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Sample records for prevention providers remain

  1. Encouraging responses in sexual and relationship violence prevention: what program effects remain 1 year later?

    Science.gov (United States)

    Moynihan, Mary M; Banyard, Victoria L; Cares, Alison C; Potter, Sharyn J; Williams, Linda M; Stapleton, Jane G

    2015-01-01

    Colleges and universities are high-risk settings for sexual and relationship violence. To address these problems, institutions of higher education have implemented prevention programs, many of which train students as potential bystanders who can step in to help diffuse risky situations, identify and challenge perpetrators, and assist victims. The impact of bystander sexual and relationship violence prevention programs on long-term behavior of bystanders has remained a key unanswered question for those who seek to offer the most effective programs as well as for policy makers. In this study, the researchers experimentally evaluated the effectiveness of the Bringing in the Bystander® in-person program. Participants were 948 1st-year college students of whom 47.8% were women and 85.2% identified as White (15% also identified as Hispanic in a separate question) between the ages of 18 and 24 at two universities (one a rural, primarily residential campus and the other an urban, highly commuter campus) in the northeastern United States. To date, this is the first study to have found positive behavior changes as long-lasting as 1 year following an educational workshop focusing on engaging bystanders in preventing sexual and relationship violence. Even so, many questions remain to be answered about prevention and intervention of this type. More prospective research is needed on bystander-focused prevention of these forms of violence to help understand and better predict the complicated relationships both between and among the attitudes and behaviors related to preventing sexual and relationship violence. In this regard, we make specific recommendations for designing and evaluating programs based on our findings relating to the importance of moderators, especially two key understudied ones, readiness to help and opportunity to intervene. © The Author(s) 2014.

  2. Prevention of Surgical Fires: A Certification Course for Healthcare Providers.

    Science.gov (United States)

    Fisher, Marquessa

    2015-08-01

    An estimated 550 to 650 surgical fires occur annually in the United States. Surgical fires may have severe consequences, including burns, disfigurement, long-term medical care, or death. This article introduces a potential certification program for the prevention of surgical fires. A pilot study was conducted with a convenience sample of 10 anesthesia providers who participated in the education module. The overall objective was to educate surgical team members and to prepare them to become certified in surgical fire prevention. On completion of the education module, participants completed the 50-question certification examination. The mean pretest score was 66%; none of the participants had enough correct responses (85%) to be considered competent in surgical fire prevention. The mean post- test score was 92.80%, with all participants answering at least 85% of questions correct. A paired-samples t test showed a statistically significant increase in knowledge: t (df = 9) = 11.40; P = .001. Results of the pilot study indicate that this course can remediate gaps in knowledge of surgical fire prevention for providers. Their poor performance on the pretest suggests that many providers may not receive sufficient instruction in surgical fire prevention.

  3. Youth Violence Prevention and Safety: Opportunities for Health Care Providers.

    Science.gov (United States)

    Duke, Naomi Nichele; Borowsky, Iris Wagman

    2015-10-01

    Violence involvement remains a leading cause of morbidity and mortality for youth and young adults in the United States. The impact of adverse childhood experiences on violence involvement can be translated to the cellular level, including alterations in brain structure and function responsible for stress reactivity and coping. This knowledge is counterbalanced by a growing understanding of what works in the realm of youth violence prevention. Incorporating a resilience framework, with its focus on building developmental assets and resources at individual, family, and community levels, offers a renewed approach to fostering healthy behaviors and coping strategies. Copyright © 2015 Elsevier Inc. All rights reserved.

  4. Patients' and providers' perceptions of the preventability of hospital readmission

    DEFF Research Database (Denmark)

    van Galen, Louise S; Brabrand, Mikkel; Cooksley, Tim

    2017-01-01

    0.24 to 0.49). CONCLUSIONS: There is no consensus between readmitted patients, their carers and treating professionals about predictability and preventability of readmissions, nor associated risk factors. A readmitted patient reporting not feeling ready for discharge at index admission was strongly...

  5. Automatic updating of times remaining in surgical cases using bayesian analysis of historical case duration data and "instant messaging" updates from anesthesia providers.

    Science.gov (United States)

    Dexter, Franklin; Epstein, Richard H; Lee, John D; Ledolter, Johannes

    2009-03-01

    Operating room (OR) whiteboards (status displays) communicate times remaining for ongoing cases to perioperative stakeholders (e.g., postanesthesia care unit, anesthesiologists, holding area, and control desks). Usually, scheduled end times are shown for each OR. However, these displays are inaccurate for predicting the time that remains in a case. Once a case scheduled for 2 h has been on-going for 1.5 h, the median time remaining is not 0.5 h but longer, and the amount longer differs among procedures. We derived the conditional Bayesian lower prediction bound of a case's duration, conditional on the minutes of elapsed OR time. Our derivations make use of the posterior predictive distribution of OR times following an exponential of a scaled Student t distribution that depends on the scheduled OR time and several parameters calculated from historical case duration data. The statistical method was implemented using Structured Query Language (SQL) running on the anesthesia information management system (AIMS) database server. In addition, AIMS workstations were sent instant messages displaying a pop-up dialog box asking for anesthesia providers' estimates for remaining times. The dialogs caused negotiated interruptions (i.e., the anesthesia provider could reply immediately, keep the dialog displayed, or defer response). There were no announcements, education, or efforts to promote buy-in. After a case had been in the OR longer than scheduled, the median remaining OR time for the case changes little over time (e.g., 35 min left at 2:30 pm and also at 3:00 pm while the case was still on-going). However, the remaining time differs substantially among surgeons and scheduled procedure(s) (16 min longer [10th percentile], 35 min [50th], and 86 min [90th]). We therefore implemented an automatic method to estimate the times remaining in cases. The system was operational for >119 of each day's 120 5-min intervals. When instant message dialogs appearing on AIMS workstations

  6. Mobile Phone Apps for Preventing Cancer Through Educational and Behavioral Interventions: State of the Art and Remaining Challenges.

    Science.gov (United States)

    Coughlin, Steven; Thind, Herpreet; Liu, Benyuan; Champagne, Nicole; Jacobs, Molly; Massey, Rachael I

    2016-05-30

    Rapid developments in technology have encouraged the use of mobile phones in smoking cessation, promoting healthy diet, nutrition, and physical activity, sun safety, and cancer screening. Although many apps relating to the prevention of cancer and other chronic diseases are available from major mobile phone platforms, relatively few have been tested in research studies to determine their efficacy. In this paper, we discuss issues related to the development and testing of new apps for preventing cancer through smoking cessation, sun safety, and other healthy behaviors, including key methodologic issues and outstanding challenges. An exploratory literature review was conducted using bibliographic searches in PubMed and CINAHL with relevant search terms (eg, smartphones, smoking cessation, cancer prevention, cancer screening, and carcinogens) to identify papers published in English through October 2015. Only 4 randomized controlled trials of the use of mobile phone apps for smoking cessation and 2 trials of apps for sun safety were identified, indicating that it is premature to conduct a systematic search and meta-analysis of the published literature on this topic. Future studies should utilize randomized controlled trial research designs, larger sample sizes, and longer study periods to better establish the cancer prevention and control capabilities of mobile phone apps. In developing new and refined apps for cancer prevention and control, both health literacy and eHealth literacy should be taken into account. There is a need for culturally appropriate, tailored health messages to increase knowledge and awareness of health behaviors such as smoking cessation, cancer screening, and sun safety. Mobile phone apps are likely to be a useful and low-cost intervention for preventing cancer through behavioral changes.

  7. Navigating the risks of prevention of mother to child transmission (PMTCT) of HIV services in Kibera, Kenya: Barriers to engaging and remaining in care.

    Science.gov (United States)

    Thomson, Kerry A; Telfer, Barbara; Opondo Awiti, Patricia; Munge, Jane; Ngunga, Mathew; Reid, Anthony

    2018-01-01

    Within the first year of implementation, 43% of women who tested HIV positive at their first antenatal care visit were no longer retained and being followed in the free prevention of mother to child transmission (PMTCT) of HIV program offered by the Kenyan Ministry of Health and Médecins Sans Frontières in the informal settlement of Kibera, Nairobi. This study aimed to explore barriers to enrolling and remaining engaged in PMTCT services throughout the pregnancy and postpartum periods. Qualitative data from 31 focus group discussions and 35 in-depth interviews across six stakeholder groups that included women, men, and PMTCT service providers were analyzed. Using an inductive exploratory approach, four researchers coded the data and identified key themes. Five themes emerged from the data that may influence attrition from PMTCT service in this setting: 1) HIV in the context of Kibera, 2) knowledge of HIV status, 3) knowledge of PMTCT, 4) disclosure of HIV status, and 5) male partner support for PMTCT services. A new HIV diagnosis during pregnancy immediately triggered an ongoing risk assessment of perceived hazards in the home, community, and clinic environments that could occur as a result of female participation in PMTCT services. Male partners were a major influence in this risk assessment, but were generally unaware of PMTCT services. To preserve relationships with male partners, meet community expectations of womanhood, and maintain confidentiality while following recommendations of healthcare providers, women had to continuously weigh the risks and benefits of PMTCT services and interventions. Community-based HIV testing and PMTCT education, male involvement in antenatal care, and counseling customized to assist each woman in her own unique risk assessment, may improve uptake of and retention in care and optimize the HIV prevention benefit of PMTCT interventions.

  8. Counseling About Skin Cancer Prevention Among Adolescents: What Do Parents Receive From Health Care Providers?

    Science.gov (United States)

    McRee, Annie-Laurie; Mays, Darren; Kornides, Melanie L; Gilkey, Melissa B

    2017-10-01

    Adolescence is a high-risk period for ultraviolet radiation exposure, a primary cause of skin cancer later in life. We sought to characterize receipt of health care provider-delivered counseling about skin cancer prevention (SCP) among parents of adolescents. In 2016, we conducted an online survey with a national sample of parents of adolescents aged 11-17 years (n = 1,253). Multivariable logistic regression assessed correlates of receiving counseling from a health care provider about any of the six skin cancer prevention (SCP) topics. Only half (49%) of parents recalled discussing any SCP topic with their child's provider; the prevalence was highest for sunscreen (39%) and lowest for indoor tanning (3%). Parents had greater odds of receiving counseling if they had a child with more sun-reactive skin (odds ratio [OR] = 1.53); a family history of skin cancer (OR = 1.38); or a higher quality relationship with the provider (OR = 1.47; all p attention to SCP counseling is needed, especially for exposures such as indoor tanning that remain prevalent among adolescents but are rarely addressed in clinical encounters. Copyright © 2017 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  9. Metabolic Testing for Adults in a State Medicaid Program Receiving Antipsychotics: Remaining Barriers to Achieving Population Health Prevention Goals.

    Science.gov (United States)

    Morrato, Elaine H; Campagna, Elizabeth J; Brewer, Sarah E; Dickinson, L Miriam; Thomas, Deborah S K; Miller, Benjamin F; Dearing, James; Druss, Benjamin G; Lindrooth, Richard C

    2016-07-01

    Medicaid quality indicators track diabetes mellitus and cardiovascular disease screening in adults receiving antipsychotics and/or those with serious mental illness. To inform performance improvement interventions by evaluating the relative importance of patient, prescriber, and practice factors affecting metabolic testing. A retrospective cohort study was conducted using Missouri Medicaid administrative claims data (January 1, 2010, to December 31, 2012) linked with prescriber market data. The analysis included 9316 adults (age, 18-64 years) who were starting antipsychotic medication. Secondary analysis included the subset of adults (n = 1813) for whom prescriber knowledge, attitudes, and behavior survey data were available. Generalized estimating equations were performed to identify factors associated with failure to receive annual testing during antipsychotic treatment (adjusted odds ratio [OR], 6 encounters vs none; 0.33 [0.28-0.39]). Analysis incorporating prescriber practice information found lower failure to receive glucose testing if the patient received care at a CMHC (0.74 [0.64-0.85]) or if the initiating prescriber was a primary care practitioner (0.81 [0.66-1.00]). However, the initiating prescriber specialty-setting was not associated with lipid testing. Compared with prior reports, progress has been made to improve diabetes screening, but lipid screening remains particularly underutilized. Medicaid performance improvement initiatives should target all prescriber settings and not just behavioral health.

  10. Perspectives on Providing And Receiving Preventive Health Care From Primary Care Providers and Their Patients With Mental Illnesses.

    Science.gov (United States)

    Stumbo, Scott P; Yarborough, Bobbi Jo H; Yarborough, Micah T; Green, Carla A

    2018-01-01

    Individuals with mental illnesses have higher morbidity rates and reduced life expectancy compared to the general population. Understanding how patients and providers perceive the need for prevention, as well as the barriers and beliefs that may contribute to insufficient care, are important for improving service delivery tailored to this population. Cross-sectional; mixed methods. An integrated health system and a network of federally qualified health centers and safety net clinics. Interviews (n = 30) and surveys (n = 249) with primary care providers. Interviews (n = 158) and surveys (n = 160) with patients diagnosed with schizophrenia, bipolar, anxiety, or major depressive disorders. Semi-structured interviews and surveys. Thematic analysis for qualitative data; frequencies for quantitative data. More than half (n = 131, 53%) of clinicians believed patients with mental illnesses care less about preventive care than the general population, yet 88% (n = 139) of patients reported interest in improving health. Most providers (n = 216, 88%) lacked confidence that patients with mental illnesses would follow preventive recommendations; 82% (n = 129) of patients reported they would try to change lifestyles if their doctor recommended. Clinicians explained that their perception of patients' chaotic lives and lack of interest in preventive care contributed to their fatalistic attitudes on care delivery to this population. Clinicians and patients agreed on substantial need for additional support for behavior changes. Clinicians reported providing informational support by keeping messages simple; patients reported a desire for more detailed information on reasons to complete preventive care. Patients also detailed the need for assistive and tangible support to manage behavioral health changes. Our results suggest a few clinical changes could help patients complete preventive care recommendations and improve health behaviors: improving clinician-patient collaboration on

  11. 75 FR 30410 - Disease, Disability, and Injury Prevention and Control Special Interest Project (SIP): Provider...

    Science.gov (United States)

    2010-06-01

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Disease, Disability, and Injury Prevention and Control Special Interest Project (SIP): Provider and Public Health... Federal Advisory Committee Act (Pub. L. 92-463), the Centers for Disease Control and Prevention (CDC...

  12. Falls prevention among older people and care providers: protocol for an integrative review

    OpenAIRE

    Cuesta Benjumea, Carmen de la; Henriques, Maria Adriana; Abad Corpa, Eva; Roe, Brenda; Orts-Cortés, María Isabel; Lidón-Cerezuela, Beatriz; Avendaño-Céspedes, Almudena; Oliver-Carbonell, José Luis; Sánchez Ardila, Carmen

    2017-01-01

    Aim. To review the evidence about the role of care providers in fall prevention in older adults aged ≥ 65 years, this includes their views, strategies, and approaches on falls prevention and effectiveness of nursing interventions. Background. Some fall prevention programmes are successfully implemented and led by nurses and it is acknowledged the vital role they play in developing plans for fall prevention. Nevertheless, there has not been a systematic review of the literature that describes ...

  13. Client and provider perspectives on new HIV prevention tools for MSM in the Americas.

    Directory of Open Access Journals (Sweden)

    Sheri A Lippman

    Full Text Available Men who have sex with men (MSM in the Americas require targeted, combination HIV prevention approaches. We solicited client and provider perspectives on emerging prevention interventions including HIV pre-exposure prophylaxis (PrEP and HIV self-tests through focus groups and in-depth interviews with 130 MSM and 41 providers across four sites: New York, San Francisco, Lima, and Rio de Janeiro. Among the MSM participants, we identified three prevention typologies: non-condom users, inconsistent condom users, and consistent condom users. Northern and Southern MSM differed in the variety of harm reduction strategies utilized: where U.S. MSM relied on condom use as well as disclosure and seroadaptive behaviors for prevention, condom use without disclosure or serostatus discussions was the norm in South America. Interest in new prevention technologies was shaped by the social context. U.S. MSM preferences differed by typology, such that non-condom users were interested in taking PrEP and using home HIV tests. MSM in Brazil, regardless of typology, were interested in exploring new prevention options. MSM in Peru demonstrated moderate interest but were less comfortable with adopting new strategies. MSM and providers' opinions differed substantially with respect to new prevention options. Across sites, most providers were reticent to engage with new prevention options, though some NGO-based providers were more supportive of exploring new prevention tools. Both clients and providers will need to be engaged in developing integrated prevention strategies for MSM.

  14. Opportunities for Pharmacists and Student Pharmacists to Provide Clinical Preventive Services

    Directory of Open Access Journals (Sweden)

    Natalie A. DiPietro Mager

    2017-01-01

    Full Text Available Pharmacists and student pharmacists can play an important role in providing clinical preventive services as specified by the United States Preventive Services Task Force (USPSTF. The USPSTF guidelines provide evidence-based recommendations about clinical preventive services for the general population. The purpose of this paper is to provide information to pharmacists and student pharmacists developing and implementing preventive health care services. Examples of successful pharmacy-based programs are also provided. Pharmacists and student pharmacists can provide preventive health care interventions by conducting screenings, providing education, and making referrals. Conflict of Interest We declare no conflicts of interest or financial interests that the authors or members of their immediate families have in any product or service discussed in the manuscript, including grants (pending or received, employment, gifts, stock holdings or options, honoraria, consultancies, expert testimony, patents and royalties   Type: Idea Paper

  15. Modification of the "Preventing Child Abuse and Neglect" (PCAN) Curriculum for IDEA Part C Providers

    Science.gov (United States)

    Kilburn, Janice E.; Shapiro, Cheri J.

    2015-01-01

    Strategic workforce training of organizations that provide services to families of young children with special needs can help strengthen families and prevent child maltreatment, but few curriculua are available for this purpose. One professional development curriculum, "Preventing Child Abuse and Neglect: Parent-Provider Partnerships in Child…

  16. Stable Isotopic signatures of Adélie penguin remains provide long-term paleodietary records in Northern Victoria Land (Ross Sea, Antarctica)

    Science.gov (United States)

    Lorenzini, Sandra; Baroni, Carlo; Fallick, Anthony Edward; Baneschi, Ilaria; Salvatore, Maria Cristina; Zanchetta, Giovanni; Dallai, Luigi

    2010-05-01

    The stable isotopes geochemistry of carbon and nitrogen provides a powerful tools for investigating in animal dietary patterns and shifts during the past. The signature of C and N isotopes provide direct information about the diet of an individual and its dietary patterns, especially when the dietary sources consist of prey from different trophic levels (i.e. different C and N isotopic composition) (DeNiro and Epstein 1978, Minawaga and Wada 1984, Koch et al. 1994, Hobson 1995). By analyzing the isotopic composition of penguin remains, we present a new detailed Adélie penguin (Pygoscelis adeliae) paleodietary record for the area of Terra Nova Bay (Victoria Land, Ross Sea). Adélie penguins primarily feed on fish (mainly the silverfish Pleuragramma antarcticum) and krill (Euphausia superba, Euphausia cristallorophias) (Ainley 2002, Lorenzini et al. 2009) that belonging to two different trophic levels. Consequently, they are characterized by different isotopic signatures. Specifically, we analyzed 13C/12C and 15N/14N ratios of more than one thousand of modern and fossil Adélie penguin eggshell and guano samples collected from ornithogenic soils (penguin guano-formed) dated back to ≈7,200 years BP (Baroni and Orombelli 1994, Lambert et al. 2002, Baroni and Hall 2004, Hall et al. 2006). The expanded database of stable isotope values obtained from Adélie penguin remains define a detailed paleodietary record with an excellent temporal continuity over all the investigated time period. Our data indicate a significant dietary shift between fish and krill, with a gradual decrease from past to present time in the proportion of fish compared to krill in Adélie penguin diet. From 7200 yrs BP to 2000 yrs BP, δ13C and δ15N values indicate fish as the most eaten prey. The dietary contribution of lower-trophic prey in penguin diet started becoming evident not earlier than 2000 yrs BP, when the δ13C values reveal a mixed diet based on fish and krill consumption. Modern

  17. Exploring Service Providers' Perspectives in Improving Childhood Obesity Prevention among CALD Communities in Victoria, Australia.

    Directory of Open Access Journals (Sweden)

    Sheila Cyril

    Full Text Available Childhood obesity rates have been increasing disproportionately among disadvantaged communities including culturally and linguistically diverse (CALD migrant groups in Australia due to their poor participation in the available obesity prevention initiatives. We sought to explore service providers' perceptions of the key factors influencing the participation of CALD communities in the existing obesity prevention services and the service requirements needed to improve CALD communities' participation in these services.We conducted a qualitative study using focus group discussions involving fifty-nine service providers from a range of services, who are involved in the health and wellbeing of children from CALD groups living in four socioeconomically disadvantaged areas in Victoria, Australia.Thematic analysis of the data showed three major themes including community-level barriers to CALD engagement in childhood obesity prevention services; service-level barriers to the delivery of these services; and proposed changes to current childhood obesity prevention approaches. Integrating obesity prevention messages within existing programs, better coordination between prevention and treatment services and the establishment of a childhood obesity surveillance system, were some of the important changes suggested by service providers.This study has found that low CALD health literacy, lack of knowledge of cultural barriers among service providers and co-existing deficiencies in the structure and delivery of obesity prevention services negatively impacted the participation of CALD communities in obesity prevention services. Cultural competency training of service providers would improve their understanding of the cultural influences of childhood obesity and incorporate them into the design and development of obesity prevention initiatives. Service providers need to be educated on the pre-migratory health service experiences and health conditions of CALD

  18. Exploring Service Providers' Perspectives in Improving Childhood Obesity Prevention among CALD Communities in Victoria, Australia.

    Science.gov (United States)

    Cyril, Sheila; Green, Julie; Nicholson, Jan M; Agho, Kingsley; Renzaho, Andre M N

    2016-01-01

    Childhood obesity rates have been increasing disproportionately among disadvantaged communities including culturally and linguistically diverse (CALD) migrant groups in Australia due to their poor participation in the available obesity prevention initiatives. We sought to explore service providers' perceptions of the key factors influencing the participation of CALD communities in the existing obesity prevention services and the service requirements needed to improve CALD communities' participation in these services. We conducted a qualitative study using focus group discussions involving fifty-nine service providers from a range of services, who are involved in the health and wellbeing of children from CALD groups living in four socioeconomically disadvantaged areas in Victoria, Australia. Thematic analysis of the data showed three major themes including community-level barriers to CALD engagement in childhood obesity prevention services; service-level barriers to the delivery of these services; and proposed changes to current childhood obesity prevention approaches. Integrating obesity prevention messages within existing programs, better coordination between prevention and treatment services and the establishment of a childhood obesity surveillance system, were some of the important changes suggested by service providers. This study has found that low CALD health literacy, lack of knowledge of cultural barriers among service providers and co-existing deficiencies in the structure and delivery of obesity prevention services negatively impacted the participation of CALD communities in obesity prevention services. Cultural competency training of service providers would improve their understanding of the cultural influences of childhood obesity and incorporate them into the design and development of obesity prevention initiatives. Service providers need to be educated on the pre-migratory health service experiences and health conditions of CALD communities to ensure

  19. Attitudes About and Practices of Health Promotion and Prevention Among Primary Care Providers.

    Science.gov (United States)

    Luquis, Raffy R; Paz, Harold L

    2015-09-01

    The Patient Protection and Affordable Care Act's emphasis on health promotion and prevention activities required an examination of the current practices of primary care providers in these areas. A total of 196 primary care providers completed a survey to assess current health promotion and prevention attitudes, practices, and barriers. Results of this study showed that family physicians in Pennsylvania recognize the importance of and their role in providing health promotion and prevention and offer advice in key behavioral and disease prevention areas. Results from the study suggest that their ability to provide these services is hindered by a lack of time and the heavy workload. Although most family physicians provided advice to patients in several health promotion and prevention areas, few participants reported that they referred patients to other health professionals. Finally, when it comes to preventive services, participants ranked blood pressure screening, tobacco use screening, and tobacco use cessation interventions as the most important services. Effective implementation of the Patient Protection and Affordable Care Act will require necessary resources and support of primary care providers to help patients achieve healthier lives. © 2014 Society for Public Health Education.

  20. Development of STEADI: a fall prevention resource for health care providers.

    Science.gov (United States)

    Stevens, Judy A; Phelan, Elizabeth A

    2013-09-01

    Falls among people aged ≥65 years are the leading cause of both injury deaths and emergency department visits for trauma. Research shows that many falls are preventable. In the clinical setting, an effective fall intervention involves assessing and addressing an individual's fall risk factors. This individualized approach is recommended in the American and British Geriatrics Societies' (AGS/BGS) practice guideline. This article describes the development of STEADI (Stopping Elderly Accidents, Deaths, and Injuries), a fall prevention tool kit that contains an array of health care provider resources for assessing and addressing fall risk in clinical settings. As researchers at the Centers for Disease Control and Prevention's Injury Center, we reviewed relevant literature and conducted in-depth interviews with health care providers to determine current knowledge and practices related to older adult fall prevention. We developed draft resources based on the AGS/BGS guideline, incorporated provider input, and addressed identified knowledge and practice gaps. Draft resources were reviewed by six focus groups of health care providers and revised. The completed STEADI tool kit, Preventing Falls in Older Patients-A Provider Tool Kit, is designed to help health care providers incorporate fall risk assessment and individualized fall interventions into routine clinical practice and to link clinical care with community-based fall prevention programs.

  1. Exploring Service Providers' Perspectives in Improving Childhood Obesity Prevention among CALD Communities in Victoria, Australia

    Science.gov (United States)

    Cyril, Sheila; Green, Julie; Nicholson, Jan M.; Agho, Kingsley; Renzaho, Andre M. N.

    2016-01-01

    Background Childhood obesity rates have been increasing disproportionately among disadvantaged communities including culturally and linguistically diverse (CALD) migrant groups in Australia due to their poor participation in the available obesity prevention initiatives. We sought to explore service providers’ perceptions of the key factors influencing the participation of CALD communities in the existing obesity prevention services and the service requirements needed to improve CALD communities’ participation in these services. Methods We conducted a qualitative study using focus group discussions involving fifty-nine service providers from a range of services, who are involved in the health and wellbeing of children from CALD groups living in four socioeconomically disadvantaged areas in Victoria, Australia. Results Thematic analysis of the data showed three major themes including community-level barriers to CALD engagement in childhood obesity prevention services; service-level barriers to the delivery of these services; and proposed changes to current childhood obesity prevention approaches. Integrating obesity prevention messages within existing programs, better coordination between prevention and treatment services and the establishment of a childhood obesity surveillance system, were some of the important changes suggested by service providers. Conclusion This study has found that low CALD health literacy, lack of knowledge of cultural barriers among service providers and co-existing deficiencies in the structure and delivery of obesity prevention services negatively impacted the participation of CALD communities in obesity prevention services. Cultural competency training of service providers would improve their understanding of the cultural influences of childhood obesity and incorporate them into the design and development of obesity prevention initiatives. Service providers need to be educated on the pre-migratory health service experiences and health

  2. Training medical providers in evidence-based approaches to suicide prevention.

    Science.gov (United States)

    DeHay, Tamara; Ross, Sarah; McFaul, Mimi

    2015-01-01

    Suicide is a significant issue in the United States and worldwide, and its prevention is a public health imperative. Primary care practices are an important setting for suicide prevention, as primary care providers have more frequent contact with patients at risk for suicide than any other type of health-care provider. The Western Interstate Commission for Higher Education, in partnership with the Suicide Prevention Resource Center, has developed a Suicide Prevention Toolkit and an associated training curriculum. These resources support the education of primary care providers in evidence-based strategies for identifying and treating patients at risk for suicide. The application of this curriculum to post-graduate medical training is presented here. © The Author(s) 2015.

  3. Breaking Boundaries: Complementary and Alternative Medicine Provider Framing of Preventive Care.

    Science.gov (United States)

    Agarwal, Vinita

    2017-11-01

    This textual examination extends understandings of how complementary and alternative medicine (CAM) providers constitute preventive care in their discourse by identifying the frame of breaking boundaries referencing relational, structural, and philosophical orientations in their practice with their clients. Analysis of semistructured, in-depth interviews with CAM providers ( n = 17) reveals that the frame of breaking boundaries was comprised of three themes: finding one's own strength; I don't prescribe, so I'm exploring; and ground yourself, and have an escape route. The themes describe preventive care by identifying how CAM providers negotiate their relational positionality in connecting with clients, structural positionality within the field of health care, and philosophical positionality within the ontological understandings that guide how health is defined and conceptualized. The study contributes toward enhancing diverse understandings of constituting preventive care in practice and suggests pragmatic implications for addressing biomedical provider communication with their patients seeking CAM care alongside conventional treatments.

  4. How music and social engagement provides healthy aging and prevents behavioural and psychological symptoms of dementia

    DEFF Research Database (Denmark)

    Ridder, Hanne Mette Ochsner

    2018-01-01

    engagement and learning, and further affects cognitive reserve and the way we age. Music and musical elements affect listeners differently but seem to regulate our body and brain at a much deeper level than we are aware of. When music touches and engages us, a release of the neurotransmitter Norepinephrine....... In addition, through musical interaction, meaningful expression of psychosocial needs may indirectly lead to a reduction of behavioural and psychological symptoms of dementia. For the person with severe dementia, with sensory and cognitive decline, this offers a healthy means of remaining active, autonomous...... follows. This process involves the brain stem (more precisely the locus coeruleus) and a compensatory effect is observed. By engaging in music from early childhood, preventive mechanisms add to healthy aging and may even slow down the development of dementia symptoms, although it cannot prevent dementia...

  5. Obesity prevention, screening, and treatment: practices of pediatric providers since the 2007 expert committee recommendations.

    Science.gov (United States)

    Rausch, John Conrad; Perito, Emily Rothbaum; Hametz, Patricia

    2011-05-01

    This study surveyed pediatric primary care providers at a major academic center regarding their attitudes and practices of obesity screening, prevention, and treatment. The authors compared the care providers' reported practices to the 2007 American Medical Association and Centers for Disease Control and Prevention Expert Committee Recommendations to evaluate their adherence to the guidelines and differences based on level of training and specialty. Of 96 providers surveyed, less than half used the currently recommended criteria for identifying children who are overweight (24.7%) and obese (34.4%), with attendings more likely to use the correct criteria than residents (P obesity, the majority felt their counseling was not effective. There was considerable variability in reported practices of lab screening and referral patterns of overweight and obese children. More efforts are needed to standardize providers' approach to overweight and obese children.

  6. Preventing Filipino Mental Health Disparities: Perspectives from Adolescents, Caregivers, Providers, and Advocates.

    Science.gov (United States)

    Javier, Joyce R; Supan, Jocelyn; Lansang, Anjelica; Beyer, William; Kubicek, Katrina; Palinkas, Lawrence A

    2014-12-01

    Filipino Americans are the second largest immigrant population and second largest Asian ethnic group in the U.S. Disparities in youth behavioral health problems and the receipt of mental health services among Filipino youth have been documented previously. However, few studies have elicited perspectives from community stakeholders regarding how to prevent mental health disparities among Filipino youth. The purpose of the current study is to identify intervention strategies for implementing mental health prevention programs among Filipino youth. We conducted semi-structured interviews (n=33) with adolescents, caregivers, advocates, and providers and focus groups (n=18) with adolescents and caregivers. Interviews were audio taped and transcribed verbatim. Transcripts were analyzed using a methodology of "coding consensus, co-occurrence, and comparison" and was rooted in grounded theory. Four recommendations were identified when developing mental health prevention strategies among Filipino populations: address the intergenerational gap between Filipino parents and children, provide evidence-based parenting programs, collaborate with churches in order to overcome stigma associated with mental health, and address mental health needs of parents. Findings highlight the implementation of evidence-based preventive parenting programs in faith settings as a community-identified and culturally appropriate strategy to prevent Filipino youth behavioral health disparities.

  7. Knowledge of Critical Care Provider on Prevention of Ventilator Associated Pneumonia

    Directory of Open Access Journals (Sweden)

    Passang Chiki Sherpa

    2014-01-01

    Full Text Available Background: Ventilator-associated pneumonia (VAP continues to be an important cause of morbidity and mortality in ventilated patient. Prevention of VAP in critically ill patient is significant concern for health care team in intensive care units (ICUs. Knowledge on prevention of VAP would have a significant impact on patient outcome. Aims and Objectives: To assess knowledge on prevention of VAP in critical care providers and to find the association between knowledge on prevention of VAP and educational qualification and years of experience in ICUs. Settings and Design: The study was conducted in 5 different ICUs of Kasturba Hospital, Manipal, and using descriptive study design. Material and Methods: The study involved a purposive sample of 138 critical care providers. Critical care providers who were willing to participate in the study were included. Tools on demographic proforma and self-administered structured knowledge questionnaire on prevention of VAP were developed and content validity was established. The reliability of the tools was established.The data was categorized and analyzed by using descriptive and inferential statistics. The SPSS 16.0 version was used for the analysis of the study. Result: Majority 89.1% of the participant were 20-29 years, 63% unmarried 51.4% had completed diploma course and majority 81.2% were from nursing discipline. The study revealed that only 55.80% of subjects were having adequate knowledge on prevention of VAP based on median score. There was no significant association between knowledge score and educational qualification (÷²=0, p=0.833, years of experience in ICU (÷²= 2.221, p=0.329.

  8. The cost-effectiveness of three interventions for providing preventive services to low-income children.

    Science.gov (United States)

    Johnson, Ben; Serban, Nicoleta; Griffin, Paul M; Tomar, Scott L

    2017-12-01

    We evaluated the impact of loan repayment programmes, revising Medicaid fee-for-service rates, and changing dental hygienist supervision requirements on access to preventive dental care for children in Georgia. We estimated cost savings from the three interventions of preventive care for young children after netting out the intervention cost. We used a regression model to evaluate the impact of changing the Medicaid reimbursement rates. The impact of supervision was evaluated by comparing general and direct supervision in school-based dental sealant programmes. Federal loan repayments to dentists and school-based sealant programmes (SBSPs) had lower intervention costs (with higher potential cost savings) than raising the Medicaid reimbursement rate. General supervision had costs 56% lower than direct supervision of dental hygienists for implementing a SBSP. Raising the Medicaid reimbursement rate by 10 percentage points would improve utilization by Loan repayment could serve almost 13 000 children for a cost of $400 000 and a potential cost saving of $176 000. The three interventions all improved met need for preventive dental care. Raising the reimbursement rate alone would marginally affect utilization of Medicaid services but would not substantially increase acceptance of Medicaid by providers. Both loan repayment programmes and amending supervision requirements are potentially cost-saving interventions. Loan repayment programmes provide complete care to targeted areas, while amending supervision requirements of dental hygienists could provide preventive care across the state. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  9. HIV prevention among street-based sex workers (SSWs) in Chongqing, China: interviews with SSWs, clients and healthcare providers.

    Science.gov (United States)

    Zeng, Huan; Zhang, Lei; Zhao, Yong; Liu, Hui; Guo, Hang; Wang, Yang; Zhang, Zhen; Mao, Limin

    2016-11-01

    Street-based female sex workers (SSWs) are subjected to a relatively high risk of HIV transmission, even higher than establishment-based female sex workers in China. However, very few HIV intervention programmes have targeted this particular group to date. Based in Southwest China, this study aims to identify perceived barriers, demands and suggestions on HIV prevention from the perspectives of SSWs, clients and healthcare providers in Chongqing. Face-to-face, in-depth interviews were conducted in July 2008 with 23 participants. They were recruited by purposive, convenience sampling and included 12 SSWs, 5 male clients, 4 government healthcare providers and 2 outreach workers from a community-based non-governmental organisation. Thematic analysis was used. SSWs were largely rural-to-urban migrants with a low socioeconomic status. Most of their clients shared a similar background. Both SSWs and their clients demonstrated a low awareness of HIV infection and a lack of understanding of effective preventive strategies. Financial hardships, lack of family support, fear of police arrest and stigma in relation to sex work were identified as SSWs' major barriers for accessing healthcare services. Both SSWs and their clients indicated an urgent demand for accessing adequate HIV prevention and care programmes. On the other hand, government organisations trying to provide services to this group have also encountered obstacles, specifically their limited ability to establish mutual trust. Programmes provided by community-based non-governmental organisation, however, were perceived to be more attractive. In conclusion, there remains a substantial gap between the need of adequate HIV prevention services for SSWs and their clients and what is currently available. Strengthening inter-sectoral collaboration, providing specifically tailored health services, actively involving SSW peers and their clients, and reducing stigma in the society are keys to meet this urgent demand by SSWs

  10. Providing a Clean Environment for Adolescents: Evaluation of the Tobacco Hazards Prevention Act in Taiwan

    Directory of Open Access Journals (Sweden)

    Min-Li Chen

    2017-06-01

    Full Text Available Cigarette smoking not only damages the health of adolescents, but also contributes to air pollution. The Tobacco Hazards Prevention Act in Taiwan stipulates that cigarettes should not be sold to persons younger than 18 years. Therefore, schools should actively educate students and raise awareness of the Tobacco Hazards Prevention Act to reduce the level of damage to the health of adolescents and maintain good air quality. This study had two main goals: (1 to evaluate the stipulation that no person shall provide tobacco products to persons under the age of 18 and the effects of counseling strategies on store managers confirming customer ages before tobacco sale in southern Taiwan; and (2 to evaluate the situation of tobacco hazard prevention education conducted by school in southern Taiwan. A cross-sectional design was adopted for this study. Study I: The investigation involved an analysis of 234 retailers including convenience stores (n = 70, grocery stores (n = 83, and betel nut stalls (n = 81. The results indicated that among the 234 retailers, 171 (73.1% of them routinely failed to confirm the buyers’ ages before allowing them to purchase tobacco. The number of retailers who exhibited failure to confirm customer ages before selling tobacco products had decreased from 171 (73.1% to 59 (25.2% and that of those who confirmed customer ages before selling tobacco products had increased from 63 (26.9% to 175 (74.8% after counseling strategies had been provided, thereby revealing statistical significance (χ2 = 11.26, p < 0.001. Study II: A total of 476 (89.1% participants had received tobacco hazards prevention education and 58 (10.9% had not. Among the various residential areas, the highest percentage of participants that did not received tobacco hazards prevention education located in the plane regions (8.4%. The government organizations should continue to adopt counseling strategies to reduce the rate of disobedience of the Tobacco Hazards

  11. Providing a Clean Environment for Adolescents: Evaluation of the Tobacco Hazards Prevention Act in Taiwan.

    Science.gov (United States)

    Chen, Min-Li; Chou, Li-Na; Zheng, Ya-Cheng

    2017-06-13

    Cigarette smoking not only damages the health of adolescents, but also contributes to air pollution. The Tobacco Hazards Prevention Act in Taiwan stipulates that cigarettes should not be sold to persons younger than 18 years. Therefore, schools should actively educate students and raise awareness of the Tobacco Hazards Prevention Act to reduce the level of damage to the health of adolescents and maintain good air quality. This study had two main goals: (1) to evaluate the stipulation that no person shall provide tobacco products to persons under the age of 18 and the effects of counseling strategies on store managers confirming customer ages before tobacco sale in southern Taiwan; and (2) to evaluate the situation of tobacco hazard prevention education conducted by school in southern Taiwan. A cross-sectional design was adopted for this study. Study I: The investigation involved an analysis of 234 retailers including convenience stores (n = 70), grocery stores (n = 83), and betel nut stalls (n = 81). The results indicated that among the 234 retailers, 171 (73.1%) of them routinely failed to confirm the buyers' ages before allowing them to purchase tobacco. The number of retailers who exhibited failure to confirm customer ages before selling tobacco products had decreased from 171 (73.1%) to 59 (25.2%) and that of those who confirmed customer ages before selling tobacco products had increased from 63 (26.9%) to 175 (74.8%) after counseling strategies had been provided, thereby revealing statistical significance (χ² = 11.26, p selling tobacco products to minors. Schools should pay close attention to tobacco hazard prevention education for junior high school students to ensure that such students are adequately educated about tobacco hazard prevention.

  12. Dealing with flood damages: will prevention, mitigation, and ex post compensation provide for a resilient triangle?

    Directory of Open Access Journals (Sweden)

    Cathy Suykens

    2016-12-01

    Full Text Available There is a wealth of literature on the design of ex post compensation mechanisms for natural disasters. However, more research needs to be done on the manner in which these mechanisms could steer citizens toward adopting individual-level preventive and protection measures in the face of flood risks. We have provided a comparative legal analysis of the financial compensation mechanisms following floods, be it through insurance, public funds, or a combination of both, with an empirical focus on Belgium, the Netherlands, England, and France. Similarities and differences between the methods in which these compensation mechanisms for flood damages enhance resilience were analyzed. The comparative analysis especially focused on the link between the recovery strategy on the one hand and prevention and mitigation strategies on the other. There is great potential within the recovery strategy for promoting preventive action, for example in terms of discouraging citizens from living in high-risk areas, or encouraging the uptake of mitigation measures, such as adaptive building. However, this large potential has yet to be realized, in part because of insufficient consideration and promotion of these connections within existing legal frameworks. We have made recommendations about how the linkages between strategies can be further improved. These recommendations relate to, among others, the promotion of resilient reinstatement through recovery mechanisms and the removal of legal barriers preventing the establishment of link-inducing measures.

  13. Characteristics of workplace violence prevention training and violent events among home health and hospice care providers.

    Science.gov (United States)

    Vladutiu, Catherine J; Casteel, Carri; Nocera, Maryalice; Harrison, Robert; Peek-Asa, Corinne

    2016-01-01

    In the rapidly growing home health and hospice industry, little is known about workplace violence prevention (WVP) training and violent events. We examined the characteristics of WVP training and estimated violent event rates among 191 home health and hospice care providers from six agencies in California. Training characteristics were identified from the Occupational Safety and Health Administration guidelines. Rates were estimated as the number of violent events divided by the total number of home visit hours. Between 2008 and 2009, 66.5% (n = 127) of providers reported receiving WVP training when newly hired or as recurrent training. On average, providers rated the quality of their training as 5.7 (1 = poor to 10 = excellent). Among all providers, there was an overall rate of 17.1 violent events per 1,000 visit-hours. Efforts to increase the number of home health care workers who receive WVP training and to improve training quality are needed. © 2015 Wiley Periodicals, Inc.

  14. Advice on malaria and yellow fever prevention provided at travel agencies in Cuzco, Peru.

    Science.gov (United States)

    Villanueva-Meyer, Pablo G; Garcia-Jasso, Carlos A; Springer, Chelsea A; Lane, Jenna K; Su, Bonny S; Hidalgo, Idania S; Goodrich, Mary R; Deichsel, Emily L; White, A C; Cabada, Miguel M

    2015-01-01

    Travelers receive medical advice from a variety of sources, including travel agencies. The aim of this study is to describe the quality of pre-travel advice provided by travel agencies in Cuzco to travelers interested in visiting malaria and yellow fever endemic areas. Trained medical students posed as tourists and visited travel agencies in Cuzco requesting travel advice for a trip to the southern Amazon of Peru, recording advice regarding risk and prevention of malaria and yellow fever. A total of 163 registered travel agencies were included in the study. The mean proposed tour duration was 6.8 days (±1.4 days) with a median time to departure of 3 days and a median tour cost of 805 US dollars (USD) [interquartile range (IQR) 580-1,095]. Overall, 45% employees failed to mention the risk for any illness. Eighteen percent of the employees acknowledged risk of malaria and 53% risk of yellow fever. However, 36% denied malaria risk and 2% denied risk of yellow fever in the region. The price of tours from travel agencies that did not mention any health risk was significantly lower [1,009.6 ± 500.5 vs 783.9 ± 402 USD, t (152) = 3, p yellow fever (100%) were able to provide at least one recommendation for prevention. However, advice was not always accurate or spontaneously volunteered. Only 7% of the employees provided both correct scheduling and location information for administration of the yellow fever vaccine. The majority of registered travel agencies in Cuzco did not provide sufficient and accurate information regarding risk and prevention of malaria and yellow fever to travelers inquiring about trips to the southern Amazon of Peru. © 2014 International Society of Travel Medicine.

  15. Assessing implementation difficulties in tobacco use prevention and cessation counselling among dental providers

    Directory of Open Access Journals (Sweden)

    Murtomaa Heikki

    2011-05-01

    Full Text Available Abstract Background Tobacco use adversely affects oral health. Clinical guidelines recommend that dental providers promote tobacco abstinence and provide patients who use tobacco with brief tobacco use cessation counselling. Research shows that these guidelines are seldom implemented, however. To improve guideline adherence and to develop effective interventions, it is essential to understand provider behaviour and challenges to implementation. This study aimed to develop a theoretically informed measure for assessing among dental providers implementation difficulties related to tobacco use prevention and cessation (TUPAC counselling guidelines, to evaluate those difficulties among a sample of dental providers, and to investigate a possible underlying structure of applied theoretical domains. Methods A 35-item questionnaire was developed based on key theoretical domains relevant to the implementation behaviours of healthcare providers. Specific items were drawn mostly from the literature on TUPAC counselling studies of healthcare providers. The data were collected from dentists (n = 73 and dental hygienists (n = 22 in 36 dental clinics in Finland using a web-based survey. Of 95 providers, 73 participated (76.8%. We used Cronbach's alpha to ascertain the internal consistency of the questionnaire. Mean domain scores were calculated to assess different aspects of implementation difficulties and exploratory factor analysis to assess the theoretical domain structure. The authors agreed on the labels assigned to the factors on the basis of their component domains and the broader behavioural and theoretical literature. Results Internal consistency values for theoretical domains varied from 0.50 ('emotion' to 0.71 ('environmental context and resources'. The domain environmental context and resources had the lowest mean score (21.3%; 95% confidence interval [CI], 17.2 to 25.4 and was identified as a potential implementation difficulty. The domain emotion

  16. Assessing implementation difficulties in tobacco use prevention and cessation counselling among dental providers.

    Science.gov (United States)

    Amemori, Masamitsu; Michie, Susan; Korhonen, Tellervo; Murtomaa, Heikki; Kinnunen, Taru H

    2011-05-26

    Tobacco use adversely affects oral health. Clinical guidelines recommend that dental providers promote tobacco abstinence and provide patients who use tobacco with brief tobacco use cessation counselling. Research shows that these guidelines are seldom implemented, however. To improve guideline adherence and to develop effective interventions, it is essential to understand provider behaviour and challenges to implementation. This study aimed to develop a theoretically informed measure for assessing among dental providers implementation difficulties related to tobacco use prevention and cessation (TUPAC) counselling guidelines, to evaluate those difficulties among a sample of dental providers, and to investigate a possible underlying structure of applied theoretical domains. A 35-item questionnaire was developed based on key theoretical domains relevant to the implementation behaviours of healthcare providers. Specific items were drawn mostly from the literature on TUPAC counselling studies of healthcare providers. The data were collected from dentists (n = 73) and dental hygienists (n = 22) in 36 dental clinics in Finland using a web-based survey. Of 95 providers, 73 participated (76.8%). We used Cronbach's alpha to ascertain the internal consistency of the questionnaire. Mean domain scores were calculated to assess different aspects of implementation difficulties and exploratory factor analysis to assess the theoretical domain structure. The authors agreed on the labels assigned to the factors on the basis of their component domains and the broader behavioural and theoretical literature. Internal consistency values for theoretical domains varied from 0.50 ('emotion') to 0.71 ('environmental context and resources'). The domain environmental context and resources had the lowest mean score (21.3%; 95% confidence interval [CI], 17.2 to 25.4) and was identified as a potential implementation difficulty. The domain emotion provided the highest mean score (60%; 95% CI, 55

  17. Examining the Highs and Lows of the Collaborative Relationship Between Technical Assistance Providers and Prevention Implementers.

    Science.gov (United States)

    Chilenski, Sarah M; Welsh, Janet; Olson, Jonathan; Hoffman, Lesa; Perkins, Daniel F; Feinberg, Mark E

    2018-02-01

    The PROSPER model uses a three-tiered community partnership, university researcher, and Cooperative Extension-based technical assistance system to support the delivery of evidence-based interventions in communities. This study examines the trajectory and predictors of the collaborative relationship between technical assistance providers and community teams across the three phases of organization, implementation, and sustainability. Members of 14 PROmoting School-university-community Partnerships to Enhance Resilience (PROSPER) community teams and directors of local agencies rated communities' levels of readiness and adolescent substance use norms. Technical assistance providers rated their collaborative relationship with their teams at 14 occasions across 4.5 years. Results from mixed models show that levels of collaboration were stable until the sustainability phase, when they increased significantly. Team differences in change were significant during the implementation phase. Community readiness predicted levels of the collaborative relationship over time: high community readiness was associated with a high level of collaboration during organization, but a decline in collaboration during implementation. These results provide a more nuanced understanding of the relationship between technical assistance provision and community prevention teams and lead to recommendations to improve dissemination models to achieve a greater public health impact.

  18. Willingness of Rhode Island Dentists to Provide Limited Preventive Primary Care.

    Science.gov (United States)

    Dang, Catherine Tuyet Mai; Shield, Renee R; Giddon, Donald B

    2016-07-01

    In response to the shortage of primary care physicians and the need for greater intercollaboration among health professionals, dentists with sufficient medical and surgical training are an untapped resource to provide limited preventive primary care (LPPC), such as chairside screening for chronic diseases. The objective of this study was to determine attitudes of Rhode Island dentists toward becoming more involved in the overall health of their patients. Using a 5-point scale (1 being highest), a pretested survey was administered to 92 respondent RI dentists who were asked to indicate their willingness to become more involved in patients' overall health, and undergo additional training to provide LPPC. Their moderate level of willingness was offset by great concern for liability, with older dentists being significantly more willing to assume these additional responsibilities than younger dentists (pstomiatrist was still dentist first, but with no significant difference between the mean ranks of dentist and oral physician.[Full article available at http://rimed.org/rimedicaljournal-2016-07.asp, free with no login].

  19. Measuring factors that influence the utilisation of preventive care services provided by general practitioners in Australia

    Directory of Open Access Journals (Sweden)

    Oldenburg Brian

    2009-12-01

    Full Text Available Abstract Background Relatively little research attention has been given to the development of standardised and psychometrically sound scales for measuring influences relevant to the utilisation of health services. This study aims to describe the development, validation and internal reliability of some existing and new scales to measure factors that are likely to influence utilisation of preventive care services provided by general practitioners in Australia. Methods Relevant domains of influence were first identified from a literature review and formative research. Items were then generated by using and adapting previously developed scales and published findings from these. The new items and scales were pre-tested and qualitative feedback was obtained from a convenience sample of citizens from the community and a panel of experts. Principal Components Analyses (PCA and internal reliability testing (Cronbach's alpha were then conducted for all of the newly adapted or developed scales utilising data collected from a self-administered mailed survey sent to a randomly selected population-based sample of 381 individuals (response rate 65.6 per cent. Results The PCA identified five scales with acceptable levels of internal consistency were: (1 social support (ten items, alpha 0.86; (2 perceived interpersonal care (five items, alpha 0.87, (3 concerns about availability of health care and accessibility to health care (eight items, alpha 0.80, (4 value of good health (five items, alpha 0.79, and (5 attitudes towards health care (three items, alpha 0.75. Conclusion The five scales are suitable for further development and more widespread use in research aimed at understanding the determinants of preventive health services utilisation among adults in the general population.

  20. Preventing Adolescent Risk Behavior in the Rural Context: An Integrative Analysis of Adolescent, Parent, and Provider Perspectives

    Science.gov (United States)

    Rishel, Carrie W.; Cottrell, Lesley; Kingery, Tricia

    2012-01-01

    Adolescent risk behavior remains prevalent and contributes to numerous social problems and growing health care costs. Contrary to popular perception, adolescents in rural areas engage in risky behaviors at least as much as youth from urban or suburban settings. Little research, however, focuses on risk behavior prevention in the rural context.…

  1. Comparing Provider and Client Preferences for HIV Prevention Services in South Africa among Men Who Have Sex with Men.

    Science.gov (United States)

    Shaver, John; Sullivan, Patrick; Siegler, Aaron; de Voux, Alex; Phaswana-Mafuya, Nancy; Bekker, Linda-Gail; Baral, Stefan D; Wirtz, Andrea L; Beyrer, Chris; Brown, Ben; Stephenson, Rob

    Combination prevention efforts are now recommended toward reducing HIV incidence among men who have sex with men (MSM). Understanding the perceptions of both MSM and service providers is critical to informing the development of prevention packages and ultimately improving intervention effectiveness. This study assessed the preferences of MSM and health service providers in the administration of HIV-prevention efforts. Qualitative data were gathered from a series of separate MSM and health care provider focus groups in 2 South African cities. Participants discussed HIV-prevention services and MSM client experiences within South Africa and identified the 3 most important clinic characteristics and 3 most important HIV-prevention services for MSM clients. Priorities indicated by both MSM and health care providers were confidentiality of visit, friendly staff, and condoms, while discrepancies existed between MSM and providers regarding provider consistency and the provision of pre-exposure prophylaxis/post-exposure prophylaxis (PrEP/PEP) and lubricant as prevention methods. Effective interventions must address these discrepancies through the design of intervention and provider training to optimally accommodate MSM.

  2. The role of the primary care provider in preventing and treating alcohol problems in adolescents

    NARCIS (Netherlands)

    Knight, [No Value

    2001-01-01

    Adolescents use alcohol more frequently and heavily than all other illicit drugs combined.(1) Given the myriad health, developmental, and social problems associated with alcohol use, it is not surprising that the American Medical Association's Guidelines for Adolescent Preventive Services recommends

  3. Prevention

    DEFF Research Database (Denmark)

    Halken, S; Høst, A

    2001-01-01

    , breastfeeding should be encouraged for 4-6 months. In high-risk infants a documented extensively hydrolysed formula is recommended if exclusive breastfeeding is not possible for the first 4 months of life. There is no evidence for preventive dietary intervention neither during pregnancy nor lactation...... populations. These theories remain to be documented in proper, controlled and prospective studies. Breastfeeding and the late introduction of solid foods (>4 months) is associated with a reduced risk of food allergy, atopic dermatitis, and recurrent wheezing and asthma in early childhood. In all infants....... Preventive dietary restrictions after the age of 4-6 months are not scientifically documented....

  4. Communication between Asian American Adolescents and Health Care Providers about Sexual Activity, Sexually Transmitted Infections, and Pregnancy Prevention

    Science.gov (United States)

    Zhao, Jessie; Lau, May; Vermette, David; Liang, David; Flores, Glenn

    2017-01-01

    Asian American adolescents have been reported to have the lowest amount of communication with health care providers regarding sexual health topics (sexual activity, contraception, sexually transmitted infections, and pregnancy prevention). This study identified Asian American adolescents' attitudes/beliefs regarding how health care providers can…

  5. Student pharmacists provide tobacco use prevention education to elementary school children: A pilot experience.

    Science.gov (United States)

    Ostroff, Jared L; Wolff, Marissa L; Andros, Christina; Nemec, Eric C

    2017-09-01

    The purpose of this article is to describe a service learning experience involving tobacco prevention education and to measure the education's effect on the learners' knowledge of tobacco products. Student pharmacists planned and presented a 40-min tobacco prevention education program using the Tar Wars curriculum to fourth and fifth grade students at three suburban elementary schools in Western Massachusetts. Mean scores on a five-question assessment given to school age children before and after the presentation were compared. A total of 206 elementary school students in ten classrooms participated. The average survey score increased from 1.87 on the pre-survey to 3.72 out of a maximum of five on the post-survey (Peducation to three suburban elementary schools. The children demonstrated an increase in short-term knowledge regarding tobacco use. Tobacco prevention is a unique co-curricular opportunity for student pharmacists to get involved in their community. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. Primary care providers' discussion of fall prevention approaches with their older adult patients—DocStyles, 2014

    Directory of Open Access Journals (Sweden)

    Elizabeth R. Burns

    2018-03-01

    Full Text Available Falls are the leading cause of fatal and non-fatal injuries among older adults. The American and British Geriatric Societies recommend a fall risk assessment to identify risk factors and guide interventions to prevent these falls. This study describes the self-reported discussion of fall prevention approaches used by primary care providers (PCPs—family practitioners, internists and nurse practitioners—who treat older adults. Results are described overall and by PCP type.We analyzed a sample of 1210 U.S. PCPs who participated in the 2014 DocStyles survey. PCPs reported on their recommendation of fall prevention approaches including general exercise, Tai Chi, medication adjustments, home safety modifications, vitamin D supplements, assistive devices, alarm systems, and referral to physical therapy, foot specialist, or vision specialist. Frequencies and adjusted odds ratios for fall prevention approaches were assessed by provider and practice characteristics.Self-reported discussion of any fall prevention approaches was 89.3%. Controlling for provider and practice characteristics, there were significant differences for some approaches by provider type. Family practitioners were more likely to suggest home modification [adjusted Odds Ratio: 1.8 (1.3–2.4], exercise [aOR: 2.0 (1.5–2.5], and Tai Chi [aOR: 1.5 (1.0–2.2] than internists. Nurse practitioners were more likely to suggest home modification [aOR: 2.1 (1.3–3.4] and less likely to suggest vitamin D [aOR: 0.6 (0.4–1.0] than internists.Fall prevention suggestions vary by type of PCP. Dissemination of geriatric guidelines should include all PCPs who routinely see older adults. Keywords: Primary care providers, Falls, Prevention, Older adults, Geriatrics

  7. United States family planning providers' knowledge of and attitudes towards preexposure prophylaxis for HIV prevention: a national survey.

    Science.gov (United States)

    Seidman, Dominika; Carlson, Kimberly; Weber, Shannon; Witt, Jacki; Kelly, Patricia J

    2016-05-01

    The Centers for Disease Control and Prevention defines HIV prevention as a core family planning service. The HIV community identified family planning visits as key encounters for women to access preexposure prophylaxis (PrEP) for HIV prevention. No studies explore US family planning providers' knowledge of and attitudes towards PrEP. We conducted a national survey of clinicians to understand barriers and facilitators to PrEP implementation in family planning. Family planning providers recruited via website postings, national meetings, and email completed an anonymous survey in 2015. Descriptive statistics were performed. Among 604 respondents, 495 were eligible for analysis and 342 were potential PrEP prescribers (physicians, nurse practitioners, midwives or physicians assistants). Among potential prescribers, 38% correctly defined PrEP [95% confidence interval (CI): 32.5-42.8], 37% correctly stated the efficacy of PrEP (95% CI: 32.0-42.4), and 36% chose the correct HIV test after a recent exposure (95% CI: 30.6-40.8). Characteristics of those who answered knowledge questions correctly included age less than 35 years, practicing in the Northeast or West, routinely offering HIV testing, providing rectal sexually transmitted infection screening or having seen any PrEP guidelines. Even among providers in the Northeast and West, the proportion of respondents answering questions correctly was less than 50%. Thirty-six percent of respondents had seen any PrEP guidelines. Providers identified lack of training as the main barrier to PrEP implementation; 87% wanted PrEP education. To offer comprehensive HIV prevention services, family planning providers urgently need training on PrEP and HIV testing. US family planning providers have limited knowledge about HIV PrEP and HIV testing, and report lack of provider training as the main barrier to PrEP provision. Provider education is needed to ensure that family planning clients access comprehensive HIV prevention methods

  8. Granistron and dexamethasone provide more improved prevention of postoperative emesis than granisetron alone in children.

    Science.gov (United States)

    Fujii, Y; Tanaka, H; Toyooka, H

    1996-12-01

    Dexamethasone decreases chemotherapy-induced emesis when added to antiemetic regimens. This study was designed to compare the effectiveness of granisetron and dexamethasone with granisetron alone in the prevention of post-operative vomiting after strabismus repair, tonsillectomy with or without adenoidectomy in children. In a randomized, double-blind study, 60 healthy children, 4-10 yr of age, received either granisetron 40 micrograms.kg-1 and saline (Group S) or granisetron 40 micrograms.kg-1 and dexamethasone 4 mg (Group D) iv immediately after the induction of anaesthesia. All subjects received anaesthetics consisting of sevoflurane and nitrous oxide in oxygen Postoperative pain was treated with acetaminophen pr or pentazocine iv. Postoperatively, during the first 24 hr after anaesthesia, the frequencies of retching and vomiting, and the incidence of adverse events were recorded by nursing staff. There were no differences between the treatment groups with regard to demographics, surgical procedure, anaesthetic administered or analgesics used for postoperative pain. The frequency of the symptoms was 27% and 7% in Groups S and D, respectively (P < 0.05). The incidence of adverse events was comparable in the two groups. The prophylactic administration of granisetron and dexamethasone was more effective than granisetron alone in the prevention of postoperative vomiting in paediatric subjects undergoing strabismus repair, tonsillectomy and adenoidectomy.

  9. The power of a collaborative relationship between technical assistance providers and community prevention teams: A correlational and longitudinal study.

    Science.gov (United States)

    Chilenski, Sarah M; Perkins, Daniel F; Olson, Jonathan; Hoffman, Lesa; Feinberg, Mark E; Greenberg, Mark; Welsh, Janet; Crowley, D Max; Spoth, Richard

    2016-02-01

    Historically, effectiveness of community collaborative prevention efforts has been mixed. Consequently, research has been undertaken to better understand the factors that support their effectiveness; theory and some related empirical research suggests that the provision of technical assistance is one important supporting factor. The current study examines one aspect of technical assistance that may be important in supporting coalition effectiveness, the collaborative relationship between the technical assistance provider and site lead implementer. Four and one-half years of data were collected from technical assistance providers and prevention team members from the 14 community prevention teams involved in the PROSPER project. Spearman correlation analyses with longitudinal data show that the levels of the collaborative relationship during one phase of collaborative team functioning associated with characteristics of internal team functioning in future phases. Results suggest that community collaborative prevention work should consider the collaborative nature of the technical assistance provider - prevention community team relationship when designing and conducting technical assistance activities, and it may be important to continually assess these dynamics to support high quality implementation. Copyright © 2015 Elsevier Ltd. All rights reserved.

  10. A Community Pediatric Prevention Partnership: Linking Schools, Providers, and Tertiary Care Services.

    Science.gov (United States)

    Farrior, Kim Crickmore; Engelke, Martha Keehner; Collins, Catherine Shoup; Cox, Carol Gordon

    2000-01-01

    Describes a partnership among a hospital, a university, private providers, and a local school system and health department to provide school health services. Noteworthy aspects of the project include the organizational structure and funding, implementation of a case management model, and a focus on documenting outcomes. The program has…

  11. Primary care providers' discussion of fall prevention approaches with their older adult patients-DocStyles, 2014.

    Science.gov (United States)

    Burns, Elizabeth R; Haddad, Yara K; Parker, Erin M

    2018-03-01

    Falls are the leading cause of fatal and non-fatal injuries among older adults. The American and British Geriatric Societies recommend a fall risk assessment to identify risk factors and guide interventions to prevent these falls. This study describes the self-reported discussion of fall prevention approaches used by primary care providers (PCPs)-family practitioners, internists and nurse practitioners-who treat older adults. Results are described overall and by PCP type. We analyzed a sample of 1210 U.S. PCPs who participated in the 2014 DocStyles survey. PCPs reported on their recommendation of fall prevention approaches including general exercise, Tai Chi, medication adjustments, home safety modifications, vitamin D supplements, assistive devices, alarm systems, and referral to physical therapy, foot specialist, or vision specialist. Frequencies and adjusted odds ratios for fall prevention approaches were assessed by provider and practice characteristics. Self-reported discussion of any fall prevention approaches was 89.3%. Controlling for provider and practice characteristics, there were significant differences for some approaches by provider type. Family practitioners were more likely to suggest home modification [adjusted Odds Ratio: 1.8 (1.3-2.4)], exercise [aOR: 2.0 (1.5-2.5)], and Tai Chi [aOR: 1.5 (1.0-2.2)] than internists. Nurse practitioners were more likely to suggest home modification [aOR: 2.1 (1.3-3.4)] and less likely to suggest vitamin D [aOR: 0.6 (0.4-1.0)] than internists. Fall prevention suggestions vary by type of PCP. Dissemination of geriatric guidelines should include all PCPs who routinely see older adults.

  12. 75 FR 41787 - Requirement for Group Health Plans and Health Insurance Issuers To Provide Coverage of Preventive...

    Science.gov (United States)

    2010-07-19

    ... Requirement for Group Health Plans and Health Insurance Issuers To Provide Coverage of Preventive Services... Insurance Oversight of the U.S. Department of Health and Human Services are issuing substantially similar interim final regulations with respect to group health plans and health insurance coverage offered in...

