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Sample records for primary areas related

  1. Modelling multiple hospital outcomes: the impact of small area and primary care practice variation

    Directory of Open Access Journals (Sweden)

    Congdon Peter

    2006-11-01

    Full Text Available Abstract Background: Appropriate management of care – for example, avoiding unnecessary attendances at, or admissions to, hospital emergency units when they could be handled in primary care – is an important part of health strategy. However, some variations in these outcomes could be due to genuine variations in health need. This paper proposes a new method of explaining variations in hospital utilisation across small areas and the general practices (GPs responsible for patient primary care. By controlling for the influence of true need on such variations, one may identify remaining sources of excess emergency attendances and admissions, both at area and practice level, that may be related to the quality, resourcing or organisation of care. The present paper accordingly develops a methodology that recognises the interplay between population mix factors (health need and primary care factors (e.g. referral thresholds, that allows for unobserved influences on hospitalisation usage, and that also reflects interdependence between hospital outcomes. A case study considers relativities in attendance and admission rates at a North London hospital involving 149 small areas and 53 GP practices. Results: A fixed effects model shows variations in attendances and admissions are significantly related (positively to area and practice need, and nursing home patients, and related (negatively to primary care access and distance of patient homes from the hospital. Modelling the impact of known factors alone is not sufficient to produce a satisfactory fit to the observations, and random effects at area and practice level are needed to improve fit and account for overdispersion. Conclusion: The case study finds variation in attendance and admission rates across areas and practices after controlling for need, and remaining differences between practices may be attributable to referral behaviour unrelated to need, or to staffing, resourcing, and access issues. In

  2. Identifying Areas of Primary Care Shortage in Urban Ohio

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    Hsin-Chung Liao

    Full Text Available ABSTRACT: This study considers both spatial and a-spatial variables in examining accessibility to primary healthcare in the three largest urban areas of Ohio (Cleveland, Columbus, and Cincinnati. Spatial access emphasizes the importance of geographic barriers between individuals and primary care physicians, while a-spatial variables include non-geographic barriers or facilitators such as age, sex, race, income, social class, education, living conditions and language skills. Population and socioeconomic data were obtained from the 2000 Census, and primary care physician data for 2008 was provided by the Ohio Medical Board. We first implemented a two-step method based on a floating catchment area using Geographic Information Systems to measure spatial accessibility in terms of 30-minute travel times. We then used principal component analysis to group various socio-demographic variables into three groups: (1 socioeconomic disadvantages, (2 living conditions, and (3 healthcare needs. Finally, spatial and a-spatial variables were integrated to identify areas with poor access to primary care in Cleveland, Columbus, and Cincinnati. KEYWORDS: Geographic information systems, healthcare access, spatial accessibility, primary care shortage areas

  3. Health-related knowledge and behaviour of primary school children ...

    African Journals Online (AJOL)

    There is a serious need for children to be informed about the negative influence of unhealthy living which has become part and parcel of the post-industrial contemporary society. The aim of this study was to investigate the health-related knowledge and behaviour of senior primary school children in the Honeydew area, and ...

  4. The primary motor and premotor areas of the human cerebral cortex.

    Science.gov (United States)

    Chouinard, Philippe A; Paus, Tomás

    2006-04-01

    Brodmann's cytoarchitectonic map of the human cortex designates area 4 as cortex in the anterior bank of the precentral sulcus and area 6 as cortex encompassing the precentral gyrus and the posterior portion of the superior frontal gyrus on both the lateral and medial surfaces of the brain. More than 70 years ago, Fulton proposed a functional distinction between these two areas, coining the terms primary motor area for cortex in Brodmann area 4 and premotor area for cortex in Brodmann area 6. The parcellation of the cortical motor system has subsequently become more complex. Several nonprimary motor areas have been identified in the brain of the macaque monkey, and associations between anatomy and function in the human brain are being tested continuously using brain mapping techniques. In the present review, the authors discuss the unique properties of the primary motor area (M1), the dorsal portion of the premotor cortex (PMd), and the ventral portion of the premotor cortex (PMv). They end this review by discussing how the premotor areas influence M1.

  5. Disparities in the access to primary healthcare in rural areas from the county of Iasi - Romania.

    Science.gov (United States)

    Duma, Olga-Odetta; Roşu, Solange Tamara; Manole, M; Petrariu, F D; Constantin, Brânduşa

    2014-01-01

    To identify the factors that may conduct to various forms of social exclusion of the population from the primary healthcare and to analyze health disparities as population-specific differences in the access to primary healthcare in rural compared to urban residence areas from Iasi, the second biggest county, situated in the North--East region of Romania. This research is a type of inquiry-based opinion survey of the access to primary healthcare in rural compared to urban areas of the county of Iasi. Data were collected by face-to-face interviews. There were taken into account the socioeconomic status (education level in the adult population, employment status, family income, household size) and two temporal variables (the interval of time spent to arrive at the primary healthcare office as a marker for the geographical access and the waiting time for a consultation). The study group consisted of two samples, from rural and urban area, each of 150 patients, all ages, randomly selected, who were waiting at the family doctor's practice. The study has identified disparities related to a poor economic status assessed through the employed status ("not working" 15% in urban and of 20% in rural).The income calculated per member of family and divided in terciles has recorded significant differences for "high" (36.7% urban and 14.7% rural) and "low", respectively (14.6% urban and 56.6% rural). High household size with more than five members represented 22.6% of the total subjects in rural and 15.3% in urban areas. The assessment of the education level in the adult population (> 18 years) revealed that in the rural areas more than a half (56%) of the sample is placed in the category primary and secondary incomplete, whereas the value for secondary complete and postsecondary was 37.3%. The proportion of respondents in the urban areas who have post-secondary education is five times higher than those in rural areas (15.4% vs. 2.7%). The reduced geographical access assessed as

  6. Defining Primary Care Shortage Areas: Do GIS-based Measures Yield Different Results?

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    Daly, Michael R; Mellor, Jennifer M; Millones, Marco

    2018-02-12

    To examine whether geographic information systems (GIS)-based physician-to-population ratios (PPRs) yield determinations of geographic primary care shortage areas that differ from those based on bounded-area PPRs like those used in the Health Professional Shortage Area (HPSA) designation process. We used geocoded data on primary care physician (PCP) locations and census block population counts from 1 US state to construct 2 shortage area indicators. The first is a bounded-area shortage indicator defined without GIS methods; the second is a GIS-based measure that measures the populations' spatial proximity to PCP locations. We examined agreement and disagreement between bounded shortage areas and GIS-based shortage areas. Bounded shortage area indicators and GIS-based shortage area indicators agree for the census blocks where the vast majority of our study populations reside. Specifically, 95% and 98% of the populations in our full and urban samples, respectively, reside in census blocks where the 2 indicators agree. Although agreement is generally high in rural areas (ie, 87% of the rural population reside in census blocks where the 2 indicators agree), agreement is significantly lower compared to urban areas. One source of disagreement suggests that bounded-area measures may "overlook" some shortages in rural areas; however, other aspects of the HPSA designation process likely mitigate this concern. Another source of disagreement arises from the border-crossing problem, and it is more prevalent. The GIS-based PPRs we employed would yield shortage area determinations that are similar to those based on bounded-area PPRs defined for Primary Care Service Areas. Disagreement rates were lower than previous studies have found. © 2018 National Rural Health Association.

  7. Predictors of relational continuity in primary care: patient, provider and practice factors.

    Science.gov (United States)

    Kristjansson, Elizabeth; Hogg, William; Dahrouge, Simone; Tuna, Meltem; Mayo-Bruinsma, Liesha; Gebremichael, Goshu

    2013-05-31

    Continuity is a fundamental tenet of primary care, and highly valued by patients; it may also improve patient outcomes and lower cost of health care. It is thus important to investigate factors that predict higher continuity. However, to date, little is known about the factors that contribute to continuity. The purpose of this study was to analyse practice, provider and patient predictors of continuity of care in a large sample of primary care practices in Ontario, Canada. Another goal was to assess whether there was a difference in the continuity of care provided by different models of primary care. This study is part of the larger a cross-sectional study of 137 primary care practices, their providers and patients. Several performance measures were evaluated; this paper focuses on relational continuity. Four items from the Primary Care Assessment Tool were used to assess relational continuity from the patient's perspective. Multilevel modeling revealed several patient factors that predicted continuity. Older patients and those with chronic disease reported higher continuity, while those who lived in rural areas, had higher education, poorer mental health status, no regular provider, and who were employed reported lower continuity. Providers with more years since graduation had higher patient-reported continuity. Several practice factors predicted lower continuity: number of MDs, nurses, opening on weekends, and having 24 hours a week or less on-call. Analyses that compared continuity across models showed that, in general, Health Service Organizations had better continuity than other models, even when adjusting for patient demographics. Some patients with greater health needs experience greater continuity of care. However, the lower continuity reported by those with mental health issues and those who live in rural areas is concerning. Furthermore, our finding that smaller practices have higher continuity suggests that physicians and policy makers need to consider

  8. Regional structural differences across functionally parcellated Brodmann areas of human primary somatosensory cortex.

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    Sánchez-Panchuelo, Rosa-María; Besle, Julien; Mougin, Olivier; Gowland, Penny; Bowtell, Richard; Schluppeck, Denis; Francis, Susan

    2014-06-01

    Ultra-high-field (UHF) MRI is ideally suited for structural and functional imaging of the brain. High-resolution structural MRI can be used to map the anatomical boundaries between functional domains of the brain by identifying changes related to the pattern of myelination within cortical gray matter, opening up the possibility to study the relationship between functional domains and underlying structure in vivo. In a recent study, we demonstrated the correspondence between functional (based on retinotopic mapping) and structural (based on changes in T2(⁎)-weighted images linked to myelination) parcellations of the primary visual cortex (V1) in vivo at 7T (Sanchez-Panchuelo et al., 2012b). Here, we take advantage of the improved BOLD CNR and high spatial resolution achievable at 7T to study regional structural variations across the functionally defined areas within the primary somatosensory cortex (S1) in individual subjects. Using a traveling wave fMRI paradigm to map the internal somatotopic representation of the index, middle, and ring fingers in S1, we were able to identify multiple map reversals at the tip and base, corresponding to the boundaries between Brodmann areas 3a, 3b, 1 and 2. Based on high resolution structural MRI data acquired in the same subjects, we inspected these functionally-parcellated Brodmann areas for differences in cortical thickness and MR contrast measures (magnetization transfer ratio (MTR) and signal intensity in phase sensitive inversion recovery (PSIR) images) that are sensitive to myelination. Consistent area-related differences in cortical thickness and MTR/PSIR measurements were found across subjects. However these measures did not have sufficient sensitivity to allow definition of areal boundaries. Copyright © 2013 Elsevier Inc. All rights reserved.

  9. Relational Aggression: The Voices of Primary School Learners

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    Botha, Johan

    2014-01-01

    The aim of this research was to explore and describe primary school learners' experiences of relational aggression at school. This was done within a qualitative research design with a phenomenological approach. In order to give a voice to primary school learners' lived experiences of relational aggression, 25 individual interviews were conducted…

  10. Unequal socioeconomic distribution of the primary care workforce: whole-population small area longitudinal study.

    Science.gov (United States)

    Asaria, Miqdad; Cookson, Richard; Fleetcroft, Robert; Ali, Shehzad

    2016-01-19

    To measure changes in socioeconomic inequality in the distribution of family physicians (general practitioners (GPs)) relative to need in England from 2004/2005 to 2013/2014. Whole-population small area longitudinal data linkage study. England from 2004/2005 to 2013/2014. 32,482 lower layer super output areas (neighbourhoods of 1500 people on average). Slope index of inequality (SII) between the most and least deprived small areas in annual full-time equivalent GPs (FTE GPs) per 100,000 need adjusted population. In 2004/2005, inequality in primary care supply as measured by the SII in FTE GPs was 4.2 (95% CI 3.1 to 5.3) GPs per 100,000. By 2013/2014, this SII had fallen to -0.7 (95% CI -2.5 to 1.1) GPs per 100,000. The number of FTE GPs per 100,000 serving the most deprived fifth of small areas increased over this period from 54.0 to 60.5, while increasing from 57.2 to 59.9 in the least deprived fifth, so that by the end of the study period there were more GPs per 100,000 need adjusted population in the most deprived areas than in the least deprived. The increase in GP supply in the most deprived fifth of neighbourhoods was larger in areas that received targeted investment for establishing new practices under the 'Equitable Access to Primary Medical Care'. There was a substantial reduction in socioeconomic inequality in family physician supply associated with national policy. This policy may not have completely eliminated socioeconomic inequality in family physician supply since existing need adjustment formulae do not fully capture the additional burden of multimorbidity in deprived neighbourhoods. The small area approach introduced in this study can be used routinely to monitor socioeconomic inequality of access to primary care and to indicate workforce shortages in particular neighbourhoods. http://creativecommons.org/licenses/by/4.0. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to

  11. Walkability around primary schools and area deprivation across Scotland.

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    Macdonald, Laura; McCrorie, Paul; Nicholls, Natalie; Ellaway, Anne

    2016-04-14

    A number of studies based in the US, Canada, and Australia, have found evidence of associations between the built environment (BE) and mode of transport to school, and links between active travel and deprivation. Limited research in the UK compares potential BE supports for walking to school by area deprivation. Within this study, we gathered data on BE attributes previously linked to active travel, i.e., street/path connectivity, and dwelling density, created a composite 'walkability score' (WS) for areas around primary schools across urban Scotland, and explored whether poorer areas exhibit lower scores than more affluent areas, or vice versa. We consider this to be a novel approach as few studies have compared BE features by deprivation across a whole country. Address and road/path maps were obtained and primary schools (N = 937) across mainland Scotland were mapped. Schools were attributed income deprivation scores (scores divided into quintiles (Q1: least deprived, Q5: most deprived)). Catchment area (CA) boundaries, i.e., the geographic area representing eligibility for local school attendance, were drawn around schools, and WS calculated for each CA. We compared mean WS by income quintile (ANOVA), for all local authorities (LAs) combined (N = 29), and separately for the four LAs with the greatest number of schools included in the analysis. For all LAs combined, the least deprived quintile (Q1) showed a significantly lower WS (-0.61), than quintiles 3, 4 and 5 (Q2: -0.04 (non-sig), Q3: 0.38, Q4: 0.09, Q5: 0.18); while for Glasgow the second least deprived quintile (Q2) showed significantly higher WS (Q1: 1.35, Q2: 1.73), than middling (Q3: 0.18) and most deprived quintiles (Q4: 0.06, Q5: -0.10). WS differ by deprivation with patterns varying depending on the spatial scale of the analysis. It is essential that less walkable areas are provided with the resources to improve opportunities to engage in active travel.

  12. Work-Related Depression in Primary Care Teams in Brazil.

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    da Silva, Andréa Tenório Correia; Lopes, Claudia de Souza; Susser, Ezra; Menezes, Paulo Rossi

    2016-11-01

    To identify work-related factors associated with depressive symptoms and probable major depression in primary care teams. Cross-sectional study among primary care teams (community health workers, nursing assistants, nurses, and physicians) in the city of São Paulo, Brazil (2011-2012; n = 2940), to assess depressive symptoms and probable major depression and their associations with job strain and other work-related conditions. Community health workers presented higher prevalence of probable major depression (18%) than other primary care workers. Higher odds ratios for depressive symptoms or probable major depression were associated with longer duration of employment in primary care; having a passive, active, or high-strain job; lack of supervisor feedback regarding performance; and low social support from colleagues and supervisors. Observed levels of job-related depression can endanger the sustainability of primary care programs. Public Health implications. Strategies are needed to deliver care to primary care workers with depression, facilitating diagnosis and access to treatment, particularly in low- and middle-income countries. Preventive interventions can include training managers to provide feedback and creating strategies to increase job autonomy and social support at work.

  13. [Primary Health Care in Austria - Tu Felix Austria nube - Concept for networking in the primary care of Upper Austria].

    Science.gov (United States)

    Kriegel, Johannes; Rebhandl, Erwin; Hockl, Wolfgang; Stöbich, Anna-Maria

    2017-10-01

    The primary health care in rural areas in Austria is currently determined by challenges such as ageing of the population, the shift towards chronic and age-related illnesses, the specialist medical and hospital-related education and training of physicians' as well growing widespread difficulty of staffing doctor's office. The objective is to realize a general practitioner centered and team-oriented primary health care (PHC) approach by establishing networked primary health care in rural areas of Austria. Using literature research, online survey, expert interviews and expert workshops, we identified different challenges in terms of primary health care in rural areas. Further, current resources and capacities of primary health care in rural areas were identified using the example of the district of Rohrbach. Twelve design dimensions and 51 relevant measurement indicators of a PHC network were delineated and described. Based on this, 12 design approaches of PHC concept for the GP-centered and team-oriented primary health care in rural areas have been developed.

  14. Relational aggression: the voices of primary school learners

    Directory of Open Access Journals (Sweden)

    Johan Botha

    2014-06-01

    Full Text Available The aim of this research was to explore and describe primary school learners' experiences of relational aggression at school. This was done within a qualitative research design with a phenomenological approach. In order to give a voice to primary school learners' lived experiences of relational aggression, 25 individual interviews were conducted with a purposeful sample of learners from two primary schools in the Dr Kenneth Kaunda District, North-West Province. Data analysis was done using Tesch's systematic open coding process. Social Learning Theory underscored the theoretical foundation that emphasises relational aggression as a socially learned phenomenon through observation. Although existing theory supports the findings, the reality, however, is that the effects of relational aggression impede negatively on learners' social and academic development and well-being. This jeopardises schools' endeavours to effectively socialise learners in order to establish and maintain effective personal and social relationships. Curtailing relational aggression has the possibility of reducing other forms of aggression in schools and will enhance the creation of effective teaching-learning environments that are conducive to teaching and learning that will support the task of schooling, which is the socialisation of learners to optimally achieve their potential in schools. The article provides some suggestions to assist teachers in endeavours to effectively curtail relational aggression.

  15. Structure of Primary Health Care: Lessons from a Rural Area in ...

    African Journals Online (AJOL)

    Structure of Primary Health Care: Lessons from a Rural Area in South-West Nigeria. ... of the facilities enjoyed community participation in planning and management. There ... None of the facilities had a functional 2-way referral system in place.

  16. Coding Theory, Cryptography and Related Areas

    DEFF Research Database (Denmark)

    Buchmann, Johannes; Stichtenoth, Henning; Tapia-Recillas, Horacio

    Proceedings of anInternational Conference on Coding Theory, Cryptography and Related Areas, held in Guanajuato, Mexico. in april 1998......Proceedings of anInternational Conference on Coding Theory, Cryptography and Related Areas, held in Guanajuato, Mexico. in april 1998...

  17. Inhalation of primary motor vehicle emissions: Effects of urbanpopulation and land area

    Energy Technology Data Exchange (ETDEWEB)

    Marshall, Julian D.; McKone, Thomas E.; Nazaroff, William W.

    2004-06-14

    Urban population density can influence transportation demand, as expressed through average daily vehicle-kilometers traveled per capita (VKT). In turn, changes in transportation demand influence total passenger vehicle emissions. Population density can also influence the fraction of total emissions that are inhaled by the exposed urban population. Equations are presented that describe these relationships for an idealized representation of an urban area. Using analytic solutions to these equations, we investigate the effect of three changes in urban population and urban land area (infill, sprawl, and constant-density growth) on per capita inhalation intake of primary pollutants from passenger vehicles. The magnitude of these effects depends on density-emissions elasticity ({var_epsilon}{sub e}), a normalized derivative relating change in population density to change in vehicle emissions. For example, if urban population increases, per capita intake is less with infill development than with constant-density growth if {var_epsilon}{sub e} is less than -0.5, while for {var_epsilon}{sub e} greater than -0.5 the reverse is true.

  18. Prehypertension and hypertension among young Indonesian adults at a primary health care in a rural area

    Directory of Open Access Journals (Sweden)

    Felix F. Widjaja

    2013-02-01

    Full Text Available Background: Prehypertension and hypertension were related with many complications of nearly every organ, but often neglected by young adults in rural area. This research was done to observe the prevalence of prehypertension and hypertension among young adult in a primary health care of rural area at Cicurug, Sukabumi District, West Java.Methods: This cross-sectional study was done in Cicurug Public Health Center, Sukabumi District, West Java. The subjects were consecutively recruited from the outpatient clinic on Monday until Saturday in September 2012,18–25 years old, not pregnant nor having shock. They were interviewed about their age, gender, physical activity, sitting hours, smoking habit, alcohol consumption, and family history and examined by trained health professionals (weight, height, body mass index [BMI], systolic and diastolic blood pressure.Results: From 111 young adults, 34.2% had prehypertension and 17.1% had hypertension. Within sex groups, the prevalence of prehypertension was higher in females, whereas hypertension was occurred more in males. Neither of family history from mother nor father were associated with prehypertension and hypertension compared with normotension. Total activity was not associated with prehypertension (OR = 2.6; p = 0.052 and hypertension (OR = 1.758; p = 0.498. BMI was associated with hypertension (OR = 3.354; p = 0.041 and not associated with prehypertension (OR = 2.343; p = 0.099.Conclusion: Prevalence of prehypertension and hypertension were relatively high among young adult in primary health care of rural area. Intervention to prevent further complications needs to be done early with lifestyle modification because blood pressure is associated with modifiable risk factors, such as BMI and total activity. (Med J Indones. 2013;22:39-45Keywords: Hypertension, prehypertension, rural area, young adult

  19. Shared "core" areas between the pain and other task-related networks.

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    Franco Cauda

    Full Text Available The idea of a 'pain matrix' specifically devoted to the processing of nociceptive inputs has been challenged. Alternative views now propose that the activity of the primary and secondary somatosensory cortices (SI, SII, the insula and cingulate cortex may be related to a basic defensive system through which significant potentially dangerous events for the body's integrity are detected. By reviewing the role of the SI, SII, the cingulate and the insular cortices in the perception of nociceptive and tactile stimuli, in attentional, emotional and reward tasks, and in interoception and memory, we found that all these task-related networks overlap in the dorsal anterior cingulate cortex, the anterior insula and the dorsal medial thalamus. A thorough analysis revealed that the 'pain-related' network shares important functional similarities with both somatomotor-somatosensory networks and emotional-interoceptive ones. We suggest that these shared areas constitute the central part of an adaptive control system involved in the processing and integration of salient information coming both from external and internal sources. These areas are activated in almost all fMRI tasks and have been indicated to play a pivotal role in switching between externally directed and internally directed brain networks.

  20. Access to primary care for socioeconomically disadvantaged older people in rural areas: a realist review.

    Science.gov (United States)

    Ford, John A; Wong, Geoff; Jones, Andy P; Steel, Nick

    2016-05-17

    The aim of this review is to identify and understand the contexts that effect access to high-quality primary care for socioeconomically disadvantaged older people in rural areas. A realist review. MEDLINE and EMBASE electronic databases and grey literature (from inception to December 2014). Broad inclusion criteria were used to allow articles which were not specific, but might be relevant to the population of interest to be considered. Studies meeting the inclusion criteria were assessed for rigour and relevance and coded for concepts relating to context, mechanism or outcome. An overarching patient pathway was generated and used as the basis to explore contexts, causal mechanisms and outcomes. 162 articles were included. Most were from the USA or the UK, cross-sectional in design and presented subgroup data by age, rurality or deprivation. From these studies, a patient pathway was generated which included 7 steps (problem identified, decision to seek help, actively seek help, obtain appointment, get to appointment, primary care interaction and outcome). Important contexts were stoicism, education status, expectations of ageing, financial resources, understanding the healthcare system, access to suitable transport, capacity within practice, the booking system and experience of healthcare. Prominent causal mechanisms were health literacy, perceived convenience, patient empowerment and responsiveness of the practice. Socioeconomically disadvantaged older people in rural areas face personal, community and healthcare barriers that limit their access to primary care. Initiatives should be targeted at local contextual factors to help individuals recognise problems, feel welcome, navigate the healthcare system, book appointments easily, access appropriate transport and have sufficient time with professional staff to improve their experience of healthcare; all of which will require dedicated primary care resources. Published by the BMJ Publishing Group Limited. For

  1. Cementoblastoma Relating to Right Mandibular Second Primary Molar

    Directory of Open Access Journals (Sweden)

    Sivakumar Nuvvula

    2016-01-01

    Full Text Available Cementoblastoma is a benign lesion of the odontogenic ectomesenchymal origin. It rarely occurs in primary dentition. This report describes a case of a cementoblastoma relating to the right mandibular second primary molar in a 7-year-old girl. Her panoramic radiograph revealed a well-defined radiopaque lesion with a radiolucent border extending from the distal surface of the mandibular right first primary molar to the distal surface of mandibular second primary molar. The tumor was attached to the mesial root of primary second molar and was excised along with the teeth involved and sent for histopathological evaluation, which showed irregular trabeculae of mineralized tissue interspersed with fibrovascular connective tissue, trabeculae of mineralized tissue with prominent reversal lines, and peripheral rimming of the mineralized tissue with blast cells. On a six-month follow-up, there has been no recurrence of the lesion.

  2. Is proportion burned severely related to daily area burned?

    International Nuclear Information System (INIS)

    Birch, Donovan S; Morgan, Penelope; Smith, Alistair M S; Kolden, Crystal A; Hudak, Andrew T

    2014-01-01

    The ecological effects of forest fires burning with high severity are long-lived and have the greatest impact on vegetation successional trajectories, as compared to low-to-moderate severity fires. The primary drivers of high severity fire are unclear, but it has been hypothesized that wind-driven, large fire-growth days play a significant role, particularly on large fires in forested ecosystems. Here, we examined the relative proportion of classified burn severity for individual daily areas burned that occurred during 42 large forest fires in central Idaho and western Montana from 2005 to 2007 and 2011. Using infrared perimeter data for wildfires with five or more consecutive days of mapped perimeters, we delineated 2697 individual daily areas burned from which we calculated the proportions of each of three burn severity classes (high, moderate, and low) using the differenced normalized burn ratio as mapped for large fires by the Monitoring Trends in Burn Severity project. We found that the proportion of high burn severity was weakly correlated (Kendall τ = 0.299) with size of daily area burned (DAB). Burn severity was highly variable, even for the largest (95th percentile) in DAB, suggesting that other variables than fire extent influence the ecological effects of fires. We suggest that these results do not support the prioritization of large runs during fire rehabilitation efforts, since the underlying assumption in this prioritization is a positive relationship between severity and area burned in a day. (letters)

  3. Non-primary motor areas in the human frontal lobe are connected directly to hand muscles.

    Science.gov (United States)

    Teitti, S; Määttä, S; Säisänen, L; Könönen, M; Vanninen, R; Hannula, H; Mervaala, E; Karhu, J

    2008-04-15

    Structural studies in primates have shown that, in addition to the primary motor cortex (M1), premotor areas are a source of corticospinal tracts. The function of these putative corticospinal neuronal tracts in humans is still unclear. We found frontal non-primary motor areas (NPMAs), which react to targeted non-invasive magnetic pulses and activate peripheral muscles as fast as or even faster than those in M1. Hand muscle movements were observed in all our subjects about 20 ms after transcranial stimulation of the superior frontal gyrus (Brodmann areas 6 and 8). Stimulation of NPMA could activate both proximal and distal upper limb muscles with the same delay as a stimulation of the M1, indicating converging motor representations with direct functional connections to the hand. We suggest that these non-primary cortical motor representations provide additional capacity for the fast execution of movements. Such a capacity may play a role in motor learning and in recovery from motor deficits.

  4. Relative importance of climate changes at different time scales on net primary productivity-a case study of the Karst area of northwest Guangxi, China.

    Science.gov (United States)

    Liu, Huiyu; Zhang, Mingyang; Lin, Zhenshan

    2017-10-05

    Climate changes are considered to significantly impact net primary productivity (NPP). However, there are few studies on how climate changes at multiple time scales impact NPP. With MODIS NPP product and station-based observations of sunshine duration, annual average temperature and annual precipitation, impacts of climate changes at different time scales on annual NPP, have been studied with EEMD (ensemble empirical mode decomposition) method in the Karst area of northwest Guangxi, China, during 2000-2013. Moreover, with partial least squares regression (PLSR) model, the relative importance of climatic variables for annual NPP has been explored. The results show that (1) only at quasi 3-year time scale do sunshine duration and temperature have significantly positive relations with NPP. (2) Annual precipitation has no significant relation to NPP by direct comparison, but significantly positive relation at 5-year time scale, which is because 5-year time scale is not the dominant scale of precipitation; (3) the changes of NPP may be dominated by inter-annual variabilities. (4) Multiple time scales analysis will greatly improve the performance of PLSR model for estimating NPP. The variable importance in projection (VIP) scores of sunshine duration and temperature at quasi 3-year time scale, and precipitation at quasi 5-year time scale are greater than 0.8, indicating important for NPP during 2000-2013. However, sunshine duration and temperature at quasi 3-year time scale are much more important. Our results underscore the importance of multiple time scales analysis for revealing the relations of NPP to changing climate.

  5. [Variations in antihypertensive drug utilization among primary care areas in the autonomous region of Valencia (Spain)].

    Science.gov (United States)

    Sanfélix-Gimeno, Gabriel; Peiró, Salvador; Librero, Julián

    2010-01-01

    To estimate consumption of five subgroups of antihypertensive drugs by primary care areas and to analyze its variation. We performed an ecological, descriptive study of antihypertensive consumption in 239 primary care areas in the autonomous region of Valencia in 2005 followed by analysis of the variability observed. The 239 primary care areas were studied by descriptive analysis of dispensation [defined daily dose (DDD) per 1,000 inhabitants/day in pensioners (DDD/1000p/day) and in the active population (DDD/1000a/day)] and standardized consumption ratios. Small-area variation analysis was used to analyze the observed variability. Associations among dispensations of the distinct therapeutic subgroups were also analyzed. Overall antihypertensive use in the autonomous region of Valencia in 2005 was 235.6DDD/1000/day. This consumption was concentrated in pensioners (800DDD/1000p/day vs. 73DDD/1000a/day). Consumption of antihypertensive subgroups oscillated from 442DDD/1000p/day for drugs with action on the renin-angiotensin system to 32DDD/1000p/day for doxazosin. The active population showed similar patterns. Variation in consumption was moderate, with coefficients of variation from 0.20 to 0.40 (slightly greater for the active population). Associations among dispensations of the different therapeutic subgroups were strong. This study shows major variations in the overall consumption of antihypertensive drugs among primary care areas of the autonomous region of Valencia. These results suggest that variation may be associated with problems of underutilization in areas with lower consumption. Copyright © 2010 SESPAS. Published by Elsevier Espana. All rights reserved.

