sustained drug delivery system for the poorly water-soluble drug felodipine

    Energy Technology Data Exchange (ETDEWEB)

    Hu, Liang [Department of Pharmaceutics, Shenyang Pharmaceutical University, P.O. Box 32, Liaoning Province, Shenyang 110016 (China); Sun, Hongrui [English Teaching Department, School of Basic Courses, Shenyang Pharmaceutical University, Wenhua Road 103, Shenyang 110016 (China); Zhao, Qinfu; Han, Ning; Bai, Ling; Wang, Ying; Jiang, Tongying [Department of Pharmaceutics, Shenyang Pharmaceutical University, P.O. Box 32, Liaoning Province, Shenyang 110016 (China); Wang, Siling, E-mail: silingwang@syphu.edu.cn [Department of Pharmaceutics, Shenyang Pharmaceutical University, P.O. Box 32, Liaoning Province, Shenyang 110016 (China)

    2015-02-01

    We used a combination of mesoporous silica nanospheres (MSN) and layer-by-layer (LBL) self-assembly technology to establish a new oral sustained drug delivery system for the poorly water-soluble drug felodipine. Firstly, the model drug was loaded into MSN, and then the loaded MSN were repeatedly encapsulated by chitosan (CHI) and acacia (ACA) via LBL self-assembly method. The structural features of the samples were studied using scanning electron microscopy (SEM), transmission electron microscopy (TEM) and nitrogen adsorption. The encapsulating process was monitored by zeta-potential and surface tension measurements. The physical state of the drug in the samples was characterized by differential scanning calorimetry (DSC) and X-ray diffractometry (XRD). The influence of the multilayer with different number of layers on the drug release rate was studied using thermal gravimetric analysis (TGA) and surface tension measurement. The swelling effect and the structure changes of the multilayer were investigated to explore the relationship between the drug release behavior and the state of the multilayer under different pH conditions. The stability and mucosa adhesive ability of the prepared nanoparticles were also explored. After multilayer coating, the drug release rate was effectively controlled. The differences in drug release behavior under different pH conditions could be attributed to the different states of the multilayer. And the nanoparticles possessed good stability and strong mucosa adhesive ability. We believe that this combination offers a simple strategy for regulating the release rate of poorly water-soluble drugs and extends the pharmaceutical applications of inorganic materials and polymers. - Highlights: • A combination of inorganic and organic materials was applied. • Mesoporous silica nanospheres (MSN) were used as drug carriers. • Chitosan and acacia were encapsulated through layer-by-layer self-assembly. • The release rate of the poorly

  3. Association between poor glycemic control, impaired sleep quality, and increased arterial thickening in type 2 diabetic patients.

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    Koichiro Yoda

    Full Text Available Poor sleep quality is an independent predictor of cardiovascular events. However, little is known about the association between glycemic control and objective sleep architecture and its influence on arteriosclerosis in patients with type-2 diabetes mellitus (DM. The present study examined the association of objective sleep architecture with both glycemic control and arteriosclerosis in type-2 DM patients.Cross-sectional study in vascular laboratory.The subjects were 63 type-2 DM inpatients (M/F, 32/31; age, 57.5±13.1 without taking any sleeping promoting drug and chronic kidney disease. We examined objective sleep architecture by single-channel electroencephalography and arteriosclerosis by carotid-artery intima-media thickness (CA-IMT.HbA1c was associated significantly in a negative manner with REM sleep latency (interval between sleep-onset and the first REM period (β=-0.280, p=0.033, but not with other measurements of sleep quality. REM sleep latency associated significantly in a positive manner with log delta power (the marker of deep sleep during that period (β=0.544, p=0.001. In the model including variables univariately correlated with CA-IMT (REM sleep latency, age, DM duration, systolic blood pressure, and HbA1c as independent variables, REM sleep latency (β=-0.232, p=0.038, but not HbA1c were significantly associated with CA-IMT. When log delta power was included in place of REM sleep latency, log delta power (β=-0.257, p=0.023 emerged as a significant factor associated with CA-IMT.In type-2 DM patients, poor glycemic control was independently associated with poor quality of sleep as represented by decrease of REM sleep latency which might be responsible for increased CA-IMT, a relevant marker for arterial wall thickening.