  13. Perceptions of vaginal microbicides as an HIV prevention method among health care providers in KwaZulu-Natal, South Africa

    Directory of Open Access Journals (Sweden)

    Mantell Joanne E

    2007-03-01

    Full Text Available Abstract Background The promise of microbicides as an HIV prevention method will not be realized if not supported by health care providers. They are the primary source of sexual health information for potential users, in both the public and private health sectors. Therefore, the aim of this study was to determine perceptions of vaginal microbicides as a potential HIV prevention method among health care providers in Durban and Hlabisa, South Africa, using a combination of quantitative and qualitative methods. Results During 2004, semi structured interviews with 149 health care providers were conducted. Fifty seven percent of hospital managers, 40% of pharmacists and 35% of nurses possessed some basic knowledge of microbicides, such as the product being used intra-vaginally before sex to prevent HIV infection. The majority of them were positive about microbicides and were willing to counsel users regarding potential use. Providers from both public and private sectors felt that an effective microbicide should be available to all people, regardless of HIV status. Providers felt that the product should be accessed over-the-counter in pharmacies and in retail stores. They also felt a need for potential microbicides to be available free of charge, and packaged with clear instructions. The media was seen by health care providers as being an effective strategy for promoting microbicides. Conclusion Overall, health care providers were very positive about the possible introduction of an effective microbicide for HIV prevention. The findings generated by this study illustrated the need for training health care providers prior to making the product accessible, as well as the importance of addressing the potential barriers to use of the product by women. These are important concerns in the health care community, and this study also served to educate them for the day when research becomes reality.

  14. Child Care Provider Awareness and Prevention of Cytomegalovirus and Other Infectious Diseases

    Science.gov (United States)

    Thackeray, Rosemary; Magnusson, Brianna M.

    2016-01-01

    Background: Child care facilities are prime locations for the transmission of infectious and communicable diseases. Children and child care providers are at high risk for cytomegalovirus (CMV) infection which causes severe birth defects and developmental delays. Objective: The goals of study were: (1) to determine the level of cytomegalovirus…

  15. The Relationship between Practices and Child Care Providers' Beliefs Related to Child Feeding and Obesity Prevention

    Science.gov (United States)

    Lanigan, Jane D.

    2012-01-01

    Objective: To examine the association between child care practices and child care provider knowledge and beliefs about their role in supporting children's healthful eating. Design: Longitudinal design using survey and observation data from baseline and year 1 of the Encouraging Healthy Activity and Eating in Childcare Environments (ENHANCE) pilot…

  16. Ethnic differences in breast cancer prevention information-seeking among rural women: will provider mobile messages work?

    Science.gov (United States)

    Kratzke, Cynthia; Wilson, Susan

    2014-09-01

    Although growing research supports cancer survivor information-seeking, little is known about breast cancer prevention information-seeking among women. The purpose of the study was to examine differences in breast cancer risk factor knowledge, information sources, and desired mobile messages among Hispanic and non-Hispanic rural women. Women were recruited to complete a survey at an imaging center during a mammography screening visit. A total of 156 women (mean age = 61, SD = 12.07) completed the survey. Breast cancer risk factor knowledge was significantly higher for non-Hispanic women compared to Hispanic women (p = .035). Television, magazines, and Internet were the most frequent information sources. Providers were the most frequent interpersonal information source. Nearly 87 % used cell phones and 47 % used texting. Hispanic women were more likely to desire breast cancer prevention cell voice messages (p breast cancer prevention education, and best practices to manage screening appointments.

  17. [PALEOPATHOLOGY OF HUMAN REMAINS].

    Science.gov (United States)

    Minozzi, Simona; Fornaciari, Gino

    2015-01-01

    Many diseases induce alterations in the human skeleton, leaving traces of their presence in ancient remains. Paleopathological examination of human remains not only allows the study of the history and evolution of the disease, but also the reconstruction of health conditions in the past populations. This paper describes the most interesting diseases observed in skeletal samples from the Roman Imperial Age necropoles found in urban and suburban areas of Rome during archaeological excavations in the last decades. The diseases observed were grouped into the following categories: articular diseases, traumas, infections, metabolic or nutritional diseases, congenital diseases and tumours, and some examples are reported for each group. Although extensive epidemiological investigation in ancient skeletal records is impossible, the palaeopathological study allowed to highlight the spread of numerous illnesses, many of which can be related to the life and health conditions of the Roman population.

  18. Family child care providers' self-perceived role in obesity prevention: working with children, parents, and external influences.

    Science.gov (United States)

    Rosenthal, Marjorie S; Crowley, Angela A; Curry, Leslie

    2013-01-01

    To describe the perspective and strategies of family child care providers (FCCPs) to reduce children's suboptimal weight trajectories. In-person, in-depth interviews with FCCPs. Family child care homes. Seventeen FCCPs caring for children 6 weeks to 9 years old; 94% caring for children paying with a state subsidy. Strategies of FCCP to reduce children's suboptimal weight trajectories. Constant comparative method of qualitative data analysis. Family child care providers described 3 core strategies: (1) improving children's behavior, (2) engaging and educating parents, and (3) leveraging influences external to their relationship with parents to effect positive change and to avoid parental conflict. These strategies were framed within their knowledge of child development, parental communication, and community services. The findings suggest that FCCPs' role in obesity prevention may be framed within knowledge that may be commonly expected of a child care provider. Partnerships between public health policy makers and FCCP may reduce obesigenic environments by employing training and resources that link obesity prevention and child care provider expertise. Copyright © 2013 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

  19. What Prevents Quality Midwifery Care? A Systematic Mapping of Barriers in Low and Middle Income Countries from the Provider Perspective.

    Directory of Open Access Journals (Sweden)

    Alex Filby

    Full Text Available Quality of care is essential for further progress in reducing maternal and newborn deaths. The integration of educated, trained, regulated and licensed midwives into the health system is associated with improved quality of care and sustained decreases in maternal and newborn mortality. To date, research on barriers to quality of care for women and newborns has not given due attention to the care provider's perspective. This paper addresses this gap by presenting the findings of a systematic mapping of the literature of the social, economic and professional barriers preventing midwifery personnel in low and middle income countries (LMICs from providing quality of care.A systematic search of five electronic databases for literature published between January 1990 and August 2013. Eligible items included published and unpublished items in all languages. Items were screened against inclusion and exclusion criteria, yielding 82 items from 34 countries. 44% discussed countries or regions in Africa, 38% in Asia, and 5% in the Americas. Nearly half the articles were published since 2011. Data was extracted and presented in a narrative synthesis and tables. Items were organized into three categories; social; economic and professional barriers, based on an analytical framework. Barriers connected to the socially and culturally constructed context of childbirth, although least reported, appear instrumental in preventing quality midwifery care.Significant social and cultural, economic and professional barriers can prevent the provision of quality midwifery care in LMICs. An analytical framework is proposed to show how the overlaps between the barriers reinforce each other, and that they arise from gender inequality. Links are made between burn out and moral distress, caused by the barriers, and poor quality care. Ongoing mechanisms to improve quality care will need to address the barriers from the midwifery provider perspective, as well as the underlying

  20. The cost of providing combined prevention and treatment services, including ART, to female sex workers in Burkina Faso.

    Directory of Open Access Journals (Sweden)

    Fiona Cianci

    Full Text Available BACKGROUND: Female Sex workers (FSW are important in driving HIV transmission in West Africa. The Yerelon clinic in Burkina Faso has provided combined preventative and therapeutic services, including anti-retroviral therapy (ART, for FSWs since 1998, with evidence suggesting it has decreased HIV prevalence and incidence in this group. No data exists on the costs of such a combined prevention and treatment intervention for FSW. This study aims to determine the mean cost of service provision per patient year for FSWs attending the Yerelon clinic, and identifies differences in costs between patient groups. METHODS: Field-based retrospective cost analyses were undertaken using top-down and bottom-up costing approaches for 2010. Expenditure and service utilisation data was collated from primary sources. Patients were divided into groups according to full-time or occasional sex-work, HIV status and ART duration. Patient specific service use data was extracted. Costs were converted to 2012 US$. Sensitivity analyses considered removal of all research costs, different discount rates and use of different ART treatment regimens and follow-up schedules. RESULTS: Using the top-down costing approach, the mean annual cost of service provision for FSWs on or off ART was US$1098 and US$882, respectively. The cost for FSWs on ART reduced by 29%, to US$781, if all research-related costs were removed and national ART monitoring guidelines were followed. The bottom-up patient-level costing showed the cost of the service varied greatly across patient groups (US$505-US$1117, primarily due to large differences in the costs of different ART regimens. HIV-negative women had the lowest annual cost at US$505. CONCLUSION: Whilst FSWs may require specialised services to optimise their care and hence, the public health benefits, our study shows that the cost of ART provision within a combined prevention and treatment intervention setting is comparable to providing ART to

  1. Characterization and typification of small ruminant farms providing fuelbreak grazing services for wildfire prevention in Andalusia (Spain).

    Science.gov (United States)

    Mena, Y; Ruiz-Mirazo, J; Ruiz, F A; Castel, J M

    2016-02-15

    Several wildfire prevention programs in Spain are using grazing livestock to maintain fuelbreaks with low levels of biomass. Even though shepherds are remunerated for these services, many of their farms are hardly viable in the current socio-economic context. By analyzing 54 small ruminant farms participating in the Grazed Fuelbreak Network in Andalusia (southern Spain), this research aimed to identify the main types and characteristics of such farms and, considering the challenges they are facing, propose strategies to improve both their economic viability and their effectiveness in fuelbreak grazing. Based on data collected through a survey on key farm management aspects, a multivariate analysis was performed and four main types of farm were identified: two clusters of dairy goat farms and two composed mostly of meat-purpose sheep farms. Farms in all clusters could benefit from improvements in the feeding and reproductive management of livestock, either to enhance their productivity or to make better use of the pasture resources available. Dairy goat farms remain more dependent on external animal feed to ensure a better lactation, therefore they should either diminish their workforce costs per animal or sell transformed products directly to consumers to improve their economic viability. Best fuelbreak grazing results were related to larger flocks combining sheep and goats, lower ratios of fuelbreak surface area per animal, and longer (year-long) grazing periods on fuelbreaks. Therefore, such farm features and adjusted fuelbreak assignments should be favored in wildfire prevention programs using grazing services. Copyright © 2015 Elsevier B.V. All rights reserved.

  2. Enhancing implementation of tobacco use prevention and cessation counselling guideline among dental providers: a cluster randomised controlled trial.

    Science.gov (United States)

    Amemori, Masamitsu; Korhonen, Tellervo; Kinnunen, Taru; Michie, Susan; Murtomaa, Heikki

    2011-02-14

    Tobacco use adversely affects oral health. Tobacco use prevention and cessation (TUPAC) counselling guidelines recommend that healthcare providers ask about each patient's tobacco use, assess the patient's readiness and willingness to stop, document tobacco use habits, advise the patient to stop, assist and help in quitting, and arrange monitoring of progress at follow-up appointments. Adherence to such guidelines, especially among dental providers, is poor. To improve guideline implementation, it is essential to understand factors influencing it and find effective ways to influence those factors. The aim of the present study protocol is to introduce a theory-based approach to diagnose implementation difficulties of TUPAC counselling guidelines among dental providers. Theories of behaviour change have been used to identify key theoretical domains relevant to the behaviours of healthcare providers involved in implementing clinical guidelines. These theoretical domains will inform the development of a questionnaire aimed at assessing the implementation of the TUPAC counselling guidelines among Finnish municipal dental providers. Specific items will be drawn from the guidelines and the literature on TUPAC studies. After identifying potential implementation difficulties, we will design two interventions using theories of behaviour change to link them with relevant behaviour change techniques aiming to improve guideline adherence. For assessing the implementation of TUPAC guidelines, the electronic dental record audit and self-reported questionnaires will be used. To improve guideline adherence, the theoretical-domains approach could provide a comprehensive basis for assessing implementation difficulties, as well as designing and evaluating interventions. After having identified implementation difficulties, we will design and test two interventions to enhance TUPAC guideline adherence. Using the cluster randomised controlled design, we aim to provide further evidence on

  3. Sub-optimal delivery of intermittent preventive treatment for malaria in pregnancy in Nigeria: influence of provider factors

    Directory of Open Access Journals (Sweden)

    Onoka Chima A

    2012-09-01

    Full Text Available Abstract Background The level of access to intermittent preventive treatment for malaria in pregnancy (IPTp in Nigeria is still low despite relatively high antenatal care coverage in the study area. This paper presents information on provider factors that affect the delivery of IPTp in Nigeria. Methods Data were collected from heads of maternal health units of 28 public and six private health facilities offering antenatal care (ANC services in two districts in Enugu State, south-east Nigeria. Provider knowledge of guidelines for IPTp was assessed with regard to four components: the drug used for IPTp, time of first dose administration, of second dose administration, and the strategy for sulphadoxine-pyrimethamine (SP administration (directly observed treatment, DOT. Provider practices regarding IPTp and facility-related factors that may explain observations such as availability of SP and water were also examined. Results Only five (14.7% of all 34 providers had correct knowledge of all four recommendations for provision of IPTp. None of them was a private provider. DOT strategy was practiced in only one and six private and public providers respectively. Overall, 22 providers supplied women with SP in the facility and women were allowed to take it at home. The most common reason for doing so amongst public providers was that women were required to come for antenatal care on empty stomachs to enhance the validity of manual fundal height estimation. Two private providers did not think it was necessary to use the DOT strategy because they assumed that women would take their drugs at home. Availability of SP and water in the facility, and concerns about side effects were not considered impediments to delivery of IPTp. Conclusion There was low level of knowledge of the guidelines for implementation of IPTp by all providers, especially those in the private sector. This had negative effects such as non-practice of DOT strategy by most of the providers

  4. What Primary Care Providers Need to Know about Pre-Exposure Prophylaxis (PrEP) for HIV Prevention: Narrative Review

    Science.gov (United States)

    Krakower, Douglas; Mayer, Kenneth H.

    2013-01-01

    As HIV prevalence climbs globally, including more than 50,000 new infections per year in the United States, we need effective HIV prevention strategies. The use of antiretrovirals for pre-exposure prophylaxis (known as “PrEP”) among high-risk HIV-uninfected persons is emerging as one such strategy. Randomized controlled trials have demonstrated that once daily oral PrEP decreased HIV incidence among at-risk MSM and African heterosexuals, including HIV serodiscordant couples. An additional randomized control trial of a pericoital topical application of antiretroviral microbicide gel reduced HIV incidence among at-risk heterosexual South African women. Two other studies in African women did not demonstrate the efficacy of oral or topical PrEP, raising concerns about adherence patterns and efficacy in this population. The FDA Antiretroviral Advisory Panel reviewed these studies and additional data in May 2012 and recommended the approval of oral tenofovir-emtricitabine for PrEP in high-risk populations. Patients may seek PrEP from their primary care providers and those on PrEP require monitoring. Thus, primary care providers should become familiar with PrEP. This review outlines the current state of knowledge about PrEP as it pertains to primary care including identification of individuals likely to benefit from PrEP, counseling to maximize adherence and minimize potential increases in risky behavior, and monitoring for potential drug toxicities, HIV acquisition, and antiretroviral drug resistance. Issues related to cost and insurance coverage are also discussed. Recent data suggest that PrEP, in conjunction with other prevention strategies, holds promise in helping to curtail the HIV epidemic. PMID:22821365

  5. User and Provider Acceptability of Intermittent Screening and Treatment and Intermittent Preventive Treatment with Dihydroartemisinin-Piperaquine to Prevent Malaria in Pregnancy in Western Kenya.

    Directory of Open Access Journals (Sweden)

    Jenny Hill

    Full Text Available The World Health Organization recommends intermittent preventive treatment in pregnancy (IPTp with sulphadoxine-pyrimethamine (SP alongside long-lasting insecticide-treated nets (LLIN and case management for reducing the risks associated with malaria in pregnancy in areas of moderate-to-high transmission in sub-Saharan Africa. Due to increasing Plasmodium falciparum resistance to SP, the search for alternative drugs or strategies to control malaria in pregnancy is a priority. We assessed the acceptability among pregnant women and health providers of intermittent screening and treatment (ISTp and IPTp with dihydroartemisinin-piperaquine (DP as alternative strategies in the context of an un-blinded clinical trial.Qualitative data were collected through ten focus group discussions with women participating in a randomized controlled trial to evaluate ISTp or IPTp with DP (multi-day regimen versus IPTp with SP (single dose in western Kenya. Individual in-depth interviews were conducted with 26 health providers working in the trial facilities and trial staff.Women appreciated the advantages of being tested with a rapid diagnostic test (RDT at every ANC visit (although a few women disliked finger pricks and accepted that they would not receive any antimalarial when tested RDT-negative. There were differences in women's experiences of the efficacy of antimalarials between the trial arms, with more women in the IPTp-SP arm reporting they had experienced malaria episodes. Side effects were experienced among women taking DP and SP. Although women and trial staff reported adherence to the full DP regimen within the trial, health providers were not confident that women would adhere to multi-day regimens in non-trial settings. Health providers recognized the advantages of ISTp in reducing unnecessary exposure to drugs, but lacked confidence in the reliability of RDTs compared to microscopy.Our findings indicate that, within a trial context, ISTp-DP and IPTp

  6. Enhancing implementation of tobacco use prevention and cessation counselling guideline among dental providers: a cluster randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Michie Susan

    2011-02-01

    Full Text Available Abstract Background Tobacco use adversely affects oral health. Tobacco use prevention and cessation (TUPAC counselling guidelines recommend that healthcare providers ask about each patient's tobacco use, assess the patient's readiness and willingness to stop, document tobacco use habits, advise the patient to stop, assist and help in quitting, and arrange monitoring of progress at follow-up appointments. Adherence to such guidelines, especially among dental providers, is poor. To improve guideline implementation, it is essential to understand factors influencing it and find effective ways to influence those factors. The aim of the present study protocol is to introduce a theory-based approach to diagnose implementation difficulties of TUPAC counselling guidelines among dental providers. Methods Theories of behaviour change have been used to identify key theoretical domains relevant to the behaviours of healthcare providers involved in implementing clinical guidelines. These theoretical domains will inform the development of a questionnaire aimed at assessing the implementation of the TUPAC counselling guidelines among Finnish municipal dental providers. Specific items will be drawn from the guidelines and the literature on TUPAC studies. After identifying potential implementation difficulties, we will design two interventions using theories of behaviour change to link them with relevant behaviour change techniques aiming to improve guideline adherence. For assessing the implementation of TUPAC guidelines, the electronic dental record audit and self-reported questionnaires will be used. Discussion To improve guideline adherence, the theoretical-domains approach could provide a comprehensive basis for assessing implementation difficulties, as well as designing and evaluating interventions. After having identified implementation difficulties, we will design and test two interventions to enhance TUPAC guideline adherence. Using the cluster

  7. Racial/Ethnic Differences in the Use of Primary Care Providers and Preventive Health Services at a Midwestern University.

    Science.gov (United States)

    Focella, Elizabeth S; Shaffer, Victoria A; Dannecker, Erin A; Clark, Mary J; Schopp, Laura H

    2016-06-01

    Many universities seek to improve the health and wellbeing of their faculty and staff through employer wellness programs but racial/ethnic disparities in health care use may still persist. The purpose of this research was to identify racial/ethnic disparities in the use of preventive health services at a Midwestern university. A record review was conducted of self-reported health data from University employees, examining the use of primary care and common screening procedures collected in a Personal Health Assessment conducted by the University's wellness program. Results show that there were significant racial/ethnic differences in the use of primary care and participation in screening. Notably, Asian employees in this sample were less likely to have a primary care provider and participate in routine cancer screenings. The observed racial/ethnic differences in screening behavior were mediated by the use of primary care. Together, these data show that despite equal access to care, racial and ethnic disparities in screening persist and that having a primary care provider is an important predictor of screening behavior. Results suggest that health communications designed to increase screening among specific racial/ethnic minority groups should target primary care use.

  8. Ground glass hepatocytes provide targets for therapy or prevention of hepatitis B virus-related hepatocellular carcinoma

    Directory of Open Access Journals (Sweden)

    Hong-Yi Chang

    2018-03-01

    Full Text Available Ground glass hepatocyte (GGH represents a histologic hallmark of chronic hepatitis B virus (HBV infection and is characterized by the accumulation of pre-S mutant surface antigens in the endoplasmic reticulum (ER. In the past decade, GGHs have been recognized as pre-neoplastic lesions of hepatocellular carcinoma (HCC. The accumulation of pre-S mutant protein in ER may induce a misfolded protein response or ER stress signals with activation of VEGF/Akt/mTOR and COX-2/NF-κB signals, leading to oxidative DNA damage, aneuploidy, and genomic instability. Molecular studies revealed clonal HBV DNA integration in type II GGHs which continue to express and secrete surface antigens, representing the sustained surface antigens in the serum after NA antiviral treatment. The persistence of GGHs in the liver after anti-viral therapy not only constitute the challenge to eliminate HBV infection but also carry the high risk to develop HCC. DNA chip and ELISA kit are designing to detect the pre-S mutants in serum. Novel or second generation anti-HBV drugs are under phase II development and include the combination of anti-virals, immunomodulators, agents for host DNA damage, and siRNA to target at the transcription of HBsAg gene in cccDNA or integrated HBV DNA. In the past years, we explored the possibility to provide drugs or natural agents targeting at ER stress signals in GGHs to prevent HCC development. In a transgenic mice model of pre-S mutant and HBx, a combination of silymarin and resveratrol targeting at mTOR and NF-κB signals could reduce a 80% of HCC development. In a pilot clinical trial, liposomal curcumin (Meriva® combined with anti-virals and immumodulators P1101 have been designed and attempted to eliminate the serum surface antigen and hence the recurrence of HCC after surgical resection. Therefore, the detection of pre-S mutants in serum or GGHs in the liver should provide rational target design for therapy or prevention of HCC in these high

  9. Preventing HIV among U.S. women of color with severe mental illness: perceptions of mental health care providers working in urban community clinics.

    Science.gov (United States)

    Agénor, Madina; Collins, Pamela Y

    2013-01-01

    Given their knowledge of the behavioral issues related to psychiatric illness, mental health care providers are in a unique position to help prevent HIV among women with severe mental illness (SMI). We conducted in-depth interviews with providers at two New York City community clinics. We identified three major, interrelated themes pertaining to HIV prevention among women of color with SMI. Interventions that address the barriers that clinicians face in discussing sex, sexuality, and HIV with patients and train providers in the cultural considerations of cross-cultural mental health care are needed to help prevent HIV among women of color with SMI.

  10. WHY DO YOU NEED TO USE A CARIES RISK ASSESSMENT PROTOCOL TO PROVIDE AN EFFECTIVE CARIES PREVENTIVE REGIME?

    Science.gov (United States)

    Afuakwah, Charles; Welbury, Richard

    2015-11-01

    Clinical guidelines recommend an individual is given a caries risk status based on analysis of defined clinical and social criteria before implementing a tailored preventive plan. Improve documentation of caries risk assessment (CRA) in a general dental practice setting, using a systems-based approach to quality improvement methods. Investigate the impact of quality improvement efforts on subsequent design and delivery of preventive care. Identify barriers to delivery of CRA and provision of preventive care. Data for patients aged 0-16 years was collected over two cycles using standard audit methodology. The first cycle was a retrospective analysis (n = 400) using random sampling. The second cycle a prospective analysis (n = 513) using consecutive sampling over a 15-week period. Five staff meetings with feedback occurred between cycles. In cycle one, no specific CRA system was identified. CRA status was not stated widely, risk factors were not analysed and there was variation with respect to the prescription and delivery of preventive strategies. These discrepancies were demonstrable for all four participating dentists and at all ages. In cycle two, 100% recorded CRA. All risk factors were analysed and individual caries risk was correctly annotated. There was 100% compliance with the protocol for preventive plans. The use of CRA improved documentation of caries risk status. This has improved subsequent prescription of age specific evidence-based preventive care appropriate to the risk status of that individual. Barriers were identified to the delivery of CRA and the provision of comprehensive preventive care by the dentists and other healthcare professionals.

  11. Kadav Moun PSA (:60) (Human Remains)

    Centers for Disease Control (CDC) Podcasts

    2010-02-18

    This is an important public health announcement about safety precautions for those handling human remains. Language: Haitian Creole.  Created: 2/18/2010 by Centers for Disease Control and Prevention (CDC).   Date Released: 2/18/2010.

  12. Early Childhood Interventionists' Perceptions of the Child Abuse Prevention and Treatment Act: Provider Characteristics and Organizational Climate

    Science.gov (United States)

    Herman-Smith, Robert L.

    2013-01-01

    Research Findings: A 2003 amendment to the Child Abuse Prevention and Treatment Act (CAPTA) required states to develop plans to ensure that children younger than the age of 3 years who are victims of substantiated abuse or neglect have access to developmental screenings. Programs authorized under Part C of the Individuals with Disabilities…

  13. Automated electronic reminders to prevent miscommunication among primary medical, surgical and anaesthesia providers: a root cause analysis.

    Science.gov (United States)

    Freundlich, Robert E; Grondin, Louise; Tremper, Kevin K; Saran, Kelly A; Kheterpal, Sachin

    2012-10-01

    In this case report, the authors present an adverse event possibly caused by miscommunication among three separate medical teams at their hospital. The authors then discuss the hospital's root cause analysis and its proposed solutions, focusing on the subsequent hospital-wide implementation of an automated electronic reminder for abnormal laboratory values that may have helped to prevent similar medical errors.

  14. Assessment of Critical Care Provider's Application of Preventive Measures for Ventilator-Associated Pneumonia in Intensive Care Units.

    Science.gov (United States)

    Bagheri-Nesami, Masoumeh; Amiri-Abchuyeh, Maryam; Gholipour-Baradari, Afshin; Yazdani-Cherati, Jamshid; Nikkhah, Attieh

    2015-08-01

    The implementation of guidelines for the prevention of Ventilator-associated pneumonia has been shown to have a significant effect in reducing the incidence of VAP. The aim of the present study was to evaluate the implementation of the preventive strategies for VAP in ICUs of university hospitals of Sari, Iran. This cross-sectional study was carried out in 600 beds/day in the ICUs of university hospitals of Sari from April to June 2012. Sampling was done by availability technique in patients receiving mechanical ventilation in the ICU. The implementation of the preventive measures was assessed by a standard checklist with previously approved validity and reliability. The percentage of implementing each of the measures was as follows: sterile suction, 88.44%; semi-recumbent position, 76.8%; oral hygiene, 58.45%; using heat and moisture exchanges (HMEs), 58%; controlling cuff pressure, 46.8%; hand hygiene, 32.8%; using anti-coagulants, 26.8% and physiotherapy, 25.5%. Closed suction system, continuous drainage of subglottic secretions and kinetic beds were not used at all. The overall mean percentage of implementing preventive measures was low and required designing integrated guidelines by considering the conditions of the ICUs in each country, as well as educating and encouraging the staffs to use the recommended guidelines.

  15. Falls prevention education between older adults and healthcare providers during transition from hospital to community-living

    OpenAIRE

    Lee, Den-Ching Angel

    2017-01-01

    Background: Falls are a problem for older adults. In particular, older hospitalised adults and those recently discharged from hospital have been shown to be at an increased risk of falls compared to older adults living in the community. Falls impact negatively on the physical and psychosocial well-being of older adults. They increase the burden of care for their family, caregivers and the healthcare system. However, many falls in older adults are preventable. Cochrane reviews demonstrated man...

  16. Messages on pregnancy and family planning that providers give women living with HIV in the context of a Positive Health, Dignity, and Prevention intervention in Mozambique

    Directory of Open Access Journals (Sweden)

    Hilliard S

    2014-12-01

    Full Text Available Starr Hilliard, Sarah A Gutin, Carol Dawson Rose Department of Community Health Systems, School of Nursing, University of California at San Francisco, San Francisco, CA, USA Background: Family planning is an important HIV prevention tool for women living with HIV (WLHIV. In Mozambique, the prevalence of HIV among women of reproductive age is 13.1% and the average fertility rate is high. However, family planning and reproductive health for WLHIV are under-addressed in Mozambique. This study explores provider descriptions of reproductive health messages in order to identify possible barriers and facilitators to successfully addressing family planning and pregnancy concerns of WLHIV. Methods: In 2006, a Positive Health, Dignity, and Prevention program was introduced in Mozambique focused on training health care providers to work with patients to reduce their transmission risks. Providers received training on multiple components, including family planning and prevention of mother-to-child transmission (PMTCT. In-depth interviews were conducted with 31 providers who participated in the training in five rural clinics in three provinces. Data were analyzed using qualitative content analysis. Results: Analysis showed that providers' clinical messages on family planning, pregnancy, and PMTCT for WLHIV could be arranged along a continuum. Provider statements ranged from saying that WLHIV should not become pregnant and condoms are the only valid form of family planning for WLHIV, to suggesting that WLHIV can have safe pregnancies. Conclusion: These data indicate that many providers continue to believe that WLHIV should not have children and this represents a challenge for integrating family planning into the care of WLHIV. Also, not offering WLHIV a full selection of family planning methods severely limits their ability to protect themselves from unintended pregnancies and to fully exercise their reproductive rights. Responding to the reproductive health

  17. Using Multiple Outcomes of Sexual Behavior to Provide Insights Into Chlamydia Transmission and the Effectiveness of Prevention Interventions in Adolescents.

    Science.gov (United States)

    Enns, Eva Andrea; Kao, Szu-Yu; Kozhimannil, Katy Backes; Kahn, Judith; Farris, Jill; Kulasingam, Shalini L

    2017-10-01

    Mathematical models are important tools for assessing prevention and management strategies for sexually transmitted infections. These models are usually developed for a single infection and require calibration to observed epidemiological trends in the infection of interest. Incorporating other outcomes of sexual behavior into the model, such as pregnancy, may better inform the calibration process. We developed a mathematical model of chlamydia transmission and pregnancy in Minnesota adolescents aged 15 to 19 years. We calibrated the model to statewide rates of reported chlamydia cases alone (chlamydia calibration) and in combination with pregnancy rates (dual calibration). We evaluated the impact of calibrating to different outcomes of sexual behavior on estimated input parameter values, predicted epidemiological outcomes, and predicted impact of chlamydia prevention interventions. The two calibration scenarios produced different estimates of the probability of condom use, the probability of chlamydia transmission per sex act, the proportion of asymptomatic infections, and the screening rate among men. These differences resulted in the dual calibration scenario predicting lower prevalence and incidence of chlamydia compared with calibrating to chlamydia cases alone. When evaluating the impact of a 10% increase in condom use, the dual calibration scenario predicted fewer infections averted over 5 years compared with chlamydia calibration alone [111 (6.8%) vs 158 (8.5%)]. While pregnancy and chlamydia in adolescents are often considered separately, both are outcomes of unprotected sexual activity. Incorporating both as calibration targets in a model of chlamydia transmission resulted in different parameter estimates, potentially impacting the intervention effectiveness predicted by the model.

  18. Impact of Provider Participation in ACO Programs on Preventive Care Services, Patient Experiences, and Health Care Expenditures in US Adults Aged 18-64.

    Science.gov (United States)

    Hong, Young-Rock; Sonawane, Kalyani; Larson, Samantha; Mainous, Arch G; Marlow, Nicole M

    2018-05-15

    Little is known about the impact of accountable care organization (ACO) on US adults aged 18-64. To examine whether having a usual source of care (USC) provider participating in an ACO affects receipt of preventive care services, patient experiences, and health care expenditures among nonelderly Americans. A cross-sectional analysis of the 2015 Medical Organizations Survey linked with the Medical Expenditure Panel Survey. Survey respondents aged 18-64 with an identified USC and continuous health insurance coverage during 2015. Preventative care services (routine checkup, flu vaccination, and cancer screening), patient experiences with health care (access to care, interaction quality with providers, and global satisfaction), and health care expenditures (total and out-of-pocket expenditures) for respondents with USC by ACO and non-ACO provider groups. Among 1563, nonelderly Americans having a USC, we found that nearly 62.7% [95% confidence interval (CI), 58.6%-66.7%; representing 15,722,208 Americans] were cared for by ACO providers. Our analysis showed no significant differences in preventive care services or patient experiences between ACO and non-ACO groups. Adjusted mean total health expenditures were slightly higher for the ACO than non-ACO group [$7016 (95% CI, $4949-$9914) vs. $6796 (95% CI, $4724-$9892)]; however, this difference was not statistically significant (P=0.250). Our findings suggest that having a USC provider participating in an ACO is not associated with preventive care services use, patient experiences, or health care expenditures among a nonelderly population.

  19. Pre/post evaluation of a pilot prevention with positives training program for healthcare providers in North West Province, Republic of South Africa.

    Science.gov (United States)

    Kemp, Christopher G; de Kadt, Julia; Pillay, Erushka; Gilvydis, Jennifer M; Naidoo, Evasen; Grignon, Jessica; Weaver, Marcia R

    2017-05-02

    Prevention interventions for people living with HIV/AIDS are an important component of HIV programs. We report the results of a pilot evaluation of a four-hour, clinic-based training for healthcare providers in South Africa on HIV prevention assessments and messages. This pre/post pilot evaluation examined whether the training was associated with providers delivering more prevention messages. Seventy providers were trained at four public primary care clinics with a high volume of HIV patients. Pre- and post-training patient exit surveys were conducted using Audio-Computer Assisted Structured Interviews. Seven provider appropriate messaging outcomes and one summary provider outcome were compared pre- and post-training using Poisson regression. Four hundred fifty-nine patients pre-training and 405 post-training with known HIV status were interviewed, including 175 and 176 HIV positive patients respectively. Among HIV positive patients, delivery of all appropriate messages by providers declined post-training. The summary outcome decreased from 56 to 50%; adjusted rate ratio 0.92 (95% CI = 0.87-0.97). Sensitivity analyses adjusting for training coverage and time since training detected fewer declines. Among HIV negative patients the summary score was stable at 32% pre- and post-training; adjusted rate ratio 1.05 (95% CI = 0.98-1.12). Surprisingly, this training was associated with a decrease in prevention messages delivered to HIV positive patients by providers. Limited training coverage and delays between training and post-training survey may partially account for this apparent decrease. A more targeted approach to prevention messages may be more effective.

  20. Brief Training of HIV Medical Providers Increases Their Frequency of Delivering Prevention Counselling to Patients at Risk of Transmitting HIV to Others

    Science.gov (United States)

    Patel, Shilpa N.; Marks, Gary; Gardner, Lytt; Golin, Carol E.; Shinde, Sanjyot; O'Daniels, Christine; Wilson, Tracey E.; Quinlivan, E. Byrd; Banderas, Julie W.

    2013-01-01

    Objective: The aim of this study was to examine whether brief training of human immunodeficiency virus (HIV) medical providers increased the frequency with which they routinely delivered prevention counselling to patients, and whether patient characteristics were associated with receipt of that counselling. Design: Longitudinal. Setting: Seven HIV…

  1. Knowledge, Beliefs and Practices Regarding Antiretroviral Medications for HIV Prevention: Results from a Survey of Healthcare Providers in New England.

    Directory of Open Access Journals (Sweden)

    Douglas S Krakower

    Full Text Available Antiretroviral treatment for HIV-infection before immunologic decline (early ART and pre-exposure chemoprophylaxis (PrEP can prevent HIV transmission, but routine adoption of these practices by clinicians has been limited.Between September and December 2013, healthcare practitioners affiliated with a regional AIDS Education and Training Center in New England were invited to complete online surveys assessing knowledge, beliefs and practices regarding early ART and PrEP. Multivariable models were utilized to determine characteristics associated with prescribing intentions and practices.Surveys were completed by 184 practitioners. Respondent median age was 44 years, 58% were female, and 82% were white. Among ART-prescribing clinicians (61% of the entire sample, 64% were aware that HIV treatment guidelines from the Department of Health and Human Services recommended early ART, and 69% indicated they would prescribe ART to all HIV-infected patients irrespective of immunologic status. However, 77% of ART-prescribing clinicians would defer ART for patients not ready to initiate treatment. Three-fourths of all respondents were aware of guidance from the U.S. Centers for Disease Control and Prevention recommending PrEP provision, 19% had prescribed PrEP, and 58% of clinicians who had not prescribed PrEP anticipated future prescribing. Practitioners expressed theoretical concerns and perceived practical barriers to prescribing early ART and PrEP. Clinicians with higher percentages of HIV-infected patients (aOR 1.16 per 10% increase in proportion of patients with HIV-infection, 95% CI 1.01-1.34 and infectious diseases specialists (versus primary care physicians; aOR 3.32, 95% CI 0.98-11.2 were more likely to report intentions to prescribe early ART. Higher percentage of HIV-infected patients was also associated with having prescribed PrEP (aOR 1.19, 95% CI 1.06-1.34, whereas female gender (aOR 0.26, 95% CI 0.10-0.71 was associated with having not

  2. Contribution of the private sector healthcare service providers to malaria diagnosis in a prevention of re-introduction setting.

    Science.gov (United States)

    Fernando, Sumadhya Deepika; Dharmawardana, Priyani; Epasinghe, Geethanee; Senanayake, Niroshana; Rodrigo, Chaturaka; Premaratne, Risintha; Wickremasinghe, Rajitha

    2016-10-18

    Sri Lanka is currently in the prevention of re-introduction phase of malaria. The engagement of the private sector health care institutions in malaria surveillance is important. The purpose of the study was to determine the number of diagnostic tests carried out, the number of positive cases identified and the referral system for diagnosis in the private sector and to estimate the costs involved. This prospective study of private sector laboratories within the Colombo District of Sri Lanka was carried out over a 6-month period in 2015. The management of registered private sector laboratories was contacted individually and the purpose of the study was explained. A reporting format was developed and introduced for monthly reporting. Forty-one laboratories were eligible to be included in the study and 28 participated by reporting data on a monthly basis. Excluding blood bank samples and routine testing for foreign employment, malaria diagnostic tests were carried out on 973 individuals during the 6-month period and nine malaria cases were identified. In 2015, a total of 36 malaria cases were reported from Sri Lanka. Of these, 24 (67 %) were diagnosed in the Colombo District and 50 % of them were diagnosed in private hospitals. An equal number of cases were diagnosed from the private sector and government sector in the Colombo District in 2015. The private sector being a major contributor in the detection of imported malaria cases in the country should be actively engaged in the national malaria surveillance system.

  3. Assessing healthcare providers' knowledge and practices relating to insecticide-treated nets and the prevention of malaria in Ghana, Laos, Senegal and Tanzania

    OpenAIRE

    Hoffman, Steven J; Guindon, G Emmanuel; Lavis, John N; Ndossi, Godwin D; Osei, Eric JA; Sidibe, Mintou Fall; Boupha, Boungnong

    2011-01-01

    Abstract Background Research evidence is not always being disseminated to healthcare providers who need it to inform their clinical practice. This can result in the provision of ineffective services and an inefficient use of resources, the implications of which might be felt particularly acutely in low- and middle-income countries. Malaria prevention is a particularly compelling domain to study evidence/practice gaps given the proven efficacy, cost-effectiveness and disappointing utilization ...

  4. Forensic considerations when dealing with incinerated human dental remains.

    Science.gov (United States)

    Reesu, Gowri Vijay; Augustine, Jeyaseelan; Urs, Aadithya B

    2015-01-01

    Establishing the human dental identification process relies upon sufficient post-mortem data being recovered to allow for a meaningful comparison with ante-mortem records of the deceased person. Teeth are the most indestructible components of the human body and are structurally unique in their composition. They possess the highest resistance to most environmental effects like fire, desiccation, decomposition and prolonged immersion. In most natural as well as man-made disasters, teeth may provide the only means of positive identification of an otherwise unrecognizable body. It is imperative that dental evidence should not be destroyed through erroneous handling until appropriate radiographs, photographs, or impressions can be fabricated. Proper methods of physical stabilization of incinerated human dental remains should be followed. The maintenance of integrity of extremely fragile structures is crucial to the successful confirmation of identity. In such situations, the forensic dentist must stabilise these teeth before the fragile remains are transported to the mortuary to ensure preservation of possibly vital identification evidence. Thus, while dealing with any incinerated dental remains, a systematic approach must be followed through each stage of evaluation of incinerated dental remains to prevent the loss of potential dental evidence. This paper presents a composite review of various studies on incinerated human dental remains and discusses their impact on the process of human identification and suggests a step by step approach. Copyright © 2014 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

  5. And the Dead Remain Behind

    Directory of Open Access Journals (Sweden)

    Peter Read

    2013-08-01

    Full Text Available In most cultures the dead and their living relatives are held in a dialogic relationship. The dead have made it clear, while living, what they expect from their descendants. The living, for their part, wish to honour the tombs of their ancestors; at the least, to keep the graves of the recent dead from disrepair. Despite the strictures, the living can fail their responsibilities, for example, by migration to foreign countries. The peripatetic Chinese are one of the few cultures able to overcome the dilemma of the wanderer or the exile. With the help of a priest, an Australian Chinese migrant may summon the soul of an ancestor from an Asian grave to a Melbourne temple, where the spirit, though removed from its earthly vessel, will rest and remain at peace. Amongst cultures in which such practices are not culturally appropriate, to fail to honour the family dead can be exquisitely painful. Violence is the cause of most failure.

  6. Red Assembly: the work remains

    Directory of Open Access Journals (Sweden)

    Leslie Witz

    installed. What to do at this limit, at the transgressive encounter between saying yes and no to history, remains the challenge. It is the very challenge of what insistently remains.

  7. An Online Health Prevention Intervention for Youth with Addicted or Mentally Ill Parents: Experiences and Perspectives of Participants and Providers from a Randomized Controlled Trial.

    Science.gov (United States)

    Woolderink, Marla; Bindels, Jill A P M; Evers, Silvia M A A; Paulus, Aggie T G; van Asselt, Antoinette D I; van Schayck, Onno C P

    2015-12-02

    Mental illnesses affect many people around the world, either directly or indirectly. Families of persons suffering from mental illness or addiction suffer too, especially their children. In the Netherlands, 864,000 parents meet the diagnostic criteria for a mental illness or addiction. Evidence shows that offspring of mentally ill or addicted parents are at risk for developing mental disorders or illnesses themselves. The Kopstoring course is an online 8-week group course with supervision by 2 trained psychologists or social workers, aimed to prevent behavioral and psychological problems for children (aged 16 to 25 years) of parents with mental health problems or addictions. The course addresses themes such as roles in the family and mastery skills. An online randomized controlled trial (RCT) was conducted to assess the effectiveness of the Kopstoring course. The aim was to gain knowledge about expectations, experiences, and perspectives of participants and providers of the online Kopstoring course. A process evaluation was performed to evaluate the online delivery of Kopstoring and the experiences and perspectives of participants and providers of Kopstoring. Interviews were performed with members from both groups. Participants were drawn from a sample from the Kopstoring RCT. Thirteen participants and 4 providers were interviewed. Five main themes emerged from these interviews: background, the requirements for the intervention, experience with the intervention, technical aspects, and research aspects. Overall, participants and providers found the intervention to be valuable because it was online; therefore, protecting their anonymity was considered a key component. Most barriers existed in the technical sphere. Additional barriers existed with conducting the RCT, namely gathering informed consent and gathering parental consent in the case of minors. This study provides valuable insight into participants' and providers' experiences and expectations with the online

  8. Green business will remain green

    International Nuclear Information System (INIS)

    Marcan, P.

    2008-01-01

    It all started with two words. Climate change. The carbon dioxide trading scheme, which was the politicians' idea on solving the number one global problem, followed. Four years ago, when the project was begun, there was no data for project initiation. Quotas for polluters mainly from energy production and other energy demanding industries were distributed based on spreadsheets, maximum output and expected future development of economies. Slovak companies have had a chance to profit from these arrangements since 2005. Many of them took advantage of the situation and turned the excessive quotas into an extraordinary profit which often reached hundreds of million Sk. The fact that the price of free quotas offered for sale dropped basically to 0 in 2006 only proved that the initial distribution was too generous. And the market reacted to the first official measurements of emissions. Slovak companies also contributed to this development. However, when planning the maximum emission volumes for 2008-2012 period, in spite of the fact that actual data were available, their expectations were not realistic. A glance at the figures in the proposal of the Ministry of Environment is sufficient to realize that there will be no major change in the future. And so for many Slovak companies business with a green future will remain green for the next five years. The state decided to give to selected companies even more free space as far as emissions are concerned. The most privileged companies can expect quotas increased by tens of percent. (author)

  9. Evaluation of a theory-driven e-learning intervention for future oral healthcare providers on secondary prevention of disordered eating behaviors.

    Science.gov (United States)

    DeBate, Rita D; Severson, Herbert H; Cragun, Deborah L; Gau, Jeff M; Merrell, Laura K; Bleck, Jennifer R; Christiansen, Steve; Koerber, Anne; Tomar, Scott L; McCormack Brown, Kelli R; Tedesco, Lisa A; Hendricson, William

    2013-06-01

    Oral healthcare providers have a clinical opportunity for early detection of disordered eating behaviors because they are often the first health professionals to observe overt oral and physical signs. Curricula regarding early recognition of this oral/systemic medical condition are limited in oral health educational programs. Web-based learning can supplement and reinforce traditional learning and has the potential to develop skills. The study purpose was to determine the efficacy of a theory-driven Web-based training program to increase the capacity of oral health students to perform behaviors related to the secondary prevention of disordered eating behaviors. Using the Reach, Effectiveness, Adoption, Implementation and Maintenance evaluation framework, a longitudinal group-randomized controlled trial involving 27 oral health classes from 12 oral health education programs in the United States was implemented to assess the efficacy of the Web-based training on attitudes, knowledge, self-efficacy and skills related to the secondary prevention of disordered eating behaviors. Mixed-model analysis of covariance indicated substantial improvements among students in the intervention group (effect sizes: 0.51-0.83) on all six outcomes of interest. Results suggest that the Web-based training program may increase the capacity of oral healthcare providers to deliver secondary prevention of disordered eating behaviors. Implications and value of using the Reach, Effectiveness, Adoption, Implementation and Maintenance framework are discussed.

  10. Assessing healthcare providers' knowledge and practices relating to insecticide-treated nets and the prevention of malaria in Ghana, Laos, Senegal and Tanzania

    Directory of Open Access Journals (Sweden)

    Hoffman Steven J

    2011-12-01

    Full Text Available Abstract Background Research evidence is not always being disseminated to healthcare providers who need it to inform their clinical practice. This can result in the provision of ineffective services and an inefficient use of resources, the implications of which might be felt particularly acutely in low- and middle-income countries. Malaria prevention is a particularly compelling domain to study evidence/practice gaps given the proven efficacy, cost-effectiveness and disappointing utilization of insecticide-treated nets (ITNs. Methods This study compares what is known about ITNs to the related knowledge and practices of healthcare providers in four low- and middle-income countries. A new questionnaire was developed, pilot tested, translated and administered to 497 healthcare providers in Ghana (140, Laos (136, Senegal (100 and Tanzania (121. Ten questions tested participants' knowledge and clinical practice related to malaria prevention. Additional questions addressed their individual characteristics, working context and research-related activities. Ordinal logistic regressions with knowledge and practices as the dependent variable were conducted in addition to descriptive statistics. Results The survey achieved a 75% response rate (372/497 across Ghana (107/140, Laos (136/136, Senegal (51/100 and Tanzania (78/121. Few participating healthcare providers correctly answered all five knowledge questions about ITNs (13% or self-reported performing all five clinical practices according to established evidence (2%. Statistically significant factors associated with higher knowledge within each country included: 1 training in acquiring systematic reviews through the Cochrane Library (OR 2.48, 95% CI 1.30-4.73; and 2 ability to read and write English well or very well (OR 1.69, 95% CI 1.05-2.70. Statistically significant factors associated with better clinical practices within each country include: 1 reading scientific journals from their own country (OR

  11. Assessing healthcare providers' knowledge and practices relating to insecticide-treated nets and the prevention of malaria in Ghana, Laos, Senegal and Tanzania.

    Science.gov (United States)

    Hoffman, Steven J; Guindon, G Emmanuel; Lavis, John N; Ndossi, Godwin D; Osei, Eric J A; Sidibe, Mintou Fall; Boupha, Boungnong

    2011-12-13

    Research evidence is not always being disseminated to healthcare providers who need it to inform their clinical practice. This can result in the provision of ineffective services and an inefficient use of resources, the implications of which might be felt particularly acutely in low- and middle-income countries. Malaria prevention is a particularly compelling domain to study evidence/practice gaps given the proven efficacy, cost-effectiveness and disappointing utilization of insecticide-treated nets (ITNs). This study compares what is known about ITNs to the related knowledge and practices of healthcare providers in four low- and middle-income countries. A new questionnaire was developed, pilot tested, translated and administered to 497 healthcare providers in Ghana (140), Laos (136), Senegal (100) and Tanzania (121). Ten questions tested participants' knowledge and clinical practice related to malaria prevention. Additional questions addressed their individual characteristics, working context and research-related activities. Ordinal logistic regressions with knowledge and practices as the dependent variable were conducted in addition to descriptive statistics. The survey achieved a 75% response rate (372/497) across Ghana (107/140), Laos (136/136), Senegal (51/100) and Tanzania (78/121). Few participating healthcare providers correctly answered all five knowledge questions about ITNs (13%) or self-reported performing all five clinical practices according to established evidence (2%). Statistically significant factors associated with higher knowledge within each country included: 1) training in acquiring systematic reviews through the Cochrane Library (OR 2.48, 95% CI 1.30-4.73); and 2) ability to read and write English well or very well (OR 1.69, 95% CI 1.05-2.70). Statistically significant factors associated with better clinical practices within each country include: 1) reading scientific journals from their own country (OR 1.67, 95% CI 1.10-2.54); 2) working

  12. Silicon photonics: some remaining challenges

    Science.gov (United States)

    Reed, G. T.; Topley, R.; Khokhar, A. Z.; Thompson, D. J.; Stanković, S.; Reynolds, S.; Chen, X.; Soper, N.; Mitchell, C. J.; Hu, Y.; Shen, L.; Martinez-Jimenez, G.; Healy, N.; Mailis, S.; Peacock, A. C.; Nedeljkovic, M.; Gardes, F. Y.; Soler Penades, J.; Alonso-Ramos, C.; Ortega-Monux, A.; Wanguemert-Perez, G.; Molina-Fernandez, I.; Cheben, P.; Mashanovich, G. Z.

    2016-03-01

    This paper discusses some of the remaining challenges for silicon photonics, and how we at Southampton University have approached some of them. Despite phenomenal advances in the field of Silicon Photonics, there are a number of areas that still require development. For short to medium reach applications, there is a need to improve the power consumption of photonic circuits such that inter-chip, and perhaps intra-chip applications are viable. This means that yet smaller devices are required as well as thermally stable devices, and multiple wavelength channels. In turn this demands smaller, more efficient modulators, athermal circuits, and improved wavelength division multiplexers. The debate continues as to whether on-chip lasers are necessary for all applications, but an efficient low cost laser would benefit many applications. Multi-layer photonics offers the possibility of increasing the complexity and effectiveness of a given area of chip real estate, but it is a demanding challenge. Low cost packaging (in particular, passive alignment of fibre to waveguide), and effective wafer scale testing strategies, are also essential for mass market applications. Whilst solutions to these challenges would enhance most applications, a derivative technology is emerging, that of Mid Infra-Red (MIR) silicon photonics. This field will build on existing developments, but will require key enhancements to facilitate functionality at longer wavelengths. In common with mainstream silicon photonics, significant developments have been made, but there is still much left to do. Here we summarise some of our recent work towards wafer scale testing, passive alignment, multiplexing, and MIR silicon photonics technology.

  13. The Relationship of Repeated Technical Assistance Support Visits to the Delivery of Positive Health, Dignity, and Prevention (PHDP) Messages by Healthcare Providers in Mozambique: A Longitudinal Multilevel Analysis.

    Science.gov (United States)

    Gutin, Sarah A; Amico, K Rivet; Hunguana, Elsa; Munguambe, António Orlando; Rose, Carol Dawson

    Positive health, dignity, and prevention (PHDP) is Mozambique's strategy to engage clinicians in the delivery of prevention messages to their HIV-positive clients. This national implementation strategy uses provider trainings on offering key messages and focuses on intervening on 9 evidence-based risk reduction areas. We investigated the impact of longitudinal technical assistance (TA) as an addition to this basic training. We followed 153 healthcare providers in 5 Mozambican provinces over 6 months to evaluate the impact of on-site, observation-based TA on PHDP implementation. Longitudinal multilevel models were estimated to model change in PHDP message delivery over time among individual providers. With each additional TA visit, providers delivered about 1 additional PHDP message ( P < .001); clinicians and nonclinicians started at about the same baseline level, but clinicians improved more quickly ( P = .004). Message delivery varied by practice sector; maternal and child health sectors outperformed other sectors. Longitudinal TA helped reach the programmatic goals of the PHDP program in Mozambique.

  14. Remain stable.; Schoen stabil bleiben.

    Energy Technology Data Exchange (ETDEWEB)

    Teroerde, Michael; Schulz, Detlef [Helmut-Schmidt-Univ., Hamburg (Germany). Professur fuer Elektrische Energiesysteme; Eckoldt, Hans-Joerg [Deutsches Elektronen-Synchrotron (DESY), Hamburg (Germany). Fachgebiet Magnetstromversorgung

    2013-11-15

    In the German power grid the increasing photovoltaic power plants and wind turbines provide due to their volatile energy supply high demands on the control of the power grid. In the case of malfunctions in the network short-term energy storage could participate in the grid control. Superconducting magnetic energy storage (SMES) belongs to the efficient short-term energy storage. A SMES system was investigated at DESY in Hamburg. [German] Im deutschen Stromnetz stellen die zunehmenden Photovoltaik- und Windkraftanlagen aufgrund ihrer stark schwankenden Energieeinspeisung hohe Anforderungen an die Regelung des Stromnetzes. Bei eventuell auftretenden Stoerungen im Netz koennten Kurzzeitenergiespeicher an der Netzregelung teilnehmen. Zu den effizienten Kurzzeitspeichern gehoeren supraleitende magnetische Energiespeicher (SMES). Ein SMES-System wurde bei DESY in Hamburg untersucht.

  15. The experiences of clients and healthcare providers regarding the provision of reproductive health services including the prevention of HIV and AIDS in an informal settlement in Tshwane

    Directory of Open Access Journals (Sweden)

    M. L.S. Mataboge

    2016-10-01

    Full Text Available Globally challenges regarding healthcare provision are sometimes related to a failure to estimate client numbers in peri-urban areas due to rapid population growth. About one-sixth of the world's population live in informal settlements which are mostly characterised by poor healthcare service provision. Poor access to primary healthcare may expose residents of informal settlement more to the human immunodeficiency virus (HIV and to acquired immunodeficiency syndrome (AIDS than their rural and urban counterparts due to a lack of access to information on prevention, early diagnosis and treatment. The objective of this study was to explore and describe the experiences of both the reproductive health services' clients and the healthcare providers with regard to the provision of reproductive health services including the prevention of HIV and AIDS in a primary healthcare setting in Tshwane. A qualitative, exploratory and contextual design using a phenomenological approach to enquire about the participants' experiences was implemented. Purposive sampling resulted in the selection of 23 clients who used the reproductive healthcare services and ten healthcare providers who were interviewed during individual and focus group interviews respectively. Tesch's method for qualitative data analysis was used. Ethical principles guided the study, and certain strategies were followed to ensure trustworthiness. The findings revealed that females who lived in informal settlements were aware of the inability of the PHC setting to provide adequate reproductive healthcare to meet their needs. The HCPs acknowledged that healthcare provision was negatively affected by policies. It was found that the community members could be taught how to coach teenagers and support each other in order to bridge staff shortages and increase health outcomes including HIV/AIDS prevention.

  16. The experiences of clients and healthcare providers regarding the provision of reproductive health services including the prevention of HIV and AIDS in an informal settlement in Tshwane

    Directory of Open Access Journals (Sweden)

    M.L.S. Mataboge

    2016-12-01

    Full Text Available Globally challenges regarding healthcare provision are sometimes related to a failure to estimate client numbers in peri-urban areas due to rapid population growth. About one-sixth of the world's population live in informal settlements which are mostly characterised by poor healthcare service provision. Poor access to primary healthcare may expose residents of informal settlement more to the human immunodeficiency virus (HIV and to acquired immunodeficiency syndrome (AIDS than their rural and urban counterparts due to a lack of access to information on prevention, early diagnosis and treatment. The objective of this study was to explore and describe the experiences of both the reproductive health services' clients and the healthcare providers with regard to the provision of reproductive health services including the prevention of HIV and AIDS in a primary healthcare setting in Tshwane. A qualitative, exploratory and contextual design using a phenomenological approach to enquire about the participants' experiences was implemented. Purposive sampling resulted in the selection of 23 clients who used the reproductive healthcare services and ten healthcare providers who were interviewed during individual and focus group interviews respectively. Tesch's method for qualitative data analysis was used. Ethical principles guided the study, and certain strategies were followed to ensure trustworthiness. The findings revealed that females who lived in informal settlements were aware of the inability of the PHC setting to provide adequate reproductive healthcare to meet their needs. The HCPs acknowledged that healthcare provision was negatively affected by policies. It was found that the community members could be taught how to coach teenagers and support each other in order to bridge staff shortages and increase health outcomes including HIV/AIDS prevention.

  17. HIV providers' likelihood to prescribe pre-exposure prophylaxis (PrEP) for HIV prevention differs by patient type: a short report.

    Science.gov (United States)

    Adams, Leah M; Balderson, Benjamin H

    2016-09-01

    Pre-exposure prophylaxis (PrEP), the antiretroviral treatment regimen for HIV-negative people at high risk of acquiring HIV, has demonstrated efficacy across clinical trials in several patient populations. The Centers for Disease Control (CDC) have released detailed guidelines to aid providers in prescribing PrEP for their high-risk patients, including men who have sex with men (MSM), high-risk heterosexuals, and injection drug users (IDUs). Given that much attention in PrEP has focused on MSM patients, the present study used an online survey to assess factors involved in HIV care providers' (n = 363) decisions about prescribing PrEP, along with their willingness to prescribe PrEP to patients from various risk populations (e.g., MSM, heterosexuals, IDUs). The efficacy of PrEP was an important factor in providers' decisions about prescribing PrEP, as were considerations about patients' adherence to the regimen, regular follow-up for care, and medication costs. This survey's findings also suggest that providers' willingness to prescribe PrEP varies by patient group, with providers most willing to initiate the regimen with MSM who have an HIV-positive partner, and least willing to prescribe to high-risk heterosexuals or IDUs. In the context of the current CDC recommendations for PrEP that include MSM, heterosexuals, and IDUs, examining providers' rationales for and barriers against supporting this HIV prevention strategy across patient groups merits further attention.

  18. Survey of women's perceptions of information provided in the prevention or treatment of iron deficiency anaemia in an Australian tertiary obstetric hospital.

    Science.gov (United States)

    Vosnacos, Emma; Pinchon, Deborah J

    2015-06-01

    There is limited literature to understand the perceptions of Australian women regarding the information provided by healthcare professionals relating to the prevention and treatment of iron deficiency anaemia in pregnancy. To establish an insight into the key themes and trends within a tertiary obstetric hospital related to the provision of dietary advice and use of iron supplements in pregnancy. A prospective patient survey of pregnant women and women up to 4 weeks postnatal attending hospital. Of the 110 women who participated, 73.6% were provided with information on iron rich foods and 67% made dietary changes. Eighty percent of women were advised to take oral iron and 65.5% of women were taking it at the time of the survey. In women who had independently ceased oral iron, 41.7% failed to inform their healthcare professional. In the women who did inform their healthcare professional 89.5% received advice to help overcome the reason that led to cessation. The main causes included forgetfulness and side effects. Women were less likely to require intravenous iron if oral iron was commenced early. Compliance with recommended oral iron is variable within a population of pregnant women. Women are provided with information on a range of issues relating to the prevention and treatment of iron deficiency anaemia; yet there is a disparity between the information provided and the resulting action. Further research should focus on targeted measures to improve understanding and compliance with treatment from the both women's and health professionals perspective. Crown Copyright © 2014. Published by Elsevier Ltd. All rights reserved.

  19. A qualitative study of provider thoughts on implementing pre-exposure prophylaxis (PrEP in clinical settings to prevent HIV infection.

    Directory of Open Access Journals (Sweden)

    Emily A Arnold

    Full Text Available A recent clinical trial demonstrated that a daily dose tenofovir disoproxil fumarate and emtricitabrine (TDF-FTC can reduce HIV acquisition among men who have sex with men (MSM and transgender (TG women by 44%, and up to 90% if taken daily. We explored how medical and service providers understand research results and plan to develop clinical protocols to prescribe, support and monitor adherence for patients on PrEP in the United States.Using referrals from our community collaborators and snowball sampling, we recruited 22 healthcare providers in San Francisco, Oakland, and Los Angeles for in-depth interviews from May-December 2011. The providers included primary care physicians seeing high numbers of MSM and TG women, HIV specialists, community health clinic providers, and public health officials. We analyzed interviews thematically to produce recommendations for setting policy around implementing PrEP. Interview topics included: assessing clinician impressions of PrEP and CDC guidance, considerations of cost, office capacity, dosing schedules, and following patients over time.Little or no demand for PrEP from patients was reported at the time of the interviews. Providers did not agree on the most appropriate patients for PrEP and believed that current models of care, which do not involve routine frequent office visits, were not well suited for prescribing PrEP. Providers detailed the need to build capacity and were concerned about monitoring side effects and adherence. PrEP was seen as potentially having impact on the epidemic but providers also noted that community education campaigns needed to be tailored to effectively reach specific vulnerable populations.While PrEP may be a novel and clinically compelling prevention intervention for MSM and TG women, it raises a number of important implementation challenges that would need to be addressed. Nonetheless, most providers expressed optimism that they eventually could prescribe and monitor Pr

  20. A qualitative study of provider thoughts on implementing pre-exposure prophylaxis (PrEP) in clinical settings to prevent HIV infection.

    Science.gov (United States)

    Arnold, Emily A; Hazelton, Patrick; Lane, Tim; Christopoulos, Katerina A; Galindo, Gabriel R; Steward, Wayne T; Morin, Stephen F

    2012-01-01

    A recent clinical trial demonstrated that a daily dose tenofovir disoproxil fumarate and emtricitabrine (TDF-FTC) can reduce HIV acquisition among men who have sex with men (MSM) and transgender (TG) women by 44%, and up to 90% if taken daily. We explored how medical and service providers understand research results and plan to develop clinical protocols to prescribe, support and monitor adherence for patients on PrEP in the United States. Using referrals from our community collaborators and snowball sampling, we recruited 22 healthcare providers in San Francisco, Oakland, and Los Angeles for in-depth interviews from May-December 2011. The providers included primary care physicians seeing high numbers of MSM and TG women, HIV specialists, community health clinic providers, and public health officials. We analyzed interviews thematically to produce recommendations for setting policy around implementing PrEP. Interview topics included: assessing clinician impressions of PrEP and CDC guidance, considerations of cost, office capacity, dosing schedules, and following patients over time. Little or no demand for PrEP from patients was reported at the time of the interviews. Providers did not agree on the most appropriate patients for PrEP and believed that current models of care, which do not involve routine frequent office visits, were not well suited for prescribing PrEP. Providers detailed the need to build capacity and were concerned about monitoring side effects and adherence. PrEP was seen as potentially having impact on the epidemic but providers also noted that community education campaigns needed to be tailored to effectively reach specific vulnerable populations. While PrEP may be a novel and clinically compelling prevention intervention for MSM and TG women, it raises a number of important implementation challenges that would need to be addressed. Nonetheless, most providers expressed optimism that they eventually could prescribe and monitor PrEP in their

  1. Prevention-of-Mother-To-Child-Transmission of HIV Services in Sub-Saharan Africa: A Qualitative Analysis of Healthcare Providers and Clients Challenges in Ghana

    Directory of Open Access Journals (Sweden)

    Amos Kankponang Laar, PhD

    2014-09-01

    Full Text Available Background: Developed by the World Health Organization (WHO and partners, the correct adaptation and implementation of the global guidelines on prevention of mother-to-child transmission (PMTCT of HIV is critical. This study explored the challenges that health workers face implementing WHO’s PMTCT guidelines, and the experiences of HIV-positive clients receiving these services. Methods: We interacted with 14 health professionals, and 16 PMTCT clients through in-depth interviews. Four of seven PMTCT sites within the Accra Metropolis were purposively included. Interviews were tape-recorded, transcribed, analyzed, and then sorted into themes. Results: Health workers had challenges translating PMTCT guidelines into useful messages for their clients. Their counselling was often prescriptive. Counselors identified inadequate in-service training as a key reason for their outdated and inconsistent messages. HIV-positive clients exhibited general knowledge about the importance of doing exclusive breast-feeding for the first six months of life. Clients had confidence in antiretroviral for PMTCT. However, deeply rooted socio-cultural practices and the attitudes of counselors remain challenges to clients. Conclusions and Global Health Implications: Counselors require refresher training which addresses, among other things, long-held socio-cultural practices. Publicizing these challenges will prod policy makers and program implementers to develop strategies that address the challenges both locally and globally.