  6. Implication of the displacement of the T1 primary target in the west area at the CERN SPS

    CERN Document Server

    Gatignon, L

    1999-01-01

    As soon as the transfer line T12 for proton injection into the LHC must be installed, the T1 primary target has to be at least partly dismantled, as its shielding would block the passage of the beam. Even though the installation of T12 is only foreseen for later, in view of sharing of workload related to the SLI project, it is preferred to move the primary production target T1 for the West Area to its new position already in the shutdown 1999/2000. The new position of the target requires major modifications of support structures in TCC6, of the transfer line towards T1 and of a more than 500 metres long section of the H3 secondary beam in the West Area, all to be completed in the 1999/2000 shutdown. To allow the work to be finished in time, part of it (including some civil engineering in TT4) is already done in the 1998/99 shutdown. In this memo the necessary modifications are described, cost estimates are given and a planning is provided.

  7. Current Knowledge of Leishmania Vectors in Mexico: How Geographic Distributions of Species Relate to Transmission Areas

    Science.gov (United States)

    González, Camila; Rebollar-Téllez, Eduardo A.; Ibáñez-Bernal, Sergio; Becker-Fauser, Ingeborg; Martínez-Meyer, Enrique; Peterson, A. Townsend; Sánchez-Cordero, Víctor

    2011-01-01

    Leishmaniases are a group of vector-borne diseases with different clinical manifestations caused by parasites transmitted by sand fly vectors. In Mexico, the sand fly Lutzomyia olmeca olmeca is the only vector proven to transmit the parasite Leishmania mexicana to humans, which causes leishmaniasis. Other vector species with potential medical importance have been obtained, but their geographic distributions and relation to transmission areas have never been assessed. We modeled the ecological niches of nine sand fly species and projected niches to estimate potential distributions by using known occurrences, environmental coverages, and the algorithms GARP and Maxent. All vector species were distributed in areas with known recurrent transmission, except for Lu. diabolica, which appeared to be related only to areas of occasional transmission in northern Mexico. The distribution of Lu. o. olmeca does not overlap with all reported cutaneous leishmaniasis cases, suggesting that Lu. cruciata and Lu. shannoni are likely also involved as primary vectors in those areas. Our study provides useful information of potential risk areas of leishmaniasis transmission in Mexico. PMID:22049037

  8. Factors Related to the Work Performance of Midwives in the IUD Contraception Service in Primary Healthcare Centers of Surabaya City

    OpenAIRE

    Anggasari, Yasi; Kartasurya, Martha Irene; Suparwati, Anneke

    2013-01-01

    The decrease of IUD active family planning participants' coverage in Surabaya in the last three years, from 12.27% to 6.1%, became a special attention for Surabaya district health office. The decrease was caused by inadequate work performance of midwives in implementing IUD contraception service in the primary healthcare centers in Surabaya area. Objective of the study was to analyze factors related to the work performance of midwives in the IUD contraception service in the primary healthcare...

  9. [Professional quality of life in workers of the Toledo primary care health area].

    Science.gov (United States)

    Villarín Castro, A; Méndez García, T; Zuzuárregui Gironés, M S; Sánchez Serrano, S; Conejo Ocaña, R

    2015-01-01

    To determine the professional quality of life in the workers of the Toledo Primary Care Health Area and to analyse its components. Descriptive, cross-sectional study, performed on workers of the Toledo Primary Care Health Area with an online self-administered questionnaire. age, sex, health centre, professional group, seniority, management experience, collaboration in working groups, employment situation, and the PQL-35 professional quality of life questionnaire. A total of 430 completed questionnaires were received (45.3%), of which 68.4% were women. The mean age was 47.7±8.6 years old. Mean seniority was 21.5±9.7 years. PQL-35 results were: perception of management support 4.8±1.5; perception of workload 6.2±1.3; intrinsic motivation 7.9±1.1; job disconnection capacity 6.3±2.6; and professional quality of life 5.2±2.1. Gender differences were found in perception of management support (4.5±1.5 in males vs 4.9±1.5 in females; P=.031) and professional quality of life (4.9±2.0 vs 5.3±2.1; p=.044). Depending on the professional group, differences were found in the perception of workload (6.4±1.1 in physicians, 6.3±1.3 in nurses, 5.9±1.6 in non-sanitary professionals, and 5.3±1.2 in support units professionals; Pquality of life in the workers of the Toledo Primary Care Health Area is similar to that of other Spanish Health Areas, even in a time of economic crisis. The intrinsic motivation of the professionals is very high, in contrast with their high perception of workload and their low perception of management support. Copyright © 2014 SECA. Published by Elsevier Espana. All rights reserved.

  10. Gender-related differences in student achievements in primary teacher education.

    NARCIS (Netherlands)

    Geerdink, G.; Bergen, T.C.M.; Dekkers, H.

    2007-01-01

    It was primarily the feminisation of primary education that spurred the research project reported on here. Feminisation is not only caused by the small percentage of male students opting for primary teacher training but also due to the relatively large percentage of male students in a teacher

  11. Forming Entrepreneurial Mindsets? Preliminary Evidence of Teaching Practices from Primary Schools in a Developing Area in South America

    Directory of Open Access Journals (Sweden)

    Maria Auxiliadora N. Figueiredo-Nery

    2008-08-01

    Full Text Available Over the past few years there has been a renewed interest by governments, companies and academics in the role of entrepreneurship in innovation and economic growth. There has also been a proliferation of studies on education for entrepreneurship in industrialised and developing countries. However, by addressing ‘entrepreneurship’ in terms of SMEs and high-tech start-ups, they overlook: (i the blurring distinctions between entrepreneurial and managerial capitalism, (ii an erosion of the Schumpeterian dichotomy between large and small firms, and (iii the growing importance of entrepreneurial management within companies as a source for economic growth. Additionally, ‘entrepreneurship’ tends to be taught as a stand-alone topic in higher education and business/non-business courses. Empirical studies related to entrepreneurship education within primary schools, especially in least developed locations in developing countries, are largely missing in this field. Drawing on first-hand empirical evidence from primary schools in a developing area in South America, this paper examines the incidence and functioning of pedagogic practices potentially related to the initial formation of entrepreneurial mindsets. The findings show that, despite some efforts, the researched schools suffered from, not surprisingly, inadequate physical conditions and, most importantly, teachers’ unawareness and deficient qualification related to the adoption of these techniques. These problems seemed to prevent children from developing important features of their initial entrepreneurial mindsets. Thus, if companies and countries want to secure their sources of revolutionary ideas and continuous and des-continuous innovation, they need to have a long-term commitment to continuously develop and nurture the seeds for their future innovative knowledge bases. Specifically, a comprehensive, long-term, geographically and socially inclusive perspective on entrepreneurship

  12. Direct observation of weight-related communication in primary care: a systematic review.

    Science.gov (United States)

    McHale, Calum T; Laidlaw, Anita H; Cecil, Joanne E

    2016-08-01

    Primary care is ideally placed to play an effective role in patient weight management; however, patient weight is seldom discussed in this context. A synthesis of studies that directly observe weight discussion in primary care is required to more comprehensively understand and improve primary care weight-related communication. To systematically identify and examine primary care observational research that investigates weight-related communication and its relationship to patient weight outcomes. A systematic review of literature published up to August 2015, using seven electronic databases (including MEDLINE, Scopus and PsycINFO), was conducted using search terms such as overweight, obese and/or doctor-patient communication. Twenty papers were included in the final review. Communication analysis focused predominantly on 'practitioner' use of specific patient-centred communication. Practitioner use of motivational interviewing was associated with improved patient weight-related outcomes, including patient weight loss and increased patient readiness to lose weight; however, few studies measured patient weight-related outcomes. Studies directly observing weight-related communication in primary care are scarce and limited by a lack of focus on patient communication and patient weight-related outcomes. Future research should measure practitioner and patient communications during weight discussion and their impact on patient weight-related outcomes. This knowledge may inform the development of a communication intervention to assist practitioners to more effectively discuss weight with their overweight and/or obese patients. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  13. The English Education in Primary Schools in Minor Ethnic Areas in Western China--Taking Leshan City as an Example

    Science.gov (United States)

    Bing, Wang

    2016-01-01

    As we all know, China is a country with many ethnic minorities mainly living in the northeastern and southwestern China. The English education in the primary schools in these areas is an important issue. The article analyzes the status quo of English education in primary schools in minor ethnic areas, taking the Leshan city, a western one as an…

  14. Research progress on related genes for primary open angle glaucoma

    Directory of Open Access Journals (Sweden)

    Ailijiang·Aierken

    2014-04-01

    Full Text Available Primary open angle glaucoma(POAGis the main cause of blindness with visual field damage and optic nerve degeneration. In recent years, a lot of researches have been done, showing that genetic factors and gene mutation play an important role in POAG. There are more than 20 related POAG genes. Now we will review the related genes of POAG, especially the well known causative genes of MYOC, OPTN, WDR36, and CAV1/CAV2, in terms of their locations, structures, research progress, et al, and provide a reference for genetic research in primary open-angle glaucoma.

  15. Outcomes of primary repair and primary anastomosis in war-related colon injuries.

    Science.gov (United States)

    Vertrees, Amy; Wakefield, Matthew; Pickett, Chris; Greer, Lauren; Wilson, Abralena; Gillern, Sue; Nelson, Jeffery; Aydelotte, Jayson; Stojadinovic, Alexander; Shriver, Craig

    2009-05-01

    The role of primary repair (PR) of modern day war-related colon injuries remains controversial. Retrospective review of medical records of combat-wounded soldiers with colon injuries sustained during March 2003 to August 2006 was conducted. Injuries were analyzed according to location: right (n = 30), transverse (n = 13), and left (n = 24) sided colon injuries. Two-tailed Fisher's Exact or chi tests were used for statistical analysis. Seventy-seven soldiers returned to Walter Reed Army Medical Center with colon injuries suffered during Operations Enduring Freedom and Iraqi Freedom. Twelve patients with minor colon injuries were excluded. The remaining 65 patients (mean age, 28 +/- 7 years) sustained 67 colon injuries from secondary blast (n = 38); gunshot (n = 27); motor vehicle crash (n = 1) and crush injury (n = 1). Patients arrived at Walter Reed Army Medical Center 5 days (range, 2-16 days) after injury and damage control operations (n = 27, 42%), and were hospitalized for a median of 22 days (range, 1-306 days). Follow-up averaged 311 days (median, 198 days). PR was attempted in right (n = 18, 60%), transverse (n = 11, 85%), and left (n = 9, 38%) sided colon injuries. Delayed definitive treatment of colon injuries occurred in 42% of patients. Failure of repair occurred in 16% of patients and was more likely with concomitant pancreatic, stomach, splenic, diaphragm, and renal injuries. Overall morbidity for ostomy closure after primary ostomy formation was 30%, but increased to 75% for ostomy closure after primary anastomotic or repair failure. PR of war-related colon injuries can be performed safely in selected circumstances in the absence of concomitant organ injury. Delayed anastomosis can often be performed after damage control operations once the patient stabilizes. Ostomy closure complications are more likely after anastomotic failure.

  16. From Hearing Sounds to Recognizing Phonemes: Primary Auditory Cortex is A Truly Perceptual Language Area

    Directory of Open Access Journals (Sweden)

    Byron Bernal

    2016-11-01

    Full Text Available The aim of this article is to present a systematic review about the anatomy, function, connectivity, and functional activation of the primary auditory cortex (PAC (Brodmann areas 41/42 when involved in language paradigms. PAC activates with a plethora of diverse basic stimuli including but not limited to tones, chords, natural sounds, consonants, and speech. Nonetheless, the PAC shows specific sensitivity to speech. Damage in the PAC is associated with so-called “pure word-deafness” (“auditory verbal agnosia”. BA41, and to a lesser extent BA42, are involved in early stages of phonological processing (phoneme recognition. Phonological processing may take place in either the right or left side, but customarily the left exerts an inhibitory tone over the right, gaining dominance in function. BA41/42 are primary auditory cortices harboring complex phoneme perception functions with asymmetrical expression, making it possible to include them as core language processing areas (Wernicke’s area.

  17. Do Quiet Areas Afford Greater Health-Related Quality of Life than Noisy Areas?

    Directory of Open Access Journals (Sweden)

    Kim N. Dirks

    2013-03-01

    Full Text Available People typically choose to live in quiet areas in order to safeguard their health and wellbeing. However, the benefits of living in quiet areas are relatively understudied compared to the burdens associated with living in noisy areas. Additionally, research is increasingly focusing on the relationship between the human response to noise and measures of health and wellbeing, complementing traditional dose-response approaches, and further elucidating the impact of noise and health by incorporating human factors as mediators and moderators. To further explore the benefits of living in quiet areas, we compared the results of health-related quality of life (HRQOL questionnaire datasets collected from households in localities differentiated by their soundscapes and population density: noisy city, quiet city, quiet rural, and noisy rural. The dose-response relationships between noise annoyance and HRQOL measures indicated an inverse relationship between the two. Additionally, quiet areas were found to have higher mean HRQOL domain scores than noisy areas. This research further supports the protection of quiet locales and ongoing noise abatement in noisy areas.

  18. New Area Law in General Relativity.

    Science.gov (United States)

    Bousso, Raphael; Engelhardt, Netta

    2015-08-21

    We report a new area law in general relativity. A future holographic screen is a hypersurface foliated by marginally trapped surfaces. We show that their area increases monotonically along the foliation. Future holographic screens can easily be found in collapsing stars and near a big crunch. Past holographic screens exist in any expanding universe and obey a similar theorem, yielding the first rigorous area law in big bang cosmology. Unlike event horizons, these objects can be identified at finite time and without reference to an asymptotic boundary. The Bousso bound is not used, but it naturally suggests a thermodynamic interpretation of our result.

  19. The silent partners? Leading parental involvement in primary schools in areas experiencing educational inequality.

    OpenAIRE

    O'Reilly, Siobhan

    2012-01-01

    This research project explored and examined parental involvement in two primary school with an emphasis on ‘leading’ this involvement. Both schools were situated in designated DEIS Urban Band 1 areas in Dublin. DEIS Urban Band 1 schools are identified as areas of high levels of socioeconomic disadvantage. The project was contextualised within the current national policy which has committed to parents as partners in their child’s education and the evidence from international literature clearly...

  20. Targeting breast cancer outcomes-what about the primary relatives?

    LENUS (Irish Health Repository)

    Johnston, Alison

    2017-07-01

    Up to 65% of newly diagnosed breast cancer patients had not been screened correctly before diagnosis resulting in increased stage of cancer at presentation. This study assessed whether their primary relatives are, in turn, assessed appropriately.

  1. Living with schizophrenia: Health-related quality of life among primary family caregivers.

    Science.gov (United States)

    Hsiao, Chiu-Yueh; Lee, Chun-Te; Lu, Huei-Lan; Tsai, Yun-Fang

    2017-12-01

    To examine influencing factors of health-related quality of life in primary family caregivers of people with schizophrenia receiving inpatient psychiatric rehabilitation services. Families, particularly primary family caregivers, have become more important than ever in mental health care. Yet, research on health-related quality of life among primarily family caregivers is limited. A correlational study design was used. A convenience sample of 122 primary family caregivers participated in the study. Data were analysed with descriptive statistics, Pearson's product-moment correlation, t test, one-way analysis of variance and a hierarchical multiple regression analysis. Primary family caregivers who were parents, older, less educated, and had a lower monthly household income, increased affiliate stigma and decreased quality of family-centred care experienced poor health-related quality of life. Particularly, monthly household income, affiliate stigma and quality of family-centred care appeared to be the most critical determinants of health-related quality of life. Efforts to enhance satisfaction of life should focus on reducing affiliate stigma as well as increasing monthly household income and strengthening the quality of family-centred care. Findings may assist in the development of culturally integrated rehabilitation programmes to decrease affiliate stigma and increase family engagement as a means of promoting quality of life for primary family caregivers living with people who have schizophrenia. © 2017 John Wiley & Sons Ltd.

  2. Individual Income, Area Deprivation, and Health: Do Income-Related Health Inequalities Vary by Small Area Deprivation?

    Science.gov (United States)

    Siegel, Martin; Mielck, Andreas; Maier, Werner

    2015-11-01

    This paper aims to explore potential associations between health inequalities related to socioeconomic deprivation at the individual and the small area level. We use German cross-sectional survey data for the years 2002 and 2006, and measure small area deprivation via the German Index of Multiple Deprivation. We test the differences between concentration indices of income-related and small area deprivation related inequalities in obesity, hypertension, and diabetes. Our results suggest that small area deprivation and individual income both yield inequalities in health favoring the better-off, where individual income-related inequalities are significantly more pronounced than those related to small area deprivation. We then apply a semiparametric extension of Wagstaff's corrected concentration index to explore how individual-level health inequalities vary with the degree of regional deprivation. We find that the concentration of obesity, hypertension, and diabetes among lower income groups also exists at the small area level. The degree of deprivation-specific income-related inequalities in the three health outcomes exhibits only little variations across different levels of multiple deprivation for both sexes. Copyright © 2014 John Wiley & Sons, Ltd.

  3. Administrative Strategies of School Management Effectiveness, Buriram Office of Primary Educational Service Area 4

    Directory of Open Access Journals (Sweden)

    Khanintipparat Prommaraj

    2017-09-01

    Full Text Available The objectives of this research were 1 to study the current and the expected Conditions of school management effectiveness, Buriram Office of Primary Educational Service Area 4 and 2 to construct administrative strategies of such schools. Eighty of directors, board chairpersons, teachers and parents were sampled. The instruments for data collection were 5-level rating scale questionnaires with the IOC value between 0.60–1.00 and the reliability value of 0.88 and in-depth interview forms. Quantitative data were analyzed by computer and qualitative data were inductively analyzed. The findings were as follows: 1. The current conditions school management effectiveness, Buriram Office of Primary Educational Service Area 4 was moderate while the expected conditions was high. By means of expected condition can be listed from high to low were atmosphere and environment management, administration, learning management and participation. 2. Strategies for effective management of schools under the Office of Educational Service Area 4 consists of four elementary Bachelor’s strategy is the first strategic development, management efficiency. 2 learners develop strategies to meet educational standards. Strategy 3: create an atmosphere and environment conducive to development. Strategy 4 and the joint cooperation of network.

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

    Science.gov (United States)

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

    2018-04-10

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

  5. The burden of polyparasitism among primary schoolchildren in rural and farming areas in Zimbabwe.

    Science.gov (United States)

    Midzi, N; Sangweme, D; Zinyowera, S; Mapingure, M P; Brouwer, K C; Munatsi, A; Mutapi, F; Mudzori, J; Kumar, N; Woelk, G; Mduluza, T

    2008-10-01

    A cross-sectional study was conducted in Zimbabwe among 1303 primary schoolchildren from a rural (53.3%) and a commercial farming area (46.7%) to determine the prevalence of co-infection by helminths and Plasmodium falciparum. Urine was examined on three successive days using the filtration method. Two stool specimens were processed using the Kato-Katz method and a third specimen was processed using the sedimentation method. Plasmodium falciparum was diagnosed from thick blood films. The prevalence of Schistosoma haematobium in the rural and farming areas was 66.8% and 52.3%, respectively, and for S. mansoni the prevalence was 12.4% and 22.7%, respectively. Plasmodium falciparum, hookworms, Ascaris lumbricoides and Trichuris trichiura occurred only in the farming area, with a prevalence of 27.9%, 23.7%, 2.1%, 2.3%, respectively. Co-infection and triple infection with schistosomes, P. falciparum and soil-transmitted helminths occurred in the commercial farming area only. Hookworm and S. mansoni infections were associated with P. falciparum malaria (P<0.001, OR=2.48, 95% CI 1.56-3.93 and P=0.005, OR=1.85, 95% CI 1.20-2.87, respectively). Overlap of helminths with malaria is a concern among primary schoolchildren and incorporating helminth control in programmes aiming to control malaria will improve funding and increase the efficiency of control for neglected tropical diseases in identified co-endemic settings.

  6. Provider-Related Linkages Between Primary Care Clinics and Community-Based Senior Centers Associated With Diabetes-Related Outcomes.

    Science.gov (United States)

    Noël, Polly Hitchcock; Wang, Chen-Pin; Finley, Erin P; Espinoza, Sara E; Parchman, Michael L; Bollinger, Mary J; Hazuda, Helen P

    2018-06-01

    The Institute of Medicine (IOM) suggests that linkages between primary care practices and community-based resources can improve health in lower income and minority patients, but examples of these are rare. We conducted a prospective, mixed-methods observational study to identify indicators of primary care-community linkage associated with the frequency of visits to community-based senior centers and improvements in diabetes-related outcomes among 149 new senior center members (72% Hispanic). We used semistructured interviews at baseline and 9-month follow-up, obtaining visit frequency from member software and clinical assessments including hemoglobin A1c (HbA1c) from colocated primary care clinics. Members' discussion of their activities with their primary care providers (PCPs) was associated with increased visits to the senior centers, as well as diabetes-related improvements. Direct feedback from the senior centers to their PCPs was desired by the majority of members and may help to reinforce use of community resources for self-management support.

  7. Mental disorders and the use of primary health care services among homeless shelter users in the Helsinki metropolitan area, Finland.

    Science.gov (United States)

    Stenius-Ayoade, Agnes; Haaramo, Peija; Erkkilä, Elisabet; Marola, Niko; Nousiainen, Kirsi; Wahlbeck, Kristian; Eriksson, Johan G

    2017-06-21

    Homelessness is associated with increased morbidity, mortality and health care use. The aim of this study was to examine the role of mental disorders in relation to the use of 1) daytime primary health care services and 2) after hours primary health care emergency room (PHER) services among homeless shelter users in the Helsinki Metropolitan Area, Finland. The study cohort consists of all 158 homeless persons using the four shelters operating in the study area during two selected nights. The health records were analyzed over a period of 3 years prior to the sample nights and data on morbidity and primary health care visits were gathered. We used negative binomial regression to estimate the association between mental disorders and daytime visits to primary health care and after hours visits to PHERs. During the 3 years the 158 homeless persons in the cohort made 1410 visits to a physician in primary health care. The cohort exhibited high rates of mental disorders, including substance use disorders (SUDs); i.e. 141 persons (89%) had a mental disorder. We found dual diagnosis, defined as SUD concurring with other mental disorder, to be strongly associated with daytime primary health care utilization (IRR 11.0, 95% CI 5.9-20.6) when compared with those without any mental disorder diagnosis. The association was somewhat weaker for those with only SUDs (IRR 4.9, 95% CI 2.5-9.9) or with only other mental disorders (IRR 5.0, 95% CI 2.4-10.8). When focusing upon the after hours visits to PHERs we observed that both dual diagnosis (IRR 14.1, 95% CI 6.3-31.2) and SUDs (11.5, 95% CI 5.7-23.3) were strongly associated with utilization of PHERs compared to those without any mental disorder. In spite of a high numbers of visits, we found undertreatment of chronic conditions such as hypertension and diabetes. Dual diagnosis is particularly strongly associated with primary health care daytime visits among homeless persons staying in shelters, while after hours visits to primary

  8. Apparatus and method for mapping an area of interest

    Science.gov (United States)

    Staab, Torsten A. Cohen, Daniel L.; Feller, Samuel [Fairfax, VA

    2009-12-01

    An apparatus and method are provided for mapping an area of interest using polar coordinates or Cartesian coordinates. The apparatus includes a range finder, an azimuth angle measuring device to provide a heading and an inclinometer to provide an angle of inclination of the range finder as it relates to primary reference points and points of interest. A computer is provided to receive signals from the range finder, inclinometer and azimuth angle measurer to record location data and calculate relative locations between one or more points of interest and one or more primary reference points. The method includes mapping of an area of interest to locate points of interest relative to one or more primary reference points and to store the information in the desired manner. The device may optionally also include an illuminator which can be utilized to paint the area of interest to indicate both points of interest and primary points of reference during and/or after data acquisition.

  9. Proton magnetic resonance spectroscopy ((1H-MRS reveals geniculocalcarine and striate area degeneration in primary glaucoma.

    Directory of Open Access Journals (Sweden)

    Yan Zhang

    Full Text Available BACKGROUND: Glaucoma is a collection of neurodegenerative diseases that affect both the retina and the central visual pathway. We investigated whether metabolites' concentrations changed in the geniculocalcarine (GCT and the striate area of occipital lobe by proton magnetic resonance spectroscopy ((1H-MRS, suggesting neurodegeneration of the central visual pathway in primary glaucoma. METHODOLOGY/PRINCIPAL FINDINGS: 20 patients with glaucoma in both eyes were paired with 20 healthy volunteers in same gender and an age difference less than 3 years. All the participants were examined by MR imaging including T1 Flair, T2 FSE and (1H-MRS. The T1 intensity and T2 intensity of their GCTs and striate areas were measured. The ratio of N-acetylaspartate (NAA/Creatine (Cr, Choline (Cho/Cr, glutamine and glutamate (Glx/Cr were derived by multi-voxels (1H-MRS in the GCT and the striate area of each brain hemisphere. The T1 intensity and T2 intensity had no difference between the groups. Significant decreases in NAA/Cr and Cho/Cr but no difference in Glx/Cr was found between the groups in both the GCT and the striate area. CONCLUSIONS/SIGNIFICANCE: Primary glaucoma affects metabolites' concentrations in the GCT and the striate area suggesting there is ongoing neurodegenerative process.

  10. Access to primary care for socio-economically disadvantaged older people in rural areas: A qualitative study.

    Science.gov (United States)

    Ford, John A; Turley, Rachel; Porter, Tom; Shakespeare, Tom; Wong, Geoff; Jones, Andy P; Steel, Nick

    2018-01-01

    We aim to explore the barriers to accessing primary care for socio-economically disadvantaged older people in rural areas. Using a community recruitment strategy, fifteen people over 65 years, living in a rural area, and receiving financial support were recruited for semi-structured interviews. Four focus groups were held with rural health professionals. Interviews and focus groups were audio-recorded and transcribed. Thematic analysis was used to identify barriers to primary care access. Older people's experience can be understood within the context of a patient perceived set of unwritten rules or social contract-an individual is careful not to bother the doctor in return for additional goodwill when they become unwell. However, most found it difficult to access primary care due to engaged telephone lines, availability of appointments, interactions with receptionists; breaching their perceived social contract. This left some feeling unwelcome, worthless or marginalised, especially those with high expectations of the social contract or limited resources, skills and/or desire to adapt to service changes. Health professionals' described how rising demands and expectations coupled with service constraints had necessitated service development, such as fewer home visits, more telephone consultations, triaging calls and modifying the appointment system. Multiple barriers to accessing primary care exist for this group. As primary care is re-organised to reduce costs, commissioners and practitioners must not lose sight of the perceived social contract and models of care that form the basis of how many older people interact with the service.

  11. Implementation of the principles of primary health care in a rural area of South Africa.

    Science.gov (United States)

    Visagie, Surona; Schneider, Marguerite

    2014-02-18

    The philosophy of primary healthcare forms the basis of South Africa's health policy and provides guidance for healthcare service delivery in South Africa. Healthcare service provision in South Africa has shown improvement in the past five years. However, it is uncertain as to whether the changes have reached rural areas and if primary healthcare is implemented successfully in these areas. The aim of this article is to explore the extent to which the principles of primary healthcare are implemented in a remote, rural setting in South Africa. A descriptive, qualitative design was implemented. Data were collected through interviews and case studies with 36 purposively-sampled participants, then analysed through Interpretative Phenomenological Analysis. Findings indicated challenges with regard to client-centred care, provision of health promotion and rehabilitation, the way care was organised, the role of the doctor, health worker attitudes, referral services and the management of complex conditions. The principles of primary healthcare were not implemented successfully. The community was not involved in healthcare management, nor were users involved in their personal health management. The initiation of a community-health forum is recommended. Service providers, users and the community should identify and address the determinants of ill health in the community. Other recommendations include the training of service managers in the logistical management of ensuring a constant supply of drugs, using a Kombi-type vehicle to provide user transport for routine visits to secondary- and tertiary healthcare services and increasing the doctors' hours.

  12. Primary collector wall local temperature fluctuations in the area of water-steam phase boundary

    Energy Technology Data Exchange (ETDEWEB)

    Matal, O.; Klinga, J.; Simo, T. [Energovyzkum Ltd., Brno (Switzerland)

    1995-12-31

    A limited number of temperature sensors could be installed at the primary collector surface in the area of water - steam phase boundary. The surface temperatures as well WWER 440 steam generator process data were measured and stored for a long time and off-line evaluated. Selected results are presented in the paper. (orig.). 2 refs.

  13. Primary collector wall local temperature fluctuations in the area of water-steam phase boundary

    Energy Technology Data Exchange (ETDEWEB)

    Matal, O; Klinga, J; Simo, T [Energovyzkum Ltd., Brno (Switzerland)

    1996-12-31

    A limited number of temperature sensors could be installed at the primary collector surface in the area of water - steam phase boundary. The surface temperatures as well WWER 440 steam generator process data were measured and stored for a long time and off-line evaluated. Selected results are presented in the paper. (orig.). 2 refs.

  14. Gravity Cues Embedded in the Kinematics of Human Motion Are Detected in Form-from-Motion Areas of the Visual System and in Motor-Related Areas.