  4. Multilayer encapsulated mesoporous silica nanospheres as an oral sustained drug delivery system for the poorly water-soluble drug felodipine

    International Nuclear Information System (INIS)

    Hu, Liang; Sun, Hongrui; Zhao, Qinfu; Han, Ning; Bai, Ling; Wang, Ying; Jiang, Tongying; Wang, Siling

    2015-01-01

    We used a combination of mesoporous silica nanospheres (MSN) and layer-by-layer (LBL) self-assembly technology to establish a new oral sustained drug delivery system for the poorly water-soluble drug felodipine. Firstly, the model drug was loaded into MSN, and then the loaded MSN were repeatedly encapsulated by chitosan (CHI) and acacia (ACA) via LBL self-assembly method. The structural features of the samples were studied using scanning electron microscopy (SEM), transmission electron microscopy (TEM) and nitrogen adsorption. The encapsulating process was monitored by zeta-potential and surface tension measurements. The physical state of the drug in the samples was characterized by differential scanning calorimetry (DSC) and X-ray diffractometry (XRD). The influence of the multilayer with different number of layers on the drug release rate was studied using thermal gravimetric analysis (TGA) and surface tension measurement. The swelling effect and the structure changes of the multilayer were investigated to explore the relationship between the drug release behavior and the state of the multilayer under different pH conditions. The stability and mucosa adhesive ability of the prepared nanoparticles were also explored. After multilayer coating, the drug release rate was effectively controlled. The differences in drug release behavior under different pH conditions could be attributed to the different states of the multilayer. And the nanoparticles possessed good stability and strong mucosa adhesive ability. We believe that this combination offers a simple strategy for regulating the release rate of poorly water-soluble drugs and extends the pharmaceutical applications of inorganic materials and polymers. - Highlights: • A combination of inorganic and organic materials was applied. • Mesoporous silica nanospheres (MSN) were used as drug carriers. • Chitosan and acacia were encapsulated through layer-by-layer self-assembly. • The release rate of the poorly

  5. How food insecurity contributes to poor HIV health outcomes: Qualitative evidence from the San Francisco Bay Area.

    Science.gov (United States)

    Whittle, Henry J; Palar, Kartika; Seligman, Hilary K; Napoles, Tessa; Frongillo, Edward A; Weiser, Sheri D

    2016-12-01

    Food-insecure people living with HIV/AIDS (PLHIV) consistently exhibit worse clinical outcomes than their food-secure counterparts. This relationship is mediated in part through non-adherence to antiretroviral therapy (ART), sub-optimal engagement in HIV care, and poor mental health. An in-depth understanding of how these pathways operate in resource-rich settings, however, remains elusive. We aimed to understand the relationship between food insecurity and HIV health among low-income individuals in the San Francisco Bay Area using qualitative methods. Semi-structured in-depth interviews were conducted with 34 low-income PLHIV receiving food assistance from a non-profit organization. Interviews explored experiences with food insecurity and its perceived effects on HIV-related health, mental health, and health behaviors including taking ART and attending clinics. Thematic content analysis of transcripts followed an integrative inductive-deductive approach. Food insecurity was reported to contribute to poor ART adherence and missing scheduled clinic visits through various mechanisms, including exacerbated ART side effects in the absence of food, physical feelings of hunger and fatigue, and HIV stigma at public free-meal sites. Food insecurity led to depressive symptoms among participants by producing physical feelings of hunger, aggravating pre-existing struggles with depression, and nurturing a chronic self-perception of social failure. Participants further explained how food insecurity, depression, and ART non-adherence could reinforce each other in complex interactions. Our study demonstrates how food insecurity detrimentally shapes HIV health behavior and outcomes through complex and interacting mechanisms, acting via multiple socio-ecological levels of influence in this setting. The findings emphasize the need for broad, multisectoral approaches to tackling food insecurity among urban poor PLHIV in the United States. Copyright © 2016 Elsevier Ltd. All rights

  6. Targeting Overconsumption of Sugar-Sweetened Beverages vs. Overall Poor Diet Quality for Cardiometabolic Diseases Risk Prevention: Place Your Bets!

