Typewriting Syllabus: Part II: Modules. 1976 Revision.

Science.gov (United States)

New York State Education Dept., Albany. Bureau of Occupational and Career Curriculum Development.

The document is the second of a two-part set on typewriting and focuses on the nine modules of instruction. The nine modules are: (1) keyboard mastery and skill development, (2) basic typewriting competencies, (2a) personal use typewriting, (3) introduction to office typewriting I, (4) introduction to office typewriting II, (5) intermediate office…

10 CFR Appendix II to Part 504 - Fuel Price Computation

Science.gov (United States)

2010-01-01

... DEPARTMENT OF ENERGY (CONTINUED) ALTERNATE FUELS EXISTING POWERPLANTS Pt. 504, App. II Appendix II to Part... effects of future real price increases for each fuel. The delivered price of an alternate fuel used to calculate delivered fuel expenses must reflect the petitioner's delivered price of the alternate fuel and...

46 CFR Appendix II to Part 150 - Explanation of Figure 1

Science.gov (United States)

2010-10-01

... COMPATIBILITY OF CARGOES Pt. 150, App. II Appendix II to Part 150—Explanation of Figure 1 Definition of a..., aromatic hydrocarbons or paraffins. Others will form hazardous combinations with many groups: For example...

40 CFR Appendix II to Part 1042 - Steady-State Duty Cycles

Science.gov (United States)

2010-07-01

... 40 Protection of Environment 32 2010-07-01 2010-07-01 false Steady-State Duty Cycles II Appendix..., App. II Appendix II to Part 1042—Steady-State Duty Cycles (a) The following duty cycles apply as specified in § 1042.505(b)(1): (1) The following duty cycle applies for discrete-mode testing: E3 mode No...

Kick, Glide, Pole! Cross-Country Skiing Fun (Part II)

Science.gov (United States)

Duoos, Bridget A.

2012-01-01

Part I of Kick, Glide, Pole! Cross-Country Skiing Fun, which was published in last issue, discussed how to select cross-country ski equipment, dress for the activity and the biomechanics of the diagonal stride. Part II focuses on teaching the diagonal stride technique and begins with a progression of indoor activities. Incorporating this fun,…

PREREM: an interactive data preprocessing code for INREM II. Part I: user's manual. Part II: code structure

Energy Technology Data Exchange (ETDEWEB)

Ryan, M.T.; Fields, D.E.

1981-05-01

PREREM is an interactive computer code developed as a data preprocessor for the INREM-II (Killough, Dunning, and Pleasant, 1978a) internal dose program. PREREM is intended to provide easy access to current and self-consistent nuclear decay and radionuclide-specific metabolic data sets. Provision is made for revision of metabolic data, and the code is intended for both production and research applications. Documentation for the code is in two parts. Part I is a user's manual which emphasizes interpretation of program prompts and choice of user input. Part II stresses internal structure and flow of program control and is intended to assist the researcher who wishes to revise or modify the code or add to its capabilities. PREREM is written for execution on a Digital Equipment Corporation PDP-10 System and much of the code will require revision before it can be run on other machines. The source program length is 950 lines (116 blocks) and computer core required for execution is 212 K bytes. The user must also have sufficient file space for metabolic and S-factor data sets. Further, 64 100 K byte blocks of computer storage space are required for the nuclear decay data file. Computer storage space must also be available for any output files produced during the PREREM execution. 9 refs., 8 tabs.

Calculus of Elementary Functions, Part II. Teacher's Commentary. Revised Edition.

Science.gov (United States)

Herriot, Sarah T.; And Others

This course is intended for students who have a thorough knowledge of college preparatory mathematics, including algebra, axiomatic geometry, trigonometry, and analytic geometry. This teacher's guide is for Part II of the course. It is designed to follow Part I of the text. The guide contains background information, suggested instructional…

Calculus of Elementary Functions, Part II. Student Text. Revised Edition.

Science.gov (United States)

Herriot, Sarah T.; And Others

This course is intended for students who have a thorough knowledge of college preparatory mathematics, including algebra, axiomatic geometry, trigonometry, and analytic geometry. This text, Part II, contains material designed to follow Part I. Chapters included in this text are: (6) Derivatives of Exponential and Related Functions; (7) Area and…

Nursing Care of Patients Undergoing Chemotherapy Desensitization: Part II.

Science.gov (United States)

Jakel, Patricia; Carsten, Cynthia; Carino, Arvie; Braskett, Melinda

2016-04-01

Chemotherapy desensitization protocols are safe, but labor-intensive, processes that allow patients with cancer to receive medications even if they initially experienced severe hypersensitivity reactions. Part I of this column discussed the pathophysiology of hypersensitivity reactions and described the development of desensitization protocols in oncology settings. Part II incorporates the experiences of an academic medical center and provides a practical guide for the nursing care of patients undergoing chemotherapy desensitization.
.

40 CFR Appendix II to Part 1054 - Duty Cycles for Laboratory Testing

Science.gov (United States)

2010-07-01

... 40 Protection of Environment 32 2010-07-01 2010-07-01 false Duty Cycles for Laboratory Testing II.... 1054, App. II Appendix II to Part 1054—Duty Cycles for Laboratory Testing (a) Test handheld engines with the following steady-state duty cycle: G3 mode No. Engine speed a Torque(percent) b Weighting...

40 CFR Appendix II to Part 1039 - Steady-State Duty Cycles

Science.gov (United States)

2010-07-01

... 40 Protection of Environment 32 2010-07-01 2010-07-01 false Steady-State Duty Cycles II Appendix... Appendix II to Part 1039—Steady-State Duty Cycles (a) The following duty cycles apply for constant-speed engines: (1) The following duty cycle applies for discrete-mode testing: D2 mode number Engine speed...

First international 26Al interlaboratory comparison - Part II

International Nuclear Information System (INIS)

Merchel, Silke; Bremser, Wolfram

2005-01-01

After finishing Part I of the first international 26 Al interlaboratory comparison with accelerator mass spectrometry (AMS) laboratories [S. Merchel, W. Bremser, Nucl. Instr. and Meth. B 223-224 (2004) 393], the evaluation of Part II with radionuclide counting laboratories took place. The evaluation of the results of the seven participating laboratories on four meteorite samples shows a good overall agreement between laboratories, i.e. it does not reveal any statistically significant differences if results are compared sample-by-sample. However, certain interlaboratory bias is observed with a more detailed statistical analysis including some multivariate approaches

Programming Models for Three-Dimensional Hydrodynamics on the CM-5 (Part II)

International Nuclear Information System (INIS)

Amala, P.A.K.; Rodrigue, G.H.

1994-01-01

This is a two-part presentation of a timing study on the Thinking Machines CORP. CM-5 computer. Part II is given in this study and represents domain-decomposition and message-passing models. Part I described computational problems using a SIMD model and connection machine FORTRAN (CMF)

Continuum Thermodynamics - Part II: Applications and Examples

Science.gov (United States)

Albers, Bettina; Wilmanski, Krzysztof

The intention by writing Part II of the book on continuum thermodynamics was the deepening of some issues covered in Part I as well as a development of certain skills in dealing with practical problems of oscopic processes. However, the main motivation for this part is the presentation of main facets of thermodynamics which appear when interdisciplinary problems are considered. There are many monographs on the subjects of solid mechanics and thermomechanics, on fluid mechanics and on coupled fields but most of them cover only special problems in great details which are characteristic for the chosen field. It is rather seldom that relations between these fields are discussed. This concerns, for instance, large deformations of the skeleton of porous materials with diffusion (e.g. lungs), couplings of deformable particles with the fluid motion in suspensions, couplings of adsorption processes and chemical reactions in immiscible mixtures with diffusion, various multi-component aspects of the motion, e.g. of avalanches, such as segregation processes, etc...

Benchmark matrix and guide: Part II.

Science.gov (United States)

1991-01-01

In the last issue of the Journal of Quality Assurance (September/October 1991, Volume 13, Number 5, pp. 14-19), the benchmark matrix developed by Headquarters Air Force Logistics Command was published. Five horizontal levels on the matrix delineate progress in TQM: business as usual, initiation, implementation, expansion, and integration. The six vertical categories that are critical to the success of TQM are leadership, structure, training, recognition, process improvement, and customer focus. In this issue, "Benchmark Matrix and Guide: Part II" will show specifically how to apply the categories of leadership, structure, and training to the benchmark matrix progress levels. At the intersection of each category and level, specific behavior objectives are listed with supporting behaviors and guidelines. Some categories will have objectives that are relatively easy to accomplish, allowing quick progress from one level to the next. Other categories will take considerable time and effort to complete. In the next issue, Part III of this series will focus on recognition, process improvement, and customer focus.

12 CFR Appendix II to Part 27 - Information for Government Monitoring Purposes

Science.gov (United States)

2010-01-01

... II Appendix II to Part 27 Banks and Banking COMPTROLLER OF THE CURRENCY, DEPARTMENT OF THE TREASURY... Monitoring Purposes The following language is approved by the Comptroller of the Currency and will satisfy... used separately. This information may also be provided orally by the applicant. The following...

31 CFR Appendix II to Part 13 - Form of Bill for Reimbursement

Science.gov (United States)

2010-07-01

... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false Form of Bill for Reimbursement II Appendix II to Part 13 Money and Finance: Treasury Office of the Secretary of the Treasury PROCEDURES FOR... title) of ______ (Country) to participate in the work of ______ (International Organization) or...

10 CFR Appendix II to Part 1050 - DOE Form 3735.3-Foreign Travel Statement

Science.gov (United States)

2010-01-01

... is official agency business. Spouses and dependents may accept such travel and expenses only when... 10 Energy 4 2010-01-01 2010-01-01 false DOE Form 3735.3-Foreign Travel Statement II Appendix II to.... II Appendix II to Part 1050—DOE Form 3735.3—Foreign Travel Statement EC01OC91.041 Statement...

Gastroesophageal reflux disease burden in Iran.

Science.gov (United States)

Delavari, Alireza; Moradi, Ghobad; Elahi, Elham; Moradi-Lakeh, Maziar

2015-02-01

Gastroesophageal reflux disease is one of the most common disorders of the gastrointestinal tract. The prevalence of this disease ranges from 5% to 20% in Asia, Europe, and North America. The aim of this study was to estimate the burden of gastroesophageal reflux disease in Iran. Burden of gastroesophageal reflux disease in Iran was estimated for one year from 21 March 2006 to 20 March 2007. The definition was adjusted with ICD-code of K21. Incident-based disability-adjusted life year (DALY) was used as the unit of analysis to quantify disease burden. A simplified disease model and DisMod II software were used for modeling. The annual incidence for total population of males and females in Iran was estimated 17.72 and 28.06 per 1000, respectively. The average duration of gastroesophageal reflux disease as a chronic condition was estimated around 10 years in both sexes. Total DALYs for an average of 59 symptomatic days per year was estimated 153,554.3 (60,330.8 for males and 93,223.5 for females).   The results of this study showed that reflux imposes high burden and high financial costs on the Iranian population. The burden of this disease in Iran is more similar to that of European countries rather than Asian countries. It is recommended to consider the disease as a public health problem and make decisions and public health plans to reduce the burden and financial costs of the disease in Iran.

A Survey of Optometry Graduates to Determine Practice Patterns: Part II: Licensure and Practice Establishment Experiences.

Science.gov (United States)

Bleimann, Robert L.; Smith, Lee W.

1985-01-01

A summary of Part II of a two-volume study of optometry graduates conducted by the Association of Schools and Colleges of Optometry is presented. Part II includes the analysis of the graduates' licensure and practice establishment experiences. (MLW)

Healing and relaxation in flows of helium II. Part II. First, second, and fourth sound

International Nuclear Information System (INIS)

Hills, R.N.; Roberts, P.H.

1978-01-01

In Part I of this series, a theory of helium II incorporating the effects of quantum healing and relaxation was developed. In this paper, the propagation of first, second, and fourth sound is discussed. Particular attention is paid to sound propagation in the vicinity of the lambda point where the effects of relaxation and quantum healing become important

Blade System Design Study. Part II, final project report (GEC).

Energy Technology Data Exchange (ETDEWEB)

Griffin, Dayton A. (DNV Global Energy Concepts Inc., Seattle, WA)

2009-05-01

As part of the U.S. Department of Energy's Low Wind Speed Turbine program, Global Energy Concepts LLC (GEC)1 has studied alternative composite materials for wind turbine blades in the multi-megawatt size range. This work in one of the Blade System Design Studies (BSDS) funded through Sandia National Laboratories. The BSDS program was conducted in two phases. In the Part I BSDS, GEC assessed candidate innovations in composite materials, manufacturing processes, and structural configurations. GEC also made recommendations for testing composite coupons, details, assemblies, and blade substructures to be carried out in the Part II study (BSDS-II). The BSDS-II contract period began in May 2003, and testing was initiated in June 2004. The current report summarizes the results from the BSDS-II test program. Composite materials evaluated include carbon fiber in both pre-impregnated and vacuum-assisted resin transfer molding (VARTM) forms. Initial thin-coupon static testing included a wide range of parameters, including variation in manufacturer, fiber tow size, fabric architecture, and resin type. A smaller set of these materials and process types was also evaluated in thin-coupon fatigue testing, and in ply-drop and ply-transition panels. The majority of materials used epoxy resin, with vinyl ester (VE) resin also used for selected cases. Late in the project, testing of unidirectional fiberglass was added to provide an updated baseline against which to evaluate the carbon material performance. Numerous unidirectional carbon fabrics were considered for evaluation with VARTM infusion. All but one fabric style considered suffered either from poor infusibility or waviness of fibers combined with poor compaction. The exception was a triaxial carbon-fiberglass fabric produced by SAERTEX. This fabric became the primary choice for infused articles throughout the test program. The generally positive results obtained in this program for the SAERTEX material have led to its

The Mid America Heart Institute: part II.

Science.gov (United States)

McCallister, Ben D; Steinhaus, David M

2003-01-01

The Mid America Heart Institute (MAHI) is one of the first and largest hospitals developed and designed specifically for cardiovascular care. The MAHI hybrid model, which is a partnership between the not-for-profit Saint Luke's Health System, an independent academic medical center, and a private practice physician group, has been extremely successful in providing high-quality patient care as well as developing strong educational and research programs. The Heart Institute has been the leader in providing cardiovascular care in the Kansas City region since its inception in 1975. Although challenges in the future are substantial, it is felt that the MAHI is in an excellent position to deal with the serious issues in health care because of the Heart Institute, its facility, organization, administration, dedicated medical and support staff, and its unique business model of physician management. In part I, the authors described the background and infrastructure of the Heart Institute. In part II, cardiovascular research and benefits of physician management are addressed.

Marketing in the E-Business World, Parts I & II | Smith | LBS ...

African Journals Online (AJOL)

Marketing in the E-Business World, Parts I & II. ... Open Access DOWNLOAD FULL TEXT ... of many of Americas largest companies gather at the Waldorf Astoria Hotel in New York City for the Conference Boards Annual Marketing Conference.

40 CFR Appendix II to Part 1045 - Duty Cycles for Propulsion Marine Engines

Science.gov (United States)

2010-07-01

... 40 Protection of Environment 32 2010-07-01 2010-07-01 false Duty Cycles for Propulsion Marine... Pt. 1045, App. II Appendix II to Part 1045—Duty Cycles for Propulsion Marine Engines (a) The following duty cycle applies for discrete-mode testing: E4 Mode No. Enginespeed 1 Torque(percent) 2...

Methods of humidity determination Part II: Determination of material humidity

OpenAIRE

Rübner, Katrin; Balköse, Devrim; Robens, E.

2008-01-01

Part II covers the most common methods of measuring the humidity of solid material. State of water near solid surfaces, gravimetric measurement of material humidity, measurement of water sorption isotherms, chemical methods for determination of water content, measurement of material humidity via the gas phase, standardisation, cosmonautical observations are reviewed.

The year 2012 in the European Heart Journal-Cardiovascular Imaging. Part II.

Science.gov (United States)

Plein, Sven; Knuuti, Juhani; Edvardsen, Thor; Saraste, Antti; Piérard, Luc A; Maurer, Gerald; Lancellotti, Patrizio

2013-07-01

The part II of the best of the European Heart Journal - Cardiovascular Imaging in 2012 specifically focuses on studies of valvular heart diseases, heart failure, cardiomyopathies, and congenital heart diseases.

On the Efficiency of Connection Charges---Part II: Integration of Distributed Energy Resources

OpenAIRE

Munoz-Alvarez, Daniel; Garcia-Franco, Juan F.; Tong, Lang

2017-01-01

This two-part paper addresses the design of retail electricity tariffs for distribution systems with distributed energy resources (DERs). Part I presents a framework to optimize an ex-ante two-part tariff for a regulated monopolistic retailer who faces stochastic wholesale prices on the one hand and stochastic demand on the other. In Part II, the integration of DERs is addressed by analyzing their endogenous effect on the optimal two-part tariff and the induced welfare gains. Two DER integrat...

Indigenous identity: burden or liberation?

DEFF Research Database (Denmark)

Steur, Luisa Johanna

2010-01-01

With the rise of ‘adivasi’ (‘indigenous’ or ‘tribal’) movements in different parts of South Asia in the past two decades, the question of how to understand ‘adivasi identity’ has become hotly debated: is it a burden, inviting distorted stereotypical depictions of subaltern people...

Subseabed disposal program annual report, January-December 1979. Volume II. Appendices (principal investigator progress reports). Part 2 of 2

International Nuclear Information System (INIS)

Talbert, D.M.

1981-04-01

Volume II of the sixth annual report describing the progress and evaluating the status of the Subseabed Disposal Program contains the appendices referred to in Volume II, Summary and Status. Because of the length of Volume II, it has been split into two parts for publication purposes. Part 1 contains Appendices A-O; Part 2 contains Appendices P-FF. Separate abstracts have been prepared for each appendix for inclusion in the Energy Data Base

Burden of diarrhea in the eastern mediterranean region, 1990-2013

NARCIS (Netherlands)

Khalil, Ibrahim; Colombara, Danny V.; Forouzanfar, Mohammad Hossein; Troeger, Christopher; Daoud, Farah; Moradi-Lakeh, Maziar; Bcheraoui, El Charbel; Rao, Puja C.; Afshin, Ashkan; Charara, Raghid; Abate, Kalkidan Hassen; Abd El Razek, Mohammed Magdy; Abd-Allah, Foad; Abu-Elyazeed, Remon; Kiadaliri, Aliasghar Ahmad; Akanda, Ali Shafqat; Akseer, Nadia; Alam, Khurshid; Alasfoor, Deena; Ali, Raghib; AlMazroa, Mohammad A.; Alomari, Mahmoud A.; Salem Al-Raddadi, Rajaa Mohammad; Alsharif, Ubai; Alsowaidi, Shirina; Altirkawi, Khalid A.; Alvis-Guzman, Nelson; Ammar, Walid; Antonio, Carl Abelardo T.; Asayesh, Hamid; Asghar, Rana Jawad; Atique, Suleman; Awasthi, Ashish; Bacha, Umar; Badawi, Alaa; Barac, Aleksandra; Bedi, Neeraj; Bekele, Tolesa; Bensenor, Isabela M.; Betsu, Balem Demtsu; Bhutta, Zulfiqar; Abdulhak, Bin Aref A.; Butt, Zahid A.; Danawi, Hadi; Dubey, Manisha; Endries, Aman Yesuf; Faghmous, Imad M.D.A.; Farid, Talha; Farvid, Maryam S.; Farzadfar, Farshad; Fereshtehnejad, Seyed Mohammad; Fischer, Florian; Anderson Fitchett, Joseph Robert; Gibney, Katherine B.; Mohamed Ginawi, Ibrahim Abdelmageem; Gishu, Melkamu Dedefo; Gugnani, Harish Chander; Gupta, Rahul; Hailu, Gessessew Bugssa; Hamadeh, Randah Ribhi; Hamidi, Samer; Harb, Hilda L.; Hedayati, Mohammad T.; Hsairi, Mohamed; Husseini, Abdullatif; Jahanmehr, Nader; Javanbakht, Mehdi; Beyene, Tariku; Jonas, Jost B.; Kasaeian, Amir; Khader, Yousef Saleh; Khan, Abdur Rahman; Khan, Ejaz Ahmad; Khan, Gulfaraz; Khoja, Tawfik Ahmed Muthafer; Kinfu, Yohannes; Kissoon, Niranjan; Koyanagi, Ai; Lal, Aparna; Abdul Latif, Asma Abdul; Lunevicius, Raimundas; Abd El Razek, Hassan Magdy; Majeed, Azeem; Malekzadeh, Reza; Mehari, Alem; Mekonnen, Alemayehu B.; Melaku, Yohannes Adama; Memish, Ziad A.; Mendoza, Walter; Misganaw, Awoke; Ibrahim Mohamed, Layla Abdalla; Nachega, Jean B.; Nguyen, Quyen Le; Nisar, Muhammad Imran; Peprah, Emmanuel Kwame; Platts-Mills, James A.; Pourmalek, Farshad; Qorbani, Mostafa; Rafay, Anwar; Rahimi-Movaghar, Vafa; Ur Rahman, Sajjad; Rai, Rajesh Kumar; Rana, Saleem M.; Ranabhat, Chhabi L.; Rao, Sowmya R.; Refaat, Amany H.; Riddle, Mark; Roshandel, Gholamreza; Ruhago, George Mugambage; Saleh, Muhammad Muhammad; Sanabria, Juan R.; Sawhney, Monika; Sepanlou, Sadaf G.; Setegn, Tesfaye; Sliwa, Karen; Sreeramareddy, Chandrashekhar T.; Sykes, Bryan L.; Tavakkoli, Mohammad; Tedla, Bemnet Amare; Terkawi, Abdullah S.; Ukwaja, Kingsley; Uthman, Olalekan A.; Westerman, Ronny; Wubshet, Mamo; Yenesew, Muluken A.; Yonemoto, Naohiro; Younis, Mustafa Z.; Zaidi, Zoubida; Sayed Zaki, El Maysaa; Rabeeah, Al Abdullah A.; Wang, Haidong; Naghavi, Mohsen; Vos, Theo; Lopez, Alan D.; Murray, Christopher J.L.; Mokdad, Ali H.

2016-01-01

Diarrheal diseases (DD) are leading causes of disease burden, death, and disability, especially in children in low-income settings. DD can also impact a child's potential livelihood through stunted physical growth, cognitive impairment, and other sequelae. As part of the Global Burden of Disease

Everyday burden of musculoskeletal conditions among villagers in rural Botswana

DEFF Research Database (Denmark)

Hondras, Maria; Hartvigsen, Jan; Myburgh, Corrie

2016-01-01

with an interpreter. Audio recordings were transcribed verbatim, with Setswana contextually translated into English. The theoretical lens included Bury's biographical disruption, in which he distinguishes between "meaning as consequence" and "meaning as significance". RESULTS: Interviews revealed co-existing accounts...... for the consequences and significance of musculoskeletal burden related to 3 themes: (i) hard work for traditional lives; (ii) bearing the load of a rugged landscape; and, (iii) caring for others with disrupted lives. Physical labour with musculoskeletal symptoms had economic and subsistence consequences. The loss...... of independence and social identity to fulfil traditional roles held meaning as significance. Outmigration for wage labour and other shifts in family structure compounded everyday musculoskeletal burden. CONCLUSION: Uncovering burden is an important first step to address musculoskeletal care needs in developing...

Assessment of Radioactivity in Man. Vol. II. Proceedings of the Symposium on the Assessment of Radioactive Body Burdens

International Nuclear Information System (INIS)

1964-01-01

This Symposium on the Assessment of Radioactive Body Burdens in Man was organized jointly by the International Atomic Energy Agency, the International Labour Organisation and the World Health Organization and was held in Heidelberg from 11-15 May 1964. It was attended by 181 participants from 28 countries and 6 international organizations. It was the objective of the Symposium to bring together experts from the various scientific disciplines of physics, chemistry, biology, medicine and mathematics, and to survey their experience in the assessment of radioactive body burdens in man and the resultant radiation doses. In most investigations of internal contamination the errors in the physical measurements are smaller than the errors associated with the interpretation of measurements. For this reason special emphasis was laid in this meeting on the interpretation of measured data. The 67 papers and the discussions which they stimulated are published in these Proceedings produced in two volumes. Volume I includes all papers which deal with problems generally common to many isotopes: in- vivo counting, bioassay techniques, sample counting and analysis of data. Volume II includes those papers concerned with radioisotopes of specific elements: caesium, radium, radon, strontium, tritium, thorium, uranium, plutonium and rare earth elements. These Proceedings should prove invaluable to all radiation protection services entrusted with the physical surveillance of internal radiation exposure of man. They should complement the studies of the International Commission on Radiological Protection (ICRP) and assist the work of the Organizations that jointly organized the meeting

Subseabed disposal program annual report, January-December 1980. Volume II. Appendices (principal investigator progress reports). Part 1

International Nuclear Information System (INIS)

Hinga, K.R.

1981-07-01

Volume II of the sixth annual report describing the progress and evaluating the status of the Subseabed Disposal Program contains the appendices referred to in Volume I, Summary and Status. Because of the length of Volume II, it has been split into two parts for publication purposes. Part 1 contains Appendices A-Q; Part 2 contains Appendices R-MM. Separate abstracts have been prepared for each appendix for inclusion in the Energy Data Base

Subseabed disposal program annual report, January-December 1980. Volume II. Appendices (principal investigator progress reports). Part 1

Energy Technology Data Exchange (ETDEWEB)

Hinga, K.R. (ed.)

1981-07-01

Volume II of the sixth annual report describing the progress and evaluating the status of the Subseabed Disposal Program contains the appendices referred to in Volume I, Summary and Status. Because of the length of Volume II, it has been split into two parts for publication purposes. Part 1 contains Appendices A-Q; Part 2 contains Appendices R-MM. Separate abstracts have been prepared for each appendix for inclusion in the Energy Data Base.

Starting a hospital-based home health agency: Part II--Key success factors.

Science.gov (United States)

Montgomery, P

1993-09-01

In Part II of a three-part series, the financial, technological and legislative issues of a hospital-based home health-agency are discussed. Beginning a home healthcare service requires intensive research to answer key environmental and operational questions--need, competition, financial projections, initial start-up costs and the impact of delayed depreciation. Assessments involving technology, staffing, legislative and regulatory issues can help project service volume, productivity and cost-control.

Association Between National Board Dental Examination Part II Scores and Comprehensive Examinations at Harvard School of Dental Medicine.

Science.gov (United States)

Lee, Min Kyeong; Allareddy, Veerasathpurush; Howell, T Howard; Karimbux, Nadeem Y

2011-01-01

Harvard School of Dental Medicine (HSDM) uses a hybrid problem-based approach to teaching in the predoctoral program. The objective structured clinical examination (OSCE) is a formative examination designed to assess the performance of students in the problem-based learning (PBL) curriculum. At HSDM three comprehensive examinations with OSCE components are administered during the third and fourth years of clinical training. The National Board Dental Examination (NBDE) Part II is taken in the final year of the predoctoral program. This study examines the association between the NBDE Part II and the comprehensive exams held at HSDM. Predoctoral students from the HSDM classes of 2005 and 2006 were included in this study. The outcome variable of interest was the scores obtained by students in the NBDE Part II, and the main independent variable of interest was the performance of students in the comprehensive exams (honors, pass, make-up exam to pass). The Mann-Whitney U-test was used to examine the association between the grades obtained in the each of the three comprehensive exams and the NBDE Part II scores. Multivariable linear regression analysis was also used to examine the association between the NBDE Part II scores and the comprehensive exam grades. The effect of potential confounding factors including age, sex, and race/ethnicity was adjusted. The results suggest that students who performed well in the comprehensive exams performed better on the NBDE Part II, even after adjusting for confounding factors. Future studies will examine the long-term impact of PBL on postdoctoral plans and career choices.

Intelligent control of HVAC systems. Part II: perceptron performance analysis

Directory of Open Access Journals (Sweden)

Ioan URSU

2013-09-01

Full Text Available This is the second part of a paper on intelligent type control of Heating, Ventilating, and Air-Conditioning (HVAC systems. The whole study proposes a unified approach in the design of intelligent control for such systems, to ensure high energy efficiency and air quality improving. In the first part of the study it is considered as benchmark system a single thermal space HVAC system, for which it is assigned a mathematical model of the controlled system and a mathematical model(algorithm of intelligent control synthesis. The conception of the intelligent control is of switching type, between a simple neural network, a perceptron, which aims to decrease (optimize a cost index,and a fuzzy logic component, having supervisory antisaturating role for neuro-control. Based on numerical simulations, this Part II focuses on the analysis of system operation in the presence only ofthe neural control component. Working of the entire neuro-fuzzy system will be reported in a third part of the study.

International Working Group on Fast Reactors Thirteenth Annual Meeting. Summary Report. Part II

International Nuclear Information System (INIS)

1980-10-01

The Thirteenth Annual Meeting of the IAEA International Working Group on Fast Reactors was held at the IAEA Headquarters, Vienna, Austria from 9 to 11 April 1980. The Summary Report (Part I) contains the Minutes of the Meeting. The Summary Report (Part II) contains the papers which review the national programme in the field of LMFBRs and other presentations at the Meeting. The Summary Report (Part III) contains the discussions on the review of the national programmes

Delivery systems for biopharmaceuticals. Part II: Liposomes, Micelles, Microemulsions and Dendrimers.

Science.gov (United States)

Silva, Ana C; Lopes, Carla M; Lobo, José M S; Amaral, Maria H

2015-01-01

Biopharmaceuticals are a generation of drugs that include peptides, proteins, nucleic acids and cell products. According to their particular molecular characteristics (e.g. high molecular size, susceptibility to enzymatic activity), these products present some limitations for administration and usually parenteral routes are the only option. To avoid these limitations, different colloidal carriers (e.g. liposomes, micelles, microemulsions and dendrimers) have been proposed to improve biopharmaceuticals delivery. Liposomes are promising drug delivery systems, despite some limitations have been reported (e.g. in vivo failure, poor long-term stability and low transfection efficiency), and only a limited number of formulations have reached the market. Micelles and microemulsions require more studies to exclude some of the observed drawbacks and guarantee their potential for use in clinic. According to their peculiar structures, dendrimers have been showing good results for nucleic acids delivery and a great development of these systems during next years is expected. This is the Part II of two review articles, which provides the state of the art of biopharmaceuticals delivery systems. Part II deals with liposomes, micelles, microemulsions and dendrimers.

Signs of revision in Don Quixote, Part II

Directory of Open Access Journals (Sweden)

Gonzalo Pontón

2016-11-01

Full Text Available This article provides new evidences in favour of the hypothesis that Cervantes, after finishing Don Quixote, Part II, partially revised the original, introducing some significant changes and additions, mainly in the last chapters. The analysis of some narrative inconsistencies, that cannot be interpreted as mere mistakes but as significant textual traces, reveals a process of re-elaboration –a process that affects at least four sections of the novel. Most of the evidence gathered here suggests that this revision is closely linked to Avellaneda’s continuation, in the sense that Cervantes tried to challenge the apocriphal Quixote making last-time interventions in his own text.

The Global Burden of Occupational Disease.

Science.gov (United States)

Rushton, Lesley

2017-09-01

Burden of occupational disease estimation contributes to understanding of both magnitude and relative importance of different occupational hazards and provides essential information for targeting risk reduction. This review summarises recent key findings and discusses their impact on occupational regulation and practice. New methods have been developed to estimate burden of occupational disease that take account of the latency of many chronic diseases and allow for exposure trends and workforce turnover. Results from these studies have shown in several countries and globally that, in spite of improvements in workplace technology, practices and exposures over the last decades, occupational hazards remain an important cause of ill health and mortality worldwide. Major data gaps have been identified particularly regarding exposure information. Reliable data on employment and disease are also lacking especially in developing countries. Burden of occupational disease estimates form an important part of decision-making processes.

Nursing as concrete philosophy, Part II: Engaging with reality.

Science.gov (United States)

Theodoridis, Kyriakos

2018-04-01

This is the second paper of an essay in two parts. The first paper (Part I) is a critical discussion of Mark Risjord's conception of nursing knowledge where I argued against the conception of nursing knowledge as a kind of nursing science. The aim of the present paper (Part II) is to explicate and substantiate the thesis of nursing as a kind of concrete philosophy. My strategy is to elaborate upon certain themes from Wittgenstein's Tractatus in order to canvass a general scheme of philosophy based on a distinction between reality and the world. This distinction will be employed in the appropriation of certain significant features of nursing and nursing knowledge. By elaborating on the contrast between the abstract and the concrete, I will suggest that nursing may be seen as a kind of concrete philosophy, being primarily concerned with reality (and secondarily with the world). This thesis, I will argue, implies that philosophy is the kind of theory that is essential to nursing (which is not so much a theory than a certain kind of activity). © 2017 John Wiley & Sons Ltd.

The in vivo mechanism of action of CD20 monoclonal antibodies depends on local tumor burden

Science.gov (United States)

Boross, Peter; Jansen, J.H. Marco; de Haij, Simone; Beurskens, Frank J.; van der Poel, Cees E.; Bevaart, Lisette; Nederend, Maaike; Golay, Josée; van de Winkel, Jan G.J.; Parren, Paul W.H.I.; Leusen, Jeanette H.W.

2011-01-01

Background CD20 monoclonal antibodies are widely used in clinical practice. Antibody-dependent cellular cytotoxicity, complement-dependent cytotoxicity and direct cell death have been suggested to be important effector functions for CD20 antibodies. However, their specific contributions to the in vivo mechanism of action of CD20 immunotherapy have not been well defined. Design and Methods Here we studied the in vivo mechanism of action of type I (rituximab and ofatumumab) and type II (HuMab-11B8) CD20 antibodies in a peritoneal, syngeneic, mouse model with EL4-CD20 cells using low and high tumor burden. Results Interestingly, we observed striking differences in the in vivo mechanism of action of CD20 antibodies dependent on tumor load. In conditions of low tumor burden, complement was sufficient for tumor killing both for type I and type II CD20 antibodies. In contrast, in conditions of high tumor burden, activating FcγR (specifically FcγRIII), active complement and complement receptor 3 were all essential for tumor killing. Our data suggest that complement-enhanced antibody-dependent cellular cytotoxicity may critically affect tumor killing by CD20 antibodies in vivo. The type II CD20 antibody 11B8, which is a poor inducer of complement activation, was ineffective against high tumor burden. Conclusions Tumor burden affects the in vivo mechanism of action of CD20 antibodies. Low tumor load can be eliminated by complement alone, whereas elimination of high tumor load requires multiple effector mechanisms. PMID:21880632

Impedance-Source Networks for Electric Power Conversion Part II

DEFF Research Database (Denmark)

Siwakoti, Yam P.; Peng, Fang Zheng; Blaabjerg, Frede

2015-01-01

Impedance-source networks cover the entire spectrum of electric power conversion applications (dc-dc, dc-ac, ac-dc, ac-ac) controlled and modulated by different modulation strategies to generate the desired dc or ac voltage and current at the output. A comprehensive review of various impedance......-source-network-based power converters has been covered in a previous paper and main topologies were discussed from an application point of view. Now Part II provides a comprehensive review of the most popular control and modulation strategies for impedance-source network-based power converters/inverters. These methods...

40 CFR 305.33 - Burden of presentation; burden of persuasion.

Science.gov (United States)

2010-07-01

... persuasion. 305.33 Section 305.33 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED... Hearing Procedure § 305.33 Burden of presentation; burden of persuasion. The Requestor has the burden of... justified. Accordingly, the Requestor bears the burdens of presentation and persuasion. Following the...

The burden of leishmaniasis in Iran, acquired from the global burden of disease during 1990–2010

Directory of Open Access Journals (Sweden)

Alireza Badirzadeh

2017-09-01

Full Text Available Objective: To report and measure the burden of leishmaniasis in Iran using the global burden of disease (GBD results, conducted by the Institute for Health Metrics and Evaluation for the years 1990 to 2010, and provide some recommendations for reaching better conclusions about the burden of disease. Methods: GBD burden and fatality rates of leishmaniasis were compared with the findings registered by the Ministry of Health and Medical Education (MOHME. Data obtained from the GBD for the years 1990 to 2010 were used to estimate the disability-adjusted life-years and fatality rates of leishmaniasis in Iran. Results: The GBD estimated 229 714 disability-adjusted life-years due to leishmaniasis in Iranian people of all ages and both sexes. The number of deaths caused by visceral leishmaniasis (VL had decreased significantly in recent years. MOHME registered data on fewer than 30 deaths in Iran from 1990 to 2010. Conclusions: The underreporting of VL deaths is always more pronounced. Findings indicate that the GBD estimation of mortality rates was surprisingly higher than MOHME’s data. The burden of leishmaniasis decreased significantly between the years 1990 and 2010 in both data sources. The possible explanation for this decrease has been discovered through the establishment of a VL surveillance system in various parts of Iran, particularly in endemic areas.

45 CFR 672.17 - Burden of presentation; burden of persuasion.

Science.gov (United States)

2010-10-01

... 45 Public Welfare 3 2010-10-01 2010-10-01 false Burden of presentation; burden of persuasion. 672.17 Section 672.17 Public Welfare Regulations Relating to Public Welfare (Continued) NATIONAL SCIENCE FOUNDATION ENFORCEMENT AND HEARING PROCEDURES § 672.17 Burden of presentation; burden of persuasion. The...

Does economic burden influence quality of life in breast cancer survivors?

Science.gov (United States)

Meneses, Karen; Azuero, Andres; Hassey, Lauren; McNees, Patrick; Pisu, Maria

2012-03-01

Economic burden is emerging as a crucial dimension in our understanding of adjustment to cancer during treatment. Yet, economic burden is rarely examined in cancer survivorship. The goal of this paper is to describe the effect of economic hardship and burden among women with breast cancer. We examined baseline and follow-up (3 and 6 month) data reported by 132 stage I and II breast cancer survivors assigned to the Wait Control arm of the Breast Cancer Education Intervention (BCEI), a clinical trial of education and support interventions. Repeated measures models fitted with linear mixed models were used to examine relationships between aspects of economic burden and overall quality of life (QOL) scores. Structural equation models (SEM) were used to examine the relationship between overall economic burden and QOL. Nineteen economic events were reported. The proportion of survivors who reported increase in insurance premiums increased in the 6-month study period (p=.022). The proportion of survivors reporting change in motivation (p=.016), productivity (p=.002), quality of work (p=.01), days missed from work (pincrease in economic events was significantly associated with poorer quality of life at each of the study time points. Economic burden of breast cancer extends into post-treatment survivorship. Better understanding of economic impact and managing economic burden may help maintain QOL. Copyright © 2011 Elsevier Inc. All rights reserved.

The "Pseudocommando" mass murderer: part II, the language of revenge.

Science.gov (United States)

Knoll, James L

2010-01-01

In Part I of this article, research on pseudocommandos was reviewed, and the important role that revenge fantasies play in motivating such persons to commit mass murder-suicide was discussed. Before carrying out their mass shootings, pseudocommandos may communicate some final message to the public or news media. These communications are rich sources of data about their motives and psychopathology. In Part II of this article, forensic psycholinguistic analysis is applied to clarify the primary motivations, detect the presence of mental illness, and discern important individual differences in the final communications of two recent pseudocommandos: Seung-Hui Cho (Virginia Tech) and Jiverly Wong (Binghamton, NY). Although both men committed offenses that qualify them as pseudocommandos, their final communications reveal striking differences in their psychopathology.

CE and nanomaterials - Part II: Nanomaterials in CE.

Science.gov (United States)

Adam, Vojtech; Vaculovicova, Marketa

2017-10-01

The scope of this two-part review is to summarize publications dealing with CE and nanomaterials together. This topic can be viewed from two broad perspectives, and this article is trying to highlight these two approaches: (i) CE of nanomaterials, and (ii) nanomaterials in CE. The second part aims at summarization of publications dealing with application of nanomaterials for enhancement of CE performance either in terms of increasing the separation resolution or for improvement of the detection. To increase the resolution, nanomaterials are employed as either surface modification of the capillary wall forming open tubular column or as additives to the separation electrolyte resulting in a pseudostationary phase. Moreover, nanomaterials have proven to be very beneficial for increasing also the sensitivity of detection employed in CE or even they enable the detection (e.g., fluorescent tags of nonfluorescent molecules). © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

40 CFR Appendix III to Part 266 - Tier II Emission Rate Screening Limits for Free Chlorine and Hydrogen Chloride

Science.gov (United States)

2010-07-01

... 40 Protection of Environment 26 2010-07-01 2010-07-01 false Tier II Emission Rate Screening Limits for Free Chlorine and Hydrogen Chloride III Appendix III to Part 266 Protection of Environment... to Part 266—Tier II Emission Rate Screening Limits for Free Chlorine and Hydrogen Chloride Terrain...

The humanistic burden of hereditary angioedema

DEFF Research Database (Denmark)

Caballero, Teresa; Aygören-Pürsün, Emel; Bygum, Anette

2014-01-01

and impact of HAE types I and II from the patient perspective. The HAE Burden of Illness Study in Europe was conducted in Spain, Germany, and Denmark to assess the real-world experience of HAE from the patient perspective via a one-time survey, which included items on clinical characteristics and physical......, traveling, and passing HAE to their children. Based on Hospital Anxiety and Depression Scale scores, 38 and 14% had clinically meaningful anxiety and depression, respectively. Despite standard of care, HAE patients still have frequent and painful attacks. Patients experience substantial impairment...

The year 2013 in the European Heart Journal--Cardiovascular Imaging: Part II.

Science.gov (United States)

Plein, Sven; Edvardsen, Thor; Pierard, Luc A; Saraste, Antti; Knuuti, Juhani; Maurer, Gerald; Lancellotti, Patrizio

2014-08-01

The new multi-modality cardiovascular imaging journal, European Heart Journal - Cardiovascular Imaging, was created in 2012. Here we summarize the most important studies from the journal's second year in two articles. Part I of the review has summarized studies in myocardial function, myocardial ischaemia, and emerging techniques in cardiovascular imaging. Part II is focussed on valvular heart diseases, heart failure, cardiomyopathies, and congenital heart diseases. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2014. For permissions please email: journals.permissions@oup.com.

Subseabed disposal program annual report, January-December 1979. Volume II. Appendices (principal investigator progress reports). Part 1 of 2

International Nuclear Information System (INIS)

Talbert, D.M.

1981-04-01

Volume II of the sixth annual report describing the progress and evaluating the status of the Subseabed Disposal Program contains the appendices referred to in Volume I, Summary and Status. Because of the length of Volume II, it has been split into two parts for publication purposes. Part 1 contains Appendices A-O; Part 2 contains Appendices P-FF. Separate abstracts have been prepared of each Appendix for inclusion in the Energy Data Base

Bloqueio do nervo supraescapular: procedimento importante na prática clínica. Parte II Suprascapular nerve block: important procedure in clinical practice. Part II

Directory of Open Access Journals (Sweden)

Marcos Rassi Fernandes

2012-08-01

Full Text Available O bloqueio do nervo supraescapular é um método de tratamento reprodutível, confiável e extremamente efetivo no controle da dor no ombro. Esse método tem sido amplamente utilizado por profissionais na prática clínica, como reumatologistas, ortopedistas, neurologistas e especialistas em dor, na terapêutica de enfermidades crônicas, como lesão irreparável do manguito rotador, artrite reumatoide, sequelas de AVC e capsulite adesiva, o que justifica a presente revisão (Parte II. O objetivo deste estudo foi descrever as técnicas do procedimento e suas complicações descritas na literatura, já que a primeira parte reportou as indicações clínicas, drogas e volumes utilizados em aplicação única ou múltipla. Apresentamse, detalhadamente, os acessos para a realização do procedimento tanto direto como indireto, anterior e posterior, lateral e medial, e superior e inferior. Diversas são as opções para se realizar o bloqueio do nervo supraescapular. Apesar de raras, as complicações podem ocorrer. Quando bem indicado, este método deve ser considerado.The suprascapular nerve block is a reproducible, reliable, and extremely effective treatment method in shoulder pain control. This method has been widely used by professionals in clinical practice such as rheumatologists, orthopedists, neurologists, and pain specialists in the treatment of chronic diseases such as irreparable rotator cuff injury, rheumatoid arthritis, stroke sequelae, and adhesive capsulitis, which justifies the present review (Part II. The objective of this study was to describe the techniques and complications of the procedure described in the literature, as the first part reported the clinical indications, drugs, and volumes used in single or multiple procedures. We present in details the accesses used in the procedure: direct and indirect, anterior and posterior, lateral and medial, upper and lower. There are several options to perform suprascapular nerve block

Burden of Diarrhea in the Eastern Mediterranean Region, 1990–2013: Findings from the Global Burden of Disease Study 2013

Science.gov (United States)

Khalil, Ibrahim; Colombara, Danny V.; Forouzanfar, Mohammad Hossein; Troeger, Christopher; Daoud, Farah; Moradi-Lakeh, Maziar; El Bcheraoui, Charbel; Rao, Puja C.; Afshin, Ashkan; Charara, Raghid; Abate, Kalkidan Hassen; El Razek, Mohammed Magdy Abd; Abd-Allah, Foad; Abu-Elyazeed, Remon; Kiadaliri, Aliasghar Ahmad; Akanda, Ali Shafqat; Akseer, Nadia; Alam, Khurshid; Alasfoor, Deena; Ali, Raghib; AlMazroa, Mohammad A.; Alomari, Mahmoud A.; Al-Raddadi, Rajaa Mohammad Salem; Alsharif, Ubai; Alsowaidi, Shirina; Altirkawi, Khalid A.; Alvis-Guzman, Nelson; Ammar, Walid; Antonio, Carl Abelardo T.; Asayesh, Hamid; Asghar, Rana Jawad; Atique, Suleman; Awasthi, Ashish; Bacha, Umar; Badawi, Alaa; Barac, Aleksandra; Bedi, Neeraj; Bekele, Tolesa; Bensenor, Isabela M.; Betsu, Balem Demtsu; Bhutta, Zulfiqar; Bin Abdulhak, Aref A.; Butt, Zahid A.; Danawi, Hadi; Dubey, Manisha; Endries, Aman Yesuf; Faghmous, Imad D. A.; Farid, Talha; Farvid, Maryam S.; Farzadfar, Farshad; Fereshtehnejad, Seyed-Mohammad; Fischer, Florian; Fitchett, Joseph Robert Anderson; Gibney, Katherine B.; Ginawi, Ibrahim Abdelmageem Mohamed; Gishu, Melkamu Dedefo; Gugnani, Harish Chander; Gupta, Rahul; Hailu, Gessessew Bugssa; Hamadeh, Randah Ribhi; Hamidi, Samer; Harb, Hilda L.; Hedayati, Mohammad T.; Hsairi, Mohamed; Husseini, Abdullatif; Jahanmehr, Nader; Javanbakht, Mehdi; Jibat, Tariku; Jonas, Jost B.; Kasaeian, Amir; Khader, Yousef Saleh; Khan, Abdur Rahman; Khan, Ejaz Ahmad; Khan, Gulfaraz; Khoja, Tawfik Ahmed Muthafer; Kinfu, Yohannes; Kissoon, Niranjan; Koyanagi, Ai; Lal, Aparna; Latif, Asma Abdul Abdul; Lunevicius, Raimundas; El Razek, Hassan Magdy Abd; Majeed, Azeem; Malekzadeh, Reza; Mehari, Alem; Mekonnen, Alemayehu B.; Melaku, Yohannes Adama; Memish, Ziad A.; Mendoza, Walter; Misganaw, Awoke; Mohamed, Layla Abdalla Ibrahim; Nachega, Jean B.; Le Nguyen, Quyen; Nisar, Muhammad Imran; Peprah, Emmanuel Kwame; Platts-Mills, James A.; Pourmalek, Farshad; Qorbani, Mostafa; Rafay, Anwar; Rahimi-Movaghar, Vafa; Ur Rahman, Sajjad; Rai, Rajesh Kumar; Rana, Saleem M.; Ranabhat, Chhabi L.; Rao, Sowmya R.; Refaat, Amany H.; Riddle, Mark; Roshandel, Gholamreza; Ruhago, George Mugambage; Saleh, Muhammad Muhammad; Sanabria, Juan R.; Sawhney, Monika; Sepanlou, Sadaf G.; Setegn, Tesfaye; Sliwa, Karen; Sreeramareddy, Chandrashekhar T.; Sykes, Bryan L.; Tavakkoli, Mohammad; Tedla, Bemnet Amare; Terkawi, Abdullah S.; Ukwaja, Kingsley; Uthman, Olalekan A.; Westerman, Ronny; Wubshet, Mamo; Yenesew, Muluken A.; Yonemoto, Naohiro; Younis, Mustafa Z.; Zaidi, Zoubida; Zaki, Maysaa El Sayed; Al Rabeeah, Abdullah A.; Wang, Haidong; Naghavi, Mohsen; Vos, Theo; Lopez, Alan D.; Murray, Christopher J. L.; Mokdad, Ali H.

2016-01-01

Diarrheal diseases (DD) are leading causes of disease burden, death, and disability, especially in children in low-income settings. DD can also impact a child's potential livelihood through stunted physical growth, cognitive impairment, and other sequelae. As part of the Global Burden of Disease Study, we estimated DD burden, and the burden attributable to specific risk factors and particular etiologies, in the Eastern Mediterranean Region (EMR) between 1990 and 2013. For both sexes and all ages, we calculated disability-adjusted life years (DALYs), which are the sum of years of life lost and years lived with disability. We estimate that over 125,000 deaths (3.6% of total deaths) were due to DD in the EMR in 2013, with a greater burden of DD in low- and middle-income countries. Diarrhea deaths per 100,000 children under 5 years of age ranged from one (95% uncertainty interval [UI] = 0–1) in Bahrain and Oman to 471 (95% UI = 245–763) in Somalia. The pattern for diarrhea DALYs among those under 5 years of age closely followed that for diarrheal deaths. DALYs per 100,000 ranged from 739 (95% UI = 520–989) in Syria to 40,869 (95% UI = 21,540–65,823) in Somalia. Our results highlighted a highly inequitable burden of DD in EMR, mainly driven by the lack of access to proper resources such as water and sanitation. Our findings will guide preventive and treatment interventions which are based on evidence and which follow the ultimate goal of reducing the DD burden. PMID:27928080

Taxonomy of the burden of treatment: a multi-country web-based qualitative study of patients with chronic conditions.

Science.gov (United States)

Tran, Viet-Thi; Barnes, Caroline; Montori, Victor M; Falissard, Bruno; Ravaud, Philippe

2015-05-14

Management strategies for patients with chronic conditions are becoming increasingly complex, which may result in a burden of treatment for patients. To develop a Minimally Disruptive Medicine designed to reduce the burden of treatment, clinicians need to understand which healthcare tasks and aggravating factors may be responsible for this burden. The objective of the present study was to describe and classify the components of the burden of treatment for patients with chronic conditions from the patient's perspective. We performed a multi-country qualitative study using an online survey and a purposive sampling strategy to select English-, French-, and Spanish-speaking participants with different chronic conditions. Participants were recruited by physicians, patients' associations, advertisement on social media, and 'snowballing'. The answers were analyzed by i) manual content analysis with a grounded theory approach, coded by two researchers, and ii) automatic textual analysis by Reinert's method. Between 2013 and 2014, 1,053 participants from 34 different countries completed the online survey using 408,625 words. Results from both analyses were synthesized in a taxonomy of the burden of treatment, which described i) the tasks imposed on patients by their diseases and by their healthcare system (e.g., medication management, lifestyle changes, follow-up, etc.); ii) the structural (e.g., access to healthcare resources, coordination between care providers), personal, situational, and financial factors that aggravated the burden of treatment; and iii) patient-reported consequences of the burden (e.g., poor adherence to treatments, financial burden, impact on professional, family, and social life, etc.). Our findings may not be applicable to patients with chronic conditions who differ from those who responded to our survey. Our taxonomy of the burden of treatment, provided by patients with chronic conditions from different countries and settings, supports the

Burden of disease in Nariño, Colombia, 2010

Science.gov (United States)

Trujillo-Montalvo, Elizabeth; Hidalgo-Patiño, Carlos; Hidalgo-Eraso, Angela

2014-01-01

Objective: This study sought to measure burden of disease and identifies health priorities from the Disability Adjusted Life Years (DALYs) indicator. Methods: This is the first study on burden of disease for a department in Colombia by using a standardized methodology. By using the DALYs indicator, burden of disease was identified in the department of Nariño according to the guidelines established by the World Health Organization. Results: The DALYs in the Department of Nariño highlight the emergence of communicable, maternal, perinatal, and nutritional diseases during the first years of life; of accidents and lesions among youth, and non-communicable diseases in older individuals. Also, accidents and lesions are highlighted in men and non-communicable diseases in women. Conclusions: This study is part of the knowledge management process in the Departmental Health Plan for Nariño - Colombia 2012-2015 and contributes to the system of indicators of the 2012 ten-year public health plan. This research evidences that communicable diseases generate the biggest part of the burden of disease in the Department of Nariño, that DALYs due to non-communicable diseases are on the rise, and that accidents and lesions, especially due to violence are an important cause of DALYs in this region, which is higher than that of the country. PMID:25386034

Response Burden in Official Business Surveys: Measurement and Reduction Practices of National Statistical Institutes

Directory of Open Access Journals (Sweden)

Bavdaž Mojca

2015-12-01

Full Text Available Response burden in business surveys has long been a concern for National Statistical Institutes (NSIs for three types of reasons: political reasons, because response burden is part of the total administrative burden governments impose on businesses; methodological reasons, because an excessive response burden may reduce data quality and increase data-collection costs; and strategic reasons, because it affects relations between the NSIs and the business community. This article investigates NSI practices concerning business response burden measurement and reduction actions based on a survey of 41 NSIs from 39 countries. Most NSIs monitor at least some burden aspects and have implemented some actions to reduce burden, but large differences exist between NSIs’ methodologies for burden measurement and actions taken to reduce burden. Future research should find ways to deal with methodological differences in burden conceptualization, operationalization, and measurement, and provide insights into the effectiveness and efficiency of burden-reduction actions.

Three Mile Island: a report to the commissioners and to the public. Volume II, Part 3

International Nuclear Information System (INIS)

1979-01-01

This is the third and final part of the second volume of a study of the Three Mile Island accident. Part 3 of Volume II contains descriptions and assessments of responses to the accident by the utility and by the NRC and other government agencies

Physical therapy in the 21st century (Part II): evidence-based practice within the context of evidence-informed practice.

Science.gov (United States)

Dean, Elizabeth

2009-07-01

Part II of this two-part introduction to this Special Issue on physical therapy practice in the 21st century outlines a health-focused strategy for physical therapists to lead in the assault on lifestyle conditions, global health care priorities, described in Part I. Consistent with contemporary definitions of physical therapy, its practice, professional education, and research, physical therapy needs to reflect 21st-century health priorities and be aligned with global and regional public health strategies. A proposed focus on health emphasizes clinical competencies, including assessments of health, lifestyle health behaviors, and lifestyle risk factors; and the prescription of interventions to promote health and well-being in every client or patient. Such an approach is aimed to increase the threshold for chronic conditions over the life cycle and reduce their rate of progression, thereby preventing, delaying, or minimizing the severity of illness and disability. The 21st-century physical therapist needs to be able to practice such competencies within the context of a culturally diverse society to effect positive health behavior change. The physical therapist is uniquely positioned to lead in health promotion and prevention of the lifestyle conditions, address many of their causes, as well as manage these conditions. Physical therapists need to impact health globally through public and social health policy as well as one-on-one care. This role is consistent with contemporary definitions of physical therapy as the quintessential noninvasive health care practitioner, and the established efficacy and often superiority of lifestyle and lifestyle change on health outcomes compared with invasive interventions, namely, drugs and surgery. A concerted commitment by physical therapists to health and well-being and reduced health risk is consistent with minimizing the substantial social and economic burdens of lifestyle conditions globally.

Numerical Simulation of Projectile Impact on Mild Steel Armour Platesusing LS-DYNA, Part II: Parametric Studies

OpenAIRE

M. Raguraman; A. Deb; N. K. Gupta; D. K. Kharat

2008-01-01

In Part I of the current two-part series, a comprehensive simulation-based study of impact of jacketed projectiles on mild steel armour plates has been presented. Using the modelling procedures developed in Part I, a number of parametric studies have been carried out for the same mild steel plates considered in Part I and reported here in Part II. The current investigation includes determination of ballistic limits of a given target plate for different projectile diameters and impact velociti...

PIC Simulations in Low Energy Part of PIP-II Proton Linac

Energy Technology Data Exchange (ETDEWEB)

Romanov, Gennady

2014-07-01

The front end of PIP-II linac is composed of a 30 keV ion source, low energy beam transport line (LEBT), 2.1 MeV radio frequency quadrupole (RFQ), and medium energy beam transport line (MEBT). This configuration is currently being assembled at Fermilab to support a complete systems test. The front end represents the primary technical risk with PIP-II, and so this step will validate the concept and demonstrate that the hardware can meet the specified requirements. SC accelerating cavities right after MEBT require high quality and well defined beam after RFQ to avoid excessive particle losses. In this paper we will present recent progress of beam dynamic study, using CST PIC simulation code, to investigate partial neutralization effect in LEBT, halo and tail formation in RFQ, total emittance growth and beam losses along low energy part of the linac.

Informal caregiver burden in middle-income countries Results from Memory Centers in Lima - Peru

Directory of Open Access Journals (Sweden)

Nilton Custodio

Full Text Available OBJECTIVE: The aim of this study was to evaluate caregiver burden based on Zarit Burden Interview (ZBI and depression in caregivers on the Beck Depression Inventory-II (BDI-II. METHODS: Literate individuals, 18 years or older, who spoke Spanish as their native language were included. Demographic characteristics: Age, sex, education, relationship to person with dementia, length of time caregiving, other sources of help for caring, impact on the household economy, family support, and perception of impaired health; and Clinical data on care-recipients: type of dementia, time since diagnosis, treatment, and Global Deterioration Scale (GDS; the ZBI and BDI-II. Descriptive and analytical statistics were employed to assess caregiver burden and predictors of higher burden in caregivers. RESULTS: A total of 92 informal caregivers were evaluated. Regarding care-recipients, 75% were 69 years old or over, 75% had at least one year since diagnosis, 73.9% had Alzheimer's disease, 84.8% received treatment, 75% scored 5 or over on the GDS. For caregivers, 75% were 55.5 years old or over, predominantly female (81.5%, married (83.7%, the spouse of care-recipients (60.87%, had at least 10 years of education (75.0% and one year of caregiving (75%, reduced entertainment time (90.2% and self-perception of impaired health (83.7%. Median score on the ZBI was 37.5 (minimum value = 3; and maximum value = 74. The coefficient of BDI was 1.38 (p-value <0.001. CONCLUSION: This sample of Peruvian informal caregivers showed elevated ZBI values. Self-perception of worsened health, repercussion on the family economy and time caregiving were the main determinants of ZBI, although only BDI was a consistent predictor of ZBI.

A thermoelectric power generating heat exchanger: Part II – Numerical modeling and optimization

DEFF Research Database (Denmark)

Sarhadi, Ali; Bjørk, Rasmus; Lindeburg, N.

2016-01-01

In Part I of this study, the performance of an experimental integrated thermoelectric generator (TEG)-heat exchanger was presented. In the current study, Part II, the obtained experimental results are compared with those predicted by a finite element (FE) model. In the simulation of the integrated...... TEG-heat exchanger, the thermal contact resistance between the TEG and the heat exchanger is modeled assuming either an ideal thermal contact or using a combined Cooper–Mikic–Yovanovich (CMY) and parallel plate gap formulation, which takes into account the contact pressure, roughness and hardness...

Understanding Medicines: Conceptual Analysis of Nurses' Needs for Knowledge and Understanding of Pharmacology (Part I). Understanding Medicines: Extending Pharmacology Education for Dependent and Independent Prescribing (Part II).

Science.gov (United States)

Leathard, Helen L.