  2. Preventing falls in older multifocal glasses wearers by providing single-lens distance glasses: the protocol for the VISIBLE randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Lee Bonsan B

    2009-03-01

    Full Text Available Abstract Background Recent research has shown that wearing multifocal glasses increases the risk of trips and falls in older people. The aim of this study is to determine whether the provision of single-lens distance glasses to older multifocal glasses wearers, with recommendations for wearing them for walking and outdoor activities, can prevent falls. We will also measure the effect of the intervention on health status, lifestyle activities and fear of falling, as well as the extent of adherence to the program. Methods/Design Approximately 580 older people who are regular wearers of multifocal glasses people will be recruited. Participants will be randomly allocated to either an intervention group (provision of single lens glasses, with counselling and advice about appropriate use or a control group (usual care. The primary outcome measure will be falls (measured with 13 monthly calendars. Secondary measures will be quality of life, falls efficacy, physical activity levels and adverse events. Discussions The study will determine the impact of providing single-lens glasses, with advice about appropriate use, on preventing falls in older regular wearers of multifocal glasses. This pragmatic intervention, if found to be effective, will guide practitioners with regard to recommending appropriate glasses for minimising the risk of falls in older people. Trial Registration The protocol for this study was registered with the Clinical Trials.gov Protocol Registration System on June 7th 2006 (#350855.

  3. Job satisfaction and turnover intentions among health care staff providing services for prevention of mother-to-child transmission of HIV in Dar es Salaam, Tanzania.

    Science.gov (United States)

    Naburi, Helga; Mujinja, Phares; Kilewo, Charles; Orsini, Nicola; Bärnighausen, Till; Manji, Karim; Biberfeld, Gunnel; Sando, David; Geldsetzer, Pascal; Chalamila, Guerino; Ekström, Anna Mia

    2017-09-06

    Option B+ for the prevention of mother-to-child transmission (PMTCT) of HIV (i.e., lifelong antiretroviral treatment for all pregnant and breastfeeding mothers living with HIV) was initiated in Tanzania in 2013. While there is evidence that this policy has benefits for the health of the mother and the child, Option B+ may also increase the workload for health care providers in resource-constrained settings, possibly leading to job dissatisfaction and unwanted workforce turnover. From March to April 2014, a questionnaire asking about job satisfaction and turnover intentions was administered to all nurses at 36 public-sector health facilities offering antenatal and PMTCT services in Dar es Salaam, Tanzania. Multivariable logistic regression models were used to identify factors associated with job dissatisfaction and intention to quit one's job. Slightly over half (54%, 114/213) of the providers were dissatisfied with their current job, and 35% (74/213) intended to leave their job. Most of the providers were dissatisfied with low salaries and high workload, but satisfied with workplace harmony and being able to follow their moral values. The odds of reporting to be globally dissatisfied with one's job were high if the provider was dissatisfied with salary (adjusted odds ratio (aOR) 5.6, 95% CI 1.2-26.8), availability of protective gear (aOR 4.0, 95% CI 1.5-10.6), job description (aOR 4.3, 95% CI 1.2-14.7), and working hours (aOR 3.2, 95% CI 1.3-7.6). Perceiving clients to prefer PMTCT Option B+ reduced job dissatisfaction (aOR 0.2, 95% CI 0.1-0.8). The following factors were associated with providers' intention to leave their current job: job stability dissatisfaction (aOR 3.7, 95% CI 1.3-10.5), not being recognized by one's superior (aOR 3.6, 95% CI 1.7-7.6), and poor feedback on the overall unit performance (aOR 2.7, 95% CI 1.3-5.8). Job dissatisfaction and turnover intentions are comparatively high among nurses in Dar es Salaam's public-sector maternal care

  4. Bolivian health providers' attitudes toward alternative technologies for cervical cancer prevention: a focus on visual inspection with acetic acid and cryotherapy.

    Science.gov (United States)

    Stormo, Analía Romina; Altamirano, Victor Conde; Pérez-Castells, Macarena; Espey, David; Padilla, Haydee; Panameño, Karen; Soria, Milton; Santos, Carlos; Saraiya, Mona; Luciani, Silvana

    2012-08-01

    Little is known about health providers' attitudes toward visual inspection with acetic acid (VIA) and cryotherapy in the prevention of cervical cancer, as most research in Latin America and the Caribbean (LAC) has examined attitudes of the general population. This study describes attitudes of Bolivian health professionals toward new technologies for cervical cancer prevention, focusing on VIA and cryotherapy. Between February 2011 and March 2012, we surveyed 7 nurses and 35 physicians who participated in 5-day workshops on VIA and cryotherapy conducted in Bolivia. Multiple choice and open-ended questions were used to assess participants' acceptability of these procedures and the feasibility of their implementation in the context of perceived barriers for the early detection of cervical cancer in this country. Most believed that cultural factors represent the main barrier for the early detection of cervical cancer (70%), although all stated that VIA and cryotherapy would be accepted by women, citing the advantages of VIA over cytology for this belief. Most also believed their colleagues would accept VIA and cryotherapy (71%) and that VIA should replace Pap testing (61%), reiterating the advantages of VIA for these beliefs. Those who believed the contrary expressed a general resistance to change associated with an already existing cytology program and national norms prioritizing Pap testing. Most participants had favorable attitudes toward VIA and cryotherapy; however, a sizable minority cited challenges to their adoption by colleagues and believed VIA should not replace cytology. This report can inform the development of strategies to expand the use of alternative cervical cancer screening methods in LAC and Bolivia.

  5. Does hypertension remain after kidney transplantation?

    Directory of Open Access Journals (Sweden)

    Gholamreza Pourmand

    2015-05-01

    Full Text Available Hypertension is a common complication of kidney transplantation with the prevalence of 80%. Studies in adults have shown a high prevalence of hypertension (HTN in the first three months of transplantation while this rate is reduced to 50- 60% at the end of the first year. HTN remains as a major risk factor for cardiovascular diseases, lower graft survival rates and poor function of transplanted kidney in adults and children. In this retrospective study, medical records of 400 kidney transplantation patients of Sina Hospital were evaluated. Patients were followed monthly for the 1st year, every two months in the 2nd year and every three months after that. In this study 244 (61% patients were male. Mean ± SD age of recipients was 39.3 ± 13.8 years. In most patients (40.8% the cause of end-stage renal disease (ESRD was unknown followed by HTN (26.3%. A total of 166 (41.5% patients had been hypertensive before transplantation and 234 (58.5% had normal blood pressure. Among these 234 individuals, 94 (40.2% developed post-transplantation HTN. On the other hand, among 166 pre-transplant hypertensive patients, 86 patients (56.8% remained hypertensive after transplantation. Totally 180 (45% patients had post-transplantation HTN and 220 patients (55% didn't develop HTN. Based on the findings, the incidence of post-transplantation hypertension is high, and kidney transplantation does not lead to remission of hypertension. On the other hand, hypertension is one of the main causes of ESRD. Thus, early screening of hypertension can prevent kidney damage and reduce further problems in renal transplant recipients.

  6. Cultural barriers to effective communication between Indigenous communities and health care providers in Northern Argentina: an anthropological contribution to Chagas disease prevention and control.

    Science.gov (United States)

    Dell'Arciprete, Ana; Braunstein, José; Touris, Cecilia; Dinardi, Graciela; Llovet, Ignacio; Sosa-Estani, Sergio

    2014-01-29

    Ninety percent of the aboriginal communities of Argentina are located in areas of endemic vectorial transmission of Chagas disease. Control activities in these communities have not been effective. The goal of this research was to explore the role played by beliefs, habits, and practices of Pilaga and Wichi indigenous communities in their interaction with the local health system in the province of Formosa. This article contributes to the understanding of the cultural barriers that affect the communication process between indigenous peoples and their health care providers. Twenty-nine open ended interviews were carried out with members of four indigenous communities (Pilaga and Wichi) located in central Formosa. These interviews were used to describe and compare these communities' approach to health and disease as they pertain to Chagas as well as their perceptions of Western medicine and its incarnation in local health practice. Five key findings are presented: 1) members of these communities tend to see disease as caused by other people or by the person's violation of taboos instead of as a biological process; 2) while the Pilaga are more inclined to accept Western medicine, the Wichi often favour the indigenous approach to health care over the Western approach; 3) members of these communities do not associate the vector with the transmission of the disease and they have little awareness of the need for vector control activities; 4) indigenous individuals who undergo diagnostic tests and accept treatment often do so without full information and knowledge; 5) the clinical encounter is rife with conflict between the expectations of health care providers and those of members of these communities. Our analysis suggests that there is a need to consider the role of the cultural patterning of health and disease when developing interventions to prevent and control Chagas disease among indigenous communities in Northern Argentina. This is especially important when

  7. The Development of a Community-Based, Pharmacist-Provided Falls Prevention MTM Intervention for Older Adults: Relationship Building, Methods, and Rationale

    Directory of Open Access Journals (Sweden)

    David A. Mott

    2014-01-01

    Full Text Available The objectives of this article are to discuss the process of community engagement experienced to plan and implement a pilot study of a pharmacist-provided MTM intervention focused on reducing the use of medications associated with falling, and to present the research methods that emerged from the community engagement process to evaluate the feasibility, acceptance, and preliminary impact of the intervention. Key lessons learned from the community engagement process also are presented and discussed. The relationship building and planning process took twelve months. The RE-AIM framework broadly guided the planning process since an overarching goal for the community partners was developing a program that could be implemented and sustained in the future. The planning phase focused on identifying research questions that were of most interest to the community partners, the population to study, the capacity of partners to perform activities, and process evaluation. Much of the planning phase was accomplished with face-to-face meetings. After all study processes, study materials, and data collection tools were developed, a focus group of older adults who represented the likely targets of the MTM intervention provided feedback related to the concept and process of the intervention. Nine key lessons were identified from the community engagement process. One key to successful community engagement is partners taking the time to educate each other about experiences, processes, and successes and failures. Additionally, partners must actively listen to each other to better understand barriers and facilitators that likely will impact the planning and implementation processes. Successful community engagement will be important to develop both formative and summative evaluation processes that will help to produce valid evidence about the effectiveness of pharmacists in modifying drug therapy and preventing falls as well as to promote the adoption and

  8. Comprehensive review of methicillin-resistant Staphylococcus aureus: screening and preventive recommendations for plastic surgeons and other surgical health care providers.

    Science.gov (United States)

    O'Reilly, Eamon B; Johnson, Mark D; Rohrich, Rod J

    2014-11-01

    Up to 2.3 million people are colonized with methicillin-resistant Staphylococcus aureus in the United States, causing well-documented morbidity and mortality. Although the association of clinical outcomes with community and hospital carriage rates is increasingly defined, less is reported about asymptomatic colonization prevalence among physicians, and specifically plastic surgeons and the subsequent association with the incidence of patient surgical-site infection. A review of the literature using the PubMed and Cochrane databases analyzing provider screening, transmission, and prevalence was undertaken. In addition, a search was completed for current screening and decontamination guidelines and outcomes. The methicillin-resistant S. aureus carriage prevalence of surgical staff is 4.5 percent. No prospective data exist regarding transmission and interventions for plastic surgeons. No studies were found specifically looking at prevalence or treatment of plastic surgeons. Current recommendations by national organizations focus on patient-oriented point-of-care testing and intervention, largely ignoring the role of the health care provider. Excellent guidelines exist regarding screening, transmission prevention, and treatment both in the workplace and in the community. No current such guidelines exist for plastic surgeons. No Level I or II evidence was found regarding physician screening, treatment, or transmission. Current expert opinion, however, indicates that plastic surgeons and their staff should be vigilant for methicillin-resistant S. aureus transmission, and once a sentinel cluster of skin and soft-tissue infections is identified, systematic screening and decontamination should be considered. If positive, topical decolonization therapy should be offered. In refractory cases, oral antibiotic therapy may be required, but this should not be used as a first-line strategy.

  9. Transforming environmental permitting and compliance policies to promote pollution prevention: Removing barriers and providing incentives to foster technology innovation, economic productivity, and environmental protection. Final report

    International Nuclear Information System (INIS)

    Berg, D.R.; Kerr, R.L.; Fleischer, S.; Gorsen, M.; Harris, E.

    1993-04-01

    The Technology Innovation and Economics (TIE) Committee, a standing committee of EPA's National Advisory Council for Environmental Policy and Technology (NACEPT), has concluded that major changes are needed in federal and state permitting and compliance programs to encourage adoption of practical pollution prevention approaches to environmental protection. The Committee recommends seven major areas for improvement, including: (1) Redesigning permit procedures to encourage regulated facilities to expand multi-media and pollution prevention environmental improvement efforts; (2) Accelerating development and use of innovative pollution prevention technologies and techniques through special permitting and review procedures during RD ampersand D and commercialization phases; (3) Developing and expanding federal and state pollution prevention enforcement initiative; (4) Supporting state initiatives in pollution prevention facility planning; (5) Expanding pollution prevention-related training, educational and technology diffusion efforts to better reach managers in all sectors of the economy; (6) Altering personnel reward systems to encourage EPA staff to champion pollution prevention; (7) Expanding and publicizing the system of national awards honoring outstanding pollution prevention research, training and technology implementation

  10. Population cycles: generalities, exceptions and remaining mysteries

    Science.gov (United States)

    2018-01-01

    Population cycles are one of nature's great mysteries. For almost a hundred years, innumerable studies have probed the causes of cyclic dynamics in snowshoe hares, voles and lemmings, forest Lepidoptera and grouse. Even though cyclic species have very different life histories, similarities in mechanisms related to their dynamics are apparent. In addition to high reproductive rates and density-related mortality from predators, pathogens or parasitoids, other characteristics include transgenerational reduced reproduction and dispersal with increasing-peak densities, and genetic similarity among populations. Experiments to stop cyclic dynamics and comparisons of cyclic and noncyclic populations provide some understanding but both reproduction and mortality must be considered. What determines variation in amplitude and periodicity of population outbreaks remains a mystery. PMID:29563267

  11. State and municipal innovations in obesity policy: why localities remain a necessary laboratory for innovation.

    Science.gov (United States)

    Reeve, Belinda; Ashe, Marice; Farias, Ruben; Gostin, Lawrence

    2015-03-01

    Municipal and state governments are surging ahead in obesity prevention, providing a testing ground for innovative policies and shifting social norms in the process. Though high-profile measures such as New York City's soda portion rule attract significant media attention, we catalog the broader array of initiatives in less-known localities. Local innovation advances prevention policy, but faces legal and political constraints-constitutional challenges, preemption, charges of paternalism, lack of evidence, and widening health inequalities. These arguments can be met with astute framing, empirical evidence, and policy design, enabling local governments to remain at the forefront in transforming obesogenic environments.

  12. Repellent plants provide affordable natural screening to prevent mosquito house entry in tropical rural settings--results from a pilot efficacy study.

    Directory of Open Access Journals (Sweden)

    Frank C Mng'ong'o

    Full Text Available Sustained malaria control is underway using a combination of vector control, prompt diagnosis and treatment of malaria cases. Progress is excellent, but for long-term control, low-cost, sustainable tools that supplement existing control programs are needed. Conventional vector control tools such as indoor residual spraying and house screening are highly effective, but difficult to deliver in rural areas. Therefore, an additional means of reducing mosquito house entry was evaluated: the screening of mosquito house entry points by planting the tall and densely foliated repellent plant Lantana camara L. around houses. A pilot efficacy study was performed in Kagera Region, Tanzania in an area of high seasonal malaria transmission, where consenting families within the study village planted L. camara (Lantana around their homes and were responsible for maintaining the plants. Questionnaire data on house design, socioeconomic status, malaria prevention knowledge, attitude and practices was collected from 231 houses with Lantana planted around them 90 houses without repellent plants. Mosquitoes were collected using CDC Light Traps between September 2008 and July 2009. Data were analysed with generalised negative binomial regression, controlling for the effect of sampling period. Indoor catches of mosquitoes in houses with Lantana were compared using the Incidence Rate Ratio (IRR relative to houses without plants in an adjusted analysis. There were 56% fewer Anopheles gambiae s.s. (IRR 0.44, 95% CI 0.28-0.68, p<0.0001; 83% fewer Anopheles funestus s.s. (IRR 0.17, 95% CI 0.09-0.32, p<0.0001, and 50% fewer mosquitoes of any kind (IRR 0.50, 95% CI 0.38-0.67, p<0.0001 in houses with Lantana relative to controls. House screening using Lantana reduced indoor densities of malaria vectors and nuisance mosquitoes with broad community acceptance. Providing sufficient plants for one home costs US $1.50 including maintenance and labour costs, (30 cents per person. L

  13. Assessing the Knowledge Level, Attitudes, Risky Behaviors and Preventive Practices on Sexually Transmitted Diseases among University Students as Future Healthcare Providers in the Central Zone of Malaysia: A Cross-Sectional Study

    Directory of Open Access Journals (Sweden)

    Adigun Temiloluwa Folasayo

    2017-02-01

    Full Text Available This study was done to assess the knowledge, attitudes, risky behaviors and preventive practices related to sexually-transmitted diseases (STDs among health and non-health sciences university students as future healthcare providers in Malaysia. A total of 700 health and non-health sciences university students (255 male; 445 female aged between 17 and 30 years were surveyed by using a self-administered questionnaire. The majority (86.6% had heard of STDs, and 50.4% knew STDs could present without symptoms. HIV remains the best known STD (83.6% by the students, while chlamydia (26% and trichomoniasis (21.0% were rarely known. Gender, age group, educational level and faculty type were strongly associated with knowledge level (p-values < 0.05. Most of them (88.8% were aware that STD screening was important while use of condoms was protective (63.8%. The majority of them strongly felt that treatment should be sought immediately if they (85.5% and their partners (87.4% have symptoms. Among the sexually-active students, 66.7% and 18% had sexual intercourse with multiple partners and commercial sex workers, while 17.4% and 9.4% took alcohol and drugs before having sex, respectively. By logistic regression analysis, students aged 24–30 years old (an odds ratio (AOR = 0.57, 95% confidence interval (CI = 0.377–0.859 and faculty type (AOR = 5.69, 95% CI = 4.019–8.057 were the significant predictors for the knowledge level. Knowledge on the non-HIV causes of STDs is still lacking, and the risky behavior practiced by the sexually-active students in this study is alarming. There is a need to revisit the existing STD education curriculum in both schools and universities so that appropriate intervention on STDs can be implemented.

  14. Assessing the Knowledge Level, Attitudes, Risky Behaviors and Preventive Practices on Sexually Transmitted Diseases among University Students as Future Healthcare Providers in the Central Zone of Malaysia: A Cross-Sectional Study.

    Science.gov (United States)

    Folasayo, Adigun Temiloluwa; Oluwasegun, Afolayan John; Samsudin, Suhailah; Saudi, Siti Nor Sakinah; Osman, Malina; Hamat, Rukman Awang

    2017-02-08

    This study was done to assess the knowledge, attitudes, risky behaviors and preventive practices related to sexually-transmitted diseases (STDs) among health and non-health sciences university students as future healthcare providers in Malaysia. A total of 700 health and non-health sciences university students (255 male; 445 female) aged between 17 and 30 years were surveyed by using a self-administered questionnaire. The majority (86.6%) had heard of STDs, and 50.4% knew STDs could present without symptoms. HIV remains the best known STD (83.6%) by the students, while chlamydia (26%) and trichomoniasis (21.0%) were rarely known. Gender, age group, educational level and faculty type were strongly associated with knowledge level ( p -values students, 66.7% and 18% had sexual intercourse with multiple partners and commercial sex workers, while 17.4% and 9.4% took alcohol and drugs before having sex, respectively. By logistic regression analysis, students aged 24-30 years old (an odds ratio (AOR) = 0.57, 95% confidence interval (CI) = 0.377-0.859) and faculty type (AOR = 5.69, 95% CI = 4.019-8.057) were the significant predictors for the knowledge level. Knowledge on the non-HIV causes of STDs is still lacking, and the risky behavior practiced by the sexually-active students in this study is alarming. There is a need to revisit the existing STD education curriculum in both schools and universities so that appropriate intervention on STDs can be implemented.

  15. Evaluation of a novel intervention providing insight into the tobacco industry to prevent the uptake of smoking in school-aged children: a mixed-methods study.

    Science.gov (United States)

    Szatkowski, Lisa; Taylor, John; Taylor, Amy; Lewis, Sarah; Wu, Qi; Parrott, Steve; McNeill, Ann; Britton, John; Bauld, Linda; Jones, Laura L; Bains, Manpreet

    2017-11-03

    Evidence from the US Truth campaign suggests that interventions focusing on tobacco industry practices and ethics may be effective in preventing youth smoking uptake. We developed, piloted and evaluated a school-based intervention based on this premise. Exploratory study students in years 7-8 (aged 11-13) in two UK schools received Operation Smoke Storm , comprising three 50 min classroom-based sessions in year 7, an accompanying family booklet and a 1-hour classroom-based booster session in year 8. We compared the risk and odds of ever smoking and susceptibility to smoking in year 8 students in study schools postintervention with students in control schools. Focus groups and interviews with students, teachers and parents evaluated the acceptability of the intervention. In intervention schools, the combined prevalence of ever smoking and susceptibility increased from 18.2% in year 7 to 33.8% in year 8. There was no significant difference in the odds of a year 8 student in an intervention school being an ever smoker or susceptible never smoker compared with controls (adjusted OR (aOR) 1.28, 95% CI 0.83 to 1.97, p=0.263) and no significant difference in the odds of ever smoking (aOR 0.82, 95% CI 0.42 to 1.58, p=0.549). Teachers highlighted differences by academic ability in how well the messages presented were understood. Use of the family component was low but was received positively by parents who engaged with it. Operation Smoke Storm is an acceptable resource for delivering smoking-prevention education, but it does not appear to have reduced smoking and susceptibility. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  16. Fish remains and humankind: part two

    Directory of Open Access Journals (Sweden)

    Andrew K G Jones

    1998-07-01

    Full Text Available The significance of aquatic resources to past human groups is not adequately reflected in the published literature - a deficiency which is gradually being acknowledged by the archaeological community world-wide. The publication of the following three papers goes some way to redress this problem. Originally presented at an International Council of Archaeozoology (ICAZ Fish Remains Working Group meeting in York, U.K. in 1987, these papers offer clear evidence of the range of interest in ancient fish remains across the world. Further papers from the York meeting were published in Internet Archaeology 3 in 1997.

  17. Why Agricultural Educators Remain in the Classroom

    Science.gov (United States)

    Crutchfield, Nina; Ritz, Rudy; Burris, Scott

    2013-01-01

    The purpose of this study was to identify and describe factors that are related to agricultural educator career retention and to explore the relationships between work engagement, work-life balance, occupational commitment, and personal and career factors as related to the decision to remain in the teaching profession. The target population for…

  18. Juveniles' Motivations for Remaining in Prostitution

    Science.gov (United States)

    Hwang, Shu-Ling; Bedford, Olwen

    2004-01-01

    Qualitative data from in-depth interviews were collected in 1990-1991, 1992, and 2000 with 49 prostituted juveniles remanded to two rehabilitation centers in Taiwan. These data are analyzed to explore Taiwanese prostituted juveniles' feelings about themselves and their work, their motivations for remaining in prostitution, and their difficulties…

  19. The Annuity Puzzle Remains a Puzzle

    NARCIS (Netherlands)

    Peijnenburg, J.M.J.; Werker, Bas; Nijman, Theo

    We examine incomplete annuity menus and background risk as possible drivers of divergence from full annuitization. Contrary to what is often suggested in the literature, we find that full annuitization remains optimal if saving is possible after retirement. This holds irrespective of whether real or

  20. Explosives remain preferred methods for platform abandonment

    International Nuclear Information System (INIS)

    Pulsipher, A.; Daniel, W. IV; Kiesler, J.E.; Mackey, V. III

    1996-01-01

    Economics and safety concerns indicate that methods involving explosives remain the most practical and cost-effective means for abandoning oil and gas structures in the Gulf of Mexico. A decade has passed since 51 dead sea turtles, many endangered Kemp's Ridleys, washed ashore on the Texas coast shortly after explosives helped remove several offshore platforms. Although no relationship between the explosions and the dead turtles was ever established, in response to widespread public concern, the US Minerals Management Service (MMS) and National Marine Fisheries Service (NMFS) implemented regulations limiting the size and timing of explosive charges. Also, more importantly, they required that operators pay for observers to survey waters surrounding platforms scheduled for removal for 48 hr before any detonations. If observers spot sea turtles or marine mammals within the danger zone, the platform abandonment is delayed until the turtles leave or are removed. However, concern about the effects of explosives on marine life remains

  1. Working with Individuals Who Provide Nursing Care to Educate Older Adults about Foodborne Illness Prevention: The Food Safety Because You Care! Intervention

    Directory of Open Access Journals (Sweden)

    Kelly C. Wohlgenant

    2015-01-01

    Full Text Available Older adults are more susceptible to foodborne infections than younger adults and many older adults do not follow recommended food safety practices. This study implemented the Food Safety Because You Care! program with 88 individuals in the United States who provide nursing care to older adult patients and subsequently surveyed them. The majority of respondents had favorable opinions of the program. Following program exposure, many of the respondents advised their older adult patients about food safety. The findings from this study suggest that the program is a useful tool that can assist those who provide nursing care as they interact with their older patients and lead them to positively influence older adults’ food safety practices. However, more research is needed to examine changes in providers’ behaviors as a result of program exposure and the accompanying effect on older adults’ food safety practices.

  2. Supply-related drivers of staff motivation for providing intermittent preventive treatment of malaria during pregnancy in Tanzania: evidence from two rural districts

    Directory of Open Access Journals (Sweden)

    Mubyazi Godfrey M

    2012-02-01

    Full Text Available Abstract Background Since its introduction in the national antenatal care (ANC system in Tanzania in 2001, little evidence is documented regarding the motivation and performance of health workers (HWs in the provision of intermittent preventive treatment of malaria during pregnancy (IPTp services in the national ANC clinics and the implications such motivation and performance might have had on HWs and services' compliance with the recommended IPTp delivery guidelines. This paper describes the supply-related drivers of motivation and performance of HWs in administering IPTp doses among other ANC services delivered in public and private health facilities (HFs in Tanzania, using a case study of Mkuranga and Mufindi districts. Methods Interviews were conducted with 78 HWs participating in the delivery of ANC services in private and public HFs and were supplemented by personal communications with the members of the district council health management team. The research instrument used in the data collection process contained a mixture of closed and open-ended questions. Some of the open-ended questions had to be coded in the form that allowed their analysis quantitatively. Results In both districts, respondents acknowledged IPTp as an essential intervention, but expressed dissatisfaction with their working environments constraining their performance, including health facility (HF unit understaffing; unsystematic and unfriendly supervision by CHMT members; limited opportunities for HW career development; and poor (HF infrastructure and staff houses. Data also suggest that poor working conditions negatively affect health workers' motivation to perform for ANC (including IPTp services. Similarities and differences were noted in terms of motivational factors for ANC service delivery between the HWs employed in private HFs and those in public HFs: those in private facilities were more comfortable with staff residential houses, HF buildings, equipment

  3. Supply-related drivers of staff motivation for providing intermittent preventive treatment of malaria during pregnancy in Tanzania: evidence from two rural districts

    Science.gov (United States)

    2012-01-01

    Background Since its introduction in the national antenatal care (ANC) system in Tanzania in 2001, little evidence is documented regarding the motivation and performance of health workers (HWs) in the provision of intermittent preventive treatment of malaria during pregnancy (IPTp) services in the national ANC clinics and the implications such motivation and performance might have had on HWs and services' compliance with the recommended IPTp delivery guidelines. This paper describes the supply-related drivers of motivation and performance of HWs in administering IPTp doses among other ANC services delivered in public and private health facilities (HFs) in Tanzania, using a case study of Mkuranga and Mufindi districts. Methods Interviews were conducted with 78 HWs participating in the delivery of ANC services in private and public HFs and were supplemented by personal communications with the members of the district council health management team. The research instrument used in the data collection process contained a mixture of closed and open-ended questions. Some of the open-ended questions had to be coded in the form that allowed their analysis quantitatively. Results In both districts, respondents acknowledged IPTp as an essential intervention, but expressed dissatisfaction with their working environments constraining their performance, including health facility (HF) unit understaffing; unsystematic and unfriendly supervision by CHMT members; limited opportunities for HW career development; and poor (HF) infrastructure and staff houses. Data also suggest that poor working conditions negatively affect health workers' motivation to perform for ANC (including IPTp) services. Similarities and differences were noted in terms of motivational factors for ANC service delivery between the HWs employed in private HFs and those in public HFs: those in private facilities were more comfortable with staff residential houses, HF buildings, equipment, availability of water

  4. Supply-related drivers of staff motivation for providing intermittent preventive treatment of malaria during pregnancy in Tanzania: evidence from two rural districts.

    Science.gov (United States)

    Mubyazi, Godfrey M; Bloch, Paul; Byskov, Jens; Magnussen, Pascal; Bygbjerg, Ib C; Hansen, Kristian S

    2012-02-18

    Since its introduction in the national antenatal care (ANC) system in Tanzania in 2001, little evidence is documented regarding the motivation and performance of health workers (HWs) in the provision of intermittent preventive treatment of malaria during pregnancy (IPTp) services in the national ANC clinics and the implications such motivation and performance might have had on HWs and services' compliance with the recommended IPTp delivery guidelines. This paper describes the supply-related drivers of motivation and performance of HWs in administering IPTp doses among other ANC services delivered in public and private health facilities (HFs) in Tanzania, using a case study of Mkuranga and Mufindi districts. Interviews were conducted with 78 HWs participating in the delivery of ANC services in private and public HFs and were supplemented by personal communications with the members of the district council health management team. The research instrument used in the data collection process contained a mixture of closed and open-ended questions. Some of the open-ended questions had to be coded in the form that allowed their analysis quantitatively. In both districts, respondents acknowledged IPTp as an essential intervention, but expressed dissatisfaction with their working environments constraining their performance, including health facility (HF) unit understaffing; unsystematic and unfriendly supervision by CHMT members; limited opportunities for HW career development; and poor (HF) infrastructure and staff houses. Data also suggest that poor working conditions negatively affect health workers' motivation to perform for ANC (including IPTp) services. Similarities and differences were noted in terms of motivational factors for ANC service delivery between the HWs employed in private HFs and those in public HFs: those in private facilities were more comfortable with staff residential houses, HF buildings, equipment, availability of water, electricity and cups for

  5. Provider costs for prevention and treatment of cardiovascular and related conditions in low- and middle-income countries: a systematic review.

    Science.gov (United States)

    Brouwer, Elizabeth D; Watkins, David; Olson, Zachary; Goett, Jane; Nugent, Rachel; Levin, Carol

    2015-11-26

    The burden of cardiovascular disease (CVD) and CVD risk conditions is rapidly increasing in low- and middle-income countries, where health systems are generally ill-equipped to manage chronic disease. Policy makers need an understanding of the magnitude and drivers of the costs of cardiovascular disease related conditions to make decisions on how to allocate limited health resources. We undertook a systematic review of the published literature on provider-incurred costs of treatment for cardiovascular diseases and risk conditions in low- and middle-income countries. Total costs of treatment were inflated to 2012 US dollars for comparability across geographic settings and time periods. This systematic review identified 60 articles and 143 unit costs for the following conditions: ischemic heart disease, non-ischemic heart diseases, stroke, heart failure, hypertension, diabetes, and chronic kidney disease. Cost data were most readily available in middle-income countries, especially China, India, Brazil, and South Africa. The most common conditions with cost studies were acute ischemic heart disease, type 2 diabetes mellitus, stroke, and hypertension. Emerging economies are currently providing a base of cost evidence for NCD treatment that may prove useful to policy-makers in low-income countries. Initial steps to publicly finance disease interventions should take account of costs. The gaps and limitations in the current literature include a lack of standardized reporting as well as sparse evidence from low-income countries.

  6. Decomposition Technique for Remaining Useful Life Prediction

    Science.gov (United States)

    Saha, Bhaskar (Inventor); Goebel, Kai F. (Inventor); Saxena, Abhinav (Inventor); Celaya, Jose R. (Inventor)

    2014-01-01

    The prognostic tool disclosed here decomposes the problem of estimating the remaining useful life (RUL) of a component or sub-system into two separate regression problems: the feature-to-damage mapping and the operational conditions-to-damage-rate mapping. These maps are initially generated in off-line mode. One or more regression algorithms are used to generate each of these maps from measurements (and features derived from these), operational conditions, and ground truth information. This decomposition technique allows for the explicit quantification and management of different sources of uncertainty present in the process. Next, the maps are used in an on-line mode where run-time data (sensor measurements and operational conditions) are used in conjunction with the maps generated in off-line mode to estimate both current damage state as well as future damage accumulation. Remaining life is computed by subtracting the instance when the extrapolated damage reaches the failure threshold from the instance when the prediction is made.

  7. Industry remains stuck in a transitional mode

    International Nuclear Information System (INIS)

    Garb, F.A.

    1991-01-01

    The near future for industry remains foggy for several obvious reasons. The shake-up of the Soviet Union and how the pieces will reform remains unclear. How successful efforts are to privatize government oil company operations around the world has yet to be determined. A long sought peace in the Middle East seems to be inching closer, but will this continue? If it does continue, what impact will it have on world energy policy? Will American companies, which are now transferring their attention to foreign E and P, also maintain an interest in domestic activities? Is the U.S. economy really on the upswing? We are told that the worst of the recession is over, but try telling this to thousands of workers in the oil patch who are being released monthly by the big players in domestic operations. This paper reports that 1992 should be a better year than 1991, if measured in opportunity. There are more exploration and acquisition options available, both domestically and internationally, than there have been in years. Probably more opportunities exist than there are players-certainly more than can be funded with current financial resources

  8. Shotgun microbial profiling of fossil remains

    DEFF Research Database (Denmark)

    Der Sarkissian, Clio; Ermini, Luca; Jónsson, Hákon

    2014-01-01

    the specimen of interest, but instead reflect environmental organisms that colonized the specimen after death. Here, we characterize the microbial diversity recovered from seven c. 200- to 13 000-year-old horse bones collected from northern Siberia. We use a robust, taxonomy-based assignment approach...... to identify the microorganisms present in ancient DNA extracts and quantify their relative abundance. Our results suggest that molecular preservation niches exist within ancient samples that can potentially be used to characterize the environments from which the remains are recovered. In addition, microbial...... community profiling of the seven specimens revealed site-specific environmental signatures. These microbial communities appear to comprise mainly organisms that colonized the fossils recently. Our approach significantly extends the amount of useful data that can be recovered from ancient specimens using...

  9. Some remaining problems in HCDA analysis

    International Nuclear Information System (INIS)

    Chang, Y.W.

    1981-01-01

    The safety assessment and licensing of liquid-metal fast breeder reactors (LMFBRs) requires an analysis on the capability of the reactor primary system to sustain the consequences of a hypothetical core-disruptive accident (HCDA). Although computational methods and computer programs developed for HCDA analyses can predict reasonably well the response of the primary containment system, and follow up the phenomena of HCDA from the start of excursion to the time of dynamic equilibrium in the system, there remain areas in the HCDA analysis that merit further analytical and experimental studies. These are the analysis of fluid impact on reactor cover, three-dimensional analysis, the treatment of the perforated plates, material properties under high strain rates and under high temperatures, the treatment of multifield flows, and the treatment of prestressed concrete reactor vessels. The purpose of this paper is to discuss the structural mechanics of HCDA analysis in these areas where improvements are needed

  10. Political, energy events will remain interwoven

    International Nuclear Information System (INIS)

    Jones, D.P.

    1991-01-01

    This paper reports that it is possible to discuss the significance of political and energy events separately, but, in truth, they are intricately interwoven. Furthermore, there are those who will argue that since the two are inseparable, the future is not predictable; so why bother in the endeavor. It is possible that the central point of the exercise may have been missed-yes, the future is unpredictable exclamation point However, the objective of prediction is secondary. The objective of understanding the dynamic forces of change is primary exclamation point With this view of recent history, it is perhaps appropriate to pause and think about the future of the petroleum industry. The future as shaped by political, energy, economic, environmental and technological forces will direct our lives and markets during this decade. Most importantly, what will be the direction that successful businesses take to remain competitive in a global environment? These are interesting issues worthy of provocative thoughts and innovative ideas

  11. Nuclear remains an economic and ecologic asset

    International Nuclear Information System (INIS)

    Le Ngoc, Boris

    2015-01-01

    The author herein outlines the several benefits of nuclear energy and nuclear industry for France. He first outlines that France possesses 97 per cent of de-carbonated electricity thanks to nuclear energy (77 pc) and renewable energies (20 pc, mainly hydraulic), and that renewable energies must be developed in the building and transport sectors to be able to get rid of the environmentally and financially costly fossil energies. He outlines that reactor maintenance and the nuclear fuel cycle industry are fields of technological leadership for the French nuclear industry which is, after motor industry and aircraft industry, the third industrial sector in France. He indicates that nuclear electricity is to remain the most competitive one, and that nuclear energy and renewable energies must not be opposed to it but considered as complementary in the struggle against climate change, i.e. to reduce greenhouse gas emissions and to get rid of the prevalence of fossil energies

  12. The Human Remains from HMS Pandora

    Directory of Open Access Journals (Sweden)

    D.P. Steptoe

    2002-04-01

    Full Text Available In 1977 the wreck of HMS Pandora (the ship that was sent to re-capture the Bounty mutineers was discovered off the north coast of Queensland. Since 1983, the Queensland Museum Maritime Archaeology section has carried out systematic excavation of the wreck. During the years 1986 and 1995-1998, more than 200 human bone and bone fragments were recovered. Osteological investigation revealed that this material represented three males. Their ages were estimated at approximately 17 +/-2 years, 22 +/-3 years and 28 +/-4 years, with statures of 168 +/-4cm, 167 +/-4cm, and 166cm +/-3cm respectively. All three individuals were probably Caucasian, although precise determination of ethnicity was not possible. In addition to poor dental hygiene, signs of chronic diseases suggestive of rickets and syphilis were observed. Evidence of spina bifida was seen on one of the skeletons, as were other skeletal anomalies. Various taphonomic processes affecting the remains were also observed and described. Compact bone was observed under the scanning electron microscope and found to be structurally coherent. Profiles of the three skeletons were compared with historical information about the 35 men lost with the ship, but no precise identification could be made. The investigation did not reveal the cause of death. Further research, such as DNA analysis, is being carried out at the time of publication.

  13. SMART POINT CLOUD: DEFINITION AND REMAINING CHALLENGES

    Directory of Open Access Journals (Sweden)

    F. Poux

    2016-10-01

    Full Text Available Dealing with coloured point cloud acquired from terrestrial laser scanner, this paper identifies remaining challenges for a new data structure: the smart point cloud. This concept arises with the statement that massive and discretized spatial information from active remote sensing technology is often underused due to data mining limitations. The generalisation of point cloud data associated with the heterogeneity and temporality of such datasets is the main issue regarding structure, segmentation, classification, and interaction for an immediate understanding. We propose to use both point cloud properties and human knowledge through machine learning to rapidly extract pertinent information, using user-centered information (smart data rather than raw data. A review of feature detection, machine learning frameworks and database systems indexed both for mining queries and data visualisation is studied. Based on existing approaches, we propose a new 3-block flexible framework around device expertise, analytic expertise and domain base reflexion. This contribution serves as the first step for the realisation of a comprehensive smart point cloud data structure.

  14. Remaining life assessment of a high pressure turbine rotor

    International Nuclear Information System (INIS)

    Nguyen, Ninh; Little, Alfie

    2012-01-01

    This paper describes finite element and fracture mechanics based modelling work that provides a useful tool for evaluation of the remaining life of a high pressure (HP) steam turbine rotor that had experienced thermal fatigue cracking. An axis-symmetrical model of a HP rotor was constructed. Steam temperature, pressure and rotor speed data from start ups and shut downs were used for the thermal and stress analysis. Operating history and inspection records were used to benchmark the damage experienced by the rotor. Fracture mechanics crack growth analysis was carried out to evaluate the remaining life of the rotor under themal cyclic loading conditions. The work confirmed that the fracture mechanics approach in conjunction with finite element modelling provides a useful tool for assessing the remaining life of high temperature components in power plants.

  15. Medicare Provider Data - Hospice Providers

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Hospice Utilization and Payment Public Use File provides information on services provided to Medicare beneficiaries by hospice providers. The Hospice PUF...

  16. Molecular genetic identification of skeletal remains of apartheid ...

    African Journals Online (AJOL)

    The Truth and Reconciliation Commission made significant progress in examining abuses committed during the apartheid era in South Africa. Despite information revealed by the commission, a large number of individuals remained missing when the commission closed its proceedings. This provided the impetus for the ...

  17. What remains of the Arrow oil?

    International Nuclear Information System (INIS)

    Sergy, G.; Owens, E.

    1993-01-01

    In February 1970, the tanker Arrow became grounded 6.5 km off the north shore of Chedabucto Bay, Nova Scotia, and nearly 72,000 bbl of Bunker C fuel oil were released from the vessel during its subsequent breakup and sinking. The oil was washed ashore in various degrees over an estimated 305 km of the bay's 604-km shoreline, of which only 48 km were cleaned. In addition, the tanker Kurdistan broke in two in pack ice in March 1979 in the Cabot Strait area, spilling ca 54,000 bbl of Bunker C, some of which was later found at 16 locations along the northeast and east shorelines of Chedabucto Bay. In summer 1992, a systematic ground survey of the bay's shorelines was conducted using Environment Canada Shoreline Cleanup Assessment Team (SCAT) procedures. Standard observations were made of oil distribution and width, thickness, and character of the oil residues in 419 coastal segments. Results from the survey are summarized. Oil was found to be present on 13.3 km of the shoreline, with heavy oiling restricted to 1.3 km primarily in the areas of Black Duck Cove and Lennox Passage. Some of this residual oil was identified as coming from the Arrow. Natural weathering processes account for removal of most of the spilled oil from the bay. Oil remaining on the shore was found in areas outside of the zone of physical wave action, in areas of nearshore mixing where fine sediments are not present to weather the oil through biophysical processes, or in crusts formed by oil weathered on the surface. The systematic description of oiled shorelines using the SCAT methodology proved very successful, even for such an old spill. 6 refs

  18. Market overview: Volume and prices remain low

    International Nuclear Information System (INIS)

    Anon.

    1997-01-01

    A summary of financial data for the uranium spot market in February 1997 is provided. Price ranges for the restricted and unrestricted markets, conversion, and separative work are listed, and total market volume and new contracts are noted. Transactions made are briefly described. Deals made and pending in the spot concentrates, medium and long-term, conversion, and markets are listed for U.S. and non-U.S. buyers

  19. Ghost Remains After Black Hole Eruption

    Science.gov (United States)

    2009-05-01

    NASA's Chandra X-ray Observatory has found a cosmic "ghost" lurking around a distant supermassive black hole. This is the first detection of such a high-energy apparition, and scientists think it is evidence of a huge eruption produced by the black hole. This discovery presents astronomers with a valuable opportunity to observe phenomena that occurred when the Universe was very young. The X-ray ghost, so-called because a diffuse X-ray source has remained after other radiation from the outburst has died away, is in the Chandra Deep Field-North, one of the deepest X-ray images ever taken. The source, a.k.a. HDF 130, is over 10 billion light years away and existed at a time 3 billion years after the Big Bang, when galaxies and black holes were forming at a high rate. "We'd seen this fuzzy object a few years ago, but didn't realize until now that we were seeing a ghost", said Andy Fabian of the Cambridge University in the United Kingdom. "It's not out there to haunt us, rather it's telling us something - in this case what was happening in this galaxy billions of year ago." Fabian and colleagues think the X-ray glow from HDF 130 is evidence for a powerful outburst from its central black hole in the form of jets of energetic particles traveling at almost the speed of light. When the eruption was ongoing, it produced prodigious amounts of radio and X-radiation, but after several million years, the radio signal faded from view as the electrons radiated away their energy. HDF 130 Chandra X-ray Image of HDF 130 However, less energetic electrons can still produce X-rays by interacting with the pervasive sea of photons remaining from the Big Bang - the cosmic background radiation. Collisions between these electrons and the background photons can impart enough energy to the photons to boost them into the X-ray energy band. This process produces an extended X-ray source that lasts for another 30 million years or so. "This ghost tells us about the black hole's eruption long after

  20. Magnetic Resonance Imaging Provides Added Value to the Prostate Cancer Prevention Trial Risk Calculator for Patients With Estimated Risk of High-grade Prostate Cancer Less Than or Equal to 10.

    Science.gov (United States)

    Kim, Eric H; Weaver, John K; Shetty, Anup S; Vetter, Joel M; Andriole, Gerald L; Strope, Seth A

    2017-04-01

    To determine the added value of prostate magnetic resonance imaging (MRI) to the Prostate Cancer Prevention Trial risk calculator. Between January 2012 and December 2015, 339 patients underwent prostate MRI prior to biopsy at our institution. MRI was considered positive if there was at least 1 Prostate Imaging Reporting and Data System 4 or 5 MRI suspicious region. Logistic regression was used to develop 2 models: biopsy outcome as a function of the (1) Prostate Cancer Prevention Trial risk calculator alone and (2) combined with MRI findings. When including all patients, the Prostate Cancer Prevention Trial with and without MRI models performed similarly (area under the curve [AUC] = 0.74 and 0.78, P = .06). When restricting the cohort to patients with estimated risk of high-grade (Gleason ≥7) prostate cancer ≤10%, the model with MRI outperformed the Prostate Cancer Prevention Trial alone model (AUC = 0.69 and 0.60, P = .01). Within this cohort of patients, there was no significant difference in discrimination between models for those with previous negative biopsy (AUC = 0.61 vs 0.63, P = .76), whereas there was a significant improvement in discrimination with the MRI model for biopsy-naïve patients (AUC = 0.72 vs 0.60, P = .01). The use of prostate MRI in addition to the Prostate Cancer Prevention Trial risk calculator provides a significant improvement in clinical risk discrimination for patients with estimated risk of high-grade (Gleason ≥7) prostate cancer ≤10%. Prebiopsy prostate MRI should be strongly considered for these patients. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. Presentations provided

    Energy Technology Data Exchange (ETDEWEB)

    Hashemian, H; Beverly, D [Analysis and Measurement Services Corp., Knoxville, TN (United States)

    1999-12-31

    The following topics covered in detail at the workshop included: temperature instrumentation; pressure instrumentation; in-situ calibration and response time testing of RTDs and pressure transmitters; on-line performance monitoring and preventive maintenance of critical equipment; automated measurement of critical parameters; nuclear power plant infrastructure, management and Quality Assurance issues and recent developments for WWER and RBMK reactors. Conclusions drawn were: aging can adversely affect the performance of nuclear plant pressure transmitters; current testing interval of once in every fuel cycle is adequate for aging management; in-situ response time measurements and on-line calibration testing methods have been developed and validated for nuclear plant pressure transmitters; NUREG/CR-5851 should be taken into account for details of aging research on pressure transmitters

  2. Presentations provided

    International Nuclear Information System (INIS)

    Hashemian, H.; Beverly, D.

    1998-01-01

    The following topics covered in detail at the workshop included: temperature instrumentation; pressure instrumentation; in-situ calibration and response time testing of RTDs and pressure transmitters; on-line performance monitoring and preventive maintenance of critical equipment; automated measurement of critical parameters; nuclear power plant infrastructure, management and Quality Assurance issues and recent developments for WWER and RBMK reactors. Conclusions drawn were: aging can adversely affect the performance of nuclear plant pressure transmitters; current testing interval of once in every fuel cycle is adequate for aging management; in-situ response time measurements and on-line calibration testing methods have been developed and validated for nuclear plant pressure transmitters; NUREG/CR-5851 should be taken into account for details of aging research on pressure transmitters

  3. Development of a remaining lifetime management system for NPPS

    International Nuclear Information System (INIS)

    Galvan, J.C.; Regano, M.; Hevia Ruperez, F.

    1994-01-01

    The interest evinced by Spain nuclear power plants in providing a tool to support remaining lifetime management led to UNESA's application to OCIDE in 1992, and the latter's approval, for financing the project to develop a Remaining Lifetime Evaluation System for LWR nuclear power plants. This project is currently being developed under UNESA leadership, and the collaboration of three Spanish engineering companies and a research centre. The paper will describe its objectives, activities, current status and prospects. The project is defined in two phases, the first consisting of the identification and analysis of the main ageing phenomena and their significant parameters and specification of the Remaining Lifetime Evaluation System (RLES), and the second implementation of a pilot application of the RLES to verify its effectiveness. (Author)

  4. Assessment of utilization of provider-initiated HIV testing and counseling as an intervention for prevention of mother to child transmission of HIV and associated factors among pregnant women in Gondar town, North West Ethiopia

    Directory of Open Access Journals (Sweden)

    Malaju Marelign

    2012-05-01

    Full Text Available Abstract Background Detection of maternal HIV infection early in pregnancy is critical for prevention of mother to child transmission of HIV/AIDS. Most efforts have focused on VCT as the primary means of encouraging people to become aware of their HIV status. However, its uptake is low in many parts of sub-Saharan Africa including Ethiopia. Provider-initiated HIV testing and counseling provides a critical opportunity to diagnose HIV infection, to begin chronic care, and to prevent mother to child transmission. However, little is known about its acceptance and associated factors among pregnant women in the country and particularly in the present study area. Methods Health institution based cross-sectional quantitative study was conducted in Gondar town from July 22-August 18, 2010. A total of 400 pregnant women were involved in the study using stratified sampling technique and multiple logistic regression analysis was employed using SPSS version 16. Results A total of 400 pregnant women actively participated in this study and 330 (82.5% of them accepted provider-initiated HIV testing and counseling to be tested for HIV and 70(17.5% of them refused. Acceptance of provider-initiated HIV testing and counseling was positively associated with greater number of antenatal care visits [Adj. OR (95%CI=2.64(1.17, 5.95], residing in the urban areas[Adj. OR (95%CI=2.85(1.10, 7.41], having comprehensive knowledge on HIV [Adj. OR (95%CI=4.30(1.72, 10.73], positive partners reaction for HIV positive result [Adj. OR (95%CI=8.19(3.57, 18.80] and having knowledge on prevention of mother to child transmission of HIV[Adj. OR (95%CI=3.27(1.34, 7.94], but negatively associated with increased maternal age and education level. Conclusion Utilization of provider-initiated HIV testing and counseling during antenatal care was relatively high among pregnant women in Gondar town. Couple counseling and HIV testing should be strengthened to promote provider-initiated HIV

  5. Assessing the Knowledge Level, Attitudes, Risky Behaviors and Preventive Practices on Sexually Transmitted Diseases among University Students as Future Healthcare Providers in the Central Zone of Malaysia: A Cross-Sectional Study

    OpenAIRE

    Folasayo, Adigun Temiloluwa; Oluwasegun, Afolayan John; Samsudin, Suhailah; Saudi, Siti Nor Sakinah; Osman, Malina; Hamat, Rukman Awang

    2017-01-01

    This study was done to assess the knowledge, attitudes, risky behaviors and preventive practices related to sexually-transmitted diseases (STDs) among health and non-health sciences university students as future healthcare providers in Malaysia. A total of 700 health and non-health sciences university students (255 male; 445 female) aged between 17 and 30 years were surveyed by using a self-administered questionnaire. The majority (86.6%) had heard of STDs, and 50.4% knew STDs could present w...

  6. Remaining Calm in the Midst of Chaos

    International Nuclear Information System (INIS)

    Sullivan, Robin S.; Ryan, Grant W.; Young, Jonathan

    2004-01-01

    At the DOE Hanford site in Washington State, Fluor Hanford, Inc is in the process of developing and, procuring systems to remove and disposition sludge from the 100 Area K Basins. The K Basins were used to store spent fuel from the operating reactors at the Hanford Site. The sludge is a by-product from th corrosion of the fuel and fuel storage canisters. The sludge removal project is very dynamic involving two basins, K East and K West, and has an ambitious schedule for removal and subsequent Basin D and D. The challenge for the safety basis development for this project is how to integrate the analysis with the project schedule and still provide the required project design, development, and regulatory (10CFR830) support. During the development of new project/systems, safety analysis activities are used throughout the design phase to assist in identifying design/safety issues before the design is complete. Control allocation and identification processes assist procurement of equipment during the development phase and a PDSA is required to support the decision to proceed with construction/installation. For the K Basins project, all the safety basis development activities need to be done in the context of new and existing facilities/equipment and an existing safety basis for the K Basins. When schedules are demanding and design, procurement, and safety documentation activities must be completed in parallel, it creates complex issues for maintaining the safety basis current. In addition, developing a safety basis that will cover the lifecycle of the facility creates issues when using it to support the necessary short term decisions at the same time as long term planning. Therefore, it was necessary to develop a safety basis strategy to deal with this situation. This paper discusses the strategy developed to deal with the complexity and project schedule issues and the methods for safety analysis development and documentation being used to assist in maintaining some

  7. Can prevention classification be improved by considering the function of prevention?

    Science.gov (United States)

    Foxcroft, David R

    2014-12-01

    Universal, selective and indicated forms of prevention have been adopted as improvements on previous notions of primary and secondary prevention. However, some conceptual confusion remains concerning the placing of environmental, community-based or mass media preventive interventions within this typology. It is suggested that a new dimension of functional types of prevention, namely environmental, developmental and informational prevention should be specified alongside the forms of prevention in a taxonomy matrix. The main advantage of this new taxonomy is that a matrix combining the form and function dimensions of prevention can be used to identify and map out prevention strategies, to consider where research evidence is present and where more is needed, and to evaluate the relative effectiveness of different categories and components of prevention for specific health and social issues. Such evaluations would provide empirical evidence as to whether the different categories of prevention are related to outcomes or processes of prevention in ways that suggest the value of the taxonomy for understanding and increasing the impact of prevention science. This new prevention taxonomy has been useful for conceptualising and planning prevention activities in a case study involving the Swedish National Institute for Public Health. Future work should assess (1) the robustness of this new taxonomy and (2) the theoretical and empirical basis for profiling prevention investments across the various forms and functions of prevention.

  8. Prognostic modelling options for remaining useful life estimation by industry

    Science.gov (United States)

    Sikorska, J. Z.; Hodkiewicz, M.; Ma, L.

    2011-07-01

    Over recent years a significant amount of research has been undertaken to develop prognostic models that can be used to predict the remaining useful life of engineering assets. Implementations by industry have only had limited success. By design, models are subject to specific assumptions and approximations, some of which are mathematical, while others relate to practical implementation issues such as the amount of data required to validate and verify a proposed model. Therefore, appropriate model selection for successful practical implementation requires not only a mathematical understanding of each model type, but also an appreciation of how a particular business intends to utilise a model and its outputs. This paper discusses business issues that need to be considered when selecting an appropriate modelling approach for trial. It also presents classification tables and process flow diagrams to assist industry and research personnel select appropriate prognostic models for predicting the remaining useful life of engineering assets within their specific business environment. The paper then explores the strengths and weaknesses of the main prognostics model classes to establish what makes them better suited to certain applications than to others and summarises how each have been applied to engineering prognostics. Consequently, this paper should provide a starting point for young researchers first considering options for remaining useful life prediction. The models described in this paper are Knowledge-based (expert and fuzzy), Life expectancy (stochastic and statistical), Artificial Neural Networks, and Physical models.

  9. Direct dating of Early Upper Palaeolithic human remains from Mladec.

    Science.gov (United States)

    Wild, Eva M; Teschler-Nicola, Maria; Kutschera, Walter; Steier, Peter; Trinkaus, Erik; Wanek, Wolfgang

    2005-05-19

    The human fossil assemblage from the Mladec Caves in Moravia (Czech Republic) has been considered to derive from a middle or later phase of the Central European Aurignacian period on the basis of archaeological remains (a few stone artefacts and organic items such as bone points, awls, perforated teeth), despite questions of association between the human fossils and the archaeological materials and concerning the chronological implications of the limited archaeological remains. The morphological variability in the human assemblage, the presence of apparently archaic features in some specimens, and the assumed early date of the remains have made this fossil assemblage pivotal in assessments of modern human emergence within Europe. We present here the first successful direct accelerator mass spectrometry radiocarbon dating of five representative human fossils from the site. We selected sample materials from teeth and from one bone for 14C dating. The four tooth samples yielded uncalibrated ages of approximately 31,000 14C years before present, and the bone sample (an ulna) provided an uncertain more-recent age. These data are sufficient to confirm that the Mladec human assemblage is the oldest cranial, dental and postcranial assemblage of early modern humans in Europe and is therefore central to discussions of modern human emergence in the northwestern Old World and the fate of the Neanderthals.

  10. USING CONDITION MONITORING TO PREDICT REMAINING LIFE OF ELECTRIC CABLES

    International Nuclear Information System (INIS)

    LOFARO, R.; SOO, P.; VILLARAN, M.; GROVE, E.

    2001-01-01

    Electric cables are passive components used extensively throughout nuclear power stations to perform numerous safety and non-safety functions. It is known that the polymers commonly used to insulate the conductors on these cables can degrade with time; the rate of degradation being dependent on the severity of the conditions in which the cables operate. Cables do not receive routine maintenance and, since it can be very costly, they are not replaced on a regular basis. Therefore, to ensure their continued functional performance, it would be beneficial if condition monitoring techniques could be used to estimate the remaining useful life of these components. A great deal of research has been performed on various condition monitoring techniques for use on electric cables. In a research program sponsored by the U.S. Nuclear Regulatory Commission, several promising techniques were evaluated and found to provide trendable information on the condition of low-voltage electric cables. These techniques may be useful for predicting remaining life if well defined limiting values for the aging properties being measured can be determined. However, each technique has advantages and limitations that must be addressed in order to use it effectively, and the necessary limiting values are not always easy to obtain. This paper discusses how condition monitoring measurements can be used to predict the remaining useful life of electric cables. The attributes of an appropriate condition monitoring technique are presented, and the process to be used in estimating the remaining useful life of a cable is discussed along with the difficulties that must be addressed

  11. Vaccine prevention of meningococcal disease in Africa: Major advances, remaining challenges.

    Science.gov (United States)

    Mustapha, Mustapha M; Harrison, Lee H

    2017-12-06

    Africa historically has had the highest incidence of meningococcal disease with high endemic rates and periodic epidemics. The meningitis belt, a region of sub-Saharan Africa extending from Senegal to Ethiopia, has experienced large, devastating epidemics. However, dramatic shifts in the epidemiology of meningococcal disease have occurred recently. For instance, meningococcal capsular group A (NmA) epidemics in the meningitis belt have essentially been eliminated by use of conjugate vaccine. However, NmW epidemics have emerged and spread across the continent since 2000; NmX epidemics have occurred sporadically, and NmC recently emerged in Nigeria and Niger. Outside the meningitis belt, NmB predominates in North Africa, while NmW followed by NmB predominate in South Africa. Improved surveillance is necessary to address the challenges of this changing epidemiologic picture. A low-cost, multivalent conjugate vaccine covering NmA and the emergent and prevalent meningococcal capsular groups C, W, and X in the meningitis belt is a pressing need.

  12. Prevention IS Care

    Centers for Disease Control (CDC) Podcasts

    2009-03-26

    This podcast provides an overview of the Prevention IS Care campaign, which provides HIV prevention tools for medical care providers to use on a daily basis with patients who are living with HIV.  Created: 3/26/2009 by National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP).   Date Released: 3/26/2009.

  13. Update on child abuse prevention.

    Science.gov (United States)

    Krugman, Scott D; Lane, Wendy G; Walsh, Christina M

    2007-12-01

    Child abuse remains a significant problem in the United States with 2.9 million reports and 825 000 indicated cases in 2005. This report will highlight recent efforts toward child abuse prevention, focusing on home visiting programs, abusive head trauma primary prevention, parent training programs, sexual abuse prevention, and the effectiveness of laws banning corporal punishment. Most home visitation programs have demonstrated a lack of effectiveness in recent randomized trials. One exception is the Nurse Family Partnership, which remains the most effective and longest enduring intervention for high-risk families. Child sexual abuse prevention programs and parent training programs need further evaluation with more rigorous methodology and outcome measures. Providing universal parent education about coping with crying infants appears to be effective in lowering the incidence of abusive head trauma. Although advocated for, further study will determine the effectiveness of laws banning corporal punishment or mandating abusive head trauma education to parents of newborns. Pediatricians play an important role in the prevention of child maltreatment. Their knowledge of the effectiveness of different programs can help guide parents toward appropriate services.

  14. Treatment in a Preventive Cardiology Clinic Utilizing Advanced Practice Providers (APPs) Effectively Closes Atherosclerotic Cardiovascular Disease (ASCVD) Risk Management Gaps Amongst a Primary Prevention Population Compared with a Propensity-Matched Primary Care Cohort: A Team Based Care Model and its Impact on Lipid and Blood Pressure Management.

    Science.gov (United States)

    Fentanes, Emilio; Vande Hei, Anthony G; Holuby, R Scott; Suarez, Norma; Slim, Yousif; Slim, Jennifer N; Slim, Ahmad M; Thomas, Dustin

    2018-04-17

    Advanced Practice Providers (APPs) can fill access to care gaps created by physician shortages and improve adherence/compliance with preventive atherosclerotic cardiovascular disease (ASCVD) interventions. We retrospectively reviewed data on 595 patients enrolled in a preventive cardiology clinic (PCC) utilizing APPs compared with a propensity-matched cohort (PMC) of 595 patients enrolled in primary care clinics alone. PCC patients were risk stratified using Framingham risk scoring (FRS) and coronary artery calcium scoring (CACS) and treated based on published guideline-based algorithms. Baseline demographics were well balanced between the groups. CACS was more commonly obtained in PCC patients (p<0.001) resulting in reclassification of 30.6% patients to a higher risk category, including statin therapy in 26.6% of low FRS PCC patients with CACS ≥75 th MESA percentile. Aspirin initiation was higher for high and intermediate FRS patients in the PCC (p <0.001). Post-intervention mean LDL, non-HDL, and triglycerides (all p<0.05) were lower in the PCC group. Compliance with appropriate lipid treatment was higher in intermediate to high FRS patients (p=0.004) in the PCC group. Aggressive LDL and non-HDL treatment goals <70mg/dL (p=0.005) and <130mg/dL (p<0.001), respectively, were more commonly achieved in high FRS PCC patients. Median post-intervention SBP was lower amongst intermediate and low FRS patients (p=0.001 & p<0.001, respectively). Cumulatively, this resulted in a reduction in median post-intervention PCC FRS across all initial FRS risk categories (p<0.001 for all). APPs within a preventive cardiology clinic effectively risk stratify and aggressively manage ASCVD risk factors resulting in a reduction in post-intervention FRS. This article is protected by copyright. All rights reserved.

  15. Carnivoran remains from the Malapa hominin site, South Africa.

    Directory of Open Access Journals (Sweden)

    Brian F Kuhn

    Full Text Available Recent discoveries at the new hominin-bearing deposits of Malapa, South Africa, have yielded a rich faunal assemblage associated with the newly described hominin taxon Australopithecus sediba. Dating of this deposit using U-Pb and palaeomagnetic methods has provided an age of 1.977 Ma, being one of the most accurately dated, time constrained deposits in the Plio-Pleistocene of southern Africa. To date, 81 carnivoran specimens have been identified at this site including members of the families Canidae, Viverridae, Herpestidae, Hyaenidae and Felidae. Of note is the presence of the extinct taxon Dinofelis cf. D. barlowi that may represent the last appearance date for this species. Extant large carnivores are represented by specimens of leopard (Panthera pardus and brown hyaena (Parahyaena brunnea. Smaller carnivores are also represented, and include the genera Atilax and Genetta, as well as Vulpes cf. V. chama. Malapa may also represent the first appearance date for Felis nigripes (Black-footed cat. The geochronological age of Malapa and the associated hominin taxa and carnivoran remains provide a window of research into mammalian evolution during a relatively unknown period in South Africa and elsewhere. In particular, the fauna represented at Malapa has the potential to elucidate aspects of the evolution of Dinofelis and may help resolve competing hypotheses about faunal exchange between East and Southern Africa during the late Pliocene or early Pleistocene.

  16. Prevention strategies in child maltreatment.

    Science.gov (United States)

    Scribano, Philip V

    2010-10-01

    Child maltreatment remains a prevalent problem for which notable best practices such as home visitation can be effective; however, most eligible families do not receive these beneficial services. Additionally, there are other promising prevention interventions to effectively address child maltreatment. This review focuses on the recent advances and strategies for child maltreatment prevention. Although home visiting does not have a single clearly defined methodology of providing service to children and families, the general supportive framework to improve maternal, child, and family factors makes this intervention the most widely studied and accepted prevention strategy. However, there has been limited effectiveness for most models. The Nurse-Family Partnership (NFP) has provided consistently positive results by targeting families with many risk factors by using highly trained professionals when implementing a research-based intervention. A promising public health approach to parent training (Triple P) may reduce maltreatment and out-of-home placement. Parent-child interaction therapy (PCIT), while a treatment model, is becoming an increasingly important approach to child maltreatment prevention. There may be an opportunity to reduce child maltreatment by enhancing care in the pediatric medical home setting. Effective child maltreatment prevention efforts exist; however, not all programs provide the same effectiveness, or target the same maltreatment issues. Pediatricians are in a key position to offer support to families in their own practice, as well as to direct families to the appropriate resources available.