    Science.gov (United States)

    Cignetti, Fabien; Chabeauti, Pierre-Yves; Menant, Jasmine; Anton, Jean-Luc J J; Schmitz, Christina; Vaugoyeau, Marianne; Assaiante, Christine

    2017-01-01

    The present study investigated the cortical areas engaged in the perception of graviceptive information embedded in biological motion (BM). To this end, functional magnetic resonance imaging was used to assess the cortical areas active during the observation of human movements performed under normogravity and microgravity (parabolic flight). Movements were defined by motion cues alone using point-light displays. We found that gravity modulated the activation of a restricted set of regions of the network subtending BM perception, including form-from-motion areas of the visual system (kinetic occipital region, lingual gyrus, cuneus) and motor-related areas (primary motor and somatosensory cortices). These findings suggest that compliance of observed movements with normal gravity was carried out by mapping them onto the observer's motor system and by extracting their overall form from local motion of the moving light points. We propose that judgment on graviceptive information embedded in BM can be established based on motor resonance and visual familiarity mechanisms and not necessarily by accessing the internal model of gravitational motion stored in the vestibular cortex.

  15. EVALUATION OF PRIMARY PRODUCTIVITY AT THE WILDLIFE PROTECTED AREA, "NEVADO DE TOLUCA" MEXICO, DURING THE DRY SEASON

    Directory of Open Access Journals (Sweden)

    J. Martínez-Hernández

    2014-08-01

    Full Text Available This is the first report on grassland primary productivity for the wildlife protected area Nevado de Toluca (APFF Nevado de Toluca. We evaluated three communities in this area during dry season: Loma Alta, La Peñuela y Agua Blanca. Following Hodgson (1994, for this study we used exclusion cages. Vegetation was cut every 28 days during a five months sampling period. A randomized block design was used, where the blocks represented the grassland communities and the different months constituted treatments. The month of September showed the higher production (610.3 kg/ha DM. No significant differences were observed among communities (P >0.05. In conclusion, these communities have similar low primary productivity through the evaluation dry season months, which in addition was found lower in comparison to other areas, therefore livestock grazing in this region should be limited this season.

  16. On the relation between primary and eutectic solidification structures in gray iron

    International Nuclear Information System (INIS)

    Elmquist, L; Sonawane, P A

    2012-01-01

    The solidification of hypoeutectic gray cast iron starts with the nucleation of primary austenite crystals. Before graphite is nucleated, and the eutectic structure is formed, these crystals start to grow as columnar or equiaxed dendrites. However, very little is known about these dendrites, and especially how they influence the subsequent eutectic structure. Besides, it has previously been shown that the primary solidification structure influences the formation of defects. Shrinkage porosity was found between the dendrites, in the grain boundaries, and the formation of the primary solidification structure was found to influence problems related to metal expansion penetration. Therefore a better understanding about the formation of this structure is of importance. In this work, different inoculants and their influence on the formation of the micro- and macrostructures has been investigated. The inoculants considered are commercially used inoculants, i.e. inoculants used in the foundries, as well as different iron powders. The addition of iron powder is used to promote the primary solidification structure. It is shown that the nucleation of the dendrites is influenced by the amount of iron powder. Secondary dendrite arm spacing is a quantitative measurement in the microstructure related to these dendrites, which in turn depends on the solidification time. Eutectic cell size, on the other hand, is found to depend on secondary dendrite arm spacing. It is shown how the addition of inoculants influences both primary and eutectic solidification structures, and how they are related to each other.

  17. Access to primary care for socio-economically disadvantaged older people in rural areas: A qualitative study

    Science.gov (United States)

    Turley, Rachel; Porter, Tom; Shakespeare, Tom; Wong, Geoff; Jones, Andy P.; Steel, Nick

    2018-01-01

    Objective We aim to explore the barriers to accessing primary care for socio-economically disadvantaged older people in rural areas. Methods Using a community recruitment strategy, fifteen people over 65 years, living in a rural area, and receiving financial support were recruited for semi-structured interviews. Four focus groups were held with rural health professionals. Interviews and focus groups were audio-recorded and transcribed. Thematic analysis was used to identify barriers to primary care access. Findings Older people’s experience can be understood within the context of a patient perceived set of unwritten rules or social contract–an individual is careful not to bother the doctor in return for additional goodwill when they become unwell. However, most found it difficult to access primary care due to engaged telephone lines, availability of appointments, interactions with receptionists; breaching their perceived social contract. This left some feeling unwelcome, worthless or marginalised, especially those with high expectations of the social contract or limited resources, skills and/or desire to adapt to service changes. Health professionals’ described how rising demands and expectations coupled with service constraints had necessitated service development, such as fewer home visits, more telephone consultations, triaging calls and modifying the appointment system. Conclusion Multiple barriers to accessing primary care exist for this group. As primary care is re-organised to reduce costs, commissioners and practitioners must not lose sight of the perceived social contract and models of care that form the basis of how many older people interact with the service. PMID:29509811

  18. ict and quality of teaching–learning related activities in primary ...

    African Journals Online (AJOL)

    Irene

    (ICT) enhance teaching learning related activities in primary schools in Ogoja education zone of Cross. River State ... A sample of six hundred and twenty ... Based on the findings of the study, it was recommended that ... video conferencing).

  19. Implementation of the principles of primary health care in a rural area of South Africa

    Directory of Open Access Journals (Sweden)

    Surona Visagie

    2014-02-01

    Full Text Available Background: The philosophy of primary healthcare forms the basis of South Africa’s health policy and provides guidance for healthcare service delivery in South Africa. Healthcare service provision in South Africa has shown improvement in the past five years. However, it is uncertain as to whether the changes have reached rural areas and if primary healthcare is implemented successfully in these areas. Objectives: The aim of this article is to explore the extent to which the principles of primary healthcare are implemented in a remote, rural setting in South Africa. Method: A descriptive, qualitative design was implemented. Data were collected through interviews and case studies with 36 purposively-sampled participants, then analysed through Interpretative Phenomenological Analysis. Results: Findings indicated challenges with regard to client-centred care, provision of health promotion and rehabilitation, the way care was organised, the role of the doctor, healthworker attitudes, referral services and the management of complex conditions. Conclusion: The principles of primary healthcare were not implemented successfully. The community was not involved in healthcare management, nor were users involved in their personal health management. The initiation of a community-health forum is recommended. Service providers, users and the community should identify and address the determinants of ill health in the community. Other recommendations include the training of service managers in the logistical management of ensuring a constant supply of drugs, using a Kombi-type vehicle to provide user transport for routine visits to secondary- and tertiary healthcareservices and increasing the doctors’ hours.

  20. Expanded emergency medical services for the provision of primary care in remote rural areas.

    Science.gov (United States)

    Mccabe, S

    2000-05-01

    It is now widely recognised that a potential recruitment crisis is looming in the provision of primary care physicians for remote rural areas of the United Kingdom. Anecdotal evidence suggests that rural registrar, associate and principal vacancies are becoming increasingly difficult to fill and for many rural GPs locums are an impossible dream. Many practitioners are no longer prepared to work in areas where out-of-hours cooperatives are not available. We are now faced with the very real possibility that in some remote areas of the Scottish Highlands and Islands the recruitment of suitable GPs may no longer be possible. So what are the alternatives? In October 1999 I visited a community in the mountains of northern New Mexico which has had to deal with this very problem.

  1. Scabies among primary schoolchildren in Egypt: sociomedical environmental study in Kafr El-Sheikh administrative area

    Directory of Open Access Journals (Sweden)

    Hegab DS

    2015-02-01

    Full Text Available Doaa Salah Hegab,1 Abdullah Mahfouz Kato,1 Ibrahim Ali Kabbash,2 Ghada Maged Dabish3 1Department of Dermatology and Venereology, Faculty of Medicine, 2Department of Public Health and Community, Faculty of Medicine, 3Faculty of Medicine, Tanta University, Tanta, Egypt Background/objectives: Scabies is a major global public health issue that might affect people from all socioeconomic levels. The primary contributing factors in contracting scabies seem to be poverty and overcrowded living conditions. Scabies often spreads among schoolchildren quite rapidly, owing to their close contact and overcrowding within the schools. However, limited information is available about its risk factors and the socioeconomic correlates among schoolchildren in Egypt. This study aimed to assess the prevalence of scabies and its risk factors among primary schoolchildren in Kafr El-Sheikh administrative area, Egypt. Methods: This cross-sectional descriptive study was performed on primary schoolchildren in urban and rural areas of Kafr El-Sheikh administrative area. A predesigned questionnaire was used for data collection from the randomly selected 2,104 children, and clinical dermatological examination was done for them. Results: Out of 2,104 children studied, there were 92 cases of scabies with a prevalence of 4.4%. The prevalence of scabies infestation in male students was 3.9%, while it was 4.8% in females, with no statistical significance. The results showed significant variations in the risk of scabies infestation by factors such as residence, paternal education and occupation, maternal education, sleeping with others, having animals at home, dealing with animals outside the house, type of building for living, family history of itchy rash, and sharing clothes with others. Conclusion: In our community, scabies is still an important health problem affecting schoolchildren, especially in rural areas. It is characterized by a complex web of causation, particularly poor

  2. Ipsilateral corticotectal projections from the primary, premotor and supplementary motor cortical areas in adult macaque monkeys: a quantitative anterograde tracing study

    Science.gov (United States)

    Fregosi, Michela; Rouiller, Eric M.

    2018-01-01

    The corticotectal projection from cortical motor areas is one of several descending pathways involved in the indirect control of spinal motoneurons. In non-human primates, previous studies reported that cortical projections to the superior colliculus originated from the premotor cortex and the primary motor cortex, whereas no projection originated from the supplementary motor area. The aim of the present study was to investigate and compare the properties of corticotectal projections originating from these three cortical motor areas in intact adult macaques (n=9). The anterograde tracer BDA was injected into one of these cortical areas in each animal. Individual axonal boutons, both en passant and terminaux, were charted and counted in the different layers of the ipsilateral superior colliculus. The data confirmed the presence of strong corticotectal projections from the premotor cortex. A new observation was that strong corticotectal projections were also found to originate from the supplementary motor area (its proper division). The corticotectal projection from the primary motor cortex was quantitatively less strong than that from either the premotor or supplementary motor areas. The corticotectal projection from each motor area was directed mainly to the deep layer of the superior colliculus, although its intermediate layer was also a consistent target of fairly dense terminations. The strong corticotectal projections from non-primary motor areas are in position to influence the preparation and planning of voluntary movements. PMID:28921678

  3. Together Achieving More: Primary Care Team Communication and Alcohol-Related Healthcare Utilization and Costs.

    Science.gov (United States)

    Mundt, Marlon P; Zakletskaia, Larissa I; Shoham, David A; Tuan, Wen-Jan; Carayon, Pascale

    2015-10-01

    Identifying and engaging excessive alcohol users in primary care may be an effective way to improve patient health outcomes, reduce alcohol-related acute care events, and lower costs. Little is known about what structures of primary care team communication are associated with alcohol-related patient outcomes. Using a sociometric survey of primary care clinic communication, this study evaluated the relation between team communication networks and alcohol-related utilization of care and costs. Between May 2013 and December 2013, a total of 155 healthcare employees at 6 primary care clinics participated in a survey on team communication. Three-level hierarchical modeling evaluated the link between connectedness within the care team and the number of alcohol-related emergency department visits, hospital days, and associated medical care costs in the past 12 months for each team's primary care patient panel. Teams (n = 31) whose registered nurses displayed more strong (at least daily) face-to-face ties and strong (at least daily) electronic communication ties had 10% fewer alcohol-related hospital days (rate ratio [RR] = 0.90; 95% confidence interval [CI]: 0.84, 0.97). Furthermore, in an average team size of 19, each additional team member with strong interaction ties across the whole team was associated with $1,030 (95% CI: -$1,819, -$241) lower alcohol-related patient healthcare costs per 1,000 team patients in the past 12 months. Conversely, teams whose primary care practitioner (PCP) had more strong face-to-face communication ties and more weak (weekly or several times a week) electronic communication ties had 12% more alcohol-related hospital days (RR = 1.12; 95% CI: 1.03, 1.23) and $1,428 (95% CI: $378, $2,478) higher alcohol-related healthcare costs per 1,000 patients in the past 12 months. The analyses controlled for patient age, gender, insurance, and comorbidity diagnoses. Excessive alcohol-using patients may fair better if cared for by teams whose

  4. Second malignancy in relation to treatment modality of primary malignancy

    International Nuclear Information System (INIS)

    Singh, Harpreet; Kaur, Parveen; Vashistha, Rajesh; Singh, Jaskaran; Passi, Kamlesh; Jain, Satish

    2001-01-01

    Second malignant tumors among long-term survivors are a sensitive indicator of successful oncologic treatment, particularly in this area of multimodal therapy. 11 patients of abdominopelvic primary malignancy were detected to have a second malignancy of different pathology, and at a different site. These patients were assessed regarding treatment modality of initial cancer and time gap between the first and second malignancy. Lack of proper cancer registries, illiteracy, and lack of resources lead to poor patient follow-up; therefore population based studies is not possible

  5. Morbidity pattern and personal hygiene in children among private primary school in urban area: are the trends changing?

    Science.gov (United States)

    Mhaske, Mayavati S; Khismatrao, Deepak S; Kevin, Fernandez; Pandve, Harshal T; Kundap, Ritesh P

    2013-07-01

    School health is an important intervention as a great deal of research tells us that schools can have a major effect on children's health, by teaching them about health and promoting healthy behaviors. The aim of this study is to determine common health problems and assess personal hygiene status among primary school children. A cross-sectional study was conducted in academic years 2009-2010 and 2010-2011, with three health check-up camps organized in private primary school of Pune city. A total of 450 students were assessed for health problems and composite score of personal hygiene status was calculated ranging from 0 to 5 by examination of hairs, nails, skin and clothes. Proportions calculated with application of Chi-square test and Pearson co-efficient applied to observe the relation between two quantitative variables. Out of 450 students examined, 56.2% were boys and 43.8% were girls with age ranging from 5 to 10 years. The major morbidities observed were dental caries (65.1%), upper respiratory tract infections (38.2%), ear wax (29.9%) and myopia (10.0%). Mean hygiene score was significantly higher in girls (4.32) than boys (3.95) and poor hygiene observed in older boys. Increasing myopia and poor dental hygiene denotes a changing morbidity pattern in private primary school of the urban area. The hygiene status of the girls is significantly better than boys.

  6. [22q11.2 deletion: handicap-related problems and coping strategies of primary caregivers].

    Science.gov (United States)

    Briegel, Wolfgang; Schneider, Marco; Schwab, K Otfried

    2009-11-01

    To investigate handicap-related problems of children and adolescents with 22q11.2 deletion syndrome and their primary caregivers' coping strategies. Primary caregivers of 153 subjects aged 2-16 years were anonymously asked to fill out questionnaires, e.g., the Handicap Related Problems for Parents Inventory. Primary caregivers of 96 subjects (53 males, 43 females; mean age: 7;0 [2;1-16;11] years) sent back questionnaires. Patient's behaviour and discipline were the most important handicap-related problems. Significant correlations could be found between the patient's age and his/her relationship with the primary caregiver (rho=0.228; p=.029) and other family members (rho=0.293; p=.004). Compared to other parents of physically handicapped children or those with multiple handicaps, these parents did not experience increased stress. The more the coping strategies "self-fulfillment" and "intensification of partnership" were used, the lower parental stress was (p=.012, p=.025, respectively). "Focusing on the handicapped child" was positively correlated with high parental stress (p=.000). With regard to parental stress and coping strategies, primary caregivers of children and adolescents with 22q11.2 deletion do not significantly differ from other parents of physically handicapped children. As handicap-related family problems increase with the patient's age, a growing need for counseling, especially for aspects of parenting and discipline, and for treatment can be presumed.

  7. Satellite remote sensing for estimating leaf area index, FPAR and primary production. A literature review

    International Nuclear Information System (INIS)

    Boresjoe Bronge, Laine

    2004-03-01

    Land vegetation is a critical component of several biogeochemical cycles that have become the focus of concerted international research effort. Most ecosystem productivity models, carbon budget models, and global models of climate, hydrology and biogeochemistry require vegetation parameters to calculate land surface photosynthesis, evapotranspiration and net primary production. Therefore, accurate estimates of vegetation parameters are increasingly important in the carbon cycle, the energy balance and in environmental impact assessment studies. The possibility of quantitatively estimating vegetation parameters of importance in this context using satellite data has been explored by numerous papers dealing with the subject. This report gives a summary of the present status and applicability of satellite remote sensing for estimating vegetation productivity by using vegetation index for calculating leaf area index (LAI) and fraction of absorbed photosynthetically active radiation (FPAR). Some possible approaches for use of satellite data for estimating LAI, FPAR and net primary production (NPP) on a local scale are suggested. Recommendations for continued work in the Forsmark and Oskarshamn investigation areas, where vegetation data and NDVI-images based on satellite data have been produced, are also given

  8. Satellite remote sensing for estimating leaf area index, FPAR and primary production. A literature review

    Energy Technology Data Exchange (ETDEWEB)

    Boresjoe Bronge, Laine [SwedPower AB, Stockholm (Sweden)

    2004-03-01

    Land vegetation is a critical component of several biogeochemical cycles that have become the focus of concerted international research effort. Most ecosystem productivity models, carbon budget models, and global models of climate, hydrology and biogeochemistry require vegetation parameters to calculate land surface photosynthesis, evapotranspiration and net primary production. Therefore, accurate estimates of vegetation parameters are increasingly important in the carbon cycle, the energy balance and in environmental impact assessment studies. The possibility of quantitatively estimating vegetation parameters of importance in this context using satellite data has been explored by numerous papers dealing with the subject. This report gives a summary of the present status and applicability of satellite remote sensing for estimating vegetation productivity by using vegetation index for calculating leaf area index (LAI) and fraction of absorbed photosynthetically active radiation (FPAR). Some possible approaches for use of satellite data for estimating LAI, FPAR and net primary production (NPP) on a local scale are suggested. Recommendations for continued work in the Forsmark and Oskarshamn investigation areas, where vegetation data and NDVI-images based on satellite data have been produced, are also given.

  9. Stunting and zinc deficiency among primary school children in rural areas with low soil zinc concentrations in Jiangsu Province, China

    NARCIS (Netherlands)

    Qin, Yu; Boonstra, A.; Zhao, J.; Wu, M.; Hu, X.; Kok, F.J.

    2009-01-01

    OBJECTIVE: To assess stunting and zinc deficiency among primary school children in north rural area of Jiangsu Province with low soil zinc concentrations, eastern part of China. METHODS: Two data collection rounds were conducted. In the first data collection round, 2268 primary school children aged

  10. Frequency and Efficacy of Talk-Related Tasks in Primary Science

    Science.gov (United States)

    Braund, Martin; Leigh, Joanne

    2013-04-01

    Pupil talk and discussion are seen as having important social and cognitive outcomes. In science classes, pupils' collaborative talk supports the construction of meaning and helps examine the status of evidence, theory and knowledge. However, pupil interactive talk in groups is rare in science lessons. The research reported is part of a project to increase the amount of pupil-pupil talk in primary schools through a programme of teaching and professional development. Pupils' self-reports of the frequency and learning efficacies of talk related activities in science lessons were collected before and after a programme of teaching in 24 schools in one of the most socially and educationally deprived areas of England. Findings showed pupils valued talking about their ideas over listening to those of other pupils. Science talk frequency (STF) was closely correlated with science talk efficacy (STE) and both were positively correlated with pupils' attitudes to school science. Analysis of covariance (ANCOVA) of the correlation of STF with STE showed values were independent of gender and ability but that school experience was a significant factor. After the teaching programme and, contrary to expectations, the frequency of talk activities in science lessons appeared to have decreased but varied according to class grades. The degree of correlation between STF and STE was stronger after the teaching in over half of the schools. Schools where STF/STE strengthened most as a result of teaching were those involved in an additional initiative to use modelled talk related to industrial contexts.

  11. ‘It’s a can of worms’: understanding primary care practitioners’ behaviours in relation to HPV using the theoretical domains framework

    Directory of Open Access Journals (Sweden)

    McSherry Lisa A

    2012-08-01

    Full Text Available Abstract Background The relationship between infection with high-risk human papillomavirus (HPV and cervical cancer is transforming cervical cancer prevention. HPV tests and vaccinations have recently become available. In Ireland, as elsewhere, primary care practitioners play a key role in prevention. ATHENS (A Trial of HPV Education and Support aims to develop a theory-based intervention to support primary care practitioners in their HPV-related practice. This study, the first step in the intervention development process, aimed to: identify HPV-related clinical behaviours that the intervention will target; clarify general practitioners’ (GPs’ and practice nurses’ roles and responsibilities; and determine factors that potentially influence clinical behaviour. A secondary objective was to informally assess the utility of the Theoretical Domains Framework (TDF in understanding clinical behaviours in an area with an evolving evidence-base. Methods In-depth semi-structured telephone interviews were conducted with GPs and practice nurses. The topic guide, which contained open questions and HPV-related clinical scenarios, was developed through literature review and clinical experience. Interview transcripts were content-analysed using the TDF as the coding framework. Results 19 GPs and 14 practice nurses were interviewed. The major HPV-related clinical behaviours were: initiating a discussion about HPV infection with female patients; offering/recommending HPV vaccination to appropriate patients; and answering patients’ questions about HPV testing. While the responsibility for taking smears was considered a female role, both male and female practitioners dealt with HPV-related issues. All 12 theoretical domains arose in relation to HPV infection; the domains judged to be most important were: knowledge, emotion, social influences, beliefs about capabilities and beliefs about consequences. Eleven domains emerged in relation to HPV vaccination

  12. [Meanings and methods of territorialization in primary health care].

    Science.gov (United States)

    Pessoa, Vanira Matos; Rigotto, Raquel Maria; Carneiro, Fernando Ferreira; Teixeira, Ana Cláudia de Araújo

    2013-08-01

    Territorially-based participative analytical methodologies taking the environmental question and work into consideration are essential for effective primary health care. The study analyzed work and environment-related processes in the primary health care area and their repercussions on the health of workers and the community in a rural city in Ceará, whose economy is based on agriculture for export,. It sought to redeem the area and the proposal of actions focused on health needs by the social subjects through the making of social, environmental and work-related maps in workshops within the framework of action research. Examining the situation from a critical perspective, based on social participation and social determination of the health-disease process with regard to the relations between production, environment and health, was the most important step in the participative map-making process, with the qualitative material interpreted in light of discourse analysis. The process helped identify the health needs, the redemption of the area, strengthened the cooperation between sectors and the tie between the health of the worker and that of the environment, and represented an advance towards the eradication of the causes of poor primary health care services.

  13. Disrupted modular organization of primary sensory brain areas in schizophrenia

    Directory of Open Access Journals (Sweden)

    Cécile Bordier

    Full Text Available Abnormal brain resting-state functional connectivity has been consistently observed in patients affected by schizophrenia (SCZ using functional MRI and other neuroimaging techniques. Graph theoretical methods provide a framework to investigate these defective functional interactions and their effects on the organization of brain connectivity networks. A few studies have shown altered distribution of connectivity within and between functional modules in SCZ patients, an indication of imbalanced functional segregation ad integration. However, no major alterations of modular organization have been reported in patients, and unambiguous identification of the neural substrates affected remains elusive. Recently, it has been demonstrated that current modularity analysis methods suffer from a fundamental and severe resolution limit, as they fail to detect features that are smaller than a scale determined by the size of the entire connectivity network. This resolution limit is likely to have hampered the ability to resolve differences between patients and controls in previous studies. Here, we apply Surprise, a novel resolution limit-free approach, to study the modular organization of resting state functional connectivity networks in a large cohort of SCZ patients and in matched healthy controls. Leveraging these important methodological advances we find new evidence of substantial fragmentation and reorganization involving primary sensory, auditory and visual areas in SCZ patients. Conversely, frontal and prefrontal areas, typically associated with higher cognitive functions, appear to be largely unaffected, with changes selectively involving language and speech processing areas. Our findings support the hypothesis that cognitive dysfunction in SCZ may involve deficits occurring already at early stages of sensory processing. Keywords: Schizophrenia, Surprise, Asymptotical surprise, Functional connectivity, Community detection, Modularity, Graph theory

  14. ICT and quality of teaching–learning related activities in primary ...

    African Journals Online (AJOL)

    The paper is a report of a study carried out to examine how information and communication technology (ICT) enhance teaching learning related activities in primary schools in Ogoja education zone of Cross River State, Nigeria. To achieve the purpose of the study, one research question was formulated to direct the study.

  15. PRIMARY PALLIATIVE CARE? - Treating terminally ill cancer patients in the primary care sector

    DEFF Research Database (Denmark)

    Neergaard, Mette Asbjørn; Jensen, Anders Bonde; Olesen, Frede

    BACKGROUND. Palliative care for cancer patients is an important part of a GP's work. Although every GP is frequently involved in care for terminally ill cancer patients, only little is known about how these palliative efforts are perceived by the patients and their families, a knowledge...... that is vital to further improve palliative care in the primary sector.AIM. The aim of the study was to analyse the quality of palliative home care with focus on the GP's role based on evaluations by relatives of recently deceased cancer patients and professionals from both the primary and secondary health care...... approach.RESULTS. The analyses revealed several key areas, e.g.: 1) How to take, give and maintain professional responsibility for palliative home care. 2) A need for transparent communication both among primary care professionals and among professionals across the primary/secondary interface. 3...

  16. Neurobehavioral effects of exposure to traffic-related air pollution and transportation noise in primary schoolchildren.

    Science.gov (United States)

    van Kempen, Elise; Fischer, Paul; Janssen, Nicole; Houthuijs, Danny; van Kamp, Irene; Stansfeld, Stephen; Cassee, Flemming

    2012-05-01

    Children living close to roads are exposed to both traffic noise and traffic-related air pollution. There are indications that both exposures affect cognitive functioning. So far, the effects of both exposures have only been investigated separately. To investigate the relationship between air pollution and transportation noise on the cognitive performance of primary schoolchildren in both the home and school setting. Data acquired within RANCH from 553 children (aged 9-11 years) from 24 primary schools were analysed using multilevel modelling with adjustment for a range of socio-economic and life-style factors. Exposure to NO(2) (which is in urban areas an indicator for traffic-related air pollution) at school was statistically significantly associated with a decrease in the memory span length measured during DMST (χ(2)=6.8, df=1, p=0.01). This remained after additional adjustment for transportation noise. Statistically significant associations were observed between road and air traffic noise exposure at school and the number of errors made during the 'arrow' (χ(2)=7.5, df=1, p=0.006) and 'switch' (χ(2)=4.8, df=1, p=0.028) conditions of the SAT. This remained after adjustment for NO(2). No effects of air pollution exposure or transportation noise exposure at home were observed. Combined exposure of air pollution and road traffic noise had a significant effect on the reaction times measured during the SRTT and the 'block' and the 'arrow' conditions of the SAT. Our results provide some support that prolonged exposure to traffic-related air pollution as well as to noise adversely affects cognitive functioning. Copyright © 2012 Elsevier Inc. All rights reserved.

  17. Multidisciplinary program for stress-related disease in primary health care

    Directory of Open Access Journals (Sweden)

    Eva Ekvall Hansson

    2009-05-01

    Full Text Available Eva Ekvall Hansson1, Eva Håkansson2, Annelie Raushed2, Anders Håkansson1 1Lund University, Department of Clinical Sciences in Malmö/General Practice, Malmö, Sweden; 2Primary Health Care Malmö, SwedenObjective: To describe a multidisciplinary program, given by an occupational therapist and a physiotherapist, for patients with stress-related disease in primary health care and to measure the effect of this program in terms of self-perceived health, degree of burnout, physical activity, symptoms, recreational activities, and psychological and physical well-being.Method: Retrospective study.Results: At measures after three months, the thirteen patients included in this study had improved in self-estimated health, measured with EuroQol-5D Visual Analogue Scale (p = 0.000, and in degree of burnout, measured with the Shirom–Melamed Burnout Questionnaire (p = 0.001. There was also a decrease in presence of headache, in physical activity and in satisfaction with leisure time, although not statistically significant. After six months, the improvements remained for all measures except physical activity. The patients were also satisfied with the program to a high degree, measured with Client Satisfaction Questionnaire (median 3.7.Conclusion: This descriptive study shows that a stress-management program, provided by a team including an occupational therapist and a physiotherapist in primary health care, is both feasible and effective in terms of self-estimated health, degree of burnout, and patient satisfaction. Keywords: stress-related health, burnout, occupational therapy, physiotherapy

  18. Review on experiments relating to primary containment vessel failure

    International Nuclear Information System (INIS)

    Suzuki, Hiroyuki; Okada, Hidetoshi; Uchida, Sunsuke; Naitoh, Masanori

    2015-01-01

    Experiments regarding failures of primary containment vessels (PCVs) are reviewed and remained issues to be investigated in the future are discussed. Experiments are categorized as those relating to criteria of PCV failures and to FP releases through breaches on PCV boundaries. In the experiments categorized as those relating to criteria of PCV failures, experiments with full-scale, scale models, and compounds used for sealing are surveyed. Experiments relating to an amount of radioactive fission products (FPs) trapped at breaches on PCV boundaries are also reviewed. As remained issues to be investigated in the future, two items are pointed out: Evaluating degradation behavior of PCV boundaries exposed to temperature and pressure from the failure onset criteria to far above them, and evaluating an amount of FPs trapped at breaches on PCV boundaries. (author)

  19. Primary schools, markets and choice: studying polarization and the core catchment areas of schools

    OpenAIRE

    Harris, R J; Johnston, RJ

    2007-01-01

    In this paper we distinguish polarization from other conceptions of segregation by conceiving the former as a local phenomenon. To this end we argue that evidence for any school-level separation of ethnic groups must be sought and contextualised within the local markets within which schools operate. By determining the ‘core catchment’ areas of primary schools from geographical micro-data reporting where pupils reside and which school they attend within the study region of Birmingham, England,...