2001-01-01

Part I reviews what nurses need to know about the administration and prescription of medicines. Part II addresses drug classifications, actions and effects, and interactions. Also discussed are the challenges pharmacological issues pose for nursing education. (SK)

Uncertainty estimation with a small number of measurements, part II: a redefinition of uncertainty and an estimator method

Science.gov (United States)

Huang, Hening

2018-01-01

This paper is the second (Part II) in a series of two papers (Part I and Part II). Part I has quantitatively discussed the fundamental limitations of the t-interval method for uncertainty estimation with a small number of measurements. This paper (Part II) reveals that the t-interval is an ‘exact’ answer to a wrong question; it is actually misused in uncertainty estimation. This paper proposes a redefinition of uncertainty, based on the classical theory of errors and the theory of point estimation, and a modification of the conventional approach to estimating measurement uncertainty. It also presents an asymptotic procedure for estimating the z-interval. The proposed modification is to replace the t-based uncertainty with an uncertainty estimator (mean- or median-unbiased). The uncertainty estimator method is an approximate answer to the right question to uncertainty estimation. The modified approach provides realistic estimates of uncertainty, regardless of whether the population standard deviation is known or unknown, or if the sample size is small or large. As an application example of the modified approach, this paper presents a resolution to the Du-Yang paradox (i.e. Paradox 2), one of the three paradoxes caused by the misuse of the t-interval in uncertainty estimation.

Associations between comorbid anxiety, diabetes control, and overall medical burden in patients with serious mental illness and diabetes.

Science.gov (United States)

Bajor, Laura A; Gunzler, Douglas; Einstadter, Douglas; Thomas, Charles; McCormick, Richard; Perzynski, Adam T; Kanuch, Stephanie W; Cassidy, Kristin A; Dawson, Neal V; Sajatovic, Martha

2015-01-01

While previous work has demonstrated elevation of both comorbid anxiety disorders and diabetes mellitus type II in individuals with serious mental illness, little is known regarding the impact of comorbid anxiety on diabetes mellitus type II outcomes in serious mental illness populations. We analyzed baseline data from patients with serious mental illness and diabetes mellitus type II to examine relationships between comorbid anxiety, glucose control as measured by hemoglobin A1c score, and overall illness burden. Using baseline data from an ongoing prospective treatment study involving 157 individuals with serious mental illness and diabetes mellitus type II, we compared individuals with and without a comorbid anxiety disorder and compared hemoglobin A1c levels between these groups to assess the relationship between anxiety and management of diabetes mellitus type II. We conducted a similar analysis using cumulative number of anxiety diagnoses as a proxy for anxiety load. Finally, we searched for associations between anxiety and overall medical illness burden as measured by Charlson score. Anxiety disorders were seen in 33.1% (N=52) of individuals with serious mental illness and diabetes mellitus type II and were associated with increased severity of depressive symptoms and decreased function. Hemoglobin A1c levels were not significantly different in those with or without anxiety, and having multiple anxiety disorders was not associated with differences in diabetes mellitus type II control. However, depressive symptoms were significantly associated with higher hemoglobin A1c levels. Neither comorbid anxiety nor anxiety load was significantly associated with overall medical burden. One in three people with serious mental illness and diabetes mellitus type II had anxiety. Depressive symptoms were significantly associated with Hb1Ac levels while anxiety symptoms had no relation to hemoglobin A1c; this is consistent with previously published work. More studies are

Bayesian inference for psychology. Part II: Example applications with JASP.

Science.gov (United States)

Wagenmakers, Eric-Jan; Love, Jonathon; Marsman, Maarten; Jamil, Tahira; Ly, Alexander; Verhagen, Josine; Selker, Ravi; Gronau, Quentin F; Dropmann, Damian; Boutin, Bruno; Meerhoff, Frans; Knight, Patrick; Raj, Akash; van Kesteren, Erik-Jan; van Doorn, Johnny; Šmíra, Martin; Epskamp, Sacha; Etz, Alexander; Matzke, Dora; de Jong, Tim; van den Bergh, Don; Sarafoglou, Alexandra; Steingroever, Helen; Derks, Koen; Rouder, Jeffrey N; Morey, Richard D

2018-02-01

Bayesian hypothesis testing presents an attractive alternative to p value hypothesis testing. Part I of this series outlined several advantages of Bayesian hypothesis testing, including the ability to quantify evidence and the ability to monitor and update this evidence as data come in, without the need to know the intention with which the data were collected. Despite these and other practical advantages, Bayesian hypothesis tests are still reported relatively rarely. An important impediment to the widespread adoption of Bayesian tests is arguably the lack of user-friendly software for the run-of-the-mill statistical problems that confront psychologists for the analysis of almost every experiment: the t-test, ANOVA, correlation, regression, and contingency tables. In Part II of this series we introduce JASP ( http://www.jasp-stats.org ), an open-source, cross-platform, user-friendly graphical software package that allows users to carry out Bayesian hypothesis tests for standard statistical problems. JASP is based in part on the Bayesian analyses implemented in Morey and Rouder's BayesFactor package for R. Armed with JASP, the practical advantages of Bayesian hypothesis testing are only a mouse click away.

Scope Oriented Thermoeconomic analysis of energy systems. Part II: Formation Structure of Optimality for robust design

International Nuclear Information System (INIS)

Piacentino, Antonio; Cardona, Ennio

2010-01-01

This paper represents the Part II of a paper in two parts. In Part I the fundamentals of Scope Oriented Thermoeconomics have been introduced, showing a scarce potential for the cost accounting of existing plants; in this Part II the same concepts are applied to the optimization of a small set of design variables for a vapour compression chiller. The method overcomes the limit of most conventional optimization techniques, which are usually based on hermetic algorithms not enabling the energy analyst to recognize all the margins for improvement. The Scope Oriented Thermoeconomic optimization allows us to disassemble the optimization process, thus recognizing the Formation Structure of Optimality, i.e. the specific influence of any thermodynamic and economic parameter in the path toward the optimal design. Finally, the potential applications of such an in-depth understanding of the inner driving forces of the optimization are discussed in the paper, with a particular focus on the sensitivity analysis to the variation of energy and capital costs and on the actual operation-oriented design.

40 CFR 179.91 - Burden of going forward; burden of persuasion.

Science.gov (United States)

2010-07-01

... persuasion. 179.91 Section 179.91 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED...; burden of persuasion. (a) The party whose request for an evidentiary hearing was granted has the burden... FFDCA has the burden of persuasion in the hearing on that issue, whether the proceeding concerns the...

Structure Learning and Statistical Estimation in Distribution Networks - Part II

Energy Technology Data Exchange (ETDEWEB)

Deka, Deepjyoti [Univ. of Texas, Austin, TX (United States); Backhaus, Scott N. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Chertkov, Michael [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

2015-02-13

Limited placement of real-time monitoring devices in the distribution grid, recent trends notwithstanding, has prevented the easy implementation of demand-response and other smart grid applications. Part I of this paper discusses the problem of learning the operational structure of the grid from nodal voltage measurements. In this work (Part II), the learning of the operational radial structure is coupled with the problem of estimating nodal consumption statistics and inferring the line parameters in the grid. Based on a Linear-Coupled(LC) approximation of AC power flows equations, polynomial time algorithms are designed to identify the structure and estimate nodal load characteristics and/or line parameters in the grid using the available nodal voltage measurements. Then the structure learning algorithm is extended to cases with missing data, where available observations are limited to a fraction of the grid nodes. The efficacy of the presented algorithms are demonstrated through simulations on several distribution test cases.

Burden of Sexual Dysfunction.

Science.gov (United States)

Balon, Richard

2017-01-02

Similar to the burden of other diseases, the burden of sexual dysfunction has not been systematically studied. However, there is growing evidence of various burdens (e.g., economic, symptomatic, humanistic) among patients suffering from sexual dysfunctions. The burden of sexual dysfunction has been studied a bit more often in men, namely the burden of erectile dysfunction (ED), premature ejaculation (PE) and testosterone deficiency syndrome (TDS). Erectile dysfunction is frequently associated with chronic conditions such as cardiovascular disease, diabetes, and depression. These conditions could go undiagnosed, and ED could be a marker of those diseases. The only available report from the United Kingdom estimated the total economic burden of ED at £53 million annually in terms of direct costs and lost productivity. The burden of PE includes significant psychological distress: anxiety, depression, lack of sexual confidence, poor self-esteem, impaired quality of life, and interpersonal difficulties. Some suggest that increase in female sexual dysfunction is associated with partner's PE, in addition to significant interpersonal difficulties. The burden of TDS includes depression, sexual dysfunction, mild cognitive impairment, and osteoporosis. One UK estimate of the economic burden of female sexual dysfunctions demonstrated that the average cost per patient was higher than the per annum cost of ED. There are no data on burden of paraphilic disorders. The burden of sexual dysfunctions is underappreciated and not well studied, yet it is significant for both the patients and the society.

Informal caregiver burden in middle-income countries: Results from Memory Centers in Lima – Peru

Science.gov (United States)

Custodio, Nilton; Lira, David; Herrera-Perez, Eder; del Prado, Liza Nuñez; Parodi, José; Guevara-Silva, Erik; Castro-Suarez, Sheila; Mar, Marcela; Montesinos, Rosa; Cortijo, Patricia

2014-01-01

Objective The aim of this study was to evaluate caregiver burden based on Zarit Burden Interview (ZBI) and depression in caregivers on the Beck Depression Inventory-II (BDI-II). Methods Literate individuals, 18 years or older, who spoke Spanish as their native language were included. Demographic characteristics: Age, sex, education, relationship to person with dementia, length of time caregiving, other sources of help for caring, impact on the household economy, family support, and perception of impaired health; and Clinical data on care-recipients: type of dementia, time since diagnosis, treatment, and Global Deterioration Scale (GDS); the ZBI and BDI-II. Descriptive and analytical statistics were employed to assess caregiver burden and predictors of higher burden in caregivers. Results A total of 92 informal caregivers were evaluated. Regarding care-recipients, 75% were 69 years old or over, 75% had at least one year since diagnosis, 73.9% had Alzheimer's disease, 84.8% received treatment, 75% scored 5 or over on the GDS. For caregivers, 75% were 55.5 years old or over, predominantly female (81.5%), married (83.7%), the spouse of care-recipients (60.87%), had at least 10 years of education (75.0%) and one year of caregiving (75%), reduced entertainment time (90.2%) and self-perception of impaired health (83.7%). Median score on the ZBI was 37.5 (minimum value = 3; and maximum value = 74). The coefficient of BDI was 1.38 (p-value <0.001). Conclusion This sample of Peruvian informal caregivers showed elevated ZBI values. Self-perception of worsened health, repercussion on the family economy and time caregiving were the main determinants of ZBI, although only BDI was a consistent predictor of ZBI. PMID:29213929

Emerging Forms of the Part II of Jonathan Swift's Novel “Gulliver’s Travels”

Directory of Open Access Journals (Sweden)

Svitlana Tikhonenko

2017-11-01

Full Text Available The article is devoted to the study of grotesque forms in Jonathan Swift's novel "Gulliver’s Travels" based on the text of part II of the novel "A Voyage to Brobdingnag". On the basis of the selected actual material, displays of the grotesque elements in the semantic field of the work’s text are traced. The grotesque world of the novel is the author's model of mankind, in which J. Swift presents his view not only on the state of the modern system of England, but also on the nature of man in general, reveals the peculiarities of the psychology of human nature, especially human socialization. In part II, the author continues to develop a complex and contradictory picture of human existence in front of the reader, the world of giants appears as an ambivalent system in which the features of an ideal society and ideal ruler, in author’s opinion, with the ugly face of man and society, are marvelously combined.

Numerical simulation of projectile impact on mild steel armour plates using LS-DYNA, Part II: Parametric studies

OpenAIRE

Raguraman, M; Deb, A; Gupta, NK; Kharat, DK

2008-01-01

In Part I of the current two-part series, a comprehensive simulation-based study of impact of Jacketed projectiles on mild steel armour plates has been presented. Using the modelling procedures developed in Part I, a number of parametric studies have been carried out for the same mild steel plates considered in Part I and reported here in Part II. The current investigation includes determination of ballistic limits of a given target plate for different projectile diameters and impact velociti...

'Tablet burden' in patients with metastatic breast cancer.

Science.gov (United States)

Milic, Marina; Foster, Anna; Rihawi, Karim; Anthoney, Alan; Twelves, Chris

2016-03-01

The implications for patients with cancer, of the 'tablet burden' resulting from increasing use of oral anticancer drugs and medication for co-morbidities have not previously been well explored. We sought to (i) quantify tablet burden in women with metastatic breast cancer (MBC), (ii) establish which groups of drug contribute most to this burden and (iii) gain insight into patients' attitudes towards oral anti-cancer treatment. One hundred patients with MBC anonymously completed a questionnaire describing their medication histories and attitudes towards their tablets. The patients (mean age 60, range 31-95) were all female and taking a median of six tablets (range 0-31) daily; 37 patients were taking >10 tablets. Oral anticancer treatment constituted the category of treatment taken by the highest proportion of patients, followed by symptomatic cancer treatments, proton pump inhibitors and cardiovascular medication. Numerically, however, symptomatic drugs accounted for 44% of all tablets and specific anti-cancer treatment for 15%; medication not directly related to the cancer accounted for the remaining 40% of tablets. A quarter of patients reported inconvenience in taking their tablets, the main reason being tablet size and one third reported forgetting their tablets at least once a week. Nearly two thirds of patients expressing a preference favoured oral anticancer treatment, the commonest reason being greater convenience. Tablet burden is considerable for many patients with MBC and can be problematic. A significant proportion of tablets represent treatment for co-morbidities, the significance of which may be questionable in women with MBC. Copyright © 2015 Elsevier Ltd. All rights reserved.

The alteration of the BPM, burden neutrality and autonomous greening

International Nuclear Information System (INIS)

2009-01-01

The foundation of the purchase tax on passenger cars (BPM) in the Netherlands is gradually altered from catalogue value to CO2 emission per kilometer of the new car. The tariffs have been established in such a way that they meet the precondition of burden neutrality of the BPM alteration. There is some discussion about this and the first part of this publication will address this issue. The issue of burden neutrality is part of a study by DHV Investment Services (DHV). The first main conclusion of the DHV study is that the alteration is not budget neutral. The study entails an applied welfare analysis of the alteration of the BPM foundation. Some comments on the welfare analysis are provided in the second part of this memo. Another issue that is addressed involves the question if and how the autonomous decrease in CO2 emission of newly sold cars can be established in practice. [nl

Technical Information on the Carbonation of the EBR-II Reactor, Summary Report Part 1: Laboratory Experiments and Application to EBR-II Secondary Sodium System

Energy Technology Data Exchange (ETDEWEB)

Steven R. Sherman

2005-04-01

Residual sodium is defined as sodium metal that remains behind in pipes, vessels, and tanks after the bulk sodium metal has been melted and drained from such components. The residual sodium has the same chemical properties as bulk sodium, and differs from bulk sodium only in the thickness of the sodium deposit. Typically, sodium is considered residual when the thickness of the deposit is less than 5-6 cm. This residual sodium must be removed or deactivated when a pipe, vessel, system, or entire reactor is permanently taken out of service, in order to make the component or system safer and/or to comply with decommissioning regulations. As an alternative to the established residual sodium deactivation techniques (steam-and-nitrogen, wet vapor nitrogen, etc.), a technique involving the use of moisture and carbon dioxide has been developed. With this technique, sodium metal is converted into sodium bicarbonate by reacting it with humid carbon dioxide. Hydrogen is emitted as a by-product. This technique was first developed in the laboratory by exposing sodium samples to humidified carbon dioxide under controlled conditions, and then demonstrated on a larger scale by treating residual sodium within the Experimental Breeder Reactor II (EBR-II) secondary cooling system, followed by the primary cooling system, respectively. The EBR-II facility is located at the Idaho National Laboratory (INL) in southeastern Idaho, U.S.A. This report is Part 1 of a two-part report. It is divided into three sections. The first section describes the chemistry of carbon dioxide-water-sodium reactions. The second section covers the laboratory experiments that were conducted in order to develop the residual sodium deactivation process. The third section discusses the application of the deactivation process to the treatment of residual sodium within the EBR-II secondary sodium cooling system. Part 2 of the report, under separate cover, describes the application of the technique to residual sodium

HERBICIDAS INIBIDORES DO FOTOSSISTEMA II – PARTE II / PHOTOSYSTEM II INHIBITOR HERBICIDES - PART

Directory of Open Access Journals (Sweden)

ILCA P. DE F. E SILVA

2013-11-01

Full Text Available Os herbicidas inibidores do fotossistema II (PSII ligam-se ao sítio da QB localizado na proteína D1 o qual se localiza na membrana dos tilacóides dos cloroplastos, causando, o bloqueia do transporte de elétrons da QA para QB, tendo como consequência, a peroxidação dos lipídios. Os principais fatores que afetam a evolução da resistência de plantas daninhas aos herbicidas têm sido agrupados em: genéticos, bioecológicos e agronômicos. A resistência de plantas daninhas a herbicidas é definida como a habilidade de uma planta sobreviver e reproduzir, após exposição a uma dose de herbicida normalmente letal para um biótipo normal da planta. A seletividade de um herbicida está relacionada à capacidade de eliminar plantas daninhas sem interferir na qualidade da planta de interesse econômico.

Clinical management and burden of bipolar disorder: a multinational longitudinal study (WAVE-bd Study

Directory of Open Access Journals (Sweden)

Moreno-Manzanaro Miriam

2011-04-01

Full Text Available Abstract Background Studies in bipolar disorder (BD to date are limited in their ability to provide a whole-disease perspective - their scope has generally been confined to a single disease phase and/or a specific treatment. Moreover, most clinical trials have focused on the manic phase of disease, and not on depression, which is associated with the greatest disease burden. There are few longitudinal studies covering both types of patients with BD (I and II and the whole course of the disease, regardless of patients' symptomatology. Therefore, the Wide AmbispectiVE study of the clinical management and burden of Bipolar Disorder (WAVE-bd (NCT01062607 aims to provide reliable information on the management of patients with BD in daily clinical practice. It also seeks to determine factors influencing clinical outcomes and resource use in relation to the management of BD. Methods WAVE-bd is a multinational, multicentre, non-interventional, longitudinal study. Approximately 3000 patients diagnosed with BD type I or II with at least one mood event in the preceding 12 months were recruited at centres in Austria, Belgium, Brazil, France, Germany, Portugal, Romania, Turkey, Ukraine and Venezuela. Site selection methodology aimed to provide a balanced cross-section of patients cared for by different types of providers of medical aid (e.g. academic hospitals, private practices in each country. Target recruitment percentages were derived either from scientific publications or from expert panels in each participating country. The minimum follow-up period will be 12 months, with a maximum of 27 months, taking into account the retrospective and the prospective parts of the study. Data on demographics, diagnosis, medical history, clinical management, clinical and functional outcomes (CGI-BP and FAST scales, adherence to treatment (DAI-10 scale and Medication Possession Ratio, quality of life (EQ-5D scale, healthcare resources, and caregiver burden (BAS scale

Polycystic ovary syndrome: a review for dermatologists: Part II. Treatment.

Science.gov (United States)

Buzney, Elizabeth; Sheu, Johanna; Buzney, Catherine; Reynolds, Rachel V

2014-11-01

Dermatologists are in a key position to treat the manifestations of polycystic ovary syndrome (PCOS). The management of PCOS should be tailored to each woman's specific goals, reproductive interests, and particular constellation of symptoms. Therefore, a multidisciplinary approach is recommended. In part II of this continuing medical education article, we present the available safety and efficacy data regarding treatments for women with acne, hirsutism, and androgenetic alopecia. Therapies discussed include lifestyle modification, topical therapies, combined oral contraceptives, antiandrogen agents, and insulin-sensitizing drugs. Treatment recommendations are made based on the current available evidence. Copyright © 2014 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

Recovery in soccer : part ii-recovery strategies.

Science.gov (United States)

Nédélec, Mathieu; McCall, Alan; Carling, Chris; Legall, Franck; Berthoin, Serge; Dupont, Gregory

2013-01-01

In the formerly published part I of this two-part review, we examined fatigue after soccer matchplay and recovery kinetics of physical performance, and cognitive, subjective and biological markers. To reduce the magnitude of fatigue and to accelerate the time to fully recover after completion, several recovery strategies are now used in professional soccer teams. During congested fixture schedules, recovery strategies are highly required to alleviate post-match fatigue, and then to regain performance faster and reduce the risk of injury. Fatigue following competition is multifactorial and mainly related to dehydration, glycogen depletion, muscle damage and mental fatigue. Recovery strategies should consequently be targeted against the major causes of fatigue. Strategies reviewed in part II of this article were nutritional intake, cold water immersion, sleeping, active recovery, stretching, compression garments, massage and electrical stimulation. Some strategies such as hydration, diet and sleep are effective in their ability to counteract the fatigue mechanisms. Providing milk drinks to players at the end of competition and a meal containing high-glycaemic index carbohydrate and protein within the hour following the match are effective in replenishing substrate stores and optimizing muscle-damage repair. Sleep is an essential part of recovery management. Sleep disturbance after a match is common and can negatively impact on the recovery process. Cold water immersion is effective during acute periods of match congestion in order to regain performance levels faster and repress the acute inflammatory process. Scientific evidence for other strategies reviewed in their ability to accelerate the return to the initial level of performance is still lacking. These include active recovery, stretching, compression garments, massage and electrical stimulation. While this does not mean that these strategies do not aid the recovery process, the protocols implemented up until

Ocean Thermal Energy Converstion (OTEC) test facilities study program. Final report. Volume II. Part B

Energy Technology Data Exchange (ETDEWEB)

None

1977-01-17

Results are presented of an 8-month study to develop alternative non-site-specific OTEC facilities/platform requirements for an integrated OTEC test program which may include land and floating test facilities. Volume II--Appendixes is bound in three parts (A, B, and C) which together comprise a compendium of the most significant detailed data developed during the study. Part B provides an annotated test list and describes component tests and system tests.

Not-for-profit versus for-profit health care providers--Part II: Comparing and contrasting their records.

Science.gov (United States)

Rotarius, Timothy; Trujillo, Antonio J; Liberman, Aaron; Ramirez, Bernardo

2006-01-01

The debate over which health care providers are most capably meeting their responsibilities in serving the public's interest continues unabated, and the comparisons of not-for-profit (NFP) versus for-profit (FP) hospitals remain at the epicenter of the discussion. From the perspective of available factual information, which of the two sides to this debate is correct? This article is part II of a 2-part series on comparing and contrasting the performance records of NFP health care providers with their FP counterparts. Although it is demonstrated that both NFP and FP providers perform virtuous and selfless feats on behalf of America's public, it is also shown that both camps have been accused of being involved in potentially willful clinical and administrative missteps. Part I provided the background information (eg, legal differences, perspectives on social responsibility, and types of questionable and fraudulent behavior) required to adequately understand the scope of the comparison issue. Part II offers actual comparisons of the 2 organizational structures using several disparate factors such as specific organizational behaviors, approach to the health care priorities of cost and quality, and business-focused goals of profits, efficiency, and community benefit.

Eleventh annual meeting, Bologna, Italy, 17-20 April 1978. Summary report. Part II

Energy Technology Data Exchange (ETDEWEB)

NONE

1978-07-01

The Summary Report - Part II of the Eleventh Annual Meeting of the IAEA International Working Group on Fast Reactors - includes reports on development of fast reactors in France from 1977 to 1978; review of the activities related to fast reactors in Germany; status of fast breeder reactors development in Belgium and Netherlands; status of activities related to fast reactors in USSR, Japan USA, UK and Italy.

Eleventh annual meeting, Bologna, Italy, 17-20 April 1978. Summary report. Part II

International Nuclear Information System (INIS)

1978-07-01

The Summary Report - Part II of the Eleventh Annual Meeting of the IAEA International Working Group on Fast Reactors - includes reports on development of fast reactors in France from 1977 to 1978; review of the activities related to fast reactors in Germany; status of fast breeder reactors development in Belgium and Netherlands; status of activities related to fast reactors in USSR, Japan USA, UK and Italy

A legacy of struggle: the OSHA ergonomics standard and beyond, Part II.

Science.gov (United States)

Delp, Linda; Mojtahedi, Zahra; Sheikh, Hina; Lemus, Jackie

2014-11-01

The OSHA ergonomics standard issued in 2000 was repealed within four months through a Congressional resolution that limits future ergonomics rulemaking. This section continues the conversation initiated in Part I, documenting a legacy of struggle for an ergonomics standard through the voices of eight labor, academic, and government key informants. Part I summarized important components of the standard; described the convergence of labor activism, research, and government action that laid the foundation for a standard; and highlighted the debates that characterized the rulemaking process. Part II explores the anti-regulatory political landscape of the 1990s, as well as the key opponents, power dynamics, and legal maneuvers that led to repeal of the standard. This section also describes the impact of the ergonomics struggle beyond the standard itself and ends with a discussion of creative state-level policy initiatives and coalition approaches to prevent work-related musculoskeletal disorders (WMSDs) in today's sociopolitical context.

Title II, Part A: Don't Scrap It, Don't Dilute It, Fix It

Science.gov (United States)

Coggshall, Jane G.

2015-01-01

The Issue: Washington is taking a close look at Title II, Part A (Title IIA) of the Elementary and Secondary Education Act (ESEA) as Congress debates reauthorization. The program sends roughly $2.5 billion a year to all states and nearly all districts to "(1) increase student academic achievement through strategies such as improving teacher…

Instructional Climates in Preschool Children Who Are At-Risk. Part II: Perceived Physical Competence

Science.gov (United States)

Robinson, Leah E.; Rudisill, Mary E.; Goodway, Jacqueline D.

2009-01-01

In Part II of this study, we examined the effect of two 9-week instructional climates (low-autonomy [LA] and mastery motivational climate [MMC]) on perceived physical competence (PPC) in preschoolers (N = 117). Participants were randomly assigned to an LA, MMC, or comparison group. PPC was assessed by a pretest, posttest, and retention test with…

Beyond Attributable Burden: Estimating the Avoidable Burden of Disease Associated with Household Air Pollution.

Directory of Open Access Journals (Sweden)

Randall Kuhn

Full Text Available The Global Burden of Disease (GBD studies have transformed global understanding of health risks by producing comprehensive estimates of attributable disease burden, or the current disease that would be eliminated if a risk factor did not exist. Yet many have noted the greater policy significance of avoidable burden, or the future disease that could actually be eliminated if a risk factor were eliminated today. Avoidable risk may be considerably lower than attributable risk if baseline levels of exposure or disease are declining, or if a risk factor carries lagged effects on disease. As global efforts to deliver clean cookstoves accelerate, a temporal estimation of avoidable risk due to household air pollution (HAP becomes increasingly important, particularly in light of the rapid uptake of modern stoves and ongoing epidemiologic transitions in regions like South and Southeast Asia.We estimate the avoidable burden associated with HAP using International Futures (IFs, an integrated forecasting system that has been used to model future global disease burdens and risk factors. Building on GBD and other estimates, we integrated a detailed HAP exposure estimation and exposure-response model into IFs. We then conducted a counterfactual experiment in which HAP exposure is reduced to theoretical minimum levels in 2015. We evaluated avoidable mortality and DALY reductions for the years 2015 to 2024 relative to a Base Case scenario in which only endogenous changes occurred. We present results by cause and region, looking at impacts on acute lower respiratory infection (ALRI and four noncommunicable diseases (NCDs. We found that just 2.6% of global DALYs would be averted between 2015 and 2024, compared to 4.5% of global DALYs attributed to HAP in the 2010 GBD study, due in large part to the endogenous tendency towards declining traditional stove usage in the IFs base case forecast. The extent of diminished impact was comparable for ALRI and affected NCDs

Burden control by artificial intelligence

Energy Technology Data Exchange (ETDEWEB)

Saxen, H.; Nikus, M. [Aabo Akademi, Turku (Finland). Heat Engineering Lab.

1998-07-01

The burden distribution plays an important role for the fuel economy of the blast furnace. By an appropriate burden distribution, the operation of the furnace is smooth and the gas is utilized well, the burden descends steadily and the wear of the lining is minimal. Since it is very difficult to obtain reliable information about the burden distribution in operating blast furnaces, this research project developed methods for interpretation of burden and gas distribution in the shaft mainly based on temperature measurements from above-burden probes.

Optimal recombination in genetic algorithms for combinatorial optimization problems: Part II

Directory of Open Access Journals (Sweden)

Eremeev Anton V.

2014-01-01

Full Text Available This paper surveys results on complexity of the optimal recombination problem (ORP, which consists in finding the best possible offspring as a result of a recombination operator in a genetic algorithm, given two parent solutions. In Part II, we consider the computational complexity of ORPs arising in genetic algorithms for problems on permutations: the Travelling Salesman Problem, the Shortest Hamilton Path Problem and the Makespan Minimization on Single Machine and some other related problems. The analysis indicates that the corresponding ORPs are NP-hard, but solvable by faster algorithms, compared to the problems they are derived from.

The basic science of dermal fillers: past and present Part II: adverse effects.

Science.gov (United States)

Gilbert, Erin; Hui, Andrea; Meehan, Shane; Waldorf, Heidi A

2012-09-01

The ideal dermal filler should offer long-lasting aesthetic improvement with a minimal side-effect profile. It should be biocompatible and stable within the injection site, with the risk of only transient undesirable effects from injection alone. However, all dermal fillers can induce serious and potentially long-lasting adverse effects. In Part II of this paper, we review the most common adverse effects related to dermal filler use.

Biology and Mechanics of Blood Flows Part II: Mechanics and Medical Aspects

CERN Document Server

Thiriet, Marc

2008-01-01

Biology and Mechanics of Blood Flows presents the basic knowledge and state-of-the-art techniques necessary to carry out investigations of the cardiovascular system using modeling and simulation. Part II of this two-volume sequence, Mechanics and Medical Aspects, refers to the extraction of input data at the macroscopic scale for modeling the cardiovascular system, and complements Part I, which focuses on nanoscopic and microscopic components and processes. This volume contains chapters on anatomy, physiology, continuum mechanics, as well as pathological changes in the vasculature walls including the heart and their treatments. Methods of numerical simulations are given and illustrated in particular by application to wall diseases. This authoritative book will appeal to any biologist, chemist, physicist, or applied mathematician interested in the functioning of the cardiovascular system.

Formulation, computation and improvement of steady state security margins in power systems. Part II: Results

International Nuclear Information System (INIS)

Echavarren, F.M.; Lobato, E.; Rouco, L.; Gomez, T.

2011-01-01

A steady state security margin for a particular operating point can be defined as the distance from this initial point to the secure operating limits of the system. Four of the most used steady state security margins are the power flow feasibility margin, the contingency feasibility margin, the load margin to voltage collapse, and the total transfer capability between system areas. This is the second part of a two part paper. Part I has proposed a novel framework of a general model able to formulate, compute and improve any steady state security margin. In Part II the performance of the general model is validated by solving a variety of practical situations in modern real power systems. Actual examples of the Spanish power system will be used for this purpose. The same computation and improvement algorithms outlined in Part I have been applied for the four security margins considered in the study, outlining the convenience of defining a general framework valid for the four of them. The general model is used here in Part II to compute and improve: (a) the power flow feasibility margin (assessing the influence of the reactive power generation limits in the Spanish power system), (b) the contingency feasibility margin (assessing the influence of transmission and generation capacity in maintaining a correct voltage profile), (c) the load margin to voltage collapse (assessing the location and quantity of loads that must be shed in order to be far away from voltage collapse) and (d) the total transfer capability (assessing the export import pattern of electric power between different areas of the Spanish system). (author)

Formulation, computation and improvement of steady state security margins in power systems. Part II: Results

Energy Technology Data Exchange (ETDEWEB)

Echavarren, F.M.; Lobato, E.; Rouco, L.; Gomez, T. [School of Engineering of Universidad Pontificia Comillas, C/Alberto Aguilera, 23, 28015 Madrid (Spain)

2011-02-15

A steady state security margin for a particular operating point can be defined as the distance from this initial point to the secure operating limits of the system. Four of the most used steady state security margins are the power flow feasibility margin, the contingency feasibility margin, the load margin to voltage collapse, and the total transfer capability between system areas. This is the second part of a two part paper. Part I has proposed a novel framework of a general model able to formulate, compute and improve any steady state security margin. In Part II the performance of the general model is validated by solving a variety of practical situations in modern real power systems. Actual examples of the Spanish power system will be used for this purpose. The same computation and improvement algorithms outlined in Part I have been applied for the four security margins considered in the study, outlining the convenience of defining a general framework valid for the four of them. The general model is used here in Part II to compute and improve: (a) the power flow feasibility margin (assessing the influence of the reactive power generation limits in the Spanish power system), (b) the contingency feasibility margin (assessing the influence of transmission and generation capacity in maintaining a correct voltage profile), (c) the load margin to voltage collapse (assessing the location and quantity of loads that must be shed in order to be far away from voltage collapse) and (d) the total transfer capability (assessing the export import pattern of electric power between different areas of the Spanish system). (author)

High perceived caregiver burden for relatives of patients following hip fracture surgery

DEFF Research Database (Denmark)

Ariza-Vega, Patrocinio; Ortiz-Piña, Mariana; Kristensen, Morten Tange

2018-01-01

treatment strategies such as the support and training of the caregivers in patient handling during hospital stay could be carried out to reduce caregiver burden. Implications for rehabilitation The main caregiver of a hip fracture patient is usually a woman who is the daughter of the patient, and reducing...... her burden of care should be included as one of the objectives of rehabilitation treatment. The caregivers of hip fracture patients must be considered as part of the treatment during the patient's recovery period, and patient handling training should be provided to the caregivers of hip fracture......PURPOSE: To determine the profile of the main informal caregivers, the evolution of the caregiver burden, and the influencing factors of caregiver burden at 1-year after hip fracture surgery. METHODS: In this prospective cohort study, a total of 172 informal caregivers of patients were interviewed...

Exploring Water Pollution. Part II

Science.gov (United States)

Rillo, Thomas J.

1975-01-01

This is part two of a three part article related to the science activity of exploring environmental problems. Part one dealt with background information for the classroom teacher. Presented here is a suggested lesson plan on water pollution. Objectives, important concepts and instructional procedures are suggested. (EB)

Part I: $\\beta$-delayed fission, laser spectroscopy and shape-coexistence studies with astatine beams; Part II: Delineating the island of deformation in the light gold isotopes by means of laser spectroscopy

CERN Document Server

Andreyev, Andrei

2013-01-01

Part I: $\\beta$-delayed fission, laser spectroscopy and shape-coexistence studies with astatine beams; Part II: Delineating the island of deformation in the light gold isotopes by means of laser spectroscopy

Final environmental statement. Final addendum to Part II: Manufacture of floating nuclear power plants by Offshore Power Systems. DOCKET-STN--50-437

International Nuclear Information System (INIS)

1978-06-01

This Addendum to Part II of the Final Environmental Statement related to manufacture of floating nuclear power plants by Offshore Power Systems (OPS), NUREG-0056, issued September 1976, was prepared by the U.S. Nuclear Regulatory Commission (NRC), Office of Nuclear Reactor Regulation. The staff's basic evaluation is presented in NUREG-0056. The current Addendum provides further consideration of a number of topics discussed in NUREG-0056, particularly additional consideration of shore zone siting at estuarine and ocean regions. This Summary and Conclusions recapitulates and is cumulative for Part II of the FES and the current Addendum. Augmentations to the Summary and Conclusions presented in Part II of the FES and arising from the evaluations contained in this Addendum are italicized

Interaction of ethanol and mercury body burden in the mouse

Energy Technology Data Exchange (ETDEWEB)

Dunn, J.D.

1978-01-01

The interaction of ethanol with mercury in the body resulting in increased exhalation of the metal was studied in the mouse. A persistent elimination of the metal in the breath was demonstrated after single, sublethal (<1 mgHg/Kg body weight) exposures to mercury vapor (Hg/sup 0/) or mercury II chloride (HgCl/sub 2/). The amount of mercury exhaled per unit time was enhanced by oral or parenteral administration of ethanol solutions. These modifications were investigated in dose-response studies in which the drug was administered in doses ranging from 0.2g to 5.5g/Kg to mice pretreated with mercury. The EC/sub 50/ for blood ethanol with respect to mercury exhalation was determined to be approximately 200 mg/dl corresponding to an output rate of approximately 0.1% of the simultaneous body burden in 30 min several days after mercury. A hypothesis that mercury expired by these animals was proportional to the body burden after mercury administration was addressed in experiments whereby mice given one of several doses of mercuric chloride (0.16 to 500 ..mu..g/Kg) were monitored for pulmonary mercury elimination for a fifteen day period. The high correlation obtained between the amount of mercury exhaled in a standard time period and the body burden by group indicated that breath sampling could be applied as an indicator of the mercury body burden which may not be limited to the mouse.

Characterization of MHC class I and II genes in a subantarctic seabird, the blue petrel, Halobaena caerulea (Procellariiformes).

Science.gov (United States)

Strandh, Maria; Lannefors, Mimi; Bonadonna, Francesco; Westerdahl, Helena

2011-10-01

The great polymorphism observed in the major histocompatibility complex (MHC) genes is thought to be maintained by pathogen-mediated selection possibly combined with MHC-disassortative mating, guided by MHC-determined olfactory cues. Here, we partly characterize the MHC class I and II B of the blue petrel, Halobaena caerulea (Procellariiformes), a bird with significant olfactory abilities that lives under presumably low pathogen burdens in Subantarctica. Blue petrels are long-lived, monogamous birds which suggest the necessity of an accurate mate choice process. The species is ancestral to songbirds (Passeriformes; many MHC loci), although not to gamefowls (Galliformes; few MHC loci). Considering the phylogenetic relationships and the low subantarctic pathogen burden, we expected few rather than many MHC loci in the blue petrel. However, when we analysed partial MHC class I and class II B cDNA and gDNA sequences we found evidence for as many as at least eight MHC class I loci and at least two class II B loci. These class I and II B sequences showed classical MHC characteristics, e.g. high nucleotide diversity, especially in putative peptide-binding regions where signatures of positive selection was detected. Trans-species polymorphism was found between MHC class II B sequences of the blue petrel and those of thin-billed prion, Pachyptila belcheri, two species that diverged ∼25 MYA. The observed MHC allele richness in the blue petrel may well serve as a basis for mate choice, especially since olfactory discrimination of MHC types may be possible in this species.

Nuclear fuel technology - Determination of uranium in solutions, uranium hexafluoride and solids - Part 2: Iron(II) reduction/cerium(IV) oxidation titrimetric method

International Nuclear Information System (INIS)

2004-01-01

This first edition of ISO 7097-1 together with ISO 7097-2:2004 cancels and replaces ISO 7097:1983, which has been technically revised, and ISO 9989:1996. ISO 7097 consists of the following parts, under the general title Nuclear fuel technology - Determination of uranium in solutions, uranium hexafluoride and solids: Part 1: Iron(II) reduction/potassium dichromate oxidation titrimetric method; Part 2: Iron(II) reduction/cerium(IV) oxidation titrimetric method. This part 2. of ISO 7097 describes procedures for determination of uranium in solutions, uranium hexafluoride and solids. The procedures described in the two independent parts of this International Standard are similar: this part uses a titration with cerium(IV) and ISO 7097-1 uses a titration with potassium dichromate

Nuclear fuel technology - Determination of uranium in solutions, uranium hexafluoride and solids - Part 1: Iron(II) reduction/potassium dichromate oxidation titrimetric method

International Nuclear Information System (INIS)

2004-01-01

This first edition of ISO 7097-1 together with ISO 7097-2:2004 cancels and replaces ISO 7097:1983, which has been technically revised, and ISO 9989:1996. ISO 7097 consists of the following parts, under the general title Nuclear fuel technology - Determination of uranium in solutions, uranium hexafluoride and solids: Part 1: Iron(II) reduction/potassium dichromate oxidation titrimetric method; Part 2: Iron(II) reduction/cerium(IV) oxidation titrimetric method. This part 1. of ISO 7097 describes procedures for the determination of uranium in solutions, uranium hexafluoride and solids. The procedures described in the two independent parts of this International Standard are similar: this part uses a titration with potassium dichromate and ISO 7097-2 uses a titration with cerium(IV)

Current antiviral drugs and their analysis in biological materials - Part II: Antivirals against hepatitis and HIV viruses.

Science.gov (United States)

Nováková, Lucie; Pavlík, Jakub; Chrenková, Lucia; Martinec, Ondřej; Červený, Lukáš

2018-01-05

This review is a Part II of the series aiming to provide comprehensive overview of currently used antiviral drugs and to show modern approaches to their analysis. While in the Part I antivirals against herpes viruses and antivirals against respiratory viruses were addressed, this part concerns antivirals against hepatitis viruses (B and C) and human immunodeficiency virus (HIV). Many novel antivirals against hepatitis C virus (HCV) and HIV have been introduced into the clinical practice over the last decade. The recent broadening portfolio of these groups of antivirals is reflected in increasing number of developed analytical methods required to meet the needs of clinical terrain. Part II summarizes the mechanisms of action of antivirals against hepatitis B virus (HBV), HCV, and HIV, their use in clinical practice, and analytical methods for individual classes. It also provides expert opinion on state of art in the field of bioanalysis of these drugs. Analytical methods reflect novelty of these chemical structures and use by far the most current approaches, such as simple and high-throughput sample preparation and fast separation, often by means of UHPLC-MS/MS. Proper method validation based on requirements of bioanalytical guidelines is an inherent part of the developed methods. Copyright © 2017 Elsevier B.V. All rights reserved.

The current total economic burden of diabetes mellitus in the Netherlands.

Science.gov (United States)

Peters, M L; Huisman, E L; Schoonen, M; Wolffenbuttel, B H R

2017-09-01

Insight into the total economic burden of diabetes mellitus (DM) is essential for decision makers and payers. Currently available estimates for the Netherlands only include part of the total burden or are no longer up-to-date. Therefore, this study aimed to determine the current total economic burden of DM and its complications in the Netherlands, by including all the relevant cost components. The study combined a systematic literature review to identify all relevant published information and a targeted review to identify relevant information in the grey literature. The identified evidence was then combined to estimate the current total economic burden. In 2016, there were an estimated 1.1 million DM patients in the Netherlands, of whom approximately 10% had type 1 and 90% had type 2 DM. The estimated current total economic burden of DM was € 6.8 billion in 2016. Healthcare costs (excluding costs of complications) were € 1.6 billion, direct costs of complications were € 1.3 billion and indirect costs due to productivity losses, welfare payments and complications were € 4.0 billion. DM and its complications pose a substantial economic burden to the Netherlands, which is expected to rise due to changing demographics and lifestyle. Indirect costs, such as welfare payments, accounted for a large portion of the current total economic burden of DM, while these cost components are often not included in cost estimations. Publicly available data for key cost drivers such as complications were scarce.

The heterogeneity in financial and time burden of caregiving to children with chronic conditions.

Science.gov (United States)

Zan, Hua; Scharff, Robert L

2015-03-01

We examine the financial and time burdens associated with caring for children with chronic conditions, focusing on disparities across types of conditions. Using linked data from the 2003 to 2006 National Health Interview Survey and 2004-2008 Medical Expenditure Panel Survey, we created measures of financial burden (out-of-pocket healthcare costs, the ratio of out-of-pocket healthcare costs to family income, healthcare costs paid by insurance, and total healthcare costs) and time burden (missed school time due to illness or injury and the number of doctor visits) associated with 14 groups of children's chronic conditions. We used the two-part model to assess the effect of condition on financial burden and finite mixture/latent class model to analyze the time burden of caregiving. Controlling for the influences of other socio-demographic characteristics on caregiving burden, children with chronic conditions have higher financial and time burdens relative to caregiving burdens for healthy children. Levels of financial burden and burden sharing between families and insurance system also vary by type of condition. For example, children with pervasive developmental disorder or heart disease have a relatively low financial burden for families, while imposing a high cost on the insurance system. In contrast, vision difficulties are associated with a high financial burden for families relative to the costs borne by others. With respect to time burden, conditions such as cerebral palsy and heart disease impose a low time burden, while conditions such as pervasive developmental disorder are associated with a high time burden. This study demonstrates that differences exist in caregiving burden for children by type of chronic condition. Each condition has a unique profile of time and financial cost burden for families and the insurance system. These results have implications for policymakers and for families' savings and employment decisions.

Optimising molecular diagnostic capacity for effective control of tuberculosis in high-burden settings.

Science.gov (United States)

Sabiiti, W; Mtafya, B; Kuchaka, D; Azam, K; Viegas, S; Mdolo, A; Farmer, E C W; Khonga, M; Evangelopoulos, D; Honeyborne, I; Rachow, A; Heinrich, N; Ntinginya, N E; Bhatt, N; Davies, G R; Jani, I V; McHugh, T D; Kibiki, G; Hoelscher, M; Gillespie, S H

2016-08-01

The World Health Organization's 2035 vision is to reduce tuberculosis (TB) associated mortality by 95%. While low-burden, well-equipped industrialised economies can expect to see this goal achieved, it is challenging in the low- and middle-income countries that bear the highest burden of TB. Inadequate diagnosis leads to inappropriate treatment and poor clinical outcomes. The roll-out of the Xpert(®) MTB/RIF assay has demonstrated that molecular diagnostics can produce rapid diagnosis and treatment initiation. Strong molecular services are still limited to regional or national centres. The delay in implementation is due partly to resources, and partly to the suggestion that such techniques are too challenging for widespread implementation. We have successfully implemented a molecular tool for rapid monitoring of patient treatment response to anti-tuberculosis treatment in three high TB burden countries in Africa. We discuss here the challenges facing TB diagnosis and treatment monitoring, and draw from our experience in establishing molecular treatment monitoring platforms to provide practical insights into successful optimisation of molecular diagnostic capacity in resource-constrained, high TB burden settings. We recommend a holistic health system-wide approach for molecular diagnostic capacity development, addressing human resource training, institutional capacity development, streamlined procurement systems, and engagement with the public, policy makers and implementers of TB control programmes.

II: Through the Western Part of the City: Charlottenburg

Science.gov (United States)

Hoffmann, Dieter

Until 1920 the city we now call Berlin was a collection of independent towns and villages — among them Charlottenburg, which was one of the most important and was the proud sister of Berlin, Prussia’s and Germany’s capital, where the wealthy and innovative bourgeoisie lived. Werner von Siemens, Germany’s pioneer in the modern electrical industry, was a prime example of that elite. His castle-like villa was located not far from today’s Ernst-Reuter-Platz at Otto-Suhr-Allee 10-16, and important parts of his enterprise expanded into the “meadows outside of Charlottenburg” during the second half of the 19th century. It was no accident that the efforts to unite Berlin’s two colleges for trade and construction (both founded around 1800) led to the foundation of a modern Technical College in Charlottenburg in 1879, today’s Technical University of Berlin. Its magnificent main building (figure 1), which was opened in 1882 by the German Emperor, was an expression of the great self-confidence of this new institution of higher learning and of Charlottenburg’s bourgeoisie. Although large parts of the building were destroyed by bombs during World War II, you can still get an impression of its monumentality from what survived at number 135 Strasse des 17. Juni.

How big is the next big thing? Estimating the burden of non–communicable diseases in low–and middle–income countries

Directory of Open Access Journals (Sweden)

Kit Yee Chan

2012-12-01

Full Text Available Non-communicable causes of death and disability will dominate global health agenda for the foreseeable future. The progress in addressing their burden and achieving measurable reduction in low– and middle– income countries (LMICs will likely require similar steps that were effective in reducing maternal and child mortality globally: (i defining the size of the burden and the main causes responsible for the majority of the burden; (ii understanding the most important risk factors and their importance in different contexts; (iii systematically assessing the effectiveness and cost of the interventions that are feasible and available in LMICs; and (iv formulating evidence–based health policies that will define appropriate health care and health research priorities to tackle the burden in the most cost–effective way.

Music in the exercise domain: a review and synthesis (Part II).

Science.gov (United States)

Karageorghis, Costas I; Priest, David-Lee

2012-03-01

Since a 1997 review by Karageorghis and Terry, which highlighted the state of knowledge and methodological weaknesses, the number of studies investigating musical reactivity in relation to exercise has swelled considerably. In this two-part review paper, the development of conceptual approaches and mechanisms underlying the effects of music are explicated (Part I), followed by a critical review and synthesis of empirical work (spread over Parts I and II). Pre-task music has been shown to optimise arousal, facilitate task-relevant imagery and improve performance in simple motoric tasks. During repetitive, endurance-type activities, self-selected, motivational and stimulative music has been shown to enhance affect, reduce ratings of perceived exertion, improve energy efficiency and lead to increased work output. There is evidence to suggest that carefully selected music can promote ergogenic and psychological benefits during high-intensity exercise, although it appears to be ineffective in reducing perceptions of exertion beyond the anaerobic threshold. The effects of music appear to be at their most potent when it is used to accompany self-paced exercise or in externally valid conditions. When selected according to its motivational qualities, the positive impact of music on both psychological state and performance is magnified. Guidelines are provided for future research and exercise practitioners.

Air Pollution, Disease Burden, and Health Economic Loss in China.

Science.gov (United States)

Niu, Yue; Chen, Renjie; Kan, Haidong

2017-01-01

As the largest developing country in the world, China is now facing one of the severest air pollution problems. The objective of this section is to evaluate the disease burden and corresponding economic loss attributable to ambient air pollution in China. We reviewed a series of studies by Chinese or foreign investigators focusing on the disease burden and economic loss in China. These studies showed both the general air pollution and haze episodes have resulted in substantial disease burden in terms of excess number of premature deaths, disability-adjusted life-year loss, and years of life lost. The corresponding economic loss has accounted for an appreciable proportion of China's national economy. Overall, the disease burden and health economic loss due to ambient air pollution in China is greater than in the remaining parts of the world, for one of the highest levels of air pollution and the largest size of exposed population. Consideration of both health and economic impacts of air pollution can facilitate the Chinese government to develop environmental policies to reduce the emissions of various air pollutants and protect the public health.

[Occupational burdens in special educators working with intellectually disabled students].

Science.gov (United States)

Plichta, Piotr

2014-01-01

The article presents the results of psychosocial burdens in special educators (specialists in the field of oligophrenopedagogy) with intellectually disabled students. In theoretical part, specific context of occupational stress in special educators was introduced. Additionally, the need of broader research context regarding occupational stress and the risk of burnout in special educators working with intellectually disabled individuals were included. The results were obtained using Plichta and Pyzalski's Questionnaire of Occupational Burdens in Teaching (QOBT). The presented results are based on a research sample (N = 100) of special educators (female) teaching intellectually disabled students attending special schools in the city of Lódz. The obtained results were compared with the results coming from a large random sample of public school teachers working with non-intellectually disabled children from the Lodi voivodeship (N = 429) and referred to the norms of QOBT. The results show significant percentage of respondents obtaining high level of occupational burdens (conflict situations - 45%, organizational burdens - 31%, lack of work sense - 40%, global score - 40%). Seniority is not related to the level of burdens. Some significant differences concerning the level of occupational burdens between both groups of teachers were found. The study showed e.g. the strong need for supporting special educators in the workplace context and the need of implementing preventive and remedial measures at both individual and organizational levels (especially in terms of improving personal relationships in a workplace). Generally, the results show similarity of the stressors' ranking in special educators and school teachers working with non-intellectually disabled children.

77 FR 39201 - 16 CFR Part 23

Science.gov (United States)

2012-07-02

... they continue to achieve their intended purpose without unduly burdening commerce. As part of this review, the Commission requests public comments on the overall costs, benefits, necessity, [[Page 39202... burdening commerce. The Commission schedules its regulations and guides for review on a ten-year cycle; i.e...

The Burden of Tick-Borne Encephalitis in Disability-Adjusted Life Years (DALYs) for Slovenia.

Science.gov (United States)

Šmit, Renata; Postma, Maarten J

2015-01-01

Tick-borne encephalitis (TBE) presents an increasing burden in many parts of Europe, Asian Russia, Siberia, Asian former USSR and Far East. Incidence can be considered as one way to express the burden. A more comprehensive measure concerns disability-adjusted life years (DALYs), better characterizing the full burden of TBE. TBE burden in DALYs has not yet been estimated, nor has it been specified by the Global Burden of Disease (GBD) studies. The purpose of the present study is to estimate the burden of TBE in Slovenia, expressed in DALYs, both from the population and individual perspectives. We discuss the impact of TBE burden on public health and potential strategies to reduce this burden in Slovenia. The burden of TBE is estimated by using the updated DALYs' methodology first introduced in the GBD project. The DALYs᾽ calculations are based on the health outcomes of the natural course of the disease being modelled. Corrections for under-reporting and under-ascertainment are applied. The impact of uncertainty in parameters in the model was assessed using sensitivity analyses. From the population perspective, total DALYs amount to 3,450 (167.8 per 100,000 population), while from the individual perspective they amount to 3.1 per case in 2011. Notably, the consequences of TBE present a larger burden than TBE itself. TBE presents a relatively high burden expressed in DALYs compared with estimates for other infectious diseases from the GBD 2010 study for Slovenia. Raising awareness and increasing vaccination coverage are needed to reduce TBE and its consequences.

The burden of illness in patients with hereditary angioedema.

Science.gov (United States)

Banerji, Aleena

2013-11-01

Hereditary angioedema (HAE) is a rare genetic disease characterized by long-term recurrent attacks of subcutaneous or submucosal edema in different parts of the body. A comprehensive review of the literature on burden of illness for patients with HAE is presented. A Boolean search was performed using MEDLINE and EMBASE databases and the Internet. Articles discussing aspects of the burden of illness in HAE were selected. Topics focused on the course of the disease, nature of attacks, treatment, quality of life, and costs. Hereditary angioedema is associated with a significant and multifaceted disease burden. Diagnosis is often delayed for years, with patients receiving ineffective treatment and unnecessary medical procedures before diagnosis. HAE attacks are painful, unpredictable, and debilitating and often require emergency medical attention. Attacks can affect a patient's daily activities, including work or schooling. Depression and anxiety are prevalent in patients with HAE. Recent advances in treatment provide patients with effective and well-tolerated prophylactic and on-demand therapeutic options. However, end points specific to HAE that better measure the impact of treatment on disease burden are lacking. Furthermore, there is a notable paucity of literature directed toward physicians who are instrumental in diagnosing and treating patients with HAE (eg, emergency department). More publications are broadening the understanding of HAE. However, important gaps remain. Effective management of HAE requires a more comprehensive understanding of the disease burden so that disease management can be individualized to meet specific patient needs. Copyright © 2013 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Characterization of cDNA for human tripeptidyl peptidase II: The N-terminal part of the enzyme is similar to subtilisin

International Nuclear Information System (INIS)

Tomkinson, B.; Jonsson, A-K

1991-01-01

Tripeptidyl peptidase II is a high molecular weight serine exopeptidase, which has been purified from rat liver and human erythrocytes. Four clones, representing 4453 bp, or 90% of the mRNA of the human enzyme, have been isolated from two different cDNA libraries. One clone, designated A2, was obtained after screening a human B-lymphocyte cDNA library with a degenerated oligonucleotide mixture. The B-lymphocyte cDNA library, obtained from human fibroblasts, were rescreened with a 147 bp fragment from the 5' part of the A2 clone, whereby three different overlapping cDNA clones could be isolated. The deduced amino acid sequence, 1196 amino acid residues, corresponding to the longest open rading frame of the assembled nucleotide sequence, was compared to sequences of current databases. This revealed a 56% similarity between the bacterial enzyme subtilisin and the N-terminal part of tripeptidyl peptidase II. The enzyme was found to be represented by two different mRNAs of 4.2 and 5.0 kilobases, respectively, which probably result from the utilziation of two different polyadenylation sites. Futhermore, cDNA corresponding to both the N-terminal and C-terminal part of tripeptidyl peptidase II hybridized with genomic DNA from mouse, horse, calf, and hen, even under fairly high stringency conditions, indicating that tripeptidyl peptidase II is highly conserved

Rise, fall and resurrection of chromosome territories: a historical perspective Part II. Fall and resurrection of chromosome territories during the 1950s to 1980s. Part III. Chromosome territories and the functional nuclear architecture: experiments and m

OpenAIRE

T Cremer; C Cremer

2009-01-01

Part II of this historical review on the progress of nuclear architecture studies points out why the original hypothesis of chromosome territories from Carl Rabl and Theodor Boveri (described in part I) was abandoned during the 1950s and finally proven by compelling evidence forwarded by laser-uvmicrobeam studies and in situ hybridization experiments. Part II also includes a section on the development of advanced light microscopic techniques breaking the classical Abbe limit written for reade...

The global burden of dengue: an analysis from the Global Burden of Disease Study 2013

NARCIS (Netherlands)

J.D. Stanaway (Jeffrey D.); D.S. Shepard (Donald); E.A. Undurraga (Eduardo); Halasa, Y.A. (Yara A); L.E. Coffeng (Luc); Brady, O.J. (Oliver J); Hay, S.I. (Simon I); Bedi, N. (Neeraj); I.M. Bensenor (Isabela M.); C.A. Castañeda-Orjuela (Carlos A); T.-W. Chuang (Ting-Wu); K.B. Gibney (Katherine B); Z.A. Memish (Ziad); A. Rafay (Anwar); K.N. Ukwaja (Kingsley N); N. Yonemoto (Naohiro); C.J.L. Murray (Christopher)

2016-01-01

textabstractBackground Dengue is the most common arbovirus infection globally, but its burden is poorly quantified. We estimated dengue mortality, incidence, and burden for the Global Burden of Disease Study 2013. Methods We modelled mortality from vital registration, verbal autopsy, and

Part I: quantum fluctuations in chains of Josephson junctions. Part II: directed aggregation on the Bethe lattice

International Nuclear Information System (INIS)

Bradley, R.M.

1985-01-01

Part I studies the effect of quantum fluctuations of the phase on the low temperature behavior of two models of Josephson junction chains with Coulomb interactions taken into account. The first model, which represents a chain of junctions close to a ground plane, is the Hamiltonian version of the two-dimensional XY model in one space and one time dimension. In the second model, the charging energy for a single junction in the chain is just the parallel-plate capacitor energy. It is shown that quantum fluctuations produce exponential decay of the order parameter correlation junction for any finite value of the junction capacitance. Part II deals with two types of directed aggregation on the Bethe lattice - directed diffusion-limited aggregation DDLA and ballistic aggregation (BA). In the DDLA problem on finite lattices, an exact nonlinear recursion relation is constructed for the probability distribution of the density. The mean density tends to zero as the lattice size is taken into infinity. Using a mapping between the model with perfect adhesion on contact and another model with a particular value of the adhesion probability, it is shown that the adhesion probability is irrelevant over an interval of values

Design of site specific radiopharmaceuticals for tumor imaging. (Parts I and II)

International Nuclear Information System (INIS)

Van Dort, M.E.

1983-01-01

Part I. Synthetic methods were developed for the preparation of several iodinated benzoic acid hydrazides as labeling moieties for indirect tagging of carbonyl-containing bio-molecules and potential tumor-imaging agents. Biodistribution studies conducted in mice on the derivatives having the I-125 label ortho to a phenolic OH demonstrated a rapid in vivo deiodination. Part II. The reported high melanin binding affinity of quinoline and other heterocyclic antimalarial drugs led to the development of many analogues of such molecules as potential melanoma-imaging agents. Once such analogue iodochloroquine does exhibit high melanin binding, but has found limited clinical use due to appreciable accumulation in non-target tissues such as the adrenal cortex and inner ear. This project developed a new series of candidate melanoma imaging agents which would be easier to radio-label, could yield higher specific activity product, and which might demonstrate more favorable pharmacokinetic and dosimetric characteristics compared to iodochloroquine

Developing guidelines for economic evaluation of environmental impacts in EIAs. Part II: Case studies and dose-response literature

International Nuclear Information System (INIS)

2005-01-01

This Part II of the report contains full versions of the case studies for air, water and land (Chapters 2-4), which were only summarised in Part I. In addition, during the work the research team has collected a large amount of literature and information on dose response relationships for air and water pollution relevant to China. This information is included as Chapters 5 and 6

Developing guidelines for economic evaluation of environmental impacts in EIAs. Part II: Case studies and dose-response literature

Energy Technology Data Exchange (ETDEWEB)

NONE

2005-07-01

This Part II of the report contains full versions of the case studies for air, water and land (Chapters 2-4), which were only summarised in Part I. In addition, during the work the research team has collected a large amount of literature and information on dose response relationships for air and water pollution relevant to China. This information is included as Chapters 5 and 6.