  17. Would it provide Free Education?

    Indian Academy of Sciences (India)

    First page Back Continue Last page Overview Graphics. Would it provide Free Education? Would it provide Free Education? Would it provide Compulsory Education? Would it guarantee education of equitable quality? Would it prevent discrimination? Would it stop schools that promote inequality & discrimination? NO! NO!

  18. Future Remains: Industrial Heritage at the Hanford Plutonium Works

    Science.gov (United States)

    Freer, Brian

    This dissertation argues that U.S. environmental and historic preservation regulations, industrial heritage projects, history, and art only provide partial frameworks for successfully transmitting an informed story into the long range future about nuclear technology and its related environmental legacy. This argument is important because plutonium from nuclear weapons production is toxic to humans in very small amounts, threatens environmental health, has a half-life of 24, 110 years and because the industrial heritage project at Hanford is the first time an entire U.S. Department of Energy weapons production site has been designated a U.S. Historic District. This research is situated within anthropological interest in industrial heritage studies, environmental anthropology, applied visual anthropology, as well as wider discourses on nuclear studies. However, none of these disciplines is really designed or intended to be a completely satisfactory frame of reference for addressing this perplexing challenge of documenting and conveying an informed story about nuclear technology and its related environmental legacy into the long range future. Others have thought about this question and have made important contributions toward a potential solution. Examples here include: future generations movements concerning intergenerational equity as evidenced in scholarship, law, and amongst Native American groups; Nez Perce and Confederated Tribes of the Umatilla Indian Reservation responses to the Hanford End State Vision and Hanford's Canyon Disposition Initiative; as well as the findings of organizational scholars on the advantages realized by organizations that have a long term future perspective. While these ideas inform the main line inquiry of this dissertation, the principal approach put forth by the researcher of how to convey an informed story about nuclear technology and waste into the long range future is implementation of the proposed Future Remains clause, as

  19. AIDS, individual behaviour and the unexplained remaining variation.

    Science.gov (United States)

    Katz, Alison

    2002-01-01

    From the start of the AIDS pandemic, individual behaviour has been put forward, implicitly or explicitly, as the main explanatory concept for understanding the epidemiology of HIV infection and in particular for the rapid spread and high prevalence in sub-Saharan Africa. This has had enormous implications for the international response to AIDS and has heavily influenced public health policy and strategy and the design of prevention and care interventions at national, community and individual level. It is argued that individual behaviour alone cannot possibly account for the enormous variation in HIV prevalence between population groups, countries and regions and that the unexplained remaining variation has been neglected by the international AIDS community. Biological vulnerability to HIV due to seriously deficient immune systems has been ignored as a determinant of the high levels of infection in certain populations. This is in sharp contrast to well proven public health approaches to other infectious diseases. In particular, it is argued that poor nutrition and co-infection with the myriad of other diseases of poverty including tuberculosis, malaria, leishmaniasis and parasitic infections, have been neglected as root causes of susceptibility, infectiousness and high rates of transmission of HIV at the level of populations. Vulnerability in terms of non-biological factors such as labour migration, prostitution, exchange of sex for survival, population movements due to war and violence, has received some attention but the solutions proposed to these problems are also inappropriately focused on individual behaviour and suffer from the same neglect of economic and political root causes. As the foundation for the international community's response to the AIDS pandemic, explanations of HIV/AIDS epidemiology in terms of individual behaviour are not only grossly inadequate, they are highly stigmatising and may in some cases, be racist. They have diverted attention from

  20. Spot market activity remains weak as prices continue to fall

    International Nuclear Information System (INIS)

    Anon.

    1996-01-01

    A summary of financial data for the uranium spot market in November 1996 is provided. Price ranges for the restricted and unrestricted markets, conversion, and separative work are listed, and total market volume and new contracts are noted. Transactions made are briefly described. Deals made and pending in the spot concentrates, medium and long-term, conversion, and markets are listed for U.S. and non-U.S. buyers. Spot market activity increased in November with just over 1.0 million lbs of U3O8 equivalent being transacted compared to October's total of 530,000 lbs of U3O8 equivalent. The restricted uranium spot market price range slipped from $15.50-$15.70/lb U3O8 last month to $14.85/lb - $15.25/lb U3O8 this month. The unrestricted uranium spot market price range also slipped to $14.85/lb - $15.00/lb this month from $15.00/lb - $15.45/lb in October. Spot prices for conversion and separative work units remained at their October levels

  1. Cancer treatment - preventing infection

    Science.gov (United States)

    ... Radiation - preventing infection; Bone marrow transplant - preventing infection; Cancer treatment - immunosuppression ... this is a short-lived side effect of cancer treatment. Your provider may give you medicines to help ...

  2. [Prevention of psychosocial risks].

    Science.gov (United States)

    Dalle, Édouard; Trichard-Salembier, Alexandra; Sobaszek, Annie

    2018-02-01

    The theme of psychosocial risks remains in the workplace. It is therefore essential that all members of a company are made aware of the terminology and specific prevention actions in this field. Distinguishing between the manifestations of these risks and their causes and consequences helps to improve prevention. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  3. The CRC 20 years: An overview of some of the major achievements and remaining challenges.

    Science.gov (United States)

    Doek, Jaap E

    2009-11-01

    On 20 November 1989, the General Assembly of the United Nations adopted the Convention on the Rights of the Child (CRC). It entered into force on 2 September 1990 and has by now been ratified by 193 States, making the most universally ratified human rights treaty. This overview will present and discuss the impact of this treaty both at the international and the national level, an overview which necessarily has to be limited to some of the developments as a result of the implementation of the CRC. The first part of this paper will be devoted to the impact the CRC had and still has on the setting and development of the international agenda for the promotion and protection of the rights and welfare of children. Special attention will given to developments, achievements, and remaining challenges at the international level with regard to protection of children in armed conflict; prevention and the protection of children from sexual exploitation; and from all forms of violence. This will include some information on the impact of these international developments and actions at the national level, for example, in the area of legislation. The second part will focus on the impact at the national level. Given the wide scope of the CRC this part will be limited to some of the General Measures of Implementation (law reform, national programmes, and independent monitoring) and the General Principles (non-discrimination, best interest, right to be heard) of the CRC. This will be based on reports of States on the implementation of the CRC submitted to the CRC Committee and the Concluding Observations of this Committee and on a number of studies. The conclusion will provide remarks on poverty as one of the major remaining challenges for the implementation of children's rights.

  4. Education Information Security: Improvements Made But Control Weaknesses Remain

    National Research Council Canada - National Science Library

    2001-01-01

    To assess the effectiveness of information system general controls in place to prevent unauthorized access, disclosure, and disruption to Education's primary accounting and payment system (i.e., EDCAPS...

  5. Remaining lifetime modeling using State-of-Health estimation

    Science.gov (United States)

    Beganovic, Nejra; Söffker, Dirk

    2017-08-01

    Technical systems and system's components undergo gradual degradation over time. Continuous degradation occurred in system is reflected in decreased system's reliability and unavoidably lead to a system failure. Therefore, continuous evaluation of State-of-Health (SoH) is inevitable to provide at least predefined lifetime of the system defined by manufacturer, or even better, to extend the lifetime given by manufacturer. However, precondition for lifetime extension is accurate estimation of SoH as well as the estimation and prediction of Remaining Useful Lifetime (RUL). For this purpose, lifetime models describing the relation between system/component degradation and consumed lifetime have to be established. In this contribution modeling and selection of suitable lifetime models from database based on current SoH conditions are discussed. Main contribution of this paper is the development of new modeling strategies capable to describe complex relations between measurable system variables, related system degradation, and RUL. Two approaches with accompanying advantages and disadvantages are introduced and compared. Both approaches are capable to model stochastic aging processes of a system by simultaneous adaption of RUL models to current SoH. The first approach requires a priori knowledge about aging processes in the system and accurate estimation of SoH. An estimation of SoH here is conditioned by tracking actual accumulated damage into the system, so that particular model parameters are defined according to a priori known assumptions about system's aging. Prediction accuracy in this case is highly dependent on accurate estimation of SoH but includes high number of degrees of freedom. The second approach in this contribution does not require a priori knowledge about system's aging as particular model parameters are defined in accordance to multi-objective optimization procedure. Prediction accuracy of this model does not highly depend on estimated SoH. This model

  6. Babesiosis for Health Care Providers

    Centers for Disease Control (CDC) Podcasts

    2012-04-25

    This podcast will educate health care providers on diagnosing babesiosis and providing patients at risk with tick bite prevention messages.  Created: 4/25/2012 by Center for Global Health, Division of Parasitic Diseases and Malaria.   Date Released: 4/25/2012.

  7. A Bayesian Framework for Remaining Useful Life Estimation

    Data.gov (United States)

    National Aeronautics and Space Administration — The estimation of remaining useful life (RUL) of a faulty component is at the center of system prognostics and health management. It gives operators a potent tool in...

  8. New Evidence Links Stellar Remains to Oldest Recorded Supernova

    Science.gov (United States)

    2006-09-01

    Recent observations have uncovered evidence that helps to confirm the identification of the remains of one of the earliest stellar explosions recorded by humans. The new study shows that the supernova remnant RCW 86 is much younger than previously thought. As such, the formation of the remnant appears to coincide with a supernova observed by Chinese astronomers in 185 A.D. The study used data from NASA's Chandra X-ray Observatory and the European Space Agency's XMM-Newton Observatory, "There have been previous suggestions that RCW 86 is the remains of the supernova from 185 A.D.," said Jacco Vink of University of Utrecht, the Netherlands, and lead author of the study. "These new X-ray data greatly strengthen the case." When a massive star runs out of fuel, it collapses on itself, creating a supernova that can outshine an entire galaxy. The intense explosion hurls the outer layers of the star into space and produces powerful shock waves. The remains of the star and the material it encounters are heated to millions of degrees and can emit intense X-ray radiation for thousands of years. Animation of a Massive Star Explosion Animation of a Massive Star Explosion In their stellar forensic work, Vink and colleagues studied the debris in RCW 86 to estimate when its progenitor star originally exploded. They calculated how quickly the shocked, or energized, shell is moving in RCW 86, by studying one part of the remnant. They combined this expansion velocity with the size of the remnant and a basic understanding of how supernovas expand to estimate the age of RCW 86. "Our new calculations tell us the remnant is about 2,000 years old," said Aya Bamba, a coauthor from the Institute of Physical and Chemical Research (RIKEN), Japan. "Previously astronomers had estimated an age of 10,000 years." The younger age for RCW 86 may explain an astronomical event observed almost 2000 years ago. In 185 AD, Chinese astronomers (and possibly the Romans) recorded the appearance of a new

  9. Robotics to Enable Older Adults to Remain Living at Home

    OpenAIRE

    Pearce, Alan J.; Adair, Brooke; Miller, Kimberly; Ozanne, Elizabeth; Said, Catherine; Santamaria, Nick; Morris, Meg E.

    2012-01-01

    Given the rapidly ageing population, interest is growing in robots to enable older people to remain living at home. We conducted a systematic review and critical evaluation of the scientific literature, from 1990 to the present, on the use of robots in aged care. The key research questions were as follows: (1) what is the range of robotic devices available to enable older people to remain mobile, independent, and safe? and, (2) what is the evidence demonstrating that robotic devices are effec...

  10. Mineralized remains of morphotypes of filamentous cyanobacteria in carbonaceous meteorites

    Science.gov (United States)

    Hoover, Richard B.

    2005-09-01

    The quest for conclusive evidence of microfossils in meteorites has been elusive. Abiotic microstructures, mineral grains, and even coating artifacts may mimic unicellular bacteria, archaea and nanobacteria with simple spherical or rod morphologies (i.e., cocci, diplococci, bacilli, etc.). This is not the case for the larger and more complex microorganisms, colonies and microbial consortia and ecosystems. Microfossils of algae, cyanobacteria, and cyanobacterial and microbial mats have been recognized and described from many of the most ancient rocks on Earth. The filamentous cyanobacteria and sulphur-bacteria have very distinctive size ranges, complex and recognizable morphologies and visibly differentiated cellular microstructures. The taphonomic modes of fossilization and the life habits and processes of these microorganisms often result in distinctive chemical biosignatures associated with carbonization, silicification, calcification, phosphatization and metal-binding properties of their cell-walls, trichomes, sheaths and extracellular polymeric substances (EPS). Valid biogenicity is provided by the combination of a suite of known biogenic elements (that differ from the meteorite matrix) found in direct association with recognizable and distinct biological features and microstructures (e.g., uniseriate or multiseriate filaments, trichomes, sheaths and cells of proper size/size range); specialized cells (e.g., basal or apical cells, hormogonia, akinetes, and heterocysts); and evidence of growth characteristics (e.g., spiral filaments, robust or thin sheaths, laminated sheaths, true or false branching of trichomes, tapered or uniform filaments) and evidence of locomotion (e.g. emergent cells and trichomes, coiling hormogonia, and hollow or flattened and twisted sheaths). Since 1997 we have conducted Environmental and Field Emission Scanning Electron Microscopy (ESEM and FESEM) studies of freshly fractured interior surfaces of carbonaceous meteorites, terrestrial

  11. Allergy prevention.

    Science.gov (United States)

    Muche-Borowski, Cathleen; Kopp, Matthias; Reese, Imke; Sitter, Helmut; Werfel, Thomas; Schäfer, Torsten

    2010-09-01

    The further increase of allergies in industrialized countries demands evidence-based measures of primary prevention. The recommendations as published in the guideline of 2004 were updated and consented on the basis of a systematic literature search. Evidence from the period February 2003-May 2008 was searched in the electronic databases Cochrane and MEDLINE as well as in reference lists of recent reviews and by contacting experts. The retrieved citations were screened for relevance first by title and abstract and in a second step as full paper. Levels of evidence were assigned to each included study and the methodological quality of the studies was assessed as high or low. Finally the revised recommendations were formally consented (nominal group process) by representatives of relevant societies and organizations including a self-help group. Of originally 4556 hits, 217 studies (4 Cochrane Reviews, 14 meta-analyses, 19 randomized controlled trials, 135 cohort and 45 case-control studies) were included and critically appraised. Grossly unchanged remained the recommendations on avoiding environmental tobacco smoke, breast-feeding over 4 months (alternatively hypoallergenic formulas for children at risk), avoiding a mold-promoting indoor climate, vaccination according to current recommendations, and avoidance of furry pets (especially cats) in children at risk. The recommendation on reducing the house dust mite allergen exposure as a measure of primary prevention was omitted and the impact of a delayed introduction of supplementary food was reduced. New recommendations were adopted concerning fish consumption (during pregnancy / breast-feeding and as supplementary food in the first year), avoidance of overweight, and reducing the exposure to indoor and outdoor air pollutants. The revision of this guideline on a profound evidence basis led to (1) a confirmation of existing recommendations, (2) substantial revisions, and (3) new recommendations. Thereby it is possible

  12. "SINCE I MUST PLEASE THOSE BELOW": HUMAN SKELETAL REMAINS RESEARCH AND THE LAW.

    Science.gov (United States)

    Holland, Thomas D

    2015-01-01

    The ethics of non-invasive scientific research on human skeletal remains are poorly articulated and lack a single, definitive analogue in western law. Laws governing invasive research on human fleshed remains, as well as bio-ethical principles established for research on living subjects, provide effective models for the establishment of ethical guidelines for non-invasive research on human skeletal remains. Specifically, non-invasive analysis of human remains is permissible provided that the analysis and collection of resulting data (1) are accomplished with respect for the dignity of the individual, (2) do not violate the last-known desire of the deceased, (3) do not adversely impact the right of the next of kin to perform a ceremonious and decent disposal of the remains, and (4) do not unduly or maliciously violate the privacy interests of the next of kin.

  13. The Right to Remain Silent in Criminal Trial

    Directory of Open Access Journals (Sweden)

    Gianina Anemona Radu

    2013-05-01

    Full Text Available A person's right not to incriminate oneself or to remain silent and not contribute to their own incrimination is a basic requirement of due process, although the right not to testify against oneself is not expressly guaranteed. This legal right is intended to protect the accused/ the defendant against the authorities’ abusive coercion. The scope of the right not to incriminate oneself is related to criminal matter under the Convention, and thus susceptible or applicable to criminal proceedings concerning all types of crimes as a guarantee to a fair trial. The European Court of Justice ruled that despite the fact that art. 6 paragraph 2 of the Convention does not expressly mention the right not to incriminate oneself and the right not to contribute to their own incrimination (nemo tenetur are ipsum accusare these are generally recognized international rules that are in consistence with the notion of “fair trial” stipulated in art. 6. By virtue of the right to silence, the person charged with a crime is free to answer the questions or not, as he/she believes it is in his/her interest. Therefore, the right to silence involves not only the right not to testify against oneself, but also the right of the accused/ defendant not to incriminate oneself. Thus, the accused/defendant cannot be compelled to assist in the production of evidence and cannot be sanctioned for failing to provide certain documents or other evidence. Obligation to testify against personal will, under the constraint of a fine or any other form of coercion constitutes an interference with the negative aspect of the right to freedom of expression which must be necessary in a democratic society. It is essential to clarify certain issues as far as this right is concerned. First of all, the statutory provision in question is specific to adversarial systems, which are found mainly in Anglo-Saxon countries and are totally different from that underlying the current Romanian Criminal

  14. Mummified remains from the Archaeological Museum in Zagreb, Croatia - Reviewing peculiarities and limitations of human and non-human radiological identification and analysis in mummified remains.

    Science.gov (United States)

    Petaros, Anja; Janković, Ivor; Cavalli, Fabio; Ivanac, Gordana; Brkljačić, Boris; Čavka, Mislav

    2015-10-01

    Forensic protocols and medico-legal techniques are increasingly being employed in investigations of museological material. The final findings of such investigations may reveal interesting facts on historical figures, customs and habits, as well as provide meaningful data for forensic use. Herein we present a case review where forensic experts were requested to identify taxonomic affinities, stage of preservation and provide skeletal analysis of mummified non-human archaeological remains, and verify whether two mummified hands are human or not. The manuscript offers a short review on the process and particularities of radiological species identification, the impact of post-mortem changes in the analysis and imaging of mummified remains as well as the macroscopical interpretation of trauma, pathology and authenticity in mummified remains, which can all turn useful when dealing with forensic cases. Copyright © 2015 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

  15. Gender differences in intention to remain a virgin until marriage ...

    African Journals Online (AJOL)

    Abstinence is often promoted in HIV-prevention programmes for adolescents, but little is known about the factors that influence adolescents' intentions to abstain from sex until marriage. This study was conducted in ten districts in the Kilimanjaro, Arusha, and Manyara regions of northern Tanzania, in July 2005. Out of 65 ...

  16. On random age and remaining lifetime for populations of items

    DEFF Research Database (Denmark)

    Finkelstein, M.; Vaupel, J.

    2015-01-01

    We consider items that are incepted into operation having already a random (initial) age and define the corresponding remaining lifetime. We show that these lifetimes are identically distributed when the age distribution is equal to the equilibrium distribution of the renewal theory. Then we...... develop the population studies approach to the problem and generalize the setting in terms of stationary and stable populations of items. We obtain new stochastic comparisons for the corresponding population ages and remaining lifetimes that can be useful in applications. Copyright (c) 2014 John Wiley...

  17. Scientific basis for the selection of absorbent underpads that remain securely attached to underlying bed or chair.

    Science.gov (United States)

    Edlich, Richard F; Winters, Kathryne L; Long, William B; Gubler, K Dean

    2006-01-01

    The occurrence of pressure ulcers in patients is very high in certain high-risk groups. These special high-risk groups include elderly patients, patients with spinal cord injuries, or any individual with an impaired ability to reposition. Prevention of pressure ulcers is by far the best treatment of this condition, warranting certain interventions and preventive measures. One major risk factor to be minimized is the exposure of skin to moisture. Underpads are often used to protect the skin of patients who are incontinent. These products effectively absorb moisture and present a quick-drying surface to the skin. The construction of an underpad should accomplish three goals. First, its backing should have a low coefficient of friction to prevent frictional skin injuries. Second, an inner absorbent core should rapidly contain moisture and disseminate it throughout the entire pad. Third, the core and coverstock should successfully work together to retain moisture and prevent wet-back or fluid return. The purpose of this study was to determine the performance of three commercially available underpads in reducing the development of pressure sores in patients at high risk. In this study we selected three underpads that could be securely attached to either the underlying bed or the chair. The three performance parameters examined were absorbent capacity, wetback prevention, and holding security of the underpads. Measurements of these performance parameters can be easily replicated in other laboratories. The results of these studies provide a scientific basis for selecting and purchasing an underpad to prevent pressure ulcers in patients. In this comprehensive evaluation, we assess an absorbent underpad with polyethylene flaps and two absorbent underpads with adhesive. The absorbent capacity results showed Tranquility SlimLine Peach Sheet to be the most absorbent. The wet-back results showed Tranquility SlimLine Peach Sheet to be the only underpad with no wet-back, with no

  18. Methodology for Extraction of Remaining Sodium of Used Sodium Containers

    International Nuclear Information System (INIS)

    Jung, Minhwan; Kim, Jongman; Cho, Youngil; Jeong, Jiyoung

    2014-01-01

    Sodium used as a coolant in the SFR (Sodium-cooled Fast Reactor) reacts easily with most elements due to its high reactivity. If sodium at high temperature leaks outside of a system boundary and makes contact with oxygen, it starts to burn and toxic aerosols are produced. In addition, it generates flammable hydrogen gas through a reaction with water. Hydrogen gas can be explosive within the range of 4.75 vol%. Therefore, the sodium should be handled carefully in accordance with standard procedures even though there is a small amount of target sodium remainings inside the containers and drums used for experiment. After the experiment, all sodium experimental apparatuses should be dismantled carefully through a series of draining, residual sodium extraction, and cleaning if they are no longer reused. In this work, a system for the extraction of the remaining sodium of used sodium drums has been developed and an operation procedure for the system has been established. In this work, a methodology for the extraction of remaining sodium out of the used sodium container has been developed as one of the sodium facility maintenance works. The sodium extraction system for remaining sodium of the used drums was designed and tested successfully. This work will contribute to an establishment of sodium handling technology for PGSFR. (Prototype Gen-IV Sodium-cooled Fast Reactor)

  19. Predicting the Remaining Useful Life of Rolling Element Bearings

    DEFF Research Database (Denmark)

    Hooghoudt, Jan Otto; Jantunen, E; Yi, Yang

    2018-01-01

    Condition monitoring of rolling element bearings is of vital importance in order to keep the industrial wheels running. In wind industry this is especially important due to the challenges in practical maintenance. The paper presents an attempt to improve the capability of prediction of remaining...

  20. The experiences of remaining nurse tutors during the transformation ...

    African Journals Online (AJOL)

    The transformation of public services and education in South Africa is part of the political and socioeconomic transition to democracy. Changes are occurring in every fi eld, including that of the health services. A qualitative study was undertaken to investigate the experiences of the remaining nurse tutors at a school of ...

  1. Remaining childless : Causes and consequences from a life course perspective

    NARCIS (Netherlands)

    Keizer, R.

    2010-01-01

    Little is know about childless individuals in the Netherlands, although currently one out of every five Dutch individuals remains childless. Who are they? How did they end up being childless? How and to what extent are their life outcomes influenced by their childlessness? By focusing on individual

  2. Palmar, Patellar, and Pedal Human Remains from Pavlov

    Czech Academy of Sciences Publication Activity Database

    Trinkaus, E.; Wojtal, P.; Wilczyński, J.; Sázelová, Sandra; Svoboda, Jiří

    2017-01-01

    Roč. 2017, June (2017), s. 73-101 ISSN 1545-0031 Institutional support: RVO:68081758 Keywords : Gravettian * human remains * isolated bones * anatomically modern humans * Upper Paleolithic Subject RIV: AC - Archeology, Anthropology, Ethnology OBOR OECD: Archaeology http://paleoanthro.org/media/journal/content/PA20170073.pdf

  3. Robotics to Enable Older Adults to Remain Living at Home

    Directory of Open Access Journals (Sweden)

    Alan J. Pearce

    2012-01-01

    Full Text Available Given the rapidly ageing population, interest is growing in robots to enable older people to remain living at home. We conducted a systematic review and critical evaluation of the scientific literature, from 1990 to the present, on the use of robots in aged care. The key research questions were as follows: (1 what is the range of robotic devices available to enable older people to remain mobile, independent, and safe? and, (2 what is the evidence demonstrating that robotic devices are effective in enabling independent living in community dwelling older people? Following database searches for relevant literature an initial yield of 161 articles was obtained. Titles and abstracts of articles were then reviewed by 2 independent people to determine suitability for inclusion. Forty-two articles met the criteria for question 1. Of these, 4 articles met the criteria for question 2. Results showed that robotics is currently available to assist older healthy people and people with disabilities to remain independent and to monitor their safety and social connectedness. Most studies were conducted in laboratories and hospital clinics. Currently limited evidence demonstrates that robots can be used to enable people to remain living at home, although this is an emerging smart technology that is rapidly evolving.

  4. Authentic leadership: becoming and remaining an authentic nurse leader.

    Science.gov (United States)

    Murphy, Lin G

    2012-11-01

    This article explores how chief nurse executives became and remained authentic leaders. Using narrative inquiry, this qualitative study focused on the life stories of participants. Results demonstrate the importance of reframing, reflection in alignment with values, and the courage needed as nurse leaders progress to authenticity.

  5. Robotics to enable older adults to remain living at home.

    Science.gov (United States)

    Pearce, Alan J; Adair, Brooke; Miller, Kimberly; Ozanne, Elizabeth; Said, Catherine; Santamaria, Nick; Morris, Meg E

    2012-01-01

    Given the rapidly ageing population, interest is growing in robots to enable older people to remain living at home. We conducted a systematic review and critical evaluation of the scientific literature, from 1990 to the present, on the use of robots in aged care. The key research questions were as follows: (1) what is the range of robotic devices available to enable older people to remain mobile, independent, and safe? and, (2) what is the evidence demonstrating that robotic devices are effective in enabling independent living in community dwelling older people? Following database searches for relevant literature an initial yield of 161 articles was obtained. Titles and abstracts of articles were then reviewed by 2 independent people to determine suitability for inclusion. Forty-two articles met the criteria for question 1. Of these, 4 articles met the criteria for question 2. Results showed that robotics is currently available to assist older healthy people and people with disabilities to remain independent and to monitor their safety and social connectedness. Most studies were conducted in laboratories and hospital clinics. Currently limited evidence demonstrates that robots can be used to enable people to remain living at home, although this is an emerging smart technology that is rapidly evolving.

  6. Dinosaur remains from the type Maastrichtian: An update

    NARCIS (Netherlands)

    Weishampel, David B.; Mulder, Eric W A; Dortangs, Rudi W.; Jagt, John W M; Jianu, Coralia Maria; Kuypers, Marcel M M; Peeters, Hans H G; Schulp, Anne S.

    1999-01-01

    Isolated cranial and post-cranial remains of hadrosaurid dinosaurs have been collected from various outcrops in the type area of the Maastrichtian stage during the last few years. In the present contribution, dentary and maxillary teeth are recorded from the area for the first time. Post-cranial

  7. Evidence-based obesity prevention in childhood and adolescence: critique of recent etiological studies, preventive interventions, and policies.

    Science.gov (United States)

    Reilly, John J

    2012-07-01

    Prevention of obesity in childhood and adolescence remains a worthwhile and realistic goal, but preventive efforts have been beset by a number of problems, which are the subject of this review. The review draws on recent systematic reviews and evidence appraisals and has a United Kingdom (UK) perspective because there is a rich evidence base in the United Kingdom that may be helpful to obesity prevention researchers elsewhere. Recent evidence of a leveling off in child and adolescent obesity prevalence in some Western nations should not encourage the belief that the obesity prevention problem has been solved, although a better understanding of recent secular trends might be helpful for prevention strategy in future. An adequate body of evidence provides behavioral targets of preventive interventions, and there are frameworks for prioritizing these targets logically and models for translating them into generalizable interventions with a wide reach (e.g., school-based prevention interventions such as Planet Health). An improved understanding of the "energy gap" that children and adolescents experience would be helpful to the design of preventive interventions and to their tailoring to particular groups. In the United Kingdom, some recent etiological evidence has been taken as indicative of the need for paradigm shifts in obesity prevention, but this evidence from single studies has not been replicated, and paradigm shifts probably occur only rarely. Ensuring that the evidence base on etiology and prevention influences policy effectively remains one of the greatest challenges for childhood obesity researchers.

  8. Evidence-Based Obesity Prevention in Childhood and Adolescence: Critique of Recent Etiological Studies, Preventive Interventions, and Policies123

    Science.gov (United States)

    Reilly, John J.

    2012-01-01

    Prevention of obesity in childhood and adolescence remains a worthwhile and realistic goal, but preventive efforts have been beset by a number of problems, which are the subject of this review. The review draws on recent systematic reviews and evidence appraisals and has a United Kingdom (UK) perspective because there is a rich evidence base in the United Kingdom that may be helpful to obesity prevention researchers elsewhere. Recent evidence of a leveling off in child and adolescent obesity prevalence in some Western nations should not encourage the belief that the obesity prevention problem has been solved, although a better understanding of recent secular trends might be helpful for prevention strategy in future. An adequate body of evidence provides behavioral targets of preventive interventions, and there are frameworks for prioritizing these targets logically and models for translating them into generalizable interventions with a wide reach (e.g., school-based prevention interventions such as Planet Health). An improved understanding of the “energy gap” that children and adolescents experience would be helpful to the design of preventive interventions and to their tailoring to particular groups. In the United Kingdom, some recent etiological evidence has been taken as indicative of the need for paradigm shifts in obesity prevention, but this evidence from single studies has not been replicated, and paradigm shifts probably occur only rarely. Ensuring that the evidence base on etiology and prevention influences policy effectively remains one of the greatest challenges for childhood obesity researchers. PMID:22798005

  9. Chemical Plants Remain Vulnerable to Terrorists: A Call to Action

    Science.gov (United States)

    Lippin, Tobi Mae; McQuiston, Thomas H.; Bradley-Bull, Kristin; Burns-Johnson, Toshiba; Cook, Linda; Gill, Michael L.; Howard, Donna; Seymour, Thomas A.; Stephens, Doug; Williams, Brian K.

    2006-01-01

    U.S. chemical plants currently have potentially catastrophic vulnerabilities as terrorist targets. The possible consequences of these vulnerabilities echo from the tragedies of the Bhopal incident in 1984 to the terrorist attacks on 11 September 2001 and, most recently, Hurricanes Katrina and Rita. Findings from a 2004 nationwide participatory research study of 125 local union leaders at sites with very large volumes of highly hazardous chemicals suggest that voluntary efforts to achieve chemical plant security are not succeeding. Study respondents reported that companies had only infrequently taken actions that are most effective in preventing or in preparing to respond to a terrorist threat. In addition, companies reportedly often failed to involve key stakeholders, including workers, local unions, and the surrounding communities, in these efforts. The environmental health community thus has an opportunity to play a key role in advocating for and supporting improvements in prevention of and preparation for terrorist attacks. Policy-level recommendations to redress chemical site vulnerabilities and the related ongoing threats to the nation’s security are as follows: a) specify detailed requirements for chemical site assessment and security; b) mandate audit inspections supported by significant penalties for cases of noncompliance; c) require progress toward achieving inherently safer processes, including the minimizing of storage of highly hazardous chemicals; d) examine and require additional effective actions in prevention, emergency preparedness, and response and remediation; e) mandate and fund the upgrading of emergency communication systems; and f) involve workers and community members in plan creation and equip and prepare them to prevent and respond effectively to an incident. PMID:16966080

  10. Decontamination and management of human remains following incidents of hazardous chemical release.

    Science.gov (United States)

    Hauschild, Veronique D; Watson, Annetta; Bock, Robert

    2012-01-01

    To provide specific guidance and resources for systematic and orderly decontamination of human remains resulting from a chemical terrorist attack or accidental chemical release. A detailed review and health-based decision criteria protocol is summarized. Protocol basis and logic are derived from analyses of compound-specific toxicological data and chemical/physical characteristics. Guidance is suitable for civilian or military settings where human remains potentially contaminated with hazardous chemicals may be present, such as sites of transportation accidents, terrorist operations, or medical examiner processing points. Guidance is developed from data-characterizing controlled experiments with laboratory animals, fabrics, and materiel. Logic and specific procedures for decontamination and management of remains, protection of mortuary affairs personnel, and decision criteria to determine when remains are sufficiently decontaminated are presented. Established procedures as well as existing materiel and available equipment for decontamination and verification provide reasonable means to mitigate chemical hazards from chemically exposed remains. Unique scenarios such as those involving supralethal concentrations of certain liquid chemical warfare agents may prove difficult to decontaminate but can be resolved in a timely manner by application of the characterized systematic approaches. Decision criteria and protocols to "clear" decontaminated remains for transport and processing are also provided. Once appropriate decontamination and verification have been accomplished, normal procedures for management of remains and release can be followed.

  11. Safety provision for nuclear power plants during remaining running time

    International Nuclear Information System (INIS)

    Rossnagel, Alexander; Hentschel, Anja

    2012-01-01

    With the phasing-out of the industrial use of nuclear energy for the power generation, the risk of the nuclear power plants has not been eliminated in principle, but only for a limited period of time. Therefore, the remaining nine nuclear power plants must also be used for the remaining ten years according to the state of science and technology. Regulatory authorities must substantiate the safety requirements for each nuclear power plant and enforce these requirements by means of various regulatory measures. The consequences of Fukushima must be included in the assessment of the safety level of nuclear power plants in Germany. In this respect, the regulatory authorities have the important tasks to investigate and assess the security risks as well as to develop instructions and orders.

  12. Structural remains at the early mediaeval fort at Raibania, Orissa

    Directory of Open Access Journals (Sweden)

    Bratati Sen

    2013-11-01

    Full Text Available The fortifications of mediaeval India occupy an eminent position in the history of military architecture. The present paper deals with the preliminary study of the structural remains at the early mediaeval fort at Raibania in the district of Balasore in Orissa. The fort was built of stone very loosely kept together. The three-walled fortification interspersed by two consecutive moats, a feature evidenced at Raibania, which is unparallel in the history of ancient and mediaeval forts and fortifications in India. Several other structures like the Jay-Chandi Temple Complex, a huge well, numerous tanks and remains of an ancient bridge add to the uniqueness of the Fort in the entire eastern region.

  13. Mineral remains of early life on Earth? On Mars?

    Science.gov (United States)

    Iberall, Robbins E.; Iberall, A.S.

    1991-01-01

    The oldest sedimentary rocks on Earth, the 3.8-Ga Isua Iron-Formation in southwestern Greenland, are metamorphosed past the point where organic-walled fossils would remain. Acid residues and thin sections of these rocks reveal ferric microstructures that have filamentous, hollow rod, and spherical shapes not characteristic of crystalline minerals. Instead, they resemble ferric-coated remains of bacteria. Because there are no earlier sedimentary rocks to study on Earth, it may be necessary to expand the search elsewhere in the solar system for clues to any biotic precursors or other types of early life. A study of morphologies of iron oxide minerals collected in the southern highlands during a Mars sample return mission may therefore help to fill in important gaps in the history of Earth's earliest biosphere. -from Authors

  14. Study on remain actinides recovery in pyro reprocessing

    International Nuclear Information System (INIS)

    Suharto, Bambang

    1996-01-01

    The spent fuel reprocessing by dry process called pyro reprocessing have been studied. Most of U, Pu and MA (minor actinides) from the spent fuel will be recovered and be fed back to the reactor as new fuel. Accumulation of remain actinides will be separated by extraction process with liquid cadmium solvent. The research was conducted by computer simulation to calculate the stage number required. The calculation's results showed on the 20 stages extractor more than 99% actinides can be separated. (author)

  15. US GAAP vs. IFRS – A COMPARISON OF REMAINING DIFFERENCES

    OpenAIRE

    Mihelčić, Eva

    2008-01-01

    In spite of the on-going harmonization process, there are still some differences between US GAAP and IFRS. Currently, companies listed on the New York Stock Exchange, which are reporting according to IFRS, must still prepare the reconciliation to US GAAP, to show the financial statements compliant with US GAAP as well. This article presents an overview of the remaining major differences between US GAAP and IFRS, descriptive as well as table-wise. First, the standards compared are shortly intr...

  16. Structural remains at the early mediaeval fort at Raibania, Orissa

    OpenAIRE

    Sen, Bratati

    2013-01-01

    The fortifications of mediaeval India occupy an eminent position in the history of military architecture. The present paper deals with the preliminary study of the structural remains at the early mediaeval fort at Raibania in the district of Balasore in Orissa. The fort was built of stone very loosely kept together. The three-walled fortification interspersed by two consecutive moats, a feature evidenced at Raibania, w...

  17. Neanderthal infant and adult infracranial remains from Marillac (Charente, France).

    Science.gov (United States)

    Dolores Garralda, María; Maureille, Bruno; Vandermeersch, Bernard

    2014-09-01

    At the site of Marillac, near the Ligonne River in Marillac-le-Franc (Charente, France), a remarkable stratigraphic sequence has yielded a wealth of archaeological information, palaeoenvironmental data, as well as faunal and human remains. Marillac must have been a sinkhole used by Neanderthal groups as a hunting camp during MIS 4 (TL date 57,600 ± 4,600BP), where Quina Mousterian lithics and fragmented bones of reindeer predominate. This article describes three infracranial skeleton fragments. Two of them are from adults and consist of the incomplete shafts of a right radius (Marillac 24) and a left fibula (Marillac 26). The third fragment is the diaphysis of the right femur of an immature individual (Marillac 25), the size and shape of which resembles those from Teshik-Tash and could be assigned to a child of a similar age. The three fossils have been compared with the remains of other Neanderthals or anatomically Modern Humans (AMH). Furthermore, the comparison of the infantile femora, Marillac 25 and Teshik-Tash, with the remains of several European children from the early Middle Ages clearly demonstrates the robustness and rounded shape of both Neanderthal diaphyses. Evidence of peri-mortem manipulations have been identified on all three bones, with spiral fractures, percussion pits and, in the case of the radius and femur, unquestionable cutmarks made with flint implements, probably during defleshing. Traces of periostosis appear on the fibula fragment and on the immature femoral diaphysis, although their aetiology remains unknown. Copyright © 2014 Wiley Periodicals, Inc.

  18. Calibration of C-14 dates: some remaining uncertainties and limitations

    International Nuclear Information System (INIS)

    Burleigh, R.

    1975-01-01

    A brief review is presented of the interpretation of radiocarbon dates in terms of calendar years. An outline is given of the factors that make such correlations necessary and of the work that has so far been done to make them possible. The calibration of the C-14 timescale very largely depends at present on the bristlecone pine chronology, but it is clear that many detailed uncertainties still remain. These are discussed. (U.K.)

  19. Remaining useful life estimation based on discriminating shapelet extraction

    International Nuclear Information System (INIS)

    Malinowski, Simon; Chebel-Morello, Brigitte; Zerhouni, Noureddine

    2015-01-01

    In the Prognostics and Health Management domain, estimating the remaining useful life (RUL) of critical machinery is a challenging task. Various research topics including data acquisition, fusion, diagnostics and prognostics are involved in this domain. This paper presents an approach, based on shapelet extraction, to estimate the RUL of equipment. This approach extracts, in an offline step, discriminative rul-shapelets from an history of run-to-failure data. These rul-shapelets are patterns that are selected for their correlation with the remaining useful life of the equipment. In other words, every selected rul-shapelet conveys its own information about the RUL of the equipment. In an online step, these rul-shapelets are compared to testing units and the ones that match these units are used to estimate their RULs. Therefore, RUL estimation is based on patterns that have been selected for their high correlation with the RUL. This approach is different from classical similarity-based approaches that attempt to match complete testing units (or only late instants of testing units) with training ones to estimate the RUL. The performance of our approach is evaluated on a case study on the remaining useful life estimation of turbofan engines and performance is compared with other similarity-based approaches. - Highlights: • A data-driven RUL estimation technique based on pattern extraction is proposed. • Patterns are extracted for their correlation with the RUL. • The proposed method shows good performance compared to other techniques

  20. Remaining life diagnosis method and device for nuclear reactor

    International Nuclear Information System (INIS)

    Yamamoto, Michiyoshi.

    1996-01-01

    A neutron flux measuring means is inserted from the outside of a reactor pressure vessel during reactor operation to forecast neutron-degradation of materials of incore structural components in the vicinity of portions to be measured based on the measured values, and the remaining life of the reactor is diagnosed by the forecast degraded state. In this case, the neutron fluxes to be measured are desirably fast and/or medium neutron fluxes. As the positions where the measuring means is to be inserted, for example, the vicinity of the structural components at the periphery of the fuel assembly is selected. Aging degradation characteristics of the structural components are determined by using the aging degradation data for the structural materials. The remaining life is analyzed based on obtained aging degradation characteristics and stress evaluation data of the incore structural components at portions to be measured. Neutron irradiation amount of structural components at predetermined positions can be recognized accurately, and appropriate countermeasures can be taken depending on the forecast remaining life thereby enabling to improve the reliability of the reactor. (N.H.)

  1. Postmortem Scavenging of Human Remains by Domestic Cats

    Directory of Open Access Journals (Sweden)

    Ananya Suntirukpong, M.D.

    2017-11-01

    Full Text Available Objective: Crime scene investigators, forensic medicine doctors and pathologists, and forensic anthropologists frequently encounter postmortem scavenging of human remains by household pets. Case presentation: The authors present a case report of a partially skeletonized adult male found dead after more than three months in his apartment in Thailand. The body was in an advanced stage of decomposition with nearly complete skeletonization of the head, neck, hands, and feet. The presence of maggots and necrophagous (flesh eating beetles on the body confirmed that insects had consumed much of the soft tissues. Examination of the hand and foot bones revealed canine tooth puncture marks. Evidence of chewing indicated that one or more of the decedent’s three house cats had fed on the body after death. Recognizing and identifying carnivore and rodent activity on the soft flesh and bones of human remains is important in interpreting and reconstructing postmortem damage. Thorough analysis may help explain why skeletal elements are missing, damaged, or out of anatomical position. Conclusion: This report presents a multi-disciplinary approach combining forensic anthropology and forensic medicine in examining and interpreting human remains.

  2. Postpartum haemorrhage: prevention and treatment.

    Science.gov (United States)

    Sentilhes, Loïc; Merlot, Benjamin; Madar, Hugo; Sztark, François; Brun, Stéphanie; Deneux-Tharaux, Catherine

    2016-11-01

    Postpartum hemorrhage (PPH) is one of the leading causes of maternal death and severe maternal morbidity worldwide and strategies to prevent and treat PPH vary among international authorities. Areas covered: This review seeks to provide a global overview of PPH (incidence, causes, risk factors), prevention (active management of the third stage of labor and prohemostatic agents), treatment (first, second and third-line measures to control PPH), by also underlining recommendations elaborated by international authorities and using algorithms. Expert commentary: When available, oxytocin is considered the drug of first choice for both prevention and treatment of PPH, while peripartum hysterectomy remains the ultimate life-saving procedure if pharmacological and resuscitation measures fail. Nevertheless, the level of evidence for preventing and treating PPH is globally low. The emergency nature of PPH makes randomized controlled trials (RCT) logistically difficult. Population-based observational studies should be encouraged as they can usefully strengthen the evidence base, particularly for components of PPH treatment that are difficult or impossible to assess through RCT.

  3. Tuberculosis remains a challenge despite economic growth in Panama.

    Science.gov (United States)

    Tarajia, M; Goodridge, A

    2014-03-01

    Tuberculosis (TB) is a disease associated with inequality, and wise investment of economic resources is considered critical to its control. Panama has recently secured its status as an upper-middle-income country with robust economic growth. However, the prioritisation of resources for TB control remains a major challenge. In this article, we highlight areas that urgently require action to effectively reduce TB burden to minimal levels. Our conclusions suggest the need for fund allocation and a multidisciplinary approach to ensure prompt laboratory diagnosis, treatment assurance and workforce reinforcement, complemented by applied and operational research, development and innovation.

  4. Yellow Fever Remains a Potential Threat to Public Health.

    Science.gov (United States)

    Vasconcelos, Pedro F C; Monath, Thomas P

    2016-08-01

    Yellow fever (YF) remains a serious public health threat in endemic countries. The recent re-emergence in Africa, initiating in Angola and spreading to Democratic Republic of Congo and Uganda, with imported cases in China and Kenya is of concern. There is such a shortage of YF vaccine in the world that the World Health Organization has proposed the use of reduced doses (1/5) during emergencies. In this short communication, we discuss these and other problems including the risk of spread of YF to areas free of YF for decades or never before affected by this arbovirus disease.

  5. The Artificial Leaf: Recent Progress and Remaining Challenges

    Directory of Open Access Journals (Sweden)

    Mark D Symes

    2016-12-01

    Full Text Available The prospect of a device that uses solar energy to split water into H2 and O2 is highly attractive in terms of producing hydrogen as a carbon-neutral fuel. In this mini review, key research milestones that have been reached in this field over the last two decades will be discussed, with special focus on devices that use earth-abundant materials. Finally, the remaining challenges in the development of such “artificial leaves” will be highlighted.

  6. Leprosy: ancient disease remains a public health problem nowadays.

    Science.gov (United States)

    Noriega, Leandro Fonseca; Chiacchio, Nilton Di; Noriega, Angélica Fonseca; Pereira, Gilmayara Alves Abreu Maciel; Vieira, Marina Lino

    2016-01-01

    Despite being an ancient disease, leprosy remains a public health problem in several countries -particularly in India, Brazil and Indonesia. The current operational guidelines emphasize the evaluation of disability from the time of diagnosis and stipulate as fundamental principles for disease control: early detection and proper treatment. Continued efforts are needed to establish and improve quality leprosy services. A qualified primary care network that is integrated into specialized service and the development of educational activities are part of the arsenal in the fight against the disease, considered neglected and stigmatizing.

  7. Studies on protozoa in ancient remains - A Review

    Directory of Open Access Journals (Sweden)

    Liesbeth Frías

    2013-02-01

    Full Text Available Paleoparasitological research has made important contributions to the understanding of parasite evolution and ecology. Although parasitic protozoa exhibit a worldwide distribution, recovering these organisms from an archaeological context is still exceptional and relies on the availability and distribution of evidence, the ecology of infectious diseases and adequate detection techniques. Here, we present a review of the findings related to protozoa in ancient remains, with an emphasis on their geographical distribution in the past and the methodologies used for their retrieval. The development of more sensitive detection methods has increased the number of identified parasitic species, promising interesting insights from research in the future.

  8. Encephalitozoon cuniculi in Raw Cow's Milk Remains Infectious After Pasteurization.

    Science.gov (United States)

    Kváč, Martin; Tomanová, Vendula; Samková, Eva; Koubová, Jana; Kotková, Michaela; Hlásková, Lenka; McEvoy, John; Sak, Bohumil

    2016-02-01

    This study describes the prevalence of Encephalitozoon cuniculi in raw cow's milk and evaluates the effect of different milk pasteurization treatments on E. cuniculi infectivity for severe combined immunodeficient (SCID) mice. Using a nested polymerase chain reaction approach, 1 of 50 milking cows was found to repeatedly shed E. cuniculi in its feces and milk. Under experimental conditions, E. cuniculi spores in milk remained infective for SCID mice following pasteurization treatments at 72 °C for 15 s or 85 °C for 5 s. Based on these findings, pasteurized cow's milk should be considered a potential source of E. cuniculi infection in humans.

  9. "Recent" macrofossil remains from the Lomonosov Ridge, central Arctic Ocean

    Science.gov (United States)

    Le Duc, Cynthia; de Vernal, Anne; Archambault, Philippe; Brice, Camille; Roberge, Philippe

    2016-04-01

    The examination of surface sediment samples collected from 17 sites along the Lomonosov Ridge at water depths ranging from 737 to 3339 meters during Polarstern Expedition PS87 in 2014 (Stein, 2015), indicates a rich biogenic content almost exclusively dominated by calcareous remains. Amongst biogenic remains, microfossils (planktic and benthic foraminifers, pteropods, ostracods, etc.) dominate but millimetric to centrimetric macrofossils occurred frequently at the surface of the sediment. The macrofossil remains consist of a large variety of taxa, including gastropods, bivalvia, polychaete tubes, scaphopods, echinoderm plates and spines, and fish otoliths. Among the Bivalvia, the most abundant taxa are Portlandia arctica, Hyalopecten frigidus, Cuspidaria glacilis, Policordia densicostata, Bathyarca spp., and Yoldiella spp. Whereas a few specimens are well preserved and apparently pristine, most mollusk shells displayed extensive alteration features. Moreover, most shells were covered by millimeter scale tubes of the serpulid polychaete Spirorbis sp. suggesting transport from low intertidal or subtidal zone. Both the ecological affinity and known geographic distribution of identified bivalvia as named above support the hypothesis of transportation rather than local development. In addition to mollusk shells, more than a hundred fish otoliths were recovered in surface sediments. The otoliths mostly belong to the Gadidae family. Most of them are well preserved and without serpulid tubes attached to their surface, suggesting a local/regional origin, unlike the shell remains. Although recovered at the surface, the macrofaunal assemblages of the Lomonosov Ridge do not necessarily represent the "modern" environments as they may result from reworking and because their occurrence at the surface of the sediment may also be due to winnowing of finer particles. Although the shells were not dated, we suspect that their actual ages may range from modern to several thousands of

  10. HPV Testing Among Providers

    Centers for Disease Control (CDC) Podcasts

    2009-10-15

    Dr. Walter Kinney, a gynecologic oncologist with The Permanente Medical Group in Sacramento, California, talks about Pap and human papillomavirus (HPV) cotesting in women aged 30 and over.  Created: 10/15/2009 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Division of Cancer Prevention and Control (DCPC).   Date Released: 6/9/2010.

  11. Fossil human remains from Bolomor Cave (Valencia, Spain).

    Science.gov (United States)

    Arsuaga, Juan Luis; Fernández Peris, Josep; Gracia-Téllez, Ana; Quam, Rolf; Carretero, José Miguel; Barciela González, Virginia; Blasco, Ruth; Cuartero, Felipe; Sañudo, Pablo

    2012-05-01

    Systematic excavations carried out since 1989 at Bolomor Cave have led to the recovery of four Pleistocene human fossil remains, consisting of a fibular fragment, two isolated teeth, and a nearly complete adult parietal bone. All of these specimens date to the late Middle and early Late Pleistocene (MIS 7-5e). The fibular fragment shows thick cortical bone, an archaic feature found in non-modern (i.e. non-Homo sapiens) members of the genus Homo. Among the dental remains, the lack of a midtrigonid crest in the M(1) represents a departure from the morphology reported for the majority of Neandertal specimens, while the large dimensions and pronounced shoveling of the marginal ridges in the C(1) are similar to other European Middle and late Pleistocene fossils. The parietal bone is very thick, with dimensions that generally fall above Neandertal fossils and resemble more closely the Middle Pleistocene Atapuerca (SH) adult specimens. Based on the presence of archaic features, all the fossils from Bolomor are attributed to the Neandertal evolutionary lineage. Copyright © 2012 Elsevier Ltd. All rights reserved.

  12. Determination of Remaining Useful Life of Gas Turbine Blade

    Directory of Open Access Journals (Sweden)

    Meor Said Mior Azman

    2016-01-01

    Full Text Available The aim of this research is to determine the remaining useful life of gas turbine blade, using service-exposed turbine blades. This task is performed using Stress Rupture Test (SRT under accelerated test conditions where the applied stresses to the specimen is between 400 MPa to 600 MPa and the test temperature is 850°C. The study will focus on the creep behaviour of the 52000 hours service-exposed blades, complemented with creep-rupture modelling using JMatPro software and microstructure examination using optical microscope. The test specimens, made up of Ni-based superalloy of the first stage turbine blades, are machined based on International Standard (ISO 24. The results from the SRT will be analyzed using these two main equations – Larson-Miller Parameter and Life Fraction Rule. Based on the results of the remaining useful life analysis, the 52000h service-exposed blade has the condition to operate in the range of another 4751 hr to 18362 hr. The microstructure examinations shows traces of carbide precipitation that deteriorate the grain boundaries that occurs during creep process. Creep-rupture life modelling using JMatPro software has shown good agreement with the accelerated creep rupture test with minimal error.

  13. A method for defleshing human remains using household bleach.

    Science.gov (United States)

    Mann, Robert W; Berryman, Hugh E

    2012-03-01

    Medical examiners and forensic anthropologists are often faced with the difficult task of removing soft tissue from the human skeleton without damaging the bones, teeth and, in some cases, cartilage. While there are a number of acceptable methods that can be used to remove soft tissue including macerating in water, simmering or boiling, soaking in ammonia, removing with scissors, knife, scalpel or stiff brush, and dermestid beetles, each has its drawback in time, safety, or potential to damage bone. This technical report using the chest plate of a stabbing victim presents a safe and effective alternative method for removing soft tissue from human remains, in particular the chest plate, following autopsy, without damaging or separating the ribs, sternum, and costal cartilage. This method can be used to reveal subtle blunt force trauma to bone, slicing and stabbing injuries, and other forms of trauma obscured by overlying soft tissue. Despite the published cautionary notes, when done properly household bleach (3-6% sodium hypochlorite) is a quick, safe, and effective method for examining cartilage and exposing skeletal trauma by removing soft tissue from human skeletal remains. 2011 American Academy of Forensic Sciences. Published 2011. This article is a U.S. Government work and is in the public domain in the U.S.A.

  14. Duplex Alu Screening for Degraded DNA of Skeletal Human Remains

    Directory of Open Access Journals (Sweden)

    Fabian Haß

    2017-10-01

    Full Text Available The human-specific Alu elements, belonging to the class of Short INterspersed Elements (SINEs, have been shown to be a powerful tool for population genetic studies. An earlier study in this department showed that it was possible to analyze Alu presence/absence in 3000-year-old skeletal human remains from the Bronze Age Lichtenstein cave in Lower Saxony, Germany. We developed duplex Alu screening PCRs with flanking primers for two Alu elements, each combined with a single internal Alu primer. By adding an internal primer, the approximately 400–500 bp presence signals of Alu elements can be detected within a range of less than 200 bp. Thus, our PCR approach is suited for highly fragmented ancient DNA samples, whereas NGS analyses frequently are unable to handle repetitive elements. With this analysis system, we examined remains of 12 individuals from the Lichtenstein cave with different degrees of DNA degradation. The duplex PCRs showed fully informative amplification results for all of the chosen Alu loci in eight of the 12 samples. Our analysis system showed that Alu presence/absence analysis is possible in samples with different degrees of DNA degradation and it reduces the amount of valuable skeletal material needed by a factor of four, as compared with a singleplex approach.

  15. Long-term health benefits of appetite suppressants remain unproven

    Directory of Open Access Journals (Sweden)

    Francisco José Roma Paumgartten

    2011-12-01

    Full Text Available Because of the increasing prevalence of obesity, prevention and treatment of overweight has become a major public health concern. In addition to diet and exercise, drugs are needed for patients who failed to lose weight with behavioral treatment. The current article aimed to summarize recent concerns on the safety and efficacy of appetite suppressants. Several appetite suppressants have been banned for safety reasons. In 2010, sibutramine was withdrawn from the market because a long-term study showed it increased the risks of cardiovascular events. So far no study with a sufficiently large sample size has demonstrated that appetite suppressants can reduce morbidity and mortality associated with overweight. The withdrawal of sibutramine highlights that guidelines for the evaluation of weight control drugs must be more stringent, and studies on their long-term health benefits are needed prior to their marketing.

  16. Prevention of preterm birth.

    LENUS (Irish Health Repository)

    Flood, Karen

    2012-02-01

    Preterm birth (delivery before 37 completed weeks of gestation) is common and rates are increasing. In the past, medical efforts focused on ameliorating the consequences of prematurity rather than preventing its occurrence. This approach resulted in improved neonatal outcomes, but it remains costly in terms of both the suffering of infants and their families and the economic burden on society. Increased understanding of the pathophysiology of preterm labor has altered the approach to this problem, with increased focus on preventive strategies. Primary prevention is a limited strategy which involves public education, smoking cessation, improved nutritional status and avoidance of late preterm births. Secondary prevention focuses on recurrent preterm birth which is the most recognisable risk factor. Widely accepted strategies include cervical cerclage, progesterone and dedicated clinics. However, more research is needed to explore the role of antibiotics and anti-inflammatory treatments in the prevention of this complex problem.

  17. Measuring waste prevention.

    Science.gov (United States)

    Zorpas, Antonis A; Lasaridi, Katia

    2013-05-01

    The Waste Framework Directive (WFD-2008/98/EC) has set clear waste prevention procedures, including reporting, reviewing, monitoring and evaluating. Based on the WFD, the European Commission and will offer support to Member States on how to develop waste prevention programmes through guidelines and information sharing on best practices. Monitoring and evaluating waste prevention activities are critical, as they constitute the main tools to enable policy makers, at the national and local level, to build their strategic plans and ensure that waste prevention initiatives are effective and deliver behaviour change. However, how one can measure something that is not there, remains an important and unresolved research question. The paper reviews and attempts to evaluate the methods that are being used for measuring waste prevention and the impact of relevant implemented activities at the household level, as the available data is still limited. Copyright © 2012 Elsevier Ltd. All rights reserved.

  18. What Remains on Your Mind After You Are Done?: Flexible Regulation of Knowledge Accessibility

    Science.gov (United States)

    Hedberg, Per H.; Higgins, E. Tory

    2011-01-01

    The accessibility of stored knowledge has been found to decline over time after activation without further stimulation. A special case is goal pursuit; goal-related knowledge remains accessible until goal completion, and then its accessibility declines rapidly. We hypothesized that after goal completion the decline in accessibility of goal-related knowledge would be especially rapid for strong promotion-focused individuals because their motivation to eagerly advance beyond the status quo would make accessibility of this knowledge an irrelevant detriment. We hypothesized an opposite effect for strongly prevention-predominant individuals because their motivation to vigilantly maintain a satisfactory state would make accessibility of this knowledge continually relevant. The results of two studies supported both these predicted moderators of accessibility change. Indeed, we found that for strongly prevention-predominant participants, knowledge accessibility actually increased over time after goal completion. We discuss how even basic cognitive mechanisms, like changes in accessibility, can be affected by general motivational concerns. PMID:21765541

  19. On use of radial evanescence remain term in kinematic hardening

    International Nuclear Information System (INIS)

    Geyer, P.

    1995-10-01

    A fine modelling of the material' behaviour can be necessary to study the mechanical strength of nuclear power plant' components under cyclic loads. Ratchetting is one of the last phenomena for which numerical models have to be improved. We discuss in this paper on use of radial evanescence remain term in kinematic hardening to improve the description of ratchetting in biaxial loading tests. It's well known that Chaboche elastoplastic model with two non linear kinematic hardening variables initially proposed by Armstrong and Frederick, usually over-predicts accumulation of ratchetting strain. Burlet and Cailletaud proposed in 1987 a non linear kinematic rule with a radial evanescence remain term. The two models lead to identical formulation for proportional loadings. In the case of a biaxial loading test (primary+secondary loading), Burlet and Cailletaud model leads to accommodation, when Chaboche one's leads to ratchetting with a constant increment of strain. So we can have an under-estimate with the first model and an over-estimate with the second. An easy method to improve the description of ratchetting is to combine the two kinematic rules. Such an idea is already used by Delobelle in his model. With analytical results in the case of tension-torsion tests, we show in a first part of the paper, the interest of radial evanescence remain term in the non linear kinematic rule to describe ratchetting: we give the conditions to get adaptation, accommodation or ratchetting and the value of the strain increment in the last case. In the second part of the paper, we propose to modify the elastoplastic Chaboche model by coupling the two types of hardening by means of two scalar parameters which can be identified independently on biaxial loading tests. Identification of these two parameters returns to speculate on the directions of strain in order to adjust the ratchetting to experimental observations. We use the experimental results on the austenitic steel 316L at room

  20. Highly efficient DNA extraction method from skeletal remains

    Directory of Open Access Journals (Sweden)

    Irena Zupanič Pajnič

    2011-03-01

    Full Text Available Background: This paper precisely describes the method of DNA extraction developed to acquire high quality DNA from the Second World War skeletal remains. The same method is also used for molecular genetic identification of unknown decomposed bodies in routine forensic casework where only bones and teeth are suitable for DNA typing. We analysed 109 bones and two teeth from WWII mass graves in Slovenia. Methods: We cleaned the bones and teeth, removed surface contaminants and ground the bones into powder, using liquid nitrogen . Prior to isolating the DNA in parallel using the BioRobot EZ1 (Qiagen, the powder was decalcified for three days. The nuclear DNA of the samples were quantified by real-time PCR method. We acquired autosomal genetic profiles and Y-chromosome haplotypes of the bones and teeth with PCR amplification of microsatellites, and mtDNA haplotypes 99. For the purpose of traceability in the event of contamination, we prepared elimination data bases including genetic profiles of the nuclear and mtDNA of all persons who have been in touch with the skeletal remains in any way. Results: We extracted up to 55 ng DNA/g of the teeth, up to 100 ng DNA/g of the femurs, up to 30 ng DNA/g of the tibias and up to 0.5 ng DNA/g of the humerus. The typing of autosomal and YSTR loci was successful in all of the teeth, in 98 % dekalof the femurs, and in 75 % to 81 % of the tibias and humerus. The typing of mtDNA was successful in all of the teeth, and in 96 % to 98 % of the bones. Conclusions: We managed to obtain nuclear DNA for successful STR typing from skeletal remains that were over 60 years old . The method of DNA extraction described here has proved to be highly efficient. We obtained 0.8 to 100 ng DNA/g of teeth or bones and complete genetic profiles of autosomal DNA, Y-STR haplotypes, and mtDNA haplotypes from only 0.5g bone and teeth samples.

  1. What HERA May Provide?

    Energy Technology Data Exchange (ETDEWEB)

    Jung, Hannes; /DESY; De Roeck, Albert; /CERN; Bartels, Jochen; /Hamburg U., Inst. Theor. Phys. II; Behnke, Olaf; Blumlein, Johannes; /DESY; Brodsky, Stanley; /SLAC /Durham U., IPPP; Cooper-Sarkar, Amanda; /Oxford U.; Deak, Michal; /DESY; Devenish, Robin; /Oxford U.; Diehl, Markus; /DESY; Gehrmann, Thomas; /Zurich U.; Grindhammer, Guenter; /Munich, Max Planck Inst.; Gustafson, Gosta; /CERN /Lund U., Dept. Theor. Phys.; Khoze, Valery; /Durham U., IPPP; Knutsson, Albert; /DESY; Klein, Max; /Liverpool U.; Krauss, Frank; /Durham U., IPPP; Kutak, Krzysztof; /DESY; Laenen, Eric; /NIKHEF, Amsterdam; Lonnblad, Leif; /Lund U., Dept. Theor. Phys.; Motyka, Leszek; /Hamburg U., Inst. Theor. Phys. II /Birmingham U. /Southern Methodist U. /DESY /Piemonte Orientale U., Novara /CERN /Paris, LPTHE /Hamburg U. /Penn State U.

    2011-11-10

    More than 100 people participated in a discussion session at the DIS08 workshop on the topic What HERA may provide. A summary of the discussion with a structured outlook and list of desirable measurements and theory calculations is given. The HERA accelerator and the HERA experiments H1, HERMES and ZEUS stopped running in the end of June 2007. This was after 15 years of very successful operation since the first collisions in 1992. A total luminosity of {approx} 500 pb{sup -1} has been accumulated by each of the collider experiments H1 and ZEUS. During the years the increasingly better understood and upgraded detectors and HERA accelerator have contributed significantly to this success. The physics program remains in full swing and plenty of new results were presented at DIS08 which are approaching the anticipated final precision, fulfilling and exceeding the physics plans and the previsions of the upgrade program. Most of the analyses presented at DIS08 were still based on the so called HERA I data sample, i.e. data taken until 2000, before the shutdown for the luminosity upgrade. This sample has an integrated luminosity of {approx} 100 pb{sup -1}, and the four times larger statistics sample from HERA II is still in the process of being analyzed.

  2. Material aging and degradation detection and remaining life assessment for plant life management

    International Nuclear Information System (INIS)

    Ramuhalli, P.; Henager, C.H. Jr.; Griffin, J.W.; Meyer, R.M.; Coble, J.B.; Pitman, S.G.; Bond, L.J.

    2012-01-01

    One of the major factors that may impact long-term operations is structural material degradation. Detecting materials degradation, estimating the remaining useful life (RUL) of the component, and determining approaches to mitigating the degradation are important from the perspective of long-term operations. In this study, multiple nondestructive measurement and monitoring methods were evaluated for their ability to assess the material degradation state. Metrics quantifying the level of damage from these measurements were defined and evaluated for their ability to provide estimates of remaining life of the component. An example of estimating the RUL from nondestructive measurements of material degradation condition is provided. (author)

  3. TMI in perspective: reactor containment stands up, difficult decisions remain

    International Nuclear Information System (INIS)

    Corey, G.R.