  20. Functional bowel disorders in primary care: factors associated with health-related quality of life and doctor consultation.

    Science.gov (United States)

    Lee, Victoria; Guthrie, Else; Robinson, Andrew; Kennedy, Anne; Tomenson, Barbara; Rogers, Anne; Thompson, David

    2008-02-01

    The role of psychological factors in irritable bowel syndrome (IBS) remains unclear, particularly in a primary care setting, where relatively little research on this common and costly condition has been carried out. The aim of this study was to investigate the relative contribution of physical and psychological factors to health-related quality of life and health-care utilization in patients with functional bowel disease (IBS-like symptoms) in primary care. We also wished to establish the relevance of formal diagnostic criteria to IBS in the primary care setting. This study used a cross-sectional design. Four hundred twenty patients with functional bowel disorders in primary care completed a series of measures, including bowel symptom status and severity, severity of psychological distress, personality, and quality of life. The number of visits to a general practitioner (GP) in the previous 12 months was recorded. The following variables were independently and highly significantly associated with health-related quality of life in patients with functional bowel disorders in primary care: total psychological symptom score, diarrhea severity, abdominal pain for >12 weeks, and abdominal distension. A similar pattern emerged between patients who met meet Rome II criteria for IBS and patients who did not meet Rome II criteria for IBS. Relatively few variables (either physical or psychological) had a major impact on the number of GP consultations, with the exception of frequency of bowel movements. This study confirms that psychological factors are significantly associated with health-related quality of life in patients with IBS in primary care. Physical symptom severity is also important. Relatively few symptom measures, either physical or psychological, have a major impact on doctor consultation rates in primary care.

  1. Development of a participatory Management approach of the Committee for Basic Education School under the Nongbualamphu Primary Educational Service Area Office 2

    Directory of Open Access Journals (Sweden)

    Jirayu Prommajak

    2016-10-01

    Full Text Available This study aimed: 1 study the present state and adverse conditions of administration with the participation of the basic education in schools. 2 Development of a participatory Management approach of the Committee for Basic Education school under the Nongbualamphu Primary Educational Service Area Office 2. Split data into 2 phases. Phase 1: The sample used for this research consisted of 128 members of the committee on basic education in school under the Nongbualamphu Primary Educational Service Area Office 2. Selected by using stratified random sampling. Instruments used included a set of rating scale questionnaires. Phase 2: Data from the interviews using a structured questionnaire and focus group discussion. The basic statistics used for analyzing the collected data were percentage, means and standard deviation. The results of this study were as follows: 1. On the present state administration with the participation of the basic education commission in schools underunder the Nongbualamphu Primary Educational Service Area Office 2 overall participation in management is moderate. Considering the individual aspects, found that the academic administration overall participation in management and budget management were moderate. The personnel management and general and administrative overall participation in management at a high level. 2. Adverse conditions of administration with the participation of the school board for basic education in schools underunder the Nongbualamphu Primary Educational Service Area Office 2 overall in a high level. Considering the individual aspects, found that the school board in basic education is desirable to participate in the management of all aspects. 3. Development of a participatory management approach of the committee for basic education school under the Nongbualamphu Primary Educational Service Area Office 2 is a developmental process management principles PDCA, 5 steps. Step 1: Creating a common understanding Step

  2. Pain-related insomnia versus primary insomnia: a comparison study of sleep pattern, psychological characteristics, and cognitive-behavioral processes.

    Science.gov (United States)

    Tang, Nicole K Y; Goodchild, Claire E; Hester, Joan; Salkovskis, Paul M

    2012-06-01

    Recent applications of cognitive-behavior therapy for primary insomnia in the management of pain-related insomnia are based on the implicit assumption that the 2 types of insomnia share the same presentation and maintaining mechanisms. The objectives of this study were to compare the characteristics of patients who have pain-related insomnia with those reporting primary insomnia and to identify psychological factors that predict pain-related insomnia. Chronic pain patients with concomitant insomnia (n=137; Pain-related Insomnia Group) completed a selection of questionnaires that measure sleep patterns, psychological attributes, and cognitive-behavioral processes associated with the persistence of insomnia. Their responses were compared with those of primary insomnia patients (n=33; Primary Insomnia Group), using 3 sets of multivariate analyses of covariance that took account of demographic differences. Hierarchical regression analyses were performed to identify predictors of insomnia severity among the chronic pain patients. The Pain-related Insomnia Group did not differ from the Primary Insomnia Group in their pattern and severity of sleep disturbance. The 2 groups were largely comparable in terms of their psychological characteristics, except that the Primary Insomnia Group was distinguishable from the Pain-related Insomnia Group by their greater tendency to worry. Patients in the Pain-related Insomnia Group reported levels of sleep-related anxiety and presleep somatic arousal that matched with those reported by patients in the Primary Insomnia Group. However, relative to patients in the Pain-related Insomnia Group, those in the Primary Insomnia Group reported more dysfunctional sleep beliefs and presleep cognitive arousal. In addition to pain intensity, depression, and presleep cognitive arousal were significant predictors of insomnia severity within the Pain-related Insomnia Group. There are more similarities than differences between the 2 types of insomnia

  3. Quality of life in patients with primary hypothyroidism related to BMI

    NARCIS (Netherlands)

    Kelderman-Bolk, Nienke; Visser, Theo J.; Tijssen, Jan P.; Berghout, Arie

    2015-01-01

    Objective: Many patients treated for primary hypothyroidism have an unexplained reduced quality of life (QOL). We studied the relation between QOL and various parameters in treated hypothyroid patients. Design and methods: QOL analysis was done in 90 consecutive patients (77.8% females) treated for

  4. Understanding Basic Temporal Relations in Primary School Pupils with Hearing Impairments.

    Science.gov (United States)

    Dulcić, Adinda; Bakota, Koraljka; Saler, Zrinka

    2015-09-01

    Time can be observed as a subjective, as well as an objective phenomenon which is a component of our life, and due to its communicational needs, it is standardized by temporal signs and symbols. The aim of this study was to determine the understanding of basic temporal relations of pupils with hearing impairments. We assumed that the knowledge of basic time relations is a precondition for the acquisition of knowledge that is connected with the understanding of the syllabus in regular school programs. Three groups of pupils have been examined: pupils with hearing impairments who attend the primary school of SUVAG Polyclinic under special condition, integrated hearing impaired pupils with minor additional difficulties who attend regular primary schools in Zagreb with a prolonged expert procedure and pupils of the control group. The subjects have been examined with a measuring instrument constructed by the expert team of the Polyclinic Suvag. Twenty nine subjects have been questioned, chronologically aged between 10 and 12.

  5. Area 5 influences excitability within the primary motor cortex in humans.

    Directory of Open Access Journals (Sweden)

    Azra Premji

    Full Text Available In non-human primates, Brodmann's area 5 (BA 5 has direct connectivity with primary motor cortex (M1, is largely dedicated to the representation of the hand and may have evolved with the ability to perform skilled hand movement. Less is known about human BA 5 and its interaction with M1 neural circuits related to hand control. The present study examines the influence of BA 5 on excitatory and inhibitory neural circuitry within M1 bilaterally before and after continuous (cTBS, intermittent (iTBS, and sham theta-burst stimulation (sham TBS over left hemisphere BA 5. Using single and paired-pulse TMS, measurements of motor evoked potentials (MEPs, short interval intracortical inhibition (SICI, and intracortical facilitation (ICF were quantified for the representation of the first dorsal interosseous muscle. Results indicate that cTBS over BA 5 influences M1 excitability such that MEP amplitudes are increased bilaterally for up to one hour. ITBS over BA 5 results in an increase in MEP amplitude contralateral to stimulation with a delayed onset that persists up to one hour. SICI and ICF were unaltered following TBS over BA 5. Similarly, F-wave amplitude and latency were unaltered following cTBS over BA 5. The data suggest that BA 5 alters M1 output directed to the hand by influencing corticospinal neurons and not interneurons that mediate SICI or ICF circuitry. Targeting BA 5 via cTBS and iTBS is a novel mechanism to powerfully modulate activity within M1 and may provide an avenue for investigating hand control in healthy populations and modifying impaired hand function in clinical populations.

  6. Abnormal language-related oscillatory responses in primary progressive aphasia

    Directory of Open Access Journals (Sweden)

    A. Kielar

    Full Text Available Patients with Primary Progressive Aphasia (PPA may react to linguistic stimuli differently than healthy controls, reflecting degeneration of language networks and engagement of compensatory mechanisms. We used magnetoencephalography (MEG to evaluate oscillatory neural responses in sentence comprehension, in patients with PPA and age-matched controls. Participants viewed sentences containing semantically and syntactically anomalous words that evoke distinct oscillatory responses. For age-matched controls, semantic anomalies elicited left-lateralized 8–30 Hz power decreases distributed along ventral brain regions, whereas syntactic anomalies elicited bilateral power decreases in both ventral and dorsal regions. In comparison to controls, patients with PPA showed altered patterns of induced oscillations, characterized by delayed latencies and attenuated amplitude, which were correlated with linguistic impairment measured offline. The recruitment of right hemisphere temporo-parietal areas (also found in controls was correlated with preserved semantic processing abilities, indicating that preserved neural activity in these regions was able to support successful semantic processing. In contrast, syntactic processing was more consistently impaired in PPA, regardless of neural activity patterns, suggesting that this domain of language is particularly vulnerable to the neuronal loss. In addition, we found that delayed peak latencies of oscillatory responses were associated with lower accuracy for detecting semantic anomalies, suggesting that language deficits observed in PPA may be linked to delayed or slowed information processing. Keywords: MEG oscillations, Primary progressive aphasia (PPA, Sentence comprehension

  7. Morphometric analysis of feedforward pathways from the primary somatosensory area (S1 of rats

    Directory of Open Access Journals (Sweden)

    A.L. de Sá

    2016-01-01

    Full Text Available We used biotinylated dextran amine (BDA to anterogradely label individual axons projecting from primary somatosensory cortex (S1 to four different cortical areas in rats. A major goal was to determine whether axon terminals in these target areas shared morphometric similarities based on the shape of individual terminal arbors and the density of two bouton types: en passant (Bp and terminaux (Bt. Evidence from tridimensional reconstructions of isolated axon terminal fragments (n=111 did support a degree of morphological heterogeneity establishing two broad groups of axon terminals. Morphological parameters associated with the complexity of terminal arbors and the proportion of beaded Bp vs stalked Bt were found to differ significantly in these two groups following a discriminant function statistical analysis across axon fragments. Interestingly, both groups occurred in all four target areas, possibly consistent with a commonality of presynaptic processing of tactile information. These findings lay the ground for additional work aiming to investigate synaptic function at the single bouton level and see how this might be associated with emerging properties in postsynaptic targets.

  8. Farm work-related asthma among US primary farm operators.

    Science.gov (United States)

    Mazurek, Jacek M; White, Gretchen E; Rodman, Chad; Schleiff, Patricia L

    2015-01-01

    The objective of this study was to estimate the prevalence of current asthma and the proportion of current asthma that is related to work on the farm among primary farm operators. The 2011 Farm and Ranch Safety Survey data were used to produce estimates and prevalence odds ratios. An estimated 5.1% of farm operators had asthma. Of these, 15.4% had farm work-related asthma. Among operators with farm work-related asthma, 54.8% (95% confidence interval [CI]: 41.8%-68.2%) had an asthma attack in the prior 12 months and 33.3% (95% CI: 21.2%-45.4%) had an asthma attack that occurred while doing farm work. Of those who had an asthma attack that occurred while doing farm work, 65.0% associated their asthma attack with plant/tree materials. This study provides updated information on asthma and the proportion of current asthma that is related to work on the farm and identifies certain groups of farm operators that might benefit from workplace asthma prevention intervention.

  9. Ballet-Related Content in Music Education in the First Cycle of Primary Education

    Directory of Open Access Journals (Sweden)

    Stergulec Tjaša

    2013-09-01

    Full Text Available This paper deals with the integration of ballet-related content into music lessons in the first cycle of primary education. It seeks to outline some current findings concerning the positive impact of dance and classical ballet on integrated child development and the results of an empirical research study the objective of which was to compare the ability of primary school pupils aged six to nine years to perform a simple ballet choreography against that of ballet school pupils and to examine pupils’ attitude towards classical ballet. For this end, we prepared additional ballet-related content in 2011 and incorporated it into classroom practice with students attending Fran Korun Koželjski Music School in Velenje and pupils attending the first and the third grades of Franc Rozman Stane Primary School in Maribor. To compare the performance of one and the other we used specific evaluation criteria, while we obtained pupils’ feedback on ballet lessons by means of a short questionnaire. It was established that children did possess the ability as well as the desire to practice classical ballet. The executions of the ballet choreography by both groups were comparable, and the only difference noticed regarded the physical ability, body coordination, and spatial coordination criteria, which were not fully achieved by the primary school pupils. Due to the positive influence of the activity on the integrated development of children and the children’s positive reaction, it is necessary to incorporate as many ballet-related subject matter as possible into music education.

  10. Estimating small area health-related characteristics of populations: a methodological review

    Directory of Open Access Journals (Sweden)

    Azizur Rahman

    2017-05-01

    Full Text Available Estimation of health-related characteristics at a fine local geographic level is vital for effective health promotion programmes, provision of better health services and population-specific health planning and management. Lack of a micro-dataset readily available for attributes of individuals at small areas negatively impacts the ability of local and national agencies to manage serious health issues and related risks in the community. A solution to this challenge would be to develop a method that simulates reliable small-area statistics. This paper provides a significant appraisal of the methodologies for estimating health-related characteristics of populations at geographical limited areas. Findings reveal that a range of methodologies are in use, which can be classified as three distinct set of approaches: i indirect standardisation and individual level modelling; ii multilevel statistical modelling; and iii micro-simulation modelling. Although each approach has its own strengths and weaknesses, it appears that microsimulation- based spatial models have significant robustness over the other methods and also represent a more precise means of estimating health-related population characteristics over small areas.

  11. Training teachers to teach mental health skills to staff in primary care settings in a vast, under-populated area.

    Science.gov (United States)

    Goldberg, D P; Gask, L; Zakroyeva, A; Proselkova, E; Ryzhkova, N; Williams, P

    2012-12-01

    Background The Arkhangelsk Oblast is an area the size of France with a sparsely distributed population. The existing primary care staff have had very little training in the management of mental health disorders, despite the frequency of these disorders in the population. They requested special teaching on depression, suicide, somatisation and alcohol problems. Methods An educational intervention was developed in partnership with mental health and primary care staff in Russia, to develop mental health skills using established, evidence-based methods. After a preliminary demonstration of teaching methods to be employed, a 5-day full-time teaching course was offered to trainers of general practitioners and feldshers. Results The findings are presented by providing details of improvements that occurred over a 3-month period in four areas, namely depression in primary care, somatic presentations of distress, dealing with suicidal patients, and alcohol problems. We present preliminary data on how the training has generalised since our visits to Archangelsk. Conclusions Teachers who are used to teaching by didactic lectures can be taught the value of short introductory talks that invite discussion, and mental health skills can be taught using role play. The content of such training should be driven by perceived local needs, and developed in conjunction with local leaders and teachers within primary care services. Further research will be needed to establish the impact on clinical outcomes.

  12. In vivo release of calcitonin gene-related peptide-like material from the cervicotrigeminal area in the rat. Effects of electrical and noxious stimulations of the muzzle.

    Science.gov (United States)

    Pohl, M; Collin, E; Bourgoin, S; Clot, A M; Hamon, M; Cesselin, F; Le Bars, D

    1992-10-01

    The continuous perfusion with an artificial cerebrospinal fluid of the cervicotrigeminal area of the spinal cord in halothane-anaesthetized rats allowed the collection of calcitonin gene-related peptide-like material with the same immunological and chromatographic characteristics as authentic rat alpha-calcitonin gene-related peptide. The spinal release of calcitonin gene-related peptide-like material could be significantly increased by the local application of 60 mM K+ (approximately +100%), high-intensity percutaneous electrical stimulation (approximately +200%) and noxious heat (by immersion in water at 52 degrees C; approximately +150%) applied to the muzzle. By contrast, noxious mechanical (pinches) and chemical (subcutaneous formalin injection) stimulations and deep cooling (by immersion in water at 0 degrees C) of the muzzle did not alter the spinal release of calcitonin gene-related peptide-like material. In addition, low-intensity electrical stimulation, recruiting only the A alpha/beta primary afferent fibres, significantly reduced (approximately -30%) the release of calcitonin gene-related peptide-like material from the cervicotrigeminal area. These data suggest that among the various types of natural noxious stimuli, noxious heat may selectively excite calcitonin gene-related peptide-containing A delta and C primary afferent fibres projecting within the dorsal horn of the spinal cord, and that activation of A alpha/beta fibres reduces spontaneous calcitonin gene-related peptide-like material release possibly through an inhibitory presynaptic control of calcitonin gene-related peptide-containing A delta/C fibres.

  13. Relations and areas of interaction between landowners in a peri-urban area

    DEFF Research Database (Denmark)

    Richardt, Ann-Sofie

    2016-01-01

    While land management can be a subject of conflict in places where the composition of landowners is socially and culturally diverse, it also holds the potential of bringing landowners together across social groups. This chapter uses the case of a peri-urban area near Copenhagen, Denmark, to examine...... the relations landowners have through their use and management of land within and across social groups. To elaborate the analysis and discussion of social groups, social coherence and fragmentation, this chapter introduces the concepts of homophily and self-categorisation. Interviews with 40 landowners from two...... parishes addressed four types of land-based relations: (1) exchange of help and services; (2) debate of farming/management; (3) shared interests and (4) friendship. While the pattern of relations overall supported the idea that people interact more with their own social group, the analysis also showed...

  14. Identifying areas of need relative to liver disease: geographic clustering within a health service district.

    Science.gov (United States)

    El-Atem, Nathan; Irvine, Katharine M; Valery, Patricia C; Wojcik, Kyle; Horsfall, Leigh; Johnson, Tracey; Janda, Monika; McPhail, Steven M; Powell, Elizabeth E

    2017-08-01

    accessing tertiary hospital liver services are clustered within specific geographic areas. The most striking geographic clustering was seen for people living with chronic hepatitis B, in regions with a relatively high proportion of people born in Vietnam and China. In addition to ethnicity, the data show an apparent ecological association between liver disease and both socioeconomic and educational and/or occupational disadvantage. What are the implications for practitioners? Identifying where demand for clinical services arises is an important step for service planning and preparing for potential outreach programs to optimise community-based care. It is likely that outreach programs to engage and enhance primary care services in geographic areas from which the greatest demand for tertiary liver disease speciality care arises would yield greater relative return on investment than non-targeted outreach programs.

  15. THE CHARACTERISTICS OF SMALL FIRMS THAT SERVE AS OWNERS’ “PRIMARY EMPLOYMENT”

    Directory of Open Access Journals (Sweden)

    HALIL DINCER KAYA

    2017-02-01

    Full Text Available Our objective in this study is to examine the relation between firm characteristics and entrepreneurship as “primary employment”. What type of small firms are organized in a way to promote “primary employment”? In order to achieve that objective, we compare firm characteristics in high “primary employment” U.S. states versus in low “primary employment” states. We use the “United States Small Business Friendliness Survey” done by Kauffman Foundation and Thumptack.com in 2013. Our nonparametric tests show that in the states where relatively high percentage of owners have their business as “primary employment” (i.e. “high primary employment states”, firms tend to be limited in their operational area (i.e. operate only in that state although their sales are less local (meaning that they focus on other areas in their state rather than their own locale. In these states, while more firms are in the “home maintenance and repair” industry, fewer firms operate in the “events” industry. We also find that there is no significant difference between high- and low-primary employment states in terms of firm age and firm size. We advise policymakers to use these findings when formulating policies that support entrepreneurship as “primary employment”.

  16. Validating the accuracy of GIS-based accessibility analysis in determining public primary health care demand in metropolitan areas: conference presentation

    CSIR Research Space (South Africa)

    Mokgalaka, H

    2014-07-01

    Full Text Available selected for the analysis are mainly those that offered public primary health care services and acted as first point of contact with the health service delivery system. Attached to the facility data are attribute data indicating the capacity...-Based Accessibility Analysis in Determining Public Primary Health Care Demand in Metropolitan Areas Hunadi Mokgalaka July 2014 Contents • Service access planning • GIS-based accessibility analysis • Key challenges to application • Methodology...

  17. CDC73-Related Disorders: Clinical Manifestations and Case Detection in Primary Hyperparathyroidism

    NARCIS (Netherlands)

    van der Tuin, Karin; Tops, Carli M. J.; Adank, Muriel A.; Cobben, Jan-Maarten; Hamdy, Neveen A. T.; Jongmans, Marjolijn C.; Menko, Fred H.; van Nesselrooij, Bernadette P. M.; Netea-Maier, Romana T.; Oosterwijk, Jan C.; Valk, Gerlof D.; Wolffenbuttel, Bruce H. R.; Hes, Frederik J.; Morreau, Hans

    2017-01-01

    Context: Heterozygous pathogenic germline variants in CDC73 predispose to the development of primary hyperparathyroidism (pHPT) and, less frequently, ossifying fibroma of the jaw and renal and uterine tumors. Clinical information on CDC73-related disorders has so far been limited to small case

  18. The relationship between BMI and dietary intake of primary school children from a rural area of South Africa: The Ellisras longitudinal study

    NARCIS (Netherlands)

    Van Den Ende, C.; Twisk, J.W.R.; Monyeki, K.D.

    2014-01-01

    Objectives: To investigate the relationship between dietary intake and BMI of primary school children from a rural area of South Africa cross-sectionally. Both under and over nutrition remain major health problems in South Africa. In rural areas, where especially undernutrition leads to child

  19. Healthcare provider perceptions of the role of interprofessional care in access to and outcomes of primary care in an underserved area.

    Science.gov (United States)

    Wan, Shaowei; Teichman, Peter G; Latif, David; Boyd, Jennifer; Gupta, Rahul

    2018-03-01

    To meet the needs of an aging population who often have multiple chronic conditions, interprofessional care is increasingly adopted by patient-centred medical homes and Accountable Care Organisations to improve patient care coordination and decrease costs in the United States, especially in underserved areas with primary care workforce shortages. In this cross-sectional survey across multiple clinical settings in an underserved area, healthcare providers perceived overall outcomes associated with interprofessional care teams as positive. This included healthcare providers' beliefs that interprofessional care teams improved patient outcomes, increased clinic efficiency, and enhanced care coordination and patient follow-up. Teams with primary care physician available each day were perceived as better able to coordinate care and follow up with patients (p = .031), while teams that included clinical pharmacists were perceived as preventing medication-associated problems (p care model as a useful strategy to improve various outcomes across different clinical settings in the context of a shortage of primary care physicians.

  20. Improvement of auditory hallucinations and reduction of primary auditory area's activation following TMS

    International Nuclear Information System (INIS)

    Giesel, Frederik L.; Mehndiratta, Amit; Hempel, Albrecht; Hempel, Eckhard; Kress, Kai R.; Essig, Marco; Schröder, Johannes

    2012-01-01

    Background: In the present case study, improvement of auditory hallucinations following transcranial magnetic stimulation (TMS) therapy was investigated with respect to activation changes of the auditory cortices. Methods: Using functional magnetic resonance imaging (fMRI), activation of the auditory cortices was assessed prior to and after a 4-week TMS series of the left superior temporal gyrus in a schizophrenic patient with medication-resistant auditory hallucinations. Results: Hallucinations decreased slightly after the third and profoundly after the fourth week of TMS. Activation in the primary auditory area decreased, whereas activation in the operculum and insula remained stable. Conclusions: Combination of TMS and repetitive fMRI is promising to elucidate the physiological changes induced by TMS.

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

    Science.gov (United States)

    Longwe, Abiba; Smits, Jeroen

    2013-06-01

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

  2. [Accidents with biological material in health care workers in 2 primary health care areas (1990-1999)].

    Science.gov (United States)

    Hernández Navarrete, M J; Montes Villameriel, F J; Solano Bernad, V M; Sánchez Matienzo, D; del Val García, J L; Gil Montalbán, E; Arribas Llorente, J L

    2001-09-15

    To find out the exposures with biological material in health care workers in primary health care, registered in the biological accidents database from Preventive Medicine Service in Miguel Servet Universitary Hospital of Zaragoza. Descriptive study of a retrospective cohort. SITE: Primary health care, Areas II and V of Zaragoza.Participants. Workers in this areas, distributed by: physician, nursing staff, auxiliary, orderly, housekeeping staff, others. Data of: workers, accident, serologic source, worker protection and vaccinal status of hepatitis B. The incidence of accidents was 26 (period 1997-1999). Most proportion of accidents were declared by nursing (78%). The highest occupational incidence was in auxiliary (63 ). In 90,1% of the cases, the accident was needlestick injury. The source was known in 67,7% of cases. The accidents occurred in hands in 96,8% of cases, and only one third of workers carried gloves. Results obtained are similar with previous studies about this event. We must insist on the need to declare these accidents, providing more information and accessibility for the declaration to worker. Moreover, we must insist on the correct application in the health care field of the standard precautions, because almost 50% of accidents are evitable, and to increase hepatitis B vaccination covertures.

  3. Factors Related to Perceived Needs of Primary Caregivers of Patients with Schizophrenia

    Directory of Open Access Journals (Sweden)

    Ling-Ling Yeh

    2008-08-01

    Conclusion: Four clusters of caregivers' perceived needs were identified and found to be related to psychopathologic and demographic factors. These data are of value in designing appropriate community psychiatric programs to improve the quality of care and enhance the capacity of primary caregivers to care for patients.

  4. Reviewing the relations between teachers' knowledge and pupils' attitude in the field of primary technology education

    NARCIS (Netherlands)

    Ruurd Taconis; dr. Ellen J. J Rohaan; Wim Jochems

    2010-01-01

    This literature review reports on the assumed relations between primary school teachers' knowledge of technology and pupils' attitude towards technology. In order to find relevant aspects of technology-specific teacher knowledge, scientific literature in the field of primary technology education was

  5. [Preventable drug-related morbidity: determining valid indicators for primary care in Portugal].

    Science.gov (United States)

    Guerreiro, Mara Pereira; Cantrill, Judith A; Martins, Ana Paula

    2007-01-01

    Preventable drug-related morbidity (PDRM) indicators are operational measures of therapeutic risk management. These clinical indicators, which cover a wide range of drugs, combine process and outcome in the same instrument. They were developed in the US and have been validated for primary care settings in the US, UK and Canada. This study is part of a research programme; it aimed to determine a valid set of PDRM indicators for adult patients in primary care in Portugal. Face validity of 61 US and UK-derived indicators translated to Portuguese was preliminarily determined by means of a postal questionnaire using a purposive sample of four Portuguese pharmacists with different backgrounds. Preliminary content validity of indicators approved in the previous stage was determined by cross-checking each definition of PDRM with standard drug information sources in Portugal. Face and content validity of indicators yielded by preliminary work were then established by a 37 expert panel (20 community pharmacists and 17 general practitioners) using a two-round Delphi survey. Data were analysed using SPSS release 11.5. Nineteen indicators were ruled out in preliminary validation. Changes were made in the content of eight of the remaining 42 indicators; these were related to differences in the drugs being marketed and patterns of drug monitoring between countries. Thirty-five indicators were consensus approved as PDRM for adult patients in Portuguese primary care by the Delphi panel.

  6. Food-Related Odors Activate Dopaminergic Brain Areas

    Directory of Open Access Journals (Sweden)

    Agnieszka Sorokowska

    2017-12-01

    Full Text Available Food-associated cues of different sensory categories have often been shown to be a potent elicitor of cerebral activity in brain reward circuits. Smells influence and modify the hedonic qualities of eating experience, and in contrast to smells not associated with food, perception of food-associated odors may activate dopaminergic brain areas. In this study, we aimed to verify previous findings related to the rewarding value of food-associated odors by means of an fMRI design involving carefully preselected odors of edible and non-edible substances. We compared activations generated by three food and three non-food odorants matching in terms of intensity, pleasantness and trigeminal qualities. We observed that for our mixed sample of 30 hungry and satiated participants, food odors generated significantly higher activation in the anterior cingulate cortex (right and left, insula (right, and putamen (right than non-food odors. Among hungry subjects, regardless of the odor type, we found significant activation in the ventral tegmental area in response to olfactory stimulation. As our stimuli were matched in terms of various perceptual qualities, this result suggests that edibility of an odor source indeed generates specific activation in dopaminergic brain areas.

  7. Developing Guidelines to Enhance Students Desirable Characteristics for Schools under the Office of Udornthani Primary Education Service Area 1

    Directory of Open Access Journals (Sweden)

    Aroonsiri Janlon

    2017-09-01

    Full Text Available The purposes of this research were 1 to study the elements and indicators students desirable characteristics for schools ; 2 to study the present condition and the desirable of students desirable characteristics for schools ; and 3 to develop guidelines to enhance students desirable characteristics for schools under the office of Udornthani primary education service area 1. Research and development. Method was divided into three phases for the purposes of research. The samples were 296 teachers and school administrators, using stratified random sampling. Instruments used were questionnaire, assessment elements and indicators, interview form and assessment guidelines. Data were analyzed using mean, standard devitation and modified priority needs index. Research findings were as follows: 1. There were 3 elements of students desirable characteristics for schools consisted of discipline, learning and commitment to work. Discipline consisted of four indicators, learning consisted of indicators and commitment to work consisted of two indicators. 2. The current situation of students desirable characteristics for schools under the office of Udornthani primary education service area 1, overall at a high level, considering each element, discipline was the highest, followed by learning and the lowest was commitment to work as well. In desirable situation the same relults on the current situation. 3. Guidelines to enhance students desirable characteristics for schools under the office of Udornthani primary education service area 1 consisted of 7 guidelines: 1 the policy clearly ; 2 providing specialized committees ; 3 creating a common understanding ; 4 targeting clearly ; 5 the environmental moral ; 6 supervision, monitoring and evaluation ; and 7 creating a network of parents and the community.