Burden of road traffic injuries related to delays in implementing safety belt laws in low- and lower-middle-income countries.

Science.gov (United States)

Martin, Aurélie; Lagarde, Emmanuel; Salmi, L Rachid

2018-02-28

Delayed implementation of effective road safety policies must be considered when quantifying the avoidable part of the fatal and nonfatal injuries burden. We sought to assess the avoidable part of disability-adjusted life years (DALYs) lost due to road traffic injuries related to delays in implementing road safety laws in low- and lower-middle-income countries. We chose one country for each of the regions of the World Health Organization (WHO) and World Bank (WB) country income levels. We used freely available data sets (WHO, International Traffic Safety Data and Analysis Group, the WB). Delays in implementation were calculated until 2013, from the year mandatory use of safety belts by motor vehicle front seat occupants was first introduced worldwide. We used life expectancy tables and age groups as social values in the DALY calculation model. From the estimated total burden, avoidable DALYs were calculated using estimates of the effectiveness of seat belt laws on fatal and nonfatal injuries combined, as extracted from published international reviews of evidence. From the reference year 1972, implementation delays varied from 27 years (Uzbekistan) to 41 years in Bolivia (no seat belt law as of 2013). During delays, total absolute numbers of DALYs lost due to road traffic injuries reached 8,462,099 in Nigeria, 7,203,570 in Morocco, 4,695,500 in Uzbekistan, 3,866,391 in Cambodia, 3,253,359 in Bolivia, and 3,128,721 in Sri Lanka. Using effectiveness estimates ranging from 3 to 20% reduction, the avoidable burden of road traffic injuries for car occupants was highest in Uzbekistan (avoidable part from 1.2 to 10.4%) and in Morocco (avoidable part from 1.5 to 12.3%). In countries where users of public transport and pedestrians were the most affected by the burden, the avoidable parts ranged from 0.5 to 4.4% (Nigeria) and from 0.5 to 3.4% (Bolivia). Burden of road traffic injuries mostly affected motorcyclists in Sri Lanka and Cambodia where the avoidable parts were

Repository Planning, Design, and Engineering: Part II-Equipment and Costing.

Science.gov (United States)

Baird, Phillip M; Gunter, Elaine W

2016-08-01

Part II of this article discusses and provides guidance on the equipment and systems necessary to operate a repository. The various types of storage equipment and monitoring and support systems are presented in detail. While the material focuses on the large repository, the requirements for a small-scale startup are also presented. Cost estimates and a cost model for establishing a repository are presented. The cost model presents an expected range of acquisition costs for the large capital items in developing a repository. A range of 5,000-7,000 ft(2) constructed has been assumed, with 50 frozen storage units, to reflect a successful operation with growth potential. No design or engineering costs, permit or regulatory costs, or smaller items such as the computers, software, furniture, phones, and barcode readers required for operations have been included.

Occupational burdens in special educators working with intellectually disabled students

Directory of Open Access Journals (Sweden)

Piotr Plichta

2014-04-01

Full Text Available Background: The article presents the results of psychosocial burdens in special educators (specialists in the field of oligophrenopedagogy with intellectually disabled students. In theoretical part, specific context of occupational stress in special educators was introduced. Additionally, the need of broader research context regarding occupational stress and the risk of burnout in special educators working with intellectually disabled individuals were included. Material and Methods: The results were obtained using Plichta and Pyżalski's Questionnaire of Occupational Burdens in Teaching (QOBT. The presented results are based on a research sample (N = 100 of special educators (female teaching intellectually disabled students attending special schools in the city of Łódź. The obtained results were compared with the results coming from a large random sample of public school teachers working with non-intellectually disabled children from the Łodź voivodeship (N = 429 and referred to the norms of QOBT. Results: The results show significant percentage of respondents obtaining high level of occupational burdens (conflict situations - 45%, organizational burdens - 31%, lack of work sense - 40%, global score - 40%. Seniority is not related to the level of burdens. Some significant differences concerning the level of occupational burdens between both groups of teachers were found. Conclusions: The study showed e.g. the strong need for supporting special educators in the workplace context and the need of implementing preventive and remedial measures at both individual and organizational levels (especially in terms of improving personal relationships in a workplace. Generally, the results show similarity of the stressors' ranking in special educators and school teachers working with non-intellectually disabled children. Med Pr 2014;65(2:239–250

Three Mile Island: a report to the commissioners and to the public. Volume II, Part 1

International Nuclear Information System (INIS)

1979-01-01

This is part one of three parts of the second volume of the Special Inquiry Group's report to the Nuclear Regulatory Commission on the accident at Three Mile Island. The first volume contained a narrative description of the accident and a discussion of the major conclusions and recommendations. This second volume is divided into three parts. Part 1 of Volume II focuses on the pre-accident licensing and regulatory background. This part includes an examination of the overall licensing and regulatory system for nuclear powerplants viewed from different perspectives: the system as it is set forth in statutes and regulations, as described in Congressional testimony, and an overview of the system as it really works. In addition, Part 1 includes the licensing, operating, and inspection history of Three Mile Island Unit 2, discussions of relevant regulatory matters, a discussion of specific precursor events related to the accident, a case study of the pressurizer design issue, and an analysis of incentives to declare commercial operation

The humanistic burden of hereditary angioedema: results from the Burden of Illness Study in Europe.

Science.gov (United States)

Caballero, Teresa; Aygören-Pürsün, Emel; Bygum, Anette; Beusterien, Kathleen; Hautamaki, Emily; Sisic, Zlatko; Wait, Suzanne; Boysen, Henrik B

2014-01-01

Hereditary angioedema (HAE) is a rare but potentially life-threatening disease marked by spontaneous, recurrent attacks of swelling. The broad range of consequences of HAE on patients' lives is not well understood. The study objective was to comprehensively characterize the burden of illness and impact of HAE types I and II from the patient perspective. The HAE Burden of Illness Study in Europe was conducted in Spain, Germany, and Denmark to assess the real-world experience of HAE from the patient perspective via a one-time survey, which included items on clinical characteristics and physical and emotional impacts. One hundred eighty-six patients participated; 59% reported having an attack at least once a month, 67% reported moderate-to-severe pain during their last attack, and 74% reported moderate-to-severe swelling. The most common sites of the last attack were the abdomen and extremities; 24% experienced an attack in more than one site. The impact of HAE on daily activities was high during attacks and did not vary significantly by body site affected; patients also reported that HAE impacted their daily activities between attacks. Patients reported substantial anxiety about future attacks, traveling, and passing HAE to their children. Based on Hospital Anxiety and Depression Scale scores, 38 and 14% had clinically meaningful anxiety and depression, respectively. Despite standard of care, HAE patients still have frequent and painful attacks. Patients experience substantial impairment physically and emotionally both during and between attacks. A better understanding of these effects may help in the clinical management of HAE patients.

40 CFR 22.24 - Burden of presentation; burden of persuasion; preponderance of the evidence standard.

Science.gov (United States)

2010-07-01

... persuasion; preponderance of the evidence standard. 22.24 Section 22.24 Protection of Environment... Burden of presentation; burden of persuasion; preponderance of the evidence standard. (a) The complainant has the burdens of presentation and persuasion that the violation occurred as set forth in the...

The Hierarchical Clustering of Tax Burden in the EU27

Directory of Open Access Journals (Sweden)

Simkova Nikola

2015-09-01

Full Text Available The issue of taxation has become more important due to a significant share of the government revenue. There are several ways of expressing the tax burden of countries. This paper describes the traditional approach as a share of tax revenue to GDP which is applied to the total taxation and the capital taxation as a part of tax systems affecting investment decisions. The implicit tax rate on capital created by Eurostat also offers a possible explanation of the tax burden on capital, so its components are analysed in detail. This study uses one of the econometric methods called the hierarchical clustering. The data on which the clustering is based comprises countries in the EU27 for the period of 1995 – 2012. The aim of this paper is to reveal clusters of countries in the EU27 with similar tax burden or tax changes. The findings suggest that mainly newly acceding countries (2004 and 2007 are in a group of countries with a low tax burden which tried to encourage investors by favourable tax rates. On the other hand, there are mostly countries from the original EU15. Some clusters may be explained by similar historical development, geographic and demographic characteristics.

Market Analysis and Consumer Impacts Source Document. Part II. Review of Motor Vehicle Market and Consumer Expenditures on Motor Vehicle Transportation

Science.gov (United States)

1980-12-01

This source document on motor vehicle market analysis and consumer impacts consists of three parts. Part II consists of studies and review on: motor vehicle sales trends; motor vehicle fleet life and fleet composition; car buying patterns of the busi...

Quantitative impact of aerosols on numerical weather prediction. Part II: Impacts to IR radiance assimilation

Science.gov (United States)

Marquis, J. W.; Campbell, J. R.; Oyola, M. I.; Ruston, B. C.; Zhang, J.

2017-12-01

This is part II of a two-part series examining the impacts of aerosol particles on weather forecasts. In this study, the aerosol indirect effects on weather forecasts are explored by examining the temperature and moisture analysis associated with assimilating dust contaminated hyperspectral infrared radiances. The dust induced temperature and moisture biases are quantified for different aerosol vertical distribution and loading scenarios. The overall impacts of dust contamination on temperature and moisture forecasts are quantified over the west coast of Africa, with the assistance of aerosol retrievals from AERONET, MPL, and CALIOP. At last, methods for improving hyperspectral infrared data assimilation in dust contaminated regions are proposed.

Caregiver burden in Alzheimer's disease patients in Spain.

Science.gov (United States)

Peña-Longobardo, Luz María; Oliva-Moreno, Juan

2015-01-01

Alzheimer's disease constitutes one of the leading causes of burden of disease, and it is the third leading disease in terms of economic and social costs. To analyze the burden and problems borne by informal caregivers of patients who suffer from Alzheimer's disease in Spain. We used the Survey on Disabilities, Autonomy and Dependency to obtain information on the characteristics of disabled people with Alzheimer's disease and the individuals who provide them with personal care. Additionally, statistical multivariate analyses using probit models were performed to analyze the burden placed on caregivers in terms of health, professional, and leisure/social aspects. 46% of informal caregivers suffered from health-related problems as a result of providing care, 90% had leisure-related problems, and 75% of caregivers under 65 years old admitted to suffering from problems related to their professional lives. The probability of a problem arising for an informal caregiver was positively associated with the degree of dependency of the person cared for. In the case of caring for a greatly dependent person, the probability of suffering from health-related problems was 22% higher, the probability of professional problems was 18% higher, and there was a 10% greater probability of suffering from leisure-related problems compared to non-dependents. The results show a part of the large hidden cost for society in terms of problems related to the burden lessened by the caregivers. This information should be a useful tool for designing policies focused toward supporting caregivers and improving their welfare.

International Working Group on Fast Reactors Eight Annual Meeting, Vienna, Austria, 15-18 April 1975. Summary Report. Part II

International Nuclear Information System (INIS)

1975-07-01

The Eighth Annual Meeting of the IAEA International Working Group on Past Reactors was held at the IAEA Headquarters in Vienna, Austria, from 15 to 18 April 1975. The Summary Report (Part I) contains the Minutes of the Meeting. The Summary Report (Part II) contains the papers which review the national programmes in the field of LMPBR’s and other presentations at the Meeting. The Summary Report (Part III) contains the discussions on the review of the national programmes

Social class, political power, and the state: their implications in medicine--parts I and II.

Science.gov (United States)

Navarro, V

1976-01-01

This three part article presents an anlysis of the distribution of power and of the nature of the state in Western industrialized societies and details their implications in medicine. Part I presents a critique of contemporary theories of the Western system of power; discusses the countervailing pluralist and power elite theories, as well as those of bureaucratic and professional control; and concludes with an examination of the Marxist theories of economic determinism, structural determinism, and corporate statism. Part II presents a Marxist theory of the role, nature, and characteristics of state intervention. Part III (which will appear in the next issue of this journal) focuses on the mode of that intervention and the reasons for its growth, with an added analysis of the attributes of state intervention in the health sector, and of the dialectical relationship between its growth and the current fiscal crisis of the state. In all three parts, the focus is on Western European countries and on North America, with many examples and categories from the area of medicine.

Reforming Science Education: Part II. Utilizing Kieran Egan's Educational Metatheory

Science.gov (United States)

Schulz, Roland M.

2009-04-01

This paper is the second of two parts and continues the conversation which had called for a shift in the conceptual focus of science education towards philosophy of education, with the requirement to develop a discipline-specific “philosophy” of science education. In Part I, conflicting conceptions of science literacy were identified with disparate “visions” tied to competing research programs as well as school-based curricular paradigms. The impasse in the goals of science education and thereto, the contending views of science literacy, were themselves associated with three underlying fundamental aims of education (knowledge-itself; personal development; socialization) which, it was argued, usually undercut the potential of each other. During periods of “crisis-talk” and throughout science educational history these three aims have repeatedly attempted to assert themselves. The inability of science education research to affect long-term change in classrooms was correlated not only to the failure to reach a consensus on the aims (due to competing programs and to the educational ideologies of their social groups), but especially to the failure of developing true educational theories (largely neglected since Hirst). Such theories, especially metatheories, could serve to reinforce science education’s growing sense of academic autonomy and independence from socio-economic demands. In Part II, I offer as a suggestion Egan’s cultural-linguistic theory as a metatheory to help resolve the impasse. I hope to make reformers familiar with his important ideas in general, and more specifically, to show how they can complement HPS rationales and reinforce the work of those researchers who have emphasized the value of narrative in learning science.

New insights on diabetes mellitus and obesity in Africa-Part 2: prevention, screening and economic burden.

Science.gov (United States)

Kengne, Andre Pascal; Sobngwi, Eugene; Echouffo-Tcheugui, Justin-Basile; Mbanya, Jean-Claude

2013-08-01

Evidence has been accumulating on the importance of the rising burden of diabetes mellitus on the African continent at an increasingly higher pace. In the first paper of this series of two companion papers, recent evidence on the prevalence, pathogenesis and comorbidities of obesity and diabetes mellitus in Africa were summarised. In this second paper, we focus on recent developments pertaining to the prevention, screening and the economic burden of diabetes and obesity on the continent. There are indications that awareness on diabetes and chronic diseases at large has increased in Africa in recent times. However, the care for diabetes largely remains suboptimal in most countries, which are not adequately prepared to face the prevention and control of diabetes, as the costs of caring for the condition pose a tremendous challenge to most local economies. Moreover, translation strategies to prevent and control diabetes and obesity, on the continent, are still to be evaluated.

Caregiver Burden in Alcohol Dependence Syndrome

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Ramanujam Vaishnavi

2017-01-01

Full Text Available Background. Alcoholism is a major threat to the individual as well as the society and the maximum burden of the illness is borne by the family. Aim. The study is aimed at assessing the pattern of burden on the caregivers of alcohol dependent patients and at assessing the relationship between the severity of dependence and the burden on caregivers. Settings and Design. Cross-sectional descriptive study conducted in the Department of Psychiatry, Sri Ramachandra Medical College and Research Institute. Materials and Methods. A cross-sectional assessment was done in 200 patients with alcohol dependence and their caregivers. The severity of dependence and the pattern of burden on caregivers were assessed. Statistical Analysis. The data thus collected was analyzed using SPSS version 20. Results. The study demonstrates that caregivers of alcohol dependent patients reported significant objective burden and subjective burden. Furthermore, the severity of alcohol dependence and the domains of burden such as financial burden, disruption of family interaction, and disruption of family routine activities were positively correlated with high level of significance. Conclusion. The current study has illustrated that all the caregivers experienced significant amount of burden which has to be addressed for better treatment outcome of the patients.

EAMJ Jan. Burden.indd

African Journals Online (AJOL)

2009-01-01

Jan 1, 2009 ... developed world where the burden of disease is accurately determined. ... Projections indicate an expected yearly incidence of 15 to 20 million new .... of global mortality and burden of diseases from 2002 to 2030. Plos. Med.

Advances in Knowledge Discovery and Data Mining 21st Pacific Asia Conference, PAKDD 2017 Held in Jeju, South Korea, May 23 26, 2017. Proceedings Part I, Part II.

Science.gov (United States)

2017-06-27

Data Mining 21’’ Pacific-Asia Conference, PAKDD 2017Jeju, South Korea, May 23-26, Sb. GRANT NUMBER 2017 Proceedings, Part I, Part II Sc. PROGRAM...Springer; Switzerland. 14. ABSTRACT The Pacific-Asia Conference on Knowledge Discovery and Data Mining (PAKDD) is a leading international conference...in the areas of knowledge discovery and data mining (KDD). We had three keynote speeches, delivered by Sang Cha from Seoul National University

(II) complexes

African Journals Online (AJOL)

activities of Schiff base tin (II) complexes. Neelofar1 ... Conclusion: All synthesized Schiff bases and their Tin (II) complexes showed high antimicrobial and ...... Singh HL. Synthesis and characterization of tin (II) complexes of fluorinated Schiff bases derived from amino acids. Spectrochim Acta Part A: Molec Biomolec.

Drinking and its burden in a global perspective: policy considerations and options.

Science.gov (United States)

Room, Robin; Graham, Kathryn; Rehm, Jürgen; Jernigan, David; Monteiro, Maristela

2003-10-01

To identify the policy implications of the magnitude and characteristics of alcohol consumption and problems, viewed globally, and to summarize conclusions on the effectiveness of the strategies available to policymakers concerned with reducing rates of alcohol problems. This summative article draws on the findings of the articles preceding it and of reviews of the literature. Overall volume of consumption is the major factor in the prevalence of harms from drinking. Since consumption and associated problems tend to increase with economic development, policymakers in developing economies should be especially aware of the need to develop policies to minimize overall increases in alcohol consumption. Unrecorded consumption is also an important consideration for policy in many parts of the world, and poses difficulties for alcohol control policies. Drinking pattern is also an important contributing factor toward alcohol-related harm. Although some drinking patterns have been shown to produce beneficial health effects, because the net effect of alcohol on coronary disease is negative in most parts of the world, policies that promote abstinence or lower drinking overall may be the safest options. Moreover, sporadic intoxication is common in many parts of the world, and policies are unlikely to change this drinking pattern at least in the short to medium term. At the same time, because injuries comprise a large proportion of the burden of alcohol, it is appropriate to enhance these policies with targeted harm reduction strategies such as drinking and driving countermeasures and interventions focused on reducing alcohol-related violence in specific high-risk settings. Alcohol consumption is a major factor for the global burden of disease and should be considered a public health priority globally, regionally, and nationally for the vast majority of countries in the world. The need for alcohol policy is even stronger when it is taken into consideration that the burden of

Research protocol for an epidemiological study on estimating disease burden of pediatric HIV in Belgaum district, India

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Anju Sinha

2016-05-01

Full Text Available Abstract Background Pediatric HIV is poised to become a major public health problem in India with the rising trend of HIV infection in pregnant women (Department of AIDS Control, Ministry of Health and Family Welfare, http://www.naco.gov.in. There is lack of information on the epidemiology of pediatric HIV infection in India. Existing surveillance systems tend to underestimate the Pediatric burden. The overall aim of the present study is to estimate the disease burden of pediatric HIV among children in Belgaum district in the state of Karnataka in Southern India. An innovative multipronged epidemiological approach to comb the district is proposed. Methods The primary objectives of the study would be attained under three strategies. A prospective cohort design for objective (i to determine the incidence rate of HIV by early case detection in infants and toddlers (0–18 months born to HIV infected pregnant women; and cross sectional design for objectives (ii to determine the prevalence of HIV infection in children (0–14 years of HIV infected parents and (iii to determine the prevalence of HIV in sick children (0–14 years presenting with suspected signs and symptoms using age specific criteria for screening. Burden of pediatric HIV will be calculated as a product of cases detected in each strategy multiplied by a net inflation factor for each strategy. Study participants (i (ii (iii: HIV infected pregnant women and their live born children (ii Any HIV-infected man/woman, of age 18–49 years, having a biological child of age 0–14 years (iii Sick children of age 0–14 years presenting with suspected signs and symptoms and satisfying age-specific criteria for screening. Setting and conduct: Belgaum district which is a Category ‘A’ district (with more than 1 % antenatal prevalence in the district over the last 3 years before the study. Age-appropriate testing is used to detect HIV infection. Discussion There is a need to strengthen

Research protocol for an epidemiological study on estimating disease burden of pediatric HIV in Belgaum district, India.

Science.gov (United States)

Sinha, Anju; Nath, Anita; Sethumadhavan, Rajeev; Isac, Shajy; Washington, Reynold

2016-05-26

Pediatric HIV is poised to become a major public health problem in India with the rising trend of HIV infection in pregnant women (Department of AIDS Control, Ministry of Health and Family Welfare, http://www.naco.gov.in). There is lack of information on the epidemiology of pediatric HIV infection in India. Existing surveillance systems tend to underestimate the Pediatric burden. The overall aim of the present study is to estimate the disease burden of pediatric HIV among children in Belgaum district in the state of Karnataka in Southern India. An innovative multipronged epidemiological approach to comb the district is proposed. The primary objectives of the study would be attained under three strategies. A prospective cohort design for objective (i) to determine the incidence rate of HIV by early case detection in infants and toddlers (0-18 months) born to HIV infected pregnant women; and cross sectional design for objectives (ii) to determine the prevalence of HIV infection in children (0-14 years) of HIV infected parents and (iii) to determine the prevalence of HIV in sick children (0-14 years) presenting with suspected signs and symptoms using age specific criteria for screening. Burden of pediatric HIV will be calculated as a product of cases detected in each strategy multiplied by a net inflation factor for each strategy. Study participants (i) (ii) (iii): HIV infected pregnant women and their live born children (ii) Any HIV-infected man/woman, of age 18-49 years, having a biological child of age 0-14 years (iii) Sick children of age 0-14 years presenting with suspected signs and symptoms and satisfying age-specific criteria for screening. Setting and conduct: Belgaum district which is a Category 'A' district (with more than 1 % antenatal prevalence in the district over the last 3 years before the study). Age-appropriate testing is used to detect HIV infection. There is a need to strengthen existing pediatric HIV estimation methods in India and other

HERBICIDAS INIBIDORES DO FOTOSSISTEMA II – PARTE I /\tPHOTOSYSTEM II INHIBITOR HERBICIDES - PART I

Directory of Open Access Journals (Sweden)

ILCA P. DE F. E SILVA

2013-11-01

Full Text Available O controle químico tem sido o mais utilizado em grandes áreas de plantio, principalmente por ser um método rápido e eficiente. Os herbicidas inibidores do fotossistema II (PSII são fundamentais para o manejo integrado de plantas daninhas e práticas conservacionista de solo. A aplicação é realizada em pré-emergência ou pós-emergência inicial das plantas daninhas. A absorção é pelas raízes, tendo como barreira as estrias de Caspari, sendo a translocação realizada pelo xilema. O processo de absorção e translocação também são dependentes das próprias características do produto, como as propriedades lipofílicas e hidrofílicas, as quais podem ser medidas através do coeficiente de partição octanol-água (Kow. A inibição da fotossíntese acontece pela ligação dos herbicidas deste grupo ao sítio de ligação da QB, na proteína D1 do fotossistema II, o qual se localiza na membrana dos tilacóides dos cloroplastos, causando, o bloqueia do transporte de elétrons da QA para QB, interrompendo a fixação do CO2 e a produção de ATP e NAPH2.

Societal Planning: Identifying a New Role for the Transport Planner-Part II: Planning Guidelines

DEFF Research Database (Denmark)

Khisty, C. Jotin; Leleur, Steen

1997-01-01

The paper seeks to formulate planning guidelines based on Habermas's theory of communicative action. Specifically, this has led to the formulation of a set of four planning validity claims concerned to four types of planning guidelines concerning adequacy, dependency, suitability and adaptability......-a-vis the planning validity claims. Among other things the contingency of this process is outlined. It is concluded (part I & II) that transport planners can conveniently utilize the guidelines in their professional practice, tailored to their particular settings....

The Global Cancer Burden

Centers for Disease Control (CDC) Podcasts

2012-02-02

This podcast describes the global burden of cancer and efforts by CDC and others to reduce that burden.  Created: 2/2/2012 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 2/2/2012.

Patients' self-perceived burden, caregivers' burden and quality of life for amyotrophic lateral sclerosis patients: a cross-sectional study.

Science.gov (United States)

Geng, Dan; Ou, RuWei; Miao, XiaoHui; Zhao, LiHong; Wei, QianQian; Chen, XuePing; Liang, Yan; Shang, HuiFang; Yang, Rong

2017-10-01

This study surveys the quality of life of amyotrophic lateral sclerosis patients and the factors associated with amyotrophic lateral sclerosis patients' self-perceived burden and their caregivers' burden. Burdens of patients with amyotrophic lateral sclerosis and their caregivers in Chinese population are largely unknown. A cross-sectional study was conducted among 81 pairs of amyotrophic lateral sclerosis patients and their caregivers. Amyotrophic lateral sclerosis patients' self-perceived burden and caregivers' burden were assessed by the Self-Perceived Burden Scale and Zarit-Burden Interview, respectively. Quality of life of amyotrophic lateral sclerosis patients was measured using the World Health Organization Quality of Life-Bref. The amyotrophic lateral sclerosis Functional Rating Scale-Revised questionnaire was used to estimate patients' physical function. Both patients and caregivers reported a mild to moderate burden. The World Health Organization quality of life-Bref scores were decreased in respondents with lower amyotrophic lateral sclerosis Functional Rating Scale-Revised, higher Self-Perceived Burden Scale and higher Zarit-Burden Interview scores. Self-Perceived Burden Scale scores were associated with patients' knowledge of amyotrophic lateral sclerosis, respiratory function and female sex. Zarit-Burden Interview scores were associated with caregivers' age, patients' motor function and out-of-pocket payment. With increase in amyotrophic lateral sclerosis patients' self-perceived burden and caregivers' burden, quality of life of amyotrophic lateral sclerosis patients decreased. Female patients, who had known more about the disease, and those with severe respiratory dysfunction were subject to higher self-perceived burden. Older caregivers and caregivers of patients with severe motor dysfunction and more out-of-pocket payment experienced more care burdens. Our study suggests that paying more attention to female amyotrophic lateral sclerosis patients

Two-loop renormalization in the standard model, part II. Renormalization procedures and computational techniques

Energy Technology Data Exchange (ETDEWEB)

Actis, S. [Deutsches Elektronen-Synchrotron (DESY), Zeuthen (Germany); Passarino, G. [Torino Univ. (Italy). Dipt. di Fisica Teorica; INFN, Sezione di Torino (Italy)

2006-12-15

In part I general aspects of the renormalization of a spontaneously broken gauge theory have been introduced. Here, in part II, two-loop renormalization is introduced and discussed within the context of the minimal Standard Model. Therefore, this paper deals with the transition between bare parameters and fields to renormalized ones. The full list of one- and two-loop counterterms is shown and it is proven that, by a suitable extension of the formalism already introduced at the one-loop level, two-point functions suffice in renormalizing the model. The problem of overlapping ultraviolet divergencies is analyzed and it is shown that all counterterms are local and of polynomial nature. The original program of 't Hooft and Veltman is at work. Finite parts are written in a way that allows for a fast and reliable numerical integration with all collinear logarithms extracted analytically. Finite renormalization, the transition between renormalized parameters and physical (pseudo-)observables, are discussed in part III where numerical results, e.g. for the complex poles of the unstable gauge bosons, are shown. An attempt is made to define the running of the electromagnetic coupling constant at the two-loop level. (orig.)

Open Architecture Standards and Information Systems (OASIS II ...

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

Open Architecture Standards and Information Systems (OASIS II) - Developing Capacity, Sharing Knowledge and Good Principles Across eHealth in Africa. Health care across much of the African continent is hampered by meager resources and a growing burden of disease, with HIV/AIDS, tuberculosis (TB) and malaria ...

Nuclear physics II

International Nuclear Information System (INIS)

Elze, T.

1988-01-01

This script consisting of two parts contains the matter of the courses Nuclear Pyhsics I and II, as they were presented in the winter term 1987/88 and summer term 1988 for students of physics at Frankfurt University. In the present part II the matter of the summer term is summarized. (orig.) [de

Roots/Routes: Part II

Science.gov (United States)

Swanson, Dalene M.

2009-01-01

This narrative acts as an articulation of a journey of many routes. Following Part I of the same research journey of rootedness/routedness, it debates the nature of transformation and transcendence beyond personal and political paradoxes informed by neoliberalism and related repressive globalizing discourses. Through a more personal, descriptive,…

Burden and happiness in head and neck cancer carers: the role of supportive care needs.

Science.gov (United States)

Hanly, Paul; Maguire, Rebecca; Balfe, Myles; Hyland, Philip; Timmons, Aileen; O'Sullivan, Eleanor; Butow, Phyllis; Sharp, Linda

2016-10-01

Our study aimed to investigate the relationship between unmet supportive care needs and carer burden and happiness, in head and neck cancer (HNC). Two hundred eighty-five HNC informal carers were sent a postal questionnaire between January and June 2014, which included the supportive care needs survey for partners and caregivers of cancer survivors (SCNS-P&C) and the CarerQol, which assesses burden and happiness. Multiple regression analysis was conducted to examine the association of (i) carer characteristics, (ii) carer situation, and (iii) unmet supportive care needs, with carer burden and happiness One hundred ninety-seven carers completed the questionnaire (response rate = 69 %), 180 of whom were included in the analysis. The majority were female (76 %), not in paid employment (68 %) and caring for their spouse (67 %). On average, carers reported relatively low levels of burden and relatively high levels of happiness. Carer factors explained 42 % of variance in levels of burden and 24 % of variance in levels of happiness. Healthcare service needs were associated with carer burden (β = .28, p = .04), while psychological needs (β = -.38, p = .028), health care service needs (β = -.30, p = .049), information needs (β = .29, p = .028), carer comorbidity (β = -.18, p = .030), and gender (β = -.16, p = .045) were associated with happiness. Our results indicate that different aspects of carer characteristics and unmet needs are associated with carer burden and happiness. Efforts directed at reducing unmet healthcare service needs in particular are merited given their associations with both aspects of carer quality of life.

76 FR 11163 - Reducing Regulatory Burden; Retrospective Review Under E.O. 13563

Science.gov (United States)

2011-03-01

... certainty for businesses and the public. Agencies consider lower-cost approaches that reduce burdens and... rule, including its costs and benefits, comes from practical, real-world experience (both on the part..., expanded, or repealed, as well as suggest specific alternative means for the Department to better achieve...

Programming an interim report on the SETL project. Part I: generalities. Part II: the SETL language and examples of its use

Energy Technology Data Exchange (ETDEWEB)

Schwartz, J T

1975-06-01

A summary of work during the past several years on SETL, a new programming language drawing its dictions and basic concepts from the mathematical theory of sets, is presented. The work was started with the idea that a programming language modeled after an appropriate version of the formal language of mathematics might allow a programming style with some of the succinctness of mathematics, and that this might ultimately enable one to express and experiment with more complex algorithms than are now within reach. Part I discusses the general approach followed in the work. Part II focuses directly on the details of the SETL language as it is now defined. It describes the facilities of SETL, includes short libraries of miscellaneous and of code optimization algorithms illustrating the use of SETL, and gives a detailed description of the manner in which the set-theoretic primitives provided by SETL are currently implemented. (RWR)

Fractional Programming for Communication Systems—Part II: Uplink Scheduling via Matching

Science.gov (United States)

Shen, Kaiming; Yu, Wei

2018-05-01

This two-part paper develops novel methodologies for using fractional programming (FP) techniques to design and optimize communication systems. Part I of this paper proposes a new quadratic transform for FP and treats its application for continuous optimization problems. In this Part II of the paper, we study discrete problems, such as those involving user scheduling, which are considerably more difficult to solve. Unlike the continuous problems, discrete or mixed discrete-continuous problems normally cannot be recast as convex problems. In contrast to the common heuristic of relaxing the discrete variables, this work reformulates the original problem in an FP form amenable to distributed combinatorial optimization. The paper illustrates this methodology by tackling the important and challenging problem of uplink coordinated multi-cell user scheduling in wireless cellular systems. Uplink scheduling is more challenging than downlink scheduling, because uplink user scheduling decisions significantly affect the interference pattern in nearby cells. Further, the discrete scheduling variable needs to be optimized jointly with continuous variables such as transmit power levels and beamformers. The main idea of the proposed FP approach is to decouple the interaction among the interfering links, thereby permitting a distributed and joint optimization of the discrete and continuous variables with provable convergence. The paper shows that the well-known weighted minimum mean-square-error (WMMSE) algorithm can also be derived from a particular use of FP; but our proposed FP-based method significantly outperforms WMMSE when discrete user scheduling variables are involved, both in term of run-time efficiency and optimizing results.

Noncardiac findings on cardiac CT. Part II: spectrum of imaging findings.

LENUS (Irish Health Repository)

Killeen, Ronan P

2012-02-01

Cardiac computed tomography (CT) has evolved into an effective imaging technique for the evaluation of coronary artery disease in selected patients. Two distinct advantages over other noninvasive cardiac imaging methods include its ability to directly evaluate the coronary arteries and to provide a unique opportunity to evaluate for alternative diagnoses by assessing the extracardiac structures, such as the lungs and mediastinum, particularly in patients presenting with the chief symptom of acute chest pain. Some centers reconstruct a small field of view (FOV) cropped around the heart but a full FOV (from skin to skin in the area irradiated) is obtainable in the raw data of every scan so that clinically relevant noncardiac findings are identifiable. Debate in the scientific community has centered on the necessity for this large FOV. A review of noncardiac structures provides the opportunity to make alternative diagnoses that may account for the patient\\'s presentation or to detect important but clinically silent problems such as lung cancer. Critics argue that the yield of biopsy-proven cancers is low and that the follow-up of incidental noncardiac findings is expensive, resulting in increased radiation exposure and possibly unnecessary further testing. In this 2-part review we outline the issues surrounding the concept of the noncardiac read, looking for noncardiac findings on cardiac CT. Part I focused on the pros and cons for and against the practice of identifying noncardiac findings on cardiac CT. Part II illustrates the imaging spectrum of cardiac CT appearances of benign and malignant noncardiac pathology.

The Historiography of British Imperial Education Policy, Part II: Africa and the Rest of the Colonial Empire

Science.gov (United States)

Whitehead, Clive

2005-01-01

Part II of this historiographical study examines British education policy in Africa, and in the many crown colonies, protectorates, and mandated territories around the globe. Up until 1920, the British government took far less interest than in India, in the development of schooling in Africa and the rest of the colonial empire, and education was…

DOE program guide for universities and other research groups. Part I. DOE Research and Development Programs; Part II. DOE Procurement and Assistance Policies/Procedures

Energy Technology Data Exchange (ETDEWEB)

1980-03-01

This guide addresses the DOE responsibility for fostering advanced research and development of all energy resources, both current and potential. It is intended to provide, in a single publication, all the fundamental information needed by an institution to develop a potential working relationship with DOE. Part I describes DOE research and development programs and facilities, and identifies areas of additional research needs and potential areas for new research opportunities. It also summarizes budget data and identifies the DOE program information contacts for each program. Part II provides researchers and research administrators with an introduction to the DOE administrative policies and procedures for submission and evaluation of proposals and the administration of resulting grants, cooperative agreements, and research contracts. (RWR)

Dementia Caregiver Burden: a Research Update and Critical Analysis.

Science.gov (United States)

Cheng, Sheung-Tak

2017-08-10

This article provides an updated review of the determinants of caregiver burden and depression, with a focus on care demands and especially the differential effects of various neuropsychiatric symptoms or symptom clusters. Moreover, studies on caregivers for frontotemporal and Lewy body dementias were referred to in order to identify differences and similarities with the mainstream literature based largely on Alzheimer caregivers. As a group, neuropsychiatric symptoms are most predictive of caregiver burden and depression regardless of dementia diagnosis, but the effects appear to be driven primarily by disruptive behaviors (e.g., agitation, aggression, disinhibition), followed by delusions and mood disturbance. Disruptive behaviors are more disturbing partly because of the adverse impact on the emotional connection between the caregiver and the care-recipient and partly because they exacerbate difficulties in other domains (e.g., caring for activities of daily living). In behavioral variant frontotemporal dementia, not only are these disruptive behaviors more prominent but they are also more disturbing due to the care-recipient's insensitivity to others' feelings. In Lewy body dementia, visual hallucinations also appear to be distressing. The disturbing nature of disruptive behaviors cuts across dementia conditions, but the roles played by symptoms that are unique or particularly serious in a certain condition need to be explored further.

Deep brain stimulation for patients with Parkinson's disease: Effect on caregiver burden.

Science.gov (United States)

Crespo-Burillo, J A; Rivero-Celada, D; Saenz-de Cabezón, A; Casado-Pellejero, J; Alberdi-Viñas, J; Alarcia-Alejos, R

2018-04-01

Our aim is to assess the burden on caregivers of patients with Parkinson's disease treated with deep brain stimulation (DBS) compared to those caring for patients at advanced stages and undergoing other treatments. We have also assessed the variables associated with presence of caregiver overload. We included consecutive patients with Parkinson's disease treated with DBS. Our control group included patients in advanced stages of Parkinson's disease undergoing other treatments. Patients were assessed with the following scales: UPDRS-II, UPDRS-III, UPDRS-IV, Hoehn and Yahr, Schwab & England, Barthel, PDQ-39, MoCA, Apathy Evaluation Scale, HADS, and the abbreviated QUIP. Caregiver burden was evaluated with the Zarit caregiver burden interview and their moods were assessed with the HADS scale. We included 11 patients treated with DBS and 11 with other treatments. For patients treated with DBS, we observed a better quality of life according to the PDQ-39 questionnaire (P=.028), and a lower score on the HADS anxiety subscale (P=.010). Caregiver overload was observed in 54.5% of the caregivers of patients in both groups (P=1.000); Zarit scores were similar (P=.835). Caregiver overload was associated with higher scores on the caregiver's Apathy Evaluation Scale (P=.048) and on the HADS anxiety subscale (P=.006). According to our results, treatment with DBS is not associated with lower caregiver burden. Apathy in patients and anxiety in caregivers are factors associated with the appearance of overload. Copyright © 2016 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

Assessing and addressing moral distress and ethical climate Part II: neonatal and pediatric perspectives.

Science.gov (United States)

Sauerland, Jeanie; Marotta, Kathleen; Peinemann, Mary Anne; Berndt, Andrea; Robichaux, Catherine

2015-01-01

Moral distress remains a pervasive and, at times, contested concept in nursing and other health care disciplines. Ethical climate, the conditions and practices in which ethical situations are identified, discussed, and decided, has been shown to exacerbate or ameliorate perceptions of moral distress. The purpose of this mixed-methods study was to explore perceptions of moral distress, moral residue, and ethical climate among registered nurses working in an academic medical center. Two versions of the Moral Distress Scale in addition to the Hospital Ethical Climate Survey were used, and participants were invited to respond to 2 open-ended questions. Part I reported the findings among nurses working in adult acute and critical care units. Part II presents the results from nurses working in pediatric/neonatal units. Significant differences in findings between the 2 groups are discussed. Subsequent interventions developed are also presented.

[Mental health of children, adolescents and young adults--part 2: burden of illness, deficits of the German health care system and efficacy and effectiveness of early intervention services].

Science.gov (United States)

Karow, A; Bock, T; Naber, D; Löwe, B; Schulte-Markwort, M; Schäfer, I; Gumz, A; Degkwitz, P; Schulte, B; König, H H; Konnopka, A; Bauer, M; Bechdolf, A; Correll, C; Juckel, G; Klosterkötter, J; Leopold, K; Pfennig, A; Lambert, M

2013-11-01

Numerous birth-control studies, epidemiological studies, and observational studies investigated mental health and health care in childhood, adolescence and early adulthood, including prevalence, age at onset, adversities, illness persistence, service use, treatment delay and course of illness. Moreover, the impact of the burden of illness, of deficits of present health care systems, and the efficacy and effectiveness of early intervention services on mental health were evaluated. According to these data, most mental disorders start during childhood, adolescence and early adulthood. Many children, adolescents and young adults are exposed to single or multiple adversities, which increase the risk for (early) manifestations of mental diseases as well as for their chronicity. Early-onset mental disorders often persist into adulthood. Service use of children, adolescents and young adults is low, even lower than in adult patients. Moreover, there is often a long delay between onset of illness and first adequate treatment with a variety of linked consequences for poorer psychosocial prognosis. This leads to a large burden of illness with respect to disability and costs. As a consequence several countries have implemented so-called "early intervention services" at the border of child and adolescent and adult psychiatry. Emerging studies show that these health care structures are effective and efficient. Part 2 of the present review focuses on illness burden including disability and costs, deficits of the present health care system in Germany, and efficacy and efficiency of early intervention services. © Georg Thieme Verlag KG Stuttgart · New York.

Mineral resources of parts of the Departments of Antioquia and Caldas, Zone II, Colombia

Science.gov (United States)

Hall, R.B.; Feininger, Tomas; Barrero, L.; Dario, Rico H.; ,; Alvarez, A.

1970-01-01

The mineral resources of an area of 40,000 sq km, principally in the Department of Antioquia, but including small parts of the Departments of Caldas, C6rdoba, Risaralda, and Tolima, were investigated during the period 1964-68. The area is designated Zone II by the Colombian Inventario Minero Nacional(lMN). The geology of approximately 45 percent of this area, or 18,000 sq km, has been mapped by IMN. Zone II has been a gold producer for centuries, and still produces 75 percent of Colombia's gold. Silver is recovered as a byproduct. Ferruginous laterites have been investigated as potential sources of iron ore but are not commercially exploitable. Nickeliferous laterite on serpentinite near Ure in the extreme northwest corner of the Zone is potentially exploitable, although less promising than similar laterites at Cerro Matoso, north of the Zone boundary. Known deposits of mercury, chromium, manganese, and copper are small and have limited economic potentia1. Cement raw materials are important among nonmetallic resources, and four companies are engaged in the manufacture of portland cement. The eastern half of Zone II contains large carbonate rock reserves, but poor accessibility is a handicap to greater development at present. Dolomite near Amalfi is quarried for the glass-making and other industries. Clay saprolite is abundant and widely used in making brick and tiles in backyard kilns. Kaolin of good quality near La Union is used by the ceramic industry. Subbituminous coal beds of Tertiary are an important resource in the western part of the zone and have good potential for greater development. Aggregate materials for construction are varied and abundant. Deposits of sodic feldspar, talc, decorative stone, and silica are exploited on a small scale. Chrysotils asbestos deposits north of Campamento are being developed to supply fiber for Colombia's thriving asbestos-cement industry, which is presently dependent upon imported fiber. Wollastonite and andalusite are

Control of uncertain systems by feedback linearization with neural networks augmentation. Part II. Controller validation by numerical simulation

Directory of Open Access Journals (Sweden)

Adrian TOADER

2010-09-01

Full Text Available The paper was conceived in two parts. Part I, previously published in this journal, highlighted the main steps of adaptive output feedback control for non-affine uncertain systems, having a known relative degree. The main paradigm of this approach was the feedback linearization (dynamic inversion with neural network augmentation. Meanwhile, based on new contributions of the authors, a new paradigm, that of robust servomechanism problem solution, has been added to the controller architecture. The current Part II of the paper presents the validation of the controller hereby obtained by using the longitudinal channel of a hovering VTOL-type aircraft as mathematical model.

Occupational burdens in special educators working with intellectually disabled students

OpenAIRE

Piotr Plichta

2014-01-01

Background: The article presents the results of psychosocial burdens in special educators (specialists in the field of oligophrenopedagogy) with intellectually disabled students. In theoretical part, specific context of occupational stress in special educators was introduced. Additionally, the need of broader research context regarding occupational stress and the risk of burnout in special educators working with intellectually disabled individuals were included. Material and Methods: The resu...

Disability-adjusted Life Years (DALYs) for Mental and Substance Use Disorders in the Korean Burden of Disease Study 2012.

Science.gov (United States)

Lim, Dohee; Lee, Won Kyung; Park, Hyesook

2016-11-01

The purpose of this study was to estimate the national burden of mental substance disorders on medical care utilization in Korea using National Health Insurance System (NHIS) data and updated disability weight, in terms of disability-adjusted life years (DALYs). For each of the 24 disorders, the incident years lived with disability (YLDs) was calculated, using NHIS data to estimate prevalence and incidence rates. The DisMod-II software program was used to model duration and remission. The years of life lost (YLLs) due to premature death were calculated from causes of death statistics. DALYs were computed as the sum of YLDs and YLLs, and time discounting and age weighting were applied. The year examined was 2012, and the subjects were divided into 9 groups according to age. In 2012, the Korean burden of mental and substance use disorders was 945,391 DALYs. More than 98% of DALYs were from YLDs, and the burden in females was greater than that in males, though the burden in males aged less than 19 years old was greater than that in females. Unipolar depressive disorders, schizophrenia, and anxiety disorders were found to be major diseases that accounted for more than 70% of the burden, and most DALYs occurred in their 30-59. Mental and substance use disorders accounted for 6.2% of the total burden of disease and were found to be the 7th greatest burden of disease. Therefore, mental and substance use disorders need to be embraced by mainstream health care with resources commensurate with the burden.

Mission Plan for the Civilian Radioactive Waste Management Program. Volume I. Part I. Overview and current program plans; Part II. Information required by the Nuclear Waste Policy Act of 1982

International Nuclear Information System (INIS)

1985-06-01

The Misson Plan is divided into two parts. Part I describes the overall goals, objectives, and strategy for the disposal of spent nuclear fuel and high-level waste. It explains that, to meet the directives of the Nuclear Waste Policy Act, the DOE intends to site, design, construct, and start operating a mined geologic repository by January 31, 1998. The Act specifies that the costs of these activities will be borne by the owners and generators of the waste received at the repository. Part I further describes the other components of the waste-management program - monitored retrievable storage, Federal interim storage, and transportation - as well as systems integration activities. Also discussed are institutional plans and activities as well as the program-management system being implemented by the Office of Civilian Radioactive Waste Management. Part II of the Mission Plan presents the detailed information required by Section 301(a) of the Act - key issues and information needs; plans for obtaining the necessary information; potential financial, institutional, and legal issues; plans for the test and evaluation facility; the principal results obtained to date from site investigations; information on the site-characterization programs; information on the waste package; schedules; costs; and socioeconomic impacts. In accordance with Section 301(a) of the Act, Part II is concerned primarily with the repository program

The Burden of Schizophrenia on Caregivers

Directory of Open Access Journals (Sweden)

Filiz Adana

2011-06-01

Full Text Available Caregivers’ burden in schizophrenia is a complex concept often with negative connotations. The concept refers to the impact of having a schizophrenia patient in the family including emotional, psychological, physical, economic distress and feelings of shame, embarrassment, guilt, and self-blame expe-rienced by the caregivers. There are objective and subjective aspects of care-givers’ burden. The objective burden refers to observed and verifiable impact of the diseased person in the family such as the patients disturbing behaviors, economic difficulties, and loss of income, restricted social activities, distressed household atmosphere, and undesirable influences on physical and mental health of the family members. The subjective burden refers to the extent of emotional distress caused by the objective burden. The data in the pertinent literature suggest an association between caregivers’ burden and sex, ethnicity, culture, caregivers’ health and quality of life, social support, and the symptomatology as presented by the patient. In order to promote mental health of schizophrenia patients along with their caregivers, the mental health workers should strive to find the means of supporting, informing, and cooperating with the family members. Psychosocial interventions designed for families and psychosocial rehabilitations programs designed for schizophrenia patients are effective means of easing caregivers’ burden.

Nuclear power plant simulators for operator licensing and training. Part I. The need for plant-reference simulators. Part II. The use of plant-reference simulators

International Nuclear Information System (INIS)

Rankin, W.L.; Bolton, P.A.; Shikiar, R.; Saari, L.M.

1984-05-01

Part I of this report presents technical justification for the use of plant-reference simulators in the licensing and training of nuclear power plant operators and examines alternatives to the use of plant-reference simulators. The technical rationale is based on research on the use of simulators in other industries, psychological learning and testing principles, expert opinion and user opinion. Part II discusses the central considerations in using plant-reference simulators for licensing examination of nuclear power plant operators and for incorporating simulators into nuclear power plant training programs. Recommendations are presented for the administration of simulator examinations in operator licensing that reflect the goal of maximizing both reliability and validity in the examination process. A series of organizational tasks that promote the acceptance, use, and effectiveness of simulator training as part of the onsite training program is delineated

Transferring diffractive optics from research to commercial applications: Part II - size estimations for selected markets

Science.gov (United States)

Brunner, Robert

2014-04-01

In a series of two contributions, decisive business-related aspects of the current process status to transfer research results on diffractive optical elements (DOEs) into commercial solutions are discussed. In part I, the focus was on the patent landscape. Here, in part II, market estimations concerning DOEs for selected applications are presented, comprising classical spectroscopic gratings, security features on banknotes, DOEs for high-end applications, e.g., for the semiconductor manufacturing market and diffractive intra-ocular lenses. The derived market sizes are referred to the optical elements, itself, rather than to the enabled instruments. The estimated market volumes are mainly addressed to scientifically and technologically oriented optical engineers to serve as a rough classification of the commercial dimensions of DOEs in the different market segments and do not claim to be exhaustive.

Adaptive Core Simulation Employing Discrete Inverse Theory - Part II: Numerical Experiments

International Nuclear Information System (INIS)

Abdel-Khalik, Hany S.; Turinsky, Paul J.

2005-01-01

Use of adaptive simulation is intended to improve the fidelity and robustness of important core attribute predictions such as core power distribution, thermal margins, and core reactivity. Adaptive simulation utilizes a selected set of past and current reactor measurements of reactor observables, i.e., in-core instrumentation readings, to adapt the simulation in a meaningful way. The companion paper, ''Adaptive Core Simulation Employing Discrete Inverse Theory - Part I: Theory,'' describes in detail the theoretical background of the proposed adaptive techniques. This paper, Part II, demonstrates several computational experiments conducted to assess the fidelity and robustness of the proposed techniques. The intent is to check the ability of the adapted core simulator model to predict future core observables that are not included in the adaption or core observables that are recorded at core conditions that differ from those at which adaption is completed. Also, this paper demonstrates successful utilization of an efficient sensitivity analysis approach to calculate the sensitivity information required to perform the adaption for millions of input core parameters. Finally, this paper illustrates a useful application for adaptive simulation - reducing the inconsistencies between two different core simulator code systems, where the multitudes of input data to one code are adjusted to enhance the agreement between both codes for important core attributes, i.e., core reactivity and power distribution. Also demonstrated is the robustness of such an application

Coal-fired power materials - Part II

Energy Technology Data Exchange (ETDEWEB)

Viswanathan, V.; Purgert, R.; Rawls, P. [Electric Power Research Institute, Palo Alto, CA (United States)

2008-09-15

Part 1 discussed some general consideration in selection of alloys for advanced ultra supercritical (USC) coal-fired power plant boilers. This second part covers results reported by the US project consortium, which has extensively evaluated the steamside oxidation, fireside corrosion, and fabricability of the alloys selected for USC plants. 3 figs.

High-salt diet combined with elevated angiotensin II accelerates atherosclerosis in apolipoprotein E-deficient mice

DEFF Research Database (Denmark)

Johansson, Maria E; Bernberg, Evelina; Andersson, Irene J

2009-01-01

to atherosclerosis. METHODS: Apolipoprotein E-deficient (ApoE-/-) mice received standard or high-salt diet (8%) alone or in combination with fixed angiotensin II (Ang II) infusion (0.5 microg/kg per min). BP was measured using telemetry, and plaque burden was assessed in the thoracic aorta and innominate artery. We...

Tobacco control and gender in south-east Asia. Part II: Singapore and Vietnam.

Science.gov (United States)

Morrow, Martha; Barraclough, Simon

2003-12-01

In the World Health Organization's Western Pacific Region, being born male is the single greatest risk marker for tobacco use. While the literature demonstrates that risks associated with tobacco use may vary according to sex, gender refers to the socially determined roles and responsibilities of men and women, who initiate, continue and quit using tobacco for complex and often different reasons. Cigarette advertising frequently appeals to gender roles. Yet tobacco control policy tends to be gender-blind. Using a broad, gender-sensitivity framework, this contradiction is explored in four Western Pacific countries. Part I of the study presented the rationale, methodology and design of the study, discussed issues surrounding gender and tobacco, and analysed developments in Malaysia and the Philippines (see the previous issue of this journal). Part II deals with Singapore and Vietnam. In all four countries gender was salient for the initiation and maintenance of smoking. Yet, with a few exceptions, gender was largely unrecognized in control policy. Suggestions for overcoming this weakness in order to enhance tobacco control are made.

[Education in our time: competency or aptitude? The case for medicine. Part II].

Science.gov (United States)

Viniegra-Velázquez, Leonardo

Part II is focused on participatory education (PE), a distinctive way to understand and practice education in contrast to passive education. The core of PE is to develop everyone's own cognitive potentialities frequently mutilated, neglected or ignored. Epistemological and experiential basis of PE are defined: the concept of incisive and creative criticism, the idea of knowledge as each person's own construct and life experience as the main focus of reflection and cognition. The PE aims towards individuals with unprecedented cognitive and creative faculties, capable of approaching a more inclusive and hospitable world. The last part criticizes the fact that medical education has remained among the passive education paradigm. The key role of cognitive aptitudes, both methodological and practical (clinical aptitude), in the progress of medical education and practice is emphasized. As a conclusion, the knowhow of education is discussed, aiming towards a better world away from human and planetary degradation. Copyright © 2017 Hospital Infantil de México Federico Gómez. Publicado por Masson Doyma México S.A. All rights reserved.

Stiffnites. Part II

Directory of Open Access Journals (Sweden)

Maria Teresa Pareschi

2011-06-01

Full Text Available

The dynamics of a stiffnite are here inferred. A stiffnite is a sheet-shaped, gravity-driven submarine sediment flow, with a fabric made up of marine ooze. To infer stiffnite dynamics, order of magnitude estimations are used. Field deposits and experiments on materials taken from the literature are also used. Stiffnites can be tens or hundreds of kilometers wide, and a few centimeters/ meters thick. They move on the sea slopes over hundreds of kilometers, reaching submarine velocities as high as 100 m/s. Hard grain friction favors grain fragmentation and formation of triboelectrically electrified particles and triboplasma (i.e., ions + electrons. Marine lipids favor isolation of electrical charges. At first, two basic assumptions are introduced, and checked a posteriori: (a in a flowing stiffnite, magnetic dipole moments develop, with the magnetization proportional to the shear rate. I have named those dipoles as Ambigua. (b Ambigua are ‘vertically frozen’ along stiffnite streamlines. From (a and (b, it follows that: (i Ambigua create a magnetic field (at peak, >1 T. (ii Lorentz forces sort stiffnite particles into two superimposed sheets. The lower sheet, L+, has a sandy granulometry and a net positive electrical charge density. The upper sheet, L–, has a silty muddy granulometry and a net negative electrical charge density; the grains of sheet L– become finer upwards. (iii Faraday forces push ferromagnetic grains towards the base of a stiffnite, so that a peak of magnetic susceptibility characterizes a stiffnite deposit. (iv Stiffnites harden considerably during their motion, due to magnetic confinement. Stiffnite deposits and inferred stiffnite characteristics are compatible with a stable flow behavior against bending, pinch, or other macro instabilities. In the present report, a consistent hypothesis about the nature of Ambigua is provided.

The T?lz Temporal Topography Study: Mapping the visual field across the life span. Part II: Cognitive factors shaping visual field maps

OpenAIRE

Poggel, Dorothe A.; Treutwein, Bernhard; Calmanti, Claudia; Strasburger, Hans

2012-01-01

Part I described the topography of visual performance over the life span. Performance decline was explained only partly by deterioration of the optical apparatus. Part II therefore examines the influence of higher visual and cognitive functions. Visual field maps for 95 healthy observers of static perimetry, double-pulse resolution (DPR), reaction times, and contrast thresholds, were correlated with measures of visual attention (alertness, divided attention, spatial cueing), visual search, an...

Human-like behavior of robot arms: general considerations and the handwriting task-part II: The robot arm in handwriting

NARCIS (Netherlands)

Potkonjak, V.; Kostic, D.; Tzafestas, S.; Popovic, M.; Lazarevic, M.; Djordjevic, G.

2001-01-01

This paper (Part II) investigates the motion of a redundant anthropomorphic arm during the writing task. Two approaches are applied. The first is based on the concept of distributed positioning which is suitable to model the "writing" task before the occurrence of fatigue symptoms. The second

Burden of depressive disorders by country, sex, age, and year: findings from the global burden of disease study 2010.

Directory of Open Access Journals (Sweden)

Alize J Ferrari

2013-11-01

Full Text Available Depressive disorders were a leading cause of burden in the Global Burden of Disease (GBD 1990 and 2000 studies. Here, we analyze the burden of depressive disorders in GBD 2010 and present severity proportions, burden by country, region, age, sex, and year, as well as burden of depressive disorders as a risk factor for suicide and ischemic heart disease.Burden was calculated for major depressive disorder (MDD and dysthymia. A systematic review of epidemiological data was conducted. The data were pooled using a Bayesian meta-regression. Disability weights from population survey data quantified the severity of health loss from depressive disorders. These weights were used to calculate years lived with disability (YLDs and disability adjusted life years (DALYs. Separate DALYs were estimated for suicide and ischemic heart disease attributable to depressive disorders. Depressive disorders were the second leading cause of YLDs in 2010. MDD accounted for 8.2% (5.9%-10.8% of global YLDs and dysthymia for 1.4% (0.9%-2.0%. Depressive disorders were a leading cause of DALYs even though no mortality was attributed to them as the underlying cause. MDD accounted for 2.5% (1.9%-3.2% of global DALYs and dysthymia for 0.5% (0.3%-0.6%. There was more regional variation in burden for MDD than for dysthymia; with higher estimates in females, and adults of working age. Whilst burden increased by 37.5% between 1990 and 2010, this was due to population growth and ageing. MDD explained 16 million suicide DALYs and almost 4 million ischemic heart disease DALYs. This attributable burden would increase the overall burden of depressive disorders from 3.0% (2.2%-3.8% to 3.8% (3.0%-4.7% of global DALYs.GBD 2010 identified depressive disorders as a leading cause of burden. MDD was also a contributor of burden allocated to suicide and ischemic heart disease. These findings emphasize the importance of including depressive disorders as a public-health priority and implementing

A step forward for understanding the morbidity burden in Guinea: a national descriptive study

Directory of Open Access Journals (Sweden)

Hu Guoqing

2011-06-01

Full Text Available Abstract Background Little evidence on the burden of disease has been reported about Guinea. This study was conducted to demonstrate the morbidity burden in Guinea and provide basic evidence for setting health priorities. Methods A retrospective descriptive study was designed to present the morbidity burden of Guinea. Morbidity data were extracted from the National Health Statistics Report of Guinea of 2008. The data are collected based on a pyramid of facilities which includes two national hospitals (teaching hospitals, seven regional hospitals, 26 prefectural hospitals, 8 communal medical centers, 390 health centers, and 628 health posts. Morbidity rates were calculated to measure the burden of non-fatal diseases. The contributions of the 10 leading diseases were presented by sex and age group. Results In 2008, a total of 3,936,599 cases occurred. The morbidity rate for males was higher than for females, 461 versus 332 per 1,000 population. Malaria, respiratory infections, diarrheal diseases, helminthiases, and malnutrition ranked in the first 5 places and accounted for 74% of the total burden, respectively having a rate of 148, 64, 33, 32, and 14 per 1,000 population. The elderly aged 65+ had the highest morbidity rate (611 per 1,000 population followed by working-age population (458 per 1,000 population and children (396 per 1,000 population while the working-age population aged 25-64 contributed the largest part (39% to total cases. The sex- and age-specific spectrum of morbidity burden showed a similar profile except for small variations. Conclusion Guinea has its unique morbidity burden. The ten leading causes of morbidity burden, especially for malaria, respiratory infections, diarrheal diseases, helminthiases, and malnutrition, need to be prioritized in Guinea.

The prevalence and burden of mental and substance use disorders in Australia: Findings from the Global Burden of Disease Study 2015.