    Science.gov (United States)

    Arsenault, Benoit J; Lamarche, Benoît; Després, Jean-Pierre

    2017-06-13

    Chronic overconsumption of sugar-sweetened beverages (SSBs) is amongst the dietary factors most consistently found to be associated with obesity, type 2 diabetes (T2D) and cardiovascular disease (CVD) risk in large epidemiological studies. Intervention studies have shown that SSB overconsumption increases intra-abdominal obesity and ectopic lipid deposition in the liver, and also exacerbates cardiometabolic risk. Similar to the prevalence of obesity and T2D, national surveys of food consumption have shown that chronic overconsumption of SSBs is skyrocketing in many parts of the world, yet with marked heterogeneity across countries. SSB overconsumption is also particularly worrisome among children and adolescents. Although the relationships between SSB overconsumption and obesity, T2D, and CVD are rather consistent in epidemiological studies, it has also been shown that SSB overconsumption is part of an overall poor dietary pattern and is particularly prevalent among subgroups of the population with low socioeconomic status, thereby questioning the major focus on SSBs to target/prevent cardiometabolic diseases. Public health initiatives aimed specifically at decreasing SSB overconsumption will most likely be successful in influencing SSB consumption per se. However, comprehensive strategies targeting poor dietary patterns and aiming at improving global dietary quality are likely to have much more impact in addressing the unprecedented public health challenges that we are currently facing.

  7. Perioperative allogenic blood transfusion is a poor prognostic factor after hepatocellular carcinoma surgery: a multi-center analysis.

    Science.gov (United States)

    Wada, Hiroshi; Eguchi, Hidetoshi; Nagano, Hiroaki; Kubo, Shoji; Nakai, Takuya; Kaibori, Masaki; Hayashi, Michihiro; Takemura, Shigekazu; Tanaka, Shogo; Nakata, Yasuyuki; Matsui, Kosuke; Ishizaki, Morihiko; Hirokawa, Fumitoshi; Komeda, Koji; Uchiyama, Kazuhisa; Kon, Masanori; Doki, Yuichiro; Mori, Masaki

    2018-01-01

    The influence of allogenic blood transfusion on the postoperative outcomes of hepatocellular carcinoma (HCC) surgery remains controversial. This study aims to clarify the clinical impacts of perioperative allogenic blood transfusion on liver resection outcome in HCC patients. We analyzed data collected over 5 years for 642 patients who underwent hepatectomy for HCC at one of the five university hospitals. We investigated the impact of allogenic blood transfusion on postoperative outcome after surgery in all patients and in 74 matched pairs, using a propensity score. Of the 642 patients, 198 (30.8%) received perioperative allogenic blood transfusion (AT group) and 444 (69.2%) did not (non-AT group). Overall survival was lower in the AT group than in the non-AT group in univariate (P blood transfusion was found to be a poor prognostic factor for HCC patients. In this multi-center study, perioperative blood transfusion was an independent factor for poor prognosis after curative surgery for primary HCC in the patient group and in pairs matched by propensity scores.

  8. Targeting Overconsumption of Sugar-Sweetened Beverages vs. Overall Poor Diet Quality for Cardiometabolic Diseases Risk Prevention: Place Your Bets!

    Directory of Open Access Journals (Sweden)

    Benoit J. Arsenault

    2017-06-01

    Full Text Available Chronic overconsumption of sugar-sweetened beverages (SSBs is amongst the dietary factors most consistently found to be associated with obesity, type 2 diabetes (T2D and cardiovascular disease (CVD risk in large epidemiological studies. Intervention studies have shown that SSB overconsumption increases intra-abdominal obesity and ectopic lipid deposition in the liver, and also exacerbates cardiometabolic risk. Similar to the prevalence of obesity and T2D, national surveys of food consumption have shown that chronic overconsumption of SSBs is skyrocketing in many parts of the world, yet with marked heterogeneity across countries. SSB overconsumption is also particularly worrisome among children and adolescents. Although the relationships between SSB overconsumption and obesity, T2D, and CVD are rather consistent in epidemiological studies, it has also been shown that SSB overconsumption is part of an overall poor dietary pattern and is particularly prevalent among subgroups of the population with low socioeconomic status, thereby questioning the major focus on SSBs to target/prevent cardiometabolic diseases. Public health initiatives aimed specifically at decreasing SSB overconsumption will most likely be successful in influencing SSB consumption per se. However, comprehensive strategies targeting poor dietary patterns and aiming at improving global dietary quality are likely to have much more impact in addressing the unprecedented public health challenges that we are currently facing.