  8. Health information technology workforce needs of rural primary care practices.

    Science.gov (United States)

    Skillman, Susan M; Andrilla, C Holly A; Patterson, Davis G; Fenton, Susan H; Ostergard, Stefanie J

    2015-01-01

    This study assessed electronic health record (EHR) and health information technology (HIT) workforce resources needed by rural primary care practices, and their workforce-related barriers to implementing and using EHRs and HIT. Rural primary care practices (1,772) in 13 states (34.2% response) were surveyed in 2012 using mailed and Web-based questionnaires. EHRs or HIT were used by 70% of respondents. Among practices using or intending to use the technology, most did not plan to hire new employees to obtain EHR/HIT skills and even fewer planned to hire consultants or vendors to fill gaps. Many practices had staff with some basic/entry, intermediate and/or advanced-level skills, but nearly two-thirds (61.4%) needed more staff training. Affordable access to vendors/consultants who understand their needs and availability of community college and baccalaureate-level training were the workforce-related barriers cited by the highest percentages of respondents. Accessing the Web/Internet challenged nearly a quarter of practices in isolated rural areas, and nearly a fifth in small rural areas. Finding relevant vendors/consultants and qualified staff were greater barriers in small and isolated rural areas than in large rural areas. Rural primary care practices mainly will rely on existing staff for continued implementation and use of EHR/HIT systems. Infrastructure and workforce-related barriers remain and must be overcome before practices can fully manage patient populations and exchange patient information among care system partners. Efforts to monitor adoption of these skills and ongoing support for continuing education will likely benefit rural populations. © 2014 National Rural Health Association.

  9. Food-Related Odors Activate Dopaminergic Brain Areas

    OpenAIRE

    Agnieszka Sorokowska; Agnieszka Sorokowska; Katherina Schoen; Cornelia Hummel; Pengfei Han; Jonathan Warr; Thomas Hummel

    2017-01-01

    Food-associated cues of different sensory categories have often been shown to be a potent elicitor of cerebral activity in brain reward circuits. Smells influence and modify the hedonic qualities of eating experience, and in contrast to smells not associated with food, perception of food-associated odors may activate dopaminergic brain areas. In this study, we aimed to verify previous findings related to the rewarding value of food-associated odors by means of an fMRI design involving careful...

  10. Investigation the opinions of the primary science teachers toward practice of teaching and learning activities in science learning area

    Science.gov (United States)

    Chamnanwong, Pornpaka; Thathong, Kongsak

    2018-01-01

    In preparing a science lesson plan, teachers may deal with numerous difficulties. Having a deep understanding of their problems and their demands is extremely essential for the teachers in preparing themselves for the job. Moreover, it is also crucial for the stakeholders in planning suitable and in-need teachers' professional development programs, in school management, and in teaching aid. This study aimed to investigate the primary school science teachers' opinion toward practice of teaching and learning activities in science learning area. Target group was 292 primary science teachers who teach Grade 4 - 6 students in Khon Kaen Province, Thailand in the academic year of 2014. Data were collected using Questionnaire about Investigation the opinions of the primary science teachers toward practice of teaching and learning activities in science learning area. The questionnaires were consisted of closed questions scored on Likert scale and open-ended questions that invite a sentence response to cover from LS Process Ideas. Research findings were as follow. The primary science teachers' level of opinion toward teaching and learning science subject ranged from 3.19 - 3.93 (mean = 3.43) as "Moderate" level of practice. The primary school science teachers' needs to participate in a training workshop based on LS ranged from 3.66 - 4.22 (mean = 3.90) as "High" level. The result indicated that they were interested in attending a training course under the guidance of the Lesson Study by training on planning of management of science learning to solve teaching problems in science contents with the highest mean score 4.22. Open-ended questions questionnaire showed the needs of the implementation of the lesson plans to be actual classrooms, and supporting for learning Medias, innovations, and equipment for science experimentation.

  11. Vision first? The development of primary visual cortical networks is more rapid than the development of primary motor networks in humans.

    Directory of Open Access Journals (Sweden)

    Patricia Gervan

    Full Text Available The development of cortical functions and the capacity of the mature brain to learn are largely determined by the establishment and maintenance of neocortical networks. Here we address the human development of long-range connectivity in primary visual and motor cortices, using well-established behavioral measures--a Contour Integration test and a Finger-tapping task--that have been shown to be related to these specific primary areas, and the long-range neural connectivity within those. Possible confounding factors, such as different task requirements (complexity, cognitive load are eliminated by using these tasks in a learning paradigm. We find that there is a temporal lag between the developmental timing of primary sensory vs. motor areas with an advantage of visual development; we also confirm that human development is very slow in both cases, and that there is a retained capacity for practice induced plastic changes in adults. This pattern of results seems to point to human-specific development of the "canonical circuits" of primary sensory and motor cortices, probably reflecting the ecological requirements of human life.

  12. Awake craniotomy for brain lesions within and near the primary motor area: A retrospective analysis of factors associated with worsened paresis in 102 consecutive patients

    Science.gov (United States)

    Shinoura, Nobusada; Midorikawa, Akira; Yamada, Ryoji; Hana, Taijun; Saito, Akira; Hiromitsu, Kentaro; Itoi, Chisato; Saito, Syoko; Yagi, Kazuo

    2013-01-01

    Background: We analyzed factors associated with worsened paresis in a large series of patients with brain lesions located within or near the primary motor area (M1) to establish protocols for safe, awake craniotomy of eloquent lesions. Methods: We studied patients with brain lesions involving M1, the premotor area (PMA) and the primary sensory area (S1), who underwent awake craniotomy (n = 102). In addition to evaluating paresis before, during, and one month after surgery, the following parameters were analyzed: Intraoperative complications; success or failure of awake surgery; tumor type (A or B), tumor location, tumor histology, tumor size, and completeness of resection. Results: Worsened paresis at one month of follow-up was significantly associated with failure of awake surgery, intraoperative complications and worsened paresis immediately after surgery, which in turn was significantly associated with intraoperative worsening of paresis. Intraoperative worsening of paresis was significantly related to preoperative paresis, type A tumor (motor tract running in close proximity to and compressed by the tumor), tumor location within or including M1 and partial removal (PR) of the tumor. Conclusions: Successful awake surgery and prevention of deterioration of paresis immediately after surgery without intraoperative complications may help prevent worsening of paresis at one month. Factors associated with intraoperative worsening of paresis were preoperative motor deficit, type A and tumor location in M1, possibly leading to PR of the tumor. PMID:24381792

  13. School Effectiveness at Primary Level of Education in Relation to Classroom Teaching

    Science.gov (United States)

    Panigrahi, Manas Ranjan

    2014-01-01

    The study aims to investigate the relationship of School Effectiveness with regard to classroom teaching at primary level of education. The objectives of the study were to identify the more-effective and less-effective schools; to find out the differences between more-effective and less-effective schools in relation to physical facilities, Head…

  14. Metaphors of Primary School Students Relating to the Concept of Global Warming

    Science.gov (United States)

    Dogru, Mustafa; Sarac, Esra

    2013-01-01

    The purpose of this study is to reveal the metaphors of primary school students (n = 362) relating to the concept of global warming. Data collected by completing the expression of "global warming is like..., because..." of the students were analysed by use of qualitative and quantitative data analysis techniques. According to findings of…

  15. School Effectiveness at Primary Level of Education in Relation to Classroom Teaching

    Directory of Open Access Journals (Sweden)

    Manas Ranjan Panigrahi

    2014-07-01

    Full Text Available The study aims to investigate the relationship of School Effectiveness with regard to classroom teaching at primary level of education. The objectives of the study were to identify the more-effective and less-effective schools; to find out the differences between more-effective and less-effective schools in relation to physical facilities, Head Master and Teachers’ performance and Students’ performance; to find out the relationship between the school effectiveness and classroom teaching. The descriptive survey method was used to carry out this study. A Total number of 27 more-effective and 35 less-effective primary schools were included in the sample of the present study. And also all principals of selected schools and from each school 2 teachers were selected to know their classroom teaching in the classroom situation. The selection of teachers was based on their teaching the classes (III, IV and V, to investigate their participation in school activities. The findings of the present study on school effectiveness and classroom teaching find adequate support from similar or related studies. Thus, the above discussion reflects that there is no simple combination of factors, which can produce effective school. The study has, however, revealed that school effectiveness has emerged as related to classroom teaching.

  16. Relative risk of visceral leishmaniasis in Brazil: a spatial analysis in urban area.

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    Valdelaine Etelvina Miranda de Araújo

    2013-11-01

    Full Text Available BACKGROUND: Visceral leishmaniasis (VL is a vector-borne disease whose factors involved in transmission are poorly understood, especially in more urban and densely populated counties. In Brazil, the VL urbanization is a challenge for the control program. The goals were to identify the greater risk areas for human VL and the risk factors involved in transmission. METHODOLOGY: This is an ecological study on the relative risk of human VL. Spatial units of analysis were the coverage areas of the Basic Health Units (146 small-areas of Belo Horizonte, Minas Gerais State, Brazil. Human VL cases, from 2007 to 2009 (n = 412, were obtained in the Brazilian Reportable Disease Information System. Bayesian approach was used to model the relative risk of VL including potential risk factors involved in transmission (canine infection, socioeconomic and environmental features and to identify the small-areas of greater risk to human VL. PRINCIPAL FINDINGS: The relative risk of VL was shown to be correlated with income, education, and the number of infected dogs per inhabitants. The estimates of relative risk of VL were higher than 1.0 in 54% of the areas (79/146. The spatial modeling highlighted 14 areas with the highest relative risk of VL and 12 of them are concentrated in the northern region of the city. CONCLUSIONS: The spatial analysis used in this study is useful for the identification of small-areas according to risk of human VL and presents operational applicability in control and surveillance program in an urban environment with an unequal spatial distribution of the disease. Thus the frequent monitoring of relative risk of human VL in small-areas is important to direct and prioritize the actions of the control program in urban environment, especially in big cities.

  17. Imaging findings of primary immunoglobulin G4-related cervical lymphadenopathy

    International Nuclear Information System (INIS)

    Kawaguchi, Masaya; Kato, Hiroki; Goshima, Satoshi; Matsuo, Masayuki; Kito, Yusuke; Mizuta, Keisuke; Aoki, Mitsuhiro; Kato, Keizo

    2017-01-01

    The purpose of the present study was to assess imaging findings of primary immunoglobulin G4 (IgG4)-related cervical lymphadenopathy. Five consecutive patients with clinically, serologically, and histopathologically confirmed primary IgG4-related cervical lymphadenopathy without any other organ involvement were included. All patients underwent contrast-enhanced computed tomography (CT), and four underwent 18 F-fluorodeoxyglucose (FDG)-positron emission tomography (PET)/CT. We retrospectively reviewed the images and assessed the number, size, location, central necrosis, perinodal infiltration, penetrating vessels, and maximum standardized uptake values (SUVmax) of the enlarged cervical nodes. Thirteen enlarged cervical nodes measuring larger than 10 mm in minimum diameter were identified. The maximum and minimum diameter of enlarged nodes ranged from 1.2 to 3.2 cm (median, 1.8 cm) and from 1.0 to 1.9 cm (median, 1.2 cm), respectively. Lymphadenopathy was unilateral in all patients, and eight enlarged nodes were located at level IB (62%), one at level II (8%), three at level IV (23%), and one at level V (8%). Central necrosis was not seen in any nodes. Perinodal infiltration was seen in only one node (8%), and penetrating vessels were seen in seven nodes (54%). The median SUVmax of nine nodes was 4.45 (range, 2.08-12.44). Eight enlarged nodes (62%) were located in the submandibular region. Central necrosis was not observed in any nodes and perinodal infiltration was observed in one node (8%). (orig.)

  18. Imaging findings of primary immunoglobulin G4-related cervical lymphadenopathy

    Energy Technology Data Exchange (ETDEWEB)

    Kawaguchi, Masaya; Kato, Hiroki; Goshima, Satoshi; Matsuo, Masayuki [Gifu University School of Medicine, Department of Radiology, Gifu (Japan); Kito, Yusuke [Gifu University School of Medicine, Department of Pathology and Translational Research, Gifu (Japan); Mizuta, Keisuke; Aoki, Mitsuhiro [Gifu University School of Medicine, Department of Otolaryngology, Gifu (Japan); Kato, Keizo [Gifu University School of Medicine, Department of Oral and Maxillofacial Sciences, Gifu (Japan)

    2017-11-15

    The purpose of the present study was to assess imaging findings of primary immunoglobulin G4 (IgG4)-related cervical lymphadenopathy. Five consecutive patients with clinically, serologically, and histopathologically confirmed primary IgG4-related cervical lymphadenopathy without any other organ involvement were included. All patients underwent contrast-enhanced computed tomography (CT), and four underwent {sup 18}F-fluorodeoxyglucose (FDG)-positron emission tomography (PET)/CT. We retrospectively reviewed the images and assessed the number, size, location, central necrosis, perinodal infiltration, penetrating vessels, and maximum standardized uptake values (SUVmax) of the enlarged cervical nodes. Thirteen enlarged cervical nodes measuring larger than 10 mm in minimum diameter were identified. The maximum and minimum diameter of enlarged nodes ranged from 1.2 to 3.2 cm (median, 1.8 cm) and from 1.0 to 1.9 cm (median, 1.2 cm), respectively. Lymphadenopathy was unilateral in all patients, and eight enlarged nodes were located at level IB (62%), one at level II (8%), three at level IV (23%), and one at level V (8%). Central necrosis was not seen in any nodes. Perinodal infiltration was seen in only one node (8%), and penetrating vessels were seen in seven nodes (54%). The median SUVmax of nine nodes was 4.45 (range, 2.08-12.44). Eight enlarged nodes (62%) were located in the submandibular region. Central necrosis was not observed in any nodes and perinodal infiltration was observed in one node (8%). (orig.)

  19. Factors affecting subspecialty referrals by pediatric primary care providers for children with obesity-related comorbidities.

    Science.gov (United States)

    Walsh, Carolyn O; Milliren, Carly E; Feldman, Henry A; Taveras, Elsie M

    2013-08-01

    To determine referral patterns from pediatric primary care to subspecialists for overweight/obesity and related comorbidities. We used the National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey to identify overweight/obesity and 5 related comorbidities in primary care visits between 2005 and 2009 by children 6 to 18 years. The primary outcome was whether the visit ended in referral. We used multivariable analysis to examine factors associated with referral. We identified 34,225 database visits. A total of 17.1% were with overweight (body mass index=85th to 94th percentile) or obese (body mass index≥95th percentile) patients. A total of 7.1% of primary care visits with overweight/obese children ended in referral. Referral was more likely when obesity was the reason for visit (odds ratio=2.83; 95% confidence interval=1.61-4.97) but was not associated with presence of a comorbidity (odds ratio=1.35; 95% confidence interval=0.75-2.44). Most overweight or obese children are not referred, regardless of comorbidity status. One reason may be low levels of appropriate diagnosis.

  20. The cooperation of the functional activation areas in human brain: an application of event-related fMRI study of the voluntary motor function

    International Nuclear Information System (INIS)

    Li Enzhong; Tian Jie; Dai Ruwei

    2002-01-01

    Objective: To detect the cooperation of the functional activation areas in human brain using event-related fMRI technique developed in recent years. Methods: Forty-four subjects were selected in this experiment and scanned by GE Signa Horizon 1.5 Tesla superconductive MR system. A CUE-GO paradigm was used in this experiment. The data were analyzed in SUN and SGI workstation. Results: The activation areas were found in contralateral primary motor area (Ml), bilateral supplementary motor areas (SMA), pre-motor areas (PMA), basal ganglia, and cerebellar cortices. The time-signal curve of Ml was a typical single-peak curve, but the curves in PMA, basal ganglia, and cerebellar cortices were double-peak curves. SMA had 2 parts, one was Pre-SMA, and another was SMA Proper. The curve was double-peak type in Pre-SMA and single-peak type in SMA Proper. There was difference between the time-signal intensity curves in above-mentioned areas. Conclusion: (1) Ml is mainly associated with motor execution, while others with both motor preparation and execution. There are differences in the function at the variant areas in the brain. (2) The fact that bilateral SMA, PMA, basal ganglia, and cerebellar cortices were activated, is different from what the classical theories told. (3) Event-related fMRI technique has higher temporary and spatial resolutions. (4) There is cooperation among different cortical areas, basal ganglia, and cerebellum

  1. Are ranger patrols effective in reducing poaching-related threats within protected areas?

    Science.gov (United States)

    Moore, Jennnifer F.; Mulindahabi, Felix; Masozera, Michel K.; Nichols, James; Hines, James; Turikunkiko, Ezechiel; Oli, Madan K.

    2018-01-01

    Poaching is one of the greatest threats to wildlife conservation world-wide. However, the spatial and temporal patterns of poaching activities within protected areas, and the effectiveness of ranger patrols and ranger posts in mitigating these threats, are relatively unknown.We used 10 years (2006–2015) of ranger-based monitoring data and dynamic multi-season occupancy models to quantify poaching-related threats, to examine factors influencing the spatio-temporal dynamics of these threats and to test the efficiency of management actions to combat poaching in Nyungwe National Park (NNP), Rwanda.The probability of occurrence of poaching-related threats was highest at lower elevations (1,801–2,200 m), especially in areas that were close to roads and tourist trails; conversely, occurrence probability was lowest at high elevation sites (2,601–3,000 m), and near the park boundary and ranger posts. The number of ranger patrols substantially increased the probability that poaching-related threats disappear at a site if threats were originally present (i.e. probability of extinction of threats). Without ranger visits, the annual probability of extinction of poaching-related threats was an estimated 7%; this probability would increase to 20% and 57% with 20 and 50 ranger visits per year, respectively.Our results suggest that poaching-related threats can be effectively reduced in NNP by adding ranger posts in areas where they do not currently exist, and by increasing the number of patrols to sites where the probability of poaching activities is high.Synthesis and applications. Our application of dynamic occupancy models to predict the probability of presence of poaching-related threats is novel, and explicitly considers imperfect detection of illegal activities. Based on the modelled relationships, we identify areas that are most vulnerable to poaching, and offer insights regarding how ranger patrols can be optimally deployed to reduce poaching-related threats and

  2. Assessment of mitochondrial dysfunction-related, drug-induced hepatotoxicity in primary rat hepatocytes

    International Nuclear Information System (INIS)

    Liu, Cong; Sekine, Shuichi; Ito, Kousei

    2016-01-01

    Evidence that mitochondrial dysfunction plays a central role in drug-induced liver injury is rapidly accumulating. In contrast to physiological conditions, in which almost all adenosine triphosphate (ATP) in hepatocytes is generated in mitochondria via aerobic respiration, the high glucose content and limited oxygen supply of conventional culture systems force primary hepatocytes to generate most ATP via cytosolic glycolysis. Thus, such anaerobically poised cells are resistant to xenobiotics that impair mitochondrial function, and are not suitable to identify drugs with mitochondrial liabilities. In this study, primary rat hepatocytes were cultured in galactose-based medium, instead of the conventional glucose-based medium, and in hyperoxia to improve the reliance of energy generation on aerobic respiration. Activation of mitochondria was verified by diminished cellular lactate release and increased oxygen consumption. These conditions improved sensitivity to the mitochondrial complex I inhibitor rotenone. Since oxidative stress is also a general cause of mitochondrial impairment, cells were exposed to test compounds in the presence of transferrin to increase the generation of reactive oxygen species via increased uptake of iron. Finally, 14 compounds with reported mitochondrial liabilities were tested to validate this new drug-induced mitochondrial toxicity assay. Overall, the culture of primary rat hepatocytes in galactose, hyperoxia and transferrin is a useful model for the identification of mitochondrial dysfunction-related drug-induced hepatotoxicity. - Highlights: • Drug-induced mitochondrial toxicity was evaluated using primary rat hepatocytes. • Galactose and hyperoxia could activate OXPHOS in primary rat hepatocytes. • Cells with enhanced OXPHOS exhibit improved sensitivity to mitochondrial toxins. • Transferrin potentiate mitochondrial toxicity via increased ROS production.

  3. Assessment of mitochondrial dysfunction-related, drug-induced hepatotoxicity in primary rat hepatocytes

    Energy Technology Data Exchange (ETDEWEB)

    Liu, Cong; Sekine, Shuichi, E-mail: ssekine@faculty.chiba-u.jp; Ito, Kousei

    2016-07-01

    Evidence that mitochondrial dysfunction plays a central role in drug-induced liver injury is rapidly accumulating. In contrast to physiological conditions, in which almost all adenosine triphosphate (ATP) in hepatocytes is generated in mitochondria via aerobic respiration, the high glucose content and limited oxygen supply of conventional culture systems force primary hepatocytes to generate most ATP via cytosolic glycolysis. Thus, such anaerobically poised cells are resistant to xenobiotics that impair mitochondrial function, and are not suitable to identify drugs with mitochondrial liabilities. In this study, primary rat hepatocytes were cultured in galactose-based medium, instead of the conventional glucose-based medium, and in hyperoxia to improve the reliance of energy generation on aerobic respiration. Activation of mitochondria was verified by diminished cellular lactate release and increased oxygen consumption. These conditions improved sensitivity to the mitochondrial complex I inhibitor rotenone. Since oxidative stress is also a general cause of mitochondrial impairment, cells were exposed to test compounds in the presence of transferrin to increase the generation of reactive oxygen species via increased uptake of iron. Finally, 14 compounds with reported mitochondrial liabilities were tested to validate this new drug-induced mitochondrial toxicity assay. Overall, the culture of primary rat hepatocytes in galactose, hyperoxia and transferrin is a useful model for the identification of mitochondrial dysfunction-related drug-induced hepatotoxicity. - Highlights: • Drug-induced mitochondrial toxicity was evaluated using primary rat hepatocytes. • Galactose and hyperoxia could activate OXPHOS in primary rat hepatocytes. • Cells with enhanced OXPHOS exhibit improved sensitivity to mitochondrial toxins. • Transferrin potentiate mitochondrial toxicity via increased ROS production.

  4. Entropy function and universality of entropy-area relation for small black holes

    International Nuclear Information System (INIS)

    Cai Ronggen; Chen, C.-M.; Maeda, Kei-ichi; Ohta, Nobuyoshi; Pang Dawei

    2008-01-01

    We discuss the entropy-area relation for the small black holes with higher curvature corrections by using the entropy function formalism and field redefinition method. We show that the entropy S BH of the small black hole is proportional to its horizon area A. In particular, we find a universal result that S BH =A/2G, the ratio is 2 times of Bekenstein-Hawking entropy-area formula in many cases of physical interest. In four dimensions, the universal relation is always true irrespective of the coefficients of the higher-order terms if the dilaton couplings are the same, which is the case for string effective theory, while in five dimensions, the relation again holds irrespective of the overall coefficient if the higher-order corrections are in the GB combination. We also discuss how this result generalizes to known physically interesting cases with Lovelock correction terms in various dimensions, and possible implications of the universal relation.

  5. Varicella-related Primary Health-care Visits, Hospitalizations and Mortality in Norway, 2008-2014.

    Science.gov (United States)

    Mirinaviciute, Grazina; Kristensen, Erle; Nakstad, Britt; Flem, Elmira

    2017-11-01

    Norway does not currently implement universal varicella vaccination in childhood. We aimed to characterize health care burden of varicella in Norway in the prevaccine era. We linked individual patient data from different national registries to examine varicella vaccinations and varicella-coded primary care consultations, hospitalizations, outpatient hospital visits, deaths and viral infections of central nervous system in the whole population of Norway during 2008-2014. We estimated health care contact rates and described the epidemiology of medically attended varicella infection. Each year approximately 14,600 varicella-related contacts occurred within primary health care and hospital sector in Norway. The annual contact rate was 221 cases per 100,000 population in primary health care and 7.3 cases per 100,000 in hospital care. Both in primary and hospital care, the highest incidences were observed among children 1 year of age: 2,654 and 78.1 cases per 100,000, respectively. The annual varicella mortality was estimated at 0.06 deaths per 100,000 and in-hospital case-fatality rate at 0.3%. Very few (0.2-0.5%) patients were vaccinated against varicella. Among hospitalized varicella patients, 22% had predisposing conditions, 9% had severe-to-very severe comorbidities and 5.5% were immunocompromised. Varicella-related complications were reported in 29.3% of hospitalized patients. Varicella zoster virus was the third most frequent virus found among 16% of patients with confirmed viral infections of central nervous system. Varicella causes a considerable health care burden in Norway, especially among children. To inform the policy decision on the use of varicella vaccination, a health economic assessment of vaccination and mathematical modeling of vaccination impact are needed.

  6. Responsiveness of Lebanon's primary healthcare centers to non-communicable diseases and related healthcare needs.

    Science.gov (United States)

    Yassoub, Rami; Hashimi, Suha; Awada, Siham; El-Jardali, Fadi

    2014-01-01

    Lebanon currently faces a rise in non-communicable diseases (NCD) that is stressing the population's health and financial well-being. Preventive care is recognized as the optimal health equitable, cost-effective solution. The study aims to assess the responsiveness of primary health care centers (PHCs) to NCD, and identify the needed health arrangements and responsibilities of PHCs, the Ministry Of Public Health and other healthcare system entities, for PHCs to purse a more preventive role against NCD. Single and group interviews were conducted via a semi-structured questionnaire with 10 PHCs from Lebanon's primary health care network that have undergone recent pilot accreditation and are recognized for having quality services and facilities. This manifested administrative aspects and NCD-related services of PHCs and generated information regarding the centers' deficiencies, strengths and areas needing improvement for fulfilling a more preventive role. Administrative features of PHCs varied according to number and type of health personnel employed. Variations and deficiencies within and among PHCs were manifested specifically at the level of cardiovascular and respiratory diseases and cancer. PHCs identified the pilot accreditation as beneficial at the administrative and clinical levels; however, various financial and non-financial resources, in addition to establishing a strong referral system with secondary care settings and further arrangements with MOPH, are necessary for PHCs to pursue a stronger preventive role. The generated results denote needed changes within the healthcare system's governance, financing and delivery. They involve empowering PHCs and increasing their breadth of services, allocating a greater portion of national budget to health and preventive care, and equipping PHCs with personnel skilled in conducting community-wide preventive activities. Copyright © 2013 John Wiley & Sons, Ltd.

  7. Incidence of second primary malignancies and related mortality in patients with imatinib-treated chronic myeloid leukemia.

    Science.gov (United States)

    Gugliotta, Gabriele; Castagnetti, Fausto; Breccia, Massimo; Albano, Francesco; Iurlo, Alessandra; Intermesoli, Tamara; Abruzzese, Elisabetta; Levato, Luciano; D'Adda, Mariella; Pregno, Patrizia; Cavazzini, Francesco; Stagno, Fabio; Martino, Bruno; La Barba, Gaetano; Sorà, Federica; Tiribelli, Mario; Bigazzi, Catia; Binotto, Gianni; Bonifacio, Massimiliano; Caracciolo, Clementina; Soverini, Simona; Foà, Robin; Cavo, Michele; Martinelli, Giovanni; Pane, Fabrizio; Saglio, Giuseppe; Baccarani, Michele; Rosti, Gianantonio

    2017-09-01

    The majority of patients with chronic myeloid leukemia are successfully managed with life-long treatment with tyrosine kinase inhibitors. In patients in chronic phase, other malignancies are among the most common causes of death, raising concerns on the relationship between these deaths and the off-target effects of tyrosine kinase inhibitors. We analyzed the incidence of second primary malignancies, and related mortality, in 514 chronic myeloid leukemia patients enrolled in clinical trials in which imatinib was given as first-line treatment. We then compared the observed incidence and mortality with those expected in the age- and sex-matched Italian general population, calculating standardized incidence and standardized mortality ratios. After a median follow-up of 74 months, 5.8% patients developed second primary malignancies. The median time from chronic myeloid leukemia to diagnosis of the second primary malignancies was 34 months. We did not find a higher incidence of second primary malignancies compared to that in the age- and sex-matched Italian general population, with standardized incidence ratios of 1.06 (95% CI: 0.57-1.54) and 1.61 (95% CI: 0.92-2.31) in males and females, respectively. Overall, 3.1% patients died of second primary malignancies. The death rate in patients with second primary malignancies was 53% (median overall survival: 18 months). Among females, the observed cancer-related mortality was superior to that expected in the age- and sex-matched Italian population, with a standardized mortality ratio of 2.41 (95% CI: 1.26 - 3.56). In conclusion, our analysis of patients with imatinib-treated chronic myeloid leukemia did not reveal a higher incidence of second primary malignancies; however, the outcome of second primary malignancies in such patients was worse than expected. Clinicaltrials.gov: NCT00514488, NCT00510926. Copyright© 2017 Ferrata Storti Foundation.

  8. Primary and heterotrophic productivity relate to multikingdom diversity in a hypersaline mat

    Energy Technology Data Exchange (ETDEWEB)

    Bernstein, Hans C.; Brislawn, Colin J.; Dana, Karl; Flores-Wentz, Tobias; Cory, Alexandra B.; Fansler, Sarah J.; Fredrickson, James K.; Moran, James J.

    2017-10-01

    Benthic microbial ecosystems are widespread yet knowledge gaps still remain on the relationships between the diversity of species across kingdoms and productivity. Here, we ask two fundamental questions: 1) How does species diversity relate to the rates of primary and heterotrophic productivity? 2) How do diel variations in light-energy inputs influence productivity and microbiome diversity? To answer these questions, microbial mats from a magnesium sulfate hypersaline Lake were used to establish microcosms. Both the number and relatedness between bacterial and eukaryotic taxa in the microbiome were assayed via amplicon based sequencing of 16S and 18S rRNA genes over two diel cycles. These results correlated with biomass productivity obtained from substrate-specific 13C stable isotope incorporation that enabled comparisons between primary and heterotrophic productivity. Both bacterial and eukaryotic species richness and evenness were related only to the rates of 13C labeled glucose and acetate biomass incorporation. Interestingly, measures of these heterotrophic relationships changed from positive and negative correlations depending on carbon derived from glucose and acetate, respectively. Bacterial and eukaryotic diversity of this ecosystem is also controlled, in part, energy constraints imposed by changing irradiance over a diel cycle.