    1979-01-01

    Commonwealth Edison Co. is increasing its commitment to nuclear energy after reviewing the performance of the Three Mile Island reactor containment systems. Both the reactor vessel and the secondary containment remained intact and no radiation was reported in the soil or water. The public discussion of energy options which followed the accident will benefit both the public and technical community even if there is a temporary slowdown in nuclear power development. The realities of energy supplies have become evident; i.e., that nuclear and coal are the only available options for the short-term. The discussion should also lead to better personnel training, regulatory reforms, risk-sharing insurance, and international standards. The public hysteria triggered by the accident stemmed partly from the combination of unfortunate incidents and the media coverage, which led to hasty conclusions

  4. Oldest Directly Dated Remains of Sheep in China

    Science.gov (United States)

    Dodson, John; Dodson, Eoin; Banati, Richard; Li, Xiaoqiang; Atahan, Pia; Hu, Songmei; Middleton, Ryan J.; Zhou, Xinying; Nan, Sun

    2014-11-01

    The origins of domesticated sheep (Ovis sp.) in China remain unknown. Previous workers have speculated that sheep may have been present in China up to 7000 years ago, however many claims are based on associations with archaeological material rather than independent dates on sheep material. Here we present 7 radiocarbon dates on sheep bone from Inner Mongolia, Ningxia and Shaanxi provinces. DNA analysis on one of the bones confirms it is Ovis sp. The oldest ages are about 4700 to 4400 BCE and are thus the oldest objectively dated Ovis material in eastern Asia. The graphitisised bone collagen had δ13C values indicating some millet was represented in the diet. This probably indicates sheep were in a domestic setting where millet was grown. The younger samples had δ13C values indicating that even more millet was in the diet, and this was likely related to changes in foddering practices

  5. On use of radial evanescence remain term in kinematic hardening

    International Nuclear Information System (INIS)

    Geyer, P.

    1995-01-01

    This paper presents the interest which lies in non-linear kinematic hardening rule with radial evanescence remain term as proposed for modelling multiaxial ratchetting. From analytical calculations in the case of the tension/torsion test, this ratchetting is compared with that proposed by Armstrong and Frederick. A modification is then proposed for Chaboche's elastoplastic model with two non-linear kinematic variables, by coupling the two types of hardening by means of two scalar parameters. Identification of these two parameters returns to speculate on the directions of strain in order to adjust the ratchetting to experimental observations. Using biaxial ratchetting tests on stainless steel 316 L specimens at ambient temperature, it is shown that satisfactory modelling of multiaxial ratchetting is obtained. (author). 4 refs., 5 figs

  6. Psychotherapy for Borderline Personality Disorder: Progress and Remaining Challenges.

    Science.gov (United States)

    Links, Paul S; Shah, Ravi; Eynan, Rahel

    2017-03-01

    The main purpose of this review was to critically evaluate the literature on psychotherapies for borderline personality disorder (BPD) published over the past 5 years to identify the progress with remaining challenges and to determine priority areas for future research. A systematic review of the literature over the last 5 years was undertaken. The review yielded 184 relevant abstracts, and after applying inclusion criteria, 16 articles were fully reviewed based on the articles' implications for future research and/or clinical practice. Our review indicated that patients with various severities benefited from psychotherapy; more intensive therapies were not significantly superior to less intensive therapies; enhancing emotion regulation processes and fostering more coherent self-identity were important mechanisms of change; therapies had been extended to patients with BPD and posttraumatic stress disorder; and more research was needed to be directed at functional outcomes.

  7. [Alcohol and work: remaining sober and return to work].

    Science.gov (United States)

    Vittadini, G; Bandirali, M

    2007-01-01

    One of the most complex alcohol-driven problems is the job loss and the subsequent attempts to return to a professional activity. In order to better understand the issue, an epidemiologic investigation was carried out on a group of 162 alcoholics whilst hospitalised in a specialised clinic. The outcome shows the importance of remaining sober to keep or to be returned to one's own job. Unfortunately, local resources at hand, first of all joining an auto-mutual-help group, re still too little known and thus clearly underemployed. Therefore, an informative action within companies is highly desirable. Those alcoholics suffering from serious illnesses, especially mental ones represent a different issue. For these people a higher involvement of public authorities is desirable in creating protected job openings.

  8. Differential Decomposition Among Pig, Rabbit, and Human Remains.

    Science.gov (United States)

    Dautartas, Angela; Kenyhercz, Michael W; Vidoli, Giovanna M; Meadows Jantz, Lee; Mundorff, Amy; Steadman, Dawnie Wolfe

    2018-03-30

    While nonhuman animal remains are often utilized in forensic research to develop methods to estimate the postmortem interval, systematic studies that directly validate animals as proxies for human decomposition are lacking. The current project compared decomposition rates among pigs, rabbits, and humans at the University of Tennessee's Anthropology Research Facility across three seasonal trials that spanned nearly 2 years. The Total Body Score (TBS) method was applied to quantify decomposition changes and calculate the postmortem interval (PMI) in accumulated degree days (ADD). Decomposition trajectories were analyzed by comparing the estimated and actual ADD for each seasonal trial and by fuzzy cluster analysis. The cluster analysis demonstrated that the rabbits formed one group while pigs and humans, although more similar to each other than either to rabbits, still showed important differences in decomposition patterns. The decomposition trends show that neither nonhuman model captured the pattern, rate, and variability of human decomposition. © 2018 American Academy of Forensic Sciences.

  9. Premortal data in the process of skeletal remains identification

    Directory of Open Access Journals (Sweden)

    Marinković Nadica

    2012-01-01

    Full Text Available Background/Aim. The basic task of a forensic examiner during the exhumation of mass graves or in mass accidents is to establish identity of a person. The results obtained through these procedures depend on the level of perceptibility of post mortal changes and they are compared with premortal data obtained from family members of those missing or killed. Experience with exhumations has shown significant differences between the results obtained through exhumation and the premortal data. The aim of the study was to suggest the existance of the difference between premortal data and the results obtained by exhumation regarding the some parameters, as well as to direct premortal data colection to the specific skeletal forms. Methods. We performed comparative analysis of the results of exhumation of skeletal remains in a mass grave and the premortal data concerning the identified persons. The least number of individuals in this mass grave was calculated according to the upper parts of the right femur and it helped in calculating the smallest number of individuals in mass graves to be 48. A total of 27 persons were identified. Sex was determined by metrics and morphology of the pelvis. Personal age in the moment of death was determined by morphology features of groin symphisis and morphology of sternal edge of ribs and other parts of scelets observations. The hight was calculated as average results of length of long bones and Rollet coefficients. Results. There was a complete match in terms of sex and age matched within an interval that could be established based on the skeletal remains. All the other parameters were different, however, which made identification significantly more difficult. Conclusion. The premortal data is an important element of identification process and it should be obtained by the forensic doctor and directed towards more detailed examination of the skeletal system.

  10. Reidentification of avian embryonic remains from the cretaceous of mongolia.

    Science.gov (United States)

    Varricchio, David J; Balanoff, Amy M; Norell, Mark A

    2015-01-01

    Embryonic remains within a small (4.75 by 2.23 cm) egg from the Late Cretaceous, Mongolia are here re-described. High-resolution X-ray computed tomography (HRCT) was used to digitally prepare and describe the enclosed embryonic bones. The egg, IGM (Mongolian Institute for Geology, Ulaanbaatar) 100/2010, with a three-part shell microstructure, was originally assigned to Neoceratopsia implying extensive homoplasy among eggshell characters across Dinosauria. Re-examination finds the forelimb significantly longer than the hindlimbs, proportions suggesting an avian identification. Additional, postcranial apomorphies (strut-like coracoid, cranially located humeral condyles, olecranon fossa, slender radius relative to the ulna, trochanteric crest on the femur, and ulna longer than the humerus) identify the embryo as avian. Presence of a dorsal coracoid fossa and a craniocaudally compressed distal humerus with a strongly angled distal margin support a diagnosis of IGM 100/2010 as an enantiornithine. Re-identification eliminates the implied homoplasy of this tri-laminate eggshell structure, and instead associates enantiornithine birds with eggshell microstructure composed of a mammillary, squamatic, and external zones. Posture of the embryo follows that of other theropods with fore- and hindlimbs folded parallel to the vertebral column and the elbow pointing caudally just dorsal to the knees. The size of the egg and embryo of IGM 100/2010 is similar to the two other Mongolian enantiornithine eggs. Well-ossified skeletons, as in this specimen, characterize all known enantiornithine embryos suggesting precocial hatchlings, comparing closely to late stage embryos of modern precocial birds that are both flight- and run-capable upon hatching. Extensive ossification in enantiornithine embryos may contribute to their relatively abundant representation in the fossil record. Neoceratopsian eggs remain unrecognized in the fossil record.

  11. Reidentification of avian embryonic remains from the cretaceous of mongolia.

    Directory of Open Access Journals (Sweden)

    David J Varricchio

    Full Text Available Embryonic remains within a small (4.75 by 2.23 cm egg from the Late Cretaceous, Mongolia are here re-described. High-resolution X-ray computed tomography (HRCT was used to digitally prepare and describe the enclosed embryonic bones. The egg, IGM (Mongolian Institute for Geology, Ulaanbaatar 100/2010, with a three-part shell microstructure, was originally assigned to Neoceratopsia implying extensive homoplasy among eggshell characters across Dinosauria. Re-examination finds the forelimb significantly longer than the hindlimbs, proportions suggesting an avian identification. Additional, postcranial apomorphies (strut-like coracoid, cranially located humeral condyles, olecranon fossa, slender radius relative to the ulna, trochanteric crest on the femur, and ulna longer than the humerus identify the embryo as avian. Presence of a dorsal coracoid fossa and a craniocaudally compressed distal humerus with a strongly angled distal margin support a diagnosis of IGM 100/2010 as an enantiornithine. Re-identification eliminates the implied homoplasy of this tri-laminate eggshell structure, and instead associates enantiornithine birds with eggshell microstructure composed of a mammillary, squamatic, and external zones. Posture of the embryo follows that of other theropods with fore- and hindlimbs folded parallel to the vertebral column and the elbow pointing caudally just dorsal to the knees. The size of the egg and embryo of IGM 100/2010 is similar to the two other Mongolian enantiornithine eggs. Well-ossified skeletons, as in this specimen, characterize all known enantiornithine embryos suggesting precocial hatchlings, comparing closely to late stage embryos of modern precocial birds that are both flight- and run-capable upon hatching. Extensive ossification in enantiornithine embryos may contribute to their relatively abundant representation in the fossil record. Neoceratopsian eggs remain unrecognized in the fossil record.

  12. Ensuring effective prevention of iodine-deficiency disorders

    DEFF Research Database (Denmark)

    Völzke, Henry; Caron, Philippe Jean; Dahl, Lisbeth

    2016-01-01

    BACKGROUND: Programs initiated to prevent iodine deficiency disorders (IDD) may not remain effective due to changes in government policies, commercial factors, and human behavior that may affect the efficacy of IDD prevention programs in unpredictable directions. Monitoring and outcome studies...... by the lack of centralized standardization procedures. In addition, data on outcomes and the cost of achieving them are needed in order to provide evidence of the beneficial effects of IDD prevention in countries with mild iodine deficiency. CONCLUSION: Monitoring studies can be optimized by including...... in mildly iodine-deficient areas and that it should include populations from regions with different environmental, ethnic, and cultural backgrounds....

  13. Factors associated with numbers of remaining teeth among type 2 diabetes: a cross-sectional study.

    Science.gov (United States)

    Huang, Jui-Chu; Peng, Yun-Shing; Fan, Jun-Yu; Jane, Sui-Whi; Tu, Liang-Tse; Chang, Chang-Cheng; Chen, Mei-Yen

    2013-07-01

    To explore the factors associated with the numbers of remaining teeth among type 2 diabetes community residents. Promoting oral health is an important nursing role for patients with diabetes, especially in disadvantaged areas. However, limited research has been carried out on the relationship between numbers of remaining teeth, diabetes-related biomarkers and personal oral hygiene among diabetic rural residents. A cross-sectional, descriptive design with a simple random sample was used. This study was part of a longitudinal cohort study of health promotion for preventing diabetic foot among rural community diabetic residents. It was carried out in 18 western coastal and inland districts of Chiayi County in central Taiwan. In total, 703 participants were enrolled in this study. The findings indicated that a high percentage of the participants (26%) had no remaining natural teeth. Nearly three quarters (74%) had fewer than 20 natural teeth. After controlling for the potential confounding factors, multivariate analysis demonstrated that the factors determining numbers of remaining teeth were age (p teeth were less tooth-brushing with dental floss, abnormal ankle brachial pressure and poor glycemic control. This study highlights the importance of nursing intervention in oral hygiene for patients with type 2 diabetes. It is necessary to initiate oral health promotion activities when diabetes is first diagnosed, especially for older diabetic residents of rural or coastal areas who are poorly educated. © 2013 John Wiley & Sons Ltd.

  14. Salmonella Prevention

    Science.gov (United States)

    ... and in vegetable and fruit harvesting and packing operations may help prevent salmonellosis caused by contaminated foods. Better education of food industry workers in basic food safety and restaurant inspection procedures may prevent cross-contamination and other ...

  15. Briquettes of plant remains from the greenhouses of Almeria (Spain)

    Energy Technology Data Exchange (ETDEWEB)

    Callejon-Ferre, A. J.; Lopez-Martinez, J. A.

    2009-07-01

    Since ancient times, plant biomass has been used as a primary fuel, and today, with the impending depletion of fossil fuels, these vegetal sources constitute a cleaner alternative and furthermore have a multitude of uses. The aim of the present study is to design a method of recycling and reuse of plant wastes from intensive agriculture under plastic, by manufacturing briquettes in an environmentally friendly manner. In Almeria (SE Spain), agriculture generates 769,500 t year{sup -}1 of plant remains from greenhouse-grown horticultural crops, a resource currently used for composting and for producing electricity.With the machinery and procedures of the present study, another potential use has been developed by detoxifying and eliminating the plastic wastes of the original biomass for the fabrication of briquettes for fireplaces. The results were slightly inferior to the commercial briquette from other non-horticultural plant materials (no forestry material), specifically 2512 kJ kg{sup -}1, in the least favourable case. On the contrary, the heating value with respect to the two charcoals was significantly lower, with a difference of 12,142 kJ kg{sup -}1. In conclusion; a procedure, applicable in ecological cultivation without agrochemicals or plastic cords, has been developed and tested to reuse and transform plant materials from intensive cultivation into a stable non-toxic product similar to composite logs, applicable in commercial settings or in residential fireplaces. (Author) 48 refs.

  16. Are the alleged remains of Johann Sebastian Bach authentic?

    Science.gov (United States)

    Zegers, Richard H C; Maas, Mario; Koopman, A Ton G; Maat, George J R

    2009-02-16

    A skeleton alleged to be that of Johann Sebastian Bach (1685-1750) was exhumed from a graveyard in Leipzig, Germany, in 1894, but its authenticity is not established. In 1895, anatomist Wilhelm His concluded from his examination of the skeleton and reconstruction of the face that it most likely belonged to Bach. In 1949, surgeon Wolfgang Rosenthal noticed exostoses on the skeleton and on x-rays of 11 living organists and proposed a condition, Organistenkrankheit, which he interpreted as evidence that the skeleton was Bach's. However, our critical assessment of the remains analysis raises doubts: the localisation of the grave was dubious, and the methods used by His to reconstruct the face are controversial. Also, our study of the pelvic x-rays of 12 living professional organists failed to find evidence for the existence of Organistenkrankheit. We believe it is unlikely that the skeleton is that of Bach; techniques such as DNA analysis might help resolve the question but, to date, church authorities have not approved their use on the skeleton.

  17. Factors influencing home care nurse intention to remain employed.

    Science.gov (United States)

    Tourangeau, Ann; Patterson, Erin; Rowe, Alissa; Saari, Margaret; Thomson, Heather; MacDonald, Geraldine; Cranley, Lisa; Squires, Mae

    2014-11-01

    To identify factors affecting Canadian home care nurse intention to remain employed (ITR). In developed nations, healthcare continues to shift into community settings. Although considerable research exists on examining nurse ITR in hospitals, similar research related to nurses employed in home care is limited. In the face of a global nursing shortage, it is important to understand the factors influencing nurse ITR across healthcare sectors. A qualitative exploratory descriptive design was used. Focus groups were conducted with home care nurses. Data were analysed using qualitative content analysis. Six categories of influencing factors were identified by home care nurses as affecting ITR: job characteristics; work structures; relationships/communication; work environment; nurse responses to work; and employment conditions. Findings suggest the following factors influence home care nurse ITR: having autonomy; flexible scheduling; reasonable and varied workloads; supportive work relationships; and receiving adequate pay and benefits. Home care nurses did not identify job satisfaction as a single concept influencing ITR. Home care nursing management should support nurse autonomy, allow flexible scheduling, promote reasonable workloads and create opportunities for team building that strengthen supportive relationships among home care nurses and other health team members. © 2013 John Wiley & Sons Ltd.

  18. DNA Profiling Success Rates from Degraded Skeletal Remains in Guatemala.

    Science.gov (United States)

    Johnston, Emma; Stephenson, Mishel

    2016-07-01

    No data are available regarding the success of DNA Short Tandem Repeat (STR) profiling from degraded skeletal remains in Guatemala. Therefore, DNA profiling success rates relating to 2595 skeletons from eleven cases at the Forensic Anthropology Foundation of Guatemala (FAFG) are presented. The typical postmortem interval was 30 years. DNA was extracted from bone powder and amplified using Identifiler and Minifler. DNA profiling success rates differed between cases, ranging from 50.8% to 7.0%, the overall success rate for samples was 36.3%. The best DNA profiling success rates were obtained from femur (36.2%) and tooth (33.7%) samples. DNA profiles were significantly better from lower body bones than upper body bones (p = <0.0001). Bone samples from males gave significantly better profiles than samples from females (p = <0.0001). These results are believed to be related to bone density. The findings are important for designing forensic DNA sampling strategies in future victim recovery investigations. © 2016 American Academy of Forensic Sciences.

  19. Using contractors to decommission while remaining as licensee

    International Nuclear Information System (INIS)

    Rankine, A.

    1997-01-01

    Over the last few years the role of the United Kingdom Atomic Energy Authority (UKAEA) has changed from one involved in research and development in the field of nuclear power and associated technology, to one of managing the liabilities left over from its previous mission. This period has also seen two significant portions of the organization move to the private sector with sale of the Facilities Services Division to PROCORD and the privatization of AEA Technology. The new UKAEA is therefore a focused liabilities management organization, making the best use of expertise in the private sector in carrying out its mission, but retaining adequate internal resource and expertise to fulful its role and responsibilities as the licensee. UKAEA continues to be committed to giving the highest priority to meeting high standards of safety and environmental protection required of the holder of the Nuclear Site Licence under the Nuclear Installations Act. This paper describes the safety management system within the UKAEA which ensures that UKAEA remains the proper and effective licensee and gives some examples of how this has worked in practice. (author)

  20. Publish or perish: remaining academically relevant and visible in the ...

    African Journals Online (AJOL)

    To improve the visibility of scholars' works and make them relevant on the academic scene, electronic publishing will be advisable. This provides the potential to readers to search and locate the ar ticles at minimum time within one journal or across multiple journals. This includes publishing articles in journals that are ...

  1. Road safety: serious injuries remain a major unsolved problem.

    Science.gov (United States)

    Beck, Ben; Cameron, Peter A; Fitzgerald, Mark C; Judson, Rodney T; Teague, Warwick; Lyons, Ronan A; Gabbe, Belinda J

    2017-09-18

    To investigate temporal trends in the incidence, mortality, disability-adjusted life-years (DALYs), and costs of health loss caused by serious road traffic injury. A retrospective review of data from the population-based Victorian State Trauma Registry and the National Coronial Information System on road traffic-related deaths (pre- and in-hospital) and major trauma (Injury Severity Score > 12) during 2007-2015.Main outcomes and measures: Temporal trends in the incidence of road traffic-related major trauma, mortality, DALYs, and costs of health loss, by road user type. There were 8066 hospitalised road traffic major trauma cases and 2588 road traffic fatalities in Victoria over the 9-year study period. There was no change in the incidence of hospitalised major trauma for motor vehicle occupants (incidence rate ratio [IRR] per year, 1.00; 95% CI, 0.99-1.01; P = 0.70), motorcyclists (IRR, 0.99; 95% CI, 0.97-1.01; P = 0.45) or pedestrians (IRR, 1.00; 95% CI, 0.97-1.02; P = 0.73), but the incidence for pedal cyclists increased 8% per year (IRR, 1.08; 95% CI; 1.05-1.10; P road traffic injuries exceeded $14 billion during 2007-2015, although the cost per patient declined for all road user groups. As serious injury rates have not declined, current road safety targets will be difficult to meet. Greater attention to preventing serious injury is needed, as is further investment in road safety, particularly for pedal cyclists.

  2. Medicare Program; Revisions to Payment Policies Under the Physician Fee Schedule and Other Revisions to Part B for CY 2017; Medicare Advantage Bid Pricing Data Release; Medicare Advantage and Part D Medical Loss Ratio Data Release; Medicare Advantage Provider Network Requirements; Expansion of Medicare Diabetes Prevention Program Model; Medicare Shared Savings Program Requirements. Final rule.

    Science.gov (United States)

    2016-11-15

    This major final rule addresses changes to the physician fee schedule and other Medicare Part B payment policies, such as changes to the Value Modifier, to ensure that our payment systems are updated to reflect changes in medical practice and the relative value of services, as well as changes in the statute. This final rule also includes changes related to the Medicare Shared Savings Program, requirements for Medicare Advantage Provider Networks, and provides for the release of certain pricing data from Medicare Advantage bids and of data from medical loss ratio reports submitted by Medicare health and drug plans. In addition, this final rule expands the Medicare Diabetes Prevention Program model.

  3. Customer service: the key to remaining competitive in managed care.

    Science.gov (United States)

    Howard, J E

    2000-01-01

    The health care industry is undergoing a rapid transformation to meet the ever-increasing needs and demands of its patient population. Employers and managed care organizations are demanding better service and higher quality care, while providers are trying to tackle reimbursement cutbacks, streamlining of services, and serving a diverse population. Providers have begun to realize that to overcome these obstacles and meet the needs of their health plans and consumers, they must focus on the demands of their customers. Health care organizations have found they can meet the demands of both the consumer and the managed care industry through initiating and maintaining a customer service program. This essay explains the importance of customer service and its link to success in the managed care environment.

  4. Clarifying some remaining questions in the anomaly puzzle

    International Nuclear Information System (INIS)

    Huang, Xing; Parker, Leonard

    2011-01-01

    We discuss several points that may help to clarify some questions that remain about the anomaly puzzle in supersymmetric theories. In particular, we consider a general N=1 supersymmetric Yang-Mills theory. The anomaly puzzle concerns the question of whether there is a consistent way in the quantized theory to put the R-current and the stress tensor in a single supermultiplet called the supercurrent, even though in the classical theory they are in the same supermultiplet. It was proposed that the classically conserved supercurrent bifurcates into two supercurrents having different anomalies in the quantum regime. The most interesting result we obtain is an explicit expression for the lowest component of one of the two supercurrents in 4-dimensional spacetime, namely the supercurrent that has the energy-momentum tensor as one of its components. This expression for the lowest component is an energy-dependent linear combination of two chiral currents, which itself does not correspond to a classically conserved chiral current. The lowest component of the other supercurrent, namely, the R-current, satisfies the Adler-Bardeen theorem. The lowest component of the first supercurrent has an anomaly, which we show is consistent with the anomaly of the trace of the energy-momentum tensor. Therefore, we conclude that there is no consistent way to construct a single supercurrent multiplet that contains the R-current and the stress tensor in the straightforward way originally proposed. We also discuss and try to clarify some technical points in the derivations of the two supercurrents in the literature. These latter points concern the significance of infrared contributions to the NSVZ β-function and the role of the equations of motion in deriving the two supercurrents. (orig.)

  5. Will southern California remain a premium market for natural gas?

    International Nuclear Information System (INIS)

    John, F.E.

    1991-01-01

    Average yearly demand for natural gas in southern California totalled just over 3 billion ft 3 /d in 1991 and is projected to increase to just over 3.2 billion ft 3 /d in 2000 and 3.4 billion ft 3 /d in 2010. In the core residential market, demand is being driven by population growth and offset by conservation measures. In the core commercial and industrial market, demand is driven by employment growth and offset by conservation. In the noncore market, natural gas use is expected to fall from 262 million ft 3 /d in 1991 to 223 million ft 3 /d in 2010. Demand for natural gas for cogeneration is expected to either remain stagnant or decrease. The largest potential for market growth in southern California is for utility electric generation. Demand in this sector is expected to increase from 468 million ft 3 /d in 1991 to 1 billion ft 3 in 2010. Air quality concerns furnish a market opportunity for natural gas vehicles, and a substantial increase in natural gas demand might be obtained from even a modest market share of the region's 10 million vehicles. Existing pipeline capacity is sufficient to supply current average year requirements, and the need for new capacity hinges on the issues of satisfying high-year demand, meeting market growth, and accessing more desirable supply regions. Planned capacity additions of 2,150 million ft 3 /d, if completed, will bring substantial excess capacity to southern California in the late 1990s. The competitive advantages of various producing regions will then be greatly influenced by the rate designs used on the pipelines connecting them to the market. 4 tabs

  6. Neutron activation analysis of the prehistoric and ancient bone remains

    International Nuclear Information System (INIS)

    Vasidov, A.; Osinskaya, N.S.; Khatamov, Sh.; Rakhmanova, T.; Akhmadshaev, A.Sh.

    2006-01-01

    Full text: In the work results of the instrumental neutron activation analysis (INAA) of prehistoric bone remains of dinosaurs and ancient bones of bear, archantrop found out on the territory of Uzbekistan are presents. A bone of dinosaur from Mongolia, standard a bone of the person and soils taken from a surface and from of the femoral joint of a dinosaur were also subject to INAA. The INAA method determines of contents of about 30 elements in bones and soils in an interval 0.043-3600 mg / kg. Among found elements Ca (46 %), Sc, Cr, Fe (up to 2.2 g/kg), Ni, Zn, Sr (up to 3.6 g/kg), Sb, Ba, Sb and some others are mainly found in bones. The contents of some elements in bones of dinosaurs reach very high values 280-3200 mg / kg, and are mainly lanthanides La, Ce, Nd, Sm, Eu, Tb, Yb and Lu. In our opinion, lanthanides and some other elements, like As, Br, and Mo in bones were formed as a result of fission of uranium and transuranium elements. Because content of uranium in bones of dinosaurs is very high, up to 180 mg / kg, and those of thorium is 20 mg/ kg. However U and Th in soils are 4.8 mg/kg and 3.7 mg / kg, respectively. The content of uranium in bones of the archantrop is 1.53 mg / kg, while U in standard bone of the human is less than 0,016 mg/kg. (author)

  7. The broad spectrum revisited: evidence from plant remains.

    Science.gov (United States)

    Weiss, Ehud; Wetterstrom, Wilma; Nadel, Dani; Bar-Yosef, Ofer

    2004-06-29

    The beginning of agriculture is one of the most important developments in human history, with enormous consequences that paved the way for settled life and complex society. Much of the research on the origins of agriculture over the last 40 years has been guided by Flannery's [Flannery, K. V. (1969) in The Domestication and Exploitation of Plants and Animals, eds. Ucko, P. J. & Dimbleby, G. W. (Duckworth, London), pp. 73-100] "broad spectrum revolution" (BSR) hypothesis, which posits that the transition to farming in southwest Asia entailed a period during which foragers broadened their resource base to encompass a wide array of foods that were previously ignored in an attempt to overcome food shortages. Although these resources undoubtedly included plants, nearly all BSR hypothesis-inspired research has focused on animals because of a dearth of Upper Paleolithic archaeobotanical assemblages. Now, however, a collection of >90,000 plant remains, recently recovered from the Stone Age site Ohalo II (23,000 B.P.), Israel, offers insights into the plant foods of the late Upper Paleolithic. The staple foods of this assemblage were wild grasses, pushing back the dietary shift to grains some 10,000 years earlier than previously recognized. Besides the cereals (wild wheat and barley), small-grained grasses made up a large component of the assemblage, indicating that the BSR in the Levant was even broader than originally conceived, encompassing what would have been low-ranked plant foods. Over the next 15,000 years small-grained grasses were gradually replaced by the cereals and ultimately disappeared from the Levantine diet.

  8. An analysis of the alleged skeletal remains of Carin Göring.

    Directory of Open Access Journals (Sweden)

    Anna Kjellström

    Full Text Available In 1991, treasure hunters found skeletal remains in an area close to the destroyed country residence of former Nazi leader Hermann Göring in northeastern Berlin. The remains, which were believed to belong to Carin Göring, who was buried at the site, were examined to determine whether it was possible to make a positive identification. The anthropological analysis showed that the remains come from an adult woman. The DNA analysis of several bone elements showed female sex, and a reference sample from Carin's son revealed mtDNA sequences identical to the remains. The profile has one nucleotide difference from the Cambridge reference sequence (rCRS, the common variant 263G. A database search resulted in a frequency of this mtDNA sequence of about 10% out of more than 7,000 European haplotypes. The mtDNA sequence found in the ulna, the cranium and the reference sample is, thus, very common among Europeans. Therefore, nuclear DNA analysis was attempted. The remains as well as a sample from Carin's son were successfully analysed for the three nuclear markers TH01, D7S820 and D8S1179. The nuclear DNA analysis of the two samples revealed one shared allele for each of the three markers, supporting a mother and son relationship. This genetic information together with anthropological and historical files provides an additional piece of circumstantial evidence in our efforts to identify the remains of Carin Göring.

  9. Patient choice of providers in a preferred provider organization.

    Science.gov (United States)

    Wouters, A V; Hester, J

    1988-03-01

    This article is an analysis of patient choice of providers by the employees of the Security Pacific Bank of California and their dependents who have access to the Med Network Preferred Provider Organization (PPO). The empirical results show that not only is the PPO used by individuals who require relatively little medical care (as measured by predicted office visit charges) but that the PPO is most intensively used for low-risk services such as treatment for minor illness and preventive care. Also, the most likely Security Pacific Health Care beneficiary to use a PPO provider is a recently hired employee who lives in the south urban region, has a relatively low income, does not have supplemental insurance coverage, and is without previous attachments to non-PPO primary care providers. In order to maximize their ability to reduce plan paid benefits, insurers who contract with PPOs should focus on increasing PPO utilization among poorer health risks.

  10. American College of Surgeons remains committed to patient safety.

    Science.gov (United States)

    Russell, Thomas R; Jones, R Scott

    2006-11-01

    Since 1913 the American College of Surgeons has addressed patient safety as a top priority, so they are pleased to contribute this article offering the College's perspective on this critical subject. More specifically, this piece reviews the College's perennial efforts to ensure surgeons and hospitals access to scientifically verifiable standards, availability of effective quality improvement tools, and a better understanding of errors in care. Additionally, they examine the cultural changes required within surgery and provide an overview of the College's recent initiatives in research, accreditation, and education.

  11. Why silicon is and will remain the dominant photovoltaic material

    Science.gov (United States)

    Singh, Rajendra

    2009-07-01

    Rising demands of energy in emerging economies, coupled with the green house gas emissions related problems around the globe have provided a unique opportunity of exploiting the advantages offered by photovoltaic (PV) systems for green energy electricity generation. Similar to cell phones, power generated by PV systems can reach over two billion people worldwide who have no access to clean energy. Only silicon based PV devices meet the low-cost manufacturing criterion of clean energy conversion (abundance of raw material and no environmental health and safety issues). The use of larger size glass substrates and manufacturing techniques similar to the ones used by the liquid crystal display industry and the large scale manufacturing of amorphous silicon thin films based modules (~ GW per year manufacturing at a single location) can lead to installed PV system cost of $3/Wp. This will open a huge market for grid connected PV systems and related markets. With further research and development, this approach can provide $2/Wp installed PV system costs in the next few years. At this cost level, PV electricity generation is competitive with any other technology, and PV power generation can be a dominant electricity generation technology in the 21st century.

  12. Prevention of suicide

    Directory of Open Access Journals (Sweden)

    Rajiv Gupta

    2017-01-01

    Full Text Available Suicide is a major public health problem in India, probably even bigger than in the West. Suicidal behavior is the best conceptualized as a multifaceted complex problem involving social factors and mental illnesses. Broadly, there are two approaches to suicide prevention; population preventive strategies and high-risk preventive strategies. Population preventive strategies include reducing availability of means for suicide, education of primary care physicians, influencing media portrayal of suicidal behavior, education of the public, telephone helplines, and addressing economic issues associated with suicidal behavior. High-risk preventive strategy includes identifying individuals with high risk of committing suicide, intensively treating mental illness if present, and providing psychosocial support. Thus, prevention requires a multipronged effort with collaboration from various sectors including mental health professionals, social justice department, and macroeconomic policy makers.

  13. Dental Sealants Prevent Cavities

    Science.gov (United States)

    ... Digital Press Kit Read the MMWR Science Clips Dental Sealants Prevent Cavities Effective protection for children Language: ... more use of sealants and reimbursement of services. Dental care providers can Apply sealants to children at ...

  14. Home Improvements Prevent Falls

    Science.gov (United States)

    ... turn JavaScript on. Feature: Falls and Older Adults Home Improvements Prevent Falls Past Issues / Winter 2014 Table ... and ensure your safety. "Safe-ty-fy" Your Home Some Questions for Your Provider Will my medicines ...

  15. Optimization of DNA recovery and amplification from non-carbonized archaeobotanical remains

    DEFF Research Database (Denmark)

    Wales, Nathan; Andersen, Kenneth; Cappellini, Enrico

    2014-01-01

    Ancient DNA (aDNA) recovered from archaeobotanical remains can provide key insights into many prominent archaeological research questions, including processes of domestication, past subsistence strategies, and human interactions with the environment. However, it is often difficult to isolate a...... extracted from non-charred ancient plant remains. Based upon the criteria of resistance to enzymatic inhibition, behavior in quantitative real-time PCR, replication fidelity, and compatibility with aDNA damage, we conclude these polymerases have nuanced properties, requiring researchers to make educated...... on the interactions between humans and past plant communities....

  16. Genomic and proteomic identification of Late Holocene remains

    DEFF Research Database (Denmark)

    Biard, Vincent; Gol'din, Pavel; Gladilina, Elena

    2017-01-01

    A critical challenge of the 21st century is to understand and minimise the effects of human activities on biodiversity. Cetaceans are a prime concern in biodiversity research, as many species still suffer from human impacts despite decades of management and conservation efforts. Zooarchaeology...... sequencing approach. In addition, shotgun sequencing produced several complete ancient odontocete mitogenomes and auxiliary nuclear genomic data for further exploration in a population genetic context. In contrast, both morphological identification and Sanger sequencing lacked taxonomic resolution and....../or resulted in misclassification of samples. We found that the combination of ZooMS and shotgun sequencing provides a powerful tool in zooarchaeology, and here allowed for a deeper understanding of past marine resource use and its implication for current management and conservation of Black Sea odontocetes....

  17. Providing value in ambulatory anesthesia.

    Science.gov (United States)

    Fosnot, Caroline D; Fleisher, Lee A; Keogh, John

    2015-12-01

    colonoscopies. With this projected increase in the demand for anesthesia services nationwide comes the analysis of its financial feasibility. Some early data looking at endoscopist-administered sedation conclude that it offers higher patient satisfaction, there were less adverse effects than anesthesiologist-administered sedation, and is economically advantageous. This and future retrospective studies will help to guide healthcare policymakers and physicians to come to a conclusion about providing ambulatory services for these millions of patients. Ambulatory anesthesia's popularity continues to rise and anesthetic techniques will continue to morph and adapt to the needs of patients seeking ambulatory surgery. Alterations in already existing medications are promising as these modifications allow for quicker recovery from anesthesia or minimization of the already known undesirable side-effects. PONV, pain, obstructive sleep apnea, and chronic comorbidities (hypertension, cardiac disease, and diabetes mellitus) are perioperative concerns in ambulatory settings as more patients are safely being treated in ambulatory settings. Regional anesthesia stands out as a modality that has multiple advantages to general anesthesia, providing a minimal recovery period and a decrease in postanesthesia care unit stay. The implementation of the Affordable Healthcare Act specifically affects ambulatory settings as the demand and need for patients to have screening procedures with anesthesia. The question remains what the best strategy is to meet the needs of our future patients while preserving economically feasibility within an already strained healthcare system.

  18. Coronavirus envelope (E) protein remains at the site of assembly

    International Nuclear Information System (INIS)

    Venkatagopalan, Pavithra; Daskalova, Sasha M.; Lopez, Lisa A.; Dolezal, Kelly A.; Hogue, Brenda G.

    2015-01-01

    Coronaviruses (CoVs) assemble at endoplasmic reticulum Golgi intermediate compartment (ERGIC) membranes and egress from cells in cargo vesicles. Only a few molecules of the envelope (E) protein are assembled into virions. The role of E in morphogenesis is not fully understood. The cellular localization and dynamics of mouse hepatitis CoV A59 (MHV) E protein were investigated to further understanding of its role during infection. E protein localized in the ERGIC and Golgi with the amino and carboxy termini in the lumen and cytoplasm, respectively. E protein does not traffic to the cell surface. MHV was genetically engineered with a tetracysteine tag at the carboxy end of E. Fluorescence recovery after photobleaching (FRAP) showed that E is mobile in ERGIC/Golgi membranes. Correlative light electron microscopy (CLEM) confirmed the presence of E in Golgi cisternae. The results provide strong support that E proteins carry out their function(s) at the site of budding/assembly. - Highlights: • Mouse hepatitis coronavirus (MHV-CoV) E protein localizes in the ERGIC and Golgi. • MHV-CoV E does not transport to the cell surface. • MHV-CoV can be genetically engineered with a tetracysteine tag appended to E. • First FRAP and correlative light electron microscopy of a CoV E protein. • Live-cell imaging shows that E is mobile in ERGIC/Golgi membranes

  19. Efforts to standardize wildlife toxicity values remain unrealized.

    Science.gov (United States)

    Mayfield, David B; Fairbrother, Anne

    2013-01-01

    Wildlife toxicity reference values (TRVs) are routinely used during screening level and baseline ecological risk assessments (ERAs). Risk assessment professionals often adopt TRVs from published sources to expedite risk analyses. The US Environmental Protection Agency (USEPA) developed ecological soil screening levels (Eco-SSLs) to provide a source of TRVs that would improve consistency among risk assessments. We conducted a survey and evaluated more than 50 publicly available, large-scale ERAs published in the last decade to evaluate if USEPA's goal of uniformity in the use of wildlife TRVs has been met. In addition, these ERAs were reviewed to understand current practices for wildlife TRV use and development within the risk assessment community. The use of no observed and lowest observed adverse effect levels culled from published compendia was common practice among the majority of ERAs reviewed. We found increasing use over time of TRVs established in the Eco-SSL documents; however, Eco-SSL TRV values were not used in the majority of recent ERAs and there continues to be wide variation in TRVs for commonly studied contaminants (e.g., metals, pesticides, PAHs, and PCBs). Variability in the toxicity values was driven by differences in the key studies selected, dose estimation methods, and use of uncertainty factors. These differences result in TRVs that span multiple orders of magnitude for many of the chemicals examined. This lack of consistency in TRV development leads to highly variable results in ecological risk assessments conducted throughout the United States. Copyright © 2012 SETAC.

  20. The road ahead, what remains to be done

    International Nuclear Information System (INIS)

    Heinonen, O.

    1999-01-01

    High priority is given to work on integrating the traditional nuclear material verification activities with the new strengthening safeguards measures. The aim is to optimize the combination of all safeguards measures available to the Agency in order to achieve maximum effectiveness and efficiency within available resources. The scope for integration is expected to be greatest in States with substantial nuclear fuel cycles and where both safeguards agreements and additional protocols are in force. The work on integration is focused on such situations. The Secretariat is elaborating a strategy and co-ordination plan for the development of integrated safeguards that reflects advice provided by the Standing Advisory Group on Safeguards Implementation (SAGSI) and takes into account the results of a consultants meeting on integrated safeguards held in December 1998. The consultants underlined that key role of State evaluation activities in integrated safeguards that will form an objective basis for the elaboration of State level approaches. Appropriate co-ordination by the Department of Safeguards is being maintained with related activities in the Secretariat and in Member States within the framework of the Agency's Safeguards Research and Development and Implementation Support Programme. (author)

  1. The road ahead, what remains to be done

    Energy Technology Data Exchange (ETDEWEB)

    Heinonen, O. [International Atomic Energy Agency, Division of Operations A, Vienna (Austria)

    1999-07-01

    High priority is given to work on integrating the traditional nuclear material verification activities with the new strengthening safeguards measures. The aim is to optimize the combination of all safeguards measures available to the Agency in order to achieve maximum effectiveness and efficiency within available resources. The scope for integration is expected to be greatest in States with substantial nuclear fuel cycles and where both safeguards agreements and additional protocols are in force. The work on integration is focused on such situations. The Secretariat is elaborating a strategy and co-ordination plan for the development of integrated safeguards that reflects advice provided by the Standing Advisory Group on Safeguards Implementation (SAGSI) and takes into account the results of a consultants meeting on integrated safeguards held in December 1998. The consultants underlined that key role of State evaluation activities in integrated safeguards that will form an objective basis for the elaboration of State level approaches. Appropriate co-ordination by the Department of Safeguards is being maintained with related activities in the Secretariat and in Member States within the framework of the Agency's Safeguards Research and Development and Implementation Support Programme. (author)

  2. Coronavirus envelope (E) protein remains at the site of assembly

    Energy Technology Data Exchange (ETDEWEB)

    Venkatagopalan, Pavithra [The Biodesign Institute, Center for Infectious Diseases and Vaccinology, Arizona State University, Tempe, AZ 85287-5401 (United States); School of Life Sciences, Arizona State University, Tempe, AZ 85287-5401 (United States); Microbiology Graduate Program, Arizona State University, Tempe, AZ 85287-5401 (United States); Daskalova, Sasha M. [The Biodesign Institute, Center for Infectious Diseases and Vaccinology, Arizona State University, Tempe, AZ 85287-5401 (United States); Department of Biochemistry and Chemistry, Arizona State University, Tempe, AZ 85287-5401 (United States); Lopez, Lisa A. [The Biodesign Institute, Center for Infectious Diseases and Vaccinology, Arizona State University, Tempe, AZ 85287-5401 (United States); School of Life Sciences, Arizona State University, Tempe, AZ 85287-5401 (United States); Molecular and Cellular Biology Graduate Program, Arizona State University, Tempe, AZ 85287-5401 (United States); Dolezal, Kelly A. [The Biodesign Institute, Center for Infectious Diseases and Vaccinology, Arizona State University, Tempe, AZ 85287-5401 (United States); School of Life Sciences, Arizona State University, Tempe, AZ 85287-5401 (United States); Microbiology Graduate Program, Arizona State University, Tempe, AZ 85287-5401 (United States); Hogue, Brenda G., E-mail: Brenda.Hogue@asu.edu [The Biodesign Institute, Center for Infectious Diseases and Vaccinology, Arizona State University, Tempe, AZ 85287-5401 (United States); School of Life Sciences, Arizona State University, Tempe, AZ 85287-5401 (United States)

    2015-04-15

    Coronaviruses (CoVs) assemble at endoplasmic reticulum Golgi intermediate compartment (ERGIC) membranes and egress from cells in cargo vesicles. Only a few molecules of the envelope (E) protein are assembled into virions. The role of E in morphogenesis is not fully understood. The cellular localization and dynamics of mouse hepatitis CoV A59 (MHV) E protein were investigated to further understanding of its role during infection. E protein localized in the ERGIC and Golgi with the amino and carboxy termini in the lumen and cytoplasm, respectively. E protein does not traffic to the cell surface. MHV was genetically engineered with a tetracysteine tag at the carboxy end of E. Fluorescence recovery after photobleaching (FRAP) showed that E is mobile in ERGIC/Golgi membranes. Correlative light electron microscopy (CLEM) confirmed the presence of E in Golgi cisternae. The results provide strong support that E proteins carry out their function(s) at the site of budding/assembly. - Highlights: • Mouse hepatitis coronavirus (MHV-CoV) E protein localizes in the ERGIC and Golgi. • MHV-CoV E does not transport to the cell surface. • MHV-CoV can be genetically engineered with a tetracysteine tag appended to E. • First FRAP and correlative light electron microscopy of a CoV E protein. • Live-cell imaging shows that E is mobile in ERGIC/Golgi membranes.

  3. Computer Security: When a person leaves - access rights remain!

    CERN Multimedia

    Computer Security Team

    2014-01-01

    We have been contacted recently by an embarrassed project manager who just figured out that a student who left at the end of 2013 still had access rights to read the whole project folder in February 2014: “How can that be?! In any other company, access rights would be purged at the same time as an employment contract terminates." Not so at CERN.   CERN has always been an open site with an open community. Physical access to the site is lightweight and you just need to have your CERN access card at hand. Further restrictions have only been put in place where safety or security really require them, and CERN does not require you to keep your access card on display. The same holds for the digital world. Once registered at CERN - either by contract, via your experiment or through the Users' office - you own a computing account that provides you with access to a wide variety of computing services. For example, last year 9,730 students/technicians/engineers/researchers/sta...

  4. Numerical modelling of river morphodynamics: Latest developments and remaining challenges

    Science.gov (United States)

    Siviglia, Annunziato; Crosato, Alessandra

    2016-07-01

    Numerical morphodynamic models provide scientific frameworks for advancing our understanding of river systems. The research on involved topics is an important and socially relevant undertaking regarding our environment. Nowadays numerical models are used for different purposes, from answering questions about basic morphodynamic research to managing complex river engineering problems. Due to increasing computer power and the development of advanced numerical techniques, morphodynamic models are now more and more used to predict the bed patterns evolution to a broad spectrum of spatial and temporal scales. The development and the success of application of such models are based upon a wide range of disciplines from applied mathematics for the numerical solution of the equations to geomorphology for the physical interpretation of the results. In this light we organized this special issue (SI) soliciting multidisciplinary contributions which encompass any aspect needed for the development and applications of such models. Most of the papers in the SI stem from contributions to session HS9.5/GM7.11 on numerical modelling and experiments in river morphodynamics at the European Geosciences Union (EGU) General Assembly held in Vienna, April 27th to May 2nd 2014.

  5. Prevention: Exercise

    Medline Plus

    Full Text Available ... Steroid Injections Lumbar Zygapophysical (Facet) Joint Injections PREVENTION Lifestyle Choices 10 Tips for a Healthy Back Smoking Weight Patient Safety Exercise Strengthening Strengthen ...

  6. 76 FR 14057 - Notice of Inventory Completion: University of Wyoming, Anthropology Department, Human Remains...

    Science.gov (United States)

    2011-03-15

    ...: University of Wyoming, Anthropology Department, Human Remains Repository, Laramie, WY AGENCY: National Park... Anthropology Department, Human Remains Repository, Laramie, WY. The human remains and associated funerary... the human remains was made by University of Wyoming, Anthropology Department, Human Remains Repository...

  7. Therapy Provider Phase Information

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Therapy Provider Phase Information dataset is a tool for providers to search by their National Provider Identifier (NPI) number to determine their phase for...

  8. Work-related factors influencing home care nurse intent to remain employed.

    Science.gov (United States)

    Tourangeau, Ann E; Patterson, Erin; Saari, Margaret; Thomson, Heather; Cranley, Lisa

    Health care is shifting out of hospitals into community settings. In Ontario, Canada, home care organizations continue to experience challenges recruiting and retaining nurses. However, factors influencing home care nurse retention that can be modified remain largely unexplored. Several groups of factors have been identified as influencing home care nurse intent to remain employed including job characteristics, work structures, relationships and communication, work environment, responses to work, and conditions of employment. The aim of this study was to test and refine a model that identifies which factors are related to home care nurse intentions to remain employed for the next 5 years with their current home care employer organization. A cross-sectional survey design was implemented to test and refine a hypothesized model of home care nurse intent to remain employed. Logistic regression was used to determine which factors influence home care nurse intent to remain employed. Home care nurse intent to remain employed for the next 5 years was associated with increasing age, higher nurse-evaluated quality of care, having greater variety of patients, experiencing greater meaningfulness of work, having greater income stability, having greater continuity of client care, experiencing more positive relationships with supervisors, experiencing higher work-life balance, and being more satisfied with salary and benefits. Home care organizations can promote home care nurse intent to remain employed by (a) ensuring nurses have adequate training and resources to provide quality client care, (b) improving employment conditions to increase income stability and satisfaction with pay and benefits, (c) ensuring manageable workloads to facilitate improved work-life balance, and (d) ensuring leaders are accessible and competent.

  9. CARAVAN: Providing Location Privacy for VANET

    National Research Council Canada - National Science Library

    Sampigethaya, Krishna; Huang, Leping; Li, Mingyan; Poovendran, Radha; Matsuura, Kanta; Sezaki, Kaoru

    2005-01-01

    .... This type of tracking leads to threats on the location privacy of the vehicle's user. In this paper, we study the problem of providing location privacy in VANET by allowing vehicles to prevent tracking of their broadcast communications...

  10. Chuanxiong preparations for preventing stroke.

    Science.gov (United States)

    Yang, Xunzhe; Zeng, Xiaoxi; Wu, Taixiang

    2010-01-20

    remaining low quality study indicated that "apoplexy 2 preventing dry ointment powder" appeared to reduce both fatal stroke and incidence of stroke (OR 0.21, 95% CI 0.10 to 0.43, and OR 0.28, 95% CI 0.16 to 0.49, respectively). Nao-an capsule may be a choice for the primary prevention of stroke. However, the design of the study providing this evidence means that there was potential for results to have been affected by bias from the way participants may have been selected, or from investigators' conflicts of interests. There was a lack of description of the methodology in the two other studies therefore evidence from these was considered too weak to draw any firm conclusions. Further high quality research is required.

  11. Aspirin for Primary Prevention.

    Science.gov (United States)

    Richman, Ilana B; Owens, Douglas K

    2017-07-01

    Aspirin reduces the risk of nonfatal myocardial infarction and stroke, and the risk of colorectal cancer. Aspirin increases the risk of gastrointestinal and intracranial bleeding. The best available evidence supports initiating aspirin in select populations. In 2016, the US Preventive Services Task Force recommended initiating aspirin for the primary prevention of both cardiovascular disease and colorectal cancer among adults ages 50 to 59 who are at increased risk for cardiovascular disease. Adults 60 to 69 who are at increased cardiovascular disease risk may also benefit. There remains considerable uncertainty about whether younger and older patients may benefit. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. Preventative Maintenance.

    Science.gov (United States)

    Migliorino, James

    Boards of education must be convinced that spending money up front for preventive maintenance will, in the long run, save districts' tax dollars. A good program of preventive maintenance can minimize disruption of service; reduce repair costs, energy consumption, and overtime; improve labor productivity and system equipment reliability; handle…

  13. Examining practical nursing experiences to discover ways in which to retain and invigorate the remaining functions of the elderly with a demented and complex disability in nursing homes.

    Science.gov (United States)

    Park, Min-Sun; Lim, Sun-Young; Kim, Eun-Young; Lee, Su-Jung; Chang, Sung-Ok

    2018-01-01

    The bedridden elderly with moderate-to-severe dementia account for a large proportion of the residents in nursing homes and form a specialized group requiring customized care in order to encourage their remaining functions, which determine the quality of their residual life. The purpose of this study was to search for ways to invigorate and foster the remaining functions of this complex-disability group, based on practical nursing strategies in nursing homes. The qualitative thematic analysis was done by conducting in-depth interviews with 29 nurses working at 11 different nursing homes in South Korea. This study proposed four main themes and 19 sub themes as keys for providing specialized nursing care to the elderly with physical and cognitive disabilities. The main themes encourage the residents' remaining functions: (i) accurate identification of an elderly resident's physical, cognitive, and behavioral baseline is necessary in order to determine their functional levels; (ii) nurses provide meticulous management to support the remaining functions in order to prevent further deterioration; (iii) optimized know-how, based on accumulated experience and knowledge, is reflected in nursing strategies that maximize the effects of nursing interventions; and (iv) steady compliance with nursing guidelines and standards in nursing homes creates the best therapeutic environment and brings unexpected positive changes in the elderly's status. A practical nursing strategy to target the group with a demented and complex disability in nursing homes was developed through thematic analysis of the empirical knowledge of nurses. The findings provide new insights for developing specialized nursing interventions and practical nursing models in long-term care facilities. © 2017 Japan Academy of Nursing Science.

  14. Enhanced Contaminated Human Remains Pouch: initial development and preliminary performance assessments

    Energy Technology Data Exchange (ETDEWEB)

    Iseli, A.M.; Kwen, H.D.; Ul-Alam, M.; Balasubramanian, M.; Rajagopalan, S.

    2011-11-07

    The objective is to produce a proof of concept prototype Enhanced Contaminated Human Remains Pouch (ECHRP) with self-decontamination capability to provide increased protection to emergency response personnel. The key objective was to decrease the concentration of toxic chemicals through the use of an absorbent and reactive nanocellulose liner. Additionally, nanomaterials with biocidal properties were developed and tested as a 'stand-alone' treatment. The setting was a private company research laboratory. The main outcome measures were production of a functional prototype. A functional prototype capable of mitigating the threats due to sulfur mustard, Soman, and a large variety of liquid and vapor toxic industrial chemicals was produced. Stand-alone biocidal treatment efficacy was validated. The ECHRP provides superior protection from both chemical and biological hazards to various emergency response personnel and human remains handlers.

  15. Assessing Health Impacts within Environmental Impact Assessments: An Opportunity for Public Health Globally Which Must Not Remain Missed

    Directory of Open Access Journals (Sweden)

    Patrick Harris

    2015-01-01

    Full Text Available Within the member states of the United Nations 190 of 193 have regulated Environmental Impact Assessments (EIA which is a systematic process to prevent and mitigate the potential environmental impacts of industry development projects before these occur. However, the routine and comprehensive assessment of health impacts within EIAs remains underdeveloped. Focusing, as an example, on the risks to global health from the global shift in the mining industry towards Low and Middle Income Countries LMIC, this viewpoint details why connecting with EIA is an essential task for the health system. Although existing knowledge is out of date in relation to global practice we identify how health has been included, to some extent, in High Income Country EIAs and the institutional requirements for doing so. Using arguments identified by industry themselves about requiring a ‘social license to operate’, we conclude that EIA regulations provide the best current mechanism to ensure health protection is a core aspect in the decision making process  to approve projects.

  16. The privacy concerns in location based services: protection approaches and remaining challenges

    OpenAIRE

    Basiri, Anahid; Moore, Terry; Hill, Chris

    2016-01-01

    Despite the growth in the developments of the Location Based Services (LBS) applications, there are still several challenges remaining. One of the most important concerns about LBS, shared by many users and service providers is the privacy. Privacy has been considered as a big threat to the adoption of LBS among many users and consequently to the growth of LBS markets. This paper discusses the privacy concerns associated with location data, and the current privacy protection approaches. It re...

  17. Updated Estimates of the Remaining Market Potential of the U.S. ESCO Industry

    Energy Technology Data Exchange (ETDEWEB)

    Larsen, Peter H. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States). Energy Analysis and Environmental Impacts Div.; Carvallo Bodelon, Juan Pablo [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States). Energy Analysis and Environmental Impacts Div.; Goldman, Charles A. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States). Energy Analysis and Environmental Impacts Div.; Murphy, Sean [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States). Energy Analysis and Environmental Impacts Div.; Stuart, Elizabeth [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States). Energy Analysis and Environmental Impacts Div.

    2017-04-01

    The energy service company (ESCO) industry has a well-established track record of delivering energy and economic savings in the public and institutional buildings sector, primarily through the use of performance-based contracts. The ESCO industry often provides (or helps arrange) private sector financing to complete public infrastructure projects with little or no up-front cost to taxpayers. In 2014, total U.S. ESCO industry revenue was estimated at $5.3 billion. ESCOs expect total industry revenue to grow to $7.6 billion in 2017—a 13% annual growth rate from 2015-2017. Researchers at Lawrence Berkeley National Laboratory (LBNL) were asked by the U.S. Department of Energy Federal Energy Management Program (FEMP) to update and expand our estimates of the remaining market potential of the U.S. ESCO industry. We define remaining market potential as the aggregate amount of project investment by ESCOs that is technically possible based on the types of projects that ESCOS have historically implemented in the institutional, commercial, and industrial sectors using ESCO estimates of current market penetration in those sectors. In this analysis, we report U.S. ESCO industry remaining market potential under two scenarios: (1) a base case and (2) a case “unfettered” by market, bureaucratic, and regulatory barriers. We find that there is significant remaining market potential for the U.S. ESCO industry under both the base and unfettered cases. For the base case, we estimate a remaining market potential of $92-$201 billion ($2016). We estimate a remaining market potential of $190-$333 billion for the unfettered case. It is important to note, however, that there is considerable uncertainty surrounding the estimates for both the base and unfettered cases.

  18. Evaluation Methods for Prevention Education.

    Science.gov (United States)

    Blue, Amy V.; Barnette, J. Jackson; Ferguson, Kristi J.; Garr, David R.

    2000-01-01

    Discusses the importance of assessing medical students' competence in prevention knowledge, skills, and attitudes. Provides general guidance for programs interested in evaluating their prevention instructional efforts, and gives specific examples of possible methods for evaluating prevention education. Stresses the need to tailor assessment…

  19. Preventive analgesia

    DEFF Research Database (Denmark)

    Dahl, Jørgen B; Kehlet, Henrik

    2011-01-01

    This paper will discuss the concepts of pre-emptive and preventive analgesia in acute and persistent postsurgical pain, based on the most recent experimental and clinical literature, with a special focus on injury-induced central sensitization and the development from acute to chronic pain. Recent...... of preventive analgesia for persistent postoperative pain are promising. However, clinicians must be aware of the demands for improved design of their clinical studies in order to get more conclusive answers regarding the different avenues for intervention. Summary: The concept of preventive analgesia is still...

  20. Time Remains

    OpenAIRE

    Gryb, Sean; Thebault, Karim

    2014-01-01

    On one popular view, the general covariance of gravity implies that change is relational in a strong sense, such that all it is for a physical degree of freedom to change is for it to vary with regard to a second physical degree of freedom. At a quantum level, this view of change as relative variation leads to a fundamentally timeless formalism for quantum gravity. Here, we will show how one may avoid this acute 'problem of time'. Under our view, duration is still regarded as relative, but te...

  1. Enhanced tumor growth in the remaining lung after major lung resection.

    Science.gov (United States)

    Sano, Fumiho; Ueda, Kazuhiro; Murakami, Junichi; Hayashi, Masataro; Nishimoto, Arata; Hamano, Kimikazu

    2016-05-01

    Pneumonectomy induces active growth of the remaining lung in order to compensate for lost lung tissue. We hypothesized that tumor progression is enhanced in the activated local environment. We examined the effects of mechanical strain on the activation of lung growth and tumor progression in mice. The mechanical strain imposed on the right lung after left pneumonectomy was neutralized by filling the empty space that remained after pneumonectomy with a polypropylene prosthesis. The neutralization of the strain prevented active lung growth. According to an angiogenesis array, stronger monocyte chemoattractant protein-1 (MCP-1) expression was found in the strain-induced growing lung. The neutralization of the strain attenuated the release of MCP-1 from the lung cells. The intravenous injection of Lewis lung cancer cells resulted in the enhanced development of metastatic foci in the strain-induced growing lung, but the enhanced development was canceled by the neutralization of the strain. An immunohistochemical analysis revealed the prominent accumulation of tumor-associated macrophages in tumors arising in the strain-induced growing lung, and that there was a relationship between the accumulation and the MCP-1 expression status. Our results suggested that mechanical lung strain, induced by pulmonary resection, triggers active lung growth, thereby creating a tumor-friendly environment. The modification of that environment, as well as the minimizing of surgical stress, may be a meaningful strategy to improve the therapeutic outcome after lung cancer surgery. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. Prevention: Exercise

    Medline Plus

    Full Text Available ... Tips for a Healthy Back Smoking Weight Patient Safety Exercise Strengthening Strengthen Your Core! Stretching/Flexibility Aerobic ... Strength Training for the Elderly Other Back Pack Safety Pregnancy and Back Pain Preventing Osteoporosis Back Pain ...

  3. Preventing Rejection

    Science.gov (United States)

    ... After the transplant Preventing rejection Post-transplant medications Types of immunosuppressants Switching immunosuppressants Side effects Other medications Generic and brand name drugs Post-transplant tests Infections and immunity Lifestyle changes Health concerns Back to work or ...

  4. Prevent Cyberbullying

    Science.gov (United States)

    ... Tips for Teachers Report Cyberbullying Print Share Prevent Cyberbullying Be Aware of What Your Kids are Doing ... Signs a Child is Being Cyberbullied or is Cyberbullying Others Many of the warning signs that cyberbullying ...

  5. Preventing Suicide

    Science.gov (United States)

    ... protective factors listed below: Skills in problem solving, conflict resolution, and nonviolent ways of handling disputes Effective ... 2017 Page last updated: August 9, 2017 Content source: National Center for Injury Prevention and Control, Division ...

  6. Prevention: Exercise

    Medline Plus

    Full Text Available ... A SPECIALIST Prevention Strengthening Exercise Committee Exercise Committee Core Strengthening Many popular forms of exercise focus on ... acute pain, you should stop doing it. Transverse Core Strengthening This strengthens the muscles that cross from ...

  7. Prevention: Exercise

    Medline Plus

    Full Text Available ... Training for the Elderly Other Back Pack Safety Pregnancy and Back Pain Preventing Osteoporosis Back Pain Basics ... increases your back pain after five repetitions, or causes acute pain, you should stop doing it. Transverse ...

  8. Preventing accidents

    Science.gov (United States)

    2005-08-01

    As the most effective strategy for improving safety is to prevent accidents from occurring at all, the Volpe Center applies a broad range of research techniques and capabilities to determine causes and consequences of accidents and to identify, asses...

  9. Prevention: Exercise

    Medline Plus

    Full Text Available ... 10 Tips for a Healthy Back Smoking Weight Patient Safety Exercise Strengthening Strengthen Your Core! Stretching/Flexibility ... Pain Preventing Osteoporosis Back Pain Basics Book RESOURCES Patient Information Feature Articles Patient Q&A Success Stories ...

  10. Prevention: Exercise

    Medline Plus

    Full Text Available ... Preventing Osteoporosis Back Pain Basics Book RESOURCES Patient Information Feature Articles Patient Q&A Success Stories Definitions Anatomy of the Spine Definitions A-Z Spine Specialists Videos 9 ...

  11. Medical service provider networks.

    Science.gov (United States)

    Mougeot, Michel; Naegelen, Florence

    2018-05-17

    In many countries, health insurers or health plans choose to contract either with any willing providers or with preferred providers. We compare these mechanisms when two medical services are imperfect substitutes in demand and are supplied by two different firms. In both cases, the reimbursement is higher when patients select the in-network provider(s). We show that these mechanisms yield lower prices, lower providers' and insurer's profits, and lower expense than in the uniform-reimbursement case. Whatever the degree of product differentiation, a not-for-profit insurer should prefer selective contracting and select a reimbursement such that the out-of-pocket expense is null. Although all providers join the network under any-willing-provider contracting in the absence of third-party payment, an asymmetric equilibrium may exist when this billing arrangement is implemented. Copyright © 2018 John Wiley & Sons, Ltd.

  12. HIV Prevention

    Centers for Disease Control (CDC) Podcasts

    2012-02-01

    Dr. Kevin Fenton, Director of CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, talks about steps people can take to protect their health from HIV.  Created: 2/1/2012 by National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP).   Date Released: 2/1/2012.

  13. Explaining why nurses remain in or leave bedside nursing: a critical ethnography.

    Science.gov (United States)

    Mahon, Paula; McPherson, Gladys

    2014-09-01

    To describe the application of critical ethnography to explain nurses' decisions to remain in or leave bedside nursing, and to describe researcher positioning and reflexivity. Enquiry into hospital nurses' decisions to remain in or leave bedside nursing positions has been conducted from a variety of theoretical perspectives by researchers adopting a range of methodological approaches. This research helps to explain how work environments can affect variables such as job satisfaction and turnover, but provides less insight into how personal and professional factors shape decisions to remain in or leave bedside nursing. A critical theoretical perspective was taken to examine the employment decisions made by nurses in a paediatric intensive care unit (PICU). Data was collected from nurses (n=31) through semi-structured interviews and unobtrusive observation. The authors describe critical ethnography as a powerful research framework for enquiry that allowed them to challenge assumptions about why nurses remain in or leave their jobs, and to explore how issues of fairness and equity contribute to these decisions. Critical ethnography offers a powerful methodology for investigations into complex interactions, such as those between nurses in a PICU. In adopting this methodology, researchers should be sensitised to manifestations of power, attend to their stance and location, and reflexion. The greatest challenges from this research included how to make sense of the insider position, how to acknowledge assumptions and allow these to be challenged, and how to ensure that power relationships in the environment and in the research were attended to.