Science.gov (United States)

Ciobanu, Liliana G; Ferrari, Alize J; Erskine, Holly E; Santomauro, Damian F; Charlson, Fiona J; Leung, Janni; Amare, Azmeraw T; Olagunju, Andrew T; Whiteford, Harvey A; Baune, Bernhard T

2018-05-01

Timely and accurate assessments of disease burden are essential for developing effective national health policies. We used the Global Burden of Disease Study 2015 to examine burden due to mental and substance use disorders in Australia. For each of the 20 mental and substance use disorders included in Global Burden of Disease Study 2015, systematic reviews of epidemiological data were conducted, and data modelled using a Bayesian meta-regression tool to produce prevalence estimates by age, sex, geography and year. Prevalence for each disorder was then combined with a disorder-specific disability weight to give years lived with disability, as a measure of non-fatal burden. Fatal burden was measured as years of life lost due to premature mortality which were calculated by combining the number of deaths due to a disorder with the life expectancy remaining at the time of death. Disability-adjusted life years were calculated by summing years lived with disability and years of life lost to give a measure of total burden. Uncertainty was calculated around all burden estimates. Mental and substance use disorders were the leading cause of non-fatal burden in Australia in 2015, explaining 24.3% of total years lived with disability, and were the second leading cause of total burden, accounting for 14.6% of total disability-adjusted life years. There was no significant change in the age-standardised disability-adjusted life year rates for mental and substance use disorders from 1990 to 2015. Global Burden of Disease Study 2015 found that mental and substance use disorders were leading contributors to disease burden in Australia. Despite several decades of national reform, the burden of mental and substance use disorders remained largely unchanged between 1990 and 2015. To reduce this burden, effective population-level preventions strategies are required in addition to effective interventions of sufficient duration and coverage.

Tunable, Flexible and Efficient Optimization of Control Pulses for Superconducting Qubits, part II - Applications

Science.gov (United States)

AsséMat, Elie; Machnes, Shai; Tannor, David; Wilhelm-Mauch, Frank

In part I, we presented the theoretic foundations of the GOAT algorithm for the optimal control of quantum systems. Here in part II, we focus on several applications of GOAT to superconducting qubits architecture. First, we consider a control-Z gate on Xmons qubits with an Erf parametrization of the optimal pulse. We show that a fast and accurate gate can be obtained with only 16 parameters, as compared to hundreds of parameters required in other algorithms. We present numerical evidences that such parametrization should allow an efficient in-situ calibration of the pulse. Next, we consider the flux-tunable coupler by IBM. We show optimization can be carried out in a more realistic model of the system than was employed in the original study, which is expected to further simplify the calibration process. Moreover, GOAT reduced the complexity of the optimal pulse to only 6 Fourier components, composed with analytic wrappers.

Reproduction in the space environment: Part II. Concerns for human reproduction

Science.gov (United States)

Jennings, R. T.; Santy, P. A.

1990-01-01

Long-duration space flight and eventual colonization of our solar system will require successful control of reproductive function and a thorough understanding of factors unique to space flight and their impact on gynecologic and obstetric parameters. Part II of this paper examines the specific environmental factors associated with space flight and the implications for human reproduction. Space environmental hazards discussed include radiation, alteration in atmospheric pressure and breathing gas partial pressures, prolonged toxicological exposure, and microgravity. The effects of countermeasures necessary to reduce cardiovascular deconditioning, calcium loss, muscle wasting, and neurovestibular problems are also considered. In addition, the impact of microgravity on male fertility and gamete quality is explored. Due to current constraints, human pregnancy is now contraindicated for space flight. However, a program to explore effective countermeasures to current constraints and develop the required health care delivery capability for extended-duration space flight is suggested. A program of Earth- and space-based research to provide further answers to reproductive questions is suggested.

Mixed ligand complexes of alkaline earth metals: Part XII. Mg(II, Ca(II, Sr(II and Ba(II complexes with 5-chlorosalicylaldehyde and salicylaldehyde or hydroxyaromatic ketones

Directory of Open Access Journals (Sweden)

MITHLESH AGRAWAL

2002-04-01

Full Text Available The reactions of alkaline earth metal chlorides with 5-chlorosalicylaldehyde and salicylaldehyde, 2-hydroxyacetophenone or 2-hydroxypropiophenone have been carried out in 1 : 1 : 1 mole ratio and the mixed ligand complexes of the type MLL’(H2O2 (where M = Mg(II, Ca(II, Sr(II and Ba(II, HL = 5-chlorosalicylaldehyde and HL’ = salicylaldehyde, 2-hydroxyacetophenone or 2-hydroxypropiophenone have been isolated. These complexes were characterized by TLC, conductance measurements, IR and 1H-NMR spectra.

The effect of gender and social capital on the dual burden of malnutrition: a multilevel study in Indonesia.

Directory of Open Access Journals (Sweden)

Masoud Vaezghasemi

Full Text Available INTRODUCTION: The paradoxical phenomenon of the coexistence of overweight and underweight individuals in the same household, referred to as the "dual burden of malnutrition", is a growing nutrition dilemma in low- and middle-income countries (LMICs. AIMS: The objectives of this study were (i to examine the extent of the dual burden of malnutrition across different provinces in Indonesia and (ii to determine how gender, community social capital, place of residency and other socio-economic factors affect the prevalence of the dual burden of malnutrition. METHODS: The current study utilized data from the fourth wave of the Indonesian Family Life Survey (IFLS conducted between November 2007 and April 2008. The dataset contains information from 12,048 households and 45,306 individuals of all ages. This study focused on households with individuals over two years old. To account for the multilevel nature of the data, a multilevel multiple logistic regression was conducted. RESULTS: Approximately one-fifth of all households in Indonesia exhibited the dual burden of malnutrition, which was more prevalent among male-headed households, households with a high Socio-economic status (SES, and households in urban areas. Minimal variation in the dual burden of malnutrition was explained by the community level differences (<4%. Living in households with a higher SES resulted in higher odds of the dual burden of malnutrition but not among female-headed households and communities with the highest social capital. CONCLUSION: To improve household health and reduce the inequality across different SES groups, this study emphasizes the inclusion of women's empowerment and community social capital into intervention programs addressing the dual burden of malnutrition.

Part II. Population

International Nuclear Information System (INIS)

2004-01-01

This monograph deals with assessment of radiological health effects of the Chernobyl accident for emergency workers (part 1) and the population of the contaminated areas in Russia (part 2). The Chernobyl emergency workers and people living in the contaminated areas of Russia received much lower doses than the population of Hiroshima and Nagasaki and it was unclear whether risks of radiation-induced cancers derived with the Japanese data could be extrapolated to the low dose range However, it was predicted as early as in 1990 that the thyroid cancer incidence might be increasing due to incorporated 131 irradiation. What conclusions can be drawn from regarding cancer incidence among emergency workers and residents of the contaminated areas in Russia and the role of the radiation factor on the basis of the registry data? Leukemia incidence. Leukemia incidence is known to be one of principal indications of radiation effects. The radiation risk for leukemias is 3-4 times higher that for solid cancers and its latent period is estimated to be 2-3 years after exposure. Results of the radiation epidemiological studies discussed in this book show that in the worst contaminated Bryansk region the leukemia incidence rate is not higher than in the country in general. Even though some evidence exists for the dose response relationship, the radiation risks appear to be not statistically significant. Since risks of leukemia are known to be higher for those who were children at exposure, long-term epidemiological studies need to be continued. The study of leukemias among emergency workers strongly suggest the existence of dose response relationship. In those who received external doses more than 0.15 Gy the leukemia incidence rate is two time higher and these emergency workers should be referred to as a group of increased radiation risk. Solid cancers. The obtained results provide no evidence to a radiation-induced increase in solid cancers among residents of the contaminated areas

30 CFR Appendix II to Subpart D of... - Appendix II to Subpart D of Part 18

Science.gov (United States)

2010-07-01

... LABOR TESTING, EVALUATION, AND APPROVAL OF MINING PRODUCTS ELECTRIC MOTOR-DRIVEN MINE EQUIPMENT AND ACCESSORIES Machines Assembled With Certified or Explosion-Proof Components, Field Modifications of Approved Machines, and Permits To Use Experimental Equipment Pt. 18, Subpt. D, App. II Appendix II to Subpart D of...

The Burden of Schizophrenia on Caregivers

OpenAIRE

Filiz Adana; Hulya Arslantas

2011-01-01

Caregivers’ burden in schizophrenia is a complex concept often with negative connotations. The concept refers to the impact of having a schizophrenia patient in the family including emotional, psychological, physical, economic distress and feelings of shame, embarrassment, guilt, and self-blame expe-rienced by the caregivers. There are objective and subjective aspects of care-givers’ burden. The objective burden refers to observed and verifiable impact of the diseased person in the family suc...

The burden of disaster: part II. applying interventions across the child's social ecology.

Science.gov (United States)

Pfefferbaum, Rose L; Jacobs, Anne K; Noffsinger, Mary A; Pfefferbaum, Betty; Sherrieb, Kathleen; Norris, Fran H

2012-01-01

This second of two articles describes the application of disaster mental health interventions within the context of the childs social ecology consisting of the Micro-, Meso-, Exo-, and Macrosystems. Microsystem interventions involving parents, siblings, and close friends include family preparedness planning andpractice, psychoeducation, role modeling, emotional support, and redirection. Mesosystem interventions provided by schools and faith-based organizations include safety and support, assessment, referral, and counseling. Exosystem interventions include those provided through community-based mental health programs, healthcare organizations, the workplace, the media, local volunteer disaster organizations, and other local organizations. Efforts to build community resilience to disasters are likely to have influence through the Exosystem. The Macrosystem - including the laws, history, cultural and subcultural characteristics, and economic and social conditions that underlie the other systems - affects the child indirectly through public policies and disaster programs and services that become available in the child's Exosystem in the aftermath of a disaster The social ecology paradigm, described more fully in a companion article (Noffsinger Pfefferbaum, Pfefferbaum, Sherrieb, & Norris,2012), emphasizes relationships among systems and can guide the development and delivery of services embedded in naturally-occurring structures in the child's environment.

CERN scientists take part in the Tevatron Run II performance review committee

CERN Multimedia

Maximilien Brice

2002-01-01

Tevatron Run II is under way at Fermilab, exploring the high-energy frontier with upgraded detectors that will address some of the biggest questions in particle physics.Until CERN's LHC switches on, the Tevatron proton-antiproton collider is the world's only source of top quarks. It is the only place where we can search for supersymmetry, for the Higgs boson, and for signatures of additional dimensions of space-time. The US Department of Energy (DOE) recently convened a high-level international review committee to examine Fermilab experts' first-phase plans for the accelerator complex. Pictured here with a dipole magnet in CERN's LHC magnet test facility are the four CERN scientists who took part in the DOE's Tevatron review. Left to right: Francesco Ruggiero, Massimo Placidi, Flemming Pedersen, and Karlheinz Schindl. Further information: CERN Courier 43 (1)

Implementing AORN recommended practices for a safe environment of care, part II.

Science.gov (United States)

Kennedy, Lynne

2014-09-01

Construction in and around a working perioperative suite is a challenge beyond merely managing traffic patterns and maintaining the sterile field. The AORN "Recommended practices for a safe environment of care, part II" provides guidance on building design; movement of patients, personnel, supplies, and equipment; environmental controls; safety and security; and control of noise and distractions. Whether the OR suite evolves through construction, reconstruction, or remodeling, a multidisciplinary team of construction experts and health care professionals should create a functional plan and communicate at every stage of the project to maintain a safe environment and achieve a well-designed outcome. Emergency preparedness, a facility-wide security plan, and minimization of noise and distractions in the OR also help enhance the safety of the perioperative environment. Copyright © 2014 AORN, Inc. Published by Elsevier Inc. All rights reserved.

The Effect of Gender and Social Capital on the Dual Burden of Malnutrition: A Multilevel Study in Indonesia

Science.gov (United States)

Vaezghasemi, Masoud; Öhman, Ann; Eriksson, Malin; Hakimi, Mohammad; Weinehall, Lars; Kusnanto, Hari; Ng, Nawi

2014-01-01

Introduction The paradoxical phenomenon of the coexistence of overweight and underweight individuals in the same household, referred to as the “dual burden of malnutrition”, is a growing nutrition dilemma in low- and middle-income countries (LMICs). Aims The objectives of this study were (i) to examine the extent of the dual burden of malnutrition across different provinces in Indonesia and (ii) to determine how gender, community social capital, place of residency and other socio-economic factors affect the prevalence of the dual burden of malnutrition. Methods The current study utilized data from the fourth wave of the Indonesian Family Life Survey (IFLS) conducted between November 2007 and April 2008. The dataset contains information from 12,048 households and 45,306 individuals of all ages. This study focused on households with individuals over two years old. To account for the multilevel nature of the data, a multilevel multiple logistic regression was conducted. Results Approximately one-fifth of all households in Indonesia exhibited the dual burden of malnutrition, which was more prevalent among male-headed households, households with a high Socio-economic status (SES), and households in urban areas. Minimal variation in the dual burden of malnutrition was explained by the community level differences (malnutrition but not among female-headed households and communities with the highest social capital. Conclusion To improve household health and reduce the inequality across different SES groups, this study emphasizes the inclusion of women's empowerment and community social capital into intervention programs addressing the dual burden of malnutrition. PMID:25153321

All About Dowels - A Review Part II Considerations After Cementation

Directory of Open Access Journals (Sweden)

Zishan Dangra

2017-10-01

Full Text Available The present review summarizes the published literature examining cementation of the dowel and factors related to it. The peer reviewed English language literature was reviewed from the period 1990 to 2015. Articles were searched in Pubmed/ Medline for the relevant terms. Additional manual searches of some dental journals were also carried out. The original key terms resulted in 228 articles. After applying inclusion criteria, 64 articles remained to be included in part II of this review. Article search indicates that most published literature on dowels are in the form of in vitro analysis. Literature on prefabricated dowel systems far exceeds than the custom cast dowel and newer fibre dowels. Clinical evidence is not sufficient and cannot be used to inform practice confidently. However, within the limitations of this review it is suggested that adhesive fixation is preferred in case of short dowel. Dowel width should be as small as possible. A ferrule of 2 mm has to be provided. Composites have proven to be a good core material provided that adequate tooth structure remained for bonding. Dowel should be inserted if endodontically treated tooth is to be used as abutment for removable partial dentures.

Thinking in nursing education. Part II. A teacher's experience.

Science.gov (United States)

Ironside, P M

1999-01-01

Across academia, educators are investigating teaching strategies that facilitate students' abilities to think critically. Because may these strategies require low teacher-student ratios or sustained involvement over time, efforts to implement them are often constrained by diminishing resources for education, faculty reductions, and increasing number of part-time teachers and students. In nursing, the challenges of teaching and learning critical thinking are compounded by the demands of providing care to patients with increasingly acute and complex problems in a wide variety of settings. To meet these challenges, nurse teachers have commonly used a variety of strategies to teach critical thinking (1). For instance, they often provide students with case studies or simulated clinical situations in classroom and laboratory settings (2). At other times, students are taught a process of critical thinking and given structured clinical assignments, such as care plans or care maps, where they apply this process in anticipating the care a particular patient will require. Accompanying students onto clinical units, teachers typically evaluate critical thinking ability by reviewing a student's preparation prior to the experience and discussing it with the student during the course of the experience. The rationales students provide for particular nursing interventions are taken as evidence of their critical thinking ability. While this approach is commonly thought to be effective, the evolving health care system has placed increased emphasis on community nursing (3,4), where it is often difficult to prespecify learning experiences or to anticipate patient care needs. In addition, teachers are often not able to accompany each student to the clinical site. Thus, the traditional strategies for teaching and learning critical thinking common to hospital-based clinical courses are being challenged, transformed, and extended (5). Part II of this article describes findings that suggest

Mammalian Toxicity of Munition Compounds. Phase II. Effects of Multiple Doses. Part III. 2,6-Dinitrotoluene

Science.gov (United States)

1976-07-01

and the neuromuscular effects in these dogs were not due to hypocalcemia . The lowest serum calcium concen- tration in these dogs was 4.2 meq/liter...motor end plate might produce a local hypocalcemia . Such a mechanism is purely speculative. Qualitatively and quantitavely, most of the effects of 2,6...I ýNw,- -MIM I/ MIDWEST RESEARCH INS14ITUTE H0q .3L I LU -_ MAMMALIAN TOXICITY OF MUNITIONS COMPOUlNDSPHASE II: EFFECTS OF MiULTIPLE DOSES C* •PART

Modelo computacional para suporte à decisão em áreas irrigadas. Parte II: testes e aplicação Computer model for decision support in irrigated areas. Part II: tests and application

Directory of Open Access Journals (Sweden)

Paulo A. Ferreira

2006-12-01

Full Text Available Apresentou-se, na Parte I desta pesquisa, o desenvolvimento de um modelo computacional denominado MCID, para suporte à tomada de decisão quanto ao planejamento e manejo de projetos de irrigação e/ou drenagem. Objetivou-se, na Parte II, testar e aplicar o MCID. No teste comparativo com o programa DRAINMOD, espaçamentos entre drenos, obtidos com o MCID, foram ligeiramente maiores ou idênticos. Os espaçamentos advindos com o MCID e o DRAINMOD foram consideravelmente maiores que os obtidos por meio de metodologias tradicionais de dimensionamento de sistemas de drenagem. A produtividade relativa total, YRT, obtida com o MCID foi, em geral, inferior à conseguida com o DRAINMOD, devido a diferenças de metodologia ao se estimar a produtividade da cultura em resposta ao déficit hídrico. Na comparação com o programa CROPWAT, obtiveram-se resultados muito próximos para (YRT e evapotranspiração real. O modelo desenvolvido foi aplicado para as condições do Projeto Jaíba, MG, para culturas perenes e anuais cultivadas em diferentes épocas. Os resultados dos testes e aplicações indicaram a potencialidade do MCID como ferramenta de apoio à decisão em projetos de irrigação e/ou drenagem.Part I of this research presented the development of a decision support model, called MCID, for planning and managing irrigation and/or drainage projects. Part II is aimed at testing and applying MCID. In a comparative test with the DRAINMOD model, drain spacings obtained with MCID were slightly larger or identical. The spacings obtained with MCID and DRAINMOD were considerably larger than those obtained through traditional methodologies of design of drainage systems. The relative crop yield (YRT obtained with MCID was, in general, lower than the one obtained with DRAINMOD due to differences in the estimate of crop response to water deficit. In comparison with CROPWAT, very close results for YRT and for actual evapotranspiration were obtained. The

Impact of monovalent cations on soil structure. Part II. Results of two Swiss soils

Science.gov (United States)

Farahani, Elham; Emami, Hojat; Keller, Thomas

2018-01-01

In this study, we investigated the impact of adding solutions with different potassium and sodium concentrations on dispersible clay, water retention characteristics, air permeability, and soil shrinkage behaviour using two agricultural soils from Switzerland with different clay content but similar organic carbon to clay ratio. Three different solutions (including only Na, only K, and the combination of both) were added to soil samples at three different cation ratio of soil structural stability levels, and the soil samples were incubated for one month. Our findings showed that the amount of readily dispersible clay increased with increasing Na concentrations and with increasing cation ratio of soil structural stability. The treatment with the maximum Na concentration resulted in the highest water retention and in the lowest shrinkage capacity. This was was associated with high amounts of readily dispersible clay. Air permeability generally increased during incubation due to moderate wetting and drying cycles, but the increase was negatively correlated with readily dispersible clay. Readily dispersible clay decreased with increasing K, while readily dispersible clay increased with increasing K in Iranian soil (Part I of our study). This can be attributed to the different clay mineralogy of the studied soils (muscovite in Part I and illite in Part II).

The methodology of population surveys of headache prevalence, burden and cost

DEFF Research Database (Denmark)

Stovner, Lars Jacob; Al Jumah, Mohammed; Birbeck, Gretchen L

2014-01-01

The global burden of headache is very large, but knowledge of it is far from complete and needs still to be gathered. Published population-based studies have used variable methodology, which has influenced findings and made comparisons difficult. Among the initiatives of the Global Campaign against...... to include experience and competence in headache epidemiology and/or epidemiology in general and drawn from all six WHO world regions. The recommendations presented are for anyone, of whatever background, with interests in designing, performing, understanding or assessing studies that measure or describe...... the burden of headache in populations. While aimed principally at researchers whose main interests are in the field of headache, they should also be useful, at least in parts, to those who are expert in public health or epidemiology and wish to extend their interest into the field of headache disorders. Most...

Seismic risk analysis for General Electric Plutonium Facility, Pleasanton, California. Final report, part II

International Nuclear Information System (INIS)

1980-01-01

This report is the second of a two part study addressing the seismic risk or hazard of the special nuclear materials (SNM) facility of the General Electric Vallecitos Nuclear Center at Pleasanton, California. The Part I companion to this report, dated July 31, 1978, presented the seismic hazard at the site that resulted from exposure to earthquakes on the Calaveras, Hayward, San Andreas and, additionally, from smaller unassociated earthquakes that could not be attributed to these specific faults. However, while this study was in progress, certain additional geologic information became available that could be interpreted in terms of the existance of a nearby fault. Although substantial geologic investigations were subsequently deployed, the existance of this postulated fault, called the Verona Fault, remained very controversial. The purpose of the Part II study was to assume the existance of such a capable fault and, under this assumption, to examine the loads that the fault could impose on the SNM facility. This report first reviews the geologic setting with a focus on specifying sufficient geologic parameters to characterize the postulated fault. The report next presents the methodology used to calculate the vibratory ground motion hazard. Because of the complexity of the fault geometry, a slightly different methodology is used here compared to the Part I report. This section ends with the results of the calculation applied to the SNM facility. Finally, the report presents the methodology and results of the rupture hazard calculation

[Burden of proof in medical cases--presumption of fact and prima facie evidence. II. Presumption of fact and prima facie evidence].

Science.gov (United States)

Sliwka, Marcin

2004-01-01

The aim of this paper was to present the main rules concerning the burden of proof in polish civil trials, including medical cases. The standard rules were presented with all the important exclusions such as presumption of law and fact or prima facie evidence. The author analyses the effect of these institutions on burden of proof in medical cases. The difference between presumptions of fact and prima facie evidence was analysed and explained. This paper also describes the importance of the res ipsa loquitur rule in United Kingdom and USA. This paper includes numerous High Court sentences on evidential and medical issues.

CHILD WELFARE IN CANADA : PART II

OpenAIRE

松本, 眞一; Shinichi, Matsumoto; 桃山学院大学社会学部

2006-01-01

This part study aims to research on the whole aspect of child protection in Canada. And so, this paper consists of five chapters as follows: (1)Canadian history of child protection, (2)definition of child abuse, (3)current situation of child protection in Canada, (4)outline of child protection and treatment, (5)triangular comparison of child protection and prevention in Canada, Australia and England. The first efforts at identifying and combating child abuse occurred in the latter part of the...

12 CFR 508.10 - Burden of persuasion.

Science.gov (United States)

2010-01-01

... 12 Banks and Banking 5 2010-01-01 2010-01-01 false Burden of persuasion. 508.10 Section 508.10 Banks and Banking OFFICE OF THRIFT SUPERVISION, DEPARTMENT OF THE TREASURY REMOVALS, SUSPENSIONS, AND PROHIBITIONS WHERE A CRIME IS CHARGED OR PROVEN § 508.10 Burden of persuasion. The petitioner has the burden of...

Incidental Findings in Imaging Research: Evaluating Incidence, Benefit and Burden

Science.gov (United States)

Orme, Nicholas M.; Fletcher, Joel G.; Siddiki, Hassan A.; Harmsen, W. Scott; O’Byrne, Megan M.; Port, John D.; Tremaine, William J.; Pitot, Henry C.; McFarland, Beth; Robinson, Marguerite E.; Koenig, Barabara A.; King, Bernard F.; Wolf, Susan M.

2013-01-01

Context Little information exists concerning the frequency of clinically significant incidental findings (IFs) identified in the course of imaging research across a broad spectrum of imaging modalities and body regions. Objective To estimate the frequency with which research imaging IFs generate further clinical action, and the medical benefit/burden of identifying these IFs. Design, Setting, and Participants Retrospective review of subjects undergoing a research imaging exam that was interpreted by a radiologist for IFs in the first quarter of 2004, with 3-year clinical follow-up. An expert panel reviewed IFs generating clinical action to determine medical benefit/burden based on predefined criteria. Main Outcome Measures Frequency of (1) IFs that generated further clinical action by modality, body part, age, gender, and (2) IFs resulting in clear medical benefit or burden. Results 1376 patients underwent 1426 research imaging studies. 40% (567/1426) of exams had at least one IF (1055 total). Risk of an IF increased significantly by age (OR=1.5; [1.4–1.7=95% C.I.] per decade increase). Abdominopelvic CT generated more IFs than other exams (OR=18.9 compared with ultrasound; 9.2% with subsequent clinical action), with CT Thorax and MR brain next (OR=11.9 and 5.9; 2.8% and 2.2% with action, respectively). Overall 6.2% of exams (35/567) with an IF generated clinical action, resulting in clear medical benefit in 1.1% (6/567) and clear medical burden in 0.5% (3/567). In most instances, medical benefit/burden was unclear (4.6%; 26/567). Conclusions The frequency of IFs in imaging research exams varies significantly by imaging modality, body region and age. Research imaging studies at high risk for generating IFs can be identified. Routine evaluation of research images by radiologists may result in identification of IFs in a substantial number of cases and subsequent clinical action to address them in much smaller number. Such clinical action can result in medical

Burden of childhood-onset arthritis

Directory of Open Access Journals (Sweden)

Hassett Afton L

2010-07-01

Full Text Available Abstract Juvenile arthritis comprises a variety of chronic inflammatory diseases causing erosive arthritis in children, often progressing to disability. These children experience functional impairment due to joint and back pain, heel pain, swelling of joints and morning stiffness, contractures, pain, and anterior uveitis leading to blindness. As children who have juvenile arthritis reach adulthood, they face possible continuing disease activity, medication-associated morbidity, and life-long disability and risk for emotional and social dysfunction. In this article we will review the burden of juvenile arthritis for the patient and society and focus on the following areas: patient disability; visual outcome; other medical complications; physical activity; impact on HRQOL; emotional impact; pain and coping; ambulatory visits, hospitalizations and mortality; economic impact; burden on caregivers; transition issues; educational occupational outcomes, and sexuality. The extent of impact on the various aspects of the patients', families' and society's functioning is clear from the existing literature. Juvenile arthritis imposes a significant burden on different spheres of the patients', caregivers' and family's life. In addition, it imposes a societal burden of significant health care costs and utilization. Juvenile arthritis affects health-related quality of life, physical function and visual outcome of children and impacts functioning in school and home. Effective, well-designed and appropriately tailored interventions are required to improve transitioning to adult care, encourage future vocation/occupation, enhance school function and minimize burden on costs.

Radiation protection instruments based on tissue equivalent proportional counters: Part II of an international intercomparison

International Nuclear Information System (INIS)

Alberts, W.G.; Dietz, E.; Guldbakke, S.; Kluge, H.; Schumacher, H.

1988-04-01

This report describes the irradiation conditions and procedures of Part II of an international intercomparison of tissue-equivalent proportional counters used for radiation protection measurements. The irradiations took place in monoenergetic reference neutron fields produced by the research reactor and accelerator facilities of the PTB Braunschweig in the range from thermal neutrons to 14.8 MeV. In addition measurements were performed in 60 Co and D 2 O-moderated 252 Cf radiation fields. Prototype instruments from 7 European groups were investigated. The results of the measurements are summarized and compared with the reference data of the irradiations. (orig.) [de

The prediction of creep damage in Type 347 weld metal: part II creep fatigue tests

International Nuclear Information System (INIS)

Spindler, M.W.

2005-01-01

Calculations of creep damage under conditions of strain control are often carried out using either a time fraction approach or a ductility exhaustion approach. In part I of this paper the rupture strength and creep ductility data for a Type 347 weld metal were fitted to provide the material properties that are used to calculate creep damage. Part II of this paper examines whether the time fraction approach or the ductility exhaustion approach gives the better predictions of creep damage in creep-fatigue tests on the same Type 347 weld metal. In addition, a new creep damage model, which was developed by removing some of the simplifying assumptions that are made in the ductility exhaustion approach, was used. This new creep damage model is a function of the strain rate, stress and temperature and was derived from creep and constant strain rate test data using a reverse modelling technique (see part I of this paper). It is shown that the new creep damage model gives better predictions of creep damage in the creep-fatigue tests than the time fraction and the ductility exhaustion approaches

A comprehensive review and update on the biologic treatment of adult noninfectious uveitis: part II.

Science.gov (United States)

Lee, Kyungmin; Bajwa, Asima; Freitas-Neto, Clovis A; Metzinger, Jamie Lynne; Wentworth, Bailey A; Foster, C Stephen

2014-11-01

Treatment of adult, noninfectious uveitis remains a major challenge for ophthalmologists around the world, especially in regard to recalcitrant cases. It is reported to comprise approximately 10% of preventable blindness in the USA. The cause of uveitis can be idiopathic or associated with infectious and systemic disorders. The era of biologic medical therapies provides new options for patients with otherwise treatment-resistant inflammatory eye disease. This two-part review gives a comprehensive overview of the existing medical treatment options for patients with adult, noninfectious uveitis, as well as important advances for the treatment ocular inflammation. Part I covers classic immunomodulation and latest information on corticosteroid therapy. In part II, emerging therapies are discussed, including biologic response modifiers, experimental treatments and ongoing clinical studies for uveitis. The hazard of chronic corticosteroid use in the treatment of adult, noninfectious uveitis is well documented. Corticosteroid-sparing therapies, which offer a very favorable risk-benefit profile when administered properly, should be substituted. Although nothing is currently approved for on-label use in this indication, many therapies, through either translation or novel basic science research, have the potential to fill the currently exposed gaps.

Adult informal caregivers reporting financial burden in Hawaii, Kansas, and Washington: Results from the 2007 Behavioral Risk Factor Surveillance System.

Science.gov (United States)

Kusano, Claudia T; Bouldin, Erin D; Anderson, Lynda A; McGuire, Lisa C; Salvail, Florentina R; Simmons, Katrina Wynkoop; Andresen, Elena M

2011-10-01

Given the unpaid nature of the work, informal caregiving can create a financial burden for caregivers. Little has been done to identify specific predictors of experiencing financial burden. This study investigated demographic and health factors comparing caregivers who reported having or not having financial burden. Data are derived from adult caregivers (N = 3,317) as part of the 2007 Behavioral Risk Factor Surveillance System in Hawaii, Kansas, and Washington. The adjusted odds ratios for reporting a financial burden were estimated for demographic and other risk factors. Caregivers who reported a financial burden were younger, had lower incomes, were more likely to be current smokers, have had a stroke, and rate their health as fair or poor compared to caregivers who did not report a financial burden. Caregivers who were younger (ages 18-34), resided with care recipients, spent 20-39 hours per week providing care, and reported having a disability were at a statistically significantly higher odds of reporting a financial burden. Given the current economic difficulties faced by many Americans, further insights into the perceived financial burdens experienced by informal caregivers as well as linkages to policy and programs designed to support caregivers are critical for public health professionals to address the expanding needs in states and communities. Published by Elsevier Inc.

Patients and Their Caregivers’ Burdens for Parkinson’s Disease in Korea

Directory of Open Access Journals (Sweden)

Jong Sam Baik

2017-09-01

Full Text Available Objective Many patients with Parkinson’s disease (PD suffer from motor and non-motor symptoms. According to these variable symptoms of PD, patients or caregivers have a poorer quality of life than patients with other neurodegenerative diseases. Since the difficulties are varied for all patients, prioritizing their difficulties differs among all cases. The goal of this study was to investigate the burdens of PD among the caregivers as well as patients and to identify areas requiring aid from the government. Methods We surveyed the awareness and perceptions of PD in patients and caregivers of PD by a face-to-face questionnaire. The questionnaire was divided into three sections: symptoms of PD (part A, desire for policies (part B, and difficulties faced by their caregivers (part C. Part A comprised 8 questions, Part B had 2 questions, and Part C had 3 questions. Results In total, 853 subjects (702 patients and 151 caregivers were enrolled in this study. The major difficulties experienced by PD patients were physical (67%, psychiatric (60% and socio-economic (52%. Assessing the physical difficulties, more than half the patients experienced severe difficulties (29% very severe, 39% severe. Psychiatric difficulties were assessed as severe (35% and very severe (21% among the patients. Severe difficulties were also experienced socio-economically, at 52% in patients and 49% in caregivers, especially among patients in their fifties (58% and those with their spouse (65% as caregivers. The topmost need was the introduction of new technology for treatment of PD (62%, followed by relief of costs for treatment (38% and a family support system (31%. The majority (91% of the patients were diagnosed with PD within two years after onset of symptoms. Conclusion We know that the difficulties of PD and the needs for government assistance are different between patients and caregivers. These results emphasize that perceiving the difficulties and needs of patients and

French RSE-M and RCC-MR code appendices for flaw analysis: Presentation of the fracture parameters calculation-Part II: Cracked plates

International Nuclear Information System (INIS)

Marie, S.; Chapuliot, S.; Kayser, Y.; Lacire, M.H.; Drubay, B.; Barthelet, B.; Le Delliou, P.; Rougier, V.; Naudin, C.; Gilles, P.; Triay, M.

2007-01-01

French nuclear codes include flaw assessment procedures: the RSE-M Code 'Rules for In-service Inspection of Nuclear Power Plant Components' and the RCC-MR code 'Design and Construction rules for mechanical components of FBR nuclear islands and high temperature applications'. An important effort of development of these analytical methods has been made for the last 10 years in the frame of a collaboration between CEA, EDF and AREVA-NP, and in the frame of R and D actions involving CEA and IRSN. These activities have led to a unification of the common methods of the two codes. The calculation of fracture mechanics parameters, and in particular the stress intensity factor K I and the J integral, has been widely developed for industrial configurations. All the developments have been integrated in the 2005 edition of RSE-M and in the 2007 edition of RCC-MR. This series of articles is composed of 5 parts: the first part presents an overview of the methods proposed in the RCC-MR and RSE-M codes. Parts II-IV provide compendia for specific components. The geometries are plates (part II), pipes (part III) and elbows (part IV). Finally, part V presents the validation elements of the methods, with details on the process followed for the development and evaluation of the accuracy of the proposed analytical methods. This second article in the series presents all details for the stress intensity factor and J calculations for cracked plates. General data applicable for all defect geometries are first presented, and then, available defect geometries where compendia for K I and σ ref calculation are provided are given

Digital logic circuit design with ALTERA MAX+PLUS II

International Nuclear Information System (INIS)

Lee, Seung Ho; Park, Yong Su; Park, Gun Jong; Lee, Ju Heon

2006-09-01

This book is composed of five parts. The first part has introduction of ALTERA MAX+PLUS II and graphic editor, text editor, compiler, waveform editor simulator and timing analyzer of it. The second part is about direction of digital logic circuit design with training kit. The third part has grammar and practice of VHDL in ALTERA MAX+PLUS II including example and history of VHDL. The fourth part shows the design example of digital logic circuit by VHDL of ALTERA MAX+PLUS II which lists designs of adder and subtractor, code converter, counter, state machine and LCD module. The last part explains design example of digital logic circuit by graphic editor in ALTERA MAX+PLUS II.

Compósitos de borracha natural ou policloropreno e celulose II: influência do tamanho de partícula Natural rubber or chloroprene rubber and cellulose II composites: influence of particle size

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Bruno de A. Napolitano

2004-01-01

Full Text Available O objetivo deste trabalho foi o desenvolvimento de compósitos claros com propriedades de interesse tecnológico utilizando elastômeros com diferentes polaridades. Para que este objetivo fosse atingido, celulose II em pó foi usada como carga, em borracha natural (NR ou policloropreno (CR. A celulose II foi obtida por coagulação da solução de xantato de celulose em meio ácido, sob agitação constante e à temperatura ambiente, constituindo uma nova forma de obtenção deste tipo de carga. Compósitos com 10 phr de celulose II com NR e CR, respectivamente, foram desenvolvidos tendo como variável o tamanho de partícula da carga. As propriedades mecânicas e os aspectos microscópicos dos diferentes compósitos foram avaliados e comparados com aqueles das formulações sem carga. Os resultados permitiram identificar o compósito como o de melhor resultado, influenciado pela polaridade da matriz elastomérica e pelo tamanho de partícula da carga, conseqüência das condições de moagem usadas.The aim of this work was to develop light composites with properties of technological interest by using elastomers of different polarities. This was achieved by employing cellulose II, in the powder form, as filler in natural rubber (NR and chloroprene (CR. Cellulose II was obtained by coagulation of cellulose xanthate solution, in acid medium, under stirring and at room temperature, which represents, to our knowledge, a new way of obtaining this type of filler. Composites with 10phr of cellulose II and NR or CR were prepared having the particle size as variable. The mechanical properties and the microscopic aspect of the different composites were evaluated and compared with compounds without filler. The results indicated best results for the CR composite, influenced by the polarity of the elastomeric matrix and by the particle size, as a consequence of the milling conditions of the filler used.

Burden of Proof in Bioethics.

Science.gov (United States)

Koplin, Julian J; Selgelid, Michael J

2015-11-01

A common strategy in bioethics is to posit a prima facie case in favour of one policy, and to then claim that the burden of proof (that this policy should be rejected) falls on those with opposing views. If the burden of proof is not met, it is claimed, then the policy in question should be accepted. This article illustrates, and critically evaluates, examples of this strategy in debates about the sale of organs by living donors, human enhancement, and the precautionary principle. We highlight general problems with this style of argument, and particular problems with its use in specific cases. We conclude that the burden ultimately falls on decision-makers (i.e. policy-makers) to choose the policy supported by the best reasons. © 2015 John Wiley & Sons Ltd.

EL español andino. II parte

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Rubén Arboleda Toro

2002-01-01

Full Text Available En el número 13 de esta revista (nov. del 2000 se publicó una primera parte del estudio sobre el español andino. Presentamos ahora una segunda parte que comprende aspectos histórico-geográficos de Nariño y Putumayo andinos, región de Colombia donde se habla esa variedad, y una descripción general de su realidad lingüística. Esperamos que sean objeto de otra publicación la descripción de los rasgos dialectales del español andino, parte nuclear del trabajo, y la presentación de la metodología y el corpus. En esto nos encontramos trabajando. Incluimos no obstante un inventario de rasgos más amplio que el presentado en la primera parte. Pero por ahora se trata de eso, de un inventario ilustrativo, no del análisis en el que estamos empeñados, en el marco del contacto de lenguas, el cambio lingüístico y la relación entre la norma y las posibilidades del sistema. Para contextualizar esta segunda parte, incluimos, a manera de introducción, un resumen de la primera.

Diet, Lifestyle and Chronic disease burden

NARCIS (Netherlands)

Struijk, E.A.

2014-01-01

Background Diet, Body Mass Index (BMI), physical activity and smoking are among the most important lifestyle factors that influence global disease burden. In this thesis we investigate the relations of these factors with total disease burden in a large Dutch population, the EPIC-NL cohort. In this

CAREGIVER BURDEN AMONG PEOPLE CARING FOR PATIENTS WITH SCHIZOPHRENIA

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Shivani Bansal

2017-04-01

Full Text Available BACKGROUND Caregivers of patients suffering from mental illness report burden in different areas including effects on family functioning, psychological problems, financial problems and health. The aim of the study is to determine the sociodemographic profile and caregiver burden among caregivers of persons with schizophrenia and to study the effect of patients’ psychopathology on caregiver burden scale. MATERIALS AND METHODS The present study was conducted in the Psychiatry Department, Government Medical College, Amritsar. A sample size of 34 was taken who were primary caregivers (preferably parents or spouse of schizophrenia patients diagnosed using ICD10. Measures included caregiver’s demographic variables and caregiver’s burden using the Zarit burden interview and PANSS scale in patients. Statistical Analysis- Data was analysed using SPSS software version 21. RESULTS The mean age of the caregiver was 42 SD (12.16 years. The majority of the caregivers were parents, married and employed. The mean average score of the responses to Zarit burden interview was (SD=59.52 ± 20.92. Majority of the caregivers experienced severe burden (52.9%, 9 (26.4% caregivers had reported moderate burden and 6 (17.6% had reported mild burden. The mean duration of illness was 6.89 (SD=5.03 years. The level of burden experienced was significantly associated with total PANSS score, negative symptoms, positive symptoms, general psychopathology score and duration of schizophrenia illness (p=0.00. CONCLUSION There is need for psychological assistance and social support for the vulnerable caregivers to help them reduce the burden levels and employ positive coping strategies.

Economic burden of disease-associated malnutrition in China.

Science.gov (United States)

Linthicum, Mark T; Thornton Snider, Julia; Vaithianathan, Rhema; Wu, Yanyu; LaVallee, Chris; Lakdawalla, Darius N; Benner, Jennifer E; Philipson, Tomas J

2015-05-01

Disease-associated malnutrition (DAM) is a well-recognized problem in many countries, but the extent of its burden on the Chinese population is unclear. This article reports the results of a burden-of-illness study on DAM in 15 diseases in China. Using data from the World Health Organization (WHO), the China Health and Nutrition Survey, and the published literature, mortality and disability-adjusted life years (DALYs) lost because of DAM were calculated; a financial value of this burden was calculated following WHO guidelines. DALYs lost annually to DAM in China varied across diseases, from a low of 2248 in malaria to a high of 1 315 276 in chronic obstructive pulmonary disease. The total burden was 6.1 million DALYs, for an economic burden of US$66 billion (Chinese ¥ 447 billion) annually. This burden is sufficiently large to warrant immediate attention from public health officials and medical providers, especially given that low-cost and effective interventions are available. © 2014 APJPH.

The Search for Another Earth–Part II

Indian Academy of Sciences (India)

Permanent link: https://www.ias.ac.in/article/fulltext/reso/021/10/0899-0910. Keywords. Exoplanets, earth, super-earth, diamond planet, neptune, habitability, extra-terrestrial life. Abstract. In the first part, we discussed the various methods for thedetection of planets outside the solar system known as theexoplanets. In this part ...

Burden of Rabies

Science.gov (United States)

... this? Submit Button Past Emails The Burden of Rabies Recommend on Facebook Tweet Share Compartir Learn how ... bitten by an animal that has the disease. Rabies in the U.S. Rabies continues to be a ...

The burden of mental disorders in the Eastern Mediterranean region, 1990-2015: findings from the global burden of disease 2015 study.

Science.gov (United States)

2017-08-03

Mental disorders are among the leading causes of nonfatal burden of disease globally. We used the global burden of diseases, injuries, and risk factors study 2015 to examine the burden of mental disorders in the Eastern Mediterranean region (EMR). We defined mental disorders according to criteria proposed in the diagnostic and statistical manual of mental disorders IV and the 10th International Classification of Diseases. Mental disorders contributed to 4.7% (95% uncertainty interval (UI) 3.7-5.6%) of total disability-adjusted life-years (DALYs), ranking as the ninth leading cause of disease burden. Depressive disorders and anxiety disorders were the third and ninth leading causes of nonfatal burden, respectively. Almost all countries in the EMR had higher age-standardized mental disorder DALYs rates compared to the global level, and in half of the EMR countries, observed mental disorder rates exceeded the expected values. The burden of mental disorders in the EMR is higher than global levels, particularly for women. To properly address this burden, EMR governments should implement nationwide quality epidemiological surveillance of mental disorders and provide adequate prevention and treatment services.

Reproduce and die! Why aging? Part II

NARCIS (Netherlands)

Schuiling, GA

Whilst in part I of this diptych on aging the question why aging exists at all is discussed; this part deals with the question which mechanisms underly aging and, ultimately, dying. It appears that aging is not just an active process as such - although all kinds of internal (e.g., oxigen-free

Financial Burden Borne by Laparoscopic Living Kidney Donors.

Science.gov (United States)

Wiseman, Jennifer F; Jacobs, Cheryl L; Larson, Dawn B; Berglund, Danielle M; Garvey, Catherine A; Ibrahim, Hassan N; Matas, Arthur J

2017-09-01

Living kidney donors have donation-related out-of-pocket costs (direct costs) and/or ongoing daily expenses while losing income (indirect costs). Yet there is little information about how much of a subjective burden these constitute for the donors. From December 2003 through December 2014, we surveyed donors 6 months postdonation to determine their financial burden related to donation (on a scale of 1 to 10) and what resources were used to cover expenses. Of 1136 surveyed, 796 (70%) responded. Among respondents, mean age at donation was 43.6 ± 10.6 years, 64% were women, 96% were white, and 53% were related by blood to their recipient. Overall, 26% scored their financial burden as 5 or higher; 8% scored it as 8 or higher. Increased expenses were associated with a higher reported burden; however, significant burden was reported by some with no out-of-pocket expenses (presumably due to lost wages and continuing expenses). The burden was scored as 5 or higher by 27% of those employed outside the home (n = 660), 15% homemakers, 13% retirees, 40% students; 28% unemployed; and 26% whose occupation was unknown. Over half (51%) of those receiving a local or (means-tested) national grant still reported moderate to severe burden. Besides grants, donors used a variety of sources to help offset expenses: dipped into savings, borrowed from friends or family, took out a loan, and/or had a fundraiser. Those with the highest burden reported using the most additional sources. Donors should not have to incur costs or a financial burden to donate; the transplant community should strive to make donation financially neutral.

Getting to the Source: a Survey of Quantitative Data Sources Available to the Everyday Librarian: Part II: Data Sources from Specific Library Applications

Directory of Open Access Journals (Sweden)

Lisa Goddard

2007-03-01

Full Text Available This is the second part of a two-part article that provides a survey of data sources which are likely to be immediately available to the typical practitioner who wishes to engage in statistical analysis of collections and services within his or her own library. Part I outlines the data elements which can be extracted from web server logs, and discusses web log analysis tools. Part II looks at logs, reports, and data sources from proxy servers, resource vendors, link resolvers, federated search engines, institutional repositories, electronic reference services, and the integrated library system.

Evaluation of modelling body burden of Cs-137

International Nuclear Information System (INIS)

Bergstroem, U.; Nordlinder, S.

1996-05-01

Within the IAEA/CEC VAMP-program one working group studied the precision in dose assessment models when calculating body burden of 137 Cs as a result of exposure through multiple exposure pathways. One scenario used data from southern Finland regarding contamination of various media due to the fallout from the Chernobyl accident. In this study, a time dependent multiple exposure pathway model was constructed based on compartment theory. Uncertainties in model responses due to uncertainties in input parameter values were studied. The initial predictions for body burden were good, within a factor of 2 of the observed, while the time dynamics of levels in milk and meat did not agree satisfactorily. Some results, nevertheless, showed good agreement with observations due to compensatory effects. After disclosure of additional observational data, major reasons for mispredictions were identified as lack of consideration of time dependence of fixation of 137 Cs in soils, and the selection of parameter values. When correction of this was made, a close agreement between predictions and observations was obtained. This study shows that the dose contribution due to 137 Cs in food products from the seminatural environment is important for long-term exposure to man. The evaluation provided a basis for improvements of crucial parts in the model. 14 refs, 18 figs, 8 tabs

Complexometric determination, Part II: Complexometric determination of Cu2+-ions

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Rajković Miloš B.

2002-01-01

Full Text Available A copper-selective electrode of the coated wire type based on sulphidized copper wire was applied successfully for determining Cu(II ions by complexometric titration with the disodium salt of EDTA (complexon III. By the formation of internal complex compounds with the Cu(II ion, the copper concentration in the solution decreases, and all this is followed by a change of potential of the indicator system Cu-DWISE (or Cu-EDWISE/SCE. At the terminal point of titration, when all the Cu(II ions are already utilized for the formation of the complex with EDTA, there occurs a steep rise of potential, thus enabling us, through the first or second derivative to note the quantity of copper that is present in the solution. Copper-selective electrode showed a responsivity towards titration with EDTA as a complexing agent, with the absence of "fatigue" due to a great number of repeated measurings. Errors occurring during quantitative measurements were more a characteristic of the overall procedure which involve, because of the impossibility of the complete absence of subjectivity, a constant error, and the reproducibility of the results confirmed this fact. The disodium salt of EDTA appeared as a very efficient titrant in all titrations and with various concentrations ot Cu(II ions in the solution, with somewhat weaker response at lower concentrations in the solution.

ANALYSIS OF TAX BURDEN PARAMETERS OF UKRAINE'S ECONOMY

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I. Moyseyenko

2017-11-01

Full Text Available The need to solve the problems of macro-economic stabilization of the country's economy on the basis of determining the tax system efficiency led to the actuality and importance of developing methodological issues of macro-economic tax regulation. In terms of macro-financial stability for the purpose of strategic analysis, the macroeconomic category of tax burden and its fiscal efficiency in terms of direct and indirect taxation is considered. Tax burden indicators at a macro-level quantitatively measure the total level of tax payment and pumping up the budget. Based on the analysis of tax burden it is found that in Ukraine the major fiscal function is performed by consumption taxes (indirect taxes. The methodological principles of the diagnostics of tax burden influence on macro-indices of economic stabilization are as follows: selecting parameters of monitoring tax burden state and fiscal burden efficiency; the assessment of an impact on fiscal efficiency on macro-indices. To prognosticate the efficiency of fiscal burden performance in terms of indirect taxes linear and exponential trend equations are calculated. In terms of the analysis of macro-financial stability the usage of tax rates of indirect taxes as indicators of fiscal efficiency provides sufficient reasons for the conclusions regarding long-term trends of pumping the budget.

The global burden of disease due to outdoor air pollution.

Science.gov (United States)

Cohen, Aaron J; Ross Anderson, H; Ostro, Bart; Pandey, Kiran Dev; Krzyzanowski, Michal; Künzli, Nino; Gutschmidt, Kersten; Pope, Arden; Romieu, Isabelle; Samet, Jonathan M; Smith, Kirk

As part of the World Health Organization (WHO) Global Burden of Disease Comparative Risk Assessment, the burden of disease attributable to urban ambient air pollution was estimated in terms of deaths and disability-adjusted life years (DALYs). Air pollution is associated with a broad spectrum of acute and chronic health effects, the nature of which may vary with the pollutant constituents. Particulate air pollution is consistently and independently related to the most serious effects, including lung cancer and other cardiopulmonary mortality. The analyses on which this report is based estimate that ambient air pollution, in terms of fine particulate air pollution (PM(2.5)), causes about 3% of mortality from cardiopulmonary disease, about 5% of mortality from cancer of the trachea, bronchus, and lung, and about 1% of mortality from acute respiratory infections in children under 5 yr, worldwide. This amounts to about 0.8 million (1.2%) premature deaths and 6.4 million (0.5%) years of life lost (YLL). This burden occurs predominantly in developing countries; 65% in Asia alone. These estimates consider only the impact of air pollution on mortality (i.e., years of life lost) and not morbidity (i.e., years lived with disability), due to limitations in the epidemiologic database. If air pollution multiplies both incidence and mortality to the same extent (i.e., the same relative risk), then the DALYs for cardiopulmonary disease increase by 20% worldwide.

Subjective burden on spouses of schizophrenia patients

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Surekha Kumari

2009-01-01

Full Text Available Background : There is limited information from India on subjective burden on spouses of schizophrenia patients. The aim of the present study was to assess and compare patterns of subjective burden on spouses of schizophrenia patients. Materials and Methods: The present study was conducted at the OPD level, and follow-up was done at the Ranchi Institute of Neuropsychiatry and Sciences (RINPAS during the period May 2008 to November 2008. Tools utilized were sociodemographic data sheet, Family Burden Interview Schedule developed by Pai and R. L. Kapur (1981. The sample comprised of 50 samples of spouses (25 male and 25 female spouses of schizophrenia patients. Results: The findings suggest that both the groups, viz., male and female spouses of schizophrenia patients, showed moderate level of subjective burden, i.e., 13 (52% and 15 (60% male and female spouses, respectively, which was statistically found to be insignificant. Conclusion : No significant difference was found between male and female spouses of schizophrenia patients with regard to the level of subjective burden.

The potential role of benefit and burden finding in school engagement of young leukaemia survivors: an exploratory study.

Science.gov (United States)

Tougas, A-M; Jutras, S; Bigras, M; Tourigny, M

2016-01-01

Childhood cancer may radically change the daily lives of young survivors, particularly in school. Depending on the sense they derive from the experience of illness, survivors may go through profound transformations in the way they approach life. This exploratory study reports on school engagement of cancer survivors by examining their perceptions of benefits and burdens in relation to their illness. Forty-nine young Quebecers, previously diagnosed and treated for leukaemia, completed a questionnaire measuring their school engagement and participated in an interview focusing on the impact of cancer on their lives. Perceptions with regard to the presence and types of benefits and burdens were described and examined in light of participants' characteristics. An analysis of variance explored whether the presence/absence of benefits and burdens were associated with participants' scores regarding school engagement. Most participants mentioned benefits from having had cancer, and in particular benefits at an interpersonal level. Half of the participants mentioned burdens, mainly of a physical and psychological nature. Significant correlations indicated that (i) the older the survivors were, the more likely they were to report benefits in terms of qualities and strengths of character; (ii) the more time had elapsed since their diagnosis, the more survivors were likely to report psychological types of burdens; and (iii) children from single-parent families reported more frequently having appreciated social or recreational activities compared with children from two-parent families. One main effect indicated that school engagement was greater for survivors who perceived the presence of benefits. An interaction effect revealed that the perception of both benefits and burdens predicts the highest scores of school engagement. While the results reveal the promising potential that an optimistic yet realistic disposition has in regard to school engagement, more research is

Double burden of malnutrition: A silent driver of double burden of disease in low– and middle–income countries

Directory of Open Access Journals (Sweden)

Ivana Kolcˇic´

2012-09-01

Full Text Available Double burden of malnutrition, characterised by undernutrition among poor children and obesity among deprived adults, is a serious global problem and an important promoter of ‘double burden of disease’ which is currently affecting low– and middle–income countries. Possible ways to reduce this burden is through education on the importance of equilibrium between energy intake and expenditure; ensuring conditions for optimal fetal and early child development; and reducing poverty as one of the main drivers of both undernutrition and obesity, through empowering local communities.

Assessment of the risk of foodborne transmission and burden of hepatitis E in Switzerland.

Science.gov (United States)

Müller, Alexandra; Collineau, Lucie; Stephan, Roger; Müller, Andrea; Stärk, Katharina D C

2017-02-02

The objective of this study was i) to quantify the risk of hepatitis E for Swiss consumers by specified pork products and ii) to estimate the total burden of human food-borne hepatitis E in Switzerland. A quantitative risk assessment from slaughter to consumption was carried out according to the Codex Alimentarius framework. In the hazard characterization, assumptions were made due to the lack of a dose-response relationship for oral exposure to hepatitis E virus (HEV). The prevalence of HEV in 160 pig livers of 40 different Swiss fattening farms was examined and determined to be 1.3% (CI 0.3%; 4.4%). This result was used as input in the risk assessment model, together with data from other published studies. The annual burden of hepatitis E was estimated in terms of Disability Adjusted Life Years (DALY), using data about hepatitis E cases diagnosed between 2010 and 2015 at two major hospitals located in the canton Ticino. Only the risk of foodborne hepatitis E from products containing pork liver was evaluated, as those containing only pork meat could not be evaluated because of lack of data on HEV load in pork. Assuming that successful oral infection occurs in 1% of servings contaminated with high HEV loads (>10 5 genome copies), and that acute illness develops in 5% of susceptible consumers, the most likely annual number of foodborne hepatitis E cases in Switzerland was estimated to be 1481 (95% CI 552; 4488) if all products containing pork liver were considered. If only high-risk products, such as plain pork liver and liver sausages (e.g. Saucisse au Foie), were considered, the annual number of cases was estimated to be 176 (95% CI 64; 498). We were unable to calculate the total burden of hepatitis E in Switzerland due to lack of data. Yet, for the canton Ticino, it was shown that a significant increase had occurred from 50 DALY per 100,000 inhabitants in 2015. This change could partly be due to an increased reporting and higher awareness among medical

Socioeconomic burden of hereditary angioedema

DEFF Research Database (Denmark)

Aygören-Pürsün, Emel; Bygum, Anette; Beusterien, Kathleen

2014-01-01

who were working or in school (n = 120), 72 provided work/school absenteeism data, resulting in an estimated 20 days missing from work/school on average per year; 51% (n = 84) indicated that HAE has hindered their career/educational advancement. CONCLUSION: HAE poses a considerable burden on patients...... and their families in terms of direct medical costs and indirect costs related to lost productivity. This burden is substantial at the time of attacks and in between attacks....

The Severity of Autism Is Associated with Toxic Metal Body Burden and Red Blood Cell Glutathione Levels

Energy Technology Data Exchange (ETDEWEB)

Adams, J B; Mitchell, I J [Division of Basic Medical Sciences, Southwest College of Naturopathic Medicine, Tempe, AZ 85282 (United States); Baral, M; Bradstreet, J [Department of Pediatric Medicine, Southwest College of Naturopathic Medicine, Tempe, AZ 85282 (United States); Geis, E; Ingram, J; Hensley, A; Zappia, I; Gehn, E; Mitchell, K [Autism Research Institute, San Diego, CA 92116-2599 (United States); Newmark, S [Center for Integrative Pediatric Medicine, Tucson, AZ 85711 (United States); Rubin, R A [Department of Mathematics, Whittier College, Whittier, CA 90601-4413 (United States); Bradstreet, J [International Child Development Resource Center, Phoenix, AZ (United States); El-Dahrn, J M [Department of Pediatrics, Tulane University School of Medicine, New Orleans, LA 70112 (United States)

2009-07-01

This study investigated the relationship of children's autism symptoms with their toxic metal body burden and red blood cell (RBC) glutathione levels. In children ages 38 years, the severity of autism was assessed using four tools: ADOS, PDD-BI, ATEC, and SAS. Toxic metal body burden was assessed by measuring urinary excretion of toxic metals, both before and after oral dimercaptosuccinic acid (DMSA). Multiple positive correlations were found between the severity of autism and the urinary excretion of toxic metals. Variations in the severity of autism measurements could be explained, in part, by regression analyses of urinary excretion of toxic metals before and after DMSA and the level of RBC glutathione (adjusted R2 of 0.220.45, P<.005 in all cases). This study demonstrates a significant positive association between the severity of autism and the relative body burden of toxic metals.

The Severity of Autism Is Associated with Toxic Metal Body Burden and Red Blood Cell Glutathione Levels

International Nuclear Information System (INIS)

Adams, J.B.; Mitchell, I.J.; Baral, M.; Bradstreet, J.; Geis, E.; Ingram, J.; Hensley, A.; Zappia, I.; Gehn, E.; Mitchell, K.; Newmark, S.; Rubin, R.A.; Bradstreet, J.; El-Dahrn, J.M.

2009-01-01

This study investigated the relationship of children's autism symptoms with their toxic metal body burden and red blood cell (RBC) glutathione levels. In children ages 38 years, the severity of autism was assessed using four tools: ADOS, PDD-BI, ATEC, and SAS. Toxic metal body burden was assessed by measuring urinary excretion of toxic metals, both before and after oral dimercaptosuccinic acid (DMSA). Multiple positive correlations were found between the severity of autism and the urinary excretion of toxic metals. Variations in the severity of autism measurements could be explained, in part, by regression analyses of urinary excretion of toxic metals before and after DMSA and the level of RBC glutathione (adjusted R2 of 0.220.45, P<.005 in all cases). This study demonstrates a significant positive association between the severity of autism and the relative body burden of toxic metals.

A Conversation with William A. Fowler Part II

Science.gov (United States)

Greenberg, John

2005-06-01

Physicist William A.Fowler initiated an experimental program in nuclear astrophysics after World War II. He recalls here the Steady State versus Big Bang controversy and his celebrated collaboration with Fred Hoyle and Geoffrey and Margaret Burbidge on nucleosynthesis in stars. He also comments on the shift away from nuclear physics in universities to large accelerators and national laboratories.

Intrinsic bacterial burden associated with intensive care unit hospital beds: effects of disinfection on population recovery and mitigation of potential infection risk.