  9. Competition and rural primary care programs.

    Science.gov (United States)

    Ricketts, T C

    1990-04-01

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

  10. Treatment of relapse in herpes simplex on labial and facial areas and of primary herpes simplex on genital areas and "area pudenda" with low-power He-Ne laser or Acyclovir administered orally

    Science.gov (United States)

    Velez-Gonzalez, Mariano; Urrea-Arbelaez, Alejandro; Nicolas, M.; Serra-Baldrich, E.; Perez, J. L.; Pavesi, M.; Camarasa, J. M.; Trelles, Mario A.

    1996-01-01

    Sixty patients (greater than 16 yrs old) suffering primary or relapse genital herpes simplex viruses (HSV) and relapse labial HSV were appointed for this study. Three or more relapses were experienced per year. Patients (under treatment) were divided into two groups (distribution areas), corresponding to either labial herpes or genital herpes. These groups were sub-divided into 3 groups. The total number of labial or facial HSV patients was 36 (10 in group 1, 12 in group 2, 14 in group 3) and 24 for genital, buttocks, or 'area pudenda' HSV patients (6 in group 1, 8 in group 2, 10 in group 3). The design was a randomized, double- blind study. The setting was hospital and outpatient. The patients diagnosed as having the HVS disease were sent to the dermatology department and were assigned to a group at random. Treatment was begun as follows: During the treatment signs and symptoms were assessed and after the treatment, the relapses were also assessed (biochemical and hematological tests before and after the treatment) and the diagnosis of the HSV type I and II. The statistical evaluation of the results was performed and carried out with the SPSS and BMDP program. The relapses of the herpes infection in the lips and the face were significantly reduced (p less than 0.026) in patients treated with laser He-Ne and laser He-Ne plus Acyclovir. The interim between the relapses also increased significantly (p less than 0.005) in relation with the group treated with Acyclovir. The duration of the herpetic eruptions was clearly reduced in all locations in patients treated with laser He-Ne plus Acyclovir. No differences were noted between patients treated with laser He-Ne only or Acyclovir only. Therefore it is probable that therapeutic synergism took place. In relation with this, laser He-Ne shows the same therapeutic efficacy as Acyclovir taken orally. The association of Acyclovir and laser Ne-Ne could be an alternative method for the treatment of HSV in the face. The number

  11. Basic Instinct Undressed: Early Spatiotemporal Processing for Primary Sexual Characteristics

    Science.gov (United States)

    Legrand, Lore B.; Del Zotto, Marzia; Tyrand, Rémi; Pegna, Alan J.

    2013-01-01

    This study investigates the spatiotemporal dynamics associated with conscious and non-conscious processing of naked and dressed human bodies. To this effect, stimuli of naked men and women with visible primary sexual characteristics, as well as dressed bodies, were presented to 20 heterosexual male and female participants while acquiring high resolution EEG data. The stimuli were either consciously detectable (supraliminal presentations) or were rendered non-conscious through backward masking (subliminal presentations). The N1 event-related potential component was significantly enhanced in participants when they viewed naked compared to dressed bodies under supraliminal viewing conditions. More importantly, naked bodies of the opposite sex produced a significantly greater N1 component compared to dressed bodies during subliminal presentations, when participants were not aware of the stimulus presented. A source localization algorithm computed on the N1 showed that the response for naked bodies in the supraliminal viewing condition was stronger in body processing areas, primary visual areas and additional structures related to emotion processing. By contrast, in the subliminal viewing condition, only visual and body processing areas were found to be activated. These results suggest that naked bodies and primary sexual characteristics are processed early in time (i.e., sexual features benefit from automatic and rapid processing, most likely due to their high relevance for the individual and their importance for the species in terms of reproductive success. PMID:23894532

  12. Networks and social capital: a relational approach to primary healthcare reform

    Directory of Open Access Journals (Sweden)

    Scott Catherine

    2007-09-01

    Full Text Available Abstract Collaboration among health care providers and across systems is proposed as a strategy to improve health care delivery the world over. Over the past two decades, health care providers have been encouraged to work in partnership and build interdisciplinary teams. More recently, the notion of networks has entered this discourse but the lack of consensus and understanding about what is meant by adopting a network approach in health services limits its use. Also crucial to this discussion is the work of distinguishing the nature and extent of the impact of social relationships – generally referred to as social capital. In this paper, we review the rationale for collaboration in health care systems; provide an overview and synthesis of key concepts; dispel some common misconceptions of networks; and apply the theory to an example of primary healthcare network reform in Alberta (Canada. Our central thesis is that a relational approach to systems change, one based on a synthesis of network theory and social capital can provide the fodation for a multi-focal approach to primary healthcare reform. Action strategies are recommended to move from an awareness of 'networks' to fully translating knowledge from existing theory to guide planning and practice innovations. Decision-makers are encouraged to consider a multi-focal approach that effectively incorporates a network and social capital approach in planning and evaluating primary healthcare reform.

  13. Counting the cost of social disadvantage in primary care: retrospective analysis of patient data.

    OpenAIRE

    Worrall, A.; Rea, J. N.; Ben-Shlomo, Y.

    1997-01-01

    OBJECTIVE: To cost the relation between socioeconomic status and various measures of primary care workload and assess the adequacy of current "deprivation" payments in relation to actual costings for patients living in qualifying areas. DESIGN: Retrospective data on primary care were collected over a 4.5 year period from both computerised and manually filed records. Standardised data on socioeconomic status were obtained by postal questionnaire. SETTING: Inner city group practice with a socio...

  14. Problems and Guidelines of Strategy Implementation in Basic Educational Institutions under the Supervision of KhonKaen Primary Educational Service Area Office 4

    Directory of Open Access Journals (Sweden)

    Sasiwan Tonkanya

    2016-09-01

    Full Text Available The research aimed to 1 study problems of strategy implementation in basic educational institutions under Khonkaen Primary Educational Service Area Office 4 ; and 2 propose the guidelines for strategy implementation in basic educational institutions under Khonkaen Primary Educational Service Area Office 4. The study was carried out in 2 phases. In phase 1, it focused on the study and analysis of the strategic implementation problems and phase 2 studied the best practice schools. The informants for the interview in phase 1 comprised 6 school administrators and teachers who were involved in strategy implementation from small-sized, medium-sized, and large-sized schools. They were selected by the use of purposive sampling technique. The population in the study of the strategic implementation problems in basic educational institutions in phase 1 consisted of 543 school administrators and teachers who were involved in strategy implementation from 181 schools under Khonkaen Primary Educational Service Area Office 4 in academic year 2014. The study samples were 217 school administrators and teachers who were involved in strategy implementation from small-sized, medium-sized, and large-sized schools under Khonkaen Primary Educational Service Area Office 4. The samples were selected by the use of stratified sampling technique. The informants of the phase 2 study were 6 school administrators and teachers who were involved in strategy implementation from small-sized, medium-sized, and large-sized best practice schools obtained from purposive sampling technique. The research instruments used for data collection consisted of 2 sets of questionnaires. The Set 1 questionnaire was the 5-point Likert scale on the levels of the problems in implementation with item discrimination at 0.60 – 1.00 and reliability of the whole questionnaire at .9359. The questionnaire contained 3 parts with 65 items. The Set 2 questionnaire comprised 2 parts with 10 items regarding

  15. Bi-phasic activation of the primary motor cortex by pain and its relation to pain-evoked potentials - an exploratory study.

    Science.gov (United States)

    Kisler, Lee-Bareket; Weissman-Fogel, Irit; Sinai, Alon; Sprecher, Elliot; Chistyakov, Andrei V; Shamay-Tsoory, Simone; Moscovitz, Nadav; Granovsky, Yelena

    2017-06-15

    The primary motor cortex (M1) is a known target for brain stimulation aimed at pain alleviation in chronic pain patients, yet the mechanisms through which analgesia occurs, and the exact pain-motor interrelations are not fully understood. We used noxious contact heat evoked potentials (CHEPs) and cortical source analysis to further explore the relevance of M1 in pain processing. Twenty-four healthy young females received brief noxious heat stimuli to their left non-dominant volar forearm, simultaneously with CHEPs recordings. Thereafter, the pain-evoked activity of M1 and a control area in the occipital cortex (OC) was analyzed and estimated using sLORETA (standardized low-resolution brain electromagnetic tomography). This analysis revealed two phases of M1 pain-evoked activation (phase 1: the peak at 261.5±25.7ms; phase 2: the peak at 381.3±28.3ms). Canonical correlations revealed that M1, but not the OC, was the main factor contributing to the relation with the CHEPs components. In detail, the activity magnitude of M1 first and second phases was related to the N2 and P2 amplitude, respectively. The latency of the second phase was associated with both N2 and P2 latencies. In relation to pain, the latency of M1's first activity phase was positively correlated with pain ratings, suggesting pain interference to synchronized activity in M1. Our results confirm the established relevance of the primary motor cortex to pain processing. Copyright © 2017 Elsevier B.V. All rights reserved.

  16. Differences in the symptom profile of methamphetamine-related psychosis and primary psychotic disorders.

    Science.gov (United States)

    McKetin, Rebecca; Baker, Amanda L; Dawe, Sharon; Voce, Alexandra; Lubman, Dan I

    2017-05-01

    We examined the lifetime experience of hallucinations and delusions associated with transient methamphetamine-related psychosis (MAP), persistent MAP and primary psychosis among a cohort of dependent methamphetamine users. Participants were classified as having (a) no current psychotic symptoms, (n=110); (b) psychotic symptoms only when using methamphetamine (transient MAP, n=85); (c) psychotic symptoms both when using methamphetamine and when abstaining from methamphetamine (persistent MAP, n=37), or (d) meeting DSM-IV criteria for lifetime schizophrenia or mania (primary psychosis, n=52). Current psychotic symptoms were classified as a score of 4 or more on any of the Brief Psychiatric Rating Scale items of suspiciousness, hallucinations or unusual thought content in the past month. Lifetime psychotic diagnoses and symptoms were assessed using the Composite International Diagnostic Interview. Transient MAP was associated with persecutory delusions and tactile hallucinations (compared to the no symptom group). Persistent MAP was additionally associated with delusions of reference, thought interference and complex auditory, visual, olfactory and tactile hallucinations, while primary psychosis was also associated with delusions of thought projection, erotomania and passivity. The presence of non-persecutory delusions and hallucinations across various modalities is a marker for persistent MAP or primary psychosis in people who use methamphetamine. Copyright © 2017. Published by Elsevier B.V.

  17. An evolutionary attractor model for sapwood cross section in relation to leaf area.

    Science.gov (United States)

    Westoby, Mark; Cornwell, William K; Falster, Daniel S

    2012-06-21

    Sapwood cross-sectional area per unit leaf area (SA:LA) is an influential trait that plants coordinate with physical environment and with other traits. We develop theory for SA:LA and also for root surface area per leaf area (RA:LA) on the premise that plants maximizing the surplus of revenue over costs should have competitive advantage. SA:LA is predicted to increase in water-relations environments that reduce photosynthetic revenue, including low soil water potential, high water vapor pressure deficit (VPD), and low atmospheric CO(2). Because sapwood has costs, SA:LA adjustment does not completely offset difficult water relations. Where sapwood costs are large, as in tall plants, optimal SA:LA may actually decline with (say) high VPD. Large soil-to-root resistance caps the benefits that can be obtained from increasing SA:LA. Where a plant can adjust water-absorbing surface area of root per leaf area (RA:LA) as well as SA:LA, optimal RA:SA is not affected by VPD, CO(2) or plant height. If selection favours increased height more so than increased revenue-minus-cost, then height is predicted to rise substantially under improved water-relations environments such as high-CO(2) atmospheres. Evolutionary-attractor theory for SA:LA and RA:LA complements models that take whole-plant conductivity per leaf area as a parameter. Copyright © 2012 Elsevier Ltd. All rights reserved.

  18. Primary aldosteronism among newly diagnosed and untreated hypertensive patients in a Swedish primary care area.

    Science.gov (United States)

    Westerdahl, Christina; Bergenfelz, Anders; Isaksson, Anders; Nerbrand, Christina; Valdemarsson, Stig

    2011-03-01

    To evaluate the prevalence of primary aldosteronism (PA) in newly diagnosed and untreated hypertensive patients in primary care using the aldosterone/renin ratio (ARR), and to assess clinical and biochemical characteristics in patients with high and normal ARR. Patient survey study. A total of 200 consecutive patients with newly diagnosed and untreated hypertension from six primary health care centres in Sweden were included. ARR was calculated from serum aldosterone and plasma renin concentrations. The cut-off level for ARR was 65. Patients with an increased ARR were considered for confirmatory testing with the fludrocortisone suppression test (FST), followed by adrenal computed tomographic radiology (CT) and adrenal venous sampling (AVS). Of 200 patients, 36 patients had an ARR > 65. Of these 36 patients, 11 patients had an incomplete aldosterone inhibition during FST. Three patients were diagnosed with an aldosterone producing adenoma (APA) and eight with bilateral adrenal hyperplasia (BHA). Except for moderately lower level of P-K in patients with an ARR > 65 and in patients with PA, there were no biochemical or clinical differences found among hypertensive patients with PA compared with patients without PA. Eleven of 200 evaluated patients (5.5%) were considered to have PA. The diagnosis of PA should therefore be considered in newly diagnosed hypertensive subjects and screening for the diagnosis is warranted.

  19. Stigma-related mental health knowledge and attitudes among primary health workers and community health volunteers in rural Kenya

    NARCIS (Netherlands)

    Mutiso, Victoria N.; Musyimi, Christine W.; Nayak, Sameera S.; Musau, Abednego M.; Rebello, Tahilia; Nandoya, Erick; Tele, Albert K.; Pike, Kathleen; Ndetei, David M.

    2017-01-01

    Background: The study was conducted in rural Kenya and assessed stigma in health workers from primary health facilities. Aims: This study compared variations in stigma-related mental health knowledge and attitudes between primary health workers (HWs) and community health volunteers (CHVs). Methods:

  20. Collaboration of midwives in primary care midwifery practices with other maternity care providers.

    Science.gov (United States)

    Warmelink, J Catja; Wiegers, Therese A; de Cock, T Paul; Klomp, Trudy; Hutton, Eileen K

    2017-12-01

    interactions with physicians (GPs, obstetricians and paediatricians). Midwives with more work experience were more satisfied with their collaboration with GPs. Midwives from the southern region of the Netherlands were more satisfied with collaboration with GPs and obstetricians. Compared to the urban areas, in the rural or mixed areas the midwives were more satisfied regarding their collaboration with MCA(O)s and clinical midwives. Midwives from non-Dutch origin were less satisfied with the collaboration with paediatricians. No relations were found between the overall mean satisfaction of collaboration and work-related and personal characteristics and attitude towards work. Inter-professionals relations in maternity care in the Netherlands can be enhanced, especially the primary care midwives' interactions with physicians and with maternity care providers in the northern and central part of the Netherlands, and in urban areas. Future exploratory or deductive research may provide additional insight in the collaborative practice in everyday work setting. Copyright © 2017 Elsevier Ltd. All rights reserved.

  1. [Waste water management in a health area: environmental hygiene in primary care].

    Science.gov (United States)

    García Cuadrado, J; Contessotto Spadetto, C; Pereñiguez Barranco, J E; Fuster Quiñonero, D; Paricio Núñez, P

    1992-01-01

    Within the scope of the programmes to be developed by the primary health care parties, we consider it interesting to investigate the sewage management in our health area because of its impact on the population health and welfare and the main socioeconomic local activities: agriculture and tourism. We carry out an epidemiological descriptive study: we review the most important structural and functional characteristics of the sewage depuration and collection in the municipality of S. Javier (Murcia). The evaluation of the collected data made it obvious that deficiencies exist in the collection system as well as in the sewage processing; both deficiencies were shown in some places of the locality and in particular periods of the year, with a consequent risk of environmental contamination and enteric diseases transmission among population and summer holidaymakers. A positive corrective action on the installations by the organisms responsible for the local sanitation as a response to these conclusions, which we informed due time, constitutes a good stimulant to go on investigating this question of such a great sanitary and general interest, which is almost unknown in medical literature.

  2. Primary studies of trace quantities of green vegetation in Mono Lake area using 1990 AVIRIS data

    Science.gov (United States)

    Chen, Zhi-Kang; Elvidge, Chris D.; Groeneveld, David P.

    1992-01-01

    Our primary results in Jasper Ridge Biological Preserve indicate that high spectral resolution Airborne Visible/Infrared Imaging Spectrometer (AVIRIS) data may provide a substantial advantage in vegetation, based on the chlorophyll red edge feature from 700-780 nm. The chlorophyll red edge was detected for green vegetation cover as low as 4.8 percent. The objective of our studies in Mono Lake area is to continue the experiments performed in Jasper Ridge and to examine the persistence of red edge feature of trace quantities of green vegetation for different plant communities with non-uniform soil backgrounds.

  3. A research agenda on patient safety in primary care. Recommendations by the LINNEAUS collaboration on patient safety in primary care

    Science.gov (United States)

    Verstappen, Wim; Gaal, Sander; Bowie, Paul; Parker, Diane; Lainer, Miriam; Valderas, Jose M.; Wensing, Michel; Esmail, Aneez

    2015-01-01

    ABSTRACT Background: Healthcare can cause avoidable serious harm to patients. Primary care is not an exception, and the relative lack of research in this area lends urgency to a better understanding of patient safety, the future research agenda and the development of primary care oriented safety programmes. Objective: To outline a research agenda for patient safety improvement in primary care in Europe and beyond. Methods: The LINNEAUS collaboration partners analysed existing research on epidemiology and classification of errors, diagnostic and medication errors, safety culture, and learning for and improving patient safety. We discussed ideas for future research in several meetings, workshops and congresses with LINNEAUS collaboration partners, practising GPs, researchers in this field, and policy makers. Results: This paper summarizes and integrates the outcomes of the LINNEAUS collaboration on patient safety in primary care. It proposes a research agenda on improvement strategies for patient safety in primary care. In addition, it provides background information to help to connect research in this field with practicing GPs and other healthcare workers in primary care. Conclusion: Future research studies should target specific primary care domains, using prospective methods and innovative methods such as patient involvement. PMID:26339841

  4. A research agenda on patient safety in primary care. Recommendations by the LINNEAUS collaboration on patient safety in primary care.

    Science.gov (United States)

    Verstappen, Wim; Gaal, Sander; Bowie, Paul; Parker, Diane; Lainer, Miriam; Valderas, Jose M; Wensing, Michel; Esmail, Aneez

    2015-09-01

    Healthcare can cause avoidable serious harm to patients. Primary care is not an exception, and the relative lack of research in this area lends urgency to a better understanding of patient safety, the future research agenda and the development of primary care oriented safety programmes. To outline a research agenda for patient safety improvement in primary care in Europe and beyond. The LINNEAUS collaboration partners analysed existing research on epidemiology and classification of errors, diagnostic and medication errors, safety culture, and learning for and improving patient safety. We discussed ideas for future research in several meetings, workshops and congresses with LINNEAUS collaboration partners, practising GPs, researchers in this field, and policy makers. This paper summarizes and integrates the outcomes of the LINNEAUS collaboration on patient safety in primary care. It proposes a research agenda on improvement strategies for patient safety in primary care. In addition, it provides background information to help to connect research in this field with practicing GPs and other healthcare workers in primary care. Future research studies should target specific primary care domains, using prospective methods and innovative methods such as patient involvement.

  5. Root canal morphology of primary molars: a micro-computed tomography study.

    Science.gov (United States)

    Fumes, A C; Sousa-Neto, M D; Leoni, G B; Versiani, M A; da Silva, L A B; da Silva, R A B; Consolaro, A

    2014-10-01

    This was to investigate the root canal morphology of primary molar teeth using micro-computed tomography. Primary maxillary (n = 20) and mandibular (n = 20) molars were scanned at a resolution of 16.7 μm and analysed regarding the number, location, volume, area, structured model index (SMI), area, roundness, diameters, and length of canals, as well as the thickness of dentine in the apical third. Data were statistically compared by using paired-sample t test, independent sample t test, and one-way analysis of variance with significance level set as 5%. Overall, no statistical differences were found between the canals with respect to length, SMI, dentine thickness, area, roundness, and diameter (p > 0.05). A double canal system was observed in the mesial and mesio-buccal roots of the mandibular and maxillary molars, respectively. The thickness in the internal aspect of the roots was lower than in the external aspect. Cross-sectional evaluation of the roots in the apical third showed flat-shaped canals in the mandibular molars and ribbon- and oval-shaped canals in the maxillary molars. External and internal anatomy of the primary first molars closely resemble the primary second molars. The reported data may help clinicians to obtain a thorough understanding of the morphological variations of root canals in primary molars to overcome problems related to shaping and cleaning procedures, allowing appropriate management strategies for root canal treatment.

  6. Analytical relation between effective mode field area and waveguide dispersion in microstructure fibers.

    Science.gov (United States)

    Moenster, Mathias; Steinmeyer, Günter; Iliew, Rumen; Lederer, Falk; Petermann, Klaus

    2006-11-15

    For optical fibers exhibiting a radially symmetric refractive index profile, there exists an analytical relation that connects waveguide dispersion and the Petermann-II mode field radius. We extend the usefulness of this relation to the nonradially symmetric case of microstructure fibers in the anomalous dispersion regime, yielding a simple relation between dispersion and effective mode field area. Assuming a Gaussian mode distribution, we derive a fundamental upper limit for the effective mode field area that is required to obtain a certain amount of anomalous waveguide dispersion. This relation is demonstrated to show excellent agreement for fiber designs suited for supercontinuum generation and soliton lasers in the near infrared.

  7. Tear osmolarity measurements in dry eye related to primary Sjögren's syndrome.

    Science.gov (United States)

    Utine, Canan Asli; Bıçakçıgil, Müge; Yavuz, Sule; Çiftçi, Ferda

    2011-08-01

    To evaluate the tear osmolarity in patients with dry eye syndrome related to primary Sjögren's Syndrome (SS). Twenty eyes of 10 patients with dry eye and primary SS (Group 1) and 20 eyes of 20 subjects who do not have dry eye syndrome (Group 2) were included in this cross-sectional study. In all eyes, ophthalmic examination was performed in the same order: International Ocular Surface Disease Index survey, visual acuity assessment, conjunctival hyperemia scoring, tear osmolarity measurement with TearLab(™) Osmolarity System, tear film break-up time assessment, corneal fluorescein staining scoring, ocular surface Lissamine Green staining scoring, anesthetized Schirmer test. Dry eye severity was graded according to Dry Eye Workshop (DEWS) classification system. Four eyes with grade 1, four eyes with grade 2, seven eyes with grade 3, and five eyes with grade 4 dryness, according to DEWS system, were included. The mean tear osmolarity value was 301.9 ± 11.40 mOsm/L (range: 290-328) in Group 1, and 294.85 ± 8.33 mOsm/L (range: 283-311) in Group 2 (p = 0.03). In Group 1, tear osmolarity values were positively correlated with OSDI scores (r(18) = 0.55, r(2) = 0.31, p = 0.01), DEWS classification grades (r(18) = 0.73, r(2) = 0.54, p dry eye syndrome related to primary SS compared to control subjects, and positively correlated with the severity of dry eye.

  8. Prevalence of head lice infestation and pediculicidal effect of permethrine shampoo in primary school girls in a low-income area in southeast of Iran.

    Science.gov (United States)

    Soleimani-Ahmadi, Moussa; Jaberhashemi, Seyed Aghil; Zare, Mehdi; Sanei-Dehkordi, Alireza

    2017-07-24

    Head lice infestation is a common public health problem that is most prevalent in primary school children throughout the world, especially in developing countries including different parts of Iran. This study aimed to determine the prevalence and risk factors associated with head lice infestation and pediculicidal effect of 1% permethrin shampoo in primary schools girls of Bashagard County, one of the low socioeconomic areas in southeast of Iran. In this interventional study six villages with similar demographical situations were selected and randomly assigned into intervention and control areas. In each area 150 girl students aged 7-12 years were selected randomly and screened for head lice infestation by visual scalp examination. In intervention area, treatment efficacy of 1% permethrin shampoo was evaluated via re-examination for infestation after one, two, and three weeks. Pre-tested structured questionnaire was used to collect data on socio-demographic and associated factors of head lice infestation. The prevalence of head lice infestation was 67.3%. There was significant association between head lice infestation and school grade, family size, parents' literacy, bathing facilities, frequency of hair washing, and use of shared articles (p shampoo for head lice treatment was 29.2, 68.9, and 90.3% after the first, second, and third weeks, respectively. The head lice infestation is a health problem in primary school girls of Bashagard County. Improvement of socioeconomic status and providing appropriate educational programs about head lice risk factors and prevention can be effective for reduction of infestation in this area. This trial has been registered and approved by Hormozgan University of Medical Sciences ethical committee (Trial No.764). Trial registration date: March 17 2014.

  9. Morbidity pattern and their socio-demographic co-relates among rural primary school children in eastern Uttar Pradesh: A cross-sectional study

    Directory of Open Access Journals (Sweden)

    Amit Kaushik

    2014-03-01

    Full Text Available Research question: What is the morbidity pattern among primary school children in rural area of Varanasi and what their socio-demographic co-relates are? Objective: To study the morbidity pattern among of primary school children in rural Varanasi and to find out various socio-demographic correlates associated with morbidity. Study Design: Descriptive cross sectional study. Setting: Four primary schools from Chiraigaon Community Development Block of Varanasi were selected for study purpose. Participants: Eight hundred and sixteen students from four schools were included in the study by total enumeration of the students present on the day of survey. Results: The present cross-sectional study revealed overall more prevalence of morbidity among female students (86.1% as compared to their male counterparts (84.4%. Children belonging to scheduled caste, socio-economic status class IV, those whose parents were illiterate and those belonging to joint family had higher prevalence of any morbidity. Caste, socio-economic status, parents’ education and type of family were significantly associated with morbidity among school children. Conclusion:  Prevalence of morbidities was found to be 2.3 morbidities per child (prevalence and 2.8 morbidities per sick child. Female students suffered more in comparison to their male counterparts. Nutritional deficiencies were most prevalent. Socio-economic status, caste, literacy of parents and type of family had significant association with morbidity.

  10. Morbidity pattern and their socio-demographic co-relates among rural primary school children in eastern Uttar Pradesh: A cross-sectional study

    Directory of Open Access Journals (Sweden)

    Amit Kaushik

    2014-03-01

    Full Text Available Research question: What is the morbidity pattern among primary school children in rural area of Varanasi and what their socio-demographic co-relates are? Objective: To study the morbidity pattern among of primary school children in rural Varanasi and to find out various socio-demographic correlates associated with morbidity. Study Design: Descriptive cross sectional study. Setting: Four primary schools from Chiraigaon Community Development Block of Varanasi were selected for study purpose. Participants: Eight hundred and sixteen students from four schools were included in the study by total enumeration of the students present on the day of survey. Results: The present cross-sectional study revealed overall more prevalence of morbidity among female students (86.1% as compared to their male counterparts (84.4%. Children belonging to scheduled caste, socio-economic status class IV, those whose parents were illiterate and those belonging to joint family had higher prevalence of any morbidity. Caste, socio-economic status, parents’ education and type of family were significantly associated with morbidity among school children. Conclusion:  Prevalence of morbidities was found to be 2.3 morbidities per child (prevalence and 2.8 morbidities per sick child. Female students suffered more in comparison to their male counterparts. Nutritional deficiencies were most prevalent. Socio-economic status, caste, literacy of parents and type of family had significant association with morbidity.

  11. LGBTQ Youth's Perceptions of Primary Care.

    Science.gov (United States)

    Snyder, Barbara K; Burack, Gail D; Petrova, Anna

    2017-05-01

    Despite published guidelines on the need to provide comprehensive care to lesbian, gay, bisexual, transgender, and questioning/queer (LGBTQ) youth, there has been limited research related to the deliverance of primary health care to this population. The goals of this study were to learn about LGBTQ youth's experiences with their primary care physicians and to identify areas for improvement. Youth attending 1 of 5 community-based programs completed a written questionnaire and participated in a focus group discussion regarding experiences at primary care visits, including topics discussed, counselling received, and physician communication. Most of the youth did not feel their health care needs were well met. The majority acknowledged poor patient-provider communication, disrespect, and lack of discussions about important topics such as sexual and emotional health. Participants cited concerns about confidentiality and inappropriate comments as barriers to care. Youth expressed a strong desire to have physicians be more aware of their needs and concerns.

  12. Bringing transcranial mapping into shape: Sulcus-aligned mapping captures motor somatotopy in human primary motor hand area

    DEFF Research Database (Denmark)

    Raffin, Estelle; Pellegrino, Giovanni; Di Lazzaro, Vincenzo

    2015-01-01

    Motor representations express some degree of somatotopy in human primary motor hand area (M1HAND), but within-M1HAND corticomotor somatotopy has been difficult to study with transcranial magnetic stimulation (TMS). Here we introduce a “linear” TMS mapping approach based on the individual shape...... of the central sulcus to obtain mediolateral corticomotor excitability profiles of the abductor digiti minimi (ADM) and first dorsal interosseus (FDI) muscles. In thirteen young volunteers, we used stereotactic neuronavigation to stimulate the right M1HAND with a small eight-shaped coil at 120% of FDI resting...