  14. Providing free autopoweroff plugs

    DEFF Research Database (Denmark)

    Jensen, Carsten Lynge; Hansen, Lars Gårn; Fjordbak, Troels

    2012-01-01

    Experimental evidence of the effect of providing households with cheap energy saving technology is sparse. We present results from a field experiment in which autopoweroff plugs were provided free of charge to randomly selected households. We use propensity score matching to find treatment effects...

  15. Archaeobotanical study of ancient food and cereal remains at the Astana Cemeteries, Xinjiang, China.

    Science.gov (United States)

    Chen, Tao; Wu, Yan; Zhang, Yongbing; Wang, Bo; Hu, Yaowu; Wang, Changsui; Jiang, Hongen

    2012-01-01

    Starch grain, phytolith and cereal bran fragments were analyzed in order to identify the food remains including cakes, dumplings, as well as porridge unearthed at the Astana Cemeteries in Turpan of Xinjiang, China. The results suggest that the cakes were made from Triticum aestivum while the dumplings were made from Triticum aestivum, along with Setaria italica. The ingredients of the porridge remains emanated from Panicum miliaceum. Moreover, direct macrobotantical evidence of the utilization of six cereal crops, such as Triticum aestivum, Hordeum vulgare var. coeleste, Panicum miliaceum, Setaria italica, Cannabis sativa, and Oryza sativa in the Turpan region during the Jin and Tang dynasties (about 3(rd) to 9(th) centuries) is also presented. All of these cereal crops not only provided food for the survival of the indigenous people, but also spiced up their daily life.

  16. Archaeobotanical study of ancient food and cereal remains at the Astana Cemeteries, Xinjiang, China.

    Directory of Open Access Journals (Sweden)

    Tao Chen

    Full Text Available Starch grain, phytolith and cereal bran fragments were analyzed in order to identify the food remains including cakes, dumplings, as well as porridge unearthed at the Astana Cemeteries in Turpan of Xinjiang, China. The results suggest that the cakes were made from Triticum aestivum while the dumplings were made from Triticum aestivum, along with Setaria italica. The ingredients of the porridge remains emanated from Panicum miliaceum. Moreover, direct macrobotantical evidence of the utilization of six cereal crops, such as Triticum aestivum, Hordeum vulgare var. coeleste, Panicum miliaceum, Setaria italica, Cannabis sativa, and Oryza sativa in the Turpan region during the Jin and Tang dynasties (about 3(rd to 9(th centuries is also presented. All of these cereal crops not only provided food for the survival of the indigenous people, but also spiced up their daily life.

  17. Regulatory perspective on remaining challenges for utilization of pharmacogenomics-guided drug developments.

    Science.gov (United States)

    Otsubo, Yasuto; Ishiguro, Akihiro; Uyama, Yoshiaki

    2013-01-01

    Pharmacogenomics-guided drug development has been implemented in practice in the last decade, resulting in increased labeling of drugs with pharmacogenomic information. However, there are still many challenges remaining in utilizing this process. Here, we describe such remaining challenges from the regulatory perspective, specifically focusing on sample collection, biomarker qualification, ethnic factors, codevelopment of companion diagnostics and means to provide drugs for off-target patients. To improve the situation, it is important to strengthen international harmonization and collaboration among academia, industries and regulatory agencies, followed by the establishment of an international guideline on this topic. Communication with a regulatory agency from an early stage of drug development is also a key to success.

  18. Fish and other faunal remains from a Late Iron Age site on the Letaba River, Kruger National Park

    Directory of Open Access Journals (Sweden)

    Ina Plug

    1991-09-01

    Full Text Available Fish remains from Late Iron Age sites in the Transvaal are relatively scarce. It seems as if the people did not utilize the riverine resources extensively. Therefore the unique assemblage of large numbers of fish bones on a Late Iron Age site, provides some insight into the fish population of a section of the Letaba River a few hundred years ago. The presence of other faunal remains provides some information on prehistoric utilization of the environment in general. Hunting strategies and aspects of herding can also be deduced from the faunal remains.

  19. Cancer prevention.

    Science.gov (United States)

    Tubiana, M

    1999-01-01

    Over 70% of human cancers are associated with lifestyle and about half of cancer deaths could be prevented by relatively simple individual actions: no smoking, moderate consumption of alcohol, increased consumption of fruit and vegetables, avoidance of sunbathing, obesity and a too high consumption of saturated lipids. Most of these efforts would also markedly decrease the incidence of cardiovascular and respiratory diseases. However, the concept of prevention is currently neither well accepted nor understood by the medical community and the general public. It is often felt that it restricts freedom, imposes a choice between pleasure and duty, and that passing judgement on lifestyle is a form of intolerance. The case of tobacco illustrates the difficulties encountered by prevention, notably among adolescents. The fight against smoking requires information, a societal approach (ban on advertising, increase in price), and a reduction of the example given by adult smoking (parents, peers, teachers, physicians, TV presenters, movie stars, have a great influence on adolescents), while tobacco cessation programs must be promoted. The various approaches should be integrated into a global program of health prevention, including health education at school from 5 to 12 years of age. The efficacy of each of the global program's components should be evaluated. Misconceptions such as overestimation of the impact of pollution on health should also be corrected. Health is created and experienced by people within the setting of their daily lives, in particular during childhood. Prevention is the responsibility of individual members of the community but also of the community as a whole.

  20. Effect of interaction of embedded crack and free surface on remaining fatigue life

    Directory of Open Access Journals (Sweden)

    Genshichiro Katsumata

    2016-12-01

    Full Text Available Embedded crack located near free surface of a component interacts with the free surface. When the distance between the free surface and the embedded crack is short, stress at the crack tip ligament is higher than that at the other area of the cracked section. It can be easily expected that fatigue crack growth is fast, when the embedded crack locates near the free surface. To avoid catastrophic failures caused by fast fatigue crack growth at the crack tip ligament, fitness-for-service (FFS codes provide crack-to-surface proximity rules. The proximity rules are used to determine whether the cracks should be treated as embedded cracks as-is, or transformed to surface cracks. Although the concepts of the proximity rules are the same, the specific criteria and the rules to transform embedded cracks into surface cracks differ amongst FFS codes. This paper focuses on the interaction between an embedded crack and a free surface of a component as well as on its effects on the remaining fatigue lives of embedded cracks using the proximity rules provided by the FFS codes. It is shown that the remaining fatigue lives for the embedded cracks strongly depend on the crack aspect ratio and location from the component free surface. In addition, it can be said that the proximity criteria defined by the API and RSE-M codes give overly conservative remaining lives. On the contrary, the WES and AME codes always give long remaining lives and non-conservative estimations. When the crack aspect ratio is small, ASME code gives non-conservative estimation.

  1. The main issues preventing Kosovo’s economic development

    OpenAIRE

    Demir Lima

    2017-01-01

    This study provides an analysis of several problematic factors preventing Kosovo’s economic development. Several sectors that could have been the main pillars of economic development, such as manufacturing, energy, mines and minerals, and other economic sectors have been neglected from the development by domestic institutions or were used clandestinely by certain interest groups, whose focus was not in the development of the country but rather their personal gain. Trade remained the preferred...

  2. Credential Service Provider (CSP)

    Data.gov (United States)

    Department of Veterans Affairs — Provides a VA operated Level 1 and Level 2 credential for individuals who require access to VA applications, yet cannot obtain a credential from another VA accepted...

  3. MAX Provider Characteristics

    Data.gov (United States)

    U.S. Department of Health & Human Services — The MAX Provider Characteristics (PC) File Implementation Report describes the design, implementation, and results of the MAXPC prototype, which was based on three...

  4. Prevention in practice

    DEFF Research Database (Denmark)

    Birch, Stephen; Bridgman, Colette; Brocklehurst, Paul

    2015-01-01

    could be identified early enough to facilitate prevention, what evidence based therapies and treatments were available and how, given the collective evidence, could these be introduced in general dental practice within different reimbursement models. CONCLUSIONS: While examples of best practice were...... provided from both social care and insurance models it was clear that further work was required on both provider and payer side to ensure that evidence based prevention was both implemented properly but also reimbursed sufficiently. It is clear that savings can be made but these must not be overstated...

  5. Behaviour, the key factor for sports injury prevention.

    Science.gov (United States)

    Verhagen, Evert A L M; van Stralen, Maartje M; van Mechelen, Willem

    2010-11-01

    Safety in sports and physical activity is an important prerequisite for continuing participation in sports, as well as for maintenance of a healthy physically active lifestyle. For this reason, prevention, reduction and control of sports injuries are important goals for society as a whole. Recent advances in sports medicine discuss the need for research on real-life injury prevention. Such views call for a more behavioural approach when it comes to actual sports injury prevention. Nevertheless, the role of behaviour in sports injury prevention remains under-researched. In order to push the field of sports injury prevention forward, this article provides an overview of the relationship between behaviour and sports injury risk. Different types of behaviour relate to injury risk factors and injury mechanisms. Behaviour that influences risk factors and injury mechanisms is not confined only to the athlete. Various types of behaviour by, for example, the coach, referee, physical therapist or sports associations, also influence risk factors and injury mechanisms. In addition, multiple behaviours often act together. Some types of behaviour may directly affect injury risk and are by definition a risk factor. Other behaviours may only affect risk factors and injury mechanisms, and influence injury risk indirectly. Recent ideas on injury prevention that call for studies on real-life injury prevention still rely heavily on preventive measures that are established through efficacy research. A serious limitation in such an approach is that one expects that proven preventive measures will be adopted if the determinants and influences of sports safety behaviours are understood. Therefore, if one truly wants to prevent sports injuries in a real-life situation, a broader research focus is needed. In trying to do so, we need to look at lessons learned from other fields of injury prevention research.

  6. Preventing food allergy

    DEFF Research Database (Denmark)

    de Silva, Debra; Panesar, Sukhmeet S; Thusu, Sundeep

    2013-01-01

    The European Academy of Allergy and Clinical Immunology is developing guidelines about how to prevent and manage food allergy. As part of the guidelines development process, a systematic review is planned to examine published research about the prevention of food allergy. This systematic review...... is one of seven inter-linked evidence syntheses that are being undertaken in order to provide a state-of-the-art synopsis of the current evidence base in relation to epidemiology, prevention, diagnosis and clinical management, and impact on quality of life, which will be used to inform clinical...... recommendations. The aim of this systematic review will be to assess the effectiveness of approaches for the primary prevention of food allergy....

  7. Prevent Pneumonia

    Centers for Disease Control (CDC) Podcasts

    2015-08-06

    CDC’s Matthew Westercamp explains what pneumonia is, its symptoms, and how to prevent it.  Created: 8/6/2015 by National Center for Immunization and Respiratory Diseases (NCIRD), Division of Bacterial Diseases (DBD), Respiratory Diseases Branch (RDB).   Date Released: 8/6/2015.

  8. Prevention: Exercise

    Medline Plus

    Full Text Available ... Information Feature Articles Patient Q&A Success Stories Definitions Anatomy of the Spine Definitions A-Z Spine Specialists Videos 9 for Spine Epidural Steroid Injections Exercise: The Backbone of Spine Treatment Spondylolisthesis BLOG FIND A SPECIALIST Prevention ...

  9. Suicide Prevention

    Science.gov (United States)

    ... corresponding to World Suicide Prevention Day, to celebrate life, hope, and reasons to live. SAMHSA is committed to ... members, and helping people navigate the struggles of life to find a sustainable sense of hope, meaning, and purpose. For information about how you ...

  10. Bullying Prevention

    Science.gov (United States)

    Kemp, Patrice

    2016-01-01

    The focus of the milestone project is to focus on bridging the gap of bullying and classroom instruction methods. There has to be a defined expectations and level of accountability that has to be defined when supporting and implementing a plan linked to bullying prevention. All individuals involved in the student's learning have to be aware of…

  11. Method and apparatus to predict the remaining service life of an operating system

    Science.gov (United States)

    Greitzer, Frank L.; Kangas, Lars J.; Terrones, Kristine M.; Maynard, Melody A.; Pawlowski, Ronald A. , Ferryman; Thomas A.; Skorpik, James R.; Wilson, Bary W.

    2008-11-25

    A method and computer-based apparatus for monitoring the degradation of, predicting the remaining service life of, and/or planning maintenance for, an operating system are disclosed. Diagnostic information on degradation of the operating system is obtained through measurement of one or more performance characteristics by one or more sensors onboard and/or proximate the operating system. Though not required, it is preferred that the sensor data are validated to improve the accuracy and reliability of the service life predictions. The condition or degree of degradation of the operating system is presented to a user by way of one or more calculated, numeric degradation figures of merit that are trended against one or more independent variables using one or more mathematical techniques. Furthermore, more than one trendline and uncertainty interval may be generated for a given degradation figure of merit/independent variable data set. The trendline(s) and uncertainty interval(s) are subsequently compared to one or more degradation figure of merit thresholds to predict the remaining service life of the operating system. The present invention enables multiple mathematical approaches in determining which trendline(s) to use to provide the best estimate of the remaining service life.

  12. Post-operative hemimaxillectomy rehabilitation using prostheses supported by zygoma implants and remaining natural teeth

    Directory of Open Access Journals (Sweden)

    Xing Zhou Qu

    Full Text Available OBJECTIVES: This study aimed to evaluate the stability of prostheses supported by zygoma implants and remaining teeth for subjects who had undergone hemi-maxillectomy. METHODS: Ten patients were included in the study. Oral rehabilitation was performed using a temporary prosthesis that was supported by remaining teeth for the first three months. Then, a zygoma implant was placed to provide support for a final prosthesis in addition to the remaining teeth. Each prosthesis was tailor-made according to biomechanical three-dimensional finite element analysis results. The patients were assessed using the prosthesis functioning scale of the Memorial Sloan-Kettering Cancer Center. In addition, retention and bite force were recorded for both the temporary prosthesis and the final prosthesis. RESULTS: The mean bite force of the prosthetic first molar was increased to 69.2 N. The mean retentive force increased to 13.5 N after zygoma implant insertion. The bite force on the prosthetic first molar was improved to 229.3 N. CONCLUSION: Bite force increased significantly with the support of a zygoma implant. The use of zygoma implants in the restoration of maxillary defects improved functional outcome and patient satisfaction.

  13. Provider software buyer's guide.

    Science.gov (United States)

    1994-03-01

    To help long term care providers find new ways to improve quality of care and efficiency, Provider magazine presents the fourth annual listing of software firms marketing computer programs for all areas of nursing facility operations. On the following five pages, more than 80 software firms display their wares, with programs such as minimum data set and care planning, dietary, accounting and financials, case mix, and medication administration records. The guide also charts compatible hardware, integration ability, telephone numbers, company contacts, and easy-to-use reader service numbers.

  14. The politics of place: presidential voting patterns and Providers' prescription of emergency contraception.

    Science.gov (United States)

    Cleland, Kelly; Wagner, Brandon; Batur, Pelin; McNamara, Megan; Wu, Justine; Rothberg, Michael B

    2018-05-17

    The most effective forms of emergency contraception (EC) require a prescription or a medical procedure; therefore, provider willingness to offer EC remains critical to patient access. This study seeks to assess whether political alignment of a provider's county is associated with provider attitudes and behaviors regarding EC. We analyzed survey data collected from 1313 healthcare providers from February 2013 to April 2014 at 14 academic medical centers in the United States. Using logistic regression, we estimated associations between the county political alignment of a provider's practice and his or her EC-related beliefs and practices: 1) if the provider is aware of the most effective EC methods; 2) if knowing that a hypothetical EC method prevented implantation would make a provider less likely to prescribe that method because of personal ethical or religious reasons; and 3) if the provider prescribes any form of EC in his or her practice. In multivariate models, a one percentage-point increase in county Republican vote share was associated with a 2.9% decrease in the odds of a provider prescribing EC, after accounting for provider knowledge and attitudes about EC. EC provides a critical last chance to prevent pregnancy after unprotected sex, yet women living in Republican-leaning counties may face difficulty obtaining EC from healthcare providers. Programs seeking to improve access to EC should focus on areas likely to have fewer providers willing to prescribe EC, which may be those that are more Republican-leaning. The most effective forms of emergency contraception (EC) require a prescription or a medical procedure; therefore, provider willingness to offer EC remains critical to patient access. Women living in Republican-leaning counties may face difficulty obtaining emergency contraception from healthcare providers. Copyright © 2018. Published by Elsevier Inc.

  15. What HERA may provide?

    Energy Technology Data Exchange (ETDEWEB)

    Jung, Hannes [DESY, Hamburg (Germany); De Roeck, Albert [CERN, Genf (Switzerland); Bartles, Jochen [Univ. Hamburg (DE). Institut fuer Theoretische Physik II] (and others)

    2008-09-15

    More than 100 people participated in a discussion session at the DIS08 workshop on the topic What HERA may provide. A summary of the discussion with a structured outlook and list of desirable measurements and theory calculations is given. (orig.)

  16. What HERA may provide?

    International Nuclear Information System (INIS)

    Jung, Hannes; De Roeck, Albert; Bartles, Jochen

    2008-09-01

    More than 100 people participated in a discussion session at the DIS08 workshop on the topic What HERA may provide. A summary of the discussion with a structured outlook and list of desirable measurements and theory calculations is given. (orig.)

  17. Provider of Services File

    Data.gov (United States)

    U.S. Department of Health & Human Services — The POS file consists of two data files, one for CLIA labs and one for 18 other provider types. The file names are CLIA and OTHER. If downloading the file, note it...

  18. Preventing diabetes in the clinical setting.

    Science.gov (United States)

    Burnet, Deborah L; Elliott, Lorrie D; Quinn, Michael T; Plaut, Andrea J; Schwartz, Mindy A; Chin, Marshall H

    2006-01-01

    Translating lessons from clinical trials on the prevention or delay of type 2 diabetes to populations in nonstudy settings remains a challenge. The purpose of this paper is to review, from the perspective of practicing clinicians, available evidence on lifestyle interventions or medication to prevent or delay the onset of type 2 diabetes. A MEDLINE search identified 4 major diabetes prevention trials using lifestyle changes and 3 using prophylactic medications. We reviewed the study design, key components, and outcomes for each study, focusing on aspects of the interventions potentially adaptable to clinical settings. The lifestyle intervention studies set modest goals for weight loss and physical activity. Individualized counseling helped participants work toward their own goals; behavioral contracting and self-monitoring were key features, and family and social context were emphasized. Study staff made vigorous follow-up efforts for subjects having less success. Actual weight loss by participants was modest; yet, the reduction in diabetes incidence was quite significant. Prophylactic medication also reduced diabetes risk; however, lifestyle changes were more effective and are recommended as first-line strategy. Cost-effectiveness analyses have shown both lifestyle and medication interventions to be beneficial, especially as they might be implemented in practice. Strong evidence exists for the prevention or delay of type 2 diabetes through lifestyle changes. Components of these programs may be adaptable for use in clinical settings. This evidence supports broader implementation and increased reimbursement for provider services related to nutrition and physical activity to forestall morbidity from type 2 diabetes.

  19. Ciguatera Fish Poisoning: Treatment, Prevention and Management

    Directory of Open Access Journals (Sweden)

    Andrew Reich

    2008-08-01

    Full Text Available Ciguatera Fish Poisoning (CFP is the most frequently reported seafood-toxin illness in the world, and it causes substantial physical and functional impact. It produces a myriad of gastrointestinal, neurologic and/or cardiovascular symptoms which last days to weeks, or even months. Although there are reports of symptom amelioration with some interventions (e.g. IV mannitol, the appropriate treatment for CFP remains unclear to many physicians. We review the literature on the treatments for CFP, including randomized controlled studies and anecdotal reports. The article is intended to clarify treatment options, and provide information about management and prevention of CFP, for emergency room physicians, poison control information providers, other health care providers, and patients.

  20. Ciguatera fish poisoning: treatment, prevention and management.

    Science.gov (United States)

    Friedman, Melissa A; Fleming, Lora E; Fernandez, Mercedes; Bienfang, Paul; Schrank, Kathleen; Dickey, Robert; Bottein, Marie-Yasmine; Backer, Lorraine; Ayyar, Ram; Weisman, Richard; Watkins, Sharon; Granade, Ray; Reich, Andrew

    2008-01-01

    Ciguatera Fish Poisoning (CFP) is the most frequently reported seafood-toxin illness in the world, and it causes substantial physical and functional impact. It produces a myriad of gastrointestinal, neurologic and/or cardiovascular symptoms which last days to weeks, or even months. Although there are reports of symptom amelioration with some interventions (e.g. IV mannitol), the appropriate treatment for CFP remains unclear to many physicians. We review the literature on the treatments for CFP, including randomized controlled studies and anecdotal reports. The article is intended to clarify treatment options, and provide information about management and prevention of CFP, for emergency room physicians, poison control information providers, other health care providers, and patients.

  1. Ciguatera Fish Poisoning: Treatment, Prevention and Management

    Science.gov (United States)

    Friedman, Melissa A.; Fleming, Lora E.; Fernandez, Mercedes; Bienfang, Paul; Schrank, Kathleen; Dickey, Robert; Bottein, Marie-Yasmine; Backer, Lorraine; Ayyar, Ram; Weisman, Richard; Watkins, Sharon; Granade, Ray; Reich, Andrew

    2008-01-01

    Ciguatera Fish Poisoning (CFP) is the most frequently reported seafood-toxin illness in the world, and it causes substantial physical and functional impact. It produces a myriad of gastrointestinal, neurologic and/or cardiovascular symptoms which last days to weeks, or even months. Although there are reports of symptom amelioration with some interventions (e.g. IV mannitol), the appropriate treatment for CFP remains unclear to many physicians. We review the literature on the treatments for CFP, including randomized controlled studies and anecdotal reports. The article is intended to clarify treatment options, and provide information about management and prevention of CFP, for emergency room physicians, poison control information providers, other health care providers, and patients. PMID:19005579

  2. 76 FR 14058 - Notice of Inventory Completion: University of Wyoming, Anthropology Department, Human Remains...

    Science.gov (United States)

    2011-03-15

    ...: University of Wyoming, Anthropology Department, Human Remains Repository, Laramie, WY AGENCY: National Park... in the possession and control of the University of Wyoming Anthropology Department, Human Remains... made by University of Wyoming, Anthropology Department, Human Remains Repository, professional staff in...

  3. Parent-based interventions for preventing or reducing adolescent substance use: A systematic literature review

    NARCIS (Netherlands)

    Kuntsche, S.; Kuntsche, E.N.

    2016-01-01

    Despite the increasing relevance of peers, parents remain important socializing agents for their adolescent children and are therefore promising agents for inclusion in prevention or intervention programs. This systematic review provides an overview of the effectiveness of parent-based programs in

  4. Guarantee of remaining life time. Integrity of mechanical components and control of ageing phenomena

    International Nuclear Information System (INIS)

    Schuler, X.; Herter, K.H.; Koenig, G.

    2012-01-01

    The life time of safety relevant systems, structures and components (SSC) of Nuclear Power Plants (NPP) is determined by two main principles. First of all the required quality has to be produced during the design and fabrication process. This means that quality has to be produced and can't be improved by excessive inspections (Basis Safety - quality through production principle). The second one is assigned to the initial quality which has to be maintained during operation. This concerns safe operation during the total life time (life time management), safety against ageing phenomena (AM - ageing management) as well as proof of integrity (e.g. break preclusion or avoidance of fracture for SSC with high safety relevance). Initiated by the Fukushima Dai-ichi event in Japan in spring 2011 for German NPP's Long Term Operation (LTO) is out of question. In June 2011 legislation took decision to phase-out from nuclear by 2022. As a fact safe operation shall be guaranteed for the remaining life time. Within this technical framework the ageing management is a key element. Depending on the safety-relevance of the SSC under observation including preventive maintenance various tasks are required in particular to clarify the mechanisms which contribute systemspecifically to the damage of the components and systems and to define their controlling parameters which have to be monitored and checked. Appropriate continuous or discontinuous measures are to be considered in this connection. The approach to ensure a high standard of quality in operation for the remaining life time and the management of the technical and organizational aspects are demonstrated and explained. The basis for ageing management to be applied to NNPs is included in Nuclear Safety Standard 1403 which describes the ageing management procedures. For SSC with high safety relevance a verification analysis for rupture preclusion (proof of integrity, integrity concept) shall be performed (Nuclear Safety Standard 3206

  5. An Update on the Hazards and Risks of Forensic Anthropology, Part I: Human Remains.

    Science.gov (United States)

    Roberts, Lindsey G; Dabbs, Gretchen R; Spencer, Jessica R

    2016-01-01

    This work reviews the hazards and risks of practicing forensic anthropology in North America, with a focus on pathogens encountered through contact with unpreserved human remains. Since the publication of Galloway and Snodgrass' seminal paper concerning the hazards of forensic anthropology, research has provided new information about known pathogen hazards, and regulating authorities have updated recommendations for the recognition and treatment of several infections. Additionally, forensic anthropology has gained popularity, exposing an increased number of students and practitioners to these hazards. Current data suggest many occupational exposures to blood or body fluids go unreported, especially among students, highlighting the need for this discussion. For each pathogen and associated disease, this work addresses important history, reviews routes of exposure, provides an overview of symptoms and treatments, lists decontamination procedures, and presents data on postmortem viability. Personal protection and laboratory guidelines should be established and enforced in conjunction with the consideration of these data. © 2015 American Academy of Forensic Sciences.

  6. Building Service Provider Capabilities

    DEFF Research Database (Denmark)

    Brandl, Kristin; Jaura, Manya; Ørberg Jensen, Peter D.

    2015-01-01

    In this paper we study whether and how the interaction between clients and the service providers contributes to the development of capabilities in service provider firms. In situations where such a contribution occurs, we analyze how different types of activities in the production process...... process. We find that clients influence the development of human capital capabilities and management capabilities in reciprocally produced services. While in sequential produced services clients influence the development of organizational capital capabilities and management capital capabilities....... of the services, such as sequential or reciprocal task activities, influence the development of different types of capabilities. We study five cases of offshore-outsourced knowledge-intensive business services that are distinguished according to their reciprocal or sequential task activities in their production...

  7. Providing x-rays

    International Nuclear Information System (INIS)

    Mallozzi, P.J.; Epstein, H.M.

    1985-01-01

    This invention provides an apparatus for providing x-rays to an object that may be in an ordinary environment such as air at approximately atmospheric pressure. The apparatus comprises: means (typically a laser beam) for directing energy onto a target to produce x-rays of a selected spectrum and intensity at the target; a fluid-tight enclosure around the target; means for maintaining the pressure in the first enclosure substantially below atmospheric pressure; a fluid-tight second enclosure adjoining the first enclosure, the common wall portion having an opening large enough to permit x-rays to pass through but small enough to allow the pressure reducing means to evacuate gas from the first enclosure at least as fast as it enters through the opening; the second enclosure filled with a gas that is highly transparent to x-rays; the wall of the second enclosure to which the x-rays travel having a portion that is highly transparent to x-rays (usually a beryllium or plastic foil), so that the object to which the x-rays are to be provided may be located outside the second enclosure and adjacent thereto and thus receive the x-rays substantially unimpeded by air or other intervening matter. The apparatus is particularly suited to obtaining EXAFS (extended x-ray fine structure spectroscopy) data on a material

  8. Why healthcare providers merge.

    Science.gov (United States)

    Postma, Jeroen; Roos, Anne-Fleur

    2016-04-01

    In many OECD countries, healthcare sectors have become increasingly concentrated as a result of mergers. However, detailed empirical insight into why healthcare providers merge is lacking. Also, we know little about the influence of national healthcare policies on mergers. We fill this gap in the literature by conducting a survey study on mergers among 848 Dutch healthcare executives, of which 35% responded (resulting in a study sample of 239 executives). A total of 65% of the respondents was involved in at least one merger between 2005 and 2012. During this period, Dutch healthcare providers faced a number of policy changes, including increasing competition, more pressure from purchasers, growing financial risks, de-institutionalisation of long-term care and decentralisation of healthcare services to municipalities. Our empirical study shows that healthcare providers predominantly merge to improve the provision of healthcare services and to strengthen their market position. Also efficiency and financial reasons are important drivers of merger activity in healthcare. We find that motives for merger are related to changes in health policies, in particular to the increasing pressure from competitors, insurers and municipalities.

  9. PROVIDING WOMEN, KEPT MEN

    Science.gov (United States)

    Mojola, Sanyu A

    2014-01-01

    This paper draws on ethnographic and interview based fieldwork to explore accounts of intimate relationships between widowed women and poor young men that emerged in the wake of economic crisis and a devastating HIV epidemic among the Luo ethnic group in Western Kenya. I show how the cooptation of widow inheritance practices in the wake of an overwhelming number of widows as well as economic crisis resulted in widows becoming providing women and poor young men becoming kept men. I illustrate how widows in this setting, by performing a set of practices central to what it meant to be a man in this society – pursuing and providing for their partners - were effectively doing masculinity. I will also show how young men, rather than being feminized by being kept, deployed other sets of practices to prove their masculinity and live in a manner congruent with cultural ideals. I argue that ultimately, women’s practice of masculinity in large part seemed to serve patriarchal ends. It not only facilitated the fulfillment of patriarchal expectations of femininity – to being inherited – but also served, in the end, to provide a material base for young men’s deployment of legitimizing and culturally valued sets of masculine practice. PMID:25489121

  10. Optimization of Aeroengine Shop Visit Decisions Based on Remaining Useful Life and Stochastic Repair Time

    Directory of Open Access Journals (Sweden)

    Jing Cai

    2016-01-01

    Full Text Available Considering the wide application of condition-based maintenance in aeroengine maintenance practice, it becomes possible for aeroengines to carry out their preventive maintenance in just-in-time (JIT manner by reasonably planning their shop visits (SVs. In this study, an approach is proposed to make aeroengine SV decisions following the concept of JIT. Firstly, a state space model (SSM for aeroengine based on exhaust gas temperature margin is developed to predict the remaining useful life (RUL of aeroengine. Secondly, the effect of SV decisions on risk and service level (SL is analyzed, and an optimization of the aeroengine SV decisions based on RUL and stochastic repair time is performed to carry out JIT manner with the requirement of safety and SL. Finally, a case study considering two CFM-56 aeroengines is presented to demonstrate the proposed approach. The results show that predictive accuracy of RUL with SSM is higher than with linear regression, and the process of SV decisions is simple and feasible for airlines to improve the inventory management level of their aeroengines.

  11. Preliminary Investigation of Time Remaining Display on the Computer-based Emergency Operating Procedure

    Science.gov (United States)

    Suryono, T. J.; Gofuku, A.

    2018-02-01

    One of the important thing in the mitigation of accidents in nuclear power plant accidents is time management. The accidents should be resolved as soon as possible in order to prevent the core melting and the release of radioactive material to the environment. In this case, operators should follow the emergency operating procedure related with the accident, in step by step order and in allowable time. Nowadays, the advanced main control rooms are equipped with computer-based procedures (CBPs) which is make it easier for operators to do their tasks of monitoring and controlling the reactor. However, most of the CBPs do not include the time remaining display feature which informs operators of time available for them to execute procedure steps and warns them if the they reach the time limit. Furthermore, the feature will increase the awareness of operators about their current situation in the procedure. This paper investigates this issue. The simplified of emergency operating procedure (EOP) of steam generator tube rupture (SGTR) accident of PWR plant is applied. In addition, the sequence of actions on each step of the procedure is modelled using multilevel flow modelling (MFM) and influenced propagation rule. The prediction of action time on each step is acquired based on similar case accidents and the Support Vector Regression. The derived time will be processed and then displayed on a CBP user interface.

  12. [Can falls be prevented?].

    Science.gov (United States)

    Dubousset, Jean

    2014-06-01

    Most recommendations and measures intended to prevent falls focus on the elderly (see HAS guideline of April 2009) but, in our opinion, this isfar too late: prevention must begin much earlier, not only by identifying persons at risk, but also by providing personalized lifestyle advice adapted to each individual's biomechanical, somatic, neurological and biological characteristics. The first preventive measure is to identify a possible deterioration of balance, starting with a physical examination at the age of 45 and repeated regularly throughout life. Extrinsic preventive measures focusing on the domestic and external environments are clearly necessary. But what is most important is to detect and, if necessary, correct any degradation of intrinsic (intracorporeal or somatic) factors starting at the age of 45 years; these include vision, vestibular function and balance, proprioception, and psychological and neurological status. Chronic illnesses and their treatments must also be taken into account: treatment must be limited to indispensable drugs; sedative psychotropics must be avoided if possible; and polymedication must be tightly controlled, as it is a major risk factor for falls. Prevention also requires a diet sufficiently rich in protein, calcium and vitamin D3 (to prevent osteoporosis), and regular daily exercise adapted to the individual, if possible associated with a simultaneous cognitive task. The last key point is the absolute need for thorough functional rehabilitation after any accidental or medical trauma, regardless of age, with the aim of restoring functional status to that existing prior to the accident.

  13. Preventive Migraine Treatment

    Science.gov (United States)

    Silberstein, Stephen D.

    2015-01-01

    Purpose of Review: This article reviews the evidence base for the preventive treatment of migraine. Recent Findings: Evidence-based guidelines for the preventive treatment of migraine have recently been published by the American Academy of Neurology (AAN) and the Canadian Headache Society (CHS), providing valuable guidance for clinicians. Strong evidence exists to support the use of metoprolol, timolol, propranolol, divalproex sodium, sodium valproate, and topiramate for migraine prevention, according to the AAN. Based on best available evidence, adverse event profile, and expert consensus, topiramate, propranolol, nadolol, metoprolol, amitriptyline, gabapentin, candesartan, Petasites (butterbur), riboflavin, coenzyme Q10, and magnesium citrate received a strong recommendation for use from the CHS. Summary: Migraine preventive drug treatments are underutilized in clinical practice. Principles of preventive treatment are important to improve compliance, minimize side effects, and improve patient outcomes. Choice of preventive treatment of migraine should be based on the presence of comorbid and coexistent illness, patient preference, reproductive potential and planning, and best available evidence. PMID:26252585

  14. Injury Prevention Research

    Centers for Disease Control (CDC) Podcasts

    2009-09-01

    Research provides the knowledge that we need to understand what is possible, what is not, and the best way to proceed in our intervention efforts.  Created: 9/1/2009 by National Center for Injury Prevention and Control (NCIPC).   Date Released: 9/1/2009.

  15. Bullying Prevention for Kids

    Centers for Disease Control (CDC) Podcasts

    2012-01-19

    This podcast discusses what victims of bullying may experience and provides recommendations for coping with it.  Created: 1/19/2012 by National Center for Injury Prevention and Control (NCIPC).   Date Released: 1/19/2012.

  16. Providing Compassion through Flow

    Directory of Open Access Journals (Sweden)

    Lydia Royeen

    2015-07-01

    Full Text Available Meg Kral, MS, OTR/L, CLT, is the cover artist for the Summer 2015 issue of The Open Journal of Occupational Therapy. Her untitled piece of art is an oil painting and is a re-creation of a photograph taken while on vacation. Meg is currently supervisor of outpatient services at Rush University Medical Center. She is lymphedema certified and has a specific interest in breast cancer lymphedema. Art and occupational therapy serve similar purposes for Meg: both provide a sense of flow. She values the outcomes, whether it is a piece of art or improved functional status

  17. Social media and suicide prevention: findings from a stakeholder survey

    Science.gov (United States)

    ROBINSON, Jo; RODRIGUES, Maria; FISHER, Steve; BAILEY, Eleanor; HERRMAN, Helen

    2015-01-01

    Background Suicide is a leading cause of death, particularly among young adults. The rapid growth of social media and its heavy use by young adults presents new challenges and opportunities for suicide prevention. Social media sites are commonly used for communicating about suicide-related behavior with others, which raises the possibility of using social media to help prevent suicide. However, the use of social media varies widely between different suicide prevention advocates. The role this type of intervention should play in a community’s overall suicide prevention strategy remains a matter of debate. Aim Explore the ways in which stakeholders use social media for suicide prevention and assess their views about the potential utility of social media as a suicide prevention tool. Methods A 12-week stakeholder consultation that involved the online administration and completion of surveys by 10 individuals who conduct research about suicide and social media, 13 organizations that use social media for suicide prevention purposes, and 64 users of social media. Results Social media was seen as a useful means of delivering a range of suicide prevention activities. Respondents reported that the key benefits of social media were the opportunity to obtain emotional support from others, to express one’s feelings, to talk to others with similar problems, and to provide help to others. The social media site believed to hold most potential for delivering suicide prevention activities was Facebook. There were concerns about potential risks of social media, but respondents felt the potential benefits outweighed the risks. Conclusions Social media was recognized by different types of stakeholders as holding potential for delivering suicide prevention activities. More research is required to establish the efficacy and safety of potential social media-based interventions and ethical standards and protocols to ensure that such interventions are delivered safely need to be

  18. Social media and suicide prevention: findings from a stakeholder survey.

    Science.gov (United States)

    Robinson, Jo; Rodrigues, Maria; Fisher, Steve; Bailey, Eleanor; Herrman, Helen

    2015-02-25

    Suicide is a leading cause of death, particularly among young adults. The rapid growth of social media and its heavy use by young adults presents new challenges and opportunities for suicide prevention. Social media sites are commonly used for communicating about suicide-related behavior with others, which raises the possibility of using social media to help prevent suicide. However, the use of social media varies widely between different suicide prevention advocates. The role this type of intervention should play in a community's overall suicide prevention strategy remains a matter of debate. Explore the ways in which stakeholders use social media for suicide prevention and assess their views about the potential utility of social media as a suicide prevention tool. A 12-week stakeholder consultation that involved the online administration and completion of surveys by 10 individuals who conduct research about suicide and social media, 13 organizations that use social media for suicide prevention purposes, and 64 users of social media. Social media was seen as a useful means of delivering a range of suicide prevention activities. Respondents reported that the key benefits of social media were the opportunity to obtain emotional support from others, to express one's feelings, to talk to others with similar problems, and to provide help to others. The social media site believed to hold most potential for delivering suicide prevention activities was Facebook. There were concerns about potential risks of social media, but respondents felt the potential benefits outweighed the risks. Social media was recognized by different types of stakeholders as holding potential for delivering suicide prevention activities. More research is required to establish the efficacy and safety of potential social media-based interventions and ethical standards and protocols to ensure that such interventions are delivered safely need to be developed and implemented.

  19. Telomere Attrition in Human Lens Epithelial Cells Associated with Oxidative Stress Provide a New Therapeutic Target for the Treatment, Dissolving and Prevention of Cataract with N-Acetylcarnosine Lubricant Eye Drops. Kinetic, Pharmacological and Activity-Dependent Separation of Therapeutic Targeting: Transcorneal Penetration and Delivery of L-Carnosine in the Aqueous Humor and Hormone-Like Hypothalamic Antiaging Effects of the Instilled Ophthalmic Drug Through a Safe Eye Medication Technique.

    Science.gov (United States)

    Babizhayev, Mark A; Yegorov, Yegor E

    2016-01-01

    the lens response to oxidative damages, aging and health, cataract versus neuroendocrine regulation and disease. The cumulative results demonstrate that carnosine, released ophthalmically from the patented 1% Nacetylcarnosine prodrug lubricant eye drops, at physiological concentration might remarkably reduce the rate of telomere shortening in the lens cells subjected to oxidative stress in the lack of efficient antioxidant lens protection. Carnosine promotes the protection of normal cells from acquiring phenotypic characteristics of cellular senescence. The data of visual functions (visual acuity, glare sensitivity) in older adult subjects and older subjects with cataract treated with 1% N-acetylcarnosine lubricant eye drops showed significant improvement as compared, by contrast with the control group which showed generally no improvement in visual functions, with no difference from baseline in visual acuity and glare sensitivity readings. N-acetylcarnosine derived from the lubricant eye drops may be transported into the hypothalamic tuberomammillary nucleus (TMN) histamine neurons and gradually hydrolyzed. The resulting L-histidine may subsequently be converted into histamine, which could be responsible for the effects of carnosine on neurotransmission and hormone-like antiaging and anti-cataract physiological function. The research utilizing the N-acetylcarnosine lubricant eye drops powerful therapeutic platform provides the findings related to the intraocular uptake exposure sources as well as a timing dosage and duration systemic absorption of said preparation from the conjunctional sac reaching the hypothalamus with activities transfer into the hypothalamic-neuroendocrine pathways affecting across the hypothalamus metabolic pathway the telomere biology and cataract disease occurrence, reversal and prevention and the average expected lifespan of an individual. Such findings can be translated into clinical practice and may provide a basis for personalized cataract

  20. The 5th Canadian Symposium on Hepatitis C Virus: We Are Not Done Yet—Remaining Challenges in Hepatitis C

    Directory of Open Access Journals (Sweden)

    Nicholas van Buuren

    2016-01-01

    Full Text Available Hepatitis C virus (HCV affects approximately 268,000 Canadians and results in more years of life lost than any other infectious disease in the country. Both the Canadian Institutes of Health Research (CIHR and the Public Health Agency of Canada (PHAC have identified HCV-related liver disease as a priority and supported the establishment of a National Hepatitis C Research Network. In 2015, the introduction of new interferon- (IFN- free therapies with high cure rates (>90% and few side effects revolutionized HCV therapy. However, a considerable proportion of the population remains undiagnosed and treatment uptake remains low in Canada due to financial, geographical, cultural, and social barriers. Comprehensive prevention strategies, including enhanced harm reduction, broader screening, widespread treatment, and vaccine development, are far from being realized. The theme of the 2016 symposium, “We’re not done yet: remaining challenges in Hepatitis C,” was focused on identifying strategies to enhance prevention, diagnosis, and treatment of HCV to reduce disease burden and ultimately eliminate HCV in Canada.

  1. Prevention: Exercise

    Medline Plus

    Full Text Available ... building the muscles that provide support for your body. Pilates, yoga and martial arts all provide well- ... knees bent. Use your hips to push your body back to a standing position, then extend your ...

  2. Energy providers: customer expectations

    International Nuclear Information System (INIS)

    Pridham, N.F.

    1997-01-01

    The deregulation of the gas and electric power industries, and how it will impact on customer service and pricing rates was discussed. This paper described the present situation, reviewed core competencies, and outlined future expectations. The bottom line is that major energy consumers are very conscious of energy costs and go to great lengths to keep them under control. At the same time, solutions proposed to reduce energy costs must benefit all classes of consumers, be they industrial, commercial, institutional or residential. Deregulation and competition at an accelerated pace is the most likely answer. This may be forced by external forces such as foreign energy providers who are eager to enter the Canadian energy market. It is also likely that the competition and convergence between gas and electricity is just the beginning, and may well be overshadowed by other deregulated industries as they determine their core competencies

  3. Device for preventing coolant in a reactor from being lost

    International Nuclear Information System (INIS)

    Maruyama, Hiromi; Matsumoto, Tomoyuki.

    1975-01-01

    Object: To prevent all of coolant from being lost from the core at the time of failure in rupture of pipe in a recirculation system to cool the core with the coolant remained within the reactor. Structure: A valve, which will be closed when a water level of the coolant within the core is in a level less than a predetermined level, is provided on a recirculating water outlet nozzle in a pressure vessel to thereby prevent the coolant from being lost when the pipe is broken, thus cooling the core by means of reduced-pressure boiling of coolant remained within the core and boiling due to heat, and restraining core reactivity by means of void produced at that time. (Kamimura, M.)

  4. The remaining risk to be accepted with test facilities and prototype plants, and the relevant legal provisions of nuclear law

    International Nuclear Information System (INIS)

    Mayinger, T.

    1995-01-01

    The first chapter explains the provisions laid down in nuclear law to assure that precaution is taken to prevent damage resulting from the operation of nuclear power reactors, in order to set a line for comparison with the relevant legal provisions relating to test facilities and prototype plants. The comparative analysis shows that the means and methods of precaution are defined to comprise three approaches, namely measures taken to avert danger, measures taken to prevent danger, and measures for (remaining) risk minimization. All three approaches are intended to prevent occurrence of specifically nuclear events. The second chapter characterizes power reactors, prototype plant and test facilities and develops criteria for distinction. The third chapter establishes the systematics for comparison, showing whether and how the mandatory precaution to prevent damage defined for power reactors, prototype plant, and test facilities can be distinguished from each other, the results being represented in a systematic survey of licensing requirements as laid down in section 7, sub-section 2 ATG (Atomic Energy Act). (orig./HP) [de

  5. Impacts of curatorial and research practices on the preservation of fossil hominid remains.

    Science.gov (United States)

    Le Cabec, Adeline; Toussaint, Michel

    2017-12-30

    Fossil remains are the only physical evidence of past forms of life which researchers can use to study the evolutionary biology of a species, especially regarding the human lineage. We review and consider the way in which the conditions surrounding a fossil's discovery and its use for scientific research impacts its long-term preservation. The deterioration of the body starts soon after death, continues in the sediments and only a subsample of the anatomical elements will persist and may finally be unearthed by archeologists. From their recovery onwards, fossil remains are exposed to many sources of further damage: from handling, restoration, measuring to invasive sampling. On the one hand, curators are faced with the inherent challenge of balancing their responsibility to protect fossil specimens with allowing researchers to perform specific analyses or invasive sampling detrimental to the preservation of the fossil. On the other hand, scientists may find their analyses complicated by multiple factors including taphonomy, or restoration techniques (e.g., consolidants, cleaning chemicals). We provide several historical examples illustrating the complex nature of the factors acting on fossil preservation. We discuss concerns about producing and sharing (digital) data from fossils. Finally, we also suggest and support some curatorial practices which maximize the traceability of treatments underwent by a fossil.

  6. Prevention of nuclear war

    International Nuclear Information System (INIS)

    Anon.

    1990-01-01

    Removing the threat of a nuclear war-as the General Assembly formally stated in the Final Document of its first special session devoted to disarmament, in 1978-is considered to be the task of the present day. In that Document, the General Assembly sought to establish principles, guidelines and procedures for preventing nuclear war. It declared that to that end, it was imperative to remove the threat of nuclear weapons, to halt and reverse the nuclear-arms race until the total elimination of nuclear weapons and their delivery systems had been achieved (see chapter iv), and to prevent the proliferation of nuclear weapons (see chapter VII). At the same time, it called for other measures designed to prevent the outbreak of nuclear war and to lessen the danger of the treat or use of nuclear weapons. The Assembly's clear call for action was dictated by the awareness that there was no insuperable barrier dividing peace from war and that, unless nations brought the spiralling nuclear-arms race to an end, the day might come when nuclear weapons would actually be used, with catastrophic consequences. In adopting the Final Document, the international community achieved, for the first time, a consensus on an international disarmament strategy having as its immediate goal the elimination of the danger of a nuclear war and the implementation of measures to halt and reverse the arms race. The General Assembly, at its second special session on disarmament, in 1982, reaffirmed the validity of the 1978 Final Document. This paper reports that nuclear issues and in particular the prevention of nuclear war remain, however, major concerns of all States. Undoubtedly, all nations have a vital interest in the negotiation of effective measures for her prevention of nuclear war, since nuclear weapons pose a unique threat to human survival. If nuclear war were to occur, its consequences would be global, not simple regional

  7. Mapping Collaborative Relations among Canada's Chronic Disease Prevention Organizations

    Science.gov (United States)

    Hanusaik, Nancy; Maximova, Katerina; Paradis, Gilles; O'Loughlin, Jennifer L.

    2016-01-01

    In the field of chronic disease prevention (CDP), collaborations between organizations provide a vital framework for intersectoral engagement and exchanges of knowledge, expertise and resources. However, little is known about how the structures of preventive health systems actually articulate with CDP capacity and outcomes. Drawing upon data from the Public Health Organizational Capacity Study – a repeat census of all public health organizations in Canada – we used social network analysis to map and examine interorganizational collaborative relationships in the Canadian preventive health system. The network of relationships obtained through our study shows that provincial boundaries remain a major factor influencing collaborative patterns. Not only are collaborations scarce on the interprovincial level but they are also mostly limited to links with federal and multi-provincial organizations. Given this finding, federal or multi-provincial organizations that occupy central bridging positions in the Canadian CDP collaborative structure should serve as key players for shaping CDP practices in the country. PMID:27585030

  8. Oesophageal Injury During AF Ablation: Techniques for Prevention

    Science.gov (United States)

    Romero, Jorge; Avendano, Ricardo; Grushko, Michael; Diaz, Juan Carlos; Du, Xianfeng; Gianni, Carola; Natale, Andrea

    2018-01-01

    Atrial fibrillation remains the most common arrhythmia worldwide, with pulmonary vein isolation (PVI) being an essential component in the treatment of this arrhythmia. In view of the close proximity of the oesophagus with the posterior wall of the left atrium, oesophageal injury prevention has become a major concern during PVI procedures. Oesophageal changes varying from erythema to fistulas have been reported, with atrio-oesophageal fistulas being the most feared as they are associated with major morbidity and mortality. This review article provides a detailed description of the risk factors associated with oesophageal injury during ablation, along with an overview of the currently available techniques to prevent oesophageal injury. We expect that this state of the art review will deliver the tools to help electrophysiologists prevent potential oesophageal injuries, as well as increase the focus on research areas in which evidence is lacking. PMID:29636969

  9. Childhood obesity prevention: Changing the focus

    Science.gov (United States)

    Obesity in the United States and throughout the world remains highly prevalent, especially among children and adolescents. Innumerable child obesity prevention trials emphasizing diet, physical activity, sedentary behavior, and recently sleep have been designed, implemented, and evaluated with the b...

  10. Prediction of pavement remaining service life based on repetition of load and permanent deformation

    Science.gov (United States)

    Usman, R. S.; Setyawan, A.; Suprapto, M.

    2018-03-01

    One of the methods which was applied in the assessment of flexible pavement performance was mechanistic method assuming structures of road pavement to become multi-layer structure for flexible pavement, that the vehicle load working on the pavement layer under repetition with power failure worth 1 (one) unit which was assumed as evenly distributed static load, and therefore the pavement material would provide response in the form of stress, strain, and deflection. This is closely related in order to assess the structure of flexible pavement and to predict the remaining service life on the roads of Pulau Indah sta 0 + 000 to sta. 0 + 845 in Kota Kupang, Nusa Tenggara Timur. The performance appraisal indicator which was used was fatigue cracking happening bottom of the asphalt layer and permanent deformation (rutting) on the surface of subgrade. The strain estimate on the flexible pavement layer structure needs carefulness and high accuracy and therefore a software like KENPAVE which produces horizontal tensile strain of 8,802E-05 and vertical compressive strain of 2,642E-04 was used. By applying equation of The Asphalt Instituteit was obtained repetition of permit load when reaching fatigue cracking (Nf) was 16.071.516 ESAL and permanent deformation (rutting) was 14.703.867 ESAL and also it was predicted the remaining service life of pavement applied the equation of AASTHO 1993 by considering Traffic Multiplier factor (TM 1.8, TM 1.9 and TM 2.0) obtained the remaining life service due to fatigue of 5.51% in the year of 13th (TM 1.8), 7.95% in the year of12th (TM 1.9) and 3.11% (TM 2.0) in the year of 12th, also the remaining service life due to rutting of 4.69% in the year of 12th(TM 1.8), 7.79% in the year of 11th (TM 1.9), and 2.94 in the year of 11th (TM 2.0).

  11. Why does the need of HEU for high flux research reactors remain?

    International Nuclear Information System (INIS)

    Glaeser, W.

    1991-01-01

    It has shown that high performance high flux reactors need an ongoing supply of highly enriched uranium. The new fuel materials in their highly enriched version offer prospective for advanced and better neutron sources vital for the future of neutron research. This is another very attractive result of the RERTR programme. One-sided restriction would only provide marginal or no values for research. If we adopt the sometimes expressed views that high enriched RERTR developed fuel should only be made available when unique benefits to mankind could be obtained, then certainly basic research at the forefront belongs to this category. HEU would only pose theoretical difficulties, if it would remain under proper safeguards and obviously this is the way to be pursued. (orig.)

  12. Brief communication: a proposed osteological method for the estimation of pubertal stage in human skeletal remains.

    Science.gov (United States)

    Shapland, Fiona; Lewis, Mary E

    2013-06-01

    Puberty forms an important threshold between childhood and adulthood, but this subject has received little attention in bioarchaeology. The new application of clinical methods to assess pubertal stage in adolescent skeletal remains is explored, concentrating on the development of the mandibular canine, hamate, hand phalanges, iliac crest and distal radius. Initial results from the medieval cemetery of St. Peter's Church, Barton-upon-Humber, England suggest that application of these methods may provide insights into aspects of adolescent development. This analysis indicates that adolescents from this medieval site were entering the pubertal growth spurt at a similar age to their modern counterparts, but that the later stages of pubertal maturation were being significantly delayed, perhaps due to environmental stress. Continued testing and refinement of these methods on living adolescents is still necessary to improve our understanding of their significance and accuracy in predicting pubertal stages. Copyright © 2013 Wiley Periodicals, Inc.

  13. 309 proteomic analysis of the blastocoel fluid and remaining cells of bovine blastocysts

    DEFF Research Database (Denmark)

    Jensen, P L; Groendahl, M L; Beck, Helle

    2012-01-01

    Human embryonic stem cells (hESC) are derived from the human blastocyst and possess the potential to differentiate into any cell type present in the adult human body. Human ESC are considered to have great potential in regenerative medicine for the future treatment of severe diseases and conditions...... such as Parkinson's disease, diabetes, and spinal cord injury. One of today's challenges in regenerative medicine is to define proper culture conditions for hESC. The natural milieu in the blastocyst may provide clues on how to improve culture conditions, and the aim of the present study was to determine...... the proteome of the blastocoel fluid and the remaining cells of bovine blastocysts. Bovine blastocysts were produced by in vitro fertilization of oocytes retrieved from slaughterhouse ovaries. The blastocoel from 195 blastocysts (1-8nL per blastocyst) were isolated by micromanipulation and analysed by nano...

  14. Indoors forensic entomology: colonization of human remains in closed environments by specific species of sarcosaprophagous flies.

    Science.gov (United States)

    Pohjoismäki, Jaakko L O; Karhunen, Pekka J; Goebeler, Sirkka; Saukko, Pekka; Sääksjärvi, Ilari E

    2010-06-15

    Fly species that are commonly recovered on human corpses concealed in houses or other dwellings are often dependent on human created environments and might have special features in their biology that allow them to colonize indoor cadavers. In this study we describe nine typical cases involving forensically relevant flies on human remains found indoors in southern Finland. Eggs, larvae and puparia were reared to adult stage and determined to species. Of the five species found the most common were Lucilia sericata Meigen, Calliphora vicina Robineau-Desvoidy and Protophormia terraenovae Robineau-Desvoidy. The flesh fly Sarcophaga caerulescens Zetterstedt is reported for the first time to colonize human cadavers inside houses and a COI gene sequence based DNA barcode is provided for it to help facilitate identification in the future. Fly biology, colonization speed and the significance of indoors forensic entomological evidence are discussed. (c) 2010 Elsevier Ireland Ltd. All rights reserved.

  15. A Tool Measuring Remaining Thickness of Notched Acoustic Cavities in Primary Reaction Control Thruster NDI Standards

    Science.gov (United States)

    Sun, Yushi; Sun, Changhong; Zhu, Harry; Wincheski, Buzz

    2006-01-01

    Stress corrosion cracking in the relief radius area of a space shuttle primary reaction control thruster is an issue of concern. The current approach for monitoring of potential crack growth is nondestructive inspection (NDI) of remaining thickness (RT) to the acoustic cavities using an eddy current or remote field eddy current probe. EDM manufacturers have difficulty in providing accurate RT calibration standards. Significant error in the RT values of NDI calibration standards could lead to a mistaken judgment of cracking condition of a thruster under inspection. A tool based on eddy current principle has been developed to measure the RT at each acoustic cavity of a calibration standard in order to validate that the standard meets the sample design criteria.

  16. Pressure Ulcer Prevention

    Science.gov (United States)

    2009-01-01

    Executive Summary In April 2008, the Medical Advisory Secretariat began an evidence-based review of the literature concerning pressure ulcers. Please visit the Medical Advisory Secretariat Web site, http://www.health.gov.on.ca/english/providers/program/mas/tech/tech_mn.html to review these titles that are currently available within the Pressure Ulcers series. Pressure ulcer prevention: an evidence based analysis The cost-effectiveness of prevention strategies for pressure ulcers in long-term care homes in Ontario: projections of the Ontario Pressure Ulcer Model (field evaluation) Management of chronic pressure ulcers: an evidence-based analysis (anticipated pubicstion date - mid-2009) Purpose A pressure ulcer, also known as a pressure sore, decubitus ulcer, or bedsore, is defined as a localized injury to the skin/and or underlying tissue occurring most often over a bony prominence and caused by pressure, shear, or friction, alone or in combination. (1) Those at risk for developing pressure ulcers include the elderly and critically ill as well as persons with neurological impairments and those who suffer conditions associated with immobility. Pressure ulcers are graded or staged with a 4-point classification system denoting severity. Stage I represents the beginnings of a pressure ulcer and stage IV, the severest grade, consists of full thickness tissue loss with exposed bone, tendon, and or muscle. (1) In a 2004 survey of Canadian health care settings, Woodbury and Houghton (2) estimated that the prevalence of pressure ulcers at a stage 1 or greater in Ontario ranged between 13.1% and 53% with nonacute health care settings having the highest prevalence rate (Table 1). Executive Summary Table 1: Prevalence of Pressure Ulcers* Setting Canadian Prevalence,% (95% CI) Ontario Prevalence,Range % (n) Acute care 25 (23.8–26.3) 23.9–29.7 (3418) Nonacute care† 30 (29.3–31.4) 30.0–53.3 (1165) Community care 15 (13.4–16.8) 13.2 (91) Mixed health care‡ 22 (20.9

  17. PREVENTIVE MAINTENANCE. HONEYWELL PLANNING GUIDE.

    Science.gov (United States)

    Honeywell, Inc., Minneapolis, Minn.

    THIS HONEYWELL PAMPHLET DISCUSSES SOME ASPECTS OF PREVENTIVE MAINTENANCE OF AUTOMATIC CONTROLS, HEATING, VENTILATING, AND AIR CONDITIONING, AND COMPARES IN-PLANT WITH CONTRACT SERVICE, CONCLUDING THAT CONTRACT SERVICE IS PREFERABLE AND DESCRIBING A NUMBER OF MAINTENANCE PLANS WHICH THEY FURNISH. PREVENTIVE MAINTENANCE PROVIDES--(1) MORE EFFICIENT…

  18. Pollution Prevention/Waste Minimization

    International Nuclear Information System (INIS)

    Fowler, Kimberly M.; Hyman, Marvin H.

    2002-01-01

    This chapter offers pollution prevention techniques for design, industrial process, maintenance, and environmental remediation activities. It provides examples of waste reduction, tools for identifying pollution prevention opportunities, and ways of calculating the payback or return on investment associated with the opportunities

  19. Educating Students in Preventive Counseling.

    Science.gov (United States)

    Conyne, Robert K.

    1997-01-01

    Provides a comprehensive set of competencies for counselors doing primary prevention. Describes 10 expanded clusters of skills (primary prevention perspective, personal attributes and behaviors, ethics, marketing, multiculturalism, group facilitation, organization and setting dynamics, trends and political dynamics, and research and evaluation)…

  20. Reliability of BOD POD Measurements Remains High After a Short-Duration Low-Carbohydrate Diet.

    Science.gov (United States)

    Greer, Beau Kjerulf; Edsall, Kathleen M; Greer, Anna E

    2016-04-01

    The purpose of the current study was to determine whether expected changes in body weight via a 3-day low-carbohydrate (LC) diet will disrupt the reliability of air displacement plethysmography measurements via BOD POD. Twenty-four subjects recorded their typical diets for 3 days before BOD POD and 7-site skinfold analyses. Subjects were matched for lean body mass and divided into low-CHO (LC) and control (CON) groups. The LC group was given instruction intended to prevent more than 50 grams/day of carbohydrate consumption for 3 consecutive days, and the CON group replicated their previously recorded diet. Body composition measurements were repeated after dietary intervention. Test-retest reliability measures were significant (p fat percentage in both the LC and the CON groups (rs = .993 and .965, respectively). Likewise, skinfold analysis for body fat percentage reliability was high in both groups (rs = .996 and .997, respectively). There were significant differences between 1st and 2nd BOD POD measurements for body mass (72.9 ± 13.3 vs. 72.1 ± 13.0 kg [M ± SD]) and body volume (69.0 ± 12.7-68.1 ± 12.2 L) in the LC group (p .05) in BOD POD-determined body fat percentage, lean body mass, or fat mass between the 1st and 2nd trial in either group. Body composition measures via BOD POD and 7-site skinfolds remain reliable after 3 days of an LC diet despite significant decreases in body mass.

  1. Rotating preventers

    International Nuclear Information System (INIS)

    Tangedahl, M.J.; Stone, C.R.

    1992-01-01

    This paper reports that recent changes in the oil and gas industry and ongoing developments in horizontal and underbalanced drilling necessitated development of a better rotating head. A new device called the rotating blowout preventer (RBOP) was developed by Seal-Tech. It is designed to replace the conventional rotating control head on top of BOP stacks and allows drilling operations to continue even on live (underbalanced) wells. Its low wear characteristics and high working pressure (1,500 psi) allow drilling rig crews to drill safely in slightly underbalanced conditions or handle severe well control problems during the time required to actuate other BOPs in the stack. Drilling with a RBOP allows wellbores to be completely closed in tat the drill floor rather than open as with conventional BOPs

  2. Environmental standards provide competitive advantage

    International Nuclear Information System (INIS)

    Chynoweth, E.; Kirshner, E.

    1993-01-01

    Quality organizations are breaking new ground with the development of international standards for environmental management. These promise to provide the platform for chemical companies wanting to establish their environmental credibility with a global audience. open-quotes It will be similar to auditing our customers to ISO 9000 close-quote, says the environmental manager for a European chemical firm. open-quote We will only want to deal with people who have got their environmental act together. And we'll be in a better competitive positions close-quote. The International Organization for Standardization (ISO;Geneva) has set up a taskforce to develop an environmental management standard, which is expected to be completed by the mid-1990s. Observers think the ISO standard will draw heavily on the British Standard Institute's (BSI;London) environmental management standard, BS7750, which will likely be the first system adopted in the world. Published last year, BS7750 has been extensively piloted in the UK (CW, Sept. 30, 1992, p. 62) and is now set to be revised before being offically adopted by BSI. The UK's Chemical Industries Association (CIA;London) is anxious to prevent a proliferation of standards, and its report on BS7750 pilot projects calls for an approach integrating quality, environment, and health and safety. But standard setters, including ISO, appear to be moving in the opposite direction. In the US, the American national Standards Institute (ANSI;Washington) has started work on an environmental management standard

  3. Osteoradionecrosis prevention myths

    International Nuclear Information System (INIS)

    Wahl, Michael J.

    2006-01-01

    Purpose: To critically analyze controversial osteoradionecrosis (ORN) prevention techniques, including preradiation extractions of healthy or restorable teeth and the use of prophylactic antibiotics or hyperbaric oxygen (HBO) treatments for preradiation and postradiation extractions. Methods: The author reviewed ORN studies found on PubMed and in other article references, including studies on overall ORN incidence and pre- and postradiation incidence, with and without prophylactic HBO or antibiotics. Results: Owing in part to more efficient radiation techniques, the incidence of ORN has been declining in radiation patients over the last 2 decades, but the prevention of ORN remains controversial. A review of the available literature does not support the preradiation extraction of restorable or healthy teeth. There is also insufficient evidence to support the use of prophylactic HBO treatments or prophylactic antibiotics before extractions or other oral surgical procedures in radiation patients. Conclusions: To prevent ORN, irradiated dental patients should maintain a high level of oral health. A preradiation referral for a dental evaluation and close collaboration by a multidisciplinary team can be invaluable for radiation patients. As with most other dental patients, restorable and healthy teeth should be retained in irradiated patients. The use of prophylactic HBO or antibiotics should be reconsidered for preradiation and postradiation extractions

  4. 75 FR 5108 - Notice of Inventory Completion: University of Wyoming, Anthropology Department, Human Remains...

    Science.gov (United States)

    2010-02-01

    ... Wyoming, Anthropology Department, Human Remains Repository, Laramie, WY AGENCY: National Park Service... funerary objects in the possession and control of the University of Wyoming, Anthropology Department, Human... of Wyoming, Anthropology Department, Human Remains Repository professional staff in consultation with...

  5. [Prevention of schizophrenia: a review].

    Science.gov (United States)

    Balhara, Yatan Pal Singh

    2013-01-01

    Research over the years has introduced multiple interventions for schizophrenia. Notwithstanding the nature of intervention pharmacological or psychological a complete cure for the condition remains a much-desired, yet unachieved goal. What is required is an exploration of alternative intervention strategies for treating schizophrenia a preventive approach is such an option. The chronic nature of schizophrenia and its associated disabilities have a tremendously negative affect the quality of life of patients, their families, and communities. Among the preferred approaches to reducing the negative consequences associated with the disorder is the prevention of its emergence. This review aimed to present the available data on the prevention of schizophrenia data that suggest some pharmacological and non-pharmacological interventions have a potential role in the prevention of schizophrenia. Nonetheless, the findings are restricted to a few sites and are at best preliminary; as such, the findings must be replicated in new studies that include large samples and different settings.