Science.gov (United States)

Attaway, Hubert H; Fairey, Sarah; Steed, Lisa L; Salgado, Cassandra D; Michels, Harold T; Schmidt, Michael G

2012-12-01

Commonly touched items are likely reservoirs from which patients, health care workers, and visitors may encounter and transfer microbes. A quantitative assessment was conducted of the risk represented by the intrinsic bacterial burden associated with bed rails in a medical intensive care unit (MICU), and how disinfection might mitigate this risk. Bacteria present on the rails from 36 patient beds in the MICU were sampled immediately before cleaning and at 0.5, 2.5, 4.5, and 6.5 hours after cleaning. Beds were sanitized with either a bottled disinfectant (BD; CaviCide) or an automated bulk-diluted disinfectant (ABDD; Virex II 256). The majority of bacteria recovered from the bed rails in the MICU were staphylococci, but not methicillin-resistant Staphylococcus aureus. Vancomycin-resistant enterococci were recovered from 3 beds. Bottled disinfectant reduced the average bacterial burden on the rails by 99%. However, the burden rebounded to 30% of that found before disinfection by 6.5 hours after disinfection. ABDD reduced the burden by an average of 45%, but levels rebounded within 2.5 hours. The effectiveness of both disinfectants was reflected in median reductions to burden of 98% for BD and 95% for ABDD. Cleaning with hospital-approved disinfectants reduced the intrinsic bacterial burden on bed rail surfaces by up to 99%, although the population, principally staphylococci, rebounded quickly to predisinfection levels. Copyright © 2012 Association for Professionals in Infection Control and Epidemiology, Inc. All rights reserved.

The psychosocial burden of psoriatic arthritis.

Science.gov (United States)

Husni, M Elaine; Merola, Joseph F; Davin, Sara

2017-12-01

To assess the psychosocial impact of psoriatic arthritis (PsA), describe how health-related quality of life (QoL) is affected in patients with PsA, discuss measures used to evaluate the psychosocial impact of PsA, and review studies examining the effect of therapy on QoL. A targeted review on the impact of PsA on QoL and the role of tailored psychosocial management in reducing the psychosocial burden of the disease was performed. PubMed literature searches were conducted using the terms PsA, psychosocial burden, QoL, and mood/behavioral changes. Articles were deemed relevant if they presented information regarding the psychosocial impact of PsA, methods used to evaluate these impacts, or ways to manage/improve management of PsA and its resulting comorbidities. The findings of this literature search are descriptively reviewed and the authors׳ expert opinion on their interpretation is provided. The psychosocial burden of PsA negatively affects QoL. Patients suffer from sleep disorders, fatigue, low-level stress, depression and mood/behavioral changes, poor body image, and reduced work productivity. Additionally, each patient responds to pain differently, depending on a variety of psychological factors including personality structure, cognition, and attention to pain. Strategies for evaluating the burdens associated with PsA and the results of properly managing patients with PsA are described. PsA is associated with a considerable psychosocial burden and new assessment tools, specific to PsA, have been developed to help quantify this burden in patients. Future management algorithms of PsA should incorporate appropriate assessment and management of psychological and physical concerns of patients. Furthermore, patients with PsA should be managed by a multidisciplinary team that works in coordination with the patient and their family or caregivers. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

Investing in improved performance of national tuberculosis programs reduces the tuberculosis burden: analysis of 22 high-burden countries, 2002-2009.

Science.gov (United States)

Akachi, Yoko; Zumla, Alimuddin; Atun, Rifat

2012-05-15

To assess the impact of investment in national tuberculosis programs (NTPs) on NTP performance and tuberculosis burden in 22 high-burden countries, as determined by the World Health Organization (WHO). Estimates of annual tuberculosis burden and NTP performance indicators and control variables during 2002-2009 were obtained from the Organization for Economic Cooperation and Development, the WHO, the World Bank, and the Penn World Table for the 22 high-burden countries. Panel data analysis was performed using the outcome variables tuberculosis incidence, prevalence, and mortality and the key explanatory variables Partnership case detection rate and treatment success rate, controlling for gross domestic product per capita, population structure, and human immunodeficiency virus (HIV) prevalence. A $1 per capita (general population) higher NTP budget (including domestic and external sources) was associated with a 1.9% (95% confidence interval, .12%-3.6%) higher estimated case detection rate the following year for the 22 high-burden countries between 2002 and 2009. In the final models, which corrected for autocorrelation and heteroskedasticity, achieving the STOP TB Partnership case detection rate target of >70% was associated with significantly (P < .01) lower tuberculosis incidence, prevalence, and mortality the following year, even when controlling for general economic development and HIV prevalence as potential confounding variables. Increased investment in NTPs was significantly associated with improved performance and with a downward trend in the tuberculosis burden in the 22 high-burden countries during 2002-2009.

Interview-Based Qualitative Research in Emergency Care Part II: Data Collection, Analysis and Results Reporting

Science.gov (United States)

Ranney, Megan L.; Meisel, Zachary; Choo, Esther K.; Garro, Aris; Sasson, Comilla; Morrow, Kathleen

2015-01-01

Qualitative methods are increasingly being used in emergency care research. Rigorous qualitative methods can play a critical role in advancing the emergency care research agenda by allowing investigators to generate hypotheses, gain an in-depth understanding of health problems or specific populations, create expert consensus, and develop new intervention and dissemination strategies. In Part I of this two-article series, we provided an introduction to general principles of applied qualitative health research and examples of its common use in emergency care research, describing study designs and data collection methods most relevant to our field (observation, individual interviews, and focus groups). Here in Part II of this series, we outline the specific steps necessary to conduct a valid and reliable qualitative research project, with a focus on interview-based studies. These elements include building the research team, preparing data collection guides, defining and obtaining an adequate sample, collecting and organizing qualitative data, and coding and analyzing the data. We also discuss potential ethical considerations unique to qualitative research as it relates to emergency care research. PMID:26284572

Interview-based Qualitative Research in Emergency Care Part II: Data Collection, Analysis and Results Reporting.

Science.gov (United States)

Ranney, Megan L; Meisel, Zachary F; Choo, Esther K; Garro, Aris C; Sasson, Comilla; Morrow Guthrie, Kate

2015-09-01

Qualitative methods are increasingly being used in emergency care research. Rigorous qualitative methods can play a critical role in advancing the emergency care research agenda by allowing investigators to generate hypotheses, gain an in-depth understanding of health problems or specific populations, create expert consensus, and develop new intervention and dissemination strategies. In Part I of this two-article series, we provided an introduction to general principles of applied qualitative health research and examples of its common use in emergency care research, describing study designs and data collection methods most relevant to our field (observation, individual interviews, and focus groups). Here in Part II of this series, we outline the specific steps necessary to conduct a valid and reliable qualitative research project, with a focus on interview-based studies. These elements include building the research team, preparing data collection guides, defining and obtaining an adequate sample, collecting and organizing qualitative data, and coding and analyzing the data. We also discuss potential ethical considerations unique to qualitative research as it relates to emergency care research. © 2015 by the Society for Academic Emergency Medicine.

Asymmetric synthesis of α-amino acids via homologation of Ni(II) complexes of glycine Schiff bases. Part 3: Michael addition reactions and miscellaneous transformations.

Science.gov (United States)

Aceña, José Luis; Sorochinsky, Alexander E; Soloshonok, Vadim

2014-09-01

The major goal of this review is a critical discussion of the literature data on asymmetric synthesis of α-amino acids via Michael addition reactions involving Ni(II)-complexes of amino acids. The material covered is divided into two conceptually different groups dealing with applications of: (a) Ni(II)-complexes of glycine as C-nucleophiles and (b) Ni(II)-complexes of dehydroalanine as Michael acceptors. The first group is significantly larger and consequently subdivided into four chapters based on the source of stereocontrolling element. Thus, a chiral auxiliary can be used as a part of nucleophilic glycine Ni(II) complex, Michael acceptor or both, leading to the conditions of matching vs. mismatching stereochemical preferences. The particular focus of the review is made on the practical aspects of the methodology under discussion and mechanistic considerations.

The economic burden of schizophrenia in Malaysia.

Science.gov (United States)

Teoh, Siew Li; Chong, Huey Yi; Abdul Aziz, Salina; Chemi, Norliza; Othman, Abdul Razak; Md Zaki, Nurzuriana; Vanichkulpitak, Possatorn; Chaiyakunapruk, Nathorn

2017-01-01

Schizophrenia (SCZ) is a highly debilitating disease despite its low prevalence. The economic burden associated with SCZ is substantial and mainly attributed to productivity loss. To improve the understanding of economic burden of SCZ in the low- and middle-income country regions, we aimed to determine the economic burden of SCZ in Malaysia. A retrospective study was conducted using a prevalence-based approach from a societal perspective in Malaysia with a 1 year period from 2013. We used micro-costing technique with bottom-up method and included direct medical cost, direct non-medical cost, and indirect cost. The main data source was medical chart review which was conducted in Hospital Kuala Lumpur (HKL). The medical charts were identified electronically by matching the unique patient's identification number registered under the National Mental Health Schizophrenia Registry and the list of patients in HKL in 2013. Other data sources were government documents, literatures, and local websites. To ensure robustness of result, probabilistic sensitivity analysis was conducted. The total estimated number of treated SCZ cases in Malaysia in 2015 was 15,104 with the total economic burden of USD 100 million (M) which was equivalent to 0.04% of the national gross domestic product. On average, the mean cost per patient was USD 6,594. Of the total economic burden of SCZ, 72% was attributed to indirect cost, costing at USD 72M, followed by direct medical cost (26%), costing at USD 26M, and direct non-medical cost (2%), costing at USD 1.7M. This study highlights the magnitude of economic burden of SCZ and informs the policy-makers that there is an inadequate support for SCZ patients. More resources should be allocated to improve the condition of SCZ patients and to reduce the economic burden.

A study of drying and cleaning methods used in preparation for fluorescent penetrant inspection - Part II

International Nuclear Information System (INIS)

Brasche, L.; Lopez, R.; Larson, B.

2003-01-01

Fluorescent penetrant inspection is the most widely used method for aerospace components such as critical rotating components of gas turbine engines. Successful use of FPI begins with a clean and dry part, followed by a carefully controlled and applied FPI process, and conscientious inspection by well trained personnel. A variety of cleaning methods are in use for cleaning of titanium and nickel parts with selection based on the soils or contamination to be removed. Cleaning methods may include chemical or mechanical methods with sixteen different types studied as part of this program. Several options also exist for use in drying parts prior to FPI. Samples were generated and exposed to a range of conditions to study the effect of both drying and cleaning methods on the flaw response of FPI. Low cycle fatigue (LCF) cracks were generated in approximately 40 nickel and 40 titanium samples for evaluation of the various cleaning methods. Baseline measurements were made for each of the samples using a photometer to measure sample brightness and a UVA videomicroscope to capture digital images of the FPI indications. Samples were exposed to various contaminants, cleaned and inspected. Brightness measurements and digital images were also taken to compare to the baseline data. A comparison of oven drying to flash dry in preparation for FPI has been completed and will be reported in Part I. Comparison of the effectiveness of various cleaning methods for the contaminants will be presented in Part II. The cleaning and drying studies were completed in cooperation with Delta Airlines using cleaning, drying and FPI processes typical of engine overhaul processes and equipment. The work was completed as part of the Engine Titanium Consortium and included investigators from Honeywell, General Electric, Pratt and Whitney, and Rolls Royce

Instructional climates in preschool children who are at-risk. Part II: perceived physical competence.

Science.gov (United States)

Robinson, Leah E; Rudisill, Mary E; Goodway, Jacqueline D

2009-09-01

In Part II of this study, we examined the effect of two 9-week instructional climates (low-autonomy [LA] and mastery motivational climate [MMC]) on perceived physical competence (PPC) in preschoolers (N = 117). Participants were randomly assigned to an LA, MMC, or comparison group. PPC was assessed by a pretest, posttest, and retention test with the Pictorial Scale of Perceived Competence and Social Acceptance. A significant Treatment x Time interaction (p < .001) was present, supporting that MMC participants reported significantly higher PPC scores over time, while no positive changes were present in LA and comparison participants. The results show that an MMC leads to psychological benefits related to achievement motivation. These findings should encourage early childhood educators to consider the effect of instructional climates on children's self-perception.

Uncertainties in Organ Burdens Estimated from PAS

International Nuclear Information System (INIS)

La Bone, T.R.

2004-01-01

To calculate committed effective dose equivalent, one needs to know the quantity of the radionuclide in all significantly irradiated organs (the organ burden) as a function of time following the intake. There are two major sources of uncertainty in an organ burden estimated from personal air sampling (PAS) data: (1) The uncertainty in going from the exposure measured with the PAS to the quantity of aerosol inhaled by the individual, and (2) The uncertainty in going from the intake to the organ burdens at any given time, taking into consideration the biological variability of the biokinetic models from person to person (interperson variability) and in one person over time (intra-person variability). We have been using biokinetic modeling methods developed by researchers at the University of Florida to explore the impact of inter-person variability on the uncertainty of organ burdens estimated from PAS data. These initial studies suggest that the uncertainties are so large that PAS might be considered to be a qualitative (rather than quantitative) technique. These results indicate that more studies should be performed to properly classify the reliability and usefulness of using PAS monitoring data to estimate organ burdens, organ dose, and ultimately CEDE

[Burden, empathy, and resilience in dependent people caregivers].

Science.gov (United States)

Navarro-Abal, Yolanda; López-López, María José; Climent-Rodríguez, José Antonio; Gómez-Salgado, Juan

2018-02-10

To analyse the differences in perceived burden between family caregivers who are users of patient associations and those who are not; to assess the relationship between burden, resilience, and empathy levels. Retrospective ex post facto study of two groups, one of them quasi control. The sample was composed of 155 informal caregivers (28 men and 155 women); 109 of them were users of patient relatives' associations and 46 were not. Both descriptive and bivariate comparative analyses were carried out. Caregivers who were members of patient associations showed lower burden and empathy levels than those who were not. This highlighted that the higher their level of perceived burden, the lower their level of resilience. Belonging to carers' associations results in a lower level of perceived burden and a lower risk of developing compassion fatigue syndrome. Copyright © 2018 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

The burden on informal caregivers of people with bipolar disorder.

Science.gov (United States)

Ogilvie, Alan D; Morant, Nicola; Goodwin, Guy M

2005-01-01

Caregivers of people with bipolar disorder may experience a different quality of burden than is seen with other illnesses. A better understanding of their concerns is necessary to improve the training of professionals working with this population. Conceptualizing caregiver burden in a conventional medical framework may not focus enough on issues important to caregivers, or on cultural and social issues. Perceptions of caregivers about bipolar disorder have important effects on levels of burden experienced. It is important to distinguish between caregivers' experience of this subjective burden and objective burden as externally appraised. Caregivers' previous experiences of health services may influence their beliefs about the illness. Caregiver burden is associated with depression, which affects patient recovery by adding stress to the living environment. The objective burden on caregivers of patients with bipolar disorder is significantly higher than for those with unipolar depression. Caregivers of bipolar patients have high levels of expressed emotion, including critical, hostile, or over-involved attitudes. Several measures have been developed to assess the care burden of patients with depressive disorders, but may be inappropriate for patients with bipolar disorder because of its cyclical nature and the stresses arising from manic and hypomanic episodes. Inter-episode symptoms pose another potential of burden in patients with bipolar disorder. Subsyndromal depressive symptoms are common in this phase of the illness, resulting in severe and widespread impairment of function. Despite the importance of assessing caregiver burden in bipolar disorder, relevant literature is scarce. The specific effects of mania and inter-episode symptoms have not been adequately addressed, and there is a lack of existing measures to assess burden adequately, causing uncertainty regarding how best to structure family interventions to optimally alleviate burden. The relatively few

Human infectious disease burdens decrease with urbanization but not with biodiversity.

Science.gov (United States)

Wood, Chelsea L; McInturff, Alex; Young, Hillary S; Kim, DoHyung; Lafferty, Kevin D

2017-06-05

Infectious disease burdens vary from country to country and year to year due to ecological and economic drivers. Recently, Murray et al. (Murray CJ et al 2012 Lancet 380 , 2197-2223. (doi:10.1016/S0140-6736(12)61689-4)) estimated country-level morbidity and mortality associated with a variety of factors, including infectious diseases, for the years 1990 and 2010. Unlike other databases that report disease prevalence or count outbreaks per country, Murray et al. report health impacts in per-person disability-adjusted life years (DALYs), allowing comparison across diseases with lethal and sublethal health effects. We investigated the spatial and temporal relationships between DALYs lost to infectious disease and potential demographic, economic, environmental and biotic drivers, for the 60 intermediate-sized countries where data were available and comparable. Most drivers had unique associations with each disease. For example, temperature was positively associated with some diseases and negatively associated with others, perhaps due to differences in disease agent thermal optima, transmission modes and host species identities. Biodiverse countries tended to have high disease burdens, consistent with the expectation that high diversity of potential hosts should support high disease transmission. Contrary to the dilution effect hypothesis, increases in biodiversity over time were not correlated with improvements in human health, and increases in forestation over time were actually associated with increased disease burden. Urbanization and wealth were associated with lower burdens for many diseases, a pattern that could arise from increased access to sanitation and healthcare in cities and increased investment in healthcare. The importance of urbanization and wealth helps to explain why most infectious diseases have become less burdensome over the past three decades, and points to possible levers for further progress in improving global public health.This article is part

Measuring the burden of neglected tropical diseases: the global burden of disease framework.

Directory of Open Access Journals (Sweden)

Colin D Mathers

2007-11-01

Full Text Available Reliable, comparable information about the main causes of disease and injury in populations, and how these are changing, is a critical input for debates about priorities in the health sector. Traditional sources of information about the descriptive epidemiology of diseases, injuries, and risk factors are generally incomplete, fragmented, and of uncertain reliability and comparability. The Global Burden of Disease (GBD study has provided a conceptual and methodological framework to quantify and compare the health of populations using a summary measure of both mortality and disability, the disability-adjusted life year (DALY.This paper describes key features of the Global Burden of Disease analytic approach, which provides a standardized measurement framework to permit comparisons across diseases and injuries, as well as risk factors, and a systematic approach to the evaluation of data. The paper describes the evolution of the GBD, starting from the first study for the year 1990, summarizes the methodological improvements incorporated into GBD revisions for the years 2000-2004 carried out by the World Health Organization, and examines priorities and issues for the next major GBD study, funded by the Bill & Melinda Gates Foundation, and commencing in 2007.The paper presents an overview of summary results from the Global Burden of Disease study 2002, with a particular focus on the neglected tropical diseases, and also an overview of the comparative risk assessment for 26 global risk factors. Taken together, trypanosomiasis, Chagas disease, schistosomiasis, leishmaniasis, lymphatic filariasis, onchocerciasis, intestinal nematode infections, Japanese encephalitis, dengue, and leprosy accounted for an estimated 177,000 deaths worldwide in 2002, mostly in sub-Saharan Africa, and about 20 million DALYs, or 1.3% of the global burden of disease and injuries. Further research is currently underway to revise and update these estimates.

Burden of illness in functional gastrointestinal disorder--the consequences for the individual and society.

Science.gov (United States)

Glise, H; Wiklund, I; Hallerbäck, B

1998-01-01

To review the consequences of functional gastrointestinal disorders (FGD), i.e. heartburn without esophagitis, dyspepsia and IBS for the individual and society. Current publications indicate that functional gastrointestinal disorders are more prevalent than organic gastrointestinal disorders in the population. Symptoms, not the organic finding per se, are most important to the individual. Functional disorders are furthermore linked to somatic symptoms, from other parts of the body, as well as to mental health. Together they constitute a large medical burden on society in terms of consultations, drug consumption and surgery. Social costs are further increased by problems at work and a considerable increase in absenteeism. Functional gastrointestinal disorders should be taken more seriously by the medical community and society, since the burden of illness seems much larger than earlier anticipated.

Short-term effects of air pollution on respiratory morbidity at Rio de Janeiro--Part II: health assessment.

Science.gov (United States)

Sousa, S I V; Pires, J C M; Martins, E M; Fortes, J D N; Alvim-Ferraz, M C M; Martins, F G

2012-08-01

The effects of air pollution on health have been studied worldwide. Given that air pollution triggers oxidative stress and inflammation, it is plausible that high levels of air pollutants cause higher number of hospitalisations. This study aimed to assess the impact of air pollution on the emergency hospitalisation for respiratory disease in Rio de Janeiro, Brazil. The study was divided in two parts: Part I specifically addressing the air pollution assessment and Part II addressing the health assessment. Accordingly, this Part II aimed to estimate the association between the concentrations of PM₁₀, SO₂ and CO observed in Rio de Janeiro and the number of emergency hospitalisations at a central hospital due to respiratory diseases. The pollutant concentrations were measured at two different sites in Rio de Janeiro, but the excess relative risks were calculated based on the concentrations observed at one of the sites, where limits were generally exceeded more frequently, between September 2000 and December 2005. A time series analysis was performed using the number of hospitalisations, divided in three categories (children until 1 year old, children aged between 1 and 5 years old and elderly with 65 years old or more) as independent variable, the concentrations of pollutants as dependent variables and temperature, relative humidity, long term trend, and seasonality as confounders. Data were analysed using generalised additive models with smoothing for some of the dependent variables. Results showed an excess risk of hospitalisation for respiratory disease higher than 2% per 10 μg m⁻³ increase in PM₁₀ concentrations for children under 5 years old, of 2% per 10 μg m⁻³ increase in SO₂ for elderly above 65 years old and around 0.1% per 10 μg m⁻³ increase in CO for children under 1 year and elderly. Other studies have found associations that are in agreement with the results achieved in this study. The study suggests that the ambient levels of air

Some remarks on the natural radiation burden of population

International Nuclear Information System (INIS)

Feher, I.; Gemesi, J.; Toth, A.

1975-04-01

A large scale of the population's radiation burden is due to the natural radioactivity of building materials. An appropriate model has been developed for the calculation of the burden of population from the concentration of radioisotopes in building materials. The external and internal radiation burden of Hungary's population were determined (weighted means were 33 mrem/year and the bronhial dose 730 mrad/year, respectively) and the effect of new building technologies and materials on the radiation burden was studied. In dwellings built of precast concrete slabs containing low-activity ballast available in Hungary the radiation burden was found to be significantly lower than the present average. The increase in the contamination hazard expected from the peaceful uses of atomic energy could be compensated by reducing the average external radiation burden together with the average bronchial dose. This reduction can be 1.6 mrem/year and 58 mrad/year, respectively (according to our estimations based on simple assumptions), requiring acceptable excess cost. (K.A.)

Evaluation of modelling body burden of Cs-137

Energy Technology Data Exchange (ETDEWEB)

Bergstroem, U; Nordlinder, S

1996-05-01

Within the IAEA/CEC VAMP-program one working group studied the precision in dose assessment models when calculating body burden of {sup 137}Cs as a result of exposure through multiple exposure pathways. One scenario used data from southern Finland regarding contamination of various media due to the fallout from the Chernobyl accident. In this study, a time dependent multiple exposure pathway model was constructed based on compartment theory. Uncertainties in model responses due to uncertainties in input parameter values were studied. The initial predictions for body burden were good, within a factor of 2 of the observed, while the time dynamics of levels in milk and meat did not agree satisfactorily. Some results, nevertheless, showed good agreement with observations due to compensatory effects. After disclosure of additional observational data, major reasons for mispredictions were identified as lack of consideration of time dependence of fixation of {sup 137}Cs in soils, and the selection of parameter values. When correction of this was made, a close agreement between predictions and observations was obtained. This study shows that the dose contribution due to {sup 137}Cs in food products from the seminatural environment is important for long-term exposure to man. The evaluation provided a basis for improvements of crucial parts in the model. 14 refs, 18 figs, 8 tabs.

Pedagogical progeniture or tactical translation? George Fordyce's additions and modifications to William Cullen's philosophical chemistry--Part II.

Science.gov (United States)

Taylor, Georgette

2014-08-01

This paper compares the affinity theories and the associated affinity diagrams of William Cullen (1710-1790) and George Fordyce (1736-1802), exploring in particular one episode that took place during the brief hiatus between Fordyce's student years at Edinburgh University and the start of his own pedagogical career in London. This investigation complements that contained in Part I of this paper, which compared the chemistry courses given by Cullen and Fordyce, demonstrating that the knowledge originally imparted to Fordyce by Cullen in his Edinburgh lectures was augmented and translated by Fordyce for his own pedagogical purposes. Part II offers greater insight into the flow of knowledge between Fordyce and Cullen. Their correspondence suggests that the relationship between master and student transmuted into something more complicated after Fordyce left Edinburgh, while the model of knowledge transmission between the two can be seen to be more collaborative than might be expected.

Estimating the true global burden of mental illness.

Science.gov (United States)

Vigo, Daniel; Thornicroft, Graham; Atun, Rifat

2016-02-01

We argue that the global burden of mental illness is underestimated and examine the reasons for under-estimation to identify five main causes: overlap between psychiatric and neurological disorders; the grouping of suicide and self-harm as a separate category; conflation of all chronic pain syndromes with musculoskeletal disorders; exclusion of personality disorders from disease burden calculations; and inadequate consideration of the contribution of severe mental illness to mortality from associated causes. Using published data, we estimate the disease burden for mental illness to show that the global burden of mental illness accounts for 32·4% of years lived with disability (YLDs) and 13·0% of disability-adjusted life-years (DALYs), instead of the earlier estimates suggesting 21·2% of YLDs and 7·1% of DALYs. Currently used approaches underestimate the burden of mental illness by more than a third. Our estimates place mental illness a distant first in global burden of disease in terms of YLDs, and level with cardiovascular and circulatory diseases in terms of DALYs. The unacceptable apathy of governments and funders of global health must be overcome to mitigate the human, social, and economic costs of mental illness. Copyright © 2016 Elsevier Ltd. All rights reserved.

The global burden of periodontal disease

DEFF Research Database (Denmark)

Petersen, Poul E; Ogawa, Hiroshi

2012-01-01

Chronic diseases are accelerating globally, advancing across all regions and pervading all socioeconomic classes. Unhealthy diet and poor nutrition, physical inactivity, tobacco use, excessive use of alcohol and psychosocial stress are the most important risk factors. Periodontal disease...... is a component of the global burden of chronic disease, and chronic disease and periodontal disease have the same essential risk factors. In addition, severe periodontal disease is related to poor oral hygiene and to poor general health (e.g. the presence of diabetes mellitus and other systemic diseases......). The present report highlights the global burden of periodontal disease: the ultimate burden of periodontal disease (tooth loss), as well as signs of periodontal disease, are described from World Health Organization (WHO) epidemiological data. High prevalence rates of complete tooth loss are found in upper...

The burden experienced by family caregivers of patients with ...

African Journals Online (AJOL)

BACKGROUND: Caring for patients with chronic medical and psychiatric disorders is associated with significant burden. However little is known about the burden experience by caregivers of patients with epilepsy in Nigeria. The objective of this study, therefore, was to assess the level and correlates of burden among ...

A systematic review of patient-reported measures of burden of treatment in three chronic diseases

Directory of Open Access Journals (Sweden)

Eton DT

2013-06-01

(89% and assessed treatment burden in diabetes (82%. Only 15 measures were developed using direct patient input and had demonstrable evidence of reliability, scale structure, and multiple forms of validity; six of these demonstrated evidence of sensitivity to change. We identified 12 content domains common across measures and disease types. Conclusion: Available measures of treatment burden in single diseases can inform derivation of a patient-centered measure of the construct in patients with multiple chronic conditions. Patients should take part in developing the measure to ensure salience and relevance. Keywords: patient-reported outcomes, treatment burden, questionnaire, psychometric properties, self-management, patient-centered

Caregiving burden and its determinants in Polish caregivers of stroke survivors.

Science.gov (United States)

Jaracz, Krystyna; Grabowska-Fudala, Barbara; Górna, Krystyna; Kozubski, Wojciech

2014-10-27

Despite the growing body of literature on the consequences of providing non-professional care to stroke survivors, the determinants of caregiving burden are still not fully recognized. Identification of significant determinants can facilitate caregiver intervention programs. The aim of this study was to evaluate the level of burden borne by caregivers of stroke patients and to identify the most important determinants of burden at 6 months after hospitalization. Data were collected from 150 pairs of stroke patients/caregivers. Caregiver burden was assessed on the Caregiver Burden scale (CB). Several characteristics were measured as potential predictors of the burden. Special attention was paid to the caregiver's sense of coherence (SOC) and anxiety. Regression analysis was employed to test the hypothesized relationships between these variables and the burden. Forty-seven percentage of the caregivers reported a substantial burden (severe or moderate). Caregiver SOC (p emotional state and the level of patients' dependency, as these are the vital and modifiable factors affecting caregiver burden following stroke.

The removal of toxic metals from liquid effluents by ion exchange resins. Part VI: Manganese(II/H+/Lewatit K2621

Directory of Open Access Journals (Sweden)

Francisco J. Alguacil

2018-05-01

Full Text Available In this sixth part of the series, Manganese(II was removed from aqueous solutions by the cationic exchange resin Lewatit K2621. The investigation was performed under various experimental conditions such as the stirring speed associated with the system, aqueous pH, temperature, resin dosage and the ionic strength of the solution. The performance of the resin against the loading of metals from metal-binary solutions as well as the removal of Manganese(II from the solutions using multiwalled carbon nanotubes and functionalized (carboxylic groups multiwalled carbon nanotubes, were also investigated. Experimental results fit well with the pseudo-first kinetic order model, whereas fit of the data show that at 20 °C the process responded well to the diffusion controlled model, and that at 60 °C, the system is controlled by the moving boundary model. Adsorption data is better related to the Freundlich isotherm. Elution of the Manganese(II loaded onto the resin was investigated using acidic (H2SO4 or HCl solutions.

Zn(II, Mn(II and Sr(II Behavior in a Natural Carbonate Reservoir System. Part I: Impact of Salinity, Initial pH and Initial Zn(II Concentration in Atmospheric Conditions

Directory of Open Access Journals (Sweden)

Auffray B.

2016-07-01

Full Text Available The sorption of inorganic elements on carbonate minerals is well known in strictly controlled conditions which limit the impact of other phenomena such as dissolution and/or precipitation. In this study, we evidence the behavior of Zn(II (initially in solution and two trace elements, Mn(II and Sr(II (released by carbonate dissolution in the context of a leakage from a CO2 storage site. The initial pH chosen are either equal to the pH of the water-CO2 equilibrium (~ 2.98 or equal to the pH of the water-CO2-calcite system (~ 4.8 in CO2 storage conditions. From this initial influx of liquid, saturated or not with respect to calcite, the batch experiments evolve freely to their equilibrium, as it would occur in a natural context after a perturbation. The batch experiments are carried out on two natural carbonates (from Lavoux and St-Emilion with PCO2 = 10−3.5 bar, with different initial conditions ([Zn(II]i from 10−4 to 10−6 M, either with pure water or 100 g/L NaCl brine. The equilibrium regarding calcite dissolution is confirmed in all experiments, while the zinc sorption evidenced does not always correspond to the two-step mechanism described in the literature. A preferential sorption of about 10% of the concentration is evidenced for Mn(II in aqueous experiments, while Sr(II is more sorbed in saline conditions. This study also shows that this preferential sorption, depending on the salinity, is independent of the natural carbonate considered. Then, the simulations carried out with PHREEQC show that experiments and simulations match well concerning the equilibrium of dissolution and the sole zinc sorption, with log KZn(II ~ 2 in pure water and close to 4 in high salinity conditions. When the simulations were possible, the log K values for Mn(II and Sr(II were much different from those in the literature obtained by sorption in controlled conditions. It is shown that a new conceptual model regarding multiple Trace Elements (TE sorption is

6 CFR 27.325 - Burden of proof.

Science.gov (United States)

2010-01-01

... 6 Domestic Security 1 2010-01-01 2010-01-01 false Burden of proof. 27.325 Section 27.325 Domestic Security DEPARTMENT OF HOMELAND SECURITY, OFFICE OF THE SECRETARY CHEMICAL FACILITY ANTI-TERRORISM... burden of proving the facts necessary to support the challenged administrative action at every proceeding...

Formalising arguments about the burden of persuasion.

NARCIS (Netherlands)

Prakken, H.; Sartor, G.

2007-01-01

This paper presents an argument-based logic for reasoning about allocations of the burden of persuasion. The logic extends the system of Prakken (2001), which in turn modified the system of Prakken & Sartor (1996) with the possibility to distribute the burden of proof over both sides in an argument

Epidemiology and burden of bipolar disorder in Africa: a systematic review of data from Africa.

Science.gov (United States)

Esan, Oluyomi; Esan, Arinola

2016-01-01

Bipolar disorder impacts negatively on the patient, the family, as well as the society. It taxes the health care services due to a combination of the illness with associated medical and psychiatric comorbidities. In Africa, unfortunately, knowledge of the epidemiology and burden of bipolar disorder is based mainly on studies from the USA and Europe. In this systematic review of literature from Africa, we highlight the epidemiology and burden of bipolar disorder. A systematic review of publications from Africa relating to the epidemiology and burden of bipolar disorder was conducted. Data from community surveys conducted in Nigeria and Ethiopia indicated a lifetime prevalence estimate of 0.1 % to 1.83 for bipolar disorder. Missed diagnosis rate of bipolar disorder was up to 36.2 %. In one study, 8.1 % of the males and 5.4 % of the females reported a previous suicide attempt. A study showed that up to 60 % of patients with bipolar disorder had at least one comorbidity. There were no reports on all-cause mortality and cost of illness. Bipolar disorder is a major mental health problem in Africa. Scientific findings on bipolar disorder from Africa are consistent with the existing literature from other parts of the world. There still exists a dearth of high quality studies addressing the epidemiological, clinical, social, and economic burden of the disorder.

Ni(II) and Cu(II) binding with a 14-aminoacid sequence of Cap43 protein, TRSRSHTSEGTRSR.

Science.gov (United States)

Zoroddu, M A; Kowalik-Jankowska, T; Kozlowski, H; Salnikow, K; Costa, M

2001-03-01

The tetradecapeptide containing the 10 aminoacid repeated sequence on the C-terminus of the Ni(II)-induced Cap43 protein, was analyzed for Ni(II) and Cu(II) binding. A combined pH-metric and spectroscopic UV-VIS, EPR, CD and NMR study of Ni(II) and Cu(II) binding to the blocked CH3CO-Thr-Arg-Ser-Arg-Ser-His-Thr-Ser-Glu-Gly-Thr-Arg-Ser-Arg-NH2 (Ac-TRSRSHTSEGTRSR-Am) peptide, modeling a part of the C-terminal sequence of the Cap43 protein, revealed the formation of octahedral complexes involving imidazole nitrogen of histidine, at pH 5.5 and pH 7 for Cu(II) and Ni(II), respectively; a major square planar 4N-Ni(II) complex (about 100% at pH 9, log K* = -28.16) involving imidazole nitrogen of histidine and three deprotonated amide nitrogens of the backbone of the peptide was revealed; a 3N-Cu(II) complex (maximum about 70% at pH 7, log K*=-13.91) and a series of 4N-Cu(II) complexes starting at pH 5.5 (maximum about 90% at pH 8.7, log K* = -21.39 for CuH(-3)L), were revealed. This work supports the existence of a metal binding site at the COOH-terminal part of the Cap43 peptide.

Double burden of disease in the slums of Kenya

NARCIS (Netherlands)

Oti, S.O.

2015-01-01

The goal of this thesis was to provide evidence of a double burden of disease in the slums of Nairobi and to make a case for an integrated health systems approach to tackling this situation. A double burden of disease refers to the coexistence of a high burden of communicable and non-communicable

The economic burden of physical inactivity: a global analysis of major non-communicable diseases.

Science.gov (United States)

Ding, Ding; Lawson, Kenny D; Kolbe-Alexander, Tracy L; Finkelstein, Eric A; Katzmarzyk, Peter T; van Mechelen, Willem; Pratt, Michael

2016-09-24

responsible for a substantial economic burden. This paper provides further justification to prioritise promotion of regular physical activity worldwide as part of a comprehensive strategy to reduce non-communicable diseases. None. Copyright © 2016 Elsevier Ltd. All rights reserved.

Burden attributable to child maltreatment in Australia.

Science.gov (United States)

Moore, Sophie E; Scott, James G; Ferrari, Alize J; Mills, Ryan; Dunne, Michael P; Erskine, Holly E; Devries, Karen M; Degenhardt, Louisa; Vos, Theo; Whiteford, Harvey A; McCarthy, Molly; Norman, Rosana E

2015-10-01

Child maltreatment is a complex phenomenon, with four main types (childhood sexual abuse, physical abuse, emotional abuse, and neglect) highly interrelated. All types of maltreatment have been linked to adverse health consequences and exposure to multiple forms of maltreatment increases risk. In Australia to date, only burden attributable to childhood sexual abuse has been estimated. This study synthesized the national evidence and quantified the burden attributable to the four main types of child maltreatment. Meta-analyses, based on quality-effects models, generated pooled prevalence estimates for each maltreatment type. Exposure to child maltreatment was examined as a risk factor for depressive disorders, anxiety disorders and intentional self-harm using counterfactual estimation and comparative risk assessment methods. Adjustments were made for co-occurrence of multiple forms of child maltreatment. Overall, an estimated 23.5% of self-harm, 20.9% of anxiety disorders and 15.7% of depressive disorders burden in males; and 33.0% of self-harm, 30.6% of anxiety disorders and 22.8% of depressive disorders burden in females was attributable to child maltreatment. Child maltreatment was estimated to cause 1.4% (95% uncertainty interval 0.4-2.3%) of all disability-adjusted life years (DALYs) in males, and 2.4% (0.7-4.1%) of all DALYs in females in Australia in 2010. Child maltreatment contributes to a substantial proportion of burden from depressive and anxiety disorders and intentional self-harm in Australia. This study demonstrates the importance of including all forms of child maltreatment as risk factors in future burden of disease studies. Copyright © 2015 Elsevier Ltd. All rights reserved.

Critical thinking and accuracy of nurses' diagnoses. Part II: application of cognitive skills and guidelines for self-development Pensamiento crítico y precisión de los diagnósticos de enfermería. II Parte: aplicación de habilidades cognitivas y guia para el autodesarrollo Pensamento crítico e acurácia dos diagnósticos de enfermagem. Parte II: aplicação de habilidades cognitivas e guia para o auto-desenvolvimento

Directory of Open Access Journals (Sweden)

Margaret Lunney

2003-09-01

Full Text Available Part I of this article, the author explained the difficulties of achieving accuracy of nurses' diagnoses, the relevance of critical thinking to the achievement of accuracy, and newer views of critical thinking. In Part II, the critical thinking dimensions identified as important for nursing practice are applied in the diagnostic process using a case study of a 16 year old girl with type 1 diabetes. Application of seven cognitive skills and ten habits of mind illustrate the importance of using critical thinking for accuracy of nurses' diagnoses. Ten strategies are proposed for self-development of critical thinking abilities.En la I Parte del artículo, el autor explicó las dificultades para alcanzar la precisión de los diagnósticos de enfermería, la relevancia del pensamiento crítico en el logro de esa precisión y las nuevas perspectivas de ese pensamiento. En la II Parte las dimensiones del pensamiento crítico, consideradas como importantes para la práctica de enfermería, son aplicadas en el estudio de caso de una joven de 16 años con Diabetes de tipo 1. La aplicación de las siete habilidades cognitivas y de las diez formas de pensar, ilustra la importancia del uso del pensamiento crítico para la precisión de los diagnósticos de enfermería. Se proponen diez estratégias para el auto-desarrollo de habilidades volcadas al pensamiento crítico.Na Parte I deste artigo, o autor explicou as dificuldades em alcançar a acurácia dos diagnósticos de enfermagem, a relevância do pensamento crítico no alcance dessa acurácia e as mais novas perspectivas desse pensamento. Na Parte II, as dimensões do pensamento crítico identificadas como importantes para a prática de enfermagem são aplicadas em um estudo de caso de uma menina de 16 anos com Diabetes do tipo 1. A aplicação das sete habilidades cognitivas e das dez formas de pensar ilustram a importância do uso do pensamento crítico para a acurácia dos diagnósticos de enfermagem

Cubby : Multiscreen Desktop VR Part II

NARCIS (Netherlands)

Gribnau, M.W.; Djajadiningrat, J.P.

2000-01-01

In this second part of our 'Cubby: Multiscreen Desktop VR' trilogy, we will introduce you to the art of creating a driver to read an Origin Instruments Dynasight input device. With the Dynasight, the position of the head of the user is established so that Cubby can display the correct images on its

The epidemiology of cardiovascular diseases in sub-Saharan Africa: the Global Burden of Diseases, Injuries and Risk Factors 2010 Study.

Science.gov (United States)

Moran, Andrew; Forouzanfar, Mohammad; Sampson, Uchechukwu; Chugh, Sumeet; Feigin, Valery; Mensah, George

2013-01-01

The epidemiology of cardiovascular diseases in sub-Saharan Africa is unique among world regions, with about half of cardiovascular diseases (CVDs) due to causes other than atherosclerosis. CVD epidemiology data are sparse and of uneven quality in sub-Saharan Africa. Using the available data, the Global Burden of Diseases, Risk Factors, and Injuries (GBD) 2010 Study estimated CVD mortality and burden of disease in sub-Saharan Africa in 1990 and 2010. The leading CVD cause of death and disability in 2010 in sub-Saharan Africa was stroke; the largest relative increases in CVD burden between 1990 and 2010 were in atrial fibrillation and peripheral arterial disease. CVD deaths constituted only 8.8% of all deaths and 3.5% of all disability-adjusted life years (DALYs) in sub-Sahara Africa, less than a quarter of the proportion of deaths and burden attributed to CVD in high income regions. However, CVD deaths in sub-Saharan Africa occur at younger ages on average than in the rest of the world. It remains uncertain if increased urbanization and life expectancy in some parts of sub-Saharan African nations will transition the region to higher CVD burden in future years. © 2013.

The Epidemiology of Cardiovascular Diseases in Sub-Saharan Africa: The Global Burden of Diseases, Injuries and Risk Factors 2010 Study

Science.gov (United States)

Moran, Andrew; Forouzanfar, Mohammad; Sampson, Uchechukwu; Chugh, Sumeet; Feigin, Valery; Mensah, George

2014-01-01

The epidemiology of cardiovascular diseases in sub-Saharan Africa is unique among world regions, with about half of cardiovascular diseases (CVDs) due to causes other than atherosclerosis. CVD epidemiology data are sparse and of uneven quality in sub-Saharan Africa. Using the available data, the Global Burden of Diseases, Risk Factors, and Injuries (GBD) 2010 Study estimated CVD mortality and burden of disease in sub-Saharan Africa in 1990 and 2010. The leading CVD cause of death and disability in 2010 in sub-Saharan Africa was stroke; the largest relative increases in CVD burden between 1990 and 2010 were in atrial fibrillation and peripheral arterial disease. CVD deaths constituted only 8.8% of all deaths and 3.5% of all disability-adjusted life years (DALYs) in sub-Sahara Africa, less than a quarter of the proportion of deaths and burden attributed to CVD in high income regions. However, CVD deaths in sub-Saharan Africa occur at younger ages on average than in the rest of the world. It remains uncertain if increased urbanization and life expectancy in some parts of sub-Saharan African nations will transition the region to higher CVD burden in future years. PMID:24267430

PACE. A Program for Acquiring Competence in Entrepreneurship. Part II: Becoming an Entrepreneur. Unit G: Resources for Managerial Assistance. Research and Development Series No. 194 B-7.

Science.gov (United States)

Ohio State Univ., Columbus. National Center for Research in Vocational Education.

This three-part curriculum for entrepreneurship education is primarily for postsecondary level, including four-year colleges and adult education, but it can be adapted for special groups or vocational teacher education. The emphasis of the seven instructional units in Part II is establishing business. Unit G focuses on obtaining managerial…

Private prayer among Alzheimer's caregivers: mediating burden and resiliency.

Science.gov (United States)

Wilks, Scott E; Vonk, M Elizabeth

2008-01-01

This study examined whether the coping method of private prayer served as a protective factor of resiliency among a sample (N = 304) of Alzheimer's caregivers. Participants in caregiver support groups completed questionnaires that assessed a number of constructs, including caregiving burden; prayer frequency; use of private prayer as a means of coping; and perceived resiliency. The sample averaged a moderate level of burden and a great extent of prayer usage. Caregiving burden had positively affected the extent of prayer usage and negatively influenced perceived resiliency. Findings from hierarchical regression analysis showed that caregiving burden and private prayer significantly influenced variation in perceived resiliency scores. Results from a regression equation series and path analysis provided support for prayer as a mediator between burden and perceived resiliency. Implications for social work practice and education are discussed.

The burden of neck pain: its meaning for persons with neck pain and healthcare providers, explored by concept mapping.

Science.gov (United States)

van Randeraad-van der Zee, Carlijn H; Beurskens, Anna J H M; Swinkels, Raymond A H M; Pool, Jan J M; Batterham, Roy W; Osborne, Richard H; de Vet, Henrica C W

2016-05-01

To empirically define the concept of burden of neck pain. The lack of a clear understanding of this construct from the perspective of persons with neck pain and care providers hampers adequate measurement of this burden. An additional aim was to compare the conceptual model obtained with the frequently used Neck Disability Index (NDI). Concept mapping, combining qualitative (nominal group technique and group consensus) and quantitative research methods (cluster analysis and multidimensional scaling), was applied to groups of persons with neck pain (n = 3) and professionals treating persons with neck pain (n = 2). Group members generated statements, which were organized into concept maps. Group members achieved consensus about the number and description of domains and the researchers then generated an overall mind map covering the full breadth of the burden of neck pain. Concept mapping revealed 12 domains of burden of neck pain: impaired mobility neck, neck pain, fatigue/concentration, physical complaints, psychological aspects/consequences, activities of daily living, social participation, financial consequences, difficult to treat/difficult to diagnose, difference of opinion with care providers, incomprehension by social environment, and how person with neck pain deal with complaints. All ten items of the NDI could be linked to the mind map, but the NDI measures only part of the burden of neck pain. This study revealed the relevant domains for the burden of neck pain from the viewpoints of persons with neck pain and their care providers. These results can guide the identification of existing measurements instruments for each domain or the development of new ones to measure the burden of neck pain.

Procedimiento para diseñar el muestreo eólico en una región promisoria. Parte II.Implementación y aplicación; Procedure to design sampling of the wind speed in a promissory region. Part II. Implementation and application

Directory of Open Access Journals (Sweden)

Eduardo Terrero Matos

2015-06-01

Full Text Available En la Parte I de este artículo fue establecido el algoritmo general de un procedimiento para el diseño del muestreo de la velocidad del viento cuyos resultados tengan la capacidad de minimizar el error probable medio durante una estimación del comportamiento espacio-temporal de la velocidad del viento. En la Parte II se describe el algoritmo de selección de puntos de muestreo y el algoritmo para el cálculo del error probable de estimación. El procedimiento para diseñarlas redes de muestreo eólico es implementado en una aplicación informática que facilita la aplicación del procedimiento a la selección de los puntos donde se ubicarán las torres anemométricas en una región promisoria del municipio Moa en la Provincia Holguín, Cuba. Los resultados obtenidos son comparados con el diseño obtenido en el año 2007 por la Empresa de Ingeniería y Proyectos de Electricidad del Ministerio de Energía y Minas de la República de Cuba.In Part I of this article was established the general algorithmof a procedure for the sampling design of the wind speed and the results have the ability to minimize the average probable error for an estimate of the conduct spatiotemporal wind speed. In Part II the selection algorithm of sampling points and the algorithm for calculating the probable error estimation is described. The procedure for the samplingdesign is implemented in an computer software that facilitates the application from the procedure to the selection of the points where theanemometer towers will be located in a promissory region of the municipality Moa in the province Holguín, Cuba. The results are compared with the design obtained in 2007 by the Empresa de Ingeniería y Proyectos de Electricidad of the Ministry of Energy and Mines of the Republic of Cuba.

20 CFR 498.215 - The hearing and burden of proof.

Science.gov (United States)

2010-04-01

... burden of going forward and the burden of persuasion with respect to affirmative defenses and any... persuasion with respect to all other issues. (c) The burden of persuasion will be judged by a preponderance...

A case study of packaging waste collection systems in Portugal - Part II: Environmental and economic analysis.

Science.gov (United States)

Pires, Ana; Sargedas, João; Miguel, Mécia; Pina, Joaquim; Martinho, Graça

2017-03-01

An understanding of the environmental impacts and costs related to waste collection is needed to ensure that existing waste collection schemes are the most appropriate with regard to both environment and cost. This paper is Part II of a three-part study of a mixed packaging waste collection system (curbside plus bring collection). Here, the mixed collection system is compared to an exclusive curbside system and an exclusive bring system. The scenarios were assessed using life cycle assessment and an assessment of costs to the waste management company. The analysis focuses on the collection itself so as to be relevant to waste managers and decision-makers who are involved only in this step of the packaging life cycle. The results show that the bring system has lower environmental impacts and lower economic costs, and is capable of reducing the environmental impacts of the mixed system. However, a sensitivity analysis shows that these results could differ if the curbside collection were to be optimized. From economic and environmental perspectives, the mixed system has few advantages. Copyright © 2016 Elsevier Ltd. All rights reserved.

Economic and disease burden of dengue in Mexico.

Directory of Open Access Journals (Sweden)

Eduardo A Undurraga

2015-03-01

Full Text Available Dengue imposes a substantial economic and disease burden in most tropical and subtropical countries. Dengue incidence and severity have dramatically increased in Mexico during the past decades. Having objective and comparable estimates of the economic burden of dengue is essential to inform health policy, increase disease awareness, and assess the impact of dengue prevention and control technologies.We estimated the annual economic and disease burden of dengue in Mexico for the years 2010-2011. We merged multiple data sources, including a prospective cohort study; patient interviews and macro-costing from major hospitals; surveillance, budget, and health data from the Ministry of Health; WHO cost estimates; and available literature. We conducted a probabilistic sensitivity analysis using Monte Carlo simulations to derive 95% certainty levels (CL for our estimates. Results suggest that Mexico had about 139,000 (95%CL: 128,000-253,000 symptomatic and 119 (95%CL: 75-171 fatal dengue episodes annually on average (2010-2011, compared to an average of 30,941 symptomatic and 59 fatal dengue episodes reported. The annual cost, including surveillance and vector control, was US$170 (95%CL: 151-292 million, or $1.56 (95%CL: 1.38-2.68 per capita, comparable to other countries in the region. Of this, $87 (95%CL: 87-209 million or $0.80 per capita (95%CL: 0.62-1.12 corresponds to illness. Annual disease burden averaged 65 (95%CL: 36-99 disability-adjusted life years (DALYs per million population. Inclusion of long-term sequelae, co-morbidities, impact on tourism, and health system disruption during outbreaks would further increase estimated economic and disease burden.With this study, Mexico joins Panama, Puerto Rico, Nicaragua, and Thailand as the only countries or areas worldwide with comprehensive (illness and preventive empirical estimates of dengue burden. Burden varies annually; during an outbreak, dengue burden may be significantly higher than that of

Economic and disease burden of dengue in Mexico.

Science.gov (United States)

Undurraga, Eduardo A; Betancourt-Cravioto, Miguel; Ramos-Castañeda, José; Martínez-Vega, Ruth; Méndez-Galván, Jorge; Gubler, Duane J; Guzmán, María G; Halstead, Scott B; Harris, Eva; Kuri-Morales, Pablo; Tapia-Conyer, Roberto; Shepard, Donald S

2015-03-01

Dengue imposes a substantial economic and disease burden in most tropical and subtropical countries. Dengue incidence and severity have dramatically increased in Mexico during the past decades. Having objective and comparable estimates of the economic burden of dengue is essential to inform health policy, increase disease awareness, and assess the impact of dengue prevention and control technologies. We estimated the annual economic and disease burden of dengue in Mexico for the years 2010-2011. We merged multiple data sources, including a prospective cohort study; patient interviews and macro-costing from major hospitals; surveillance, budget, and health data from the Ministry of Health; WHO cost estimates; and available literature. We conducted a probabilistic sensitivity analysis using Monte Carlo simulations to derive 95% certainty levels (CL) for our estimates. Results suggest that Mexico had about 139,000 (95%CL: 128,000-253,000) symptomatic and 119 (95%CL: 75-171) fatal dengue episodes annually on average (2010-2011), compared to an average of 30,941 symptomatic and 59 fatal dengue episodes reported. The annual cost, including surveillance and vector control, was US$170 (95%CL: 151-292) million, or $1.56 (95%CL: 1.38-2.68) per capita, comparable to other countries in the region. Of this, $87 (95%CL: 87-209) million or $0.80 per capita (95%CL: 0.62-1.12) corresponds to illness. Annual disease burden averaged 65 (95%CL: 36-99) disability-adjusted life years (DALYs) per million population. Inclusion of long-term sequelae, co-morbidities, impact on tourism, and health system disruption during outbreaks would further increase estimated economic and disease burden. With this study, Mexico joins Panama, Puerto Rico, Nicaragua, and Thailand as the only countries or areas worldwide with comprehensive (illness and preventive) empirical estimates of dengue burden. Burden varies annually; during an outbreak, dengue burden may be significantly higher than that of the pre

Prevalence and burden of Sickle Cell Disease among ...

African Journals Online (AJOL)

femi oloka

the variables pain severity, monthly income, the psychological and ... 44% had significant psychological burden while 37.3% have socio-cultural burden. The ..... 6. Otis-Green S. Psychosocial Pain. Assessment Form. In Dow (Ed.), Nursing.

A microencapsulation process of liquid mercury by sulfur polymer stabilization/solidification technology. Part II: Durability of materials

Energy Technology Data Exchange (ETDEWEB)

Lopez-Delgado, A.; Guerrero, A.; Lopez, F. A.; Perez, C.; Alguacil, F. J.

2012-11-01

Under the European LIFE Program a microencapsulation process was developed for liquid mercury using Sulfur Polymer Stabilization/Solidification (SPSS) technology, obtaining a stable concrete-like sulfur matrix that allows the immobilization of mercury for long-term storage. The process description and characterization of the materials obtained were detailed in Part I. The present document, Part II, reports the results of different tests carried out to determine the durability of Hg-S concrete samples with very high mercury content (up to 30 % w/w). Different UNE and RILEM standard test methods were applied, such as capillary water absorption, low pressure water permeability, alkali/acid resistance, salt mist aging, freeze-thaw resistance and fire performance. The samples exhibited no capillarity and their resistance in both alkaline and acid media was very high. They also showed good resistance to very aggressive environments such as spray salt mist, freeze-thaw and dry-wet. The fire hazard of samples at low heat output was negligible. (Author)

PACE. A Program for Acquiring Competence in Entrepreneurship. Part II: Becoming an Entrepreneur. Unit A: Developing the Business Plan. Research and Development Series No. 194 B-1.

Science.gov (United States)

Ohio State Univ., Columbus. National Center for Research in Vocational Education.

This three-part curriculum for entrepreneurship education is primarily for postsecondary level, including four-year colleges and adult education, but it can be adapted for special groups or vocational teacher education. The emphasis of the seven instructional units in Part II is establishing a business. Unit A focuses on developing a business…

Burden of mortality in Greenland--today and tomorrow

DEFF Research Database (Denmark)

Nielsen, Lasse Christian; Hansen, Kristian Schultz; Nielsen, Ulla Ringgren

2004-01-01

: Concerted multi-sectoral approaches and broad holistic health strategies related to health promotion and prevention today will strategically improve the capability of the Greenlandic society to manage the future disease burden from ageing via its health care sector and the institutional sector for care......OBJECTIVES: Investigation of the relative impact of three factors expected to influence the future mortality burden in Greenland: demographic change, epidemiological transition and behavioural patterns. STUDY DESIGN: To identify general trends in public health status, evaluating the effect...... of public health campaigns and providing the basis for making predictions of future trends in the mortality burden data from the Greenlandic Death Causes Register to estimate Years of Life Lost (YLL) in the period 1976-1998 has been used. METHODS: YLL were estimated according to the Burden of Disease Method...

The impact of dietary risk factors on the burden of non-communicable diseases in Ethiopia : findings from the Global Burden of Disease study 2013

NARCIS (Netherlands)

Melaku, Yohannes Adama; Temesgen, Awoke Misganaw; Deribew, Amare; Tessema, Gizachew Assefa; Deribe, Kebede; Sahle, Berhe W.; Abera, Semaw Ferede; Bekele, Tolesa; Lemma, Ferew; Amare, Azmeraw T.; Seid, Oumer; Endris, Kedir; Hiruye, Abiy; Worku, Amare; Adams, Robert; Taylor, Anne W.; Gill, Tiffany K.; Shi, Zumin; Afshin, Ashkan; Forouzanfar, Mohammad H.

2016-01-01

Background: The burden of non-communicable diseases (NCDs) has increased in sub-Saharan countries, including Ethiopia. The contribution of dietary behaviours to the NCD burden in Ethiopia has not been evaluated. This study, therefore, aimed to assess diet-related burden of disease in Ethiopia

Multiobjective Optimization for Fixture Locating Layout of Sheet Metal Part Using SVR and NSGA-II

Directory of Open Access Journals (Sweden)

Yuan Yang

2017-01-01

Full Text Available Fixture plays a significant role in determining the sheet metal part (SMP spatial position and restraining its excessive deformation in many manufacturing operations. However, it is still a difficult task to design and optimize SMP fixture locating layout at present because there exist multiple conflicting objectives and excessive computational cost of finite element analysis (FEA during the optimization process. To this end, a new multiobjective optimization method for SMP fixture locating layout is proposed in this paper based on the support vector regression (SVR surrogate model and the elitist nondominated sorting genetic algorithm (NSGA-II. By using ABAQUS™ Python script interface, a parametric FEA model is established. And the fixture locating layout is treated as design variables, while the overall deformation and maximum deformation of SMP under external forces are as the multiple objective functions. First, a limited number of training and testing samples are generated by combining Latin hypercube design (LHD with FEA. Second, two SVR prediction models corresponding to the multiple objectives are established by learning from the limited training samples and are integrated as the multiobjective optimization surrogate model. Third, NSGA-II is applied to determine the Pareto optimal solutions of SMP fixture locating layout. Finally, a multiobjective optimization for fixture locating layout of an aircraft fuselage skin case is conducted to illustrate and verify the proposed method.

[Burden of proof in medical cases--presumption of fact and prima facie evidence. 1. Burden of proof].

Science.gov (United States)

Sliwka, Marcin

2004-01-01

The aim of this paper was to present the main rules concerning the burden of proof in polish civil trials, including medical cases. This paper also describes the subject of evidence were presented and explained. The court influence on evidence procedure was also analysed. The effect of the institution of informed consent on burden of proof in polish civil law is also described. This paper includes numerous High Court sentences on evidential and medical issues.

Mechanical performance of carbon-epoxy laminates. Part II: quasi-static and fatigue tensile properties

Directory of Open Access Journals (Sweden)

José Ricardo Tarpani

2006-06-01

Full Text Available In Part II of this work, quasi-static tensile properties of four aeronautical grade carbon-epoxy composite laminates, in both the as-received and pre-fatigued states, have been determined and compared. Quasi-static mechanical properties assessed were tensile strength and stiffness, tenacity (toughness at the maximum load and for a 50% load drop-off. In general, as-molded unidirectional cross-ply carbon fiber (tape reinforcements impregnated with either standard or rubber-toughened epoxy resin exhibited the maximum performance. The materials also displayed a significant tenacification (toughening after exposed to cyclic loading, resulting from the increased stress (the so-called wear-in phenomenon and/or strain at the maximum load capacity of the specimens. With no exceptions, two-dimensional woven textile (fabric pre-forms fractured catastrophically under identical cyclic loading conditions imposed to the fiber tape architecture, thus preventing their residual properties from being determined.

The Global Burden of Cancer 2013

OpenAIRE

2015-01-01

Importance Cancer is among the leading causes of death worldwide. Current estimates of cancer burden in individual countries and regions are necessary to inform local cancer control strategies. Objective To estimate mortality, incidence, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs) for 28 cancers in 188 countries by sex from 1990 to 2013. Evidence Review The general methodology of the Global Burden of Disease (GBD) 2013 study was us...

The unrecognized burden of typhoid fever.