  9. Nuclear HER4 mediates acquired resistance to trastuzumab and is associated with poor outcome in HER2 positive breast cancer

    Science.gov (United States)

    Nafi, Siti Norasikin Mohd; Generali, Daniele; Kramer-Marek, Gabriela; Gijsen, Merel; Strina, Carla; Cappelletti, Mariarosa; Andreis, Daniele; Haider, Syed; Li, Ji-Liang; Bridges, Esther; Capala, Jacek; Ioannis, Roxanis; Harris, Adrian L; Kong, Anthony

    2014-01-01

    The role of HER4 in breast cancer is controversial and its role in relation to trastuzumab resistance remains unclear. We showed that trastuzumab treatment and its acquired resistance induced HER4 upregulation, cleavage and nuclear translocation. However, knockdown of HER4 by specific siRNAs increased trastuzumab sensitivity and reversed its resistance in HER2 positive breast cancer cells. Preventing HER4 cleavage by a γ-secretase inhibitor and inhibiting HER4 tyrosine kinase activity by neratinib decreased trastuzumab-induced HER4 nuclear translocation and enhanced trastuzumab response. There was also increased nuclear HER4 staining in the tumours from BT474 xenograft mice and human patients treated with trastuzumab. Furthermore, nuclear HER4 predicted poor clinical response to trastuzumab monotherapy in patients undergoing a window study and was shown to be an independent poor prognostic factor in HER2 positive breast cancer. Our data suggest that HER4 plays a key role in relation to trastuzumab resistance in HER2 positive breast cancer. Therefore, our study provides novel findings that HER4 activation, cleavage and nuclear translocation influence trastuzumab sensitivity and resistance in HER2 positive breast cancer. Nuclear HER4 could be a potential prognostic and predictive biomarker and understanding the role of HER4 may provide strategies to overcome trastuzumab resistance in HER2 positive breast cancer. PMID:25153719

  10. Obesity stigma as a determinant of poor birth outcomes in women with high BMI: a conceptual framework.

    Science.gov (United States)

    DeJoy, Sharon Bernecki; Bittner, Krystle

    2015-04-01

    Obesity stigma has been linked to poor health outcomes on an individual and population basis. However, little research has been conducted on the role of chronic or recent obesity stigma in the health disparities experienced by pregnant women with high body mass index. The purpose of this article is to discuss poor birth outcomes in this population from an integrated perinatal health framework perspective, incorporating obesity stigma as a social determinant. In studies of non-pregnant populations, obesity stigma has been associated with stress, unhealthy coping strategies, psychological disorders, and exacerbations of physical illness. This article examines the mechanisms by which obesity stigma influences health outcomes and suggests how they might apply to selected complications of pregnancy, including macrosomia, preterm birth and cesarean delivery. Given the rates of obesity and associated pregnancy complications in the United States, it is critical to examine the determinants of those problems from a life course and multiple determinants perspective. This paper offers a conceptual framework to guide exploratory research in this area, incorporating the construct of obesity stigma.

  11. Poor Comprehenders in the Classroom: Teacher Ratings of Behavior in Children with Poor Reading Comprehension and Its Relationship with Individual Differences in Working Memory

    Science.gov (United States)

    Pimperton, Hannah; Nation, Kate

    2014-01-01

    Differing etiological explanations have been proposed to account for poor comprehenders' difficulties with reading comprehension, with some researchers emphasizing working memory deficits and others arguing for oral language weaknesses playing a key causal role. The authors contrasted these two theoretical accounts using data obtained from direct…

  12. Working poor in the Netherlands: Transitions in and out of the working poor Werkende armen in Nederland: Transities in en uit werkende armoede

    NARCIS (Netherlands)