  13. Factors Related to Soil Transmitted Helminth Infection on Primary School Children

    Directory of Open Access Journals (Sweden)

    Liena Sofiana

    2018-01-01

    Full Text Available ABSTRACT Infeksi Soil Transmitted Helminth (STH is the third ranks of the top 10 common infectious diseases in the world with an incidence rate of about 1.4 billion per year. The incidence of STH in Indonesia is still quite high. This figure occurs in primary school students of 60-80%, while for all ages of 40% -60%. The purpose of this study was to determine factors related to STH infection in elementary school children at primary school of Moyudan Sleman. The type of research used was analytic observational with the cross-sectional design. The population in this study were all students of class I, II, and III in Moyudan Sleman primary school with total sampling technique of 60 respondents. Data analysis used chi-square. The test results showed that the habit of hand washing before eating (sig= 0.010; RP= 3.850, the habit of hand washing  after defecating(sig= 0.007; RP= 4.571, nail hygiene (sig= 0.179; RP= 2.138, the habit of wearing footwear (sig= 0.008; RP= 3.714, and bowel habits (sig= 0.004; RP= 4.000. It can be concluded that there was a relationship between hand washing before eating, hand washing after defecating, the habit of wearing footwear, bowel habits and STH infection on the students of Moyudan Sleman primary school but there was no relationship between nail hygiene and STH infection. ABSTRAK Infeksi Soil Transmitted Helminth (STH adalah penyakit yang menempati urutan ketiga dari 10 penyakit menular di dunia dengan tingkat kejadian sekitar 1,4 miliar per tahun. Insiden STH di Indonesia masih cukup tinggi. Angka tersebut terjadi pada siswa di sekolah dasar mencapai 60-80%, sedangkan untuk semua usia berkisar antara 40%-60%. Tujuan dari penelitian ini adalah untuk mengetahui faktor yang berhubungan dengan infeksi STH pada anak sekolah dasar di SD Negeri Moyudan Sleman. Penelitian ini adalah observasional analitik dengan rancangan cross sectional. Populasi dalam penelitian ini adalah semua siswa kelas I, II, dan III di SD Moyudan

  14. Supplementary motor area and primary auditory cortex activation in an expert break-dancer during the kinesthetic motor imagery of dance to music.

    Science.gov (United States)

    Olshansky, Michael P; Bar, Rachel J; Fogarty, Mary; DeSouza, Joseph F X

    2015-01-01

    The current study used functional magnetic resonance imaging to examine the neural activity of an expert dancer with 35 years of break-dancing experience during the kinesthetic motor imagery (KMI) of dance accompanied by highly familiar and unfamiliar music. The goal of this study was to examine the effect of musical familiarity on neural activity underlying KMI within a highly experienced dancer. In order to investigate this in both primary sensory and motor planning cortical areas, we examined the effects of music familiarity on the primary auditory cortex [Heschl's gyrus (HG)] and the supplementary motor area (SMA). Our findings reveal reduced HG activity and greater SMA activity during imagined dance to familiar music compared to unfamiliar music. We propose that one's internal representations of dance moves are influenced by auditory stimuli and may be specific to a dance style and the music accompanying it.

  15. PREVALENCE AND RISK FACTORS OF OBESITY IN PRIMARY SCHOOL IN URBAN AND RURAL AREAS

    Directory of Open Access Journals (Sweden)

    Made Ratna Dewi

    2013-10-01

    Full Text Available Normal 0 false false false IN X-NONE X-NONE Obesity has become a continous increasing global health problem. Obesity can happen in adult population and also on children as well as teenagers. There are several factors that influence the occurrence of obesity. The aim of this study is to determine the prevalence and risk factors for obesity in primary school children in urban and rural areas. A cross sectional study was conducted with a total sample of 241 pupils in several elementary schools. Anthropometric status determine using body mass index for age and obesity stated if measurement exceed ?95th percentile based on CDC 2000. Analysis data perform with the Pearson Chi-square, Fisher's Exact Test, and logistic regression. A P value of <0.05 was considered significant. This study showed the prevalence of obesity was 15%. The prevalence of obesity in urban areas was 21% and rural areas was 5%. The result showed risk of obesity multiplied by 3.8 times in urban children as they had a habit of "snacking" had risk of suffering obesity by 3.4 times (95% CI 1.2 to 9.0. Children who had habit of having fast food more than 2 times per week had the more risk of obesity by 5 times (95% CI 1.9 to 13.5. Mothers education in urban areas as a protective factor. Conclusion of this study show that the prevalence of obesity in urban areas is 21% and 5% in rural areas. “Snacking” habit and eating fast food more than 2 times per week increase the risk of obesity in urban areas, while in rural areas no risk factors consider significant for obesity. /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin-top:0cm; mso-para-margin-right:0cm; mso-para-margin-bottom:10.0pt; mso-para-margin-left:0cm; line-height:115%; mso

  16. Availability and Primary Health Care Orientation of Dementia-Related Services in Rural Saskatchewan, Canada.

    Science.gov (United States)

    Morgan, Debra G; Kosteniuk, Julie G; Stewart, Norma J; O'Connell, Megan E; Kirk, Andrew; Crossley, Margaret; Dal Bello-Haas, Vanina; Forbes, Dorothy; Innes, Anthea

    2015-01-01

    Community-based services are important for improving outcomes for individuals with dementia and their caregivers. This study examined: (a) availability of rural dementia-related services in the Canadian province of Saskatchewan, and (b) orientation of services toward six key attributes of primary health care (i.e., information/education, accessibility, population orientation, coordinated care, comprehensiveness, quality of care). Data were collected from 71 rural Home Care Assessors via cross-sectional survey. Basic health services were available in most communities (e.g., pharmacists, family physicians, palliative care, adult day programs, home care, long-term care facilities). Dementia-specific services typically were unavailable (e.g., health promotion, counseling, caregiver support groups, transportation, week-end/night respite). Mean scores on the primary health care orientation scales were low (range 12.4 to 17.5/25). Specific services to address needs of rural individuals with dementia and their caregivers are limited in availability and fit with primary health care attributes.

  17. Prevalence of dental fluorosis among primary school children in rural areas of Chidambaram taluk, Cuddalore district, Tamil Nadu, India

    Directory of Open Access Journals (Sweden)

    Saravanan S

    2008-01-01

    Full Text Available Background: Fluorosis is one of the common but major emerging areas of research in the tropics. It is considered endemic in 17 states of India. However, the Cuddalore district of Tamil Nadu is categorised as a fluorosis non-endemic area. But clinical cases of dental fluorosis were reported in the field practice area of Department of Community Medicine, Rajah Muthiah Medical College, Annamalai University, Chidambaram. Since dental fluorosis has been described as a biomarker of exposure to fluoride, we assessed the prevalence and severity of dental fluorosis among primary school children in the service area. Materials and Methods: Children studying in six primary schools of six villages in the field practice area of Rural Health Centre of Faculty of Medicine, Annamalai University, Chidambaram, were surveyed. Every child was clinically examined at the school by calibrated examiners with Dean′s fluorosis index recommended by WHO (1997. Chi-square test, Chi-square trend test and Spearman′s rank correlation coefficient test were used for statistical analysis. Results: Five hundred and twenty-five 5- to 12-year-old school children (255 boys and 270 girls were surveyed. The overall dental fluorosis prevalence was found to be 31.4% in our study sample. Dental fluorosis increased with age P < 0.001, whereas gender difference was not statistically significant. Aesthetically objectionable dental fluorosis was found in 2.1% of the sample. Villages Senjicherry, Keezhaperambai and Kanagarapattu revealed a community fluorosis index (CFI score of 0.43, 0.54 and 0.54 with 5.6%, 4.8% and 1.4% of objectionable dental fluorosis, respectively. Correlation between water fluoride content and CFI values in four villages was noted to be positively significant. Conclusion: Three out of six villages studied were in ′borderline′ public health significance (CFI score 0.4-0.6. A well-designed epidemiological investigation can be undertaken to evaluate the risk factors

  18. Rock geochemistry related to mineralization processes in geothermal areas

    Science.gov (United States)

    Kausar, A. Al; Indarto, S.; Setiawan, I.

    2018-02-01

    Abundant geothermal systems in Indonesia suggest high heat and mass transfer associated with recent or paleovolcanic arcs. In the active geothermal system, the upflow of mixed fluid between late stage hydrothermal and meteoric water might contain mass of minerals associated with epithermal mineralisation process as exemplified at Lihir gold mine in Papua New Guinea. In Indonesia, there is a lack of study related to the precious metals occurrence within active geothermal area. Therefore, in this paper, we investigate the possibility of mineralization process in active geothermal area of Guci, Central Java by using geochemical analysis. There are a lot of conducted geochemical analysis of water, soil and gas by mapping the temperature, pH, Hg and CO2 distribution, and estimating subsurface temperature based on geothermometry approach. Then we also apply rock geochemistry to find minerals that indicate the presence of mineralization. The result from selected geothermal area shows the presence of pyrite and chalcopyrite minerals on the laharic breccias at Kali Putih, Sudikampir. Mineralization is formed within host rock and the veins are associated with gold polymetallic mineralization.

  19. Nitrogen-controlled intra- and interspecific competition between Populus purdomii and Salix rehderiana drive primary succession in the Gongga Mountain glacier retreat area.

    Science.gov (United States)

    Song, Mengya; Yu, Lei; Jiang, Yonglei; Lei, Yanbao; Korpelainen, Helena; Niinemets, Ülo; Li, Chunyang

    2017-06-01

    In this study, intra- and interspecific competition were investigated in early successional Salix rehderiana Schneider and later-appearing Populus purdomii Rehder under non-fertilized (control) and nitrogen (N)-fertilized conditions in the Hailuogou glacier retreat area. Our aim was to discover whether N is a key factor in plant-plant competition and whether N drives the primary succession process in a glacier retreat area. We analyzed differences in responses to intra- and interspecific competition and N fertilization between P. purdomii and S. rehderiana, including parameters such as biomass accumulation, nutrient absorption, non-structural carbohydrates, photosynthetic capacity, hydrolysable amino acids and leaf ultrastructure. In the control treatments, S. rehderiana individuals subjected to interspecific competition benefited from the presence of P. purdomii plants, as indicated by higher levels of biomass accumulation, photosynthetic capacity, N absorption, amino acid contents and photosynthetic N-use efficiency. However, in the N-fertilized treatments, P. purdomii individuals exposed to interspecific competition benefited from the presence of S. rehderiana plants, as shown by a higher growth rate, enhanced carbon gain capacity, greater amino acid contents, and elevated water-use efficiency, whereas the growth of S. rehderiana was significantly reduced. Our results demonstrate that N plays a pivotal role in determining the asymmetric competition pattern among Salicaceae species during primary succession. We argue that the interactive effects of plant-plant competition and N availability are key mechanisms that drive primary succession in the Gongga Mountain glacier retreat area. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  20. Relating species abundance distributions to species-area curves in two Mediterranean-type shrublands

    Science.gov (United States)

    Keeley, Jon E.

    2003-01-01

    Based on both theoretical and empirical studies there is evidence that different species abundance distributions underlie different species-area relationships. Here I show that Australian and Californian shrubland communities (at the scale from 1 to 1000 m2) exhibit different species-area relationships and different species abundance patterns. The species-area relationship in Australian heathlands best fits an exponential model and species abundance (based on both density and cover) follows a narrow log normal distribution. In contrast, the species-area relationship in Californian shrublands is best fit with the power model and, although species abundance appears to fit a log normal distribution, the distribution is much broader than in Australian heathlands. I hypothesize that the primary driver of these differences is the abundance of small-stature annual species in California and the lack of annuals in Australian heathlands. Species-area is best fit by an exponential model in Australian heathlands because the bulk of the species are common and thus the species-area curves initially rise rapidly between 1 and 100 m2. Annuals in Californian shrublands generate very broad species abundance distributions with many uncommon or rare species. The power function is a better model in these communities because richness increases slowly from 1 to 100 m2 but more rapidly between 100 and 1000 m2due to the abundance of rare or uncommon species that are more likely to be encountered at coarser spatial scales. The implications of this study are that both the exponential and power function models are legitimate representations of species-area relationships in different plant communities. Also, structural differences in community organization, arising from different species abundance distributions, may lead to different species-area curves, and this may be tied to patterns of life form distribution.

  1. Modelling of the local chemistry in stagnant areas in the PWR primary circuit

    International Nuclear Information System (INIS)

    Reid, Rick; Fruzzetti, Keith; Ahluwalia, Al; Summe, Alex; Dame, Cecile; Schmitt, Kyle

    2014-01-01

    MRP-236 demonstrated a correlation between stagnant or low flow conditions and stress corrosion cracking (SCC) of stainless steel components in the PWR primary system. Of the approximately 140 SCC events documented (affecting 15 different components), 83% involved stagnant or low flow conditions that were likely to be associated with chemical environments different from the well mixed bulk coolant. The chemistry in such locations is typically not monitored, and sampling is difficult or impossible. Actions to improve chemistry in regions of low or no coolant flow, such as flushing, cycling of components and imposition of more stringent make up water chemistry controls affect both operational costs and outage schedules. Similarly, design changes to improve flow in affected areas are costly or impracticable. Improving the understanding of the factors controlling chemistry in such areas and development of the capability to predict typical and worst case conditions will allow an informed assessment of procedural actions and/or design changes to improve local chemistry and thereby reduce SCC susceptibility. A project was undertaken to develop a model to predict local chemistry conditions in stagnant locations. The model comprises the iterative application of the EPRI MULTEQ solution chemistry equilibrium code and standard thermodynamic relationships to predict local chemistry conditions considered likely to have been present at the surfaces of components when SCC was initiated. The starting chemistry conditions are based on PWR primary system chemistry from different plant maneuvers (e.g., startup and shutdown conditions). The model was applied to three example components where SCC has occurred in the field. The selected components were: control rod drive mechanism canopy seals; valve drain lines; and reactor vessel o-ring leak-off lines. This paper provides a summary of the model and predicted local chemistry conditions that develop for the three example component as a

  2. Determinants of undernutrition among primary school children residing in slum areas of a Nigerian city.

    Science.gov (United States)

    Ndukwu, C I; Egbuonu, I; Ulasi, T O; Ebenebe, J C

    2013-01-01

    Undernutrition remains the largest contributor to the global disease burden. Different factors affecting the nutritional status of children need to be studied to determine those to be targeted in a country like Nigeria, characterized by widespread poverty and inequitable distribution of wealth. This study was aimed at ascertaining the relationship between prevailing socioeconomic and environmental factors, and the nutritional status of children residing in a typical urban slum. A cross-sectional descriptive study of 788 children aged 6-12 years selected by stratified, multistage random sampling method from public primary schools in slum and non-slum areas of Onitsha was carried out. Their nutritional status was determined using anthropometric measures. The socioeconomic and environmental variables of interest were analyzed to determine their relationship with undernutrition in the children. Socioeconomic status was the major determinant of nutritional status in this study. Poor housing also affected the nutritional status of the slum children who were significantly from poorer families than those residing in non-slum areas (χ2 = 66.69, P = 0.000). This study highlights the need for an effective nutrition program targeted at school children in urban slums surrounded by factors predisposing them to undernutrition.

  3. Spatial analysis of elderly access to primary care services

    Directory of Open Access Journals (Sweden)

    Lozano-Gracia Nancy

    2006-05-01

    Full Text Available Abstract Background Admissions for Ambulatory Care Sensitive Conditions (ACSCs are considered preventable admissions, because they are unlikely to occur when good preventive health care is received. Thus, high rates of admissions for ACSCs among the elderly (persons aged 65 or above who qualify for Medicare health insurance are signals of poor preventive care utilization. The relevant geographic market to use in studying these admission rates is the primary care physician market. Our conceptual model assumes that local market conditions serving as interventions along the pathways to preventive care services utilization can impact ACSC admission rates. Results We examine the relationships between market-level supply and demand factors on market-level rates of ACSC admissions among the elderly residing in the U.S. in the late 1990s. Using 6,475 natural markets in the mainland U.S. defined by The Health Resources and Services Administration's Primary Care Service Area Project, spatial regression is used to estimate the model, controlling for disease severity using detailed information from Medicare claims files. Our evidence suggests that elderly living in impoverished rural areas or in sprawling suburban places are about equally more likely to be admitted for ACSCs. Greater availability of physicians does not seem to matter, but greater prevalence of non-physician clinicians and international medical graduates, relative to U.S. medical graduates, does seem to reduce ACSC admissions, especially in poor rural areas. Conclusion The relative importance of non-physician clinicians and international medical graduates in providing primary care to the elderly in geographic areas of greatest need can inform the ongoing debate regarding whether there is an impending shortage of physicians in the United States. These findings support other authors who claim that the existing supply of physicians is perhaps adequate, however the distribution of them across

  4. A restrospective study of the nutritional status of primary school ...

    African Journals Online (AJOL)

    A retrospective study was conducted in Harare using data collected and compiled by the Harare City Council Nutrition Unit. Trends of nutritional status of primary school children in high density areas of Harare were examined in relation to stunting and wasting. All anthropometric data generated from 2003 to 2011 by the ...

  5. Area-wide traffic calming for preventing traffic related injuries.

    Science.gov (United States)

    Bunn, F; Collier, T; Frost, C; Ker, K; Roberts, I; Wentz, R

    2003-01-01

    It is estimated that by 2020 road traffic crashes will have moved from ninth to third in the world disease burden ranking, as measured in disability adjusted life years, and second in developing countries. The identification of effective strategies for the prevention of traffic related injuries is of global health importance. Area-wide traffic calming schemes that discourage through traffic on residential roads is one such strategy. To evaluate the effectiveness of area-wide traffic calming in preventing traffic related crashes, injuries, and deaths. We searched the following electronic databases: Cochrane Injuries Group's Specialised Register, Cochrane Controlled Trials Register, MEDLINE, EMBASE and TRANSPORT (NTIS, TRIS, TRANSDOC). We searched the web sites of road safety organisations, handsearched conference proceedings, checked reference lists of relevant papers and contacted experts in the area. The search was not restricted by language or publication status. Randomised controlled trials, and controlled before-after studies of area-wide traffic calming schemes. Two reviewers independently extracted data on type of study, characteristics of intervention and control areas, and length of data collection periods. Before and after data were collected on the total number of road traffic crashes, all road user deaths and injuries, pedestrian-motor vehicle collisions and road user deaths. The statistical package STATA was used to calculate rate ratios for each study, which were then pooled to give an overall estimate using a random effects model. We found no randomised controlled trials, but 16 controlled before-after trials met our inclusion criteria. Seven studies were done in Germany, six in the UK, two in Australia and one in the Netherlands. There were no studies in low or middle income countries. Eight trials reported the number of road traffic crashes resulting in deaths. The pooled rate ratio was 0.63 (0.14, 2.59 95% CI). Sixteen studies reported the number

  6. Health-related quality of life in patients by COPD severity within primary care in Europe

    NARCIS (Netherlands)

    Jones, P. W.; Brusselle, G.; Dal Negro, R. W.; Ferrer, M.; Kardos, P.; Levy, M. L.; Perez, T.; Soler-Cataluna, J. J.; van der Molen, T.; Adamek, L.; Banik, N.

    Pan-European data on health-related quality of life (HRQL) in chronic obstructive pulmonary disease (COPD) are lacking. This cross-sectional epidemiological study evaluated health status in 1817 COPD patients from an 'all-comers' primary care population in seven European countries (87% stable

  7. Communication-related behavior change techniques used in face-to-face lifestyle interventions in primary care: a systematic review of the literature.

    Science.gov (United States)

    Noordman, Janneke; van der Weijden, Trudy; van Dulmen, Sandra

    2012-11-01

    To systematically review the literature on the relative effectiveness of face-to-face communication-related behavior change techniques (BCTs) provided in primary care by either physicians or nurses to intervene on patients' lifestyle behavior. PubMed, EMBASE, PsychINFO, CINAHL and The Cochrane Library were searched for studies published before October 2010. Fifty studies were included and assessed on methodological quality. Twenty-eight studies reported significantly favorable health outcomes following communication-related BCTs. In these studies, 'behavioral counseling' was most frequently used (15 times), followed by motivational interviewing (eight times), education and advice (both seven times). Physicians and nurses seem equally capable of providing face-to-face communication-related BCTs in primary care. Behavioral counseling, motivational interviewing, education and advice all seem effective communication-related BCTs. However, BCTs were also found in less successful studies. Furthermore, based on existing literature, one primary care profession does not seem better equipped than the other to provide face-to-face communication-related BCTs. There is evidence that behavioral counseling, motivational interviewing, education and advice can be used as effective communication-related BCTs by physicians and nurses. However, further research is needed to examine the underlying working mechanisms of communication-related BCTs, and whether they meet the requirements of patients and primary care providers. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  8. Management of mining-related damages in abandoned underground coal mine areas using GIS

    International Nuclear Information System (INIS)

    Lee, U.J.; Kim, J.A.; Kim, S.S.; Kim, W.K.; Yoon, S.H.; Choi, J.K.

    2005-01-01

    The mining-related damages such as ground subsidence, acid mine drainage (AMD), and deforestation in the abandoned underground coal mine areas become an object of public concern. Therefore, the system to manage the mining-related damages is needed for the effective drive of rehabilitation activities. The management system for Abandoned Underground Coal Mine using GIS includes the database about mining record and information associated with the mining-related damages and application programs to support mine damage prevention business. Also, this system would support decision-making policy for rehabilitation and provide basic geological data for regional construction works in abandoned underground coal mine areas. (authors)

  9. Interpretation of the peak areas in gamma-ray spectra that have a large relative uncertainty

    International Nuclear Information System (INIS)

    Korun, M.; Maver Modec, P.; Vodenik, B.

    2012-01-01

    Empirical evidence is provided that the areas of peaks having a relative uncertainty in excess of 30% are overestimated. This systematic influence is of a statistical nature and originates in way the peak-analyzing routine recognizes the small peaks. It is not easy to detect this influence since it is smaller than the peak-area uncertainty. However, the systematic influence can be revealed in repeated measurements under the same experimental conditions, e.g., in background measurements. To evaluate the systematic influence, background measurements were analyzed with the peak-analyzing procedure described by Korun et al. (2008). The magnitude of the influence depends on the relative uncertainty of the peak area and may amount, in the conditions used in the peak analysis, to a factor of 5 at relative uncertainties exceeding 60%. From the measurements, the probability for type-II errors, as a function of the relative uncertainty of the peak area, was extracted. This probability is near zero below an uncertainty of 30% and rises to 90% at uncertainties exceeding 50%. - Highlights: ► A systematic influence affecting small peak areas in gamma-ray spectra is described. ► The influence originates in the peak locating procedure, using a pre-determined sensitivity. ► The predetermined sensitivity makes peak areas with large uncertainties to be overestimated. ► The influence depends on the relative uncertainty of the number of counts in the peak. ► Corrections exceeding a factor of 3 are attained at peak area uncertainties exceeding 60%.

  10. Current programmes on physical metallurgy and related areas in BARC

    International Nuclear Information System (INIS)

    1994-01-01

    Current research and development programmes on physical metallurgy and related areas from the following Divisions of Bhabha Atomic Research Centre are included in this report : Atomic Fuels Division, High Pressure Physics Division, Metallurgy Division, Radio Metallurgy Division, Solid State Physics Division. Important publications corresponding to each activity have also been listed. (author)

  11. Stormwater Management: Calculation of Traffic Area Runoff Loads and Traffic Related Emissions

    Directory of Open Access Journals (Sweden)

    Maximilian Huber

    2016-07-01

    Full Text Available Metals such as antimony, cadmium, chromium, copper, lead, nickel, and zinc can be highly relevant pollutants in stormwater runoff from traffic areas because of their occurrence, toxicity, and non-degradability. Long-term measurements of their concentrations, the corresponding water volumes, the catchment areas, and the traffic volumes can be used to calculate specific emission loads and annual runoff loads that are necessary for mass balances. In the literature, the annual runoff loads are often specified by a distinct catchment area (e.g., g/ha. These loads were summarized and discussed in this paper for all seven metals and three types of traffic areas (highways, parking lots, and roads; 45 sites. For example, the calculated median annual runoff loads of all sites are 355 g/ha for copper, 110 g/ha for lead (only data of the 21st century, and 1960 g/ha for zinc. In addition, historical trends, annual variations, and site-specific factors were evaluated for the runoff loads. For Germany, mass balances of traffic related emissions and annual heavy metal runoff loads from highways and total traffic areas were calculated. The influences on the mass fluxes of the heavy metal emissions and the runoff pollution were discussed. However, a statistical analysis of the annual traffic related metal fluxes, in particular for different traffic area categories and land uses, is currently not possible because of a lack of monitoring data.

  12. The distribution feature of size-fractionated chlorophyll a and primary productivity in Prydz Bay and its north sea area during the austral summer

    Institute of Scientific and Technical Information of China (English)

    刘子琳; 陈忠元

    2003-01-01

    The investigation of size-fractionated chlorophyll a and primary productivity were carried out in three longitudinal sections (63°-69°12′S, 70°30′E, 73°E and 75(30′E) at December 18 -26, 1998 and January 12 -18, 1999 in Prydz Bay and its north sea area, Antarctica. The results showed that surface chlorophyll a concentration were 0.16 - 3.99 μg dm -3. The high values of chlorophyll a concentration ( more than 3.5 μg dm -3 ) were in Prydz Bay and in the west Ladies Bank. The average chlorophyll a concentration at sub-surface layer was higher than that at surface layer; its concentration at the deeper layers of 50 m decreased with increasing depth and that at 200 m depth was only 0.01 -0.95 μg dm-3. The results of size-fractionated chlorophyll a showed that the contribution of the netplanktion to total chlorophyll a was 56% , those of the nanoplankton and the picoplankton were 24% and 20% respectively in the surveyed area. The potential primary productivity at the euphotic zone in the surveyed area was 0. 11 - 11.67 mgC m-3 h -1 and average value was 2.00 ±2.80 mgC m-3h-1. The in-situ productivity in the bay and the continental shelf was higher and that in the deep-sea area was lower. The assimilation number of ted primary productivity show that the contribution of the netplanktion to total productivity was 58% , those of the nanoplankton and the picoplankton were 26% and 16% respectively. The cell abundance of phytoplankton was 1. 6 + 103 - 164. 8 + 103 cell dm-3 in the surface water.

  13. Basic instinct undressed: early spatiotemporal processing for primary sexual characteristics.

    Directory of Open Access Journals (Sweden)

    Lore B Legrand

    Full Text Available This study investigates the spatiotemporal dynamics associated with conscious and non-conscious processing of naked and dressed human bodies. To this effect, stimuli of naked men and women with visible primary sexual characteristics, as well as dressed bodies, were presented to 20 heterosexual male and female participants while acquiring high resolution EEG data. The stimuli were either consciously detectable (supraliminal presentations or were rendered non-conscious through backward masking (subliminal presentations. The N1 event-related potential component was significantly enhanced in participants when they viewed naked compared to dressed bodies under supraliminal viewing conditions. More importantly, naked bodies of the opposite sex produced a significantly greater N1 component compared to dressed bodies during subliminal presentations, when participants were not aware of the stimulus presented. A source localization algorithm computed on the N1 showed that the response for naked bodies in the supraliminal viewing condition was stronger in body processing areas, primary visual areas and additional structures related to emotion processing. By contrast, in the subliminal viewing condition, only visual and body processing areas were found to be activated. These results suggest that naked bodies and primary sexual characteristics are processed early in time (i.e., <200 ms and activate key brain structures even when they are not consciously detected. It appears that, similarly to what has been reported for emotional faces, sexual features benefit from automatic and rapid processing, most likely due to their high relevance for the individual and their importance for the species in terms of reproductive success.

  14. Indications for primary cesarean delivery relative to body mass index

    Science.gov (United States)

    Kawakita, Tetsuya; Reddy, Uma M.; Landy, Helain J.; Iqbal, Sara N.; Huang, Chun-Chih; Grantz, Katherine L.

    2016-01-01

    Background Obesity is a known risk factor for cesarean delivery. Limited data are available regarding the reasons for the increased rate of primary cesarean in obese women. It is important to identify the factors leading to an increased risk of cesarean to identify opportunities to reduce the primary cesarean rate. Objective We evaluated indications for primary cesarean across body mass index kg/m2 classes to identify the factors contributing to the increase rate of cesarean among obese women. Study design In the Consortium of Safe Labor study between 2002 and 2008, we calculated indications for primary cesarean including failure to progress or cephalopelvic disproportion, non-reassuring fetal heart tracing, malpresentation, elective, hypertensive disease, multiple gestation, placenta previa or vasa previa, failed induction, human immunodeficiency virus or active herpes simplex virus, history of uterine scar, fetal indication, placental abruption, chorioamnionitis, macrosomia, and failed operative delivery. For women with primary cesarean for failure to progress or cephalopelvic disproportion, dilation at the last recorded cervical examination was evaluated. Women were categorized according to body mass index on admission: normal weight (18.5-24.9), overweight (25.0-29.9), obese class I (30.0-34.9), II (35.0-39.9), and III (≥40). Cochran-Armitage Trend Test and Chi-square tests were performed. Results Of 66,502 nulliparous and 76,961 multiparous women in the study population, 19,431 nulliparous (29.2%) and 7,329 multiparous women (9.5%) underwent primary cesarean. Regardless of parity, malpresentation, failure to progress or cephalopelvic disproportion, and non-reassuring fetal heart tracing were the common indications for primary cesarean. Regardless of parity, the rates of primary cesarean for failure to progress or cephalopelvic disproportion increased with increasing body mass index (normal weight, class I, II and III obesity in nulliparous: 33.2%, 41.6%, 46

  15. Childhood obesity, self-esteem and health-related quality of life among urban primary schools children in Kuching, Sarawak, Malaysia.