Science.gov (United States)

Obaro, Stephen K; Iroh Tam, Pui-Ying; Mintz, Eric Daniel

2017-03-01

Typhoid fever (TF), caused by Salmonella enterica serovar Typhi, is the most common cause of enteric fever, responsible for an estimated 129,000 deaths and more than 11 million cases annually. Although several reviews have provided global and regional TF disease burden estimates, major gaps in our understanding of TF epidemiology remain. Areas covered: We provide an overview of the gaps in current estimates of TF disease burden and offer suggestions for addressing them, so that affected communities can receive the full potential of disease prevention offered by vaccination and water, sanitation, and hygiene interventions. Expert commentary: Current disease burden estimates for TF do not capture cases from certain host populations, nor those with atypical presentations of TF, which may lead to substantial underestimation of TF cases and deaths. These knowledge gaps pose major obstacles to the informed use of current and new generation typhoid vaccines.

Magnetic resonance imaging of the elbow. Part II: Abnormalities of the ligaments, tendons, and nerves

Energy Technology Data Exchange (ETDEWEB)

Kijowski, Richard; Tuite, Michael; Sanford, Matthew [University of Wisconsin Hospital, Department of Radiology, Madison, WI (United States)

2005-01-01

Part II of this comprehensive review on magnetic resonance imaging of the elbow discusses the role of magnetic resonance imaging in evaluating patients with abnormalities of the ligaments, tendons, and nerves of the elbow. Magnetic resonance imaging can yield high-quality multiplanar images which are useful in evaluating the soft tissue structures of the elbow. Magnetic resonance imaging can detect tears of the ulnar collateral ligament and lateral collateral ligament of the elbow with high sensitivity and specificity. Magnetic resonance imaging can determine the extent of tendon pathology in patients with medial epicondylitis and lateral epicondylitis. Magnetic resonance imaging can detect tears of the biceps tendon and triceps tendon and can distinguishing between partial and complete tendon rupture. Magnetic resonance imaging is also helpful in evaluating patients with nerve disorders at the elbow. (orig.)

The humanistic and economic burden of Dravet syndrome on caregivers and families: Implications for future research.

Science.gov (United States)

Jensen, Mark P; Brunklaus, Andreas; Dorris, Liam; Zuberi, Sameer M; Knupp, Kelly G; Galer, Bradley S; Gammaitoni, Arnold R

2017-05-01

We reviewed the current literature with respect to the humanistic and financial burdens of Dravet Syndrome (DS) on the caregivers of children with DS, in order to (1) identify key unanswered questions or gaps in knowledge that need to be addressed and then, based on these knowledge gaps, (2) propose a research agenda for the scientific community to address in the coming decade. The findings support the conclusion that caring for a child with DS is associated with significant humanistic burden and direct costs. However, due in part to the paucity of studies, as well as the lack of measures of specific burden domains, there remains much that is not known regarding the burden of caregiving for children with DS. To address the significant knowledge gaps in this area, research is needed that will: (1) identify the specific domains of caregivers' lives that are impacted by caring for a child with DS; (2) identify or, if needed, develop measures of caregiving impact in this area; (3) identify the factors that influence DS caregiving burden; (4) develop and evaluate the efficacy of treatments for reducing the negative impact of DS and its comorbidities on DS caregivers; (5) quantify the direct medical costs associated with DS and DS comorbidities and identify the factors that influence these costs; and (6) quantify and fully explore the indirect costs of DS. Research that addresses these goals will provide the empirical foundation needed for improving the quality of life of children with DS and their families. Copyright © 2017 Elsevier Inc. All rights reserved.

Burdens of Proof, Presumptions and Standards of Proof in Criminal ...

African Journals Online (AJOL)

Worku_Y

evidential and persuasive burdens of proof as between the state and the ..... scholars have observed that the evidential burden is a function of the burden of ..... required to convince judges by creating such an intensity of belief in their minds.

Utilization of real time PCR for the assessment of egg burden in the organs of Schistosoma japonicum experimentally infected mice.

Science.gov (United States)

Dang-Trinh, Minh-Anh; Angeles, Jose Ma M; Moendeg, Kharleezelle J; Macalanda, Adrian Miki C; Higuchi, Luna; Oto, Chiho; Kirinoki, Masashi; Chigusa, Yuichi; Kawazu, Shin-Ichiro

2018-06-01

Schistosoma japonicum, causing zoonotic intestinal schistosomiasis, is found in China, the Philippines and parts of Indonesia. Severe disease manifestations are basically due to the deposition of eggs in some vital organs such as the liver, spleen and brain. Traditionally, histopathological microscopic examination of the egg burden was used to evaluate the intensity of infection in the affected organs. However, this technique is laborious, time-consuming and requires trained personnel. In this study, real time PCR targeting the mitochondrial NADH dehydrogenase I gene was used to compare with microscopic examination of tissue sections in evaluating the egg burdens in different affected organs. Livers, spleens and brains of the S. japonicum infected mice after 8 and 18 weeks post-infection (p.i) were harvested and examined. Results showed that there were statistically significant correlations between the egg burden evaluated by tissue section examination, and the Ct values of the real time PCR of livers with heavy egg burden at 8 (r = -0.81) and 18 (r = -0.80) weeks p.i. Furthermore, a correlation (r = -0.56) between the egg burden assessed by the microscopic examination and Ct value of the real time PCR of spleens with moderate egg burden after 18 weeks p.i and not 8 weeks p.i was also observed. Brains with low egg burden showed no schistosome eggs in the microscopic examination, however one sample tested positive by real time PCR. These results suggested that real time PCR is useful in evaluating schistosome egg burden in the organs of the experimentally infected mice model that will give further insights into the pathology of schistosomiasis. Copyright © 2018 Elsevier Inc. All rights reserved.

34 CFR 34.14 - Burden of proof.

Science.gov (United States)

2010-07-01

... 34 Education 1 2010-07-01 2010-07-01 false Burden of proof. 34.14 Section 34.14 Education Office of the Secretary, Department of Education ADMINISTRATIVE WAGE GARNISHMENT § 34.14 Burden of proof. (a... those in § 34.24. (d)(1) If you object on the ground that applicable law bars us from collecting the...

Estimating the Global Burden of Endemic Canine Rabies

Science.gov (United States)

Hampson, Katie; Coudeville, Laurent; Lembo, Tiziana; Sambo, Maganga; Kieffer, Alexia; Attlan, Michaël; Barrat, Jacques; Blanton, Jesse D.; Briggs, Deborah J.; Cleaveland, Sarah; Costa, Peter; Freuling, Conrad M.; Hiby, Elly; Knopf, Lea; Leanes, Fernando; Meslin, François-Xavier; Metlin, Artem; Miranda, Mary Elizabeth; Müller, Thomas; Nel, Louis H.; Recuenco, Sergio; Rupprecht, Charles E.; Schumacher, Carolin; Taylor, Louise; Vigilato, Marco Antonio Natal; Zinsstag, Jakob; Dushoff, Jonathan

2015-01-01

Background Rabies is a notoriously underreported and neglected disease of low-income countries. This study aims to estimate the public health and economic burden of rabies circulating in domestic dog populations, globally and on a country-by-country basis, allowing an objective assessment of how much this preventable disease costs endemic countries. Methodology/Principal Findings We established relationships between rabies mortality and rabies prevention and control measures, which we incorporated into a model framework. We used data derived from extensive literature searches and questionnaires on disease incidence, control interventions and preventative measures within this framework to estimate the disease burden. The burden of rabies impacts on public health sector budgets, local communities and livestock economies, with the highest risk of rabies in the poorest regions of the world. This study estimates that globally canine rabies causes approximately 59,000 (95% Confidence Intervals: 25-159,000) human deaths, over 3.7 million (95% CIs: 1.6-10.4 million) disability-adjusted life years (DALYs) and 8.6 billion USD (95% CIs: 2.9-21.5 billion) economic losses annually. The largest component of the economic burden is due to premature death (55%), followed by direct costs of post-exposure prophylaxis (PEP, 20%) and lost income whilst seeking PEP (15.5%), with only limited costs to the veterinary sector due to dog vaccination (1.5%), and additional costs to communities from livestock losses (6%). Conclusions/Significance This study demonstrates that investment in dog vaccination, the single most effective way of reducing the disease burden, has been inadequate and that the availability and affordability of PEP needs improving. Collaborative investments by medical and veterinary sectors could dramatically reduce the current large, and unnecessary, burden of rabies on affected communities. Improved surveillance is needed to reduce uncertainty in burden estimates and to

Estimating the global burden of endemic canine rabies.

Directory of Open Access Journals (Sweden)

Katie Hampson

2015-04-01

Full Text Available Rabies is a notoriously underreported and neglected disease of low-income countries. This study aims to estimate the public health and economic burden of rabies circulating in domestic dog populations, globally and on a country-by-country basis, allowing an objective assessment of how much this preventable disease costs endemic countries.We established relationships between rabies mortality and rabies prevention and control measures, which we incorporated into a model framework. We used data derived from extensive literature searches and questionnaires on disease incidence, control interventions and preventative measures within this framework to estimate the disease burden. The burden of rabies impacts on public health sector budgets, local communities and livestock economies, with the highest risk of rabies in the poorest regions of the world. This study estimates that globally canine rabies causes approximately 59,000 (95% Confidence Intervals: 25-159,000 human deaths, over 3.7 million (95% CIs: 1.6-10.4 million disability-adjusted life years (DALYs and 8.6 billion USD (95% CIs: 2.9-21.5 billion economic losses annually. The largest component of the economic burden is due to premature death (55%, followed by direct costs of post-exposure prophylaxis (PEP, 20% and lost income whilst seeking PEP (15.5%, with only limited costs to the veterinary sector due to dog vaccination (1.5%, and additional costs to communities from livestock losses (6%.This study demonstrates that investment in dog vaccination, the single most effective way of reducing the disease burden, has been inadequate and that the availability and affordability of PEP needs improving. Collaborative investments by medical and veterinary sectors could dramatically reduce the current large, and unnecessary, burden of rabies on affected communities. Improved surveillance is needed to reduce uncertainty in burden estimates and to monitor the impacts of control efforts.

The economic burden of kidney disorders in Korea.

Science.gov (United States)

Kim, Ju Hee; Ho, Seung Hee; Kim, Hyun-Jin; Lee, Sol

2018-03-01

To estimate the economic burden of kidney disorders in Korea. The economic burden of kidney disorders was estimated using a prevalence-based approach. Related kidney diseases in patients with kidney disorders (RPWKD) were defined using codes from the tenth International Classification of Disease (E70-E90, F30-F48, F60-F69, F90-F99, K65-K67, N00-N08, N17-N19, and N30-N39). All diseases in patients with kidney disorders (APWKD) were defined as kidney disorders that involved all disease codes. Economic costs were divided into direct costs (medical costs and non-medical costs) and indirect costs (productivity loss because of morbidity and premature mortality). The prevalence of kidney disorders increased from 0.08% (2008) to 0.11% (2011). The total economic burden of RPWKD also substantially increased from $898.9 million (2008) to $1.43 billion (2011). This ∼59.4% increase in the economic burden was equal to 0.12% of the Korean gross domestic product. The economic burden of APWKD also increased during the study period: $1.06 billion (2008), $1.23 billion (2009), $1.44 billion (2010), and $1.46 billion (2011). The present study provides the first data regarding the economic burden of kidney disorders in Korea. The findings support the need for early intervention services and prevention programs to prevent, identify, and manage kidney disorders.

Burden Sharing with Climate Change Impacts

Science.gov (United States)

Tavoni, M.; van Vuuren, D.; De Cian, E.; Marangoni, G.; Hof, A.

2014-12-01

Efficiency and equity have been at the center of the climate change policy making since the very first international environmental agreements on climate change, though over time how to implement these principles has taken different forms. Studies based on Integrated Assessment Models have also shown that the economic effort of achieving a 2 degree target in a cost-effective way would differ widely across regions (Tavoni et al. 2013) because of diverse economic and energy structure, baseline emissions, energy and carbon intensity. Policy instruments, such as a fully-fledged, global emission trading schemes can be used to pursuing efficiency and equity at the same time but the literature has analyzed the compensations required to redistribute only mitigation costs. However, most of these studies have neglected the potential impacts of climate change. In this paper we use two integrated assessment models -FAIR and WITCH- to explore the 2°C policy space when accounting for climate change impacts. Impacts are represented via two different reduced forms equations, which despite their simplicity allows us exploring the key sensitivities- Our results show that in a 2 degree stabilization scenarios residual damages remain significant (see Figure 1) and that if you would like to compensate those as part of an equal effort scheme - this would lead to a different allocation than focusing on a mitigation based perspective only. The residual damages and adaptation costs are not equally distributed - and while we do not cover the full uncertainty space - with 2 different models and 2 sets of damage curves we are still able to show quite similar results in terms of vulnerable regions and the relative position of the different scenarios. Therefore, accounting for the residual damages and the associated adaptation costs on top of the mitigation burden increases and redistributes the full burden of total climate change.

The economic burden of tuberculosis in Indonesia.

Science.gov (United States)

Collins, D; Hafidz, F; Mustikawati, D

2017-09-01

Indonesia has a high prevalence of tuberculosis (TB) and is one of the 22 countries with the highest TB burdens in the world. To understand the economic burden of TB in Indonesia. TB data for 2015 were combined with cost data using a simple type of cost-benefit analysis in a decision tree model to show the economic burden under different scenarios. In Indonesia, there were an estimated 1 017 378 new active TB cases in 2015, including multidrug-resistant TB. It is estimated that 417 976 of these cases would be treated and cured, 160 830 would be unsuccessfully treated and would die, 131 571 would be untreated and would achieve cure spontaneously, and 307 000 would be untreated and would die. The total economic burden related to treated and untreated cases would be approximately US$6.9 billion. Loss of productivity due to premature death would be by far the largest element, comprising US$6.0 billion (discounted), which represents 86.6% of the total cost. Loss of productivity due to illness would be US$700 million (10.1%), provider medical costs US$156 million (2.2%), and direct non-medical costs incurred by patients and their households US$74 million (1.1%). The economic burden of TB in Indonesia is extremely high. Detecting and treating more cases would result not only in major reductions in suffering but also in economic savings to society.

Global burden of disease--a race against time

DEFF Research Database (Denmark)

Meyrowitsch, Dan W; Bygbjerg, Ib Christian

2007-01-01

Low-income communities will within the next decades undergo rapid changes. The burden of non-communicable diseases (NCDs), such as diabetes, cardio-vascular disease and cancer, will comprise an increasing proportion of the total disease burden. The results of projections indicate that the already...... constrained health systems will face a double burden of disease, in which HIV/AIDS and other common infectious diseases will co-exist with the new NCDs. In order for preventive measures directed towards NCD to be cost-effective, these have to be implemented within the next 10-20 years....

The economic burden of schizophrenia in Malaysia

Directory of Open Access Journals (Sweden)

Teoh SL

2017-07-01

Full Text Available Siew Li Teoh,1 Huey Yi Chong,1 Salina Abdul Aziz,2 Norliza Chemi,2 Abdul Razak Othman,2 Nurzuriana Md Zaki,2 Possatorn Vanichkulpitak,3 Nathorn Chaiyakunapruk1,4–6 1School of Pharmacy, Monash University Malaysia, Selangor, 2Department of Psychiatry and Mental Health, Hospital Kuala Lumpur, Kuala Lumpur, Malaysia; 3Faculty of Pharmacy, Silpakorn University, Nakhon Pathom, 4Center of Pharmaceutical Outcomes Research (CPOR, Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand; 5School of Pharmacy, University of Wisconsin, Madison, WI, USA; 6Health and Well-being Cluster, Global Asia in the 21st Century (GA21 Platform, Monash University Malaysia, Selangor, MalaysiaIntroduction: Schizophrenia (SCZ is a highly debilitating disease despite its low prevalence. The economic burden associated with SCZ is substantial and mainly attributed to productivity loss. To improve the understanding of economic burden of SCZ in the low- and middle-income country regions, we aimed to determine the economic burden of SCZ in Malaysia.Methods: A retrospective study was conducted using a prevalence-based approach from a societal perspective in Malaysia with a 1 year period from 2013. We used micro-costing technique with bottom-up method and included direct medical cost, direct non-medical cost, and indirect cost. The main data source was medical chart review which was conducted in Hospital Kuala Lumpur (HKL. The medical charts were identified electronically by matching the unique patient’s identification number registered under the National Mental Health Schizophrenia Registry and the list of patients in HKL in 2013. Other data sources were government documents, literatures, and local websites. To ensure robustness of result, probabilistic sensitivity analysis was conducted.Results: The total estimated number of treated SCZ cases in Malaysia in 2015 was 15,104 with the total economic burden of USD 100 million

The PIP-II Conceptual Design Report

Energy Technology Data Exchange (ETDEWEB)

Ball, M. [Fermi National Accelerator Lab. (FNAL), Batavia, IL (United States); Burov, A. [Fermi National Accelerator Lab. (FNAL), Batavia, IL (United States); Chase, B. [Fermi National Accelerator Lab. (FNAL), Batavia, IL (United States); Chakravarty, A. [Fermi National Accelerator Lab. (FNAL), Batavia, IL (United States); Chen, A. [Fermi National Accelerator Lab. (FNAL), Batavia, IL (United States); Dixon, S. [Fermi National Accelerator Lab. (FNAL), Batavia, IL (United States); Edelen, J. [Fermi National Accelerator Lab. (FNAL), Batavia, IL (United States); Grassellino, A. [Fermi National Accelerator Lab. (FNAL), Batavia, IL (United States); Johnson, D. [Fermi National Accelerator Lab. (FNAL), Batavia, IL (United States); Holmes, S. [Fermi National Accelerator Lab. (FNAL), Batavia, IL (United States); Kazakov, S. [Fermi National Accelerator Lab. (FNAL), Batavia, IL (United States); Klebaner, A. [Fermi National Accelerator Lab. (FNAL), Batavia, IL (United States); Kourbanis, I. [Fermi National Accelerator Lab. (FNAL), Batavia, IL (United States); Leveling, A. [Fermi National Accelerator Lab. (FNAL), Batavia, IL (United States); Melnychuk, O. [Fermi National Accelerator Lab. (FNAL), Batavia, IL (United States); Neuffer, D. [Fermi National Accelerator Lab. (FNAL), Batavia, IL (United States); Nicol, T. [Fermi National Accelerator Lab. (FNAL), Batavia, IL (United States); Ostiguy, J. -F. [Fermi National Accelerator Lab. (FNAL), Batavia, IL (United States); Pasquinelli, R. [Fermi National Accelerator Lab. (FNAL), Batavia, IL (United States); Passarelli, D. [Fermi National Accelerator Lab. (FNAL), Batavia, IL (United States); Ristori, L. [Fermi National Accelerator Lab. (FNAL), Batavia, IL (United States); Pellico, W. [Fermi National Accelerator Lab. (FNAL), Batavia, IL (United States); Patrick, J. [Fermi National Accelerator Lab. (FNAL), Batavia, IL (United States); Prost, L. [Fermi National Accelerator Lab. (FNAL), Batavia, IL (United States); Rakhno, I. [Fermi National Accelerator Lab. (FNAL), Batavia, IL (United States); Saini, A. [Fermi National Accelerator Lab. (FNAL), Batavia, IL (United States); Schappert, W. [Fermi National Accelerator Lab. (FNAL), Batavia, IL (United States); Shemyakin, A. [Fermi National Accelerator Lab. (FNAL), Batavia, IL (United States); Steimel, J. [Fermi National Accelerator Lab. (FNAL), Batavia, IL (United States); Scarpine, V. [Fermi National Accelerator Lab. (FNAL), Batavia, IL (United States); Vivoli, A. [Fermi National Accelerator Lab. (FNAL), Batavia, IL (United States); Warner, A. [Fermi National Accelerator Lab. (FNAL), Batavia, IL (United States); Yakovlev, V. [Fermi National Accelerator Lab. (FNAL), Batavia, IL (United States); Ostroumov, P. [Argonne National Lab. (ANL), Argonne, IL (United States); Conway, Z. [Argonne National Lab. (ANL), Argonne, IL (United States)

2017-03-01

The Proton Improvement Plan-II (PIP-II) encompasses a set of upgrades and improvements to the Fermilab accelerator complex aimed at supporting a world-leading neutrino program over the next several decades. PIP-II is an integral part of the strategic plan for U.S. High Energy Physics as described in the Particle Physics Project Prioritization Panel (P5) report of May 2014 and formalized through the Mission Need Statement approved in November 2015. As an immediate goal, PIP-II is focused on upgrades to the Fermilab accelerator complex capable of providing proton beam power in excess of 1 MW on target at the initiation of the Long Baseline Neutrino Facility/Deep Underground Neutrino Experiment (LBNF/DUNE) program, currently anticipated for the mid- 2020s. PIP-II is a part of a longer-term goal of establishing a high-intensity proton facility that is unique within the world, ultimately leading to multi-MW capabilities at Fermilab....

Plasma Astrophysics, part II Reconnection and Flares

CERN Document Server

Somov, Boris V

2007-01-01

This well-illustrated monograph is devoted to classic fundamentals, current practice, and perspectives of modern plasma astrophysics. The first part is unique in covering all the basic principles and practical tools required for understanding and working in plasma astrophysics. The second part presents the physics of magnetic reconnection and flares of electromagnetic origin in space plasmas within the solar system; single and double stars, relativistic objects, accretion disks, and their coronae are also covered. This book is designed mainly for professional researchers in astrophysics. However, it will also be interesting and useful to graduate students in space sciences, geophysics, as well as advanced students in applied physics and mathematics seeking a unified view of plasma physics and fluid mechanics.

A comprehensive review with potential significance during skull base and neck operations, Part II: glossopharyngeal, vagus, accessory, and hypoglossal nerves and cervical spinal nerves 1-4.

Science.gov (United States)

Shoja, Mohammadali M; Oyesiku, Nelson M; Shokouhi, Ghaffar; Griessenauer, Christoph J; Chern, Joshua J; Rizk, Elias B; Loukas, Marios; Miller, Joseph H; Tubbs, R Shane

2014-01-01

Knowledge of the possible neural interconnections found between the lower cranial and upper cervical nerves may prove useful to surgeons who operate on the skull base and upper neck regions in order to avoid inadvertent traction or transection. We review the literature regarding the anatomy, function, and clinical implications of the complex neural networks formed by interconnections between the lower cranial and upper cervical nerves. A review of germane anatomic and clinical literature was performed. The review is organized into two parts. Part I discusses the anastomoses between the trigeminal, facial, and vestibulocochlear nerves or their branches and other nerve trunks or branches in the vicinity. Part II deals with the anastomoses between the glossopharyngeal, vagus, accessory and hypoglossal nerves and their branches or between these nerves and the first four cervical spinal nerves; the contribution of the autonomic nervous system to these neural plexuses is also briefly reviewed. Part II is presented in this article. Extensive and variable neural anastomoses exist between the lower cranial nerves and between the upper cervical nerves in such a way that these nerves with their extra-axial communications can be collectively considered a plexus. Copyright © 2013 Wiley Periodicals, Inc.

The burden and management of dyslipidemia: practical issues.

Science.gov (United States)

Schultz, Alyssa B; Chen, Chin-Yu; Burton, Wayne N; Edington, Dee W

2012-10-01

The objective of this study is to describe briefly the burden of dyslipidemia, and to discuss and present strategies for health professionals to improve dyslipidemia management, based on a review of selected literature focusing on interventions for dyslipidemia treatment adherence. Despite the availability of effective lifestyle and pharmaceutical therapies for dyslipidemias, they continue to present a significant economic burden in the United States. Adherence to evidence-based guidelines for the treatment of dyslipidemias is unsatisfactory. The reasons for medication nonadherence are complex and specific to each patient. The lack of progress in achieving optimal lipid targets is caused by many factors: patient (medication adherence, cost of medication, literacy), medication (adverse effects, complexity of regimen), provider (lack of adherence to evidence-based practice guidelines, poor communication), and the US healthcare system (being focused on acute care rather than prevention, lack of continuity of care, general lack of use of an electronic health record). Combined interventions that target each part of the system have been effective in improving treatment adherence and achieving lipid goals. Patients, providers, pharmacists, and employers all play a role in management of dyslipidemia. No single approach will solve the complex issue of improving dyslipidemia management. The required lifestyle changes are known and effective medications are available. The challenge is for all interested parties-including nurses, nurse practitioners, doctors, pharmacists, other health care professionals, employers, and health plans-to help patients achieve behavioral changes.

A microencapsulation process of liquid mercury by sulfur polymer stabilization/solidification technology. Part II: Durability of materials

Directory of Open Access Journals (Sweden)

López-Delgado, A.

2012-02-01

Full Text Available Under the European LIFE Program a microencapsulation process was developed for liquid mercury using Sulfur Polymer Stabilization/Solidification (SPSS technology, obtaining a stable concrete-like sulfur matrix that allows the immobilization of mercury for long-term storage. The process description and characterization of the materials obtained were detailed in Part I. The present document, Part II, reports the results of different tests carried out to determine the durability of Hg-S concrete samples with very high mercury content (up to 30 % w/w. Different UNE and RILEM standard test methods were applied, such as capillary water absorption, low pressure water permeability, alkali/acid resistance, salt mist aging, freeze-thaw resistance and fire performance. The samples exhibited no capillarity and their resistance in both alkaline and acid media was very high. They also showed good resistance to very aggressive environments such as spray salt mist, freeze-thaw and dry-wet. The fire hazard of samples at low heat output was negligible.

Dentro del Programa Europeo LIFE, se ha desarrollado un proceso de microencapsulación de mercurio liquido, utilizando la tecnología de estabilización/solidificación con azufre polimérico (SPSS. Como resultado se ha obtenido un material estable tipo concreto que permite la inmovilización de mercurio y su almacenamiento a largo plazo. La descripción del proceso y la caracterización de los materiales obtenidos, denominados concretos Hg-S, se detallan en la Parte I. El presente trabajo, Parte II, incluye los resultados de los diferentes ensayos realizados para determinar la durabilidad de las muestras de concreto Hg-S con un contenido de mercurio de hasta el 30 %. Se han utilizado diferentes métodos de ensayo estándar, UNE y RILEM, para determinar propiedades como la absorción de agua por capilaridad, la permeabilidad de agua a baja presión, la resistencia a álcali y ácido, el comportamiento en

The hereditary angioedema burden of illness study in Europe (HAE-BOIS-Europe: background and methodology

Directory of Open Access Journals (Sweden)

Bygum Anette

2012-04-01

Full Text Available Abstract Background Hereditary angioedema (HAE is a rare but serious disease marked by swelling attacks in the extremities, face, trunk, airway, or abdominal areas that can be spontaneous or the result of trauma and other triggers. It can be life-threatening due to the risk of asphyxiation. While there have been major advancements in our understanding of the immunogenetics of HAE, there are significant gaps in the literature regarding understanding of the humanistic and economic impact of the disease, particularly in Europe. The purpose of the HAE Burden of Illness Study-Europe (HAE-BOIS-Europe, the development and methodology of which is described here, is to better understand the management and impact of HAE from the patient perspective in Europe. Methods/Design This is a cross-sectional study in which retrospective data were also collected being conducted in Denmark, Germany and Spain. The study is open to patients ages 12 and older with a diagnosis of HAE-I or HAE-II. Data collection includes: (i a survey on individuals’ health care resource use, direct and indirect medical costs, impact on work and school, treatment satisfaction, and emotional functioning (via the Hospital Anxiety and Depression Scale; and (ii one-on-one interviews to collect detailed descriptive data and patient testimonials on the impact of HAE on patients’ health-related quality of life. Discussion The present manuscript describes the development and plans for implementing a multi-country European study with the aim of characterizing the humanistic and economic burden of HAE from the patient perspective. This study will help raise awareness of HAE as a rare but debilitating condition with wide-ranging impacts.

The hereditary angioedema burden of illness study in Europe (HAE-BOIS-Europe): background and methodology.

Science.gov (United States)

Bygum, Anette; Aygören-Pürsün, Emel; Caballero, Teresa; Beusterien, Kathleen; Gholizadeh, Shadi; Musingarimi, Patience; Wait, Suzanne; Boysen, Henrik

2012-04-26

Hereditary angioedema (HAE) is a rare but serious disease marked by swelling attacks in the extremities, face, trunk, airway, or abdominal areas that can be spontaneous or the result of trauma and other triggers. It can be life-threatening due to the risk of asphyxiation. While there have been major advancements in our understanding of the immunogenetics of HAE, there are significant gaps in the literature regarding understanding of the humanistic and economic impact of the disease, particularly in Europe. The purpose of the HAE Burden of Illness Study-Europe (HAE-BOIS-Europe), the development and methodology of which is described here, is to better understand the management and impact of HAE from the patient perspective in Europe. This is a cross-sectional study in which retrospective data were also collected being conducted in Denmark, Germany and Spain. The study is open to patients ages 12 and older with a diagnosis of HAE-I or HAE-II. Data collection includes: (i) a survey on individuals' health care resource use, direct and indirect medical costs, impact on work and school, treatment satisfaction, and emotional functioning (via the Hospital Anxiety and Depression Scale); and (ii) one-on-one interviews to collect detailed descriptive data and patient testimonials on the impact of HAE on patients' health-related quality of life. The present manuscript describes the development and plans for implementing a multi-country European study with the aim of characterizing the humanistic and economic burden of HAE from the patient perspective. This study will help raise awareness of HAE as a rare but debilitating condition with wide-ranging impacts.

Economic burden to primary informal caregivers of hospitalized older adults in Mexico: a cohort study.

Science.gov (United States)

López-Ortega, Mariana; García-Peña, Carmen; Granados-García, Víctor; García-González, José Juan; Pérez-Zepeda, Mario Ulises

2013-02-08

The burden of out of pocket spending for the Mexican population is high compared to other countries. Even patients insured by social security institutions have to face the cost of health goods, services or nonmedical expenses related to their illness. Primary caregivers, in addition, experience losses in productivity by taking up responsibilities in care giving activities. This situation represents a mayor economic burden in an acute care setting for elderly population. There is evidence that specialized geriatric services could represent lower overall costs in these circumstances and could help reduce these burdens.The aim of this study was to investigate economic burden differences in caregivers of elderly patients comparing two acute care services (Geriatric and Internal Medicine). Specifically, economic costs associated with hospitalization of older adults in these two settings by evaluating health care related out of pocket expenditures (OOPE), non-medical OOPE and indirect costs. A comparative analysis of direct and indirect costs in hospitalised elderly patients (60-year or older) and their primary informal caregivers in two health care settings, using a prospective cohort was performed. Economic burden was measured by out of pocket expenses and indirect costs (productivity lost) due to care giving activities. The analysis included a two-part model, the first one allowing the estimation of the probability of observing any health care related and non-medical OOPE; and the second one, the positive observations or expenditures. A total of 210 subjects were followed during their hospital stay. Of the total number of subjects 95% reported at least one non-medical OOPE, being daily transportation the most common expense. Regarding medical OOPE, medicines were the most common expense, and the mean numbers of days without income were 4.12 days. Both OOPE and indirect costs were significantly different between type of services, with less overall economic burden to

Joint stability characteristics of the ankle complex in female athletes with histories of lateral ankle sprain, part II: clinical experience using arthrometric measurement.

Science.gov (United States)

Kovaleski, John E; Heitman, Robert J; Gurchiek, Larry R; Hollis, J M; Liu, Wei; Pearsall, Albert W

2014-01-01

This is part II of a 2-part series discussing stability characteristics of the ankle complex. In part I, we used a cadaver model to examine the effects of sectioning the lateral ankle ligaments on anterior and inversion motion and stiffness of the ankle complex. In part II, we wanted to build on and apply these findings to the clinical assessment of ankle-complex motion and stiffness in a group of athletes with a history of unilateral ankle sprain. To examine ankle-complex motion and stiffness in a group of athletes with reported history of lateral ankle sprain. Cross-sectional study. University research laboratory. Twenty-five female college athletes (age = 19.4 ± 1.4 years, height = 170.2 ± 7.4 cm, mass = 67.3 ± 10.0 kg) with histories of unilateral ankle sprain. All ankles underwent loading with an ankle arthrometer. Ankles were tested bilaterally. The dependent variables were anterior displacement, anterior end-range stiffness, inversion rotation, and inversion end-range stiffness. Anterior displacement of the ankle complex did not differ between the uninjured and sprained ankles (P = .37), whereas ankle-complex rotation was greater for the sprained ankles (P = .03). The sprained ankles had less anterior and inversion end-range stiffness than the uninjured ankles (P ankle-complex laxity and end-range stiffness were detected in ankles with histories of sprain. These results indicate the presence of altered mechanical characteristics in the soft tissues of the sprained ankles.

Converting Eucalyptus biomass into ethanol: Financial and sensitivity analysis in a co-current dilute acid process. Part II

International Nuclear Information System (INIS)

Gonzalez, R.; Treasure, T.; Phillips, R.; Jameel, H.; Saloni, D.; Wright, J.; Abt, R.

2011-01-01

The technical and financial performance of high yield Eucalyptus biomass in a co-current dilute acid pretreatment followed by enzymatic hydrolysis process was simulated using WinGEMS registered and Excel registered . Average ethanol yield per dry Mg of Eucalyptus biomass was approximately 347.6 L of ethanol (with average carbohydrate content in the biomass around 66.1%) at a cost of 0.49 L -1 of ethanol, cash cost of ∝0.46 L -1 and CAPEX of 1.03 L -1 of ethanol. The main cost drivers are: biomass, enzyme, tax, fuel (gasoline), depreciation and labor. Profitability of the process is very sensitive to biomass cost, carbohydrate content (%) in biomass and enzyme cost. Biomass delivered cost was simulated and financially evaluated in Part I; here in Part II the conversion of this raw material into cellulosic ethanol using the dilute acid process is evaluated. (author)

[The external patello-tibial transfixation (EPTT). Part II: Clinical application and results].

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Ishaque, B; Gotzen, L; Ziring, E; Petermann, J

1999-07-01

In part I of the paper the biomechanical and technical background of the EPTT using the MPT fixator and the indications for this procedure have been described. In part II we report about the clinical application of the EPTT in 67 patients with a wide spectrum of repairs and reconstructions of the extensor mechanism. 48 patients had fresh injuries, 18 of them with severe concomitant knee lesions and 19 patients had neglected rsp. unsuccessfully operated injuries. There were 4 deep infections, two of them related to the MPT fixator. In the patients with uneventful healing the fixator remained in place for 7.3 weeks in average. The clinical, isokinetic and radiological results were reviewed in 17 patients with an average follow-up time of 37.3 months. There were 5 patients with partial patellectomy and tendon reattachment because of lower patella pole comminution and 12 patients with tendon reattachment ruptured at the inferior patella pole or suture repair in midsubstance rupture. The clinical results according to the IKDC score were rated in 3 patients as normal, in 10 patients as nearly normal and in 4 patients as abnormal. This rating was highly dependend on the subjective judgement by the patients who considered their operated knees not as normal as the contralateral knees. From our clinical experiences and results we can derive that the EPTT enables the surgical management of extensor mechanism disruptions with a minimum of internal fixation material and provides a safe protection of the repairs and reconstructions during the healing period. The EPTT allows immediate unrestricted functional rehabilitation and early walking without crutches. Thus the EPTT represents an effective alternative to the patello-tibial cerclage with a wire or synthetic ligaments.

‘Mother-in-child’ thrombectomy technique: a novel and effective approach to decrease intracoronary thrombus burden in acute myocardial infarction

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Dauvergne, Christian; Araya, Mario [Department of Cardiology, Clinica Alemana, Santiago (Chile); Uriarte, Polentzi [Department of Cardiology, Instituto Nacional del Torax, Santiago (Chile); Novoa, Oscar; Novoa, Lilian [Department of Cardiology, Clinica Alemana, Santiago (Chile); Maluenda, Gabriel, E-mail: gabrielmaluenda@gmail.com [Department of Cardiology, Clinica Alemana, Santiago (Chile)

2013-01-15

Background: The presence of large thrombus burden in patients presenting with acute myocardial infarction (AMI) is common and associated with poor prognosis. This study aimed to describe the feasibility and safety of the novel ‘mother-in-child’ thrombectomy (MCT) technique in patients presenting with AMI and large thrombus burden undergoing percutaneous coronary intervention (PCI). Methods: We studied 13 patients presenting with AMI who underwent PCI with persistent large intracoronary thrombus after standard thrombectomy. The procedure was performed using a 5 F ‘Heartrail II-ST01’ catheter (Terumo Medical) into a 6 F guiding system. Angiographic assessment of thrombus burden and coronary flow was obtained at baseline, immediately after thrombectomy and at the end of the procedure. Results: The mean age was 55.9 ± 13.0 years and involved mostly males (76.9%). All patients underwent PCI via radial approach. Following MCT Thrombolysis In Myocardial Infarction (TIMI) flow improved by 2 or more degrees in 11 patients (84.5%), while visible angiographic thrombus was reduced in 11 patients (84.5%). In the final angiogram, normal TIMI flow was restored in 11 patients (84.5%), with normal myocardial ‘blush’ in 7 patients (53.8%) and total clearance of a visible thrombus in 7 patients (53.8%). Overall, 6 patients received thrombectomy as ‘stand-alone’ procedure. All patients were discharged alive after a mean of 5.6 ± 2 days. Conclusion: This initial report suggests that significant reduction in thrombus burden and improvement of the coronary flow can be safely achieved in patients presenting with AMI and large thrombus burden by using the novel MCT technique.

Economic and Disease Burden of Dengue in Mexico

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Undurraga, Eduardo A.; Betancourt-Cravioto, Miguel; Ramos-Castañeda, José; Martínez-Vega, Ruth; Méndez-Galván, Jorge; Gubler, Duane J.; Guzmán, María G.; Halstead, Scott B.; Harris, Eva; Kuri-Morales, Pablo; Tapia-Conyer, Roberto; Shepard, Donald S.

2015-01-01

Background Dengue imposes a substantial economic and disease burden in most tropical and subtropical countries. Dengue incidence and severity have dramatically increased in Mexico during the past decades. Having objective and comparable estimates of the economic burden of dengue is essential to inform health policy, increase disease awareness, and assess the impact of dengue prevention and control technologies. Methods and Findings We estimated the annual economic and disease burden of dengue in Mexico for the years 2010–2011. We merged multiple data sources, including a prospective cohort study; patient interviews and macro-costing from major hospitals; surveillance, budget, and health data from the Ministry of Health; WHO cost estimates; and available literature. We conducted a probabilistic sensitivity analysis using Monte Carlo simulations to derive 95% certainty levels (CL) for our estimates. Results suggest that Mexico had about 139,000 (95%CL: 128,000–253,000) symptomatic and 119 (95%CL: 75–171) fatal dengue episodes annually on average (2010–2011), compared to an average of 30,941 symptomatic and 59 fatal dengue episodes reported. The annual cost, including surveillance and vector control, was US$170 (95%CL: 151–292) million, or $1.56 (95%CL: 1.38–2.68) per capita, comparable to other countries in the region. Of this, $87 (95%CL: 87–209) million or $0.80 per capita (95%CL: 0.62–1.12) corresponds to illness. Annual disease burden averaged 65 (95%CL: 36–99) disability-adjusted life years (DALYs) per million population. Inclusion of long-term sequelae, co-morbidities, impact on tourism, and health system disruption during outbreaks would further increase estimated economic and disease burden. Conclusion With this study, Mexico joins Panama, Puerto Rico, Nicaragua, and Thailand as the only countries or areas worldwide with comprehensive (illness and preventive) empirical estimates of dengue burden. Burden varies annually; during an outbreak

Instruments for assessing the burden of informal caregiving for stroke patients in clinical practice: a comparison of CSI, CRA, SCQ and self-rated burden.

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van Exel, N Job A; Scholte op Reimer, Wilma J M; Brouwer, Werner B F; van den Berg, Bernard; Koopmanschap, Marc A; van den Bos, Geertrudis A M

2004-03-01

To compare the feasibility, convergent and clinical validity of three commonly used burden scales: Caregiver Strain Index (CSI), Caregiver Reaction Assessment (CRA) and Sense of Competence Questionnaire (SCQ), with a self-developed single question on self-rated burden (SRB). Stroke patients receiving support from an informal caregiver (n = 148) and their caregivers were followed up to six months after stroke. Feasibility was assessed with several measures of missing values. Convergent validity was assessed on the basis of the correlation patterns between the burden scales, and clinical validity through evaluation of expected associations between levels of burden and explanatory patients' and caregivers' characteristics. Missing values were less often observed on CSI and SRB than SCQ and CRA. Significant correlation coefficients (p CRA. Evidence for clinical validity was strongest for CSI and SRB, based on associations between higher burden scores and patients' disability, and patients' and caregivers' poor level of health-related quality of life (all p CRA. SRB could be used for quick screening of caregivers at risk. CSI is indicated for further diagnosis of the burden of informal caregivers.

STUDY ON SOFTENING AND DROPPING PROPERTIES OF METALIZED BURDEN INSIDE BLAST FURNACE

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Bi-yang Tuo

2014-12-01

Full Text Available The inferences of burden metallization rate on softening-melting dropping properties were investigated through softening-melting dropping test of three kinds of metalized burden pressure drop. The results indicated that the softeningmelting temperature interval of pre-reduction mixed burden is bigger than primeval mixed burden, the melting interval narrow with the rise of metallization rate of ferric burden as well as dropping temperature interval. The average pressure drop, maximum pressure drop and softening-melting dropping properties eigenvalue decrease with the rise of metallization rate of ferric burden. Besides, the dropping temperature of burden reduces with the rise of carbon content of molten iron. The combination high metalized burden and higher carbon content of molten iron is benefit to decreasing thickness of cohesive zone and improve permeability of cohesive zone.

Long-term solar activity and terrestrial connections. Part II: at the beckon of the sun?

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N. D. Diamantides

1998-05-01

Full Text Available The research task described herein aims at the structuring of an analytical tool that traces the time course of geophysical phenomena, regional or global, and compares it to the course of long-term solar conditions, long-term meaning decades or a few centuries. The model is based on the premise that since in a last analysis the preponderance of atmospheric, hydrospheric, and, possibly, some aspects of geospheric phenomena are, or have been, powered by energy issuing from the sun - either now or in the past - the long-term behavior of such phenomena is ultimately "connected" to long-term changes occurring in the sun itself. Accordingly, the proposed research firstly derives and models a stable surrogate pattern for the long-term solar activity, secondly introduces a transfer-function algorithm for modeling the connection between the surrogate and terrestrial phenomena viewed as partners in the connection, and thirdly probes the connection outcome for episodic or unanticipated effects that may arise due to the fact that in the present context, the connection, should it exist, is very likely nonlinear. Part I of the study presents the theory of the concept, while Part II demonstrates the concept's pertinence to a number of terrestrial phenomena.Key words. Solar activity · Kolmogorov algorithm

PACE. A Program for Acquiring Competence in Entrepreneurship. Part II: Becoming an Entrepreneur. Unit F: How to Finance the Business. Research and Development Series No. 194 B-6.

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Ohio State Univ., Columbus. National Center for Research in Vocational Education.

This three-part curriculum for entrepreneurship education is primarily for postsecondary level, including four-year colleges and adult education, but it can be adapted for special groups or vocational teacher education. The emphasis of the seven instructional units in Part II is establishing a business. Unit F focuses on financing the business. It…

PACE. A Program for Acquiring Competence in Entrepreneurship. Part II: Becoming an Entrepreneur. Unit B: Where to Locate the Business. Research and Development Series No. 194 B-2.

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Ohio State Univ., Columbus. National Center for Research in Vocational Education.

This three-part curriculum for entrepreneurship education is primarily for postsecondary level, including four-year colleges and adult education, but it can be adapted for special groups or vocational teacher education. The emphasis of the seven instructional units in Part II is on establishing a business. Unit B focuses on choosing a business…

PACE. A Program for Acquiring Competence in Entrepreneurship. Part II: Becoming an Entrepreneur. Unit C: Legal Issues and Small Business. Research and Development Series No. 194 B-3.

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Ohio State Univ., Columbus. National Center for Research in Vocational Education.

This three-part curriculum for entrepreneurship education is primarily for postsecondary level, including four-year colleges and adult education, but it can be adapted for special groups or vocational teacher education. The emphasis of the seven instructional units in Part II is establishing a business. Unit C focuses on legal issues that affect…

PACE. A Program for Acquiring Competence in Entrepreneurship. Part II: Becoming an Entrepreneur. Unit D: Government Regulations and Small Businesses. Research and Development Series No. 194 B-4.

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Ohio State Univ., Columbus. National Center for Research in Vocational Education.

This three-part curriculum for entrepreneurship education is primarily for postsecondary level, including four-year colleges and adult education, but it can be adapted for special groups or vocational teacher education. The emphasis of the seven instructional units in Part II is establishing a business. Unit D focuses on business regulations at…

Burden of gout in the Nordic region, 1990-2015: findings from the Global Burden of Disease Study 2015.

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Kiadaliri, A A; Uhlig, T; Englund, M

2018-01-29

To explore the burden of gout in the Nordic region, with a population around 27 million in 2015 distributed across six countries. We used the findings of the 2015 Global Burden of Diseases study to report prevalence and disability associated with gout in the Nordic region. From 1990 to 2015, the number of prevalent gout cases rose by 30% to 252 967 [95% uncertainty interval (UI) 223 478‒287 288] in the Nordic region. In 2015, gout contributed to 7982 (95% UI 5431‒10 800) years lived with disability (YLDs) in the region, an increase of 29% (95% UI 24‒35%) from 1990. While the crude YLD rate of gout increased by 12.9% (95% UI 7.8‒18.1%) between 1990 and 2015, the age-standardized YLD rate remained stable. Gout was ranked as the 63rd leading cause of total YLDs in the region in 2015, with the highest rank in men aged 55-59 years (38th leading cause of YLDs). The corresponding rank at the global level was 94. Of 195 countries studied, four Nordic countries [Greenland (2nd), Iceland (12th), Finland (14th), and Sweden (15th)] were among the top 15 countries with the highest age-standardized YLD rate of gout. The burden of gout is rising in the Nordic region. Gout's contribution to the total burden of diseases in the region is more significant than the global average. Expected increases in gout burden owing to population growth and ageing call for stronger preventive and therapeutic strategies for gout management in Nordic countries.

State plans to force companies to eliminate environmental burdens

International Nuclear Information System (INIS)

Marcan, P.

2004-01-01

The Ministry of Environment is preparing legislation aimed at forcing the state and especially private enterprises to map and eliminate tips, refuse from company premises and farmyards, and manure heaps. It is expected that the main burden will fall on private enterprises. The department is still working on the wording of this new Act on environmental burdens and so it is not yet clear whether it will be of assistance in the elimination of environmental burdens. The Ministry is aware that economic aspects must also be taken into account when exercising pressure on the companies. Closing down a company that cannot meet environmental criteria would result in redundancies and so the time schedule for the elimination of environmental burdens will be adjusted to fit the financial situation of the company involved. The ministry plans to first find companies responsible for environmental debts and then set a deadline for the preparation of a project to eliminate the environmental burden. The project would have to contain a description of elimination methods, in addition to a time schedule and cost assessment. If a private company does not report an environmental burden, the competent public authority will have the power to request access to the premises to undertake an inspection. (author)

26 CFR 1.534-2 - Burden of proof as to unreasonable accumulations in cases before the Tax Court.

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2010-04-01

..., DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES (CONTINUED) Corporations Used to Avoid Income Tax on Shareholders § 1.534-2 Burden of proof as to unreasonable accumulations in cases... a Tax Court proceeding with respect to an allegation that all or any part of the earnings and...

The burden of disaster: Part I. Challenges and opportunities within a child's social ecology.

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Noffsinger, Mary A; Pfefferbaum, Betty; Pfefferbaum, Rose L; Sherrib, Kathleen; Norris, Fran H

2012-01-01

Child development and adaptation are best understood as biological and psychological individual processes occurring within the context of interconnecting groups, systems, and communities which, along with family, constitute the child's social ecology. This first of two articles describes the challenges and opportunities within a child's social ecology consisting of Micro-, Meso-, Exo-, and Macrosystems. The parent-child relationship, the most salient Microsystem influence in children's lives, plays an influential role in children's reactions to and recovery from disasters. Children, parents, and other adults participate in Mesosystem activities at schools and faith-based organizations. The Exosystem--including workplaces, social agencies, neighborhood, and mass media--directly affects important adults in children's lives. The Macrosystem affects disaster response and recovery indirectly through intangible cultural, social, economic, and political structures and processes. Children's responses to adversity occur in the context of these dynamically interconnected and interdependent nested environments, all of which endure the burden of disaster Increased understanding of the influences of and the relationships between key components contributes to recovery and rebuilding efforts, limiting disruption to the child and his or her social ecology A companion article (R. L. Pfefferbaum et al., in press) describes interventions across the child's social ecology.

Assessing burden in families of critical care patients.

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Kentish-Barnes, Nancy; Lemiale, Virginie; Chaize, Marine; Pochard, Frédéric; Azoulay, Elie

2009-10-01

To provide critical care clinicians with information on validated instruments for assessing burden in families of critical care patients. PubMed (1979-2009). We included all quantitative studies that used a validated instrument to evaluate the prevalence of, and risk factors for, burden on families. We extracted the descriptions of the instruments used and the main results. Family burden after critical illness can be detected reliably and requires preventive strategies and specific treatments. Using simple face-to-face interviews, intensivists can learn to detect poor comprehension and its determinants. Instruments for detecting symptoms of anxiety, depression, or stress can be used reliably even by physicians with no psychiatric training. For some symptoms, the evaluation should take place at a distance from intensive care unit discharge or death. Experience with families of patients who died in the intensive care unit and data from the literature have prompted studies of bereaved family members and the development of interventions aimed at decreasing guilt and preventing complicated grief. We believe that burden on families should be assessed routinely. In clinical studies, using markers for burden measured by validated tools may provide further evidence that effective communication and efforts to detect and to prevent symptoms of stress, anxiety, or depression provide valuable benefits to families.

Global economic burden of schizophrenia: a systematic review

Directory of Open Access Journals (Sweden)

Chong HY

2016-02-01

Full Text Available Huey Yi Chong,1 Siew Li Teoh,1 David Bin-Chia Wu,1 Surachai Kotirum,1 Chiun-Fang Chiou,2 Nathorn Chaiyakunapruk1,3–5 1School of Pharmacy, Monash University Malaysia, Selangor, Malaysia; 2Janssen Pharmaceutical Companies Asia Pacific, Singapore; 3Center of Pharmaceutical Outcomes Research (CPOR, Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand; 4School of Pharmacy, University of Wisconsin, Madison, WI, USA; 5School of Population Health, University of Queensland, Brisbane, Australia Background: Schizophrenia is one of the top 25 leading causes of disability worldwide in 2013. Despite its low prevalence, its health, social, and economic burden has been tremendous, not only for patients but also for families, caregivers, and the wider society. The magnitude of disease burden investigated in an economic burden study is an important source to policymakers in decision making. This study aims to systematically identify studies focusing on the economic burden of schizophrenia, describe the methods and data sources used, and summarize the findings of economic burden of schizophrenia. Methods: A systematic review was performed for economic burden studies in schizophrenia using four electronic databases (Medline, EMBASE, PsycINFO, and EconLit from inception to August 31, 2014. Results: A total of 56 articles were included in this review. More than 80% of the studies were conducted in high-income countries. Most studies had undertaken a retrospective- and prevalence-based study design. The bottom-up approach was commonly employed to determine cost, while human capital method was used for indirect cost estimation. Database and literature were the most commonly used data sources in cost estimation in high-income countries, while chart review and interview were the main data sources in low and middle-income countries. Annual costs for the schizophrenia population in the country ranged from US$94

Economic Burden for Lung Cancer Survivors in Urban China.

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Zhang, Xin; Liu, Shuai; Liu, Yang; Du, Jian; Fu, Wenqi; Zhao, Xiaowen; Huang, Weidong; Zhao, Xianming; Liu, Guoxiang; Mao, Zhengzhong; Hu, Teh-Wei

2017-03-15

With the rapid increase in the incidence and mortality of lung cancer, a growing number of lung cancer patients and their families are faced with a tremendous economic burden because of the high cost of treatment in China. This study was conducted to estimate the economic burden and patient responsibility of lung cancer patients and the impact of this burden on family income. This study uses data from a retrospective questionnaire survey conducted in 10 communities in urban China and includes 195 surviving lung cancer patients diagnosed over the previous five years. The calculation of direct economic burden included both direct medical and direct nonmedical costs. Indirect costs were calculated using the human capital approach, which measures the productivity lost for both patients and family caregivers. The price index was applied for the cost calculation. The average economic burden from lung cancer was $43,336 per patient, of which the direct cost per capita was $42,540 (98.16%) and the indirect cost per capita was $795 (1.84%). Of the total direct medical costs, 35.66% was paid by the insurer and 9.84% was not covered by insurance. The economic burden for diagnosed lung cancer patients in the first year following diagnosis was $30,277 per capita, which accounted for 171% of the household annual income, a percentage that fell to 107% after subtracting the compensation from medical insurance. The economic burden for lung cancer patients is substantial in the urban areas of China, and an effective control strategy to lower the cost is urgently needed.

Acculturation level and caregiver outcomes from a randomized intervention trial to enhance caregivers' health: evidence from REACH II.

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Meyer, Oanh L; Liu, Xiaoyan Lucia; Tancredi, Daniel; Ramirez, A Susana; Schulz, Richard; Hinton, Ladson

2018-06-01

Latinos comprise a growing segment of the caregiver population and vary widely in acculturation, yet little is known regarding how acculturation might affect caregiver stress or intervention outcomes. This study examined the relationship between acculturation and burden, bother, and depression in Latino dementia caregivers at baseline and following an intervention. This was a secondary data analysis of 211 Latino caregivers of older adults with dementia from Resources for Enhancing Alzheimer's Caregiver Health (REACH) II, a multisite randomized trial of caregiver interventions. Baseline and follow-up data were used to run mixed-effects models examining the main and moderating effect of acculturation on caregiver stress. No significant main effect of acculturation was found for any of the outcome measures, controlling for demographic covariates. Acculturation moderated the effect of the intervention on caregiver burden: those who were more acculturated benefited more from the intervention. Differential acculturation for Latino caregivers was not directly associated with caregiver burden, bother, or depression, but was associated with reducing burden from the intervention. Future research should explore by what mechanism acculturation influences caregiver burden following an intervention.

Acuity and case management: a healthy dose of outcomes, part II.

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Craig, Kathy; Huber, Diane L

2007-01-01

This is the second of a 3-part series presenting 2 effective applications-acuity and dosage-that describe how the business case for case management (CM) can be made. In Part I, dosage and acuity concepts were explained as client need-severity, CM intervention-intensity, and CM activity-dose prescribed by amount, frequency, duration, and breadth of activities. Part I also featured a specific exemplar, the CM Acuity Tool, and described how to use acuity to identify and score the complexity of a CM case. Appropriate dosage prescription of CM activity was discussed. Part II further explains dosage and presents two acuity instruments, the Acuity Tool and AccuDiff. Details are provided that show how these applications produce opportunities for better communication about CM cases and for more accurate measurement of the right content that genuinely reflects the essentials of CM practice. The information contained in the 3-part series applies to all CM practice settings and contains ideas and recommendations useful to CM generalists, specialists, and supervisors, plus business and outcomes managers. The Acuity Tools Project was developed from frontline CM practice in one large, national telephonic CM company. Dosage: A literature search failed to find research into dosage of a behavioral intervention. The Huber-Hall model was developed and tested in a longitudinal study of CM models in substance abuse treatment and reported in the literature. Acuity: A structured literature search and needs assessment launched the development of the suite of acuity tools. A gap analysis identified that an instrument to assign and measure case acuity specific to CM activities was needed. Clinical experts, quality specialists, and business analysts (n = 7) monitored the development and testing of the tools, acuity concepts, scores, differentials, and their operating principles and evaluated the validity of the Acuity Tools' content related to CM activities. During the pilot phase of

PACE. A Program for Acquiring Competence in Entrepreneurship. Part II: Becoming an Entrepreneur. Unit E: Choosing the Type of Ownership. Research and Development Series No. 194 B-5.

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Ohio State Univ., Columbus. National Center for Research in Vocational Education.

This three-part curriculum for entrepreneurship education is primarily for postsecondary level, including four-year colleges and adult education, but it can be adapted for special groups or vocational teacher education. The emphasis of the seven instructional units in Part II is establishing a business. Unit E focuses on the three major types of…

Interaction of Zn(II) with hematite nanoparticles and microparticles: Part 2. ATR-FTIR and EXAFS study of the aqueous Zn(II)/oxalate/hematite ternary system.

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Ha, Juyoung; Trainor, Thomas P; Farges, François; Brown, Gordon E

2009-05-19

Sorption of Zn(II) to hematite nanoparticles (HN) (av diam=10.5 nm) and microparticles (HM) (av diam=550 nm) was studied in the presence of oxalate anions (Ox2-(aq)) in aqueous solutions as a function of total Zn(II)(aq) to total Ox2-(aq) concentration ratio (R=[Zn(II)(aq)]tot/[Ox2-(aq)]tot) at pH 5.5. Zn(II) uptake is similar in extent for both the Zn(II)/Ox/HN and Zn(II)/Ox/HM ternary systems and the Zn(II)/HN binary system at [Zn(II)(aq)](tot)system than for the Zn(II)/Ox/HM ternary and the Zn(II)/HN and Zn(II)/HM binary systems at [Zn(II)(aq)]tot>4 mM. In contrast, Zn(II) uptake for the Zn(II)/HM binary system is a factor of 2 greater than that for the Zn(II)/Ox/HM and Zn(II)/Ox/HN ternary systems and the Zn(II)/HN binary system at [Zn(II)(aq)]totternary system at both R values examined (0.16 and 0.68), attenuated total reflectance Fourier transform infrared (ATR-FTIR) results are consistent with the presence of inner-sphere oxalate complexes and outer-sphere ZnOx(aq) complexes, and/or type A ternary complexes. In addition, extended X-ray absorption fine structure (EXAFS) spectroscopic results suggest that type A ternary surface complexes (i.e., >O2-Zn-Ox) are present. In the Zn(II)/Ox/HN ternary system at R=0.15, ATR-FTIR results indicate the presence of inner-sphere oxalate and outer-sphere ZnOx(aq) complexes; the EXAFS results provide no evidence for inner-sphere Zn(II) complexes or type A ternary complexes. In contrast, ATR-FTIR results for the Zn/Ox/HN sample with R = 0.68 are consistent with a ZnOx(s)-like surface precipitate and possibly type B ternary surface complexes (i.e., >O2-Ox-Zn). EXAFS results are also consistent with the presence of ZnOx(s)-like precipitates. We ascribe the observed increase of Zn(II)(aq) uptake in the Zn(II)/Ox/HN ternary system at [Zn(II)(aq)]tot>or=4 mM relative to the Zn(II)/Ox/HM ternary system to formation of a ZnOx(s)-like precipitate at the hematite nanoparticle/water interface.

Estimating the burden of antimicrobial resistance: a systematic literature review.

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Naylor, Nichola R; Atun, Rifat; Zhu, Nina; Kulasabanathan, Kavian; Silva, Sachin; Chatterjee, Anuja; Knight, Gwenan M; Robotham, Julie V

2018-01-01

Accurate estimates of the burden of antimicrobial resistance (AMR) are needed to establish the magnitude of this global threat in terms of both health and cost, and to paramaterise cost-effectiveness evaluations of interventions aiming to tackle the problem. This review aimed to establish the alternative methodologies used in estimating AMR burden in order to appraise the current evidence base. MEDLINE, EMBASE, Scopus, EconLit, PubMed and grey literature were searched. English language studies evaluating the impact of AMR (from any microbe) on patient, payer/provider and economic burden published between January 2013 and December 2015 were included. Independent screening of title/abstracts followed by full texts was performed using pre-specified criteria. A study quality score (from zero to one) was derived using Newcastle-Ottawa and Philips checklists. Extracted study data were used to compare study method and resulting burden estimate, according to perspective. Monetary costs were converted into 2013 USD. Out of 5187 unique retrievals, 214 studies were included. One hundred eighty-seven studies estimated patient health, 75 studies estimated payer/provider and 11 studies estimated economic burden. 64% of included studies were single centre. The majority of studies estimating patient or provider/payer burden used regression techniques. 48% of studies estimating mortality burden found a significant impact from resistance, excess healthcare system costs ranged from non-significance to $1 billion per year, whilst economic burden ranged from $21,832 per case to over $3 trillion in GDP loss. Median quality scores (interquartile range) for patient, payer/provider and economic burden studies were 0.67 (0.56-0.67), 0.56 (0.46-0.67) and 0.53 (0.44-0.60) respectively. This study highlights what methodological assumptions and biases can occur dependent on chosen outcome and perspective. Currently, there is considerable variability in burden estimates, which can lead in

Predictors of caregiver burden in Iranian family caregivers of cancer patients.