    E. Snel (Erik)

    2017-01-01

    textabstractThe Netherlands has increasing numbers of working poor. Recent figures show that one in twenty working individuals in the Netherlands lives in a household below the poverty threshold. In Amsterdam, the in-work poverty risk is even higher than average; the reason for this research. The

  13. What Sways People's Judgment of Sleep Quality? A Quantitative Choice-Making Study With Good and Poor Sleepers.

    Science.gov (United States)

    Ramlee, Fatanah; Sanborn, Adam N; Tang, Nicole K Y

    2017-07-01

    We conceptualized sleep quality judgment as a decision-making process and examined the relative importance of 17 parameters of sleep quality using a choice-based conjoint analysis. One hundred participants (50 good sleepers; 50 poor sleepers) were asked to choose between 2 written scenarios to answer 1 of 2 questions: "Which describes a better (or worse) night of sleep?". Each scenario described a self-reported experience of sleep, stringing together 17 possible determinants of sleep quality that occur at different times of the day (day before, pre-sleep, during sleep, upon waking, day after). Each participant answered 48 questions. Logistic regression models were fit to their choice data. Eleven of the 17 sleep quality parameters had a significant impact on the participants' choices. The top 3 determinants of sleep quality were: Total sleep time, feeling refreshed (upon waking), and mood (day after). Sleep quality judgments were most influenced by factors that occur during sleep, followed by feelings and activities upon waking and the day after. There was a significant interaction between wake after sleep onset and feeling refreshed (upon waking) and between feeling refreshed (upon waking) and question type (better or worse night of sleep). Type of sleeper (good vs poor sleepers) did not significantly influence the judgments. Sleep quality judgments appear to be determined by not only what happened during sleep, but also what happened after the sleep period. Interventions that improve mood and functioning during the day may inadvertently also improve people's self-reported evaluation of sleep quality. © Sleep Research Society 2017. Published by Oxford University Press [on behalf of the Sleep Research Society].

  14. Expression of Genes Involved in Cellular Adhesion and Extracellular Matrix Remodeling Correlates with Poor Survival of Patients with Renal Cancer.

    Science.gov (United States)

    Boguslawska, Joanna; Kedzierska, Hanna; Poplawski, Piotr; Rybicka, Beata; Tanski, Zbigniew; Piekielko-Witkowska, Agnieszka

    2016-06-01

    Renal cell carcinoma is the most common highly metastatic kidney malignancy. Adhesion has a crucial role in the metastatic process. TGF (transforming growth factor)-β1 is a pleiotropic cytokine that influences cancerous transformation. We hypothesized that 1) changes in the expression of adhesion related genes may influence survival rate of patients with renal cell carcinoma and 2) TGF-β1 may contribute to changed expression of adhesion related genes. Two-step quantitative real-time polymerase chain reaction arrays were used to analyze the expression of adhesion related genes in 77 tumors and matched pair controls. The prognostic significance of genes was evaluated in TCGA (The Cancer Genome Atlas) data on 468 patients with renal cell carcinoma. Quantitative real-time polymerase chain reaction and Western blot were applied for TGF-β1 analysis. TGF-β1 mediated regulation of gene expression was analyzed by TGF-β1 supplementation of Caki-2 cells and quantitative real-time polymerase chain reaction. The expression of 19 genes related to adhesion and extracellular matrix remodeling was statistically significantly disturbed in renal cell carcinoma compared with controls. The 10-gene expression signature (COL1A1, COL5A1, COL11A1, FN1, ICAM1, ITGAL, ITGAM, ITGB2, THBS2 and TIMP1) correlated with poor survival (HR 2.85, p = 5.7e-10). TGF-β1 expression was 22 times higher in renal cell carcinoma than in controls (p adhesion and extracellular matrix remodeling develops early during renal cell carcinoma carcinogenesis and correlates with poor survival. TGF-β1 contributes to changed expression of extracellular matrix and adhesion related genes. Bioinformatic analysis performed on a broad panel of cancers of nonkidney origin suggests that disturbed expression of genes related to extracellular matrix and adhesion may be a universal feature of cancerous progression. Copyright © 2016 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All

  15. How much more exposed are the poor to natural disasters? Global and regional measurement.

    Science.gov (United States)