  6. Preventing Infections in Cancer Patients

    Science.gov (United States)

    ... Protect: Know the Signs and Symptoms of Infection Neutropenia and Risk for Infection Health Care Providers Educational Materials Cancer and Flu How to Prevent Flu from Spreading Flu Symptoms Information for Families and Caregivers Flu Treatment for Cancer Patients and ...

  7. Tips to Prevent Mosquito Bites

    Science.gov (United States)

    ... discourage mosquitoes, ticks and other biting insects from landing on you. Here are tips for other preventive ... CDC Mosquito Control Methods - NPIC Exit Top of Page Contact Us to ask a question, provide feedback, ...

  8. Prevention: Exercise

    Medline Plus

    Full Text Available ... support for your body. Pilates, yoga and martial arts all provide well-rounded core strengthening programs. Simple ... use progressively heavier balls, you will experience more benefit from this exercise... Sagittal Core Strengthening You can ...

  9. Prevention: Exercise

    Medline Plus

    Full Text Available ... body. Pilates, yoga and martial arts all provide well-rounded core strengthening programs. Simple exercises can be done at home as well. Some specific core strengthening exercises are described below. ...

  10. Prevention: Exercise

    Medline Plus

    Full Text Available ... Physical Therapy Postural Training Traction Watchful Waiting and Education Injection Treatments for ... Core Strengthening Many popular forms of exercise focus on core strengthening, or building the muscles that provide ...

  11. Prevention: Exercise

    Medline Plus

    Full Text Available ... back to a standing position, then extend your arms and reach over your head and slightly backward. ... providing resistance. It can be done with weights (hand-held or training machines) or using isometric techniques. ...

  12. Prevention: Exercise

    Medline Plus

    Full Text Available ... provide well-rounded core strengthening programs. Simple exercises can be done at home as well. Some specific ... benefit from this exercise... Sagittal Core Strengthening You can stretch and strengthen the low back muscles that ...

  13. Prevention: Exercise

    Medline Plus

    Full Text Available ... 15 repetitions at a slow and controlled pace... Resistance Training Resistance training is exercise done against something providing resistance. It can be done with weights (hand-held ...

  14. Sunburn: Treatment and Prevention

    Science.gov (United States)

    ... Healthy Living Healthy Living Healthy Living Nutrition Fitness Sports Oral Health Emotional Wellness Growing Healthy Sleep Safety & Prevention Safety & Prevention Safety and Prevention Immunizations ...

  15. 25 CFR 291.15 - How long do Class III gaming procedures remain in effect?

    Science.gov (United States)

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false How long do Class III gaming procedures remain in effect... ENTERPRISES CLASS III GAMING PROCEDURES § 291.15 How long do Class III gaming procedures remain in effect? Class III gaming procedures remain in effect for the duration specified in the procedures or until...

  16. Bullying Prevention for the Public

    Centers for Disease Control (CDC) Podcasts

    2012-01-19

    This is the first podcast of a series to discuss the severity of bullying and provide resources for prevention efforts. CDC shares the most recent statistics and trends, provides valuable tips to implement in communities, and teaches individuals how to take action against bullying.  Created: 1/19/2012 by National Center for Injury Prevention and Control (NCIPC).   Date Released: 1/19/2012.

  17. Teleophthalmology in preventive medicine

    CERN Document Server

    Michelson, Georg

    2014-01-01

    This book provides an up-to-date overview of the clinical applications, methods, and technologies of teleophthalmology within the field of preventive medicine. The ability of novel methods to detect the initial signs of neurodegenerative diseases on the basis of alterations in the retina is reviewed, and detailed attention is paid to the role of teleophthalmology in screening for vision-threatening diseases such as diabetic retinopathy, glaucoma, and age-related macular degeneration. A major part of the book is devoted to novel imaging methods and the latest information technologies, including advanced mobile communication and Web 2.0 applications in teleophthalmology. In addition, the initial projects of an interdisciplinary cooperation in preventive medicine are described. All of the authors are experienced in the scientific and practical aspects of teleophthalmology, including e-learning, and have produced a book that will meet the needs of all medical care providers interested in using teleophthalmology.

  18. Biomarkers reveal sea turtles remained in oiled areas following the Deepwater Horizon oil spill

    Science.gov (United States)

    Vander Zanden, Hannah B.; Bolten, Alan B.; Tucker, Anton D.; Hart, Kristen M.; Lamont, Margaret M.; Fujisaki, Ikuko; Reich, Kimberly J.; Addison, David S.; Mansfield, Katherine L.; Phillips, Katrina F.; Pajuelo, Mariela; Bjorndal, Karen A.

    2016-01-01

    Assessments of large-scale disasters, such as the Deepwater Horizon oil spill, are problematic because while measurements of post-disturbance conditions are common, measurements of pre-disturbance baselines are only rarely available. Without adequate observations of pre-disaster organismal and environmental conditions, it is impossible to assess the impact of such catastrophes on animal populations and ecological communities. Here, we use long-term biological tissue records to provide pre-disaster data for a vulnerable marine organism. Keratin samples from the carapace of loggerhead sea turtles record the foraging history for up to 18 years, allowing us to evaluate the effect of the oil spill on sea turtle foraging patterns. Samples were collected from 76 satellite-tracked adult loggerheads in 2011 and 2012, approximately one to two years after the spill. Of the 10 individuals that foraged in areas exposed to surface oil, none demonstrated significant changes in foraging patterns post spill. The observed long-term fidelity to foraging sites indicates that loggerheads in the northern Gulf of Mexico likely remained in established foraging sites, regardless of the introduction of oil and chemical dispersants. More research is needed to address potential long-term health consequences to turtles in this region. Mobile marine organisms present challenges for researchers to monitor effects of environmental disasters, both spatially and temporally. We demonstrate that biological tissues can reveal long-term histories of animal behavior and provide critical pre-disaster baselines following an anthropogenic disturbance or natural disaster.

  19. Vaccines provided by family physicians.

    Science.gov (United States)

    Campos-Outcalt, Doug; Jeffcott-Pera, Michelle; Carter-Smith, Pamela; Schoof, Bellinda K; Young, Herbert F

    2010-01-01

    This study was conducted to document current immunization practices by family physicians. In 2008 the American Academy of Family Physicians (AAFP) conducted a survey among a random sample of 2,000 of its members who reported spending 80% or more of their time in direct patient care. The survey consisted of questions regarding the demographics of the practice, vaccines that are provided at the physicians' clinical site, whether the practice refers patients elsewhere for vaccines, and participation in the Vaccines for Children (VFC) program. The response rate was 38.5%, 31.8% after non-office-based respondents were deleted. A high proportion of respondents (80% or more) reported providing most routinely recommended child, adolescent, and adult vaccines at their practice sites. The exceptions were rotavirus vaccine for children and herpes zoster vaccine for adults., A significant proportion, however, reported referring elsewhere for some vaccines (44.1% for children and adolescent vaccines and 53.5% for adult vaccines), with the most frequent referral location being a public health department. A higher proportion of solo and 2-physician practices than larger practices reported referring patients. A lack of adequate payment was listed as the reason for referring patients elsewhere for vaccines by one-half of those who refer patients. One-half of responders do not participate in the VFC program. Provision of recommended vaccines by most family physicians remains an important service. Smaller practices have more difficulty offering a full array of vaccine products, and lack of adequate payment contributes to referring patients outside the medical home. The reasons behind the lack of participation in the VFC program deserve further study.

  20. Review of the Dinosaur Remains from the Middle Jurassic of Scotland, UK

    Directory of Open Access Journals (Sweden)

    Neil D. L. Clark

    2018-02-01

    Full Text Available Dinosaurs are rare from the Middle Jurassic worldwide. The Isle of Skye, is the only place in Scotland thus far to have produced dinosaur remains. These remains consist mainly of footprints, but also several bones and teeth. These Bajocian and Bathonian remains represent an important collection of a basal eusauropod, early examples of non-neosauropod and possible basal titanosauriform eusauropods, and theropod remains that may belong to an early coelurosaur and a possible megalosaurid, basal tyrannosauroid, or dromaeosaurid. The footprints from here also suggest a rich and diverse dinosaur fauna for which further better diagnosable remains are likely to be found.

  1. Promoting a Shared Representation of Workers' Activities to Improve Integrated Prevention of Work-Related Musculoskeletal Disorders

    Directory of Open Access Journals (Sweden)

    Yves Roquelaure

    2016-06-01

    Full Text Available Effective and sustainable prevention of work-related musculoskeletal disorders (WR-MSDs remains a challenge for preventers and policy makers. Coordination of stakeholders involved in the prevention of WR-MSDs is a key factor that requires greater reflection on common knowledge and shared representation of workers' activities among stakeholders. Information on workers' strategies and operational leeway should be the core of common representations, because it places workers at the center of the “work situation system” considered by the intervention models. Participatory ergonomics permitting debates among stakeholders about workers' activity and strategies to cope with the work constraints in practice could help them to share representations of the “work situation system” and cooperate. Sharing representation therefore represents a useful tool for prevention, and preventers should provide sufficient space and time for dialogue and discussion of workers' activities among stakeholders during the conception, implementation, and management of integrated prevention programs.

  2. Reconstruction of sub-surface archaeological remains from magnetic data using neural computing.

    Science.gov (United States)

    Bescoby, D. J.; Cawley, G. C.; Chroston, P. N.

    2003-04-01

    The remains of a former Roman colonial settlement, once part of the classical city of Butrint in southern Albania have been the subject of a high resolution magnetic survey using a caesium-vapour magnetometer. The survey revealed the surviving remains of an extensive planned settlement and a number of outlying buildings, today buried beneath over 0.5 m of alluvial deposits. The aim of the current research is to derive a sub-surface model from the magnetic survey measurements, allowing an enhanced archaeological interpretation of the data. Neural computing techniques are used to perform the non-linear mapping between magnetic data and corresponding sub-surface model parameters. The adoption of neural computing paradigms potentially holds several advantages over other modelling techniques, allowing fast solutions for complex data, while having a high tolerance to noise. A multi-layer perceptron network with a feed-forward architecture is trained to estimate the shape and burial depth of wall foundations using a series of representative models as training data. Parameters used to forward model the training data sets are derived from a number of trial trench excavations targeted over features identified by the magnetic survey. The training of the network was optimized by first applying it to synthetic test data of known source parameters. Pre-processing of the network input data, including the use of a rotationally invariant transform, enhanced network performance and the efficiency of the training data. The approach provides good results when applied to real magnetic data, accurately predicting the depths and layout of wall foundations within the former settlement, verified by subsequent excavation. The resulting sub-surface model is derived from the averaged outputs of a ‘committee’ of five networks, trained with individualized training sets. Fuzzy logic inference has also been used to combine individual network outputs through correlation with data from a second

  3. First diagnostic marine reptile remains from the Aalenian (Middle Jurassic): a new ichthyosaur from southwestern Germany.

    Science.gov (United States)

    Maxwell, Erin E; Fernández, Marta S; Schoch, Rainer R

    2012-01-01

    The Middle Jurassic was a critical time in the evolutionary history of ichthyosaurs. During this time interval, the diverse, well-studied faunas of the Lower Jurassic were entirely replaced by ophthalmosaurids, a new group that arose sometime prior to the Aalenian-Bajocian boundary and by the latest middle Jurassic comprised the only surviving group of ichthyosaurs. Thus, the Middle Jurassic Aalenian-Bathonian interval (176-165 million years ago) comprises the time frame during which ophthalmosaurids not only originated but also achieved taxonomic dominance. However, diagnostic ichthyosaur remains have been described previously from only a single locality from this interval, from the Bajocian of Argentina. In this paper, we describe a new species of ichthyosaur based on a partial articulated specimen from the Middle Jurassic of southwestern Germany. This specimen was recovered from the Opalinuston Formation (early Aalenian) and is referable to Stenopterygius aaleniensis sp. nov. reflecting features of the skull and forefin. The genus Stenopterygius is diverse and abundant in the Lower Jurassic of Europe, but its presence has not previously been confirmed in younger (Middle Jurassic) rocks from the northern hemisphere. This specimen represents the only diagnostic ichthyosaur remains reported from the Aalenian. It bears numerous similarities in size and in morphology to the Lower Jurassic species of the genus Stenopterygius and provides additional evidence that the major ecological changes hypothesized to have occurred at the end of the Toarcian took place sometime after this point and most likely did not occur suddenly. There is currently no evidence for the presence of ophthalmosaurids in the northern hemisphere during the Aalenian-Bathonian interval.

  4. The cochlear implant and possibilities for narrowing the remaining gaps between prosthetic and normal hearing

    Directory of Open Access Journals (Sweden)

    Blake S. Wilson

    2017-12-01

    Full Text Available Background: The cochlear implant has become the standard of care for severe or worse losses in hearing and indeed has produced the first substantial restoration of a lost or absent human sense using a medical intervention. However, the devices are not perfect and many efforts to narrow the remaining gaps between prosthetic and normal hearing are underway. Objective: To assess the present status of cochlear implants and to describe possibilities for improving them. Results: The present-day devices work well in quiet conditions for the great majority of users. However, not all users have high levels of speech reception in quiet and nearly all users struggle with speech reception in typically noisy acoustic environments. In addition, perception of sounds more complex than speech, such as most music, is generally poor unless residual hearing at low frequencies can be stimulated acoustically in conjunction with the electrical stimuli provided by the implant. Possibilities for improving the present devices include increasing the spatial specificity of neural excitation by reducing masking effects or with new stimulus modes; prudent pruning of interfering or otherwise detrimental electrodes from the stimulation map; a further relaxation in the criteria for implant candidacy, based on recent evidence from persons with high levels of residual hearing and to allow many more people to benefit from cochlear implants; and “top down” or “brain centric” approaches to implant designs and applications. Conclusions: Progress in the development of the cochlear implant and related treatments has been remarkable but room remains for improvements. The future looks bright as there are multiple promising possibilities for improvements and many talented teams are pursuing them. Keywords: Auditory prosthesis, Cochlear implant, Cochlear prosthesis, Deafness, Neural prosthesis

  5. First diagnostic marine reptile remains from the Aalenian (Middle Jurassic: a new ichthyosaur from southwestern Germany.

    Directory of Open Access Journals (Sweden)

    Erin E Maxwell

    Full Text Available BACKGROUND: The Middle Jurassic was a critical time in the evolutionary history of ichthyosaurs. During this time interval, the diverse, well-studied faunas of the Lower Jurassic were entirely replaced by ophthalmosaurids, a new group that arose sometime prior to the Aalenian-Bajocian boundary and by the latest middle Jurassic comprised the only surviving group of ichthyosaurs. Thus, the Middle Jurassic Aalenian-Bathonian interval (176-165 million years ago comprises the time frame during which ophthalmosaurids not only originated but also achieved taxonomic dominance. However, diagnostic ichthyosaur remains have been described previously from only a single locality from this interval, from the Bajocian of Argentina. METHODOLOGY/PRINCIPAL FINDINGS: In this paper, we describe a new species of ichthyosaur based on a partial articulated specimen from the Middle Jurassic of southwestern Germany. This specimen was recovered from the Opalinuston Formation (early Aalenian and is referable to Stenopterygius aaleniensis sp. nov. reflecting features of the skull and forefin. The genus Stenopterygius is diverse and abundant in the Lower Jurassic of Europe, but its presence has not previously been confirmed in younger (Middle Jurassic rocks from the northern hemisphere. CONCLUSIONS/SIGNIFICANCE: This specimen represents the only diagnostic ichthyosaur remains reported from the Aalenian. It bears numerous similarities in size and in morphology to the Lower Jurassic species of the genus Stenopterygius and provides additional evidence that the major ecological changes hypothesized to have occurred at the end of the Toarcian took place sometime after this point and most likely did not occur suddenly. There is currently no evidence for the presence of ophthalmosaurids in the northern hemisphere during the Aalenian-Bathonian interval.

  6. CONTEMPORARY PRINCIPLES OF SUICIDE PREVENTION.

    Science.gov (United States)

    Ljusic, Dragana; Ravanic, Dragan; Filipovic Danic, Snezana; Soldatovic, Ivan; Cvetkovic, Jovana; Stojanovic Tasic, Mirjana

    2016-11-01

    Suicide remains a significant public health problem worldwide. This study is aimed at analyzing and presenting contemporary methods in suicide prevention in the world as well as at identifying specific risk groups and risk factors in order to explain their importance. in suicide prevention. The literature search covered electronic databases PubMed, Web of Science and Scopus. In order to select the relevant articles, the authors searched for the combination of key-words which included the following medical subject heading terms (suicide or suicide ideation or attempted) and (prevention or risk factors) and (man or elders or mental disorders). Data analysis covered meta-analyses, systematic reviews and original scientific papers with different characteristics of suicide preventions, risk factors and risk groups. Worldwide evidence-based interventions for suicide prevention are divided in universal, selective and indicated interventions. Restricted approach to various methods of committing suicide as well as pharmacotherapy contributes to a lower suicide rate. Suicide risk factors can be categorized as proximal and distal. The following groups are at highest risk of committing suicide: males. older persons and persons with registered psychiatric disorders. There is a lot of evidence that suicide is preventable. It is known that only 28 coun tries in the world have national suicide prevention strategies and Serbia is not one of them.

  7. Opioid-induced hyperalgesia in clinical anesthesia practice: what has remained from theoretical concepts and experimental studies?

    Science.gov (United States)

    Weber, Lena; Yeomans, David C; Tzabazis, Alexander

    2017-08-01

    This article reviews the phenomenon of opioid-induced hyperalgesia (OIH) and its implications for clinical anesthesia. The goal of this review is to give an update on perioperative prevention and treatment strategies, based on findings in preclinical and clinical research. Several systems have been suggested to be involved in the pathophysiology of OIH with a focus on the glutaminergic system. Very recently preclinical data revealed that peripheral μ-opioid receptors (MORs) are key players in the development of OIH and acute opioid tolerance (AOT). Peripheral MOR antagonists could, thus, become a new prevention/treatment option of OIH in the perioperative setting. Although the impact of OIH on postoperative pain seems to be moderate, recent evidence suggests that increased hyperalgesia following opioid treatment correlates with the risk of developing persistent pain after surgery. In clinical practice, distinction among OIH, AOT and acute opioid withdrawal remains difficult, especially because a specific quantitative sensory test to diagnose OIH has not been validated yet. Since the immediate postoperative period is not ideal to initiate long-term treatment for OIH, the best strategy is to prevent its occurrence. A multimodal approach, including choice of opioid, dose limitations and addition of nonopioid analgesics, is recommended.

  8. Diabetes Prevention Program (DPP)

    Science.gov (United States)

    ... Recruiting Patients & Families Consortia, Networks & Centers Reports & Planning Diabetes Prevention Program (DPP) The NIDDK-sponsored Diabetes Prevention ... Diabetes Prevention Program for those who are eligible. Diabetes Prevention Program (DPP) DPP Goal The DPP looked ...

  9. Cholera Prevention and Control

    Science.gov (United States)

    ... name=”commit” type=”submit” value=”Submit” /> Prevention & Control Recommend on Facebook Tweet Share Compartir Prevention of ... of cholera and other diarrheal disease prevention. Prevention & Control Topics Ending Cholera: The Global Roadmap to 2030 ...

  10. Prevention : T

    NARCIS (Netherlands)

    Boot, Willemijn; Vogely, H. Charles

    2017-01-01

    Joint replacement is a successful surgical procedure that provides pain relief, restores joint function and improves the quality of life of patients. A minority of patients will experience complications like aseptic failure or prosthetic joint infection (PJI; Tande and Patel 2014).

  11. Prevention: Exercise

    Medline Plus

    Full Text Available ... Information Feature Articles Patient Q&A Success Stories Definitions Anatomy of the Spine Definitions A-Z Spine Specialists Videos 9 for Spine ... CARE PROVIDERS GO HERE © 2018 North American Spine Society | Terms Of Use | Privacy Statement

  12. Prevention: Exercise

    Medline Plus

    Full Text Available ... Feature Articles Patient Q&A Success Stories Definitions Anatomy of the Spine Definitions A-Z Spine ... Strengthening Many popular forms of exercise focus on core strengthening, or building the muscles that provide support for your body. Pilates, yoga ...

  13. Prevention: Exercise

    Medline Plus

    Full Text Available ... something providing resistance. It can be done with weights (hand-held or training machines) or using isometric techniques. Common household items (like small canned goods) can be used instead of hand weights. Ask your doctor or physical therapist to prescribe ...

  14. Registered nurses' attention to and perceptions of pressure ulcer prevention in hospital settings.

    Science.gov (United States)

    Sving, Eva; Gunningberg, Lena; Högman, Marieann; Mamhidir, Anna-Greta

    2012-05-01

    To describe how registered nurses perform, document and reflect on pressure ulcer prevention in a specific nurse-patient care situation, as well as generally, on hospital wards. Registered nurses should provide safe and qualified pressure ulcer prevention, but pressure ulcers remain a problem. Compliance with evidence-based guidelines impedes pressure ulcer formation. A descriptive design with a multimethods approach. Nine registered nurses at three wards and hospitals participated. The registered nurses were observed in a specific nurse-patient care situation with patients at risk for pressure ulcers. Interviews followed and patients' records were reviewed. Quantitative and qualitative data analysis methods were used. Pressure ulcer prevention performed by the registered nurses was dependent on the cultural care, which ranged from planned to unplanned prevention. Diversity was found in compliance with evidence-based guidelines across the wards. Although all patients involved were at risk and the nurses described pressure ulcer prevention as basic care, the nurses' attention to prevention was lacking. Few prevention activities and no structured risk assessments using risk assessment tools were observed, and few care plans were identified. The lack of attention was explained by registered nurses' trust in assistant nurses' knowledge, and prevention was seen as an assistant nurse task. Registered nurses paid little attention to pressure ulcer prevention among patients at risk. The planned and unplanned care structures affected the prevention. The nurses trusted and largely delegated their responsibility to the assistant nurses. Evidence-based pressure ulcer prevention is fundamental to patient safety. Care quality is created in situations where patients and care providers meet. How registered nurses work with pressure ulcer prevention, their role and communication, particularly with assistant nurses, should be of major concern to them as well as to healthcare

  15. Vaccine Development against Zoonotic Hepatitis E Virus: Open Questions and Remaining Challenges

    Directory of Open Access Journals (Sweden)

    Yuchen Nan

    2018-02-01

    Full Text Available Hepatitis E virus (HEV is a fecal-orally transmitted foodborne viral pathogen that causes acute hepatitis in humans and is responsible for hepatitis E outbreaks worldwide. Since the discovery of HEV as a zoonotic agent, this virus has been isolated from a variety of hosts with an ever-expanding host range. Recently, a subunit HEV vaccine developed for the prevention of human disease was approved in China, but is not yet available to the rest of the world. Meanwhile, notable progress and knowledge has been made and revealed in recent years to better understand HEV biology and infection, including discoveries of quasi-enveloped HEV virions and of a new function of the HEV-ORF3 product. However, the impact of these new findings on the development of a protective vaccine against zoonotic HEV infection requires further discussion. In this review, hallmark characteristics of HEV zoonosis, the history of HEV vaccine development, and recent discoveries in HEV virology are described. Moreover, special attention is focused on quasi-enveloped HEV virions and the potential role of the HEV-ORF3 product as antibody-neutralization target on the surface of quasi-enveloped HEV virions to provide new insights for the future development of improved vaccines against zoonotic HEV infection.

  16. Vaccine Development against Zoonotic Hepatitis E Virus: Open Questions and Remaining Challenges

    Science.gov (United States)

    Nan, Yuchen; Wu, Chunyan; Zhao, Qin; Sun, Yani; Zhang, Yan-Jin; Zhou, En-Min

    2018-01-01

    Hepatitis E virus (HEV) is a fecal-orally transmitted foodborne viral pathogen that causes acute hepatitis in humans and is responsible for hepatitis E outbreaks worldwide. Since the discovery of HEV as a zoonotic agent, this virus has been isolated from a variety of hosts with an ever-expanding host range. Recently, a subunit HEV vaccine developed for the prevention of human disease was approved in China, but is not yet available to the rest of the world. Meanwhile, notable progress and knowledge has been made and revealed in recent years to better understand HEV biology and infection, including discoveries of quasi-enveloped HEV virions and of a new function of the HEV-ORF3 product. However, the impact of these new findings on the development of a protective vaccine against zoonotic HEV infection requires further discussion. In this review, hallmark characteristics of HEV zoonosis, the history of HEV vaccine development, and recent discoveries in HEV virology are described. Moreover, special attention is focused on quasi-enveloped HEV virions and the potential role of the HEV-ORF3 product as antibody-neutralization target on the surface of quasi-enveloped HEV virions to provide new insights for the future development of improved vaccines against zoonotic HEV infection. PMID:29520257

  17. The Role of the Food Industry in Obesity Prevention.

    Science.gov (United States)

    Binks, Martin

    2016-06-01

    Obesity is a complex disease of diverse etiology. Among the potential influences in the development of obesity, the food supply chain remains an important influence. We provide a conceptual overview related to the food industry's role in obesity prevention. We first discuss some limitations of current public health efforts. We then describe how a model that attends to personal autonomy in the context of supportive policy intervention can empower individuals in their efforts to navigate the food supply chain. We then provide an evidence informed overview of key areas where continued efforts to collaboratively engage the food industry, through solution-focused dialogue and action, have the potential to contribute to obesity prevention. While challenging, appropriately transparent, well-governed public-private partnerships have the demonstrated potential to benefit the communities we serve.

  18. Xylitol and caries prevention.

    Science.gov (United States)

    Duane, Brett

    2015-06-01

    Cochrane Oral Health Group Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL), Medline, Embase, CINAHL, Web of Science Conference Proceedings, Proquest Dissertations and Theses, US National Institutes of Health Trials Register (http://clinicaltrials.gov) and the WHO Clinical Trials Registry Platform for ongoing trials. No language or year restrictions were used. Randomised controlled trials assessing the effects of xylitol products on dental caries in children and adults. Two review authors independently screened the results of the electronic searches, extracted data and assessed the risk of bias of the included studies. Authors were contacted where possible for missing data or clarification where feasible. For continuous outcomes, means and standard deviations were used to obtain the mean difference and 95% confidence interval (CI). Continuous data was used to calculate prevented fractions (PF) and 95% CIs to summarise the percentage reduction in caries. For dichotomous outcomes, reported risk ratios (RR) and 95% CIs were used. As there were fewer than four studies included in the meta-analysis, a fixed effect model was used. Ten studies were included with a total of 5903 participants. One study was assessed as being at low risk of bias, two were assessed as unclear risk of bias with seven at high risk of bias. Over 2.5–3 years, low quality evidence demonstrated that with 4216 children analysed, a fluoride toothpaste with 10% xylitol (exact dosage unsure) reduced caries by 13% when compared to a fluoride only toothpaste. (PF −0.13, 95% CI −0.18 to −0.08. Remaining evidence of the use of xylitol in children has risk of bias and uncertainty of effect and was therefore insufficient to determine a benefit from xylitol. Four studies reported that there were no adverse effects from any of the interventions. Two studies reported similar rates of adverse effects between study arms. The remaining studies either mentioned adverse effects

  19. Data-driven remaining useful life prognosis techniques stochastic models, methods and applications

    CERN Document Server

    Si, Xiao-Sheng; Hu, Chang-Hua

    2017-01-01

    This book introduces data-driven remaining useful life prognosis techniques, and shows how to utilize the condition monitoring data to predict the remaining useful life of stochastic degrading systems and to schedule maintenance and logistics plans. It is also the first book that describes the basic data-driven remaining useful life prognosis theory systematically and in detail. The emphasis of the book is on the stochastic models, methods and applications employed in remaining useful life prognosis. It includes a wealth of degradation monitoring experiment data, practical prognosis methods for remaining useful life in various cases, and a series of applications incorporated into prognostic information in decision-making, such as maintenance-related decisions and ordering spare parts. It also highlights the latest advances in data-driven remaining useful life prognosis techniques, especially in the contexts of adaptive prognosis for linear stochastic degrading systems, nonlinear degradation modeling based pro...

  20. Management and prevention of chronic obstructive pulmonary disease exacerbations: a state of the art review

    Directory of Open Access Journals (Sweden)

    Wedzicha Jadwiga A

    2009-08-01

    Full Text Available Abstract Exacerbations of chronic obstructive pulmonary disease (COPD are important events in the natural history of this prevalent and devastating condition. This review provides a concise, state of the art summary on prevention and management of exacerbations. Considerable new data underpins evidence in support of many preventative interventions, pharmacological and non-pharmacological, that are now available. Challenges remain in developing new approaches, and delivering those that already exist to the right patient at the right time. Management of an exacerbation remains stepwise according to clinical severity, but there is now additional focus on addressing comorbidities and taking the opportunity at acute events to optimise preventative strategies for the future. Ultimately, exacerbations are heterogeneous events in a heterogeneous disease, and an individualised approach is paramount.

  1. Lemonade from lemons: the taphonomic effect of lawn mowers on skeletal remains.

    Science.gov (United States)

    Martin, D C; Dabbs, Gretchen R; Roberts, Lindsey G

    2013-09-01

    This study provides a descriptive analysis of the taphonomic changes produced by passing over skeletonized remains (n = 4, Sus scrofa) with three common lawn mowers. Two skeletons were mowed over with a riding lawn mower set at multiple blade heights (10.16, 7.62, 5.08 cm) and one each with a rotary mower (9.53, 6.35 cm) and a mulching mower (6.35 cm). Results show that different types of common lawn mowers will produce different patterns of bone dispersal and fragmentation rates. Overall, skeletal elements projecting upward from the surface frequently exhibited a sheared morphology characterized by a smooth, flat, cut surface (7.0-7.6% of elements). The push mowers yielded a higher frequency of undamaged bone than the riding mower (54.8-61.2% vs. 17.7%), and the riding mower created more catastrophic damage to skeletal elements. Additionally, each mower produced a distinct dispersal pattern of skeletal fragments. The dispersal patterns have been identified as "bull's-eye" (riding), circular (mulching), and discontinuous rectangle (rotary). © 2013 American Academy of Forensic Sciences.

  2. Norepinephrine remains increased in the six-minute walking test after heart transplantation

    Directory of Open Access Journals (Sweden)

    Guilherme Veiga Guimarães

    2010-01-01

    Full Text Available OBJECTIVE: We sought to evaluate the neurohormonal activity in heart transplant recipients and compare it with that in heart failure patients and healthy subjects during rest and just after a 6-minute walking test. INTRODUCTION: Despite the improvements in quality of life and survival provided by heart transplantation, the neurohormonal profile is poorly described. METHODS: Twenty heart transplantation (18 men, 49±11 years and 8.5±3.3 years after transplantation, 11 heart failure (8 men, 43±10 years, and 7 healthy subjects (5 men 39±8 years were included in this study. Blood samples were collected immediately before and during the last minute of the exercise. RESULTS: During rest, patients' norepinephrine plasma level (659±225 pg/mL was higher in heart transplant recipients (463±167 pg/mL and heathy subjects (512±132, p<0.05. Heart transplant recipient's norepinephrine plasma level was not different than that of healthy subjects. Just after the 6-minute walking test, the heart transplant recipient's norepinephrine plasma level (1248±692 pg/mL was not different from that of heart failure patients (1174±653 pg/mL. Both these groups had a higher level than healthy subjects had (545±95 pg/mL, p<0.05. CONCLUSION: Neurohormonal activity remains increased after the 6-minute walking test after heart transplantation.

  3. Commentary: Recommendations and remaining questions for health care leadership training programs.

    Science.gov (United States)

    Stoller, James K

    2013-01-01

    Effective leadership is critical for optimizing cost, access, and quality in health care. Creating a pipeline of effective health care leaders requires developing leadership competencies that differ from the usual criteria of clinical and scientific excellence by which physicians have traditionally been promoted to leadership positions. Specific competencies that differentiate effective leaders from average leaders, especially emotional intelligence and its component abilities, are essential for effective leadership.Adopting a long-standing practice from successful corporations, some health care institutions, medical societies, and business schools now offer leadership programs that address these differentiating leadership competencies. The author draws on experience with such programs through the Cleveland Clinic Academy to provide recommendations for health care leadership training and to identify unanswered questions about such programs.The author recommends that such training should be broadly available to all health care leadership communities (i.e., nurses, administrators, and physicians). A progressive curriculum, starting with foundational concepts and extending to coaching and feedback opportunities through experiential learning, recognizes the challenge of becoming an effective leader and the long time line needed to do so. Linking leadership courses to continuing medical education and to graduate credit opportunities is appealing to participants. Other recommendations focus on the importance of current leaders' involvement in nominating emerging leaders for participation, embedding leadership development discussions in faculty's professional reviews, and blending discussion of frameworks and theory with practical, experiential lessons. The author identifies questions about the benefits of formal health care leadership training that remain to be answered.

  4. Remaining Useful Life Prediction for Lithium-Ion Batteries Based on Gaussian Processes Mixture

    Science.gov (United States)

    Li, Lingling; Wang, Pengchong; Chao, Kuei-Hsiang; Zhou, Yatong; Xie, Yang

    2016-01-01

    The remaining useful life (RUL) prediction of Lithium-ion batteries is closely related to the capacity degeneration trajectories. Due to the self-charging and the capacity regeneration, the trajectories have the property of multimodality. Traditional prediction models such as the support vector machines (SVM) or the Gaussian Process regression (GPR) cannot accurately characterize this multimodality. This paper proposes a novel RUL prediction method based on the Gaussian Process Mixture (GPM). It can process multimodality by fitting different segments of trajectories with different GPR models separately, such that the tiny differences among these segments can be revealed. The method is demonstrated to be effective for prediction by the excellent predictive result of the experiments on the two commercial and chargeable Type 1850 Lithium-ion batteries, provided by NASA. The performance comparison among the models illustrates that the GPM is more accurate than the SVM and the GPR. In addition, GPM can yield the predictive confidence interval, which makes the prediction more reliable than that of traditional models. PMID:27632176

  5. Cognitive performance of detoxified alcoholic Korsakoff syndrome patients remains stable over two years.

    Science.gov (United States)

    Fujiwara, Esther; Brand, Matthias; Borsutzky, Sabine; Steingass, Hans-P; Markowitsch, Hans J

    2008-07-01

    Excessive alcohol consumption is assumed to promote cognitive decline, eventually increasing the risk of dementia. However, little is known about the time course of cognitive functions in patients with chronic alcoholic Korsakoff syndrome (KS). Therefore, we assessed neuropsychological performance in 20 detoxified chronic KS inpatients at time 1 (T1) with a follow-up after two years (T2). The neuropsychological tests assessed verbal and visual short- and long-term memory, working memory, basic executive functions, language, general knowledge, and visual-spatial abilities. Surveys with caregivers and medical records provided information about current and previous disease-related parameters, drinking history, additional pathologies, as well as psychosocial and cognitive therapy within the two-year period. At both sessions, the majority of the KS patients' results were inferior to those of normal subjects. Comparing T1 and T2 revealed no significant decline in any of the investigated functions. Instead, general knowledge, visual long-term memory, and verbal fluency improved slightly after two years, though they still remained within pathological range. Comparing most improved and most deteriorated patients, better outcome occurred more frequently in men than women and was associated with higher premorbid education and fewer detoxifications in the past. In this sample of detoxified KS patients there was no indication of accelerated cognitive decline or onset of dementia-like symptoms over two years.

  6. Remaining dischargeable time prediction for lithium-ion batteries using unscented Kalman filter

    Science.gov (United States)

    Dong, Guangzhong; Wei, Jingwen; Chen, Zonghai; Sun, Han; Yu, Xiaowei

    2017-10-01

    To overcome the range anxiety, one of the important strategies is to accurately predict the range or dischargeable time of the battery system. To accurately predict the remaining dischargeable time (RDT) of a battery, a RDT prediction framework based on accurate battery modeling and state estimation is presented in this paper. Firstly, a simplified linearized equivalent-circuit-model is developed to simulate the dynamic characteristics of a battery. Then, an online recursive least-square-algorithm method and unscented-Kalman-filter are employed to estimate the system matrices and SOC at every prediction point. Besides, a discrete wavelet transform technique is employed to capture the statistical information of past dynamics of input currents, which are utilized to predict the future battery currents. Finally, the RDT can be predicted based on the battery model, SOC estimation results and predicted future battery currents. The performance of the proposed methodology has been verified by a lithium-ion battery cell. Experimental results indicate that the proposed method can provide an accurate SOC and parameter estimation and the predicted RDT can solve the range anxiety issues.

  7. Remaining useful life prediction based on variation coefficient consistency test of a Wiener process

    Directory of Open Access Journals (Sweden)

    Juan LI

    2018-01-01

    Full Text Available High-cost equipment is often reused after maintenance, and whether the information before the maintenance can be used for the Remaining Useful Life (RUL prediction after the maintenance is directly determined by the consistency of the degradation pattern before and after the maintenance. Aiming at this problem, an RUL prediction method based on the consistency test of a Wiener process is proposed. Firstly, the parameters of the Wiener process estimated by Maximum Likelihood Estimation (MLE are proved to be biased, and a modified unbiased estimation method is proposed and verified by derivation and simulations. Then, the h statistic is constructed according to the reciprocal of the variation coefficient of the Wiener process, and the sampling distribution is derived. Meanwhile, a universal method for the consistency test is proposed based on the sampling distribution theorem, which is verified by simulation data and classical crack degradation data. Finally, based on the consistency test of the degradation model, a weighted fusion RUL prediction method is presented for the fuel pump of an airplane, and the validity of the presented method is verified by accurate computation results of real data, which provides a theoretical and practical guidance for engineers to predict the RUL of equipment after maintenance.

  8. Embryology of Early Jurassic dinosaur from China with evidence of preserved organic remains.

    Science.gov (United States)

    Reisz, Robert R; Huang, Timothy D; Roberts, Eric M; Peng, ShinRung; Sullivan, Corwin; Stein, Koen; LeBlanc, Aaron R H; Shieh, DarBin; Chang, RongSeng; Chiang, ChengCheng; Yang, Chuanwei; Zhong, Shiming

    2013-04-11

    Fossil dinosaur embryos are surprisingly rare, being almost entirely restricted to Upper Cretaceous strata that record the late stages of non-avian dinosaur evolution. Notable exceptions are the oldest known embryos from the Early Jurassic South African sauropodomorph Massospondylus and Late Jurassic embryos of a theropod from Portugal. The fact that dinosaur embryos are rare and typically enclosed in eggshells limits their availability for tissue and cellular level investigations of development. Consequently, little is known about growth patterns in dinosaur embryos, even though post-hatching ontogeny has been studied in several taxa. Here we report the discovery of an embryonic dinosaur bone bed from the Lower Jurassic of China, the oldest such occurrence in the fossil record. The embryos are similar in geological age to those of Massospondylus and are also assignable to a sauropodomorph dinosaur, probably Lufengosaurus. The preservation of numerous disarticulated skeletal elements and eggshells in this monotaxic bone bed, representing different stages of incubation and therefore derived from different nests, provides opportunities for new investigations of dinosaur embryology in a clade noted for gigantism. For example, comparisons among embryonic femora of different sizes and developmental stages reveal a consistently rapid rate of growth throughout development, possibly indicating that short incubation times were characteristic of sauropodomorphs. In addition, asymmetric radial growth of the femoral shaft and rapid expansion of the fourth trochanter suggest that embryonic muscle activation played an important role in the pre-hatching ontogeny of these dinosaurs. This discovery also provides the oldest evidence of in situ preservation of complex organic remains in a terrestrial vertebrate.

  9. Politics of prevention: The emergence of prevention science.

    Science.gov (United States)

    Roumeliotis, Filip

    2015-08-01

    This article critically examines the political dimension of prevention science by asking how it constructs the problems for which prevention is seen as the solution and how it enables the monitoring and control of these problems. It also seeks to examine how prevention science has established a sphere for legitimate political deliberation and which kinds of statements are accepted as legitimate within this sphere. The material consists of 14 publications describing and discussing the goals, concepts, promises and problems of prevention science. The analysis covers the period from 1993 to 2012. The analysis shows that prevention science has established a narrow definition of "prevention", including only interventions aimed at the reduction of risks for clinical disorders. In publications from the U.S. National Institute of Drug Abuse, the principles of prevention science have enabled a commitment to a zero-tolerance policy on drugs. The drug using subject has been constructed as a rational choice actor lacking in skills in exerting self-control in regard to drug use. Prevention science has also enabled the monitoring and control of expertise, risk groups and individuals through specific forms of data gathering. Through the juxtaposition of the concepts of "objectivity" and "morality", prevention science has constituted a principle of delineation, disqualifying statements not adhering to the principles of prevention science from the political field, rendering ethical and conflictual dimensions of problem representations invisible. The valorisation of scientific accounts of drugs has acted to naturalise specific political ideals. It simultaneously marginalises the public from the public policy process, giving precedence to experts who are able to provide information that policy-makers are demanding. Alternative accounts, such as those based on marginalisation, poverty or discrimination are silenced within prevention science. Copyright © 2015 Elsevier B.V. All rights

  10. Land, lake, and fish: Investigation of fish remains from Gesher Benot Ya'aqov (paleo-Lake Hula).

    Science.gov (United States)

    Zohar, Irit; Biton, Rebecca

    2011-04-01

    The question of whether or not pre-modern hominins were responsible for the accumulation of fish remains is discussed through analyses of remains recovered from two lacustrine facies (I-4 and I-5) from Area A of the Acheulian site of Gesher Benot Ya'aqov (GBY) in the Jordan Rift Valley, Israel. The fish remains provide the first glimpse into the naturally accumulated fish assemblage from the fluctuating shores of a lake that had been continually exploited by early hominins some 780,000 years ago. Preliminary analysis of the remains show that thirteen of the seventeen species native to Lake Hula were identified at GBY. These represent three of the five freshwater fish families native to the lake: Cyprinidae (carps), Cichlidae (tilapini, St. Peter's fish), and Clariidae (catfish). From a taphonomical perspective, a significant difference is found between the two lithofacies (Layers I-4 and I-5) in terms of species composition, richness, diversity, and skeleton completeness. It appears that the fish remains recovered from Layer I-4 (clay) are better preserved than those from Layer I-5 (coquina). In both lithofacies, Cyprinidae are highly abundant while Cichlidae and Clariidae are rare and under-represented, especially when compared to the Lake Hula fishery report from the 1950s. All of these identified species may have contributed significantly to the diet of GBY hominins. Copyright © 2010 Elsevier Ltd. All rights reserved.

  11. Allergy and asthma prevention 2014

    DEFF Research Database (Denmark)

    Nieto, Antonio; Wahn, Ulrich; Bufe, Albrecht

    2014-01-01

    Asthma and allergic diseases have become one of the epidemics of the 21st century in developed countries. Much of the success of other areas of medicine, such as infectious diseases, lies on preventive measures. Thus, much effort is also being placed lately in the prevention of asthma and allergy....... This manuscript reviews the current evidence, divided into four areas of activity. Interventions modifying environmental exposure to allergens have provided inconsistent results, with multifaceted interventions being more effective in the prevention of asthma. Regarding nutrition, the use of hydrolyzed formulas...... that antiviral vaccines could be useful in the future. Allergen-specific immunotherapy is effective for the treatment of allergic patients with symptoms; the study of its value for primary and secondary prevention of asthma and allergy is in its very preliminary phases. The lack of success in the prevention...

  12. Practical Strategies for Preventing Adolescent Suicide

    Science.gov (United States)

    King, Keith

    2006-01-01

    A comprehensive approach to suicide prevention is needed to effectively address the problem of teen suicide. This article describes three levels of prevention (primary prevention, intervention, and postvention) and provides practical strategies that community, mental, and social health professionals can use within each level to help prevent…

  13. CDC Vital Signs: Preventing Teen Pregnancy

    Science.gov (United States)

    ... Press Kit Read the MMWR Science Clips Preventing Teen Pregnancy A Key Role for Health Care Providers Language: ... Battles: Teen Pregnancy Prevention Status Reports (PSRs): Teen Pregnancy FastStats: Teen Births Vital Signs – Preventing Teen Pregnancy [PODCAST – 1: ...

  14. A systematic review of elderly suicide prevention programs

    DEFF Research Database (Denmark)

    Lapierre, Sylvie; Erlangsen, Annette; Waern, Margda

    2011-01-01

    Suicide rates are highest among the elderly, yet research on suicide prevention in old age remains a much-neglected area.......Suicide rates are highest among the elderly, yet research on suicide prevention in old age remains a much-neglected area....

  15. Can prevention eliminate caries?

    Science.gov (United States)

    O'Mullane, D

    1995-07-01

    There are four main factors involved in the carious process: at-risk tooth structure, plaque flora, fermentable carbohydrates, and time. Based on our knowledge of the carious process, four main preventive strategies have been developed over the years, namely, fluorides, fissure sealing, dietary choice, and plaque control. Fluorides are having a major impact on smooth-surface caries; hence, strategies combining fluorides and fissure sealing are very effective. However, use of fissure sealing is still problematic. Changing dietary practices with a view to reducing dental caries seems to be having little impact on a global scale. Plaque control, as practiced routinely by the majority of people, is not sufficient to result in caries reductions. Deprivation and poverty are strongly associated with high caries levels. Although the preventive strategies currently available are likely to result in lower caries levels for many, for logistical reasons and because of factors associated with deprivation and poverty, caries is likely to remain a major public health problem in most communities for the foreseeable future.

  16. Prevention and management of gastroesophageal varices.

    Science.gov (United States)

    Seo, Yeon Seok

    2018-03-01

    Bleeding from gastroesophageal varices is a serious complication in patients with liver cirrhosis and portal hypertension. Although there has been significance improvement in the prognosis of variceal bleeding with advancement in diagnostic and therapeutic modalities for its management, mortality rate still remains high. Therefore, appropriate prevention and rapid, effective management of bleeding from gastroesophageal varices is very important. Recently, various studies about management of gastoesophageal varices, including prevention of development and aggravation of varices, prevention of first variceal bleeding, management of acute variceal bleeding, and prevention of variceal rebleeding, have been published. The present article reviews published articles and practice guidelines to present the most optimal management of patients with gastroesophageal varices.

  17. Ancient plant remains with special reference to buckthorn, Frangula alnus Mill., pyrenes from Dascyleum, Balıkesir, NW Turkey

    Directory of Open Access Journals (Sweden)

    Emel Oybak Dönmez

    2016-12-01

    Full Text Available Carbonized plant remains recovered from the ancient city Dascyleum (Daskyleion in the province of Balıkesir in northwestern Turkey provide an outline of several phases of plant use in archaic, Hellenistic, and medieval times. At the study site, various crop plant remains of Near Eastern agriculture, including cereals (barley, Hordeum vulgare L. and bread/durum/rivet wheat, Triticum aestivum L. / T. durum Desf. / T. turgidum L. and pulses [bitter vetch, Vicia ervilia (L. Willd.; grass pea, Lathyrus sativus L. / L. cicera L.; fava bean, V. faba L.; and chickpea, Cicer arietinum L.] were found. Drupaceous fruits and pyrenes of buckthorn (Frangula alnus Mill. were also found, probably representing dyes and/or medicines used by the inhabitants of the mound. Archaeometrical analyses of the ancient buckthorn pyrenes by high performance liquid chromatography with photodiode array detector (HPLC-PDA provide chemical evidence for traces of ancient mordants remaining until the present day. Some of the pulse seed remains retrieved from the medieval layers at the study site were found to have been infested by bruchid beetles (Bruchidae.

  18. Veterans Affairs Suicide Prevention Synthetic Dataset

    Data.gov (United States)

    Department of Veterans Affairs — The VA's Veteran Health Administration, in support of the Open Data Initiative, is providing the Veterans Affairs Suicide Prevention Synthetic Dataset (VASPSD). The...

  19. Information Security - Data Loss Prevention Procedure

    Science.gov (United States)

    The purpose of this procedure is to extend and provide specificity to the Environmental Protection Agency (EPA) Information Security Policy regarding data loss prevention and digital rights management.

  20. Career Motivation in Newly Licensed Registered Nurses: What Makes Them Remain

    Science.gov (United States)

    Banks, Zarata Mann; Bailey, Jessica H.

    2010-01-01

    Despite vast research on newly licensed registered nurses (RNs), we don't know why some newly licensed registered nurses remain in their current jobs and others leave the nursing profession early in their career. Job satisfaction, the most significant factor emerging from the literature, plays a significant role in nurses' decisions to remain in…

  1. Stable isotopes, niche partitioning and the paucity of elasmosaur remains in the Maastrichtian type area

    NARCIS (Netherlands)

    Schulp, Anne S.; Janssen, Renée; Van Baal, Remy R.; Jagt, John W M; Mulder, Eric W A; Vonhof, Hubert B.

    2017-01-01

    Remains of elasmosaurid plesiosaurs are exceedingly rare in the type-Maastrichtian strata (Late Cretaceous, southeast Netherlands and northeast Belgium), in stark contrast to relatively common skeletal remains of mosasaurs. Here, we present an analysis of δ13C stable isotope values for tooth enamel

  2. 20 CFR 408.330 - How long will your application remain in effect?

    Science.gov (United States)

    2010-04-01

    ... effect? 408.330 Section 408.330 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SPECIAL BENEFITS FOR CERTAIN WORLD WAR II VETERANS Filing Applications Filing Your Application § 408.330 How long will your application remain in effect? Your application for SVB will remain in effect from the date it is filed until...

  3. Screw Remaining Life Prediction Based on Quantum Genetic Algorithm and Support Vector Machine

    Directory of Open Access Journals (Sweden)

    Xiaochen Zhang

    2017-01-01

    Full Text Available To predict the remaining life of ball screw, a screw remaining life prediction method based on quantum genetic algorithm (QGA and support vector machine (SVM is proposed. A screw accelerated test bench is introduced. Accelerometers are installed to monitor the performance degradation of ball screw. Combined with wavelet packet decomposition and isometric mapping (Isomap, the sensitive feature vectors are obtained and stored in database. Meanwhile, the sensitive feature vectors are randomly chosen from the database and constitute training samples and testing samples. Then the optimal kernel function parameter and penalty factor of SVM are searched with the method of QGA. Finally, the training samples are used to train optimized SVM while testing samples are adopted to test the prediction accuracy of the trained SVM so the screw remaining life prediction model can be got. The experiment results show that the screw remaining life prediction model could effectively predict screw remaining life.

  4. Shock Prevention

    Science.gov (United States)

    1978-01-01

    The electrician pictured is installing a General Electric Ground Fault Interrupter (GFI), a device which provides protection against electrical shock in the home or in industrial facilities. Shocks due to defective wiring in home appliances or other electrical equipment can cause severe burns, even death. As a result, the National Electrical Code now requires GFIs in all new homes constructed. This particular type of GFI employs a sensing element which derives from technology acquired in space projects by SCI Systems, Inc., Huntsville, Alabama, producer of sensors for GE and other manufacturers of GFI equipment. The sensor is based on the company's experience in developing miniaturized circuitry for space telemetry and other spacecraft electrical systems; this experience enabled SCI to package interruptor circuitry in the extremely limited space available and to produce sensory devices at practicable cost. The tiny sensor measures the strength of the electrical current and detects current differentials that indicate a fault in the functioning of an electrical system. The sensing element then triggers a signal to a disconnect mechanism in the GFI, which cuts off the current in the faulty circuit.

  5. Bullying Prevention for the Public

    Centers for Disease Control (CDC) Podcasts

    This is the first podcast of a series to discuss the severity of bullying and provide resources for prevention efforts. CDC shares the most recent statistics and trends, provides valuable tips to implement in communities, and teaches individuals how to take action against bullying.

  6. Human rights-based approach to unintentional injury prevention.

    Science.gov (United States)

    MacKay, J Morag; Ryan, Mark Andrew

    2018-06-01

    Unintentional injury remains an important global public health issue, and efforts to address it are often hampered by a lack of visibility, leadership, funding, infrastructure, capacity and evidence of effective solutions. The growing support for a socioecological model and a systems approach to prevention-along with the acknowledgement that injury prevention can be a byproduct of salutogenic design and activities-has increased opportunities to integrate unintentional injury prevention into other health promotion and disease prevention agendas. It has also helped to integrate it into the broader human development agenda through the Sustainable Development Goals. This growing support provides new opportunities to use a human rights-based approach to address the issue. The human rights-based approach is based on the idea that all members of society have social, economic and cultural rights and that governments are responsible and accountable for upholding those rights. It incorporates a systems approach, addresses inequity and places an emphasis on the most vulnerable corners of humanity. It also leverages legal statutes and provides organisations with the opportunity to build existing international goals and benchmarks into their monitoring efforts. This paper describes the approach and highlights how it can leverage attention and investment to address current challenges for unintentional injury. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  7. Trauma Center Based Youth Violence Prevention Programs: An Integrative Review.

    Science.gov (United States)

    Mikhail, Judy Nanette; Nemeth, Lynne Sheri

    2016-12-01

    Youth violence recidivism remains a significant public health crisis in the United States. Violence prevention is a requirement of all trauma centers, yet little is known about the effectiveness of these programs. Therefore, this systematic review summarizes the effectiveness of trauma center-based youth violence prevention programs. A systematic review of articles from MEDLINE, CINAHL, and PsychINFO databases was performed to identify eligible control trials or observational studies. Included studies were from 1970 to 2013, describing and evaluating an intervention, were trauma center based, and targeted youth injured by violence (tertiary prevention). The social ecological model provided the guiding framework, and findings are summarized qualitatively. Ten studies met eligibility requirements. Case management and brief intervention were the primary strategies, and 90% of the studies showed some improvement in one or more outcome measures. These results held across both social ecological level and setting: both emergency department and inpatient unit settings. Brief intervention and case management are frequent and potentially effective trauma center-based violence prevention interventions. Case management initiated as an inpatient and continued beyond discharge was the most frequently used intervention and was associated with reduced rearrest or reinjury rates. Further research is needed, specifically longitudinal studies using experimental designs with high program fidelity incorporating uniform direct outcome measures. However, this review provides initial evidence that trauma centers can intervene with the highest of risk patients and break the youth violence recidivism cycle. © The Author(s) 2015.

  8. Are we having fun yet? Fostering adherence to injury preventive exercise recommendations in young athletes.

    Science.gov (United States)

    Keats, Melanie R; Emery, Carolyn A; Finch, Caroline F

    2012-03-01

    Sport and recreational activities are the leading cause of injury in youth, yet there is increasing evidence that many sport-related injuries are preventable. For injury prevention strategies to be effective, individuals must understand, adopt and adhere to the recommended prevention strategy or programme. Despite the recognized importance of a behavioural approach, the inclusion of behavioural change strategies in sport injury prevention has been historically neglected. The purpose of this commentary is to outline the rationale for the inclusion and application of behavioural science in reducing the burden of injury by increasing adherence to proven prevention strategies. In an effort to provide an illustrative example of a behavioural change approach, the authors suggest a specific plan for the implementation of a neuromuscular training strategy to reduce the risk of lower limb injury in youth sport. Given the paucity of evidence in the sport injury prevention setting, and the lack of application of theoretical frameworks to predicting adoption and adherence to injury preventive exercise recommendations in youth sport, data from the related physical activity promotion domain is utilized to describe how sound, theory-based injury prevention exercise interventions in youth may be developed. While the question of how to facilitate behavioural change and optimize adherence to preventive exercise recommendations remains an ongoing challenge, the authors detail several strategies based on two prominent behavioural theories to aid the reader in conceptualizing, designing and implementing effective interventions. Despite the minimal application of behavioural theory within the field of sport injury prevention in youth, behavioural science has the potential to make a significant impact on the understanding and prevention of youth sport injury. Appropriate evaluation of adherence and maintenance components based on models of behavioural change should be a critical

  9. 2010 drug packaging review: identifying problems to prevent errors.

    Science.gov (United States)

    2011-06-01

    Prescrire's analyses showed that the quality of drug packaging in 2010 still left much to be desired. Potentially dangerous packaging remains a significant problem: unclear labelling is source of medication errors; dosing devices for some psychotropic drugs create a risk of overdose; child-proof caps are often lacking; and too many patient information leaflets are misleading or difficult to understand. Everything that is needed for safe drug packaging is available; it is now up to regulatory agencies and drug companies to act responsibly. In the meantime, health professionals can help their patients by learning to identify the pitfalls of drug packaging and providing safe information to help prevent medication errors.

  10. Ancient urban ecology reconstructed from archaeozoological remains of small mammals in the Near East.

    Science.gov (United States)

    Weissbrod, Lior; Malkinson, Dan; Cucchi, Thomas; Gadot, Yuval; Finkelstein, Israel; Bar-Oz, Guy

    2014-01-01

    Modern rapidly expanding cities generate intricate patterns of species diversity owing to immense complexity in urban spatial structure and current growth trajectories. We propose to identify and uncouple the drivers that give rise to these patterns by looking at the effect of urbanism on species diversity over a previously unexplored long temporal frame that covers early developments in urbanism. To provide this historical perspective we analyzed archaeozoological remains of small mammals from ancient urban and rural sites in the Near East from the 2nd to the 1st millennium BCE, and compared them to observations from modern urban areas. Our data show that ancient urban assemblages consistently comprised two main taxa (Mus musculus domesticus and Crocidura sp.), whereas assemblages of contemporaneous rural sites were significantly richer. Low species diversity also characterizes high-density core areas of modern cities, suggesting that similar ecological drivers have continued to operate in urban areas despite the vast growth in their size and population densities, as well as in the complexity of their technologies and social organization. Research in urban ecology has tended to emphasize the relatively high species diversity observed in low-density areas located on the outskirts of cities, where open and vegetated patches are abundant. The fact that over several millennia urban evolution did not significantly alter species diversity suggests that low diversity is an attribute of densely-populated settlements. The possibility that high diversity in peripheral urban areas arose only recently as a short-term phenomenon in urban ecology merits further research based on long-term data.

  11. Ancient Urban Ecology Reconstructed from Archaeozoological Remains of Small Mammals in the Near East

    Science.gov (United States)

    Weissbrod, Lior; Malkinson, Dan; Cucchi, Thomas; Gadot, Yuval; Finkelstein, Israel; Bar-Oz, Guy

    2014-01-01

    Modern rapidly expanding cities generate intricate patterns of species diversity owing to immense complexity in urban spatial structure and current growth trajectories. We propose to identify and uncouple the drivers that give rise to these patterns by looking at the effect of urbanism on species diversity over a previously unexplored long temporal frame that covers early developments in urbanism. To provide this historical perspective we analyzed archaeozoological remains of small mammals from ancient urban and rural sites in the Near East from the 2nd to the 1st millennium BCE, and compared them to observations from modern urban areas. Our data show that ancient urban assemblages consistently comprised two main taxa (Mus musculus domesticus and Crocidura sp.), whereas assemblages of contemporaneous rural sites were significantly richer. Low species diversity also characterizes high-density core areas of modern cities, suggesting that similar ecological drivers have continued to operate in urban areas despite the vast growth in their size and population densities, as well as in the complexity of their technologies and social organization. Research in urban ecology has tended to emphasize the relatively high species diversity observed in low-density areas located on the outskirts of cities, where open and vegetated patches are abundant. The fact that over several millennia urban evolution did not significantly alter species diversity suggests that low diversity is an attribute of densely-populated settlements. The possibility that high diversity in peripheral urban areas arose only recently as a short-term phenomenon in urban ecology merits further research based on long-term data. PMID:24622726

  12. Mechanisms of action of brief alcohol interventions remain largely unknown – A narrative review

    Directory of Open Access Journals (Sweden)

    Jacques eGaume

    2014-08-01

    Full Text Available A growing body of evidence has shown efficacy of brief intervention (BI for hazardous and harmful alcohol use in primary health care settings. Evidence for efficacy in other settings, and effectiveness when implemented at larger scale is disappointing. Indeed, BI comprises varying content, and exploring BI content and mechanisms of action may be a promising way to enhance efficacy and effectiveness.We searched Medline and PsychInfo, as well as references of retrieved publications for original research or reviews on active ingredients (or components, or mechanisms of face-to-face BIs (and its subtypes, including brief advice and brief motivational interviewing [BMI] for alcohol. Overall, BI active ingredients have been scarcely investigated, almost only within BMI, and mostly among Emergency Room patients, young adults, and US college students. This body of research has shown that personalized feedback may be an effective component; specific MI techniques showed mixed findings; decisional balance findings tended to suggest a potential detrimental effect; while change plan exercises, advice to reduce or stop drinking, presenting alternative change options, and moderation strategies are promising but need further study. Client change talk is a potential mediator of BMI effects; change in norm perceptions and enhanced discrepancy between current behavior and broader life goals and values have received preliminary support; readiness to change was only partially supported as a mediator; while enhanced awareness of drinking, perceived risks/benefits of alcohol use, alcohol treatment seeking, and self-efficacy were seldom studied and have as yet found no significant support as such.Research is obviously limited and has provided no clear and consistent evidence on the mechanisms of alcohol BI. How BI achieves the effects seen in randomized trials remains mostly unknown and should be investigated to inform the development of more effective interventions.

  13. [Palliative care after neonatal intensive care: Contributions of Leonetti Law and remaining challenges].

    Science.gov (United States)

    Kuhn, P; Dillenseger, L; Cojean, N; Escande, B; Zores, C; Astruc, D

    2017-02-01

    The 2005 enactment of the "Patients' rights and end-of-life care" act, known as the Leonetti law, has been accompanied by practical changes in the processes of withdrawal and withholding of active life-sustaining treatments. This law has also promoted the implementation of palliative care in perinatal medicine to avoid unreasonable therapeutic interventions and to preserve the dying patient's quality of life and human dignity. Recently, a new law has been voted by the French National Assembly and new reflections on the ethical aspects of the end of life in neonatal medicine should resume again within the French Society of Neonatology in the working group on ethical issues in neonatology. This is why it appears important to discuss the perceived benefits and the persistent difficulties related to the implementation of the Leonetti law in neonatology. Collegiality in the decision-making processes as well as withdrawal and withholding of life-sustaining treatments that were already present in the practices of many centers has been stipulated within a legal framework and promoted in clinical practice. It has brought serenity within perinatal nursing and medical teams. It has helped them face the always-difficult end-of-life situations with parents and deal with decision-making processes in an intense emotional climate. However, new questions inherent to the law have appeared. The most important ones concern the withholding of artificial nutrition and hydration, the time pressure in the management of the decision-making process, and the management of the duration of palliative care. Challenges remain in addressing various persistent ethical dilemmas such as the possible survival of newborns with significant brain lesions detected after the period of life-sustaining treatments that have allowed their survival. The new law carried by Mr. Clayes and Mr. Léonetti should provide answers to some of these ethical issues, but it would probably not solve all of them. Copyright

  14. Run-of-River Impoundments Can Remain Unfilled While Transporting Gravel Bedload: Numerical Modeling Results

    Science.gov (United States)

    Pearson, A.; Pizzuto, J. E.

    2015-12-01

    Previous work at run-of-river (ROR) dams in northern Delaware has shown that bedload supplied to ROR impoundments can be transported over the dam when impoundments remain unfilled. Transport is facilitated by high levels of sand in the impoundment that lowers the critical shear stresses for particle entrainment, and an inversely sloping sediment ramp connecting the impoundment bed (where the water depth is typically equal to the dam height) with the top of the dam (Pearson and Pizzuto, in press). We demonstrate with one-dimensional bed material transport modeling that bed material can move through impoundments and that equilibrium transport (i.e., a balance between supply to and export from the impoundment, with a constant bed elevation) is possible even when the bed elevation is below the top of the dam. Based on our field work and previous HEC-RAS modeling, we assess bed material transport capacity at the base of the sediment ramp (and ignore detailed processes carrying sediment up and ramp and over the dam). The hydraulics at the base of the ramp are computed using a weir equation, providing estimates of water depth, velocity, and friction, based on the discharge and sediment grain size distribution of the impoundment. Bedload transport rates are computed using the Wilcock-Crowe equation, and changes in the impoundment's bed elevation are determined by sediment continuity. Our results indicate that impoundments pass the gravel supplied from upstream with deep pools when gravel supply rate is low, gravel grain sizes are relatively small, sand supply is high, and discharge is high. Conversely, impoundments will tend to fill their pools when gravel supply rate is high, gravel grain sizes are relatively large, sand supply is low, and discharge is low. The rate of bedload supplied to an impoundment is the primary control on how fast equilibrium transport is reached, with discharge having almost no influence on the timing of equilibrium.