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Mirsoleymani, Seyed Reza; Rohani, Camelia; Matbouei, Mahsa; Nasiri, Malihe; Vasli, Parvaneh

2017-01-01

Caregiver burden threatens the psychological, emotional, functional and even physical health of caregivers. The aims of this study were to determine caregiver burden and family distress and the relationship between them, also to explore predictors of caregiver burden in a sample of Iranian family caregivers of cancer patients. This is a cross-sectional study with correlational design. A total of 104 family caregivers of cancer patients were asked to respond to the Caregiver Burden Inventory (CBI) and the Family Distress Index (FDI) together with a sociodemographic questionnaire. For evaluating the relationship between CBI and FDI scores, the Pearson's product-moment correlation was used. In addition, multiple linear regression analysis was applied to explore the predictive factors of caregiver burden. A high burden was experienced by almost half of the caregivers (48.1%). The FDI mean score was 9.76 ± 5.40 ranged from 0 to 24. A strong positive correlation was found between the caregiver burden and family distress ( r = 0.76). Multiple linear regression results showed the predictive role of FDI score (β = 0.71, P = 0.001), patient's gender (β = -0.25, P = 0.001), and early cancer diagnosis (β =0.13, P = 0.027) in caregiver burden. They could explain 65% of variance in the level of burden in family caregivers. Family nurses should consider the caregivers burden and vulnerability of families with cancer patient, especially if the patient is a male or has a new diagnosis. They should also design special programs for the whole family as a system that family can adapt to the new situation.

Factors associated with the quality of life of subjects with Parkinson's disease and burden on their caregivers.

Science.gov (United States)

Rodríguez-Violante, M; Camacho-Ordoñez, A; Cervantes-Arriaga, A; González-Latapí, P; Velázquez-Osuna, S

2015-06-01

Parkinson's disease affects the quality of life of the individual with the disease in addition to creating a burden on the caregiver. Factors related to these effects include motor and non-motor aspects of the disease, as well as traits inherent to the caregiver. We evaluated subjects with Parkinson's disease using the following instruments: Quality of Life Questionnaire PDQ-8, Movement Disorders Society Unified Parkinson's disease Rating Scale part i to iv (MDS-UPDRS), and Hoehn and Yahr staging. The Zarit Burden Inventory was used to assess all primary caregivers. Major demographic and clinical variables were also recorded. A total of 250 subjects with Parkinson's disease were included, of whom 201 had a primary caregiver. In the multivariate analysis, predictors of poor quality of life for a subject with Parkinson's disease were the MDS-UPDRS I score (β=.39, PParkinson's disease and the caregiver's perceived burden. However, the factors that determine each situation appear to be distinct. Copyright © 2013 Sociedad Española de Neurología. Published by Elsevier España, S.L.U. All rights reserved.

Cytogenetic and genetic studies of radiation-induced chromosome damage in mouse oocytes. Part 1. Numerical and structural chromosome anomalies in metaphase II oocytes, pre- and post-implantation embryos

International Nuclear Information System (INIS)

Tease, Charles; Fisher, Graham

1996-01-01

The incidences of X-ray induced numerical and structural chromosome anomalies were screened in a range of developmental stages from metaphase II oocytes through to post-implantation embryos. Following 1 Gy of acute X-rays to immediately preovulatory stage oocytes, the rate of hyperploidy (chromosome gain) was found to be elevated over levels in unirradiated controls, at metaphase II, in 1-cell and 3.5 day pre-implantation embryos but not in 8.5 day post-implantation foetuses. In the latter, however, the frequency of mosaicism was significantly increased. A similar response of an increase in mosaicism but not in hyperploidy in 8.5 day post-implantation embryos was also found after irradiation of dictyate stage oocytes with 4 Gy of acute X-rays. Significantly elevated frequencies of structural chromosome anomalies were present in metaphase II oocytes and pre-implantation embryonic stages, but could not be detected in block-stained chromosome preparations from 8.5 day post-implantation foetuses. However, analysis of chromosome preparations after G-banding showed that almost 14% of 14.5 day foetuses carried a chromosome rearrangement after 1 Gy of X-rays to immediately preovulatory stage oocytes. Overall, our data indicate that the presence of radiation-induced chromosome gains are incompatible with embryonic survival but that a proportion of embryos with structural chromosome damage develop past mid-gestation. These latter embryos are therefore potentially capable of contributing to the genetic burden of the next generation

Socioeconomic differences in the burden of disease in Sweden

DEFF Research Database (Denmark)

Ljung, Rickard; Peterson, Stefan; Hallqvist, Johan

2005-01-01

OBJECTIVE: We sought to analyse how much of the total burden of disease in Sweden, measured in disability-adjusted life years (DALYs), is a result of inequalities in health between socioeconomic groups. We also sought to determine how this unequal burden is distributed across different disease...... of disease that take both mortality and morbidity into account can help policy-makers understand the magnitude of inequalities in health for different disease groups....... groups and socioeconomic groups. METHODS: Our analysis used data from the Swedish Burden of Disease Study. We studied all Swedish men and women in three age groups (15-44, 45-64, 65-84) and five major socioeconomic groups. The 18 disease and injury groups that contributed to 65% of the total burden...

In-gap discounts in Medicare Part D and specialty drug use.

Science.gov (United States)

Jung, Jeah; Xu, Wendy Yi; Cheong, Chelim

2017-09-01

Specialty drugs can bring significant benefits to patients, but they can be expensive. Medicare Part D plans charge relatively high cost-sharing costs for specialty drugs. A provision in the Affordable Care Act reduced cost sharing in the Part D coverage gap phase in an attempt to mitigate the financial burden of beneficiaries with high drug spending. We examined the early impact of the Part D in-gap discount on specialty cancer drug use and patients' out-of-pocket (OOP) spending. Natural experimental design. We compared changes in outcomes before and after the in-gap discount among beneficiaries with and without low-income subsidies (LIS). Beneficiaries with LIS, who were not affected by the in-gap discount, made up the control group. We studied a random sample of elderly standalone prescription drug plan enrollees with relatively uncommon cancers (eg, leukemia, skin, pancreas, kidney, sarcomas, and non-Hodgkin lymphoma) between 2009 and 2013. We constructed 4 outcome variables annually: 1) use of any specialty cancer drug, 2) the number of specialty cancer drug fills, 3) total specialty drug spending, and 4) OOP spending for specialty cancer drugs. The in-gap discount did not influence specialty cancer drug use, but reduced annual OOP spending for specialty cancer drugs among users without LIS by $1108. In-gap discounts in Part D decreased patients' financial burden to some extent, but resulted in no change in specialty drug use. As demand for specialty drugs increases, it will be important to ensure patients' access to needed drugs, while simultaneously reducing their financial burden.

Primary caregivers of schizophrenia outpatients: burden and predictor variables.

Science.gov (United States)

Grandón, Pamela; Jenaro, Cristina; Lemos, Serafín

2008-04-15

This article explores family burden in relation to relatives' coping strategies and social networks, as well as in relation to the patients' severity of positive and negative symptoms. Data on the severity of symptoms (Positive and Negative Syndrome Scale for Schizophrenia [PANSS]), social functioning (Social Functioning Scale [SFS]), caregivers burden (Interview on Objective and Subjective Family Burden or Entrevista de Carga Familiar Objetiva y Subjetiva [ECFOS]), coping skills (Family Coping Questionnaire [FCQ]), and social support (Social Network Questionnaire [SNQ]) were gathered from a randomized sample of 101 Chilean outpatients and their primary caregivers, mostly mothers. Low levels of burden were typically found, with the exception of moderate levels on general concerns for the ill relative. A hierarchical regression analysis with four blocks showed that clinical characteristics, such as higher frequency of relapses, more positive symptoms and lower independence-performance, together with lower self-control attributed to the patient, decrease in social interests, and less affective support, predict burden. The results support the relevance of psychoeducational interventions where families' needs are addressed.

Japanese contributions to IAEA INTOR workshop, phase two A, part 2, chapter I: introduction, and chapter II: summary

International Nuclear Information System (INIS)

Mori, Sigeru; Tomabechi, Ken; Fujisawa, Noboru; Iida, Hiromasa; Sugihara, Masayoshi; Seki, Masahiro; Honda, Tsutomu; Kasai, Masao; Itoh, Shin-ichi.

1985-07-01

This report corresponds to Chapters I and II of Japanese contribution report to IAEA INTOR Workshop, Phase Two A, Part 2. The major objectives of the INTOR workshop, Phase Two A, Part 2 are to study critical technical issues, and to assess scientific and technical data bases, and to finally upgrade the INTOR design concept. To study critical technical issues that affect the feasibility or practicability of the INTOR design concept, the following five groups are organized; (A) Impurity control, (B) RF heating and current drive, (C) Transient electromagnetics, (D) Maintainability, (E) Technical benefit. In addition to those groups, the three disciplinary groups are organized to assess the worldiode scientific and technical data bases that exist now and that will exist 4-5 years to support the detailed design and construction of an INTOR-like machine, and to identify additional R D that is required; (F) Physics, (G) Engineering, (H) Nuclear. (author)

Burden differentiation: criteria for evaluation and development of burden sharing rules. The Joint CICERO-ECN project on sharing the burden of greenhouse gas reduction among countries

International Nuclear Information System (INIS)

Torvanger, Asbjoern; Ringius, Lasse

2000-02-01

This article discusses nine criteria for evaluation of potential Burden Sharing Rules (BSRs) in climate policy agreements. Three of the criteria reflect fairness principles while six of them are operational requirements. These criteria are useful for identifying potential BSRs that could be promising in future climate policy negotiations. The two sector approaches, Multi-sector Convergence Approach and Triptych, received the highest score according to the criteria presented in this article. The Multi-sector Convergence Approach was developed in the joint ECN (Netherlands Energy Research Foundation) and CICERO (Center for International Climate and Environmental Research - Oslo) project on burden sharing in climate policy agreements. This is a sector-oriented approach that comprises convergence of per capita emissions to the same level for all countries, and has a global coverage. The Triptych approach has been employed by the European Union for their internal differentiation of national abatement targets. Sector approaches have some specific advantages in linking burden sharing to the economic structure of countries. This indicates that the Multi-sector Convergence Approach could play a useful role in climate policy negotiations among a larger group of countries, and could encourage developing countries to take on greenhouse gas abatement targets. (author)

Individual Prognosis of Symptom Burden and Functioning in Chronic Diseases: A Generic Method Based on Patient-Reported Outcome (PRO) Measures

DEFF Research Database (Denmark)

Hjollund, Niels Henrik Ingvar

2017-01-01

BACKGROUND: Information to the patient about the long-term prognosis of symptom burden and functioning is an integrated part of clinical practice, but relies mostly on the clinician’s personal experience. Relevant prognostic models based on patient-reported outcome (PRO) data with repeated measur...

Introduction of organic/hydro-organic matrices in inductively coupled plasma optical emission spectrometry and mass spectrometry: a tutorial review. Part II. Practical considerations.

Science.gov (United States)

Leclercq, Amélie; Nonell, Anthony; Todolí Torró, José Luis; Bresson, Carole; Vio, Laurent; Vercouter, Thomas; Chartier, Frédéric

2015-07-23

Inductively coupled plasma optical emission spectrometry (ICP-OES) and mass spectrometry (ICP-MS) are increasingly used to carry out analyses in organic/hydro-organic matrices. The introduction of such matrices into ICP sources is particularly challenging and can be the cause of numerous drawbacks. This tutorial review, divided in two parts, explores the rich literature related to the introduction of organic/hydro-organic matrices in ICP sources. Part I provided theoretical considerations associated with the physico-chemical properties of such matrices, in an attempt to understand the induced phenomena. Part II of this tutorial review is dedicated to more practical considerations on instrumentation, instrumental and operating parameters, as well as analytical strategies for elemental quantification in such matrices. Two important issues are addressed in this part: the first concerns the instrumentation and optimization of instrumental and operating parameters, pointing out (i) the description, benefits and drawbacks of different kinds of nebulization and desolvation devices and the impact of more specific instrumental parameters such as the injector characteristics and the material used for the cone; and, (ii) the optimization of operating parameters, for both ICP-OES and ICP-MS. Even if it is at the margin of this tutorial review, Electrothermal Vaporization and Laser Ablation will also be shortly described. The second issue is devoted to the analytical strategies for elemental quantification in such matrices, with particular insight into the isotope dilution technique, particularly used in speciation analysis by ICP-coupled separation techniques. Copyright © 2015 Elsevier B.V. All rights reserved.

Caregiver burden among relatives of patients with schizophrenia in Katsina, Nigeria

Directory of Open Access Journals (Sweden)

Abdulkareem Jika Yusuf

2009-06-01

Full Text Available Objective: Caring for patients’ with schizophrenia leads to an enormous burden on the caregivers. However, the magnitude of this problem remains largely unknown in Sub-Saharan Africa. The objective of this study was to determine the burden of care giving among relatives of patients with schizophrenia. Materials and method: A total of 129 primary care-givers of patients with schizophrenia attending out-patient clinic of Katsina state Psychiatric Hospital were interviewed using a socio-demographic data collection sheet and Zarith Burden Interview (ZBI. Data obtained was analysed using Statistical Package for Social Sciences version 13. Results: The mean age of the respondents was 45.07±8.91. Majority of the caregivers are females. High level of burden was found in 47.3% of the respondents. The level of burden experienced was significantly associated with place of residence and family size. Conclusion: Schizophrenia is associated with high level of caregiver burden and effort should be made at alleviating this burden for better out come in both the patients and caregivers.

The dual burden of malnutrition in Colombia.

Science.gov (United States)

Sarmiento, Olga L; Parra, Diana C; González, Silvia A; González-Casanova, Inés; Forero, Ana Y; Garcia, Johnattan

2014-12-01

Almost all nutrition policies in Colombia currently focus on either undernutrition or obesity, with the predominant emphasis on undernutrition. It is crucial to assess the prevalence of the dual burden of malnutrition in Colombia to better target programs and policies. The aim was to estimate the national prevalence of the dual burden of malnutrition in Colombia at the individual and household levels in children aged malnutrition was defined as the coexistence of overweight and stunting or anemia in the same person or household. In Colombia, low to high prevalences of overweight and obesity (3.4-51.2%) coexist with moderate to high prevalences of anemia (8.1-27.5%) and stunting (13.2%). The observed prevalence of the dual burden was lower than expected. Approximately 5% of households had at least one stunted child aged malnutrition in Colombia are lower than expected. Despite the independence of the occurrence of these conditions, the fact that the dual burden coexists at the national, household, and intraindividual levels suggests that public policies should address both conditions through multiple strategies. It is imperative to evaluate the current nutrition policies to inform malnutrition prevention efforts in Colombia and to share lessons with other countries at a similar stage of nutritional transition. © 2014 American Society for Nutrition.

The Tax Burden on Tobacco Volume 51, 1970-2016

Data.gov (United States)

U.S. Department of Health & Human Services — 1970-2016. Orzechowski and Walker. Tax Burden on Tobacco. Tax burden data was obtained from the annual compendium on tobacco revenue and industry statistics, The Tax...

Multiscale modeling, simulations, and experiments of coating growth on nanofibers. Part II. Deposition

International Nuclear Information System (INIS)

Buldum, A.; Clemons, C.B.; Dill, L.H.; Kreider, K.L.; Young, G.W.; Zheng, X.; Evans, E.A.; Zhang, G.; Hariharan, S.I.

2005-01-01

This work is Part II of an integrated experimental/modeling investigation of a procedure to coat nanofibers and core-clad nanostructures with thin-film materials using plasma-enhanced physical vapor deposition. In the experimental effort, electrospun polymer nanofibers are coated with aluminum materials under different operating conditions to observe changes in the coating morphology. This procedure begins with the sputtering of the coating material from a target. Part I [J. Appl. Phys. 98, 044303 (2005)] focused on the sputtering aspect and transport of the sputtered material through the reactor. That reactor level model determines the concentration field of the coating material. This field serves as input into the present species transport and deposition model for the region surrounding an individual nanofiber. The interrelationships among processing factors for the transport and deposition are investigated here from a detailed modeling approach that includes the salient physical and chemical phenomena. Solution strategies that couple continuum and atomistic models are used. At the continuum scale, transport dynamics near the nanofiber are described. At the atomic level, molecular dynamics (MD) simulations are used to study the deposition and sputtering mechanisms at the coating surface. Ion kinetic energies and fluxes are passed from the continuum sheath model to the MD simulations. These simulations calculate sputtering and sticking probabilities that in turn are used to calculate parameters for the continuum transport model. The continuum transport model leads to the definition of an evolution equation for the coating-free surface. This equation is solved using boundary perturbation and level set methods to determine the coating morphology as a function of operating conditions

Assessment of the Future Health Burden Attributable to Undernutrition under the Latest Scenario Framework for Climate Change Research

Science.gov (United States)

Ishida, Hiroyuki; Kobayashi, Shota; Yoshikawa, Sayaka; Kanae, Shinjiro; Hasegawa, Tomoko; Fujimori, Shinichiro; Shin, Yonghee; Takahashi, Kiyoshi; Masui, Toshihiko; Tanaka, Akemi; Honda, Yasushi

2014-05-01

There are growing concerns that future food security will be negatively affected by various factors, such as changes in socioeconomic and climate conditions. The health burden attributable to childhood undernutrition is among the most severe problems related to food crisis in the world. This study assessed the health burden attributable to childhood underweight through 2050 focusing on disability-adjusted life years (DALYs), by considering the latest scenarios for climate change studies (Representative Concentration Pathways (RCPs) and Shared Socioeconomic Pathways (SSPs)) and conducting sensitivity analysis. We used three SSPs (SSP1, SSP2 and SSP3) as future population and gross domestic products (GDP), three RCPs (RCP2.6, RCP4.5 and RCP8.5) for a greenhouse gas emissions constraint, and 12 Global Circulation Models (12 GCMs) to estimate climate conditions. A regression model for estimating DALYs attributable to childhood underweight (DAtU) was developed using the relationship between DAtU and childhood stunting. A logarithmic relationship was proposed for the regression model. We combined a global computable general equilibrium model, a crop model (M-GAEZ), and two regression models to assess the future health burden. We found that i) world total DAtU decreases from 2005 by 23 ~ 60% in 2030 depending on the socioeconomic scenarios. DAtU decreases further by 2050 for SSP1 and SSP2 scenario, whereas it slightly increases for SSP3. Per capita DAtU also decreases in all regions under either scenario in 2050, but the decreases vary significantly by regions and scenarios. ii) the impact of climate change is relatively small in the framework of this study but, on the other hand, socioeconomic conditions have a great impact on the future health burden. The impact of changes in socioeconomic conditions on the health burden is greater in the regions where current health burden is high. iii) parameter uncertainty of the regression models is the second largest factor on

Drugs, money and society (Part II).

Science.gov (United States)

Walley, Tom

2010-09-01

Pharmacoeconomics started as marketing but has developed into a valuable tool in the fuller assessment of drug therapies. Its principles are now widely accepted, and many countries have government-funded agencies with responsibility for its application, most notably the National Institute for Health and Clinical Excellence in England. Many clinical pharmacologists are active in this area, and the discipline itself is part of the clinical pharmacology trainees' curriculum. Further developments will include value-based pricing and its use in cost sharing arrangements between health service and manufacturers.

The Many Meanings of History, Part II

Science.gov (United States)

Szasz, Ferenc M.

1974-01-01

This article contains a collection of quotations about history collected by Professor Szasz. The first part of the collection appeared in the August 1974 issue of "The History Teacher." Readers are invited to send in other definitions they have found. (Author/RM)

Burden of motorcycle-related injury in Malaysia

OpenAIRE

Rahman, Nik Hisamuddin NA; Baharuddin, Kamarul A; Mohamad, Syarifah Mastura S

2015-01-01

Background Road traffic injury (RTI) contributes to major morbidity and mortality in both developed and developing countries. Most of the injuries are caused by road-related injuries that specifically relate to motorcycle crash. We attempted to conduct a short survey to determine the magnitude of burden related to motorcycle-related RTIs in Malaysia. We hypothesize that motorcycle-related RTI in Malaysia contributes significantly to the health burden in the country. Methods The cross-sectiona...

Personalized translational epilepsy research - Novel approaches and future perspectives: Part II: Experimental and translational approaches.

Science.gov (United States)

Bauer, Sebastian; van Alphen, Natascha; Becker, Albert; Chiocchetti, Andreas; Deichmann, Ralf; Deller, Thomas; Freiman, Thomas; Freitag, Christine M; Gehrig, Johannes; Hermsen, Anke M; Jedlicka, Peter; Kell, Christian; Klein, Karl Martin; Knake, Susanne; Kullmann, Dimitri M; Liebner, Stefan; Norwood, Braxton A; Omigie, Diana; Plate, Karlheinz; Reif, Andreas; Reif, Philipp S; Reiss, Yvonne; Roeper, Jochen; Ronellenfitsch, Michael W; Schorge, Stephanie; Schratt, Gerhard; Schwarzacher, Stephan W; Steinbach, Joachim P; Strzelczyk, Adam; Triesch, Jochen; Wagner, Marlies; Walker, Matthew C; von Wegner, Frederic; Rosenow, Felix

2017-11-01

Despite the availability of more than 15 new "antiepileptic drugs", the proportion of patients with pharmacoresistant epilepsy has remained constant at about 20-30%. Furthermore, no disease-modifying treatments shown to prevent the development of epilepsy following an initial precipitating brain injury or to reverse established epilepsy have been identified to date. This is likely in part due to the polyetiologic nature of epilepsy, which in turn requires personalized medicine approaches. Recent advances in imaging, pathology, genetics, and epigenetics have led to new pathophysiological concepts and the identification of monogenic causes of epilepsy. In the context of these advances, the First International Symposium on Personalized Translational Epilepsy Research (1st ISymPTER) was held in Frankfurt on September 8, 2016, to discuss novel approaches and future perspectives for personalized translational research. These included new developments and ideas in a range of experimental and clinical areas such as deep phenotyping, quantitative brain imaging, EEG/MEG-based analysis of network dysfunction, tissue-based translational studies, innate immunity mechanisms, microRNA as treatment targets, functional characterization of genetic variants in human cell models and rodent organotypic slice cultures, personalized treatment approaches for monogenic epilepsies, blood-brain barrier dysfunction, therapeutic focal tissue modification, computational modeling for target and biomarker identification, and cost analysis in (monogenic) disease and its treatment. This report on the meeting proceedings is aimed at stimulating much needed investments of time and resources in personalized translational epilepsy research. This Part II includes the experimental and translational approaches and a discussion of the future perspectives, while the diagnostic methods, EEG network analysis, biomarkers, and personalized treatment approaches were addressed in Part I [1]. Copyright © 2017

A multinational review of recent trends and reports in dementia caregiver burden.

Science.gov (United States)

Torti, Frank M; Gwyther, Lisa P; Reed, Shelby D; Friedman, Joëlle Y; Schulman, Kevin A

2004-01-01

This systematic review of the literature focuses on the influence of ethnic, cultural, and geographic factors on the caregivers of patients with dementia. In particular, we explore the impact of cultural expectations on five important questions: 1) Do the characteristics of dementia affect caregiver burden? 2) Do characteristics of the caregiver independently predict burden? 3) Does the caregiver affect patient outcomes? 4) Does support or intervention for caregiver result in reduced caregiver burden or improved patient outcomes? 5) Finally, do patient interventions result in reduced caregiver burden or improved patient outcomes? Our findings suggest that noncognitive, behavioral disturbances of patients with dementia result in increased caregiver burden and that female caregivers bear a particularly heavy burden across cultures, particularly in Asian societies. Caregiver burden influences time to medical presentation of patients with dementia, patient condition at presentation, and patient institutionalization. Moreover, interventions designed to reduce caregiver burden have been largely, although not universally, unsuccessful. Pharmacological treatments for symptoms of dementia were found to be beneficial in reducing caregiver burden. The consistency of findings across studies, geographic regions, cultural differences, and heathcare delivery systems is striking. Yet, there are critical differences in cultural expectations and social resources. Future interventions to reduce caregiver burden must consider these differences, identify patients and caregivers at greatest risk, and develop targeted programs that combine aspects of a number of interventional strategies.

A study of the stressor, family environment and family burden in dissociative (conversion disorder patients

Directory of Open Access Journals (Sweden)

Kamal K Verma

2017-01-01

Full Text Available Background: Dissociative disorder is a stress-related disorder usually present in adolescent and younger age group. It is also accompanied with significant impairment in activity of daily living and family relationship. Family environment plays important role in initiation and maintenance of symptoms and this put significant burden on family. Aim and Objective: To study presence of stressor, family environment, and assessment of family burden in dissociative disorder patients. Material and Method: This was a cross-sectional observational study in which 100 dissociatives disorder patients were included after fulfilling inclusion criteria from both inpatients and outpatient department of psychiatry. Results: In our study major part of the sample were women 60 (60%, among them most of were housewife and educated up to primary school. According to a stressor, 63 (63% patients had family stress/problem and out of them, 35 (58.4 were women. Seventy-four (74% patients had dissociative convulsion and out of them, 45 (75% were women. The dissociative disorder patients cause a considerable degree of burden over other family members in both men and women. There is a significant difference found in the family environment in term of personal growth dimension, relationship dimension in both men and women. Conclusion: Present study concludes that dissociative disorder patients cause a considerable degree of burden over other family members in term of leisure, physical, mental, financial, and routines family interrelationship domains. The family environment in term of personal growth dimension, relationship dimension has a casual effect on symptoms of dissociative disorder patients.

Caregiver burden in Danish family members of patients with severe brain injury

DEFF Research Database (Denmark)

Doser, Karoline; Norup, Anne

2016-01-01

OBJECTIVE: To investigate caregiver burden and factors associated with caregiver burden among family members of patients with severe brain injury in the chronic phase. Additionally, the study aimed at investigating differences in burden between parents and spouses. METHODS: Forty-four Danish...... caregivers of patients with severe brain injury were contacted 3-6 years post-injury and asked to complete a measure of caregiver burden. RESULTS: Medium, high and low levels of burden were observed in 45%, 16% and 39% of family members, respectively. Higher burden was seen in caregivers of patients...... with more severe injuries, who spent more time on caregiving and reported more unmet needs. Overall, spouses spent significantly more time taking care of their family member than parents and reported higher levels of burden. CONCLUSIONS: The findings emphasized the continuing consequences of brain injury...

Topics in Finance: Part II--Financial Analysis

Science.gov (United States)

Laux, Judy

2010-01-01

The second article in a series designed to supplement the introductory financial management course, this essay addresses financial statement analysis, including its impact on stock valuation, disclosure, and managerial behavior. [For "Topics in Finance Part I--Introduction and Stockholder Wealth Maximization," see EJ1060345.

Comparing contemporary revision burden among hip and knee joint replacement registries

Directory of Open Access Journals (Sweden)

Brian J. McGrory, MD, MS

2016-06-01

Conclusions: Revision burden has gradually decreased for hip replacements and has remained relatively constant for knee replacements both for the last 4 years and compared to historic controls. Knee revision burden was lower than hip revision burden for each period examined. Revision burden is one measure that may be helpful in following the effect of changes in surgical technique and implant design over time in registry populations and may be a helpful way to compare overall results between registries.

Dependence and caregiver burden in Alzheimer's disease and mild cognitive impairment.

LENUS (Irish Health Repository)

Gallagher, Damien

2011-03-01

The dependence scale has been designed to be sensitive to the overall care needs of the patient and is considered distinct from standard measures of functional ability in this regard. Little is known regarding the relationship between patient dependence and caregiver burden. We recruited 100 patients with Alzheimer\\'s disease or mild cognitive impairment and their caregivers through a memory clinic. Patient function, dependence, hours of care, cognition, neuropsychiatric symptoms, and caregiver burden were assessed. Dependence was significantly correlated with caregiver burden. Functional decline and dependence were most predictive of caregiver burden in patients with mild impairment while behavioral symptoms were most predictive in patients with moderate to severe disease. The dependence scale demonstrated good utility as a predictor of caregiver burden. Interventions to reduce caregiver burden should address patient dependence, functional decline, and behavioral symptoms while successful management of the latter becomes more critical with disease progression.

Moving beyond caregiver burden: identifying helpful interventions for family caregivers.

Science.gov (United States)

Sorrell, Jeanne M

2014-03-01

Family members serving as informal caregivers for loved ones often experience physical, psychological, emotional, social, and financial consequences that can be conceptualized as caregiver burden. As the number of older adults in our society continues to increase, there will be even more demand for family caregivers. It is important to move beyond a focus on the statistics and characteristics of caregiver burden and identify helpful interventions to reduce this burden. Interventions that decrease caregiver burden can enable family caregivers to delay placement of the individual in an institutional setting and improve quality of life for both the caregiver and care recipient. Copyright 2014, SLACK Incorporated.

Technical realisation of the VISA-II project, phase I, part IV, IZ-165-o268-1962

International Nuclear Information System (INIS)

Pavicevic, M.

1962-12-01

Project VISA-II is described in IX chapters as follows: introduction, definition of experiments and possibilities of performance; VISA-II channel, new experimental space in the RA reactor; hydraulic tests in the VISA-II channel; measurement of fast neutron and gamma flux in VISA-II channels; measurement of water flow through different VISA-2 irradiation capsules; fabrication of VISA-II capsules; corrosion and heavy water purity problems; safety problems of experiment VISA-2; experimental operation of VISA-II. This chapter VI includes documentation for each type of capsule, review about each experiment within the VISA-II project, the objective and purpose of the experiment as well as experimental device [sr

Long-term solar activity and terrestrial connections. Part II: at the beckon of the sun?

Directory of Open Access Journals (Sweden)

N. D. Diamantides

Full Text Available The research task described herein aims at the structuring of an analytical tool that traces the time course of geophysical phenomena, regional or global, and compares it to the course of long-term solar conditions, long-term meaning decades or a few centuries. The model is based on the premise that since in a last analysis the preponderance of atmospheric, hydrospheric, and, possibly, some aspects of geospheric phenomena are, or have been, powered by energy issuing from the sun - either now or in the past - the long-term behavior of such phenomena is ultimately "connected" to long-term changes occurring in the sun itself. Accordingly, the proposed research firstly derives and models a stable surrogate pattern for the long-term solar activity, secondly introduces a transfer-function algorithm for modeling the connection between the surrogate and terrestrial phenomena viewed as partners in the connection, and thirdly probes the connection outcome for episodic or unanticipated effects that may arise due to the fact that in the present context, the connection, should it exist, is very likely nonlinear. Part I of the study presents the theory of the concept, while Part II demonstrates the concept's pertinence to a number of terrestrial phenomena.

Key words. Solar activity · Kolmogorov algorithm

The psychosocial burden of human papillomavirus related disease and screening interventions.

Science.gov (United States)

Pirotta, M; Ung, L; Stein, A; Conway, E L; Mast, T C; Fairley, C K; Garland, S

2009-12-01

(i) To assess the psychosocial burden of testing for human papillomavirus (HPV) related genital disease or of a HPV-related diagnosis; (ii) to compare an instrument specifically designed to measure HPV-related psychosocial burden with other generic quality of life (QoL) instruments. A cross-sectional design. Researchers recruited women from outpatient clinics at a major tertiary women's hospital and a sexual health centre who completed surveys within 3 months of receiving 331 women, 18-45 years, who had experienced a normal cervical Papanicolaou (Pap) result, an abnormal Pap result, biopsy confirmed cervical intraepithelial neoplasia (CIN) or external genital warts (EGW). The HPV impact profile (HIP) designed to assess the psychosocial impact of HPV; two general health-related QoL surveys-the EuroQoL VAS and the Sheehan disability scale; and a HPV knowledge survey. Response rate was 78%. Significant psychosocial impacts were found for women screened for, or having a diagnosis of, HPV-related genital disease. The largest impact was in women with CIN 2/3 and EGW. This HPV-related psychosocial impact was most sensitively detected with the HIP. Relative to generic measures of QoL, the HIP provided insight into the full range of psychosocial impacts of HPV testing and diagnoses. Clinicians need to be aware of the potential psychosocial impact of testing for or diagnosing HPV-related genital disease, in particular CIN 2/3 and EGW. The HIP survey is a more sensitive measure of the psychosocial impact of HPV-related genital disease than generic QoL surveys.

A Kinetic Model Describing Injury-Burden in Team Sports.

Science.gov (United States)

Fuller, Colin W

2017-12-01

Injuries in team sports are normally characterised by the incidence, severity, and location and type of injuries sustained: these measures, however, do not provide an insight into the variable injury-burden experienced during a season. Injury burden varies according to the team's match and training loads, the rate at which injuries are sustained and the time taken for these injuries to resolve. At the present time, this time-based variation of injury burden has not been modelled. To develop a kinetic model describing the time-based injury burden experienced by teams in elite team sports and to demonstrate the model's utility. Rates of injury were quantified using a large eight-season database of rugby injuries (5253) and exposure (60,085 player-match-hours) in English professional rugby. Rates of recovery from injury were quantified using time-to-recovery analysis of the injuries. The kinetic model proposed for predicting a team's time-based injury burden is based on a composite rate equation developed from the incidence of injury, a first-order rate of recovery from injury and the team's playing load. The utility of the model was demonstrated by examining common scenarios encountered in elite rugby. The kinetic model developed describes and predicts the variable injury-burden arising from match play during a season of rugby union based on the incidence of match injuries, the rate of recovery from injury and the playing load. The model is equally applicable to other team sports and other scenarios.

Reversal burden of proof on corruption in Indonesia

Directory of Open Access Journals (Sweden)

Hibnu Nugroho

2018-03-01

Full Text Available Corruption becomes the greatest enemy most countries face including Indonesia. Commitment to eradicate corruption significantly increases yet it would be meaningless if it is not supported by adequate legislation to implement the law effectively. Reversal burden of proof essentially aims to facilitate law enforcers to seek and disclose assets a suspect owns allegedly as corruption crime. The principle of reversal burden of proof was originated from Anglo-Saxon countries and this still applies to certain cases such as bribery-related gratifications as Malaysia and Singapore implement. In Indonesia, provisions on the principle of reversal burden of proof have been long recognized even since 1960 on the first law on corruption crimes. Nevertheless, for more than a half of century, the provision on reversal burden of proof has never been implemented. It occurs since articles which govern the issues barely provide clear regulation. It only mentions the principle yet never issues an implemented regulation to support the principle. In regards to this, the research is aimed at investigating, seeking and analyzing the weaknesses in implementing the principle of reversal burden of proof in corruption crimes recently as well as discussing obstacles in law enforcement.

Ultra-violet radiation: hazard in workplaces? (part II)

International Nuclear Information System (INIS)

Mohd Yusof Mohd Ali

2003-01-01

Not many workers are aware that apart from chemicals, physical agents, noise and machines which are known to be hazardous in workplaces, there exist another source of hazard which is equally important to be recognised and respected, that is hazard due to ultrviolet radiation (UV). This is the continuation of part I, which was discussed in the later issue. In this part, hazard of ultraviolet radiation were briefly discused i.e. effects on the skin and the eyes. Other subjects discussed are exposure limits, how to assess the radiation, protection against ultraviolet radiation

Burden of musculoskeletal disorders in the Eastern Mediterranean Region, 1990–2013: findings from the Global Burden of Disease Study 2013

Science.gov (United States)

Forouzanfar, Mohammad H; Vollset, Stein Emil; El Bcheraoui, Charbel; Daoud, Farah; Afshin, Ashkan; Charara, Raghid; Khalil, Ibrahim; Higashi, Hideki; Abd El Razek, Mohamed Magdy; Kiadaliri, Aliasghar Ahmad; Alam, Khurshid; Akseer, Nadia; Al-Hamad, Nawal; Ali, Raghib; AlMazroa, Mohammad AbdulAziz; Alomari, Mahmoud A; Al-Rabeeah, Abdullah A; Alsharif, Ubai; Altirkawi, Khalid A; Atique, Suleman; Badawi, Alaa; Barrero, Lope H; Basulaiman, Mohammed; Bazargan-Hejazi, Shahrzad; Bedi, Neeraj; Bensenor, Isabela M; Buchbinder, Rachelle; Danawi, Hadi; Dharmaratne, Samath D; Zannad, Faiez; Farvid, Maryam S; Fereshtehnejad, Seyed-Mohammad; Farzadfar, Farshad; Fischer, Florian; Gupta, Rahul; Hamadeh, Randah Ribhi; Hamidi, Samer; Horino, Masako; Hoy, Damian G; Hsairi, Mohamed; Husseini, Abdullatif; Javanbakht, Mehdi; Jonas, Jost B; Kasaeian, Amir; Khan, Ejaz Ahmad; Khubchandani, Jagdish; Knudsen, Ann Kristin; Kopec, Jacek A; Lunevicius, Raimundas; Abd El Razek, Hassan Magdy; Majeed, Azeem; Malekzadeh, Reza; Mate, Kedar; Mehari, Alem; Meltzer, Michele; Memish, Ziad A; Mirarefin, Mojde; Mohammed, Shafiu; Naheed, Aliya; Obermeyer, Carla Makhlouf; Oh, In-Hwan; Park, Eun-Kee; Peprah, Emmanuel Kwame; Pourmalek, Farshad; Qorbani, Mostafa; Rafay, Anwar; Rahimi-Movaghar, Vafa; Shiri, Rahman; Rahman, Sajjad Ur; Rai, Rajesh Kumar; Rana, Saleem M; Sepanlou, Sadaf G; Shaikh, Masood Ali; Shiue, Ivy; Sibai, Abla Mehio; Silva, Diego Augusto Santos; Singh, Jasvinder A; Skogen, Jens Christoffer; Terkawi, Abdullah Sulieman; Ukwaja, Kingsley N; Westerman, Ronny; Yonemoto, Naohiro; Yoon, Seok-Jun; Younis, Mustafa Z; Zaidi, Zoubida; Zaki, Maysaa El Sayed; Lim, Stephen S; Wang, Haidong; Vos, Theo; Naghavi, Mohsen; Lopez, Alan D; Murray, Christopher J L; Mokdad, Ali H

2017-01-01

Objectives We used findings from the Global Burden of Disease Study 2013 to report the burden of musculoskeletal disorders in the Eastern Mediterranean Region (EMR). Methods The burden of musculoskeletal disorders was calculated for the EMR's 22 countries between 1990 and 2013. A systematic analysis was performed on mortality and morbidity data to estimate prevalence, death, years of live lost, years lived with disability and disability-adjusted life years (DALYs). Results For musculoskeletal disorders, the crude DALYs rate per 100 000 increased from 1297.1 (95% uncertainty interval (UI) 924.3–1703.4) in 1990 to 1606.0 (95% UI 1141.2–2130.4) in 2013. During 1990–2013, the total DALYs of musculoskeletal disorders increased by 105.2% in the EMR compared with a 58.0% increase in the rest of the world. The burden of musculoskeletal disorders as a proportion of total DALYs increased from 2.4% (95% UI 1.7–3.0) in 1990 to 4.7% (95% UI 3.6–5.8) in 2013. The range of point prevalence (per 1000) among the EMR countries was 28.2–136.0 for low back pain, 27.3–49.7 for neck pain, 9.7–37.3 for osteoarthritis (OA), 0.6–2.2 for rheumatoid arthritis and 0.1–0.8 for gout. Low back pain and neck pain had the highest burden in EMR countries. Conclusions This study shows a high burden of musculoskeletal disorders, with a faster increase in EMR compared with the rest of the world. The reasons for this faster increase need to be explored. Our findings call for incorporating prevention and control programmes that should include improving health data, addressing risk factors, providing evidence-based care and community programmes to increase awareness. PMID:28209629

Caregiver burden and correlates among caregivers of children and ...

African Journals Online (AJOL)

Journal of Child and Adolescent Mental Health ... Data on socio-demographic factors, psychiatric morbidity among caregivers, and level of caregiver burden was collected using a researcher-designed socio-demographic questionnaire, Mini International Neuropsychiatric Interview, and Zarit burden interview, respectively.

Caregiver burden in Alzheimer-type dementia and psychosis: A comparative study from India.

Science.gov (United States)

Sinha, P; Desai, N G; Prakash, O; Kushwaha, S; Tripathi, C B

2017-04-01

Caregiver burden in dementia is an important area of research. Providing care for a relative can be a potent source of chronic stress and can have deleterious consequences for both the physical and emotional health of caregivers. This study aims to evaluate the burden of care in caregivers of patients with Alzheimer-type dementia and compare it with elderly psychosis; and to also study the factors that influence burden of care in Alzheimer's dementia. Thirty-two caregiver-patient dyads of Alzheimer-type dementia were compared with thirty-two caregiver-patient dyads of psychosis. Cognitive assessment, abilities to perform activities of daily living and severity of dementia was assessed in the patients. Zarit Burden Interview was used to study the caregiver burden in both groups. The mean burden score in dementia caregivers was high at 47.7, whereas the mean burden score for elderly psychosis caregivers was lesser at 33.6, and this difference in mean burden scores was found to be statistically significant. Spouses had the highest mean burden scores of 53.48. Caregiver burden in dementia was positively correlated with cognitive impairment and inability to carry out ADLs. Presence of psychological distress in caregivers was also an indicator for greater caregiver burden in dementia. The study revealed that dementia carries a greater caregiver burden when compared with elderly patients with psychosis. Innovative interventions are needed to remove burden from caregiving, making it a meaningful practice integral to the Indian society. Copyright © 2017 Elsevier B.V. All rights reserved.

Burden of epilepsy in rural Kenya measured in disability-adjusted life years

Science.gov (United States)

Ibinda, Fredrick; Wagner, Ryan G; Bertram, Melanie Y; Ngugi, Anthony K; Bauni, Evasius; Vos, Theo; Sander, Josemir W; Newton, Charles R

2014-01-01

Objectives The burden of epilepsy, in terms of both morbidity and mortality, is likely to vary depending on the etiology (primary [genetic/unknown] vs. secondary [structural/metabolic]) and with the use of antiepileptic drugs (AEDs). We estimated the disability-adjusted life years (DALYs) and modeled the remission rates of active convulsive epilepsy (ACE) using epidemiologic data collected over the last decade in rural Kilifi, Kenya. Methods We used measures of prevalence, incidence, and mortality to model the remission of epilepsy using disease-modeling software (DisMod II). DALYs were calculated as the sum of Years Lost to Disability (YLD) and Years of Life Lost (YLL) due to premature death using the prevalence approach, with disability weights (DWs) from the 2010 Global Burden of Disease (GBD) study. DALYs were calculated with R statistical software with the associated uncertainty intervals (UIs) computed by bootstrapping. Results A total of 1,005 (95% UI 797–1,213) DALYs were lost to ACE, which is 433 (95% UI 393–469) DALYs lost per 100,000 people. Twenty-six percent (113/100,000/year, 95% UI 106–117) of the DALYs were due to YLD and 74% (320/100,000/year, 95% UI 248–416) to YLL. Primary epilepsy accounted for fewer DALYs than secondary epilepsy (98 vs. 334 DALYs per 100,000 people). Those taking AEDs contributed fewer DALYs than those not taking AEDs (167 vs. 266 DALYs per 100,000 people). The proportion of people with ACE in remission per year was estimated at 11.0% in males and 12.0% in females, with highest rates in the 0–5 year age group. Significance The DALYs for ACE are high in rural Kenya, but less than the estimates of 2010 GBD study. Three-fourths of DALYs resulted from secondary epilepsy. Use of AEDs was associated with 40% reduction of DALYs. Improving adherence to AEDs may reduce the burden of epilepsy in this area. PMID:25131901

Burden of disease, research funding and innovation in the UK: Do new health technologies reflect research inputs and need?

Science.gov (United States)

Ward, Derek; Martino, Orsolina; Packer, Claire; Simpson, Sue; Stevens, Andrew

2013-04-01

New and emerging health technologies (innovation outputs) do not always reflect conditions representing the greatest disease burden. We examine the role of research and development (R&D) funding in this relationship, considering whether areas with fewer innovative outputs receive an appropriate share of funding relative to their disease burden. We report a retrospective observational study, comparing burden of disease with R&D funding and innovation output. UK disability-adjusted life years (DALYs) and deaths came from the World Health Organization (WHO) 2004 Global Burden of Disease estimates; funding estimates from the UK Clinical Research Collaboration's 2006 Health Research Analysis; and innovation output was estimated by the number of new and emerging technologies reported by the National Institute for Health Research (NIHR) Horizon Scanning Centre between 2000 and 2009. Disease areas representing the biggest burden were generally associated with the most funding and innovation output; cancer, neuropsychiatric conditions and cardiovascular disease together comprised approximately two-thirds of DALYs, funding and reported technologies. Compared with DALYs, funding and technologies were disproportionately high for cancer, and technologies alone were disproportionately high for musculoskeletal conditions and endocrine/metabolic diseases. Neuropsychiatric conditions had comparatively few technologies compared to both DALYs and funding. The relationship between DALYs and innovation output appeared to be mediated by R&D funding. The relationship between burden of disease and new and emerging health technologies for different disease areas is partly dependent on the associated level of R&D funding (input). Discrepancies among key groups may reflect differential focus of research funding across disease areas. © The Author(s) 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Report on the baseline measurement of the administrative burden from the Department of Health

OpenAIRE

Department of Health (Ireland)

2013-01-01

The Irish Government in March 2008 set a target to identify measure and reduce the Administrative Burden (AB) of domestic regulation for businesses by 25% by the end of 2012 – on foot of a European Council invitation to all member states in March 2007. As part of a cross-Government process led by the Business Regulation Unit of the Department of Jobs, Enterprise and Innovation (DJEI), the Department of Health carried out a measurement exercise in 2012 on the main Information Obligations...

"Mad or bad?": burden on caregivers of patients with personality disorders.

Science.gov (United States)

Bauer, Rita; Döring, Antje; Schmidt, Tanja; Spießl, Hermann

2012-12-01

The burden on caregivers of patients with personality disorders is often greatly underestimated or completely disregarded. Possibilities for caregiver support have rarely been assessed. Thirty interviews were conducted with caregivers of such patients to assess illness-related burden. Responses were analyzed with a mixed method of qualitative and quantitative analysis in a sequential design. Patient and caregiver data, including sociodemographic and disease-related variables, were evaluated with regression analysis and regression trees. Caregiver statements (n = 404) were summarized into 44 global statements. The most frequent global statements were worries about the burden on other family members (70.0%), poor cooperation with clinical centers and other institutions (60.0%), financial burden (56.7%), worry about the patient's future (53.3%), and dissatisfaction with the patient's treatment and rehabilitation (53.3%). Linear regression and regression tree analysis identified predictors for more burdened caregivers. Caregivers of patients with personality disorders experience a variety of burdens, some disorder specific. Yet these caregivers often receive little attention or support.

Caregiver burden among relatives of patients with schizophrenia in ...

African Journals Online (AJOL)

both patients and their caregivers.1,2 Caregiver burden in mental illness can either be ... with chronic mental illness.9 Consequently, there is a need to study the burden of ..... References. 1. Kung W. The illness, stigma, culture or immigration?

Caregiver burden in amyotrophic lateral sclerosis : A systematic review

NARCIS (Netherlands)

de Wit, Jessica; Bakker, Leonhard A; van Groenestijn, Annerieke C; van den Berg, Leonard H; Schröder, Carin D; Visser-Meily, Johanna Ma; Beelen, Anita

BACKGROUND: Informal caregivers of patients with amyotrophic lateral sclerosis experience increased levels of caregiver burden as the disease progresses. Insight in the factors related to caregiver burden is needed in order to develop supportive interventions. AIM: To evaluate the evidence on

Burden, genotype and phenotype profiles of adult patients with ...

African Journals Online (AJOL)

burden of SCD disease, with in excess of 300 000 new affected births annually ... child births globally.[3] In spite of the high burden of disease in SSA, SCD is often ..... supportive medication such as folic acid and patient clinic attendance.

Use of the Tax Prism Method When Forming Tax Part of the Budget

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Verovska Ludmila

2017-06-01

Full Text Available The tax prism method is developed for the assessment of tax part of the budget as well as for forecasting the influence of tax optimisation on it. There are certain trends in global practice. Developing and transition economies are characterised by low tax burden. Economically developed countries with a high level of social security of population are characterised by high tax burden. The analytical and graphic-analytical research for the purpose of determination of optimum size of the taxation using the tax prism has been conducted. In addition to the concept of ‘tax prism’, concepts such as static and dynamic tax prisms have been introduced, allowing to consider changes in the part of the budget of interest in connection with a possibility of taxation subjects to reduce the size of a tax burden by various methods of tax optimisation, and also to consider the influence of other factors on it. The use of this approach helps effectively to enhance the tax legislation by modelling high-quality and quantitative consequences of one or another changes and innovations.

[The current perspectives regarding the burden on mental health caregivers].

Science.gov (United States)

Cardoso, Lucilene; Vieira, Mariana Verderoce; Ricci, Maira Aparecida Malagutti; Mazza, Rafael Severio

2012-04-01

A systematic literature review was performed regarding the burden on mental health caregivers. The studies were selected from the Virtual Health Library - Biblioteca Virtual de Saúde (BVS), using the keyword caregiver burden. The main criteria for this study were: full-text articles published between 2000 and 2010, in Portuguese, English or Spanish; indexed on the BVS databases; which investigated the burden of mental health caregivers, and had caregivers as the main subject. The analysis was performed considering the following: title, year of publication, objectives, methodological approach, instruments and main results. The analysis of 114 full-text articles showed the predominant objectives were the burden on informal caregivers and the validation of psychometric scales, particularly the Zarit Scale. Some studies showed an association between high levels of burden, feelings of guilt and depressive symptoms. On the other hand, psycho-educational interventions were indicated as having a positive impact. This theme has a growing scientific interest and there is a need for deeper studies addressing formal caregivers.

The personal financial burden of chronic rhinosinusitis: A Canadian perspective.

Science.gov (United States)

Yip, Jonathan; Vescan, Allan D; Witterick, Ian J; Monteiro, Eric

2017-07-01

Previous studies describe the financial burden of chronic rhinosinusitis (CRS) from the perspective of third-party payers, but, to our knowledge, none analyze the costs borne by patients (i.e., out-of-pocket expenses [OOPE]). Furthermore, this burden has not been previously investigated in the context of a publicly funded health care system. The purpose of this study was to characterize the financial impact of CRS on patients, specifically by evaluating its associated OOPEs and the perceived financial burden. The secondary aim was to determine the factors predictive of OOPEs and perceived burden. Patients with CRS at a tertiary care sinus center completed a self-administered questionnaire that assessed their socioeconomic characteristics, disease-specific quality of life (22-item Sino-Nasal Outcome Test [SNOT-22]), workdays missed due to CRS, perceived financial burden, and direct medical and nonmedical OOPEs over a 12-month period. Total OOPEs were calculated from the sum of direct medical and nonmedical OOPEs. Regression analyses determined factors predictive of OOPEs and the perceived burden. A total of 84 patients completed the questionnaires. After accounting for health insurance coverage and the median direct medical, direct nonmedical, and total OOPEs per patient over a 12-month period were Canadian dollars (CAD) $336.00 (2011) [U.S. $339.85], CAD $129.87 [U.S. $131.86], and CAD $607.10 [U.S. $614.06], respectively. CRS resulted in an average of 20.6 workdays missed over a 12-month period. Factors predictive of a higher financial burden included younger age, a greater number of previous sinus surgeries, financial burden and consider counseling them on strategies to offset expenses, including obtaining travel grants, using telemedicine for follow-up assessments, providing drug samples, and streamlining diagnostic testing with medical visits.

Influence of home care services on caregivers' burden and satisfaction.

Science.gov (United States)

Kim, Eun-Young; Yeom, Hyun-E

2016-06-01

To examine the factors affecting the burden and satisfaction of family caregivers, focusing on the beneficial impacts of home care service use. Long-term care for older patients is a multifaceted process that brings both burden and satisfaction to family caregivers. It is expected that home care services offered by the Korean long-term care insurance may contribute to decreasing the burden of family caregivers and enhancing their satisfaction by assisting with practical caregiving tasks. A cross-sectional study. A convenience sample of 157 family caregivers was recruited from five home care service agencies in South Korea. Information about the caregivers, caregiving history, older care recipients and use of home care services was assessed. The effects of home care service use on caregiving burden and satisfaction were tested using hierarchical multiple regression analyses after adjusting for the characteristics of the caregivers, caregiving history and older care recipients. There was no significant influence of home care service use on reducing caregiving burden or on increasing caregivers' satisfaction. Although several factors were associated with caregiving burden and satisfaction, family functioning was the most unique factor to significantly affect both caregiving burden and satisfaction. Home care services might not automatically have a positive impact on caregivers' burden and satisfaction, but maintaining healthy family functioning is an important issue for family caregivers. The findings highlight the important need to reconsider ways to provide home care services and to develop nursing interventions to reinforce supportive family functioning. Practical strategies for providing home care services should be developed through a concrete assessment of the family dynamics and the needs of family caregivers. Health professionals should play a pivotal role in performing the assessment and in developing interventions to strengthen supportive family functioning

Association of pro-inflammatory cytokines and iron regulatory protein 2 (IRP2 with Leishmania burden in canine visceral leishmaniasis.

Directory of Open Access Journals (Sweden)

Paulo Ricardo Porfírio do Nascimento

Full Text Available Leishmania infantum infection in humans and dogs can evolve with a wide range of clinical presentations, varying from asymptomatic infections to visceral leishmaniasis. We hypothesized that the immune response elicited by L. infantum infection could modulate whether the host will remain asymptomatic or progress to disease. A total of 44 dogs naturally infected with L. infantum were studied. Leishmania burden was estimated in the blood and spleen by qPCR. The expression of IFN-γ, TNF-α, IL-10 and Iron Regulatory Protein 2 (IRP2 were determined in the spleen by quantitative PCR. Sera cytokines were evaluated by ELISA. Dogs were grouped in quartiles according parasite burden. Increased expression of IFN-γ and TNF-α was associated with reduced Leishmania burden, whereas increased IL-10 and IRP2 expressions were associated with higher Leishmania load. Increased plasma albumin and IFN-γ expression explained 22.8% of the decrease in parasite burden in the spleen. These data confirm that lower IFN-γ response and higher IL-10 correlated with increased parasite load and severity of the visceral leishmaniasis in dogs. The balance between the branches of immune response and the intracellular iron availability could determine, in part, the course of Leishmania infection.

Failure analysis of leakage on titanium tubes within heat exchangers in a nuclear power plant. Part II: Mechanical degradation

Energy Technology Data Exchange (ETDEWEB)

Gong, Y.; Yang, Z.G. [Department of Materials Science, Fudan University, Shanghai (China); Yuan, J.Z. [Third Qinshan Nuclear Power Co. Ltd., Haiyan, Zhejiang Province (China)

2012-01-15

Serious failure incidents like clogging, quick thinning, and leakage frequently occurred on lots of titanium tubes of heat exchangers in a nuclear power plant in China. In the Part I of the whole failure analysis study with totally two parts, factors mainly involving three kinds of electrochemical corrosions were investigated, including galvanic corrosion, crevice corrosion, and hydrogen-assisted corrosion. In the current Part II, through microscopically analyzing the ruptures on the leaked tubes by scanning electron microscopy (SEM) and energy dispersive spectrometry (EDS), another four causes dominantly lying in the aspect of mechanical degradation were determined - clogging, erosion, mechanical damaging, and fretting. Among them, the erosion effect was the primary one, thus the stresses it exerted on the tube wall were also supplementarily evaluated by finite element method (FEM). Based on the analysis results, the different degradation extents and morphologies by erosion on the tubes when they were clogged by different substances such as seashell, rubber debris, and sediments were compared, and relevant mechanisms were discussed. Finally, countermeasures were put forward as well. (Copyright copyright 2012 WILEY-VCH Verlag GmbH and Co. KGaA, Weinheim)

Notes on the Birds of Central Oaxaca, Part II: Columbidae to Vireonidae

Directory of Open Access Journals (Sweden)

John M. Forcey

2015-06-01

Full Text Available Notas sobre las aves de Oaxaca central, parte II: Columbidae a Vireonidae Se reportan  nuevos datos que amplían y clarifican nuestro conocimiento del estatus y distribución de 70 especies de aves en la región central del Estado de Oaxaca. Las observaciones se realizaron abarcando partes de los distritos de Etla, Ixtlan, Tlacolula, y Zaachila, dentro de un círculo de radio de 35 km alrededor de la Ciudad de Oaxaca. El reporte se basa en observaciones tomadas durante 738 días, comprendidos entre diciembre 1996 y marzo 2002. Los hábitats principalmente visitados fueron pino-encino (incluyendo zonas pequeñas de pino-encino-oyamel y pino-encino mezclado con pastizales, matorral de encino, matorral subtropical, vegetación riparia, y vegetación secundaria, campos agrícolas y otros (incluyendo áreas urbanas, como jardines y parques. Las siguientes especies se reportan por primera vez en la zona: Heliomaster constantii, Tilmatura dupontii, Empidonax flaviventris, Empidonax virescens, Myiarchus crinitus, Myiodynastes luteiventris, Vireo philadelphicus, Vireo olivaceus y Vireo flavoviridis. Además, las siguientes diez especies se han reportado anteriormente una sola vez o solamente en los Conteos Navideños: Caprimulgus ridgwayi (residente,Panyptila sanctihieronymi (residente local, Amazilia cyanocephala (residente local, Amazilia viridifrons, Lamprolaima rhami, Momotus mexicanus (residente en la Sierra Juárez, Sayornis phoebe, Myiozetetes similis (residente, Pachyramphus major (residente y Vireo griseus. Se reportan datos de la reproducción de 25 especies, 18 de las cuales no se habían registrado como reproduciéndose en la zona antes. De estos, 24 se pueden agrupar como reproduciéndose en los meses de abril a julio, y 17 se reproducen en zonas riparias, seis de ellos casi exclusivamente.

Subjective caregiver burden: validity of the 10-item short version of the Burden Scale for Family Caregivers BSFC-s.

Science.gov (United States)

Graessel, Elmar; Berth, Hendrik; Lichte, Thomas; Grau, Hannes

2014-02-20

Subjective burden is a central variable describing the situation encountered by family caregivers. The 10-item short version of the Burden Scale for Family Caregivers (BSFC-short/BSFC-s) was developed to provide an economical measure of this variable. The present study examined the reliability and validity of the BSFC-s. Comprehensive data from "the IDA project" were the basis of the calculations, which included 351 dyads and examined medical data on people with dementia, interview data from their family caregivers, and health insurance data. A factor analysis was performed to explore the structure of the BSFC-s; Cronbach's alpha was used to evaluate the internal consistency of the scale. The items were analyzed to determine the item difficulty and the discriminatory power. Construct validity was tested with five hypotheses. To establish the predictive validity of the BSFC-s, predictors of institutionalization at a follow-up time of 2.5 years were analyzed (binary logistic regression). The BSFC-s score adhered to a one-factor structure. Cronbach's alpha for the complete scale was .92. A significant increase in the BSFC-s score was observed when dementia progressed, disturbing behavior occurred more frequently, care requirements increased, and when caregivers were diagnosed with depression. Caregiver burden was the second strongest predictor of institutionalization out of a total of four significant predictors. All hypotheses that referred to the construct validity were supported. The BSFC-short with its ten items is a very economical instrument for assessing the caregiver's total subjective burden in a short time frame. The BSFC-s score has predictive validity for the institutionalization of people with dementia. Therefore it is an appropriate outcome measure to evaluate caregiver interventions. The scale is available for free in 20 languages (http://www.caregiver-burden.eu). This availability facilitates the comparison of international research findings.