    Kim, Namsuk

    2012-04-01

    This paper proposes a simple indicator to measure the exposure to natural disasters for the poor and non-poor population, in order to assess the global and regional trend of natural hazard and poverty. Globally, poor people are two times more exposed to natural disasters than the non-poor in the twenty-first century. The time trend varies across regions, with poor people in East Asia and Pacific being most exposed to natural disasters, followed by those in South Asia and Sub-Saharan Africa. The change of exposure measure over time is decomposed into two factors: a pure exposure change, which could be fuelled by climate change; and a concentration component. The result shows that the total net increase of exposure between the 1970s and the 2000s is driven significantly by the increased concentration of the poor (26 per cent) in disaster-prone areas, whereas the contribution of that factor remains very small for the non-poor (six per cent). © 2012 The Author(s). Disasters © Overseas Development Institute, 2012.

  16. Stressful working conditions and poor self-rated health among financial services employees

    Directory of Open Access Journals (Sweden)

    Luiz Sérgio Silva

    2012-06-01

    Full Text Available OBJECTIVE: To assess the association between exposure to adverse psychosocial working conditions and poor self-rated health among bank employees. METHODS: A cross-sectional study including a sample of 2,054 employees of a government bank was conducted in 2008. Self-rated health was assessed by a single question: "In general, would you say your health is (...." Exposure to adverse psychosocial working conditions was evaluated by the effort-reward imbalance model and the demand-control model. Information on other independent variables was obtained through a self-administered semi-structured questionnaire. A multiple logistic regression analysis was performed and odds ratio calculated to assess independent associations between adverse psychosocial working conditions and poor self-rated health. RESULTS: The overall prevalence of poor self-rated health was 9%, with no significant gender difference. Exposure to high demand and low control environment at work was associated with poor self-rated health. Employees with high effort-reward imbalance and overcommitment also reported poor self-rated health, with a dose-response relationship. Social support at work was inversely related to poor self-rated health, with a dose-response relationship. CONCLUSIONS: Exposure to adverse psychosocial work factors assessed based on the effort-reward imbalance model and the demand-control model is independently associated with poor self-rated health among the workers studied.

  17. Reduced connectivity in the self-processing network of schizophrenia patients with poor insight.

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    Edith J Liemburg

    Full Text Available Lack of insight (unawareness of illness is a common and clinically relevant feature of schizophrenia. Reduced levels of self-referential processing have been proposed as a mechanism underlying poor insight. The default mode network (DMN has been implicated as a key node in the circuit for self-referential processing. We hypothesized that during resting state the DMN network would show decreased connectivity in schizophrenia patients with poor insight compared to patients with good insight. Patients with schizophrenia were recruited from mental health care centers in the north of the Netherlands and categorized in groups having good insight (n= 25 or poor insight (n = 19. All subjects underwent a resting state fMRI scan. A healthy control group (n = 30 was used as a reference. Functional connectivity of the anterior and posterior part of the DMN, identified using Independent Component Analysis, was compared between groups. Patients with poor insight showed lower connectivity of the ACC within the anterior DMN component and precuneus within the posterior DMN component compared to patients with good insight. Connectivity between the anterior and posterior part of the DMN was lower in patients than controls, and qualitatively different between the good and poor insight patient groups. As predicted, subjects with poor insight in psychosis showed decreased connectivity in DMN regions implicated in self-referential processing, although this concerned only part of the network. This finding is compatible with theories implying a role of reduced self-referential processing as a mechanism contributing to poor insight.

  18. Determinants of adherence to methylphenidate and the impact of poor adherence on maternal and family measures.

    Science.gov (United States)

    Gau, Susan S F; Shen, Hsin-Yi; Chou, Miao-Churn; Tang, Ching-Shu; Chiu, Yen-Nan; Gau, Churn-Shiouh