  15. Mechanisms of action of brief alcohol interventions remain largely unknown - a narrative review.

    Science.gov (United States)

    Gaume, Jacques; McCambridge, Jim; Bertholet, Nicolas; Daeppen, Jean-Bernard

    2014-01-01

    A growing body of evidence has shown the efficacy of brief intervention (BI) for hazardous and harmful alcohol use in primary health care settings. Evidence for efficacy in other settings and effectiveness when implemented at larger scale are disappointing. Indeed, BI comprises varying content; exploring BI content and mechanisms of action may be a promising way to enhance efficacy and effectiveness. Medline and PsychInfo, as well as references of retrieved publications were searched for original research or review on active ingredients (components or mechanisms) of face-to-face BIs [and its subtypes, including brief advice and brief motivational interviewing (BMI)] for alcohol. Overall, BI active ingredients have been scarcely investigated, almost only within BMI, and mostly among patients in the emergency room, young adults, and US college students. This body of research has shown that personalized feedback may be an effective component; specific MI techniques showed mixed findings; decisional balance findings tended to suggest a potential detrimental effect; while change plan exercises, advice to reduce or stop drinking, presenting alternative change options, and moderation strategies are promising but need further study. Client change talk is a potential mediator of BMI effects; change in norm perceptions and enhanced discrepancy between current behavior and broader life goals and values have received preliminary support; readiness to change was only partially supported as a mediator; while enhanced awareness of drinking, perceived risks/benefits of alcohol use, alcohol treatment seeking, and self-efficacy were seldom studied and have as yet found no significant support as such. Research is obviously limited and has provided no clear and consistent evidence on the mechanisms of alcohol BI. How BI achieves the effects seen in randomized trials remains mostly unknown and should be investigated to inform the development of more effective interventions.

  16. Remaining life prediction of I and C cables for reliability assessment of NPP systems

    International Nuclear Information System (INIS)

    Santhosh, T.V.; Ghosh, A.K.; Fernandes, B.G.

    2012-01-01

    Highlights: ► A framework for time dependent reliability prediction of I and C cables for use in PSA of NPP has been developed using stress–strength interference theory. ► The proposed methodology has been illustrated with the accelerated thermal aging data on a typical XLPE cable. ► The behavior of insulation resistance when the degradation process is linear or exponential has also been modeled. ► The reliability index or probability of failure obtained from this approach can be used in system reliability evaluation to account for cable aging for PSA of NPP. - Abstract: Instrumentation and control (I and C) cables are one of the most important components in nuclear power plants (NPPs) because they provide power to safety-related equipment and also to transmit signals to and from various controllers to perform safety operations. I and C cables in NPP are subjected to a variety of aging and degradation stressors that can produce immediate degradation or aging-related mechanisms causing the degradation of cable components over time. Although, there exits several life estimation techniques, currently there is no any standard methodology or an approach toward estimating the time dependent reliability of I and C cables that can be directly used in probabilistic safety assessment (PSA) applications. Hence, the objective of this study is to develop an approach to estimate and confirm the continued acceptable margin in cable insulation life over time subjected to aging. This paper presents a framework based on the structural reliability theory to quantify the life time of I and C cable subjecting to thermal aging. Since cross-linked polyethylene (XLPE) cables are extensively being used in Indian NPPs, the remaining life time evaluations have been carried out for a typical XLPE cable. However, the methodology can be extended to other cables such as polyvinyl chloride (PVC), ethylene propylene rubber (EPR), etc.

  17. The Aesthetic Surgery Literature: Do Plastic Surgeons Remain at the Cutting Edge?

    Science.gov (United States)

    Dolan, Roisin T; Zins, James E; Morrison, Colin M

    2016-07-01

    The aesthetic surgery arena has become a competitive marketplace. Recognition as an authority in aesthetic surgery remains a powerful marketing tool for plastic surgeons, but have significant inroads been made by other specialties? The aims of this study were to analyze publication trends relating to the top five most commonly performed aesthetic surgical procedures, and to assess the origins (i.e., source specialty, authorship, institutions, and countries) of published aesthetic surgical research. Based on the seventeenth annual multispecialty data set provided by the American Society for Aesthetic Plastic Surgery, the top five most commonly performed aesthetic surgical procedures were selected. A temporal analysis of publication and citation rates, source institution and country, publishing journal, funding agency trends, and level of evidence was undertaken from 1970 to 2013. Using the search criteria, 7762 articles were identified. There was an 8.8-fold increase in publication volume when the first decade (n = 375) was compared with the last decade (n = 3326). Over the past four decades, 52.2 percent of publications (n = 4053 of 7762) originated from plastic surgery research institutions, with varying contributions from other specialties. Competition was greatest in relation to authorship of blepharoplasty- and rhinoplasty-related publications. Although plastic surgeons continue to maintain a center-stage presence in terms of authorship of aesthetic surgical literature, significant contributions are now made by other specialties. Plastic surgeons must continue to foster high-quality, peer-reviewed research and innovations to maintain their visibility as leaders in the aesthetic surgery literature and sustain a competitive advantage in aesthetic surgery practice.

  18. Use of Technology for HIV Prevention Among Adolescent and Adult Women in the United States.

    Science.gov (United States)

    Blackstock, Oni J; Patel, Viraj V; Cunningham, Chinazo O

    2015-12-01

    Although the proportion of new HIV infections in the USA among women has decreased over the last few years, still, approximately 20 % of new infections occur annually among adolescent and adult women. The development of effective evidence-based prevention interventions remains an important approach to further decreasing these numbers. Technology-delivered prevention interventions hold tremendous potential due, in part, to their ability to reach beyond the walls of brick-and-mortar intervention sites to engage individuals where they are. While most technology-delivered interventions have focused on adolescents and men who have sex with men, much fewer have specifically targeted adolescent or adult women despite evidence showing that interventions tailored to specific target populations are most effective. We summarize the recently published literature on technology-delivered HIV prevention interventions for US adolescent and adult women and provide suggestions for next steps in this nascent but emergent area of prevention research.

  19. Geomagnetic and geoelectrical prospection for buried archaeological remains on the Upper City of Amorium, a Byzantine city in midwestern Turkey

    International Nuclear Information System (INIS)

    Ekinci, Yunus Levent; Balkaya, Çağlayan; Şeren, Aysel; Kaya, Mehmet Ali; Lightfoot, Christopher Sherwin

    2014-01-01

    On the basis of geophysical imaging surveys, including geomagnetic and geoelectrical resistivity, possible archaeological remains and their spatial parameters (i.e., location, extension, depth and thickness) were explored to provide useful data for future excavations on the Upper City of the ancient Amorium site, which comprises a large prehistoric man-made mound. The surveys were performed very close to the main axis of the Basilica, and the derived geophysical traces indicated some subsurface structures that appear to confirm that more-substantial brick and masonry buildings lie near the present-day surface of the mound. Analyzing the local gradients by total horizontal derivatives of pseudogravity data enhanced the edges of the magnetic sources. Additionally, a profile curvature technique, which has rarely been applied to potential field data sets, dramatically improved the magnetic-source body edges and the lineaments that may be associated with buried archaeological remains. The depths of these possible anthropogenic remains were estimated by applying the Euler deconvolution technique to the geomagnetic data set. The Euler solutions on tentative indices indicated that the depths of the source bodies are not more than about 3 m. Moreover, geoelectrical resistivity depth slices produced from the results of two- and three-dimensional linearized least-squares inversion techniques revealed high-resistivity anomalies within a depth of about 3 m from the ground surface, which is in close agreement with those obtained by applying the Euler deconvolution technique to the magnetic data. Based on the existence of some archaeological remains in the vicinity of the surveyed area, these geophysical anomalies were thought to be the possible traces of the buried remains and were suggested as targets for excavations. This study also emphasized that the data-processing techniques applied in this investigation should be suitable for providing an insight into the layout of the

  20. Determining Remaining Useful Life of Aging Cables in Nuclear Power Plants – Interim Study FY13

    Energy Technology Data Exchange (ETDEWEB)

    Simmons, Kevin L.; Fifield, Leonard S.; Westman, Matthew P.; Ramuhalli, Pradeep; Pardini, Allan F.; Tedeschi, Jonathan R.; Jones, Anthony M.

    2013-09-27

    The most important criterion for cable performance is its ability to withstand a design-basis accident. With nearly 1000 km of power, control, instrumentation, and other cables typically found in an NPP, it would be a significant undertaking to inspect all of the cables. Degradation of the cable jacket, electrical insulation, and other cable components is a key issue that is likely to affect the ability of the currently installed cables to operate safely and reliably for another 20 to 40 years beyond the initial operating life. The development of one or more nondestructive evaluation (NDE) techniques and supporting models that could assist in determining the remaining life expectancy of cables or their current degradation state would be of significant interest. The ability to nondestructively determine material and electrical properties of cable jackets and insulation without disturbing the cables or connections has been deemed essential. Currently, the only technique accepted by industry to measure cable elasticity (the gold standard for determining cable insulation degradation) is the indentation measurement. All other NDE techniques are used to find flaws in the cable and do not provide information to determine the current health or life expectancy. There is no single NDE technique that can satisfy all of the requirements needed for making a life-expectancy determination, but a wide range of methods have been evaluated for use in NPPs as part of a continuous evaluation program. The commonly used methods are indentation and visual inspection, but these are only suitable for easily accessible cables. Several NDE methodologies using electrical techniques are in use today for flaw detection but there are none that can predict the life of a cable. There are, however, several physical and chemical ptoperty changes in cable insulation as a result of thermal and radiation damage. In principle, these properties may be targets for advanced NDE methods to provide early

  1. Determining Remaining Useful Life of Aging Cables in Nuclear Power Plants - Interim Study FY13

    International Nuclear Information System (INIS)

    Simmons, Kevin L.; Fifield, Leonard S.; Westman, Matthew P.; Ramuhalli, Pradeep; Pardini, Allan F.; Tedeschi, Jonathan R.; Jones, Anthony M.

    2013-01-01

    The most important criterion for cable performance is its ability to withstand a design-basis accident. With nearly 1000 km of power, control, instrumentation, and other cables typically found in an NPP, it would be a significant undertaking to inspect all of the cables. Degradation of the cable jacket, electrical insulation, and other cable components is a key issue that is likely to affect the ability of the currently installed cables to operate safely and reliably for another 20 to 40 years beyond the initial operating life. The development of one or more nondestructive evaluation (NDE) techniques and supporting models that could assist in determining the remaining life expectancy of cables or their current degradation state would be of significant interest. The ability to nondestructively determine material and electrical properties of cable jackets and insulation without disturbing the cables or connections has been deemed essential. Currently, the only technique accepted by industry to measure cable elasticity (the gold standard for determining cable insulation degradation) is the indentation measurement. All other NDE techniques are used to find flaws in the cable and do not provide information to determine the current health or life expectancy. There is no single NDE technique that can satisfy all of the requirements needed for making a life-expectancy determination, but a wide range of methods have been evaluated for use in NPPs as part of a continuous evaluation program. The commonly used methods are indentation and visual inspection, but these are only suitable for easily accessible cables. Several NDE methodologies using electrical techniques are in use today for flaw detection but there are none that can predict the life of a cable. There are, however, several physical and chemical ptoperty changes in cable insulation as a result of thermal and radiation damage. In principle, these properties may be targets for advanced NDE methods to provide early

  2. Prevention of acute malnutrition

    DEFF Research Database (Denmark)

    de Pee, Saskia; Grais, Rebecca; Fenn, Bridget

    2015-01-01

    of cash or food, enables households to better meet the food, health, and other needs of household members and may increase resilience; water, sanitation, and hygiene (WASH) and health interventions help prevent and address illness and hence reduce wasting risk. The contributions of specific interventions...... "best possible" treatment, can provide evidence about what works, to what extent, at what cost, and under which circumstances. Programs should address the most important causes in given contexts, be feasible to implement at scale, and assess implementation, coverage, and outcomes....

  3. Workers' opinions on the effect of contact with health care providers on sickness absence duration.

    Science.gov (United States)

    Steenbeek, Romy

    2014-01-01

    Because of the aging working population and the increasing age of retirement the number of workers with chronic illnesses and disabilities is growing. It is important that workers with health complaints receive efficient health care in order to remain fully or at least partly productive. To explore workers' opinions about the effectiveness of contact with health care providers in shortening sickness absence duration. Data come from a four-wave study from 2005 to 2008 among Dutch workers (n=1,424). Data were obtained on visits to health care providers, sickness absence and workers' opinions on whether and how their absence could have been shortened. A third of the workers were of the opinion that the health care provider (most often the general practitioner, GP) had played a role in preventing sickness absence and 35% were of the opinion that the health care provider had limited their absence. Most often the physical therapist (71%) and mental health therapist (61%) shortened sickness absence duration, in contrast to the occupational physician (OP, 25%) and GP (32%). The effectiveness of the health care providers' treatment was associated with the cause of sickness absence. Approximately 15% of the workers reported that their sickness absence could have been shortened if health care providers had provided the proper treatment and if waiting times had been reduced. Health care providers differ in their potential to shorten sickness absence duration. Health care providers can further reduce sickness absence and health care costs by providing the proper treatment and by reducing waiting times.

  4. Polio and Prevention

    Science.gov (United States)

    ... Essays Photo Collections Videos Polio Today → Polio + Prevention Polio + Prevention Polio and prevention Polio is a crippling ... for poliovirus within 48 hours of onset. Bulbar polio More extensive paralysis, involving the trunk and muscles ...

  5. Prevent Child Abuse America

    Science.gov (United States)

    ... the Week Parenting Tip of the Week – Preventing Child Sexual Abuse Parenting Tip of the Week Parenting Tip of the Week – Talking to Teens about Healthy Relationships ... of child abuse prevention through our Pinwheels for Prevention campaign. ...

  6. National Suicide Prevention Lifeline

    Science.gov (United States)

    ... Initiatives Best Practices Our Network Media Resources National Suicide Prevention Lifeline We can all help prevent suicide. The ... Call The Lifeline Everyone Plays A Role In Suicide Prevention Here are some helpful links: GET HELP NOW ...

  7. Prevention Research Matters

    Centers for Disease Control (CDC) Podcasts

    Prevention Research Matters is a series of one-on-one interviews with researchers from 26 university prevention research centers across the country. Their work focuses on preventing and controlling chronic diseases like obesity, cancer, and heart disease.

  8. How Do Health Care Providers Diagnose Intellectual & Developmental Disabilities (IDDs)?

    Science.gov (United States)

    ... www.nbstrn.org/ or the Centers for Disease Control and Prevention webpage at http://www.cdc.gov/ncbddd/birthdefects/diagnosis.html . Prenatal Screening Health care providers recommend that certain pregnant ...

  9. The status of occupational safety among health service providers in ...

    African Journals Online (AJOL)

    identify and bring under control at workplaces all health risks; provide ... on the status of occupational safety among hospital workers in Tanzania. ..... The assistance from the IPC/IS. National ... tions of the Healthcare Infection Prevention.

  10. Predictors of patients remaining anovulatory during clomiphene citrate induction of ovulation in normogonadotropic oligoamenorrheic infertility

    NARCIS (Netherlands)

    B. Imani (Babak); M.J.C. Eijkemans (René); E.R. te Velde (Egbert); J.D.F. Habbema (Dik); B.C.J.M. Fauser (Bart)

    1998-01-01

    textabstractThe diagnostic criteria used to identify patients suffering from polycystic ovary syndrome remain controversial. The present prospective longitudinal follow-up study was designed to identify whether certain criteria assessed during standardized initial

  11. BTC method for evaluation of remaining strength and service life of bridge cables.

    Science.gov (United States)

    2011-09-01

    "This report presents the BTC method; a comprehensive state-of-the-art methodology for evaluation of remaining : strength and residual life of bridge cables. The BTC method is a probability-based, proprietary, patented, and peerreviewed : methodology...

  12. Cognitive bias in forensic anthropology: visual assessment of skeletal remains is susceptible to confirmation bias.

    Science.gov (United States)

    Nakhaeizadeh, Sherry; Dror, Itiel E; Morgan, Ruth M

    2014-05-01

    An experimental study was designed to examine cognitive biases within forensic anthropological non-metric methods in assessing sex, ancestry and age at death. To investigate examiner interpretation, forty-one non-novice participants were semi randomly divided into three groups. Prior to conducting the assessment of the skeletal remains, two of the groups were given different extraneous contextual information regarding the sex, ancestry and age at death of the individual. The third group acted as a control group with no extraneous contextual information. The experiment was designed to investigate if the interpretation and conclusions of the skeletal remains would differ amongst participants within the three groups, and to assess whether the examiners would confirm or disagree with the given extraneous context when establishing a biological profile. The results revealed a significant biasing effect within the three groups, demonstrating a strong confirmation bias in the assessment of sex, ancestry and age at death. In assessment of sex, 31% of the participants in the control group concluded that the skeleton remains were male. In contrast, in the group that received contextual information that the remains were male, 72% concluded that the remains were male, and in the participant group where the context was that the remains were of a female, 0% of the participants concluded that the remains were male. Comparable results showing bias were found in assessing ancestry and age at death. These data demonstrate that cognitive bias can impact forensic anthropological non-metric methods on skeletal remains and affects the interpretation and conclusions of the forensic scientists. This empirical study is a step in establishing an evidence base approach for dealing with cognitive issues in forensic anthropological assessments, so as to enhance this valuable forensic science discipline. Copyright © 2013 Forensic Science Society. Published by Elsevier Ireland Ltd. All rights

  13. Provision of relapse prevention interventions in UK NHS Stop Smoking Services: a survey

    Directory of Open Access Journals (Sweden)

    McEwen Andy

    2010-07-01

    Full Text Available Abstract Background UK NHS Stop Smoking Services provide cost effective smoking cessation interventions but, as yet, there has been no assessment of their provision of relapse prevention interventions. Methods Electronic questionnaire survey of 185 UK Stop Smoking Services Managers. Results Ninety six Stop Smoking Service managers returned completed questionnaires (52% response rate. Of these, 58.3% (n = 56 ran NHS Stop Smoking Services which provided relapse prevention interventions for clients with the most commonly provided interventions being behavioural support: telephone (77%, group (73%, and individual (54%. Just under half (48%, n = 27 offered nicotine replacement therapy (NRT, 21.4% (n = 12 bupropion; 19.6% (n = 11 varenicline. Over 80% of those providing relapse prevention interventions do so for over six months. Nearly two thirds of all respondents thought it was likely that they would either continue to provide or commence provision of relapse prevention interventions in their services. Of the remaining respondents, 66.7% (n = 22 believed that the government focus on four-week quit rates, and 42.9% (14 services believed that inadequate funding for provision of relapse prevention interventions, were major barriers to introducing these interventions into routine care. Conclusions Just over half of UK managers of NHS Stop Smoking Services who responded to the questionnaire reported that, in their services, relapse prevention interventions were currently provided for clients, despite, at that time, there being a weak evidence base for their effectiveness. The most commonly provided relapse prevention interventions were those for which there was least evidence. If these interventions are found to be effective, barriers would need to be removed before they would become part of routine care.

  14. Spontaneous recovery of locomotion induced by remaining fibers after spinal cord transection in adult rats.

    Science.gov (United States)

    You, Si-Wei; Chen, Bing-Yao; Liu, Hui-Ling; Lang, Bing; Xia, Jie-Lai; Jiao, Xi-Ying; Ju, Gong

    2003-01-01

    A major issue in analysis of experimental results after spinal cord injury is spontaneous functional recovery induced by remaining nerve fibers. The authors investigated the relationship between the degree of locomotor recovery and the percentage and location of the fibers that spared spinal cord transection. The spinal cords of 12 adult rats were transected at T9 with a razor blade, which often resulted in sparing of nerve fibers in the ventral spinal cord. The incompletely-transected animals were used to study the degree of spontaneous recovery of hindlimb locomotion, evaluated with the BBB rating scale, in correlation to the extent and location of the remaining fibers. Incomplete transection was found in the ventral spinal cord in 42% of the animals. The degree of locomotor recovery was highly correlated with the percentage of the remaining fibers in the ventral and ventrolateral funiculi. In one of the rats, 4.82% of remaining fibers in unilateral ventrolateral funiculus were able to sustain a certain recovery of locomotion. Less than 5% of remaining ventrolateral white matter is sufficient for an unequivocal motor recovery after incomplete spinal cord injury. Therefore, for studies with spinal cord transection, the completeness of sectioning should be carefully checked before any conclusion can be reached. The fact that the degree of locomotor recovery is correlated with the percentage of remaining fibers in the ventrolateral spinal cord, exclusive of most of the descending motor tracts, may imply an essential role of propriospinal connections in the initiation of spontaneous locomotor recovery.

  15. Scabies: Prevention and Control

    Science.gov (United States)

    ... Information Scabies FAQs Workplace FAQs Epidemiology & Risk Factors Biology Disease Diagnosis Treatment Prevention & Control Resources for Health Professionals Medications Institutional Settings Prevention ...

  16. Safety regulation of geological disposal of radioactive waste: progress since Cordoba and remaining challenges

    International Nuclear Information System (INIS)

    Duncan, A.; Pescatore, C.

    2010-01-01

    Claudio Pescatore, Deputy Division Head (NEA) presented a paper, the purpose of which was to recall where we stood at the time of the Cordoba Workshop (1997) on the regulation of disposal of long-lived radioactive waste, to review developments since then, to present the key existing issues, and reflect on the remaining challenges and possible responses. The overview study on progress in regulation for geological disposal since the Cordoba workshop [NEA/RWMC/RF(2008)6], provides a good list of references regarding the first two issues. The presentation of the existing issues takes advantage of the synthesis of the responses to a questionnaire completed by the regulatory organisations in preparation for this workshop. It warns regulators and implementers that international work to date seems to have created an expectation in the mind of the public and in some organisations that nothing less than a guarantee by the regulator is needed of maintaining current levels of protection of both individuals and populations practically forever, regardless of the impracticality of this. This expectation needs to be replaced with a carefully and clearly explained understanding of the choices involved in dealing with long-lived radioactive waste against a background of our responsibilities to both current and future generations and our practical capacity to deliver them. Concerning the current major challenges faced in regulation, the paper comes back to the issue of the 'guarantee' by the regulator and it observes that there is no doubt that there is a willingness to do the best to comply with the principle of protection and that we are broadly convinced that current concepts for geological disposal, supported by multiple lines of reasoning and application of best available techniques (BAT) will meet that principle. However, we do not have the capacity to prove or guarantee this, nor do we believe that it is possible in practice. Although we are advised that it is neither

  17. Barriers in the implementation of isoniazid preventive therapy for people living with HIV in Northern Ethiopia: a mixed quantitative and qualitative study

    Directory of Open Access Journals (Sweden)

    Gebrehiwot Teklay

    2016-08-01

    Full Text Available Abstract Background Isoniazid preventive therapy is a key public health intervention for the prevention of tuberculosis disease among people living with HIV. Despite the confirmed efficacy of isoniazid preventive therapy and global recommendations existing for decades, its implementation remains limited. In resource constrained settings, few have investigated why isoniazid preventive therapy is not implemented on full scale. This study was designed to investigate the level of isoniazid preventive therapy implementation and reasons for suboptimal implementation in Tigray region of Ethiopia. Methods A review of patient records combined with a qualitative study using in-depth interviews and focus group discussions was conducted in 11 hospitals providing isoniazid preventive therapy in the Tigray Region. The study participants were health providers working in the HIV clinics of the 11 hospitals in the province. Health providers were interviewed about their experience of providing isoniazid preventive therapy and challenges faced during its implementation. All conversations were audio-recorded. Record review of 16,443 HIV patients registered for care in these hospitals between September 2011 and April 2014 was done to determine isoniazid preventive therapy utilization. Data were collected from April to August 2014. Results Fifty health providers participated in the study. Overall isoniazid preventive therapy coverage of the region was estimated to be 20 %. Isoniazid stock out, fear of creating isoniazid resistance, problems in patient acceptance, and lack of commitment of health managers to scale up the program were indicated by health providers as the main barriers hindering implementation of isoniazid preventive therapy. Conclusion Implementation of isoniazid preventive therapy in Tigray region of Ethiopia had low coverage. Frequent interruption of isoniazid supplies raises the concern of interrupted therapy resulting in creation of isoniazid

  18. Preventing urinary incontinence in women.

    Science.gov (United States)

    Newman, Diane K; Cardozo, Linda; Sievert, Karl-Dietrich

    2013-10-01

    This review examines the evidence to date, analyzes specific risk factors and assesses the ability to prevent urinary incontinence in women, while providing clinical recommendations. More extraordinary risk factors such as ethnicity and race, mixed and fecal incontinence, iatrogenic and neurogenic factors should be discussed in a follow-up report. Studies have revealed that certain factors place women at risk for developing urinary incontinence, including age, obesity, diabetes, pregnancy and delivery, high-impact physical exercise factors and estrogen deficiency. Healthcare providers should screen women who are at risk for developing urinary incontinence and institute specific interventions, specifically behavioral and even rehabilitative techniques, to prevent this prevalent and distressing condition.

  19. Cholera - management and prevention.

    Science.gov (United States)

    Davies, Hannah G; Bowman, Conor; Luby, Stephen P

    2017-06-01

    Cholera is an acute secretory diarrhoeal infection caused by the bacterium Vibrio cholerae. It is likely to have originated in the Indian sub-continent; however, it spread to cause six worldwide pandemics between 1817-1923. The ongoing seventh worldwide pandemic of cholera began in 1961. The intensity, duration and severity of cholera epidemics have been increasing, signaling the need for more effective control and prevention measures. The response to the cholera pandemics of the 19th century led to the development of safe and effective sanitation and water systems which have effectively removed the risk of cholera in many settings. However, such systems are not in place to protect billions of people worldwide. Although some progress has been made in expanding access to water in recent years, achieving optimal infrastructure will, in the most optimistic scenario, take decades. Climate change, extreme weather events and rapid urbanisation suggests that alternatives to the current paradigm of providing large centralised water and sanitation systems should be considered, including smaller decentralised systems. The aim of this review paper is to provide an overview of current knowledge regarding management of cholera with a focus on prevention measures including vaccination and water and sanitation interventions. © 2017 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

  20. Nuclear Power Remains Important Energy Option for Many Countries, IAEA Ministerial Conference Concludes

    International Nuclear Information System (INIS)

    2013-01-01

    Full text: Nuclear power remains an important option for many countries to improve energy security, provide energy for development and fight climate change, the International Ministerial Conference on Nuclear Power in the 21st Century concluded today. Participants also emphasised the importance of nuclear safety in the future growth of nuclear power, noting that nuclear safety has been strengthened worldwide following the March 2011 accident at TEPCO's Fukushima Daiichi Nuclear Power Station. The Conference was organised by the International Atomic Energy Agency (IAEA) in cooperation with the Nuclear Energy Agency (NEA) of the Organisation for Economic Co-operation and Development (OECD), and hosted by the Government of the Russian Federation through the State Atomic Energy Corporation ROSATOM. Sergei Kirienko, Director General of the State Atomic Energy Corporation ROSATOM, said: ''The Conference has achieved its main goal: to confirm that nuclear energy is an important part of the world's energy-mix. The innovative character of this type of energy provides us with sustainable development in the future. The closed nuclear fuel cycle and fusion may open for humanity absolutely new horizons. The Conference underlined the leading role of the IAEA in promoting the peaceful use of nuclear power and provision of the non-proliferation regime. Russia as a co-founder of the IAEA will always support its efforts to develop and expand safety and security standards all over the world.'' ''I believe we can look ahead with confidence and optimism to the future of nuclear power in the 21st century,'' said IAEA Director General Yukiya Amano. After the accident at the Fukushima Daiichi Nuclear Power Plant in Japan in March 2011, ''effective steps have been taken to make nuclear power plants safer everywhere,'' he stressed. ''Nuclear power will make a significant and growing contribution to sustainable development in the coming decades. The IAEA is committed to ensuring that the

  1. Specialist training in Fiji: Why do graduates migrate, and why do they remain? A qualitative study

    Directory of Open Access Journals (Sweden)

    Usher Kim

    2009-02-01

    Full Text Available Abstract Background Specialist training was established in the late 1990s at the Fiji School of Medicine. Losses of graduates to overseas migration and to the local private sector prompted us to explore the reasons for these losses from the Fiji public workforce. Methods Data were collected on the whereabouts and highest educational attainments of the 66 Fiji doctors who had undertaken specialist training to at least the diploma level between 1997 and 2004. Semistructured interviews focusing on career decisions were carried out with 36 of these doctors, who were purposively sampled to include overseas migrants, temporary overseas trainees, local private practitioners and public sector doctors. Results 120 doctors undertook specialist training to at least the diploma level between 1997 and 2004; 66 of the graduates were Fiji citizens or permanent residents; 54 originated from other countries in the region. Among Fiji graduates, 42 completed a diploma and 24 had either completed (21 or were enrolled (3 in a master's programme. Thirty-two (48.5% were working in the public sectors, four (6.0% were temporarily training overseas, 30.3% had migrated overseas and the remainder were mostly in local private practice. Indo-Fijian ethnicity and non-completion of full specialist training were associated with lower retention in the public sectors, while gender had little impact. Decisions to leave the public sectors were complex, with concerns about political instability and family welfare predominating for overseas migrants, while working conditions not conducive to family life or frustrations with career progression predominated for local private practitioners. Doctors remaining in the public sectors reported many satisfying aspects to their work despite frustrations, though 40% had seriously considered resigning from the public service and 60% were unhappy with their career progression. Conclusion Overall, this study provides some support for the view that

  2. New paleoradiological investigations of ancient human remains from North West Lombardy archaeological excavations

    International Nuclear Information System (INIS)

    Licata, Marta; Borgo, Melania; Armocida, Giuseppe; Nicosia, Luca; Ferioli, Elena

    2016-01-01

    Since its birth in 1895, radiology has been used to study ancient mummies. The purpose of this article is to present paleoradiological investigations conducted on several medieval human remains in Varese province. Anthropological (generic identification) and paleopathological analyses were carried out with the support of diagnostic imaging (X-ray and CT scans). Human remains were discovered during excavations of medieval archaeological sites in northwest Lombardy. Classical physical anthropological methods were used for the macroscopic identification of the human remains. X-ray and CT scans were performed on the same scanner (16-layer Hitachi Eclos 16 X-ray equipment). Radiological analysis permitted investigating (1) the sex, (2) age of death, (3) type of trauma, (4) therapeutic interventions and (5) osteomas in ancient human remains. In particular, X-ray and CT examinations showed dimorphic facial traits on the mummified skull, and the same radiological approaches allowed determining the age at death from a mummified lower limb. CT analyses allow investigating different types of traumatic lesions in skulls and postcranial skeleton portions and reconstructing the gait and functional outcomes of a fractured femur. Moreover, one case of possible Gardner's syndrome (GS) was postulated from observing multiple osteomas in an ancient skull. Among the medical tests available to the clinician, radiology is the most appropriate first-line procedure for a diagnostic approach to ancient human remains because it can be performed without causing any significant damage to the specimen. (orig.)

  3. New paleoradiological investigations of ancient human remains from North West Lombardy archaeological excavations

    Energy Technology Data Exchange (ETDEWEB)

    Licata, Marta; Borgo, Melania; Armocida, Giuseppe; Nicosia, Luca; Ferioli, Elena [University of Insubria (Varese), Department of Biotechnology and Life Sciences, Varese (Italy)

    2016-03-15

    Since its birth in 1895, radiology has been used to study ancient mummies. The purpose of this article is to present paleoradiological investigations conducted on several medieval human remains in Varese province. Anthropological (generic identification) and paleopathological analyses were carried out with the support of diagnostic imaging (X-ray and CT scans). Human remains were discovered during excavations of medieval archaeological sites in northwest Lombardy. Classical physical anthropological methods were used for the macroscopic identification of the human remains. X-ray and CT scans were performed on the same scanner (16-layer Hitachi Eclos 16 X-ray equipment). Radiological analysis permitted investigating (1) the sex, (2) age of death, (3) type of trauma, (4) therapeutic interventions and (5) osteomas in ancient human remains. In particular, X-ray and CT examinations showed dimorphic facial traits on the mummified skull, and the same radiological approaches allowed determining the age at death from a mummified lower limb. CT analyses allow investigating different types of traumatic lesions in skulls and postcranial skeleton portions and reconstructing the gait and functional outcomes of a fractured femur. Moreover, one case of possible Gardner's syndrome (GS) was postulated from observing multiple osteomas in an ancient skull. Among the medical tests available to the clinician, radiology is the most appropriate first-line procedure for a diagnostic approach to ancient human remains because it can be performed without causing any significant damage to the specimen. (orig.)

  4. The potential and biological test on cloned cassava crop remains on local sheep

    Science.gov (United States)

    Ginting, R.; Umar, S.; Hanum, C.

    2018-02-01

    This research aims at knowing the potential of cloned cassava crop remains dry matter and the impact of the feeding of the cloned cassava crop remains based complete feed on the consumption, the body weight gain, and the feed conversion of the local male sheep with the average of initial body weight of 7.75±1.75 kg. The design applied in the first stage research was random sampling method with two frames of tile and the second stage research applied Completely Randomized Design (CRD) with three (3) treatments and four (4) replicates. These treatments consisted of P1 (100% grass); P2 (50% grass, 50% complete feed pellet); P3 (100% complete feed from the raw material of cloned cassava crop remaining). Statistical tests showed that the feeding of complete feed whose raw material was from cloned cassava crop remains gave a highly significant impact on decreasing feed consumption, increasing body weight, lowering feed conversion, and increasing crude protein digestibility. The conclusion is that the cloned cassava crop remains can be used as complete sheep feed to replace green grass and can give the best result.

  5. Remaining useful life prediction of degrading systems subjected to imperfect maintenance: Application to draught fans

    Science.gov (United States)

    Wang, Zhao-Qiang; Hu, Chang-Hua; Si, Xiao-Sheng; Zio, Enrico

    2018-02-01

    Current degradation modeling and remaining useful life prediction studies share a common assumption that the degrading systems are not maintained or maintained perfectly (i.e., to an as-good-as new state). This paper concerns the issues of how to model the degradation process and predict the remaining useful life of degrading systems subjected to imperfect maintenance activities, which can restore the health condition of a degrading system to any degradation level between as-good-as new and as-bad-as old. Toward this end, a nonlinear model driven by Wiener process is first proposed to characterize the degradation trajectory of the degrading system subjected to imperfect maintenance, where negative jumps are incorporated to quantify the influence of imperfect maintenance activities on the system's degradation. Then, the probability density function of the remaining useful life is derived analytically by a space-scale transformation, i.e., transforming the constructed degradation model with negative jumps crossing a constant threshold level to a Wiener process model crossing a random threshold level. To implement the proposed method, unknown parameters in the degradation model are estimated by the maximum likelihood estimation method. Finally, the proposed degradation modeling and remaining useful life prediction method are applied to a practical case of draught fans belonging to a kind of mechanical systems from steel mills. The results reveal that, for a degrading system subjected to imperfect maintenance, our proposed method can obtain more accurate remaining useful life predictions than those of the benchmark model in literature.

  6. The first Neanderthal remains from an open-air Middle Palaeolithic site in the Levant.

    Science.gov (United States)

    Been, Ella; Hovers, Erella; Ekshtain, Ravid; Malinski-Buller, Ariel; Agha, Nuha; Barash, Alon; Mayer, Daniella E Bar-Yosef; Benazzi, Stefano; Hublin, Jean-Jacques; Levin, Lihi; Greenbaum, Noam; Mitki, Netta; Oxilia, Gregorio; Porat, Naomi; Roskin, Joel; Soudack, Michalle; Yeshurun, Reuven; Shahack-Gross, Ruth; Nir, Nadav; Stahlschmidt, Mareike C; Rak, Yoel; Barzilai, Omry

    2017-06-07

    The late Middle Palaeolithic (MP) settlement patterns in the Levant included the repeated use of caves and open landscape sites. The fossil record shows that two types of hominins occupied the region during this period-Neandertals and Homo sapiens. Until recently, diagnostic fossil remains were found only at cave sites. Because the two populations in this region left similar material cultural remains, it was impossible to attribute any open-air site to either species. In this study, we present newly discovered fossil remains from intact archaeological layers of the open-air site 'Ein Qashish, in northern Israel. The hominin remains represent three individuals: EQH1, a nondiagnostic skull fragment; EQH2, an upper right third molar (RM 3 ); and EQH3, lower limb bones of a young Neandertal male. EQH2 and EQH3 constitute the first diagnostic anatomical remains of Neandertals at an open-air site in the Levant. The optically stimulated luminescence ages suggest that Neandertals repeatedly visited 'Ein Qashish between 70 and 60 ka. The discovery of Neandertals at open-air sites during the late MP reinforces the view that Neandertals were a resilient population in the Levant shortly before Upper Palaeolithic Homo sapiens populated the region.

  7. Analysis of Information Remaining on Hand Held Devices Offered for Sale on the Second Hand Market

    Directory of Open Access Journals (Sweden)

    Andy Jones

    2008-06-01

    resellers.The study was carried out by the security research team at the BT IT Futures Centre in conjunction with Edith Cowan University in Australia and the University of Glamorgan in the UK. The basis of the research was to acquire a number of second hand held devices from a diverse range of sources and then determine whether they still contained information relating to a previous owner or whether the information had been effectively removed. The devices that were obtained for the research were supplied blind to the researchers through a third party. The ‘blind’ supply of the devices meant that the people undertaking the research were provided with no information about the device and that the source of the devices and any external markings were hidden from them. This process was put in place to ensure that any findings of the research were based solely on the information that could be recovered from the digital storage media that was contained within the device.The underlying methodology that was used in the research was based on the forensic imaging of the devices. A forensic image of a device is a copy of the digital media that has been created in a scientifically sound manner to a standard that is acceptable to the courts. This procedure was implemented to ensure that the evidential integrity of the devices was maintained, with the devices also then being stored in a secure manner.  All subsequent research was then conducted on the image of the device. This was considered to be a sensible precaution against the possibility that information discovered on a device might indicate criminal activity and require the involvement of law enforcement.  Following the forensic imaging of the devices, the images that were created were then analyzed to determine whether any information remained and whether it could be easily recovered using commonly available tools and techniques that anyone who had purchased the device could acquire.

  8. The work of the Child Accident Prevention Trust.

    OpenAIRE

    Jackson, R H; Cooper, S; Hayes, H R

    1988-01-01

    In 1983 an article was published in this Journal describing the work of the Child Accident Prevention Trust. Since that time many developments have taken place in the field of child accident prevention. There has been an increased recognition of the role of accidents and injuries in child health and the importance of accident prevention at an international, national, and local level. This has, in part, been a result of work undertaken by the Child Accident Prevention Trust. Much remains to be...

  9. Hand hygiene knowledge and perceptions among anesthesia providers.

    Science.gov (United States)

    Fernandez, Patrick G; Loftus, Randy W; Dodds, Thomas M; Koff, Matthew D; Reddy, Sundara; Heard, Stephen O; Beach, Michael L; Yeager, Mark P; Brown, Jeremiah R

    2015-04-01

    Health care worker compliance with hand hygiene guidelines is an important measure for health care-associated infection prevention, yet overall compliance across all health care arenas remains low. A correct answer to 4 of 4 structured questions pertaining to indications for hand decontamination (according to types of contact) has been associated with improved health care provider hand hygiene compliance when compared to those health care providers answering incorrectly for 1 or more questions. A better understanding of knowledge deficits among anesthesia providers may lead to hand hygiene improvement strategies. In this study, our primary aims were to characterize and identify predictors for hand hygiene knowledge deficits among anesthesia providers. We modified this previously tested survey instrument to measure anesthesia provider hand hygiene knowledge regarding the 5 moments of hand hygiene across national and multicenter groups. Complete knowledge was defined by correct answers to 5 questions addressing the 5 moments for hand hygiene and received a score of 1. Incomplete knowledge was defined by an incorrect answer to 1 or more of the 5 questions and received a score of 0. We used a multilevel random-effects XTMELOGIT logistic model clustering at the respondent and geographic location for insufficient knowledge and forward/backward stepwise logistic regression analysis to identify predictors for incomplete knowledge. The survey response rates were 55.8% and 18.2% for the multicenter and national survey study groups, respectively. One or more knowledge deficits occurred with 81.6% of survey respondents, with the mean number of correct answers 2.89 (95% confidence interval, 2.78- 2.99). Failure of providers to recognize prior contact with the environment and prior contact with the patient as hand hygiene opportunities contributed to the low mean. Several cognitive factors were associated with a reduced risk of incomplete knowledge including providers responding

  10. Preferred Provider Organization (PPO) Plans

    Science.gov (United States)

    ... Find & compare doctors, hospitals, & other providers Preferred Provider Organization (PPO) Plans How PPO Plans Work A Medicare ... extra for these benefits. Related Resources Health Maintenance Organization (HMO) Private Fee-for-Service (PFFS) Special Needs ...

  11. Properties and effects of remaining carbon from waste plastics gasifying on iron scale reduction.

    Science.gov (United States)

    Zhang, Chongmin; Chen, Shuwen; Miao, Xincheng; Yuan, Hao

    2011-06-01

    The carbonous activities of three kinds of carbon-bearing materials gasified from plastics were tested with coal coke as reference. The results showed that the carbonous activities of these remaining carbon-bearing materials were higher than that of coal-coke. Besides, the fractal analyses showed that the porosities of remaining carbon-bearing materials were higher than that of coal-coke. It revealed that these kinds of remaining carbon-bearing materials are conducive to improve the kinetics conditions of gas-solid phase reaction in iron scale reduction. Copyright © 2011 The Research Centre for Eco-Environmental Sciences, Chinese Academy of Sciences. Published by Elsevier B.V. All rights reserved.

  12. Some social and forensic aspects of exhumation and reinterment of industrial revolution remains.

    Science.gov (United States)

    Duff, E J; Johnson, J S

    1974-03-23

    The aetiological aspects of exhumed remains from two burial sites were examined using 1839 and 1879 as years of comparison. We tried to discover whether the sample of recovered remains was representative of those buried. The state of the remains varied according to the type of soil and coffin material in which they were buried. At the earlier date most deaths were caused by infectious lesions rather than degenerative ones and 76% of those who died were below employable age-whereas in 1879 the commonest causes of death were tuberculosis ("phthisis") and bronchitis, and 42% died before they could be employed. The registration of deaths were recorded more accurately at the later date, and it was easier to build up a picture of the age, sex, and occupation of the people who died.

  13. Ethical Issues Surrounding the Use of Modern Human Remains for Research in South Africa.

    Science.gov (United States)

    Briers, N; Dempers, J J

    2017-02-01

    Chapter 8 of the South African National Health Act 61 of 2003 (NHA) that deals with the donation of human tissue was promulgated in 2012. The new Act is perceived to impose restrictions on low-risk research involving human remains. This study aimed to identify the issues raised by a research ethics committee (REC) when reviewing protocols where human remains are used as data source. REC minutes from 2009 to 2014 were reviewed, and issues raised by the committee were categorized. In total, 127 protocols submitted to the committee over 6 years involved human remains. Queries relating to science (22.2%) and administration (18.9%) were the most common, whereas queries relating to legal issues constituted only 10.2%. Ethical issues centered on informed consent regarding sensitive topics such as HIV, DNA, and deceased children. The change in legislation did not change the number or type of legal issues identified by the REC.

  14. Prevention of Periprosthetic Joint Infection

    Directory of Open Access Journals (Sweden)

    Alisina Shahi

    2015-04-01

    Full Text Available Prosthetic joint infection (PJI is a calamitous complication with high morbidity and substantial cost. The reported incidence is low but it is probably underestimated due to the difficulty in diagnosis. PJI has challenged the orthopaedic community for several years and despite all the advances in this field, it is still a real concern with immense impact on patients, and the healthcare system. Eradication of infection can be very difficult. Therefore, prevention remains the ultimate goal. The medical community has executed many practices with the intention to prevent infection and treat it effectively when it encounters. Numerous factors can predispose patients to PJI. Identifying the host risk factors, patients’ health modification, proper wound care, and optimizing operative room environment remain some of the core fundamental steps that can help minimizing the overall incidence of infection. In this review we have summarized the effective prevention strategies along with the recommendations of a recent International Consensus Meeting on Surgical Site and Periprosthetic Joint Infection.

  15. A Study on Generic Representation of Skeletal Remains Replication of Prehistoric Burial

    Directory of Open Access Journals (Sweden)

    C.-W. Shao

    2015-08-01

    Full Text Available Generic representation of skeletal remains from burials consists of three dimensions which include physical anthropologists, replication technicians, and promotional educators. For the reason that archaeological excavation is irreversible and disruptive, detail documentation and replication technologies are surely needed for many purposes. Unearthed bones during the process of 3D digital scanning need to go through reverse procedure, 3D scanning, digital model superimposition, rapid prototyping, mould making, and the integrated errors generated from the presentation of colours and textures are important issues for the presentation of replicate skeleton remains among professional decisions conducted by physical anthropologists, subjective determination of makers, and the expectations of viewers. This study presents several cases and examines current issues on display and replication technologies for human skeletal remains of prehistoric burials. This study documented detail colour changes of human skeleton over time for the reference of reproduction. The tolerance errors of quantification and required technical qualification is acquired according to the precision of 3D scanning, the specification requirement of rapid prototyping machine, and the mould making process should following the professional requirement for physical anthropological study. Additionally, the colorimeter is adopted to record and analyse the “colour change” of the human skeletal remains from wet to dry condition. Then, the “colure change” is used to evaluate the “real” surface texture and colour presentation of human skeletal remains, and to limit the artistic presentation among the human skeletal remains reproduction. The“Lingdao man No.1”, is a well preserved burial of early Neolithic period (8300 B.P. excavated from Liangdao-Daowei site, Matsu, Taiwan , as the replicating object for this study. In this study, we examined the reproduction procedures step by

  16. Assessment of the potential for exploitation of the remaining reserves of coal in Poland

    International Nuclear Information System (INIS)

    Wodarski, K.; Bijanska, J.

    2014-01-01

    In mining areas belonging to the Polish mining companies, there is a significant amount of coal, contained in remaining reserves, that have not been exploited so far. For years, the mines have been evaluating the possibility of its exploitation, since it would expand its resource base and would extend its useful life. In addition, exploitation of the remaining reserves can minimize stress concentration zones in the soil, the rebel y improving conditions for maintenance of excavations and limiting the risk of shock rock. (Author)

  17. Evaluation method of radon preventing effect in underground construction

    International Nuclear Information System (INIS)

    Luo Shaodong; Deng Yuequan; Dong Faqin; Qu Ruixue; Xie Zhonglei

    2014-01-01

    Background: It's difficult to evaluate the radon prevention effect because of the short operating time of measuring instrument under the circumstances of high humidity in underground construction. Purpose: A new rapid method to evaluate the radon prevention efficiency of underground construction was introduced. Methods: The radon concentrations before and after shielding operation were determined, and according to the regularity of radon decay, the shielding rate can be calculated. Results: The results showed that radon shielding rate in underground construction remains generally stable with variation of time, and the actual relatively standard deviation was 3.95%. So the rapid determination and evaluation of radon preventing effect under special conditions in underground construction can be realized by taking shielding rate in a short time for the final shielding rate. Compared with those by the local static method in ground lab, the results were similar. Conclusion: This paper provided a prompt, accurate and practicable way for the evaluation of radon prevention in underground construction, having a certain reference value. (authors)

  18. Promoting gynecologic cancer awareness at a critical juncture--where women and providers meet.

    Science.gov (United States)

    Cooper, Crystale Purvis; Gelb, Cynthia A; Rodriguez, Juan; Hawkins, Nikki A

    2014-06-01

    Given the absence of effective population-based screening tests for ovarian, uterine, vaginal, and vulvar cancers, early detection can depend on women and health care providers recognizing the potential significance of symptoms. In 2008, the Centers for Disease Control and Prevention's (CDC) Inside Knowledge campaign began distributing consumer education materials promoting awareness of gynecologic cancer symptoms. We investigated providers' in-office use of CDC gynecologic cancer materials and their recognition of the symptoms highlighted in the materials. We analyzed data from a national 2012 survey of US primary care physicians, nurse practitioners, and gynecologists (N = 1,380). Less than a quarter of providers (19.4%) reported using CDC gynecologic cancer education materials in their offices. The provider characteristics associated with the use of CDC materials were not consistent across specialties. However, recognition of symptoms associated with gynecologic cancers was consistently higher among providers who reported using CDC materials. The possibility that providers were educated about gynecologic cancer symptoms through the dissemination of materials intended for their patients is intriguing and warrants further investigation. Distributing consumer education materials in health care provider offices remains a priority for the Inside Knowledge campaign, as the setting where women and health care providers interact is one of the most crucial venues to promote awareness of gynecologic cancer symptoms.

  19. Primary prevention of periodontitis: managing gingivitis.

    Science.gov (United States)

    Chapple, Iain L C; Van der Weijden, Fridus; Doerfer, Christof; Herrera, David; Shapira, Lior; Polak, David; Madianos, Phoebus; Louropoulou, Anna; Machtei, Eli; Donos, Nikos; Greenwell, Henry; Van Winkelhoff, Ari J; Eren Kuru, Bahar; Arweiler, Nicole; Teughels, Wim; Aimetti, Mario; Molina, Ana; Montero, Eduardo; Graziani, Filippo

    2015-04-01

    Periodontitis is a ubiquitous and irreversible inflammatory condition and represents a significant public health burden. Severe periodontitis affects over 11% of adults, is a major cause of tooth loss impacting negatively upon speech, nutrition, quality of life and self-esteem, and has systemic inflammatory consequences. Periodontitis is preventable and treatment leads to reduced rates of tooth loss and improved quality of life. However, successful treatment necessitates behaviour change in patients to address lifestyle risk factors (e.g. smoking) and, most importantly, to attain and sustain high standards of daily plaque removal, lifelong. While mechanical plaque removal remains the bedrock of successful periodontal disease management, in high-risk patients it appears that the critical threshold for plaque accumulation to trigger periodontitis is low, and such patients may benefit from adjunctive agents for primary prevention of periodontitis. The aims of this working group were to systematically review the evidence for primary prevention of periodontitis by preventing gingivitis via four approaches: 1) the efficacy of mechanical self-administered plaque control regimes; 2) the efficacy of self-administered inter-dental mechanical plaque control; 3) the efficacy of adjunctive chemical plaque control; and 4) anti-inflammatory (sole or adjunctive) approaches. Two meta-reviews (mechanical plaque removal) and two traditional systematic reviews (chemical plaque control/anti-inflammatory agents) formed the basis of this consensus. Data support the belief that professionally administered plaque control significantly improves gingival inflammation and lowers plaque scores, with some evidence that reinforcement of oral hygiene provides further benefit. Re-chargeable power toothbrushes provide small but statistically significant additional reductions in gingival inflammation and plaque levels. Flossing cannot be recommended other than for sites of gingival and periodontal

  20. Interventions for preventing and managing of skin lesions after radiation.

    Directory of Open Access Journals (Sweden)

    Eleni Bafe

    2017-12-01

    Full Text Available Introduction: Radiotherapy has a pivotal role in the fight against cancer. However 85% of patients, who undergo radiotherapy, will face moderate to severe skin reactions, for the treatment of which various local products, available in the market, are used. Aim: The aim of this systematic literature review was to investigate the prevention and treatment of these skin lesions induced by radiation. Methods: For this purpose 34 articles were collected concerning materials, approved by the FDA, for the prevention and treatment of skin damage due to radiation, preclinical factors tested in animal models, factors involved in the prevention and treatment of moist desquamation and unauthorized agents or with little information about them. Results: According to the study results, the moisturizing and hydrophilic creams, herbal preparations, gels based on hyaluronic acid, and Vitamin E, heparinoid creams and formulations based on oils appear to have a positive effect in preventing dermatitis as well as in providing symptom relief. Patches are suitable for the case of moist desquamation. Vasculotide, agent EUK-207, agent RTA 408, agent ALDH2 and the agent Celecoxib are still in the preclinical stage but may become future therapeutic targets. Conclusion: Skin reactions due to radiation remain a significant problem for patients undergoing radical treatment. However, thanks to the multitude of formulations available in the market and several clinical trials it is possible that early prevention and treatment for actinic dermatitis could be achieved. In conclusion, it is crucial that health professionals are aware of the formulations indicated and contraindicated in case of skin reactions induced by radiation and adjust the treatment for the prevention and management of skin reactions in patients receiving radiation therapy.

  1. Remaining life assessment and plant life extension in high temperature components of power and petrochemical plant

    International Nuclear Information System (INIS)

    Fleming, A.

    2003-01-01

    This paper explains the reasons why plant life can so easily be extended beyond the original design life. It details the means by which plant life extension is normally achieved, a structured plan for achieving such plant life extension at reasonable cost and some of the key techniques used in assessing the remaining life and discusses the simple repair options available. (author)

  2. The remaining percentage of 32P after burning of sulphur tablet containing 32P

    International Nuclear Information System (INIS)

    Ke Weiqing

    1991-01-01

    Three types of sulphur tablet containing 32 P are made artificially. The remaining percentage of 32 P after burning of three types of sulphur tablets containing 32 P is 98.1 ± 1.3% for 1st and 2nd types and 97.2 ± 2.8% for 3rd type

  3. 43 CFR 10.11 - Disposition of culturally unidentifiable human remains.

    Science.gov (United States)

    2010-10-01

    ... AMERICAN GRAVES PROTECTION AND REPATRIATION REGULATIONS Human Remains, Funerary Objects, Sacred Objects, or... religious leaders of all Indian tribes and Native Hawaiian organizations: (i) From whose tribal lands, at... objects; (ii) The names and appropriate methods to contact any traditional religious leaders who should be...

  4. Regeneration of dermal patterns from the remaining pigments after surgery in Eublepharis macularius (a case report).

    Science.gov (United States)

    Nakashima, Noriyuki

    2016-07-12

    Dermal injury of the Eublepharis macularius (leopard gecko) often results in a loss of the spotted patterns. The scar is usually well recovered, but the spots and the tubercles may be lost depending on the size and part of the lesion. This report presents a surgical attempting, in which the pigments in the edge of the remaining skin flap are partially preserved to maximally restore the natural pigmentation patterns during the course of dermal regeneration. A four-year-old female lizard E. macularius was evaluated due to a subcutaneous tumor in the occipito-pterional portion behind its right eye. A solid tumor beneath the skin was surgically enucleated under general anesthesia. Then, the ulcerated skin was dissected away together with the tumor. The necrotic edge of the remaining skin flap was carefully trimmed to leave as much of the pigmented portions as possible on the outskirt of the skin flap. The scar was covered with the remaining skin flap, and the uncovered lesion was protected with Vaseline containing gentamicin. The lesion was rapidly covered with regenerated dermis within a week, and the epidermis with round and well-oriented pigmented spots were almost completely restored in four months. The surgical suture of the skin flap after removal of the ulcerated margins resulted in the scar-free regeneration of the scales and the pigmented spots. And the pigmented spots of the remaining skin close to the lesion site might be a source of the regenerated spots.

  5. The Remaining Service Time Upon Reaching a High Level in M/G/1 Queues

    NARCIS (Netherlands)

    de Boer, Pieter-Tjerk; Nicola, V.F.; van Ommeren, Jan C.W.

    The distribution of the remaining service time upon reaching some target level in an M/G/1 queue is of theoretical as well as practical interest. In general, this distribution depends on the initial level as well as on the target level, say, B. Two initial levels are of particular interest, namely,

  6. Beyond Race and Gender: Motivating Enlisted Personnel to Remain in Today's Military

    National Research Council Canada - National Science Library

    Moore, Brenda

    2001-01-01

    ... to remain in the military than do the race, gender, or racial climate variables. Satisfaction with pay and benefits has a significant positive effect on the likelihood that respondents will stay in the military, but pride in service is more robust...

  7. Skeletal Indicators of Shark Feeding on Human Remains: Evidence from Florida Forensic Anthropology Cases.

    Science.gov (United States)

    Stock, Michala K; Winburn, Allysha P; Burgess, George H

    2017-11-01

    This research examines a series of six Florida forensic anthropology cases that exhibit taphonomic evidence of marine deposition and shark-feeding activities. In each case, we analyzed patterns of trauma/damage on the skeletal remains (e.g., sharp-force bone gouges and punctures) and possible mechanisms by which they were inflicted during shark predation/scavenging. In some cases, shark teeth were embedded in the remains; in the absence of this evidence, we measured interdental distance from defects in the bone to estimate shark body length, as well as to draw inferences about the potential species responsible. We discuss similarities and differences among the cases and make comparisons to literature documenting diagnostic shark-inflicted damage to human remains from nearby regions. We find that the majority of cases potentially involve bull or tiger sharks scavenging the remains of previously deceased, adult male individuals. This scavenging results in a distinctive taphonomic signature including incised gouges in cortical bone. © 2017 American Academy of Forensic Sciences.

  8. Remaining Life Estimation Of Secondary Superheater Outlet On Industrial Electrical Boiler

    International Nuclear Information System (INIS)

    Soedardjo; Andryansyah; Arhatari, B.D.; Natsir, Muhammad; Triyadi, Ari; Farokhi

    2001-01-01

    Remaining life estimation of secondary superheater header outlet (SSHO) on industrial electrical boiler has been carried out. Estimation conducted by the observation of microstructure cavitation development based on Neubauer and Wedel theory. The result is available for isolated cavitation development present yet. That Secondary Superheater Outlet component is in good condition after 14 years operated and predicted could be operated for 36 years again

  9. Remaining recoverable petroleum in giant oil fields of the Los Angeles Basin, southern California

    Science.gov (United States)

    Gautier, Donald L.; Tennyson, Marilyn E.; Cook, Troy A.; Charpentier, Ronald R.; Klett, Timothy R.

    2012-01-01

    Using a probabilistic geology-based methodology, a team of U.S. Geological Survey (USGS) scientists recently assessed the remaining recoverable oil in 10 oil fields of the Los Angeles Basin in southern California. The results of the assessment suggest that between 1.4 and 5.6 billion barrels of additional oil could be recovered from those fields with existing technology.

  10. Remaining in an Abusive Relationship: An Investment Model Analysis of Nonvoluntary Dependence.

    Science.gov (United States)

    Rusbult, Caryl E.; Martz, John M.

    1995-01-01

    Analyzes the nature of interdependence in ongoing relationships, using an investment model to understand decisions to remain in abusive relationships. Found that feelings of commitment were greater among women who had poorer-quality economic alternatives, were more heavily invested in their relationship, and who experienced less dissatisfaction…

  11. Fish remains from Miocene beds of Višnja vas near Vojnik, Slovenia

    Directory of Open Access Journals (Sweden)

    Aleš Šoster

    2013-06-01

    Full Text Available This paper discusses fossil teeth of sharks (Elasmobranchii, Neoselachii and porgies (Teleostei, Sparidae fromthe Miocene glauconite sandstones of Vi{nja vas near Vojnik. The remains of fish teeth, mostly tooth crowns, belongto cartilaginous fishes of the genera Notorynchus, Carcharias, Carcharoides, Isurus and Cosmopolitodus and to abony fish genus Pagrus.

  12. Nuclear Weapons Sustainment: Improvements Made to Budget Estimates Report, but Opportunities Remain to Further Enhance Transparency

    Science.gov (United States)

    2015-12-01

    Enhance Transparency Report to Congressional Committees December 2015 GAO-16-23 United States Government Accountability Office United...SUSTAINMENT Improvements Made to Budget Estimates Report, but Opportunities Remain to Further Enhance Transparency Why GAO Did This Study DOD and DOE are...modernization plans and (2) complete, transparent information on the methodologies used to develop those estimates. GAO analyzed the departments

  13. Editorial Forestry faces big issues to remain sustainable — a role for ...

    African Journals Online (AJOL)

    Plantation forestry remains an attractive land use, both from an economic perspective through the production of costeffective wood and from a sustainable development perspective through the generation of jobs in rural areas. The forest industry directly employs over 100 000 people and if one considers that all of plantation ...

  14. New fossil remains of Homo naledi from the Lesedi Chamber, South Africa

    Science.gov (United States)

    Hawks, John; Elliott, Marina; Schmid, Peter; Churchill, Steven E; de Ruiter, Darryl J; Roberts, Eric M; Hilbert-Wolf, Hannah; Garvin, Heather M; Williams, Scott A; Delezene, Lucas K; Feuerriegel, Elen M; Randolph-Quinney, Patrick; Kivell, Tracy L; Laird, Myra F; Tawane, Gaokgatlhe; DeSilva, Jeremy M; Bailey, Shara E; Brophy, Juliet K; Meyer, Marc R; Skinner, Matthew M; Tocheri, Matthew W; VanSickle, Caroline; Walker, Christopher S; Campbell, Timothy L; Kuhn, Brian; Kruger, Ashley; Tucker, Steven; Gurtov, Alia; Hlophe, Nompumelelo; Hunter, Rick; Morris, Hannah; Peixotto, Becca; Ramalepa, Maropeng; van Rooyen, Dirk; Tsikoane, Mathabela; Boshoff, Pedro; Dirks, Paul HGM; Berger, Lee R

    2017-01-01

    The Rising Star cave system has produced abundant fossil hominin remains within the Dinaledi Chamber, representing a minimum of 15 individuals attributed to Homo naledi. Further exploration led to the discovery of hominin material, now comprising 131 hominin specimens, within a second chamber, the Lesedi Chamber. The Lesedi Chamber is far separated from the Dinaledi Chamber within the Rising Star cave system, and represents a second depositional context for hominin remains. In each of three collection areas within the Lesedi Chamber, diagnostic skeletal material allows a clear attribution to H. naledi. Both adult and immature material is present. The hominin remains represent at least three individuals based upon duplication of elements, but more individuals are likely present based upon the spatial context. The most significant specimen is the near-complete cranium of a large individual, designated LES1, with an endocranial volume of approximately 610 ml and associated postcranial remains. The Lesedi Chamber skeletal sample extends our knowledge of the morphology and variation of H. naledi, and evidence of H. naledi from both recovery localities shows a consistent pattern of differentiation from other hominin species. DOI: http://dx.doi.org/10.7554/eLife.24232.001 PMID:28483039

  15. 76 FR 58037 - Notice of Inventory Completion for Native American Human Remains and Associated Funerary Objects...

    Science.gov (United States)

    2011-09-19

    ... Mexico; and Pueblo of Zia, New Mexico. History and Description of the Remains Upon preparation for... Historical Society (History Colorado), Denver, CO; Correction AGENCY: National Park Service, Interior. ACTION...-10909, February 20, 2001). The Colorado Historical Society (History Colorado) completed an inventory of...

  16. How do Older Employees with Health Problems Remain Productive at Work?: A Qualitative Study

    NARCIS (Netherlands)

    Leijten, F.; van den Heuvel, S.; Geuskens, G.; Ybema, J.F.; de Wind, A.; Burdorf, A.; Robroek, S.

    2013-01-01

    Purpose The goal of this qualitative study was to gain insight into how older employees remain productive at work in spite of health problems. Methods Twenty-six semi-structured telephone interviews were conducted with older employees, 46-63 years of age, who reported a poor health in the Study on

  17. Dementia and Friendship: The Quality and Nature of the Relationships That Remain

    Science.gov (United States)

    Harris, Phyllis Braudy

    2013-01-01

    Friendships are an integral part of the human experience. Yet, dementia often takes a toll on social relationships, and many friends withdraw. This research, however, focuses on friendships that remain, despite a diagnosis of dementia. It examines the quality of the friendships of people with dementia and long-term friendships. Data were collected…

  18. Taming Disruptive Technologies, or How To Remain Relevant in the Digital Age.

    Science.gov (United States)

    Blackwell, Philip

    2001-01-01

    Discusses electronic books as a disruptive technology, that is, a technology that has appeal to its users but upsets the traditional models. Highlights include a history of print technology; types of electronic books; reader devices; stakeholders, including users, librarians, and publishers; and how vendors can remain relevant. (LRW)

  19. Stratigraphy and chronology of the WLH 50 human remains, Willandra Lakes World Heritage Area, Australia.

    Science.gov (United States)

    Grün, Rainer; Spooner, Nigel; Magee, John; Thorne, Alan; Simpson, John; Yan, Ge; Mortimer, Graham

    2011-05-01

    We present a detailed description of the geological setting of the burial site of the WLH 50 human remains along with attempts to constrain the age of this important human fossil. Freshwater shells collected at the surface of Unit 3, which is most closely associated with the human remains, and a carbonate sample that encrusted the human bone were analysed. Gamma spectrometry was carried out on the WLH 50 calvaria and TIMS U-series analysis on a small post-cranial bone fragment. OSL dating was applied to a sample from Unit 3 at a level from which the WLH 50 remains may have eroded, as well as from the underlying sediments. Considering the geochemistry of the samples analysed, as well as the possibility of reworking or burial from younger layers, the age of the WLH 50 remains lies between 12.2 ± 1.8 and 32.8 ± 4.6 ka (2-σ errors). Copyright © 2010 Elsevier Ltd. All rights reserved.

  20. Digital Marketing Budgets for Independent Hotels: Continuously Shifting to Remain Competitive in the Online World

    Directory of Open Access Journals (Sweden)

    Leora Halpern Lanz

    2015-08-01

    Full Text Available The hotel marketing budget, typically amounting to approximately 4-5% of an asset’s total revenue, must remain fluid, so that the marketing director can constantly adapt the marketing tools to meet consumer communications methods and demands. This article suggests how an independent hotel can maximize their marketing budget by using multiple channels and strategies.