Environmental burdens over the entire life cycle of a biomass CHP plant

International Nuclear Information System (INIS)

Jungmeier, G.; Spitzer, J.; Resch, G.

1998-01-01

To increase the use of biomass for energy production it is important to know the possible and significant environmental effects. A life cycle inventory (LCI) was made on a 1.3 MW el biomass CHP plant located in Reuthe/Vorarlberg/Austria with the purpose of analysing the different environmental burdens over the entire life cycle. The plant is fired with coarse and small fuelwood (10,000 t/yr) from industrial waste and forest residues. The boiler for the steam process has a moving grate burner and a muffle burner. The annual production is 4700 MWh of electricity and 29,000 MWh of district heat. The methodology of the analysis is orientated on the ISO Committee Draft of the Series 13,600. The analysis was carried out for the different sections of the biomass plant over their entire life cycle-construction (1 yr), operation (20 yrs) and dismantling (1 yr). The plant in Reuthe, which is the first cogeneration system of this kind in Austria, is a model for other similar projects. The results are shown as environmental burdens of one year and of the entire life cycle. Some results of the life cycle inventory, like the mass and energy balances, selected emissions to air, allocation results and effects on carbon storage pools are given. The results demonstrate that depending on the stage and the period of life, different environmental burdens become significant, i.e. CO 2 emissions of fossil fuels during construction. NO x emission during operation, emissions to soil during dismantling. The different options for allocation the environmental burdens to electricity and heat show a wide range of possible results, depending on the choice of allocation parameters (energy, exergy, credits for heat or electricity, price) i.e. for the particles emissions: 161 mg/kWh el to minus 566 mg/kWh el , 0 mg/kWh th to 118 mg/kWh th . With the results of the analysis it is thus possible for future similar projects to know when and where significant environmental burdens might be further

Preliminary Guideline for the High Temperature Structure Integrity Assessment Procedure Part II. High Temperature Structural Integrity Assessment

Energy Technology Data Exchange (ETDEWEB)

Lee, Jae Han; Kim, J. B.; Lee, H. Y.; Park, C. G.; Joo, Y. S.; Koo, G. H.; Kim, S. H

2007-02-15

A high temperature structural integrity assessment belongs to the Part II of a whole preliminary guideline for the high temperature structure. The main contents of this guideline are the evaluation procedures of the creep-fatigue crack initiation and growth in high temperature condition, the high temperature LBB evaluation procedure, and the inelastic evaluations of the welded joints in SFR structures. The methodologies for the proper inelastic analysis of an SFR structures in high temperatures are explained and the guidelines of inelastic analysis options using ANSYS and ABAQUS are suggested. In addition, user guidelines for the developed NONSTA code are included. This guidelines need to be continuously revised to improve the applicability to the design and analysis of the SFR structures.

The Burden of disease attributable to mental and substance use disorders in Brazil: Global Burden of Disease Study, 1990 and 2015.

Science.gov (United States)

Bonadiman, Cecília Silva Costa; Passos, Valéria Maria de Azeredo; Mooney, Meghan; Naghavi, Mohsen; Melo, Ana Paula Souto

2017-05-01

Mental and substance use disorders (MD) are highly prevalent and have a high social and economic cost. To describe the burden of disease attributable to mental and substance use disorders in Brazil and Federated Units in 1990 and 2015. Descriptive study of the burden of mental and substance use disorders, using age-standardized estimates from the Global Burden of Disease Study 2015: years of life lost due to premature mortality (YLL); years lived with disability (YLD); and disability-adjusted life year (DALY=YLL+YLD). In Brazil, despite low mortality rates, there has been a high burden for mental and substance use disorders since 1990, with high YLD. In 2015, these disorders accounted for 9.5% of all DALY, ranking in the third and first position in DALY and YLD, respectively, with an emphasis on depressive and anxiety disorders. Drug use disorders had their highest increase in DALY rates between 1990 and 2015 (37.1%). The highest proportion of DALY occurred in adulthood and in females. There were no substantial differences in burden of mental and substance use disorders among Federated Units. Despite a low mortality rate, mental and substance use disorders are highly disabling, which indicates the need for preventive and protective actions, especially in primary health care. The generalization of estimates in all the Federated Units obtained from studies conducted mostly in the south and southeast regions probably does not reflect the reality of Brazil, indicating the need for studies in all regions of the country.

Burden of care in the caregivers of patients with anxiety disorders

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Manu Agarwal

2017-01-01

Full Text Available Introduction: Anxiety disorders are one of the frequently encountered psychiatric disorders in psychiatric clinics which have significant impact on the psychosocial well-being of the patient as well as their caregivers. Study Design and Aims: This study is a non- invasive, cross sectional study of 91 patients with anxiety disorder (except obsessive compulsive disorder aimed to assess the burden of care on their key-relatives and to study various socio demographic and clinical variables of the patient in relation to burden of care on key-relatives. Methodology: Patients diagnosed with anxiety disorders other than obsessive compulsive disorder and their key relatives satisfying the selection criteria were enrolled in the study. Assessment was done on semi-structured proforma, ICD 10 DCR, SCAN (Schedules for Clinical Assessment in Neuropsychiatry, International Personality Disorder Examination (IPDE, Burden assessment schedule, Hamilton Anxiety Rating Scale (HAM-A. Result: Total adjusted burden score in our study was 40.41 which is suggestive of mild burden. It was found that the burden of care was higher in male gender, married individuals, in joint families, among spouses, urban background, in the age group 41 to 50 years, low income group particularly on farmers and laborers. Generalized anxiety disorder was associated with more burden of care in comparison to other anxiety disorders. Conclusion: Key relatives of patients with anxiety disorder have significant burden of care in different domains along the socio-demographic strata.

Factors associated with perceived donation-related financial burden among living kidney donors.

Science.gov (United States)

Ruck, Jessica M; Holscher, Courtenay M; Purnell, Tanjala S; Massie, Allan B; Henderson, Macey L; Segev, Dorry L

2018-03-01

The perception of living kidney donation-related financial burden affects willingness to donate and the experience of donation, yet no existing tools identify donors who are at higher risk of perceived financial burden. We sought to identify characteristics that predicted higher risk of perceived financial burden. We surveyed 51 living kidney donors (LKDs) who donated from 01/2015 to 3/2016 about socioeconomic characteristics, predonation cost concerns, and perceived financial burden. We tested associations between both self-reported and ZIP code-level characteristics and perceived burden using Fisher's exact test and bivariate modified Poisson regression. Donors who perceived donation-related financial burden were less likely to have an income above their ZIP code median (14% vs. 72%, P = .006); however, they were more likely than donors who did not perceive burden to rent their home (57% vs. 16%, P = .03), have an income donation-related cost concerns prior to donation might allow transplant centers to target financial support interventions toward potential donors at higher risk of perceiving donation-related financial burden. © 2017 The American Society of Transplantation and the American Society of Transplant Surgeons.

Disease burden of methylmercury in the German birth cohort 2014.

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Julia Lackner

Full Text Available This study aimed to estimate the disease burden of methylmercury for children born in Germany in the year 2014. Humans are mainly exposed to methylmercury when they eat fish or seafood. Prenatal methylmercury exposure is associated with IQ loss. To quantify this disease burden, we used Monte Carlo simulation to estimate the incidence of mild and severe mental retardation in children born to mothers who consume fish based on empirical data. Subsequently, we calculated the disease burden with the disability-adjusted life years (DALY-method. DALYs combine mortality and morbidity in one measure and quantify the gap between an ideal situation, where the entire population experiences the standard life expectancy without disease and disability, and the actual situation. Thus, one DALY corresponds to the loss of one year of life in good health. The methylmercury-induced burden of disease for the German birth cohort 2014 was an average of 14,186 DALY (95% CI 12,915-15,440 DALY. A large majority of the DALYs was attributed to morbidity as compared to mortality. Of the total disease burden, 98% were attributed to mild mental retardation, which only leads to morbidity. The remaining disease burden was a result of severe mental retardation with equal proportions of premature death and morbidity.

Proceedings of the Annual Meeting of the Association for Education in Journalism and Mass Communication (83rd, Phoenix, Arizona, August 9-12, 2000). Miscellaneous, Part II.

Science.gov (United States)

Association for Education in Journalism and Mass Communication.

The Miscellaneous, Part II Section of the proceedings contains the following eight papers: "Academic Letters of Recommendation: Perceived Ethical Implications and Harmful Effects of Exaggeration" (David L. Martinson and Michael Ryan); "It's All about the Information Salience Effects on the Perceptions of News Exemplification"…

Patient-experienced burden of treatment in patients suffering from multimorbidity data

DEFF Research Database (Denmark)

Rosbach, Michael; Andersen, John Sahl

2017-01-01

the multimorbid patients. In studies conducted in the US and Australia the financial burden and the time and travel burden were found most straining to patients with deprived socioeconomic status. The burden of treatment was found to be a complex concept consisting of many different components and factors...... interacting with each other. The size of the burden was associated to the workload of demands (number of conditions, number of medications and health status), the capacity (cognitive, physical and financial resources, educational level, cultural background, age, gender and employment conditions...

HIV / AIDS: An Unequal Burden

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Skip Navigation Bar Home Current Issue Past Issues HIV / AIDS HIV / AIDS: An Unequal Burden Past Issues / Summer 2009 ... high-risk category, emphasizes Dr. Cargill. Photo: iStock HIV and Pregnancy Are there ways to help HIV- ...

Atmospheric fluoride pollution. Part II

Energy Technology Data Exchange (ETDEWEB)

Hasegawa, T; Yamazaki, Y

1969-01-01

In East Osaka, agricultural crops either died or showed poor growth in the neighborhood of a factory producing white cosmetic bottles. Since fluorite was used as a material and there was no damage before the establishment of the factory, it was suspected that fluorine compounds were causing the damage. Quantitative analysis was performed on the agricultural crops and the exhaust gas as well as the dust particles in order to determine the fluorine content. Gas samplers were used to collect the dusts from the surrounding atmosphere. The fluorine content of dust near the factory was about 93 mg per cubic meter per day, and in some parts, as high as 1.54 mq per cubic meter per day. Relatively larger quantities of fluorine were measured at the southwestern and southeastern area of the factory, corresponding to the general wind pattern. Rice and soy beans from the neighborhood of the factory showed concentrations of fluorine and, especially in the leaves of the damaged crops, the concentrations were several hundred times higher than those of the undamaged leaves.

High-salt diet combined with elevated angiotensin II accelerates atherosclerosis in apolipoprotein E-deficient mice

DEFF Research Database (Denmark)

Johansson, Maria E; Bernberg, Evelina; Andersson, Irene J

2009-01-01

OBJECTIVES: High-salt diet likely elevates blood pressure (BP), thus increasing the risk of cardiovascular events. We hypothesized that a high-salt diet plays a critical role in subjects whose renin-angiotensin systems cannot adjust to variable salt intake, rendering them more susceptible...... to atherosclerosis. METHODS: Apolipoprotein E-deficient (ApoE-/-) mice received standard or high-salt diet (8%) alone or in combination with fixed angiotensin II (Ang II) infusion (0.5 microg/kg per min). BP was measured using telemetry, and plaque burden was assessed in the thoracic aorta and innominate artery. We...... used urinary isoprostane as a marker for oxidative stress. RESULTS: Although high-salt diet per se did not affect plaque extension, high salt combined with Ang II increased plaque area significantly in both the aorta and the innominate artery as compared with Ang II or salt alone (P

The disease burden of congenital toxoplasmosis in Denmark, 2014

DEFF Research Database (Denmark)

Nissen, Ioanna; Jokelainen, Pikka; Stensvold, Christen Rune

2017-01-01

Congenital toxoplasmosis (CT) causes a substantial disease burden worldwide. The aim of this study was to estimate the disease burden of CT in Denmark, a developed country with free public healthcare and nationwide data available. Using data primarily from two public health surveillance programmes...

Burden and depression in primary caregivers of persons with visual impairment

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Shubhank Khare

2016-01-01

Full Text Available Context: Caregivers who assist persons with visual impairment often neglect their needs, resulting in burden and depression. Rehabilitation efforts, directed to the disabled, seldom target the caregiver. Aim: To assess burden and depression in persons caring for blind individuals. Settings and Design: This was a cross-sectional study carried out in the outpatient department of a tertiary-level teaching hospital in New Delhi. Materials and Methods : Institutional Ethical Board approval was obtained and written informed consent too was obtained from the participants involved in this study. Persons with best-corrected vision <20/200 in the better eye, and their primary caregivers, were recruited. We recorded demography, other illness/disability, household income, relationship with disabled person, and caregiver burden (Caregiver Burden Scale and depression (Centre for Epidemiologic Studies Depression Scale. Statistical Analysis: Statistical analysis was carried out using SPSS version 20 (Released 2011. Armonk, NY: IBM Corp.; range, average, and standard deviation were determined for age, burden, and depression. The association between burden and depression was determined using Pearson′s correlation; the relationship between degree of disability and caregiver burden and depression was determined using unpaired t-test; using multiple linear regression, factors were found to be statistically significant; significance was taken at P < 0.05. Results: Twenty-seven (53.0% men and 24 (47.0% women had visual impairment. Most caregivers (n = 40; 81.6% were first-degree relatives or a spouse; 32 (65% had schooling <5 years; and 29 (59% were unemployed. Depression ranged from 21 to 52 (average 43.2 ± 5.71; it correlated with degree of disability (P = 0.012, household income (r = −0.320; P = 0.025, and burden (r = 0.616; P < 0.001. Burden ranged from 30 to 73 (average 54.5 ± 6.73 and correlated with degree of disability (P = 0.006. On multiple linear

Reassessing Phase II Heart Failure Clinical Trials: Consensus Recommendations

Science.gov (United States)

Butler, Javed; Hamo, Carine E.; Udelson, James E.; O’Connor, Christopher; Sabbah, Hani N.; Metra, Marco; Shah, Sanjiv J.; Kitzman, Dalane W.; Teerlink, John; Bernstein, Harold S.; Brooks, Gabriel; Depre, Christophe; DeSouza, Mary M.; Dinh, Wilfried; Donovan, Mark; Frische-Danielson, Regina; Frost, Robert J.; Garza, Dahlia; Gohring, Udo-Michael; Hellawell, Jennifer; Hsia, Judith; Ishihara, Shiro; Kay-Mugford, Patricia; Koglin, Joerg; Kozinn, Marc; Larson, Christopher J.; Mayo, Martha; Gan, Li-Ming; Mugnier, Pierrre; Mushonga, Sekayi; Roessig, Lothar; Russo, Cesare; Salsali, Afshin; Satler, Carol; Shi, Victor; Ticho, Barry; van der Laan, Michael; Yancy, Clyde; Stockbridge, Norman; Gheorghiade, Mihai

2017-01-01

The increasing burden and the continued suboptimal outcomes for patients with heart failure underlines the importance of continued research to develop novel therapeutics for this disorder. This can only be accomplished with successful translation of basic science discoveries into direct human application through effective clinical trial design and execution that results in a substantially improved clinical course and outcomes. In this respect, phase II clinical trials play a pivotal role in determining which of the multitude of potential basic science discoveries should move to the large and expansive registration trials in humans. A critical examination of the phase II trials in heart failure reveals multiple shortcomings in their concept, design, execution, and interpretation. To further a dialogue regarding the challenges and potential for improvement and the role of phase II trials in patients with heart failure, the Food and Drug Administration facilitated a meeting on October 17th 2016 represented by clinicians, researchers, industry members, and regulators. This document summarizes the discussion from this meeting and provides key recommendations for future directions. PMID:28356300

Impact of a community based implementation of REACH II program for caregivers of Alzheimer's patients.

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Kristine Lykens

Full Text Available BACKGROUND: In 2009 an estimated 5.3 million people in the United States were afflicted with Alzheimer's disease, a degenerative form of dementia. The impact of this disease is not limited to the patient but also has significant impact on the lives and health of their family caregivers. The Resources for Enhancing Alzheimer's Caregiver Health (REACH II program was developed and tested in clinical studies. The REACH II program is now being delivered by community agencies in several locations. This study examines the impact of the REACH II program on caregiver lives and health in a city in north Texas. STUDY DESIGN: Family caregivers of Alzheimer's patients were assessed using an instrument covering the multi-item domains of Caregiver Burden, Depression, Self-Care, and Social Support upon enrollment in the program and at the completion of the 6 month intervention. The domain scores were analyzed using a multivariate paired t-test and Bonferroni confidence interval for the differences in pre- and post-service domain scores. RESULTS: A total of 494 families were enrolled in the program during the period January 1, 2011 through June 30, 2012. Of these families 177 completed the 6 month program and have pre - and post service domain scores. The median age for the caregivers was 62 years. The domain scores for Depression and Caregiver Burden demonstrated statistically significant improvements upon program completion. CONCLUSION: The REACH II intervention was successfully implemented by a community agency with comparable impacts to those of the clinical trial warranting wider scale implementation.

The Relationship between Sleep Quality and Brain Amyloid Burden.

Science.gov (United States)

Brown, Belinda M; Rainey-Smith, Stephanie R; Villemagne, Victor L; Weinborn, Michael; Bucks, Romola S; Sohrabi, Hamid R; Laws, Simon M; Taddei, Kevin; Macaulay, S Lance; Ames, David; Fowler, Christopher; Maruff, Paul; Masters, Colin L; Rowe, Christopher C; Martins, Ralph N

2016-05-01

To evaluate the association between self-reported sleep quality and levels of brain β-amyloid (Aβ) burden, and to determine the effect of the apolipoprotein E (APOE) ε4 allele on any associations found. This study is a cross-sectional analysis of 184 cognitively healthy men and women aged over 60 y. We measured sleep quality factors: specifically, sleep duration, latency (time taken to fall asleep), disturbances, efficiency, daytime dysfunction, and overall sleep quality, using the Pittsburgh Sleep Quality Index. All participants underwent Aβ positron emission tomography imaging for the quantification of brain Aβ burden and were APOE genotyped. Linear regression analyses were used to evaluate the relationship between sleep quality factors and brain Aβ burden, adjusting for age, body mass index, cardiovascular disease, and symptoms of depression, with APOE ε4 carriage entered as a moderator. Of the sleep factors, longer sleep latency was associated with higher levels of brain Aβ (B = 0.003 [standard error = 0.001], P = 0.02). APOE ε4 allele (carrier/noncarrier) did not moderate the relationship between sleep latency and brain Aβ burden. Our findings suggest a relationship between brain Aβ burden and sleep latency, independent of APOE ε4 genotype. © 2016 Associated Professional Sleep Societies, LLC.

Contamination smoke: a simulation of heavy metal containing aerosols from fires in plutonium glove boxes: part II

International Nuclear Information System (INIS)

Buijs, K.; Chavane de Dalmassy, B.; Baumgaertner, E.

1992-01-01

The study of the dispersion of plutonium bearing aerosols during glove box fires on a laboratory scale has been, in part I of this work, focussed on fires of polymethylmethacrylate (PMMA - the major glove box construction material) whose surfaces were contaminated with cerium-europium oxide powder as a substitute for plutonium-uranium oxide. The present part II completes the study with comparative fire experiments involving contaminated samples of various glove box materials burning in or exposed to the flames of the standardized 0.6 MW fire source previously developed. Beyond spreading of the Ce-Eu-oxide powder as mentioned above, the other important surface contamination process is used, i.e. deposition and subsequent drying of droplets from acid cerium-europium solutions. It is shown that, among the tested materials, and with the exception of synthetic glove rubber, burning PMMA spreads the most radioactive contamination. On the other hand, this potential risk is much lower for fires involving materials contaminated from solution deposition than from powder or pellets. Attempts to measure the airborne contaminant particle sizes did not yield conclusive results. They suggest, however, that contamination from solutions leads to smaller heavy-metal containing aerosol particles than contamination with powder

Biological markers for anxiety disorders, OCD and PTSD: A consensus statement. Part II: Neurochemistry, neurophysiology and neurocognition

Science.gov (United States)

Bandelow, Borwin; Baldwin, David; Abelli, Marianna; Bolea-Alamanac, Blanca; Bourin, Michel; Chamberlain, Samuel R.; Cinosi, Eduardo; Davies, Simon; Domschke, Katharina; Fineberg, Naomi; Grünblatt, Edna; Jarema, Marek; Kim, Yong-Ku; Maron, Eduard; Masdrakis, Vasileios; Mikova, Olya; Nutt, David; Pallanti, Stefano; Pini, Stefano; Ströhle, Andreas; Thibaut, Florence; Vaghix, Matilde M.; Won, Eunsoo; Wedekind, Dirk; Wichniak, Adam; Woolley, Jade; Zwanzger, Peter; Riederer, Peter

2017-01-01

Objective Biomarkers are defined as anatomical, biochemical or physiological traits that are specific to certain disorders or syndromes. The objective of this paper is to summarise the current knowledge of biomarkers for anxiety disorders, obsessive-compulsive disorder (OCD) and posttraumatic stress disorder (PTSD). Methods Findings in biomarker research were reviewed by a task force of international experts in the field, consisting of members of the World Federation of Societies for Biological Psychiatry Task Force on Biological Markers and of the European College of Neuropsychopharmacology Anxiety Disorders Research Network. Results The present article (Part II) summarises findings on potential biomarkers in neurochemistry (neurotransmitters such as serotonin, norepinephrine, dopamine or GABA, neuropeptides such as cholecystokinin, neurokinins, atrial natriuretic peptide, or oxytocin, the HPA axis, neurotrophic factors such as NGF and BDNF, immunology and CO2 hypersensitivity), neurophysiology (EEG, heart rate variability) and neurocognition. The accompanying paper (Part I) focuses on neuroimaging and genetics. Conclusions Although at present, none of the putative biomarkers is sufficient and specific as a diagnostic tool, an abundance of high quality research has accumulated that should improve our understanding of the neurobiological causes of anxiety disorders, OCD and PTSD. PMID:27419272

Dependency aspect of caregiver burden is uniquely related to cognitive impairment in Veterans.

Science.gov (United States)

Stinson, Jennifer M; Collins, Robert L; Maestas, Kacey Little; Pacheco, Vitor; LeMaire, Ashley; Benge, Jared

2014-01-01

The psychosocial toll of caring for an individual with dementia is an important, if understudied, concept. For practitioners and researchers alike, understanding the relation between patient characteristics and different facets of caregiver burden is important for guiding treatment and prevention efforts. The current study analyzed the dimensions of caregiver burden and the relation between caregiver burden and results of neuropsychological testing. Participants included 243 dyads of caregivers and Veterans referred for neuropsychological evaluation. Caregivers completed the Zarit Burden Interview (ZBI) to assess caregiver burden. Patients completed a battery of neuropsychological tests measuring the domains of attention/processing speed, memory, language, and executive functioning. A principal components analysis of the ZBI revealed a three-factor structure: psychosocial burden, dependency burden, and guilt. Correlations with neuropsychological test performance by Veteran patients suggested that test performance in the memory, attention, processing speed, executive functioning, and emotional functioning domains were solely related to the caregiver dependency burden factor of the ZBI. Additional analyses suggested severity of dementia and number of tests in the impaired range further influenced reported caregiver burden. The current study is one of the few studies examining caregiver burden in relation to neuropsychological functioning in a mixed clinical sample and has important implications for clinical practice.

Transition metal complexes with pyrazole-based ligands.Part 29. Reactions of zinc(II and mercury(II thiocyanate with 4-acetyl-3-amino-5-methylpyrazole

Directory of Open Access Journals (Sweden)

KATALIN MÉSZÁROS SZÉCSÉNYI

2009-11-01

Full Text Available The work is concerned with the crystal and molecular structures of zinc(II and mercury(II complexes with 4-acetyl-3-amino-5-methyl-pyrazole (aamp of the coordination formulae [Zn(NCS2(aamp2] and (Haamp2[Hg(SCN4]. The zinc(II complex was obtained by the reaction of a warm methanolic solution of aamp with a mixture of zinc(II nitrate and ammonium thiocyanate, whereas the mercury(II complex was prepared by the reaction of a warm ethanolic solution of aamp and a warm, slightly acidified aqueous solution of [Hg(SCN4]2-. Both complexes have a tetrahedral geometry, which in the case of zinc complex is formed by monodentate coordination of two aamp molecules and two isothiocyanate groups. The Zn(II and Hg(II atoms have significantly deformed coordination geometry. In both crystal structures the pyrazole derivative has a planar form, probably stabilized by an intramolecular N–H···O hydrogen bond. Apart from the X-ray structural analysis, the isolated complexes were characterized by elemental analysis, IR spectroscopy, conductometric measurements and thermal analysis.

Differences between easy- and difficult-to-mill chickpea (Cicer arietinum L.) genotypes. Part II: protein, lipid and mineral composition.

Science.gov (United States)

Wood, Jennifer A; Knights, Edmund J; Campbell, Grant M; Choct, Mingan

2014-05-01

Part I introduced the concept of easy- and difficult-to-mill chickpea genotypes, the broad chemical composition of their seed fractions and proposed mechanistic explanations for physical differences consistent with observed variation in milling ease. Part II continues this research by delving deeper into the amino acid, fatty acid and mineral components. No association between fatty acid composition and ease of milling was observed. However, particular amino acids and mineral elements were identified that further support roles of lectins, pectins and mineral-facilitated binding in the adhesion of chickpea seed coat and cotyledons. These differences suggest underlying mechanisms that could be exploited by breeding programmes to improve milling performance. This study shows that the content and composition of amino acids, fatty acids and minerals within different chickpea tissues vary with seed type (desi and kabuli) and within desi genotypes in ways that are consistent with physical explanations of how seed structure and properties relate to milling behaviour. © 2013 Society of Chemical Industry.

Global, Regional, and National Burden of Rheumatic Heart Disease, 1990-2015.

Science.gov (United States)

Watkins, David A; Johnson, Catherine O; Colquhoun, Samantha M; Karthikeyan, Ganesan; Beaton, Andrea; Bukhman, Gene; Forouzanfar, Mohammed H; Longenecker, Christopher T; Mayosi, Bongani M; Mensah, George A; Nascimento, Bruno R; Ribeiro, Antonio L P; Sable, Craig A; Steer, Andrew C; Naghavi, Mohsen; Mokdad, Ali H; Murray, Christopher J L; Vos, Theo; Carapetis, Jonathan R; Roth, Gregory A

2017-08-24

Rheumatic heart disease remains an important preventable cause of cardiovascular death and disability, particularly in low-income and middle-income countries. We estimated global, regional, and national trends in the prevalence of and mortality due to rheumatic heart disease as part of the 2015 Global Burden of Disease study. We systematically reviewed data on fatal and nonfatal rheumatic heart disease for the period from 1990 through 2015. Two Global Burden of Disease analytic tools, the Cause of Death Ensemble model and DisMod-MR 2.1, were used to produce estimates of mortality and prevalence, including estimates of uncertainty. We estimated that there were 319,400 (95% uncertainty interval, 297,300 to 337,300) deaths due to rheumatic heart disease in 2015. Global age-standardized mortality due to rheumatic heart disease decreased by 47.8% (95% uncertainty interval, 44.7 to 50.9) from 1990 to 2015, but large differences were observed across regions. In 2015, the highest age-standardized mortality due to and prevalence of rheumatic heart disease were observed in Oceania, South Asia, and central sub-Saharan Africa. We estimated that in 2015 there were 33.4 million (95% uncertainty interval, 29.7 million to 43.1 million) cases of rheumatic heart disease and 10.5 million (95% uncertainty interval, 9.6 million to 11.5 million) disability-adjusted life-years due to rheumatic heart disease globally. We estimated the global disease prevalence of and mortality due to rheumatic heart disease over a 25-year period. The health-related burden of rheumatic heart disease has declined worldwide, but high rates of disease persist in some of the poorest regions in the world. (Funded by the Bill and Melinda Gates Foundation and the Medtronic Foundation.).

Neutronics and thermohydraulics of the reactor C.E.N.E. Part II; Analisis neutronico y termohidraulico del reactor C.E.N.E. Parte II

Energy Technology Data Exchange (ETDEWEB)

Caro, R

1976-07-01

In this report the analysis of neutronics thermohydraulics and shielding of the 10 HWt swimming pool reactor C.E.N.E is included. In each of these chapters is given a short description of the theoretical model used, along with the theoretical versus experimental checking carried out, whenever possible, with the reactors JEN-I and JEN-II of Junta de Energia Nuclear. (Author) 11 refs.

Kafka, Borges, and the creation of consciousness, Part II: Borges--a life of letters encompassing everything and nothing.

Science.gov (United States)

Ogden, Thomas H

2009-04-01

The ways in which Kafka and Borges struggled with the creation of consciousness in their lives and in their literary works are explored in this two-part essay. In Part II, a biographical sketch of Jorge Luis Borges is juxtaposed with a close reading of one of his fictions, "The Library of Babel" (1941a). In this story, the universe is an infinite Library, a psychological/literary space comprised of books that contain everything that has ever been or ever will be written. By the end of the story, Borges becomes a character in his own fiction. This development was paralleled in Borges's "real life" as he invented a persona named "Borges," a literary creation that allowed Borges to become a character in a story that was his life. The essay concludes with a comparison of the ways in which Borges and Kafka each used writing as a way of creating his own distinctive form of consciousness, and, in so doing, contributed to the creation of twentieth-century consciousness.

The Tölz Temporal Topography Study: mapping the visual field across the life span. Part II: cognitive factors shaping visual field maps.

Science.gov (United States)

Poggel, Dorothe A; Treutwein, Bernhard; Calmanti, Claudia; Strasburger, Hans

2012-08-01

Part I described the topography of visual performance over the life span. Performance decline was explained only partly by deterioration of the optical apparatus. Part II therefore examines the influence of higher visual and cognitive functions. Visual field maps for 95 healthy observers of static perimetry, double-pulse resolution (DPR), reaction times, and contrast thresholds, were correlated with measures of visual attention (alertness, divided attention, spatial cueing), visual search, and the size of the attention focus. Correlations with the attentional variables were substantial, particularly for variables of temporal processing. DPR thresholds depended on the size of the attention focus. The extraction of cognitive variables from the correlations between topographical variables and participant age substantially reduced those correlations. There is a systematic top-down influence on the aging of visual functions, particularly of temporal variables, that largely explains performance decline and the change of the topography over the life span.

Tratamento sistêmico da psoríase - Parte II: Imunomoduladores biológicos Systemic treatment of psoriasis - Part II: Biologic immunomodulator agents

Directory of Open Access Journals (Sweden)

Lúcia Arruda

2004-08-01

Full Text Available Em continuidade ao capítulo da edição anterior dos Anais Brasileiros de Dermatologia, nesta segunda parte da EMC-D serão discutidas as novas drogas, os imunomoduladores biológicos, que agem em determinadas fases da imunopatogênese da doença, modificando fenotipicamente sua evolução. Também serão discutidos alguns aspectos imunológicos que, atualmente, são responsáveis pelo desencadeamento da doençaAs part of its continued studies of psoriasis, this second part of the Continuing Medical Education in Dermatology segment of the Anais Brasileiros de Dermatologia introduces biological immunomodulators. Also known as "biologics", these drugs act on the immunopathogenetic steps of psoriasis by changing its features and progression. This paper also reviews some of the immunologic aspects of psoriasis.

Designer ligands. Part 15. Synthesis and characterisation of novel Mn(lI), Ni(II) and Zn(II) complexes of 1,10-phenanthroline-derived ligands

CSIR Research Space (South Africa)

Wellington, Kevin W

2009-01-01

Full Text Available Series of manganese(II), nickel(II) and zinc(II) complexes have been prepared using 1,10-phenanthroline-derived ligands, and their coordination geometries have been assigned using infrared data. It is apparent that, depending on the ligand...

Caregiver burden among relatives of patients with schizophrenia in ...

African Journals Online (AJOL)

Background. Caring for patients with schizophrenia places an enormous burden on the caregivers. The magnitude of this problem remains largely unknown in sub-Saharan Africa. Objective. The objective of this study was to determine the nature of the burden reported by caregiving relatives of patients with schizophrenia.

The burden of non-filarial elephantiasis in Ethiopia.

Science.gov (United States)

Animut, Abebe

2007-12-01

Although known for many years, non-filarial elephantiasis remains a public health problem in tropical Africa, including the farming community of Ethiopia. The problem may be exacerbated in women who shoulder most of the burden of agricultural labour in the countryside. The intention of this brief review is to emphasise the burden of the disease and to alert researchers and organisations concerned with health care and prevention.

Exploration of Logistics Information Technology (IT) Solutions for the Royal Saudi Naval Force Within the Saudi Naval Expansion Program II (SNEP II)

Science.gov (United States)

2017-12-01

NAVAL POSTGRADUATE SCHOOL MONTEREY, CALIFORNIA MBA PROFESSIONAL REPORT EXPLORATION OF LOGISTICS INFORMATION TECHNOLOGY (IT) SOLUTIONS FOR THE...INFORMATION TECHNOLOGY (IT) SOLUTIONS FOR THE ROYAL SAUDI NAVAL FORCE WITHIN THE SAUDI NAVAL EXPANSION PROGRAM II (SNEP II) 5. FUNDING NUMBERS 6. AUTHOR(S...Expansion Program II (SNEP II). A part of this program includes upgrading and rebuilding its information technology (IT) infrastructure. The United

NSLS-II booster timing system

International Nuclear Information System (INIS)

Cheblakov, P.; Karnaev, S.; De Long, J.

2012-01-01

NSLS-II light source includes the main storage ring with beam lines and injection part consisting of 200 MeV linac, a full-energy 3 GeV booster synchrotron and two transport lines. The booster timing system is a part of NSLS-II timing system which uses hardware from MicroResearch Finland: Event Generator (EVG) and Event Receivers (EVRs). The booster timing is based on the events coming from NSLS-II EVG: 'Pre-Injection', 'Injection', 'Pre-Extraction', 'Extraction'. These events are referenced to the selected RF bucket of the storage ring and correspond to the first RF bucket of the booster. EVRs provide triggers both for the injection and the extraction pulse devices. EVRs also provide the timing of booster cycle operation and generation of events for cycle-to-cycle updates of pulsed and ramping parameters, and synchronization of the booster beam instrumentation devices. This paper describes the final design of the booster timing system. The timing system functional diagrams and block diagram are presented. (authors)

Economic Burden of Human Papillomavirus-Related Diseases in Italy

Science.gov (United States)

Baio, Gianluca; Capone, Alessandro; Marcellusi, Andrea; Mennini, Francesco Saverio; Favato, Giampiero

2012-01-01

Introduction Human papilloma virus (HPV) genotypes 6, 11, 16, and 18 impose a substantial burden of direct costs on the Italian National Health Service that has never been quantified fully. The main objective of the present study was to address this gap: (1) by estimating the total direct medical costs associated with nine major HPV-related diseases, namely invasive cervical cancer, cervical dysplasia, cancer of the vulva, vagina, anus, penis, and head and neck, anogenital warts, and recurrent respiratory papillomatosis, and (2) by providing an aggregate measure of the total economic burden attributable to HPV 6, 11, 16, and 18 infection. Methods For each of the nine conditions, we used available Italian secondary data to estimate the lifetime cost per case, the number of incident cases of each disease, the total economic burden, and the relative prevalence of HPV types 6, 11, 16, and 18, in order to estimate the aggregate fraction of the total economic burden attributable to HPV infection. Results The total direct costs (expressed in 2011 Euro) associated with the annual incident cases of the nine HPV-related conditions included in the analysis were estimated to be €528.6 million, with a plausible range of €480.1–686.2 million. The fraction attributable to HPV 6, 11, 16, and 18 was €291.0 (range €274.5–315.7 million), accounting for approximately 55% of the total annual burden of HPV-related disease in Italy. Conclusions The results provided a plausible estimate of the significant economic burden imposed by the most prevalent HPV-related diseases on the Italian welfare system. The fraction of the total direct lifetime costs attributable to HPV 6, 11, 16, and 18 infections, and the economic burden of noncervical HPV-related diseases carried by men, were found to be cost drivers relevant to the making of informed decisions about future investments in programmes of HPV prevention. PMID:23185412

COMPARATIVE STUDY ON THE BURDEN OF BIPOLAR AFFECTIVE DISORDER AND SCHIZOPHRENIA

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C. Jayakrishnaveni

2018-01-01

Full Text Available BACKGROUND Mental and behavioural disorders have a large impact on individuals, family and communities. There is a paucity of studies on burden and cost of illness of Bipolar Affective Disorder both internationally and in India. Such studies are important for clinical management and policy decisions. Aim of the study - The aim of the present study is to assess the magnitude of the cost of illness and family burden of Bipolar Affective Disorder and Schizophrenia and to find out the difference in the burden of the caregivers for both the groups. MATERIALS AND METHODS The study was conducted in the outpatient department of Institute of Mental Health, Chennai. Sixty patients in each group were included by stratified sampling. Caregivers living with patients for atleast one year are included in the study, and those with any comorbid illness, were excluded from the study. ICD -10 diagnostic and research criteria were used for diagnosis of BPAD and Schizophrenia, Questionnaire for Assessment of Cost of Illness was used to assess cost of illness and Family Burden Interview Schedule was used to assess burden of caregivers. RESULTS Schizophrenia patients are mostly from urban, nuclear family. The illness characters & sociodemographic profile of caregivers are comparable. Lifetime costs and loss of income over lifetime was more in schizophrenia. Loss of income in the past year was similar. The burden was comparable for caregivers of both groups in disruption of family routine, interaction with family members, effect on mental health. CONCLUSION Burden of both diseases were comparable except schizophrenics experience more financial burden.

Immunologic burden links periodontitis to acute coronary syndrome.

Science.gov (United States)

Liljestrand, John M; Paju, Susanna; Pietiäinen, Milla; Buhlin, Kåre; Persson, G Rutger; Nieminen, Markku S; Sinisalo, Juha; Mäntylä, Päivi; Pussinen, Pirkko J

2018-01-01

Periodontitis, a common polymicrobial inflammatory disease in the tooth supporting tissues, is a risk factor for coronary artery disease. One of the proposed underlying mechanisms is the systemic immune response to periodontal infection. We studied how serum antibodies against seven periodontal pathogens and their subgingival levels associate with each other, periodontitis, and coronary artery disease. The Parogene cohort included 505 Finnish patients (mean age 63 y) who underwent coronary angiography, and clinical and radiographic oral examinations. Coronary diagnosis was defined as no significant coronary artery disease (disease (≥50% stenosis, n = 184) and acute coronary syndrome (n = 169). Levels of subgingival Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Porphyromonas endodontalis, Prevotella intermedia, Tannerella forsythia, Campylobacter rectus, and Fusobacterium nucleatum were determined by checkerboard DNA-DNA hybridization. Serum antibody (IgA/IgG) levels were analyzed with enzyme-linked immunosorbent assay (ELISA). Aggregate IgA/IgG burdens were calculated by summing and standardizing the serum antibody levels. Patients with active periodontitis were characterized by higher levels of subgingival bacteria and corresponding IgA/IgG response. Quartiles 2-4 of serum IgA/IgG burden indicated higher risk for acute coronary syndrome (OR 1.84, 95%CI 1.01-3.35 for IgA; OR 1.87, 95%CI 1.01-3.46 for IgG) independently of established cardiovascular risk factors, body mass index, number of teeth, subgingival bacterial levels and periodontal diagnosis. Our findings support the hypothesis that the association between periodontitis and cardiovascular diseases is partly mediated by the immunologic response for periodontal pathogens. Copyright © 2017 Elsevier B.V. All rights reserved.

Química general II

OpenAIRE

Olba Torrent, Amparo

2018-01-01

El document forma part dels materials docents programats mitjançant l'ajut del Servei de Política Lingüística de la Universitat de València Temes de l'assignatura: Química general II del primer curs del Grau de Química Topics of the course: General Chemistry II in the first year of the Degree in Chemistry

On the burden of proof in civil procedure

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Keča Ranko

2013-01-01

Full Text Available The appliance of burden of proof rules is conceived of assumption that evidences are taken and that court didn't reach the required degree of conviction of a particular fact, what implies limitation of application of these rules on proceedings in which the judgment is rendered after the plenary proceedings. The Code of Civil Procedure (CCP has no suitable answers for the problems arising from new conception of the principle of party control of facts and means of proof in Serbian litigation legislature, by which the court has no more power to take the evidence ex offo. There is no answer to the question how should court conduct when evidence is not taken because of a lack of parties' indication of the means of proof. In this case courts practice somehow wider conception of burden of proof rules, which however has no explicit legal ground. They are applying them even though evidences are not taken. In any case it would be useful to reformulate basic rule of burden of proof in manner which would correspondent to the new conception of the principle of party presentation. The rule of burden of proof applies when the high degree of conviction of facts is demanded from the court, in order to render the judgment. Consequently this rule loses its' sense when mere probability of factual findings is demanded. The broader conception of parties' representation principle however does not liberate court from his responsibility to clarify facts that should be base for adjudication. Circumstance that CCP does mention the principle of material truth anymore should not be seen as argument for liberation of mentioned responsibility. It is still expected from the court to be active. Only when joint effort of the court and parties is left without of goal, in sense that court doesn't reach the high degree conviction, there would be ground for burden of proof rule's application. In this situation court also must justify why he couldn't reach required degree of

Household burden of chronic diseases in Ghana | Togoe | Ghana ...

African Journals Online (AJOL)

Conclusion: The relatively high direct cost of illness among households with person(s) living with NCDs and the associated high indirect burden of illness places undue stress on households. Research requires better measurement of the indirect burden with focus on the household. These findings suggest the necessity of ...

Ultrasonic inspection of heavy section steel components: the PISC II final report

International Nuclear Information System (INIS)

Nichols, R.W.; Crutzen, S.

1988-01-01

This Symposium represented the end of the PISC (Programme for Inspection of Steel Components), II Round Robin Test Project, and the book is the final report. The contents are divided into three parts: part 1 contains contributions from the PISC Management Group, part II contains individual contributions, part III contains views of Licensing Authorities. All the twenty three papers presented in the three parts are selected for INIS and indexed separately. (author)

Factors Underpinning Caregiver Burden in Frontotemporal Dementia Differ in Spouses and their Children

Science.gov (United States)

Kaizik, Cassandra; Caga, Jashelle; Camino, Julieta; O’Connor, Claire M.; McKinnon, Colleen; Oyebode, Jan R.; Piguet, Olivier; Hodges, John R.; Mioshi, Eneida

2017-01-01

The objectives of this observational study were to (1) compare spousal and child caregiver burden; (2) compare co-resident and live-out child caregiver burden; and (3) investigate factors influencing spousal and child caregiver burden. Data was collected from 90 caregivers of people with frontotemporal degeneration (FTD) recruited from the Frontotemporal Dementia Research Group (Frontier) at Neuroscience Research, Australia. Of this caregiver group, 43 were spousal caregivers and 47 were child caregivers. Caregiver burden and emotional state were evaluated using the short Zarit Burden Interview and the short version of the Depression, Anxiety and Stress Scale-21. The Social Network Index was applied to ascertain the social network of the caregiver, while the Intimate Bond Measure was used to evaluate the current quality of the relationship between the caregiver and the person with dementia. The Frontotemporal Dementia Rating Scale was used to assess severity of dementia. Spousal and child caregivers experienced similar levels of burden, depression, anxiety, and stress, regardless of disease severity. Co-resident child caregivers had smaller social networks and greater burden than live-out caregivers. Dementia severity was key in spousal caregiver burden, whereas caregiver depression was most important in child caregiver burden. Child and spousal caregivers of individuals with FTD share similar levels of burden, influenced by different factors. Future interventions need to account for these differences. PMID:28106550

The Burden Attributable to Mental and Substance Use Disorders as Risk Factors for Suicide: Findings from the Global Burden of Disease Study 2010

Science.gov (United States)

Ferrari, Alize J.; Norman, Rosana E.; Freedman, Greg; Baxter, Amanda J.; Pirkis, Jane E.; Harris, Meredith G.; Page, Andrew; Carnahan, Emily; Degenhardt, Louisa; Vos, Theo; Whiteford, Harvey A.

2014-01-01

Background The Global Burden of Disease Study 2010 (GBD 2010) identified mental and substance use disorders as the 5th leading contributor of burden in 2010, measured by disability adjusted life years (DALYs). This estimate was incomplete as it excluded burden resulting from the increased risk of suicide captured elsewhere in GBD 2010's mutually exclusive list of diseases and injuries. Here, we estimate suicide DALYs attributable to mental and substance use disorders. Methods Relative-risk estimates of suicide due to mental and substance use disorders and the global prevalence of each disorder were used to estimate population attributable fractions. These were adjusted for global differences in the proportion of suicide due to mental and substance use disorders compared to other causes then multiplied by suicide DALYs reported in GBD 2010 to estimate attributable DALYs (with 95% uncertainty). Results Mental and substance use disorders were responsible for 22.5 million (14.8–29.8 million) of the 36.2 million (26.5–44.3 million) DALYs allocated to suicide in 2010. Depression was responsible for the largest proportion of suicide DALYs (46.1% (28.0%–60.8%)) and anorexia nervosa the lowest (0.2% (0.02%–0.5%)). DALYs occurred throughout the lifespan, with the largest proportion found in Eastern Europe and Asia, and males aged 20–30 years. The inclusion of attributable suicide DALYs would have increased the overall burden of mental and substance use disorders (assigned to them in GBD 2010 as a direct cause) from 7.4% (6.2%–8.6%) to 8.3% (7.1%–9.6%) of global DALYs, and would have changed the global ranking from 5th to 3rd leading cause of burden. Conclusions Capturing the suicide burden attributable to mental and substance use disorders allows for more accurate estimates of burden. More consideration needs to be given to interventions targeted to populations with, or at risk for, mental and substance use disorders as an effective strategy for suicide

Standing on shaky ground- US patent-eligibility of isolated DNA and genetic diagnostics after AMP v. USPTO - Part II (practical implications & chances for Supreme Court Review)

DEFF Research Database (Denmark)

Minssen, Timo; Nilsson, David

2012-01-01

This is the second part of a four-partite article discussing the US Federal Circuit decision in AMP v. USPTO , also known as the ACLU /Myriad "gene patenting" case ("Myriad"). Part I commenced with a description of the legal framework and an explanation of how the decision relates to the recently...... of the outcome, i.e. the three different opinions of the Federal Circuit judges Lourie, Moore & Bryson who comprised the panel (3). Part II will now continue the tale with a detailed analysis of the decision's practical implications (4), which is followed by a closer look on the chances for an ultimate Supreme...

HPC Colony II: FAST_OS II: Operating Systems and Runtime Systems at Extreme Scale

Energy Technology Data Exchange (ETDEWEB)

Moreira, Jose [IBM, Armonk, NY (United States)

2013-11-13

HPC Colony II has been a 36-month project focused on providing portable performance for leadership class machines—a task made difficult by the emerging variety of more complex computer architectures. The project attempts to move the burden of portable performance to adaptive system software, thereby allowing domain scientists to concentrate on their field rather than the fine details of a new leadership class machine. To accomplish our goals, we focused on adding intelligence into the system software stack. Our revised components include: new techniques to address OS jitter; new techniques to dynamically address load imbalances; new techniques to map resources according to architectural subtleties and application dynamic behavior; new techniques to dramatically improve the performance of checkpoint-restart; and new techniques to address membership service issues at scale.

Research on determination of bio-burden for radiation sterilization of health care products

International Nuclear Information System (INIS)

Liu Qinfang

2008-01-01

In order to provide data of bio-burden for dose setting in radiation sterilization, determination of bio-burden on 148 kinds of health care products from 52 manufacturers were carried out. The culture of microorganisms, different elution technology, and correction coefficient of the microbiological methods have been used for determination of bio-burden. Frequent distribution of bio-burden was established. 5 kinds of elution processes were checked. Actual data of bio-burden for dose setting in radiation sterilization was gotten. (authors)

Has the tsunami arrived? Part II.

Science.gov (United States)

Halverson, Dean; Glowac, Wayne

2009-01-01

Healthcare is an industry in the midst of significant change. After years of double-digit cost increases, the system has reached a tipping point. Where once only employers were heard crying out for change, the call is now coming from all levels of American society. The voice that is most important to effect change is the newest--that of the consumer. In part two of our overview of the healthcare tsunami, we hope to offer you some insights and practical ideas on how to improve the return on investment of your marketing. We believe those who work to understand the new market forces and react with insight will not just survive during the tsunami, they will thrive.

Burdens and Standards of Proof in Possession of Unexplained ...

African Journals Online (AJOL)

Cases such as Workineh Kenbato & Amelework Dalie demonstrate the confusion regarding who bears what burden, for which facts the burden would apply and the required standard of proof thereof. Despite efforts to use the prosecution of illicit enrichment as a weapon in the combat against corruption, there are concerns ...

FRAMES User Defined Body Burden Concentration File Module Documentation

International Nuclear Information System (INIS)

Pelton, Mitchell A.; Rutz, Frederick C.; Eslinger, Melany A.; Gelston, Gariann M.

2001-01-01

The Framework for Risk Analysis in Multimedia Environmental Systems (FRAMES) Body Burden Concentration File (BBF) contains time-varying, instantaneous, constituent concentrations for body burden by contaminant. This report contains the requirements for this file and will be used by software engineers and testers to ensure that the file inputs properly.

The increasing burden of depression

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Lépine J-P

2011-05-01

Full Text Available Jean-Pierre Lépine1, Mike Briley21Hôpital Lariboisière Fernand Widal, Assistance Publique Hôpitaux de Paris Unité INSERM 705 CNRS UMR 8206, Université Paris Diderot, Paris, France; 2NeuroBiz Consulting and Communication, Castres, FranceAbstract: Recent epidemiological surveys conducted in general populations have found that the lifetime prevalence of depression is in the range of 10% to 15%. Mood disorders, as defined by the World Mental Health and the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, have a 12-month prevalence which varies from 3% in Japan to over 9% in the US. A recent American survey found the prevalence of current depression to be 9% and the rate of current major depression to be 3.4%. All studies of depressive disorders have stressed the importance of the mortality and morbidity associated with depression. The mortality risk for suicide in depressed patients is more than 20-fold greater than in the general population. Recent studies have also shown the importance of depression as a risk factor for cardiovascular death. The risk of cardiac mortality after an initial myocardial infarction is greater in patients with depression and related to the severity of the depressive episode. Greater severity of depressive symptoms has been found to be associated with significantly higher risk of all-cause mortality including cardiovascular death and stroke. In addition to mortality, functional impairment and disability associated with depression have been consistently reported. Depression increases the risk of decreased workplace productivity and absenteeism resulting in lowered income or unemployment. Absenteeism and presenteeism (being physically present at work but functioning suboptimally have been estimated to result in a loss of $36.6 billion per year in the US. Worldwide projections by the World Health Organization for the year 2030 identify unipolar major depression as the leading cause of disease burden

Psychological Stressors and Burden of Medical Conditions in Older Adults: A Psychosomatic Approach

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Arash Mani

2009-12-01

Full Text Available "n  "n  "nObjective: "nIn geriatric practice, the impact of psychological distress on health status has been undermined due to ageism, atypical presentation and less tendency to report negative affect among elderly people. Few studies have examined the impact of psychological stressors on medical burden in older adults. The current study has investigated the correlation of psychological distress and burden of medical conditions in a sample of older people .     "n  "n  "nMethod: A convenient study sample of 120 elderly subjects was recruited from the places where there was greater chance for the elderly people to attend. Data were collected by a trained research assistant using perceived stress scale, cumulative illness rating scale, geriatric depressive scale and a demographic questionnaire.     "n  "n  "nResults: "nOur participants perceived more level of stress than the average for their age. In the current study, the burden of medical condition was significantly correlated with the level of perceived stress(r = .197, p = .044. Moreover, in regression analysis, perceived stress was the strongest predictor for physical health morbidity (R2 =.049, significant f= .03.     "n  "n  "nConclusions: "nThe result of this study suggested that the psychological stressors contribute to poor health outcome in older adults ; the area that is usually overlooked due to ageism and its physiological related changes. The medical practitioners should consider the psychological distress as a part of etiological factors implicating in health morbidity among their aged patients.

Economic burden of informal care attributable to stroke among those aged 65 years or older in China.

Science.gov (United States)

Joo, Heesoo; Liang, Di

2017-02-01

Stroke is a leading cause of disability in China, frequently resulting in the need for informal care. No information, however, is available on costs of informal care associated with stroke, required to understand the true cost of stroke in China. Using the 2011 China Health and Retirement Longitudinal Study, we identified 4447 respondents aged ≥65 years suitable for analyses, including 184 stroke survivors. We estimated the economic burden of informal care associated with stroke using a two-part model. The monthly number of hours of informal caregiving associated with stroke was 29.2 h/stroke survivor, and the average annual cost of informal care associated with stroke was 10,612 RMB per stroke survivor. The findings stress the necessity of proper interventions to prevent stroke and will be useful for estimating the economic burden of stroke.

Instruments for assessing the burden of informal caregiving for stroke patients in clinical practice: a comparison of CSI, CRA, SCQ and self-rated burden

NARCIS (Netherlands)

van Exel, N. Job A.; Scholte op Reimer, Wilma J. M.; Brouwer, Werner B. F.; van den Berg, Bernard; Koopmanschap, Marc A.; van den Bos, Geertrudis A. M.

2004-01-01

Objective: To compare the feasibility, convergent and clinical validity of three commonly used burden scales: Caregiver Strain Index (CSI), Caregiver Reaction Assessment (CRA) and Sense of Competence Questionnaire (SCQ), with a self-developed single question on self-rated burden (SRB). Subjects:

A study on caregiver burden: stressors, challenges, and possible solutions.

Science.gov (United States)

Bialon, Laura Nelson; Coke, Sallie

2012-05-01

The purpose of this qualitative study was to explore factors impacting caregiver burden and to explore possible solutions for family caregivers of terminally ill patients. The majority of caregivers reported experiencing role conflict and inadequate stress management. Caregivers who worked outside the home, those who cared for two parents concurrently, those with the least amount of outside assistance, and caregivers who spent a longer period of time caregiving reported the highest levels of health problems and overall burden. Caregivers stated a need for more support from Hospice agencies, more education on caregiver training, and more public education about Hospice services. Faith played a positive role in alleviating caregiver burden. Early identification, intervention, education and coordination of services may help to alleviate caregiver burden, which will improve quality of life for both patient and caregiver.

Estimation of lung cancer burden in Australia, the Philippines, and Singapore: an evaluation of disability adjusted life years.

Science.gov (United States)

Morampudi, Suman; Das, Neha; Gowda, Arun; Patil, Anand

2017-02-01

Lung cancer is one of the leading cancers and major causes of cancer mortality worldwide. The economic burden associated with the high mortality of lung cancer is high, which accounts for nearly $180 billion on a global scale in 2008. This paper aims to understand the economic burden of lung cancer in terms of disability adjusted life years (DALY) in Australia, the Philippines, and Singapore. The years of life lost (YLL) and years lost due to disability (YLD) were calculated using the formula developed by Murray and Lopez in 1996 as part of a comprehensive assessment of mortality and disability for diseases, injuries and risk factors in 1990 and projected to 2020. The same formula is represented in the Global Burden of Disease template provided by the World Health Organization. Appropriate assumptions were made when data were unavailable and projections were performed using regression analysis to obtain data for 2015. The total DALYs due to lung cancer in Australia, the Philippines, and Singapore were 91,695, 38,584, and 12,435, respectively, and the corresponding DALY rates per a population of 1,000 were 4.0, 0.4, and 2.2, respectively, with a discount rate of 3%. When researchers calculated DALYs without the discount rate, the burden of disease increased substantially; the DALYs were 117,438 in Australia, 50,977 in the Philippines, and 16,379 in Singapore. Overall, YLL or premature death accounted for more than 95% of DALYs in these countries. Strategies for prevention, early diagnosis, and prompt treatment must be devised for diseases where the major burden is due to mortality.

Atrial therapies reduce atrial arrhythmia burden in defibrillator patients.

Science.gov (United States)

Friedman, P A; Dijkman, B; Warman, E N; Xia, H A; Mehra, R; Stanton, M S; Hammill, S C

2001-08-28

Approximately 25% of patients who receive an implantable cardioverter-defibrillator (ICD) to treat ventricular tachyarrhythmias have documented atrial tachyarrhythmias before implantation. This study assessed the ability of device-based prevention and termination therapies to reduce the burden of spontaneous atrial tachyarrhythmias. Patients with a standard indication for the implantation of an ICD and 2 episodes of atrial tachyarrhythmias in the preceding year received a dual-chamber ICD (Medtronic 7250 Jewel AF) that uses pacing and shock therapies for prevention and/or termination of atrial tachyarrhythmias. In a multicenter trial, patients were randomized to 3-month periods with atrial therapies "on" or "off" and subsequently crossed over. Analysis was performed on the 52 of 269 patients who had episodes of atrial tachyarrhythmia and had >/=30 days of follow-up with atrial therapies on and off. The atrial therapies resulted in a reduction of atrial tachyarrhythmia burden from a mean of 58.5 to 7.8 h/mo. A paired analysis (Wilcoxon signed-rank test) showed that the median difference in burden (1.1 h/mo) was highly significant (P=0.007). When the subgroup of 41 patients treated only with atrial pacing therapies was analyzed, the reduction in burden persisted (P=0.01). In this study, patients with a standard ICD indication and atrial tachyarrhythmias had a significant reduction in atrial tachyarrhythmia burden with use of atrial pacing and shock therapies.

Predictor of increase in caregiver burden for disabled elderly at home.

Science.gov (United States)

Okamoto, Kazushi; Harasawa, Yuko

2009-01-01

In order to classify the caregivers at high risk of increase in their burden early, linear discriminant analysis was performed to obtain an effective discriminant model for differentiation of the presence or absence of increase in caregiver burden. The data obtained by self-administered questionnaire from 193 caregivers of frail elderly from January to February of 2005 were used. The discriminant analysis yielded a statistically significant function explaining 35.0% (Rc=0.59; d.f.=6; p=0.0001). The configuration indicated that the psychological predictors of change in caregiver burden with much perceived stress (1.47), high caregiver burden at baseline (1.28), emotional control (0.75), effort to achieve (-0.28), symptomatic depression (0.20) and "ikigai" (purpose in life) (0.18) made statistically significant contributions to the differentiation between no increase and increase in caregiver burden. The discriminant function showed a sensitivity of 86% and specificity of 81%, and successfully classified 83% of the caregivers. The function at baseline is a simple and useful method for screening of an increase in caregiver burden among caregivers for the frail elderly at home.

Prevenzione e terapia precoce del diabete mellito di tipo II: aspetti farmacoeconomici

Directory of Open Access Journals (Sweden)

Lorenzo Pradelli

2005-09-01

Full Text Available Type II (non-insulin-dependent diabetes is one of the most widespread chronic patologies in the developed countries and its prevalence in Italy is about 2-3% of the population. Type II diabetes is also associated with several other metabolic abnormalities such as central obesity, hypertension, and dyslipidemia, which contributes to the very high rate of cardiovascular morbidity and mortality. Therefore Type II diabetes involves a significant financial burden on the health care system. The purpose of this paper is to explain the composition of the healthcare costs of managing people with Type II diabetes and the economic repercussions due to the adoption of an aggressive strategy against the pathology. To carry out this evaluation we considered the CODE-2 (The Cost of Diabetes in Europe - Type II Study results, the American Diabetes Association Position Statement, the Diabetes Prevention Program and the UK Prospective Diabetes Study. Evidence exists to show that introducing prevention program or an early therapy can avert or delay significantly the onset of cardiovascular morbidity in Type II diabetes patients. According to the pharmacoeconomical criteria, this very desiderable clinical goal is associated to a little increase of the health expenditures, and sometimes also to a costs saving.

Conference on the Trend in Income Inequality in the U.S. Part I, Trends in Inequality of Well-Offness in the United States since World War II. Part 2, Conference Overview: Conceptual Issues, Data Issues, and Policy Implications

Science.gov (United States)

Taussig, Michael K.; Danziger, Sheldon

The first part of this document summarizes the current state of knowledge on trends in inequality of economic well-being in the United States since World War II. It surveys alternative answers to the often asked question: Has inequality in the U.S. increased, decreased, or remained roughly the same over a period of time? Intelligent laymen, and…