    2006-06-01

    The aim of this study was to examine the association between adherence to immediate-release methylphenidate (IR MPH) and maternal psychological distress, parenting style, parent- child relationship, and perceived family support. The sample consisted of 307 children with attention-deficit hyperactivity disorder (ADHD) (271 boys and 36 girls), 6-17 years of age, who had been treated with IR MPH for the past 6 months. The measures included the Chinese Health Questionnaire, Parental Bonding Instrument, Family APGAR, and Home Behaviors of the Social Adjustment Inventory for Children and Adolescents. Reasons for poor adherence (n = 79; 25.7%) included forgetting medication (72.7%), the medication having no effect (20.0%), and refusing medication (12.7%). Increased age and three-times-daily administration were the major predictors for poor adherence to IR MPH. Poor adherence was associated with increased degree of maternal psychological distress, indifferent parenting, maternal overprotection/control, poor family support, decreased interaction with parents, and increased problems at home. Findings indicate that multiple daily dosing of MPH increases the likelihood of poor adherence, particularly in adolescents, and that poor adherence is associated with impaired maternal/family process. Once-daily administration of MPH is necessary to improve adherence and to decrease the possible exacerbation of tense parent-child relationships caused by poor drug adherence.

  19. Estimated Under-Five Deaths Associated with Poor-Quality Antimalarials in Sub-Saharan Africa

    Science.gov (United States)

    Renschler, John P.; Walters, Kelsey M.; Newton, Paul N.; Laxminarayan, Ramanan

    2015-01-01

    Many antimalarials sold in sub-Saharan Africa are poor-quality (falsified, substandard, or degraded), and the burden of disease caused by this problem is inadequately quantified. In this article, we estimate the number of under-five deaths caused by ineffective treatment of malaria associated with consumption of poor-quality antimalarials in 39 sub-Saharan countries. Using Latin hypercube sampling our estimates were calculated as the product of the number of private sector antimalarials consumed by malaria-positive children in 2013; the proportion of private sector antimalarials consumed that were of poor-quality; and the case fatality rate (CFR) of under-five malaria-positive children who did not receive appropriate treatment. An estimated 122,350 (interquartile range [IQR]: 91,577–154,736) under-five malaria deaths were associated with consumption of poor-quality antimalarials, representing 3.75% (IQR: 2.81–4.75%) of all under-five deaths in our sample of 39 countries. There is considerable uncertainty surrounding our results because of gaps in data on case fatality rates and prevalence of poor-quality antimalarials. Our analysis highlights the need for further investigation into the distribution of poor-quality antimalarials and the need for stronger surveillance and regulatory efforts to prevent the sale of poor-quality antimalarials. PMID:25897068

  20. Poverty and behavior problems trajectories from 1.5 to 8 years of age: Is the gap widening between poor and non-poor children?

    Science.gov (United States)

    Mazza, Julia Rachel S E; Boivin, Michel; Tremblay, Richard E; Michel, Gregory; Salla, Julie; Lambert, Jean; Zunzunegui, Maria Victoria; Côté, Sylvana M

    2016-08-01

    Poverty has been associated with high levels of behavior problems across childhood, yet patterns of associations over time remain understudied. This study aims: (a) to examine whether poverty predicts changes in behavior problems between 1.5 and 8 years of age; (b) to estimate potential selection bias for the observed associations. We used the 1998-2006 waves of the Quebec Longitudinal Study of Child Development (N = 2120). Main outcomes were maternal ratings of hyperactivity, opposition and physical aggression from 1.5 to 8 years of age. Linear mixed-effects models were used to assess the longitudinal association between poverty and behavior problems. Models were re-estimated adjusting for wave nonresponse and using multiple imputation to account for attrition. Poverty predicted higher levels of behavior problems between 1.5 and 8 years of age. Poverty predicted hyperactivity and opposition in a time dependent manner. Hyperactivity [Bpoverty*age = 0.052; CI 95 % (0.002; 0.101)] and opposition [Bpoverty*age = 0.049; CI 95 % (0.018; 0.079)] increased at a faster rate up to age 5 years, and then decreased at a slower rate for poor than non-poor children. Physical aggression decreased at a steady rate over time for all children [Bpoverty*age = -0.030; p = 0.064). Estimates remained similar when accounting for attrition. Poverty predicted higher levels of behavior problems between 1.5 and 8 years of age. The difference between poor and non-poor children was stable over time for physical aggression, but increased with age for hyperactivity and opposition. Attrition among poor children did not compromise the validity of results.