    Science.gov (United States)

    Lee, P Y; Cheah, W l; Chang, C T; Siti Raudzah, G

    2012-08-01

    There is limited data on childhood obesity and its impact on children from diverse cultural backgrounds. This study is aimed at determining the association between obesity, self-esteem and health-related quality of life (HRQOL) among Malaysian urban primary school children of different ethnicity. A cross-sectional study was conducted involving 311 children aged 11-13 years from primary schools in Kuching, Sarawak. Self-esteem and health-related quality of life (HRQOL) were measured using the Lawrence Self-esteem Questionnaire (LAWSEQ) questionnaire and the Paediatric Quality of Life Inventory (PedsQL), respectively. Body weight and height were taken and body mass index for age calculated. The prevalence of overweight and obesity among the children were 18.2% and 15.2% respectively. Parent-proxy and child self-reported PedsQL scores were higher for normal weight children compared to thin and obese children, but lower than overweight children. At the subscale level, only parent-proxy PedsQL scores in psychosocial health and emotional component were significantly different between overweight and obese children (p=0.019, p=0.02). The Self-esteem score was significantly correlated with parent and child PedsQL scores. Although obesity was associated with lower HRQOL among children, both parent and child PedsQL scores among the overweight group were higher than that for the normal weight group. Overweight and obesity did affect quality of life and self-esteem of children in this study, particularly in the areas of psychosocial and emotional health. Policy makers and programme managers should take into consideration the impact of obesity on children and parents in designing intervention programmes.

  16. Recruitment and condition of juvenile sandeel on the Faroe shelf in relation to primary production

    DEFF Research Database (Denmark)

    Eliasen, Kirstin; Reinert, Jákup; Gaard, Eilif

    The food of early-life sandeel is dominated by zooplankton, which again depends on primary production. On the Faroe Shelf, measurements of accumulated new primary production and chlorophyll a during spring and summer have been carried out since 1990 and 1997, respectively. Large inter...... availability. We compare the time series from the sandeel 0-group surveys with data on phytoplankton production and biomass. The results confirm that survival and condition of the early-life stages of sandeel on the Faroe Shelf is dependent on the magnitude of the primary production. Although the sandeel......-annual variations in the onset of the spring bloom and its intensity have been observed. Since 1974 juvenile sandeels have been sampled annually on the Faroe shelf. These results also show large variations – both in number and in average length. Here, we investigate the variations in recruitment in relation to food...

  17. Role of informal care providers in home based long term care in diabetes mellitus at Kaiwara Primary Health Center area, Karnataka, India

    Directory of Open Access Journals (Sweden)

    Arjunan Isaac

    2011-06-01

    Full Text Available Objective: To find the prevalence of diabetics, identify informal care providers for them in Kaiwara Primary Health Center (PHC area, assess the level of knowledge and skills of an informal care provider in home based long term care and improve the level of knowledge and skill of the informal care provider through a structured training capsule. Methods: A cross sectional and an interventional study was conducted on diabetics and their informal care providers in Kaiwara PHC area. Data were collected using pre-tested, structured questionnaire by an interview method. A structured training capsule was developed and implemented. Evaluation of the knowledge and skills was assessed at the beginning and at the end of the training. Student ’s paired/unpaired ‘t ’ tests and correlation analysis were done. Results: Improvement scores were calculated by subtracting the pre-evaluation scores from the post-evaluation scores. The mean improvement scores was (2.66暲0.32 and was statistically significant (P<0.001. No significant difference in mean values was found in the knowledge and skills scores in relation to the socio-demographic variables in the study. Conclusions: Knowledge and skills component of the informal care provider in home based care of diabetes could be perceived as a “felt need ”.

  18. The complex scenario of obesity, diabetes and hypertension in the area of influence of primary healthcare facilities in Mexico.

    Science.gov (United States)

    Alcalde-Rabanal, J E; Orozco-Núñez, E; Espinosa-Henao, O E; Arredondo-López, A; Alcayde-Barranco, L

    2018-01-01

    Among non-communicable chronic diseases (NCCD), diabetes and hypertension are the main cause of adult mortality worldwide. Among the members of the Organization for Economic Cooperation and Development, Mexico is first in prevalence of diabetes and second in obesity. To face this problematic situation of NCCDs the Ministry of Health declared a national epidemiological alert against the overweight, obesity and diabetes. The target of this study is to characterize the status of obesity, diabetes and hypertension in the adult population in the area of influence of primary health facilities located in high social marginality areas. We conducted a cross-sectional observational study and used a convenience sample. A survey was conducted on a population of 18 years old and above in four primary health facilities in four Mexican States. The survey explored sociodemographic characteristics, the presence of chronic diseases, the access to healthcare services, risk factors and life styles. We also applied a complementary questionnaire to 20% of the participants, in order to explore food consumption during the last week and physical activity (International Physical Activity Questionnaire). We based our analysis on descriptive statistics and logistic multivariate regression to analyze factors associated with diabetes and hypertension. 73% (n = 7531, CI 0.72-0.74) percent of the population reported being diabetic, hypertensive and/or overweight. The majority of them receive healthcare in public health services. People over 40 years old, are 11 times more probable of living with diabetes and 8.7 times more probable of living with hypertension. Both conditions affect mostly women, whose main activity is to be a housewife. People who have lunch and dinner out of home are more likely to develop diabetes. People who perform intense physical activity are less likely to live with hypertension. According to the self-report, more than 70% of adult population living in areas with high

  19. Surface Rupture Effects on Earthquake Moment-Area Scaling Relations

    Science.gov (United States)

    Luo, Yingdi; Ampuero, Jean-Paul; Miyakoshi, Ken; Irikura, Kojiro

    2017-09-01

    Empirical earthquake scaling relations play a central role in fundamental studies of earthquake physics and in current practice of earthquake hazard assessment, and are being refined by advances in earthquake source analysis. A scaling relation between seismic moment ( M 0) and rupture area ( A) currently in use for ground motion prediction in Japan features a transition regime of the form M 0- A 2, between the well-recognized small (self-similar) and very large (W-model) earthquake regimes, which has counter-intuitive attributes and uncertain theoretical underpinnings. Here, we investigate the mechanical origin of this transition regime via earthquake cycle simulations, analytical dislocation models and numerical crack models on strike-slip faults. We find that, even if stress drop is assumed constant, the properties of the transition regime are controlled by surface rupture effects, comprising an effective rupture elongation along-dip due to a mirror effect and systematic changes of the shape factor relating slip to stress drop. Based on this physical insight, we propose a simplified formula to account for these effects in M 0- A scaling relations for strike-slip earthquakes.

  20. Ambient Levels of Primary and Secondary Pollutants in a Residential Area: Population Risk and Hazard Index Calculation over a Three Years Study Period

    OpenAIRE

    S. Al-Salem; A. Al-Fadhlee

    2007-01-01

    This paper aims at presenting data collected over the period of three years (2004-2006) in a residential area in the state of Kuwait. The data collected include ambient levels of primary and secondary pollutants with a number of metrological parameters. A series of unfiltered and filtered concentration roses were plotted to determine the predominant sources as well as the prevailing winds affecting the area under investigation. Local and international air quality regulations were cross refere...

  1. Study on Net Primary Productivity over Complicated Mountainous Area based on Multi-Source Remote Sensing Data

    Science.gov (United States)

    Guan, X.; Shen, H.; Li, X.; Gan, W.

    2017-12-01

    Mountainous area hosts approximately a quarter of the global land surface, with complex climate and ecosystem conditions. More knowledge about mountainous ecosystem could highly advance our understanding of the global carbon cycle and climate change. Net Primary Productivity (NPP), the biomass increment of plants, is a widely used ecological indicator that can be obtained by remote sensing methods. However, limited by the defective characteristic of sensors, which cannot be long-term with enough spatial details synchronously, the mountainous NPP was far from being understood. In this study, a multi-sensor fusion framework was applied to synthesize a 1-km NPP series from 1982 to 2014 in mountainous southwest China, where elevation ranged from 76m to 6740m. The validation with field-measurements proved this framework greatly improved the accuracy of NPP (r=0.79, prun-off. What is more, it was indicated that the NPP variation showed three distinct stages at the year break-point of 1992 and 2002 over the region. The NPP in low-elevation area varied almost triple more drastic than the high-elevation area for all the three stages, due to the much greater change rate of precipitation. In summary, this study innovatively conducted a long-term and accurate NPP study on the not understood mountainous ecosystem with multi-source data, the framework and conclusions will be beneficial for the further cognition of global climate change.

  2. Correlation between patients' reasons for encounters/health problems and population density in Japan: a systematic review of observational studies coded by the International Classification of Health Problems in Primary Care (ICHPPC) and the International Classification of Primary care (ICPC).

    Science.gov (United States)

    Kaneko, Makoto; Ohta, Ryuichi; Nago, Naoki; Fukushi, Motoharu; Matsushima, Masato

    2017-09-13

    The Japanese health care system has yet to establish structured training for primary care physicians; therefore, physicians who received an internal medicine based training program continue to play a principal role in the primary care setting. To promote the development of a more efficient primary health care system, the assessment of its current status in regard to the spectrum of patients' reasons for encounters (RFEs) and health problems is an important step. Recognizing the proportions of patients' RFEs and health problems, which are not generally covered by an internist, can provide valuable information to promote the development of a primary care physician-centered system. We conducted a systematic review in which we searched six databases (PubMed, the Cochrane Library, Google Scholar, Ichushi-Web, JDreamIII and CiNii) for observational studies in Japan coded by International Classification of Health Problems in Primary Care (ICHPPC) and International Classification of Primary Care (ICPC) up to March 2015. We employed population density as index of accessibility. We calculated Spearman's rank correlation coefficient to examine the correlation between the proportion of "non-internal medicine-related" RFEs and health problems in each study area in consideration of the population density. We found 17 studies with diverse designs and settings. Among these studies, "non-internal medicine-related" RFEs, which was not thought to be covered by internists, ranged from about 4% to 40%. In addition, "non-internal medicine-related" health problems ranged from about 10% to 40%. However, no significant correlation was found between population density and the proportion of "non-internal medicine-related" RFEs and health problems. This is the first systematic review on RFEs and health problems coded by ICHPPC and ICPC undertaken to reveal the diversity of health problems in Japanese primary care. These results suggest that primary care physicians in some rural areas of Japan

  3. Sleep-related memory consolidation in primary insomnia.

    Science.gov (United States)

    Nissen, Christoph; Kloepfer, Corinna; Feige, Bernd; Piosczyk, Hannah; Spiegelhalder, Kai; Voderholzer, Ulrich; Riemann, Dieter

    2011-03-01

    It has been suggested that healthy sleep facilitates the consolidation of newly acquired memories and underlying brain plasticity. The authors tested the hypothesis that patients with primary insomnia (PI) would show deficits in sleep-related memory consolidation compared to good sleeper controls (GSC). The study used a four-group parallel design (n=86) to investigate the effects of 12 h of night-time, including polysomnographically monitored sleep ('sleep condition' in PI and GSC), versus 12 h of daytime wakefulness ('wake condition' in PI and GSC) on procedural (mirror tracing task) and declarative memory consolidation (visual and verbal learning task). Demographic characteristics and memory encoding did not differ between the groups at baseline. Polysomnography revealed a significantly disturbed sleep profile in PI compared to GSC in the sleep condition. Night-time periods including sleep in GSC were associated with (i) a significantly enhanced procedural and declarative verbal memory consolidation compared to equal periods of daytime wakefulness in GSC and (ii) a significantly enhanced procedural memory consolidation compared to equal periods of daytime wakefulness and night-time sleep in PI. Across retention intervals of daytime wakefulness, no differences between the experimental groups were observed. This pattern of results suggests that healthy sleep fosters the consolidation of new memories, and that this process is impaired for procedural memories in patients with PI. Future work is needed to investigate the impact of treatment on improving sleep and memory. © 2010 European Sleep Research Society.

  4. Behaviors Related to Mosquito-Borne Diseases among Different Ethnic Minority Groups along the China-Laos Border Areas.

    Science.gov (United States)

    Wu, Chao; Guo, Xiaofang; Zhao, Jun; Lv, Quan; Li, Hongbin; McNeil, Edward B; Chongsuvivatwong, Virasakdi; Zhou, Hongning

    2017-10-15

    Background : In China, mosquito-borne diseases are most common in the sub-tropical area of Yunnan province. The objective of this study was to examine behaviors related to mosquito-borne diseases in different ethnic minority groups and different socioeconomic groups of people living in this region. Methods : A stratified two-stage cluster sampling technique with probability proportional to size was used in Mengla County, Xishuangbanna Prefecture, Yunnan. Twelve villages were used to recruit adult (≥18 years old) and eight schools were used for children (related to mosquito-borne diseases was devised. Results : Multiple correspondence analysis (MCA) grouped 20 behaviors into three domains, namely, environmental condition, bed net use behaviors, and repellent use behaviors, respectively. The Han ethnicity had the lowest odds of rearing pigs, their odds being significantly lower than those of Yi and Yao. For bed net use, Dai and other ethnic minority groups were less likely to use bed nets compared to Yi and Yao. The odds of repellent use in the Han ethnicity was lower than in Yi, but higher than in Dai. The Dai group was the most likely ethnicity to use repellents. Farmers were at a higher risk for pig rearing and not using repellents. Education of less than primary school held the lowest odds of pig rearing. Those with low income were at a higher risk for not using bed nets and repellent except in pig rearing. Those with a small family size were at a lower risk for pig rearing. Conclusion : Different ethnic and socioeconomic groups in the study areas require different specific emphases for the prevention of mosquito-borne diseases.

  5. What? Me? Teach Dance? Background and Confidence of Primary Preservice Teachers in Dance Education across Five Countries

    Science.gov (United States)

    Russell-Bowie, Deirdre E.

    2013-01-01

    In primary schools across many countries, dance is now included within the arts key learning area with its own outcomes and content. But as future teachers of dance and other art forms, how do preservice generalist primary teachers perceive their background and confidence in relation to dance and dance education? This study investigates the…

  6. Sun-Protection Habits of Primary Students in a Coastal Area of Greece

    Directory of Open Access Journals (Sweden)

    M. Saridi

    2012-01-01

    Full Text Available Aim. The aim of the present study was to record habits and attitudes of primary school students in Greece regarding sun-protection measures. Materials and Methods. 2,163 students with an average age of 9.9 (±1.1 years, studying in 14 schools of a Greek region, constituted our sample. The SPSS 17.0 software was used for the statistical analysis and significance level was set to P≤0.05. Results. Our sample had an equal gender distribution. 16% of the students belonged to the high-risk group, 70.2% of the participants lived 0–5 km away from the sea (urban area, 84.2% of the students were Greek, and 15.8% had non-Greek nationality. Half of the participants said they wear a hat when under the sun and 72% of them said they use sunscreen. 33.1% of the students said they had a sunburn last summer. Greek students as well as those who lived near the sea had better behaviour patterns regarding sun protection. Finally, children who did not use a sunscreen systematically had suffered sunburns more often than the rest. Conclusions. Health education programmes are necessary for students and parents/teachers alike, in order to raise awareness about everyday sun protection.

  7. Sun-Protection Habits of Primary Students in a Coastal Area of Greece

    International Nuclear Information System (INIS)

    Saridi, M.; Toska, A.; Rekleiti, M.; Liachopoulou, A.; Wozniak, G.; Kalokairinou, A.; Birbas, K.; Souliotis, K.

    2012-01-01

    The aim of the present study was to record habits and attitudes of primary school students in Greece regarding sun-protection measures. Materials and Methods. 2,163 students with an average age of 9.9 (±1.1) years, studying in 14 schools of a Greek region, constituted our sample. The SPSS 17.0 software was used for the statistical analysis and significance level was set toρ≤0.05. Results. Our sample had an equal gender distribution. 16% of the students belonged to the high-risk group, 70.2% of the participants lived 0-5 km away from the sea (urban area), 84.2% of the students were Greek, and 15.8% had non-Greek nationality. Half of the participants said they wear a hat when under the sun and 72% of them said they use sunscreen. 33.1% of the students said they had a sunburn last summer. Greek students as well as those who lived near the sea had better behaviour patterns regarding sun protection. Finally, children who did not use a sunscreen systematically had suffered sunburns more often than the rest. Conclusions. Health education programmes are necessary for students and parents/teachers alike, in order to raise awareness about everyday sun protection.

  8. Policies and practices of parental involvement and parent-teacher relations in Irish primary education: a critical discourse analysis

    OpenAIRE

    Bennett, Brigid

    2015-01-01

    This thesis presents a critical discourse analysis of policies of parental involvement in Irish education from the past decade. It explores three questions: Do discourses of parental involvement and teacher professionalism construct parent-teacher relations in Irish primary education?; What implications do these constructions have for policies and practices of parent-teacher relationships, particularly parent-teacher partnerships, in Irish primary education?; How can these constructions be ch...

  9. [Coping and subjective burden in primary caregivers of dependent elderly relatives in Andalusia, Spain].

    Science.gov (United States)

    Pérez-Cruz, Margarita; Muñoz-Martínez, M Ángeles; Parra-Anguita, Laura; Del-Pino-Casado, Rafael

    To analyse the relationship between the type of coping and subjective burden in caregivers of dependent elderly relatives in Andalusia (Spain). Cross-sectional study. Primary Health Care (autonomous community of Andalusia, Spain). A convenience sample of 198 primary caregivers of dependent elderly relatives. Coping (Brief COPE), subjective burden (caregiver stress index), objective burden (functional capacity [Barthel Index], cognitive impairment [Pfeiffer Test], behavioural problems of the care recipient [Neuropsychiatric Inventory], and caregivers' dedication to caring), gender and kinship. Most caregivers were women (89.4%), daughters of the care recipient (57.1%), and shared home with him/her (69.7%). On controlling for objective burden, gender and kinship, it was found that subjective burden was positively associated with dysfunctional coping (β=0.28; P<.001) and negatively with emotion-focused coping (β=-0.25; P=.001), while no association was found with problem-focused coping. Dysfunctional coping may be a risk factor for subjective burden, and emotion-focused coping may be a protective factor for that subjective burden regardless of the objective burden, and gender and kinship of the caregivers. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

  10. Dynamic Modelling with "MLE-Energy Dynamic" for Primary School

    Science.gov (United States)

    Giliberti, Enrico; Corni, Federico

    During the recent years simulation and modelling are growing instances in science education. In primary school, however, the main use of software is the simulation, due to the lack of modelling software tools specially designed to fit/accomplish the needs of primary education. In particular primary school teachers need to use simulation in a framework that is both consistent and simple enough to be understandable by children [2]. One of the possible area to approach modelling is about the construction of the concept of energy, in particular for what concerns the relations among substance, potential, power [3]. Following the previous initial research results with this approach [2], and with the static version of the software MLE Energy [1], we suggest the design and the experimentation of a dynamic modelling software—MLE dynamic-capable to represent dynamically the relations occurring when two substance-like quantities exchange energy, modifying their potential. By means of this software the user can graphically choose the dependent and independent variables and leave the other parameters fixed. The software has been initially evaluated, during a course of science education with a group of primary school teachers-to-be, to test the ability of the software to improve teachers' way of thinking in terms of substance-like quantities and their effects (graphical representation of the extensive, intensive variables and their mutual relations); moreover, the software has been tested with a group of primary school teachers, asking their opinion about the software didactical relevance in the class work.

  11. PRIMARY STUDENTS' STEREOTYPIC IMAGE OF INVENTOR IN KOREA

    Directory of Open Access Journals (Sweden)

    Eunsang Lee

    2018-04-01

    Full Text Available The purpose of this research is to compare the previous stereotypes of the scientist image and the current stereotypes of the inventor image among Korean students. For this purpose, three primary schools located in the metropolitan area of Korea were selected under a convenience sampling method, with one class selected for each of the 2nd, 4th, and 6th grades of each school. The conclusions of this research are as follows. First, analyzing students' stereotypes of the inventor image showed that older students had more stereotypes about inventors than younger students did. Second, as a result of analyzing the images according to each indicator, Korean students were found to have stereotypes about the inventor. Third, the symbol of research was expressed together with one of the science-related experiment tool and the making-related experiment tool. Fourth, primary students perceived the inventor as mainly male. Male students mostly drew male inventors and female students mostly drew female inventors. Based on the conclusions obtained through this research, various educational implications to be reflected in primary technology education were suggested to escape the stereotypes of the inventor’s image.

  12. [Evaluating the relation of premenstrual syndrome and primary dysmenorrhea in women diagnosed with fibromyalgia].

    Science.gov (United States)

    Terzi, Rabia; Terzi, Hasan; Kale, Ahmet

    2015-01-01

    In this study, we aimed to investigate the presence of premenstrual syndrome (PMS), primary dysmenorrhea (PD) and depression among women with fibromyalgia (FM) and healthy females and to determine possible factors related with PMS and PD in FM. The present study was conducted on 98 female patients diagnosed with FM and 102 age and sex-matched healthy controls. All patients were evaluated for premenstrual syndrome (PMS) and primary dysmenorrhea (PD). Premenstrual syndrome was assessed among the patients for the presence of one or more affective or somatic symptoms within the five days preceding menses. The diagnosis of primary dysmenorrhea was defined as having abdominal pain or lower back pain lasting at least two days during a menstrual period. Dysmenorrhea was assessed via visual analog scale. Dysmenorrhea was rated via Multidimensional Scoring System. The Hamilton depression scale was applied to all patients. Primary dysmenorrhea was established in 41% of FM patients and 28% of the control group. A statistically significant difference was found in PD between the two groups (p=0.03). PMS was established in 42% of the FM patients and 25% of the control group. A statistically significant difference was found in PMS between the two groups (p=0.03). There is an increased frequency of premenstrual syndrome and dysmenorrhea in FM patients. The patients with high symptom severity scores and high depression scores among the FM patients are at risk of PMS and PD. Copyright © 2015 Elsevier Editora Ltda. All rights reserved.

  13. Place of residence and primary treatment of prostate cancer: examining trends in rural and nonrural areas in Wisconsin.

    Science.gov (United States)

    Cetnar, Jeremy P; Hampton, John M; Williamson, Amy A; Downs, Tracy; Wang, Dian; Owen, Jean B; Crouse, Byron; Jones, Nathan; Wilson, J Frank; Trentham-Dietz, Amy

    2013-03-01

    To determine whether rural residents were at a disadvantage compared with urban residents with regard to the receipt of curative therapy for prostate cancer. Using the Breast and Prostate Cancer Data Quality and Patterns of Care Study II, patients with prostate cancer who were diagnosed in 2004 were identified. Registrars reviewed the medical records of randomly selected patients with incident prostate cancer (n = 1906). The patients' residential address was geocoded and linked to the census tract from the 2000 U.S. Census. The place of residence was defined as rural or nonrural according to the census tract and rural-urban commuting area categorization. The distance from the residence to the nearest radiation oncology facility was calculated. The odds ratio and 95% confidence intervals associated with receipt of noncurative treatment was calculated from logistic regression models and adjusted for several potential confounders. Of the incident patients, 39.1% lived in urban census tracts, 41.5% lived in mixed tracts, and 19.4% lived in rural tracts. Hormone-only or active surveillance was received by 15.4% of the patients. Relative to the urban patients, the odds ratio for noncurative treatment was 1.01 (95% confidence interval 0.59-1.74) for those living in mixed tracts and 0.96 (95% confidence interval 0.52-1.77) for those living in rural tracts. No association was found for noncurative treatment according to the Rural-Urban Commuting Area categorization. The linear trend was null between noncurative treatment and the distance to nearest radiation oncology facility (P = .92). The choice of curative treatment did not significantly depend on the patient's place of residence, suggesting a lack of geographic disparity for the primary treatment of prostate cancer. Copyright © 2013 Elsevier Inc. All rights reserved.

  14. Association between respiratory prescribing, air pollution and deprivation, in primary health care.

    Science.gov (United States)

    Sofianopoulou, Eleni; Rushton, Stephen P; Diggle, Peter J; Pless-Mulloli, Tanja

    2013-12-01

    We investigated the association between respiratory prescribing, air quality and deprivation in primary health care. Most previous studies have used data from secondary and tertiary care to quantify air pollution effects on exacerbations of asthma and chronic obstructive pulmonary disease (COPD). However, these outcomes capture patients who suffer from relatively severe symptoms. This is a population-based ecological study. We analysed respiratory medication (salbutamol) prescribed monthly by 63 primary care practices, UK. Firstly, we captured the area-wide seasonal variation in prescribing. Then, using the area-wide variation in prescribing as an offset, we built a mixed-effects model to assess the remaining variation in relation to air quality and demographic variables. An increase of 10 μg/m(3) in ambient PM10 was associated with an increase of 1% (95% CI: 0.1-2%) in salbutamol prescribing. An increase of 1 SD in income and employment deprivation was associated with an increase of 20.5% (95% CI: 8.8-33.4%) and 14.7% (95% CI: 4.3-26.2%) in salbutamol prescribing rate, respectively. The study provides evidence that monthly respiratory prescribing in primary care is a useful indicator of the extent to which air pollution exacerbates asthma and COPD symptoms. Respiratory prescribing was higher on deprived populations.

  15. Primary fibromyalgia

    DEFF Research Database (Denmark)

    Jacobsen, S; Jensen, L T; Foldager, M

    1990-01-01

    Serum concentrations of procollagen type III aminoterminal peptide have previously been reported to be low in some patients with primary fibromyalgia and the aim of this study was to determine if such patients differ clinically from primary fibromyalgia patients with normal levels of procollagen...... type III aminoterminal peptide. Subjective symptoms, tender points and dynamic muscle strength in 45 women with primary fibromyalgia were related to serum concentrations of procollagen type III aminoterminal peptide. Patients with low serum concentrations of procollagen type III aminoterminal peptide...... concentrations of procollagen type III aminoterminal peptide of primary fibromyalgia patients are connected to the disease impact....

  16. Relational aggression: the voices of primary school learners

    African Journals Online (AJOL)

    This was done within a qualitative research design with a ... the research design and methods that were used to explore primary school learners' experience of RA at ...... “Qualitative research” Analysis types and software tools. New York: ...

  17. Integrated model of primary and secondary eye care for underserved rural areas: The L V Prasad Eye Institute experience

    Directory of Open Access Journals (Sweden)

    Gullapalli N Rao

    2012-01-01

    Full Text Available Blindness is a major global public health problem and recent estimates from World Health Organization (WHO showed that in India there were 62 million visually impaired, of whom 8 million are blind. The Andhra Pradesh Eye Disease Study (APEDS provided a comprehensive estimate for prevalence and causes of blindness for the state of Andhra Pradesh (AP. It also highlighted that uptake of services was also an issue, predominantly among lower socio-economic groups, women, and rural populations. On the basis of this analysis, L V Prasad Eye Institute (LVPEI developed a pyramidal model of eye care delivery. This article describes the LVPEI eye care delivery model. The article discusses infrastructure development, human resource development, and service delivery (including prevention and promotion in the context of primary and secondary care service delivery in rural areas. The article also alludes to opportunities for research at these levels of service delivery and the amenability of the evidence generated at these levels of the LVPEI eye health pyramid for advocacy and policy planning. In addition, management issues related to the sustainability of service delivery in rural areas are discussed. The article highlights the key factors required for the success of the LVPEI rural service delivery model and discusses challenges that need to be overcome to replicate the model. The article concludes by noting the potential to convert these challenges into opportunities by integrating certain aspects of the existing healthcare system into the model. Examples include screening of diabetes and diabetic retinopathy in order to promote higher community participation. The results of such integration can serve as evidence for advocacy and policy.

  18. The applicability of Relative Floristic Resemblance to evaluate the conservation value of protected areas.

    NARCIS (Netherlands)

    Wieringa, J.J.; Sosef, M.S.M.

    2011-01-01

    s – It is important to know the contribution of a protected area to global conservation. A new method called ‘Relative Floristic Resemblance’ that uses databased and georeferenced herbarium specimens, is introduced. Its usefulness and applicability to assess the conservation value of protected areas

  19. Primary care physician perceptions of the nurse practitioner in the 1990s.

    Science.gov (United States)

    Aquilino, M L; Damiano, P C; Willard, J C; Momany, E T; Levy, B T

    1999-01-01

    To evaluate factors associated with primary care physician attitudes toward nurse practitioners (NPs) providing primary care. A mailed survey of primary care physicians in Iowa. Half (N = 616) of the non-institutional-based, full-time, primary care physicians in Iowa in spring 1994. Although 360 (58.4%) responded, only physicians with complete data on all items in the model were used in these analyses (n = 259 [42.0%]). There were 2 principal dependent measures: physician attitudes toward NPs providing primary care (an 11-item instrument) and physician experience with NPs in this role. Bivariate relationships between physician demographic and practice characteristics were evaluated by chi 2 tests, as were both dependent variables. Ordinary least-squares regression was used to determine factors related to physician attitudes toward NPs. In bivariate analyses, physicians were significantly more likely to have had experience with an NP providing primary care if they were in pediatrics or obstetrics-gynecology (78.3% and 70.0%, respectively; P < .001), had been in practice for fewer than 20 years (P = .045), or were in practices with 5 or more physicians. The ordinary least-squares regression indicated that physicians with previous experience working with NPs providing primary care (P = .01), physicians practicing in urban areas with populations greater than 20,000 but far from a metropolitan area (P = .03), and general practice physicians (P = .04) had significantly more favorable attitudes toward NPs than did other primary care physicians. The association between previous experience with a primary care NP and a more positive attitude toward NPs has important implications for the training of primary care physicians, particularly in community-based, multidisciplinary settings.

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

    Science.gov (United States)

    2017-08-18

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

  1. Developing a research agenda for patient safety in primary care. Background, aims and output of the LINNEAUS collaboration on patient safety in primary care.

    Science.gov (United States)

    Esmail, Aneez; Valderas, Jose M; Verstappen, Wim; Godycki-Cwirko, Maciek; Wensing, Michel

    2015-09-01

    This paper is an introduction to a supplement to The European Journal of General Practice, bringing together a body of research focusing on the issue of patient safety in relation to primary care. The supplement represents the outputs of the LINNEAUS collaboration on patient safety in primary care, which was a four-year (2009-2013) coordination and support action funded under the Framework 7 programme by the European Union. Being a coordination and support action, its aim was not to undertake new research, but to build capacity through engaging primary care researchers and practitioners in identifying some of the key challenges in this area and developing consensus statements, which will be an essential part in developing a future research agenda. This introductory article describes the aims of the LINNEAUS collaboration, provides a brief summary of the reasons to focus on patient safety in primary care, the epidemiological and policy considerations, and an introduction to the papers included in the supplement.

  2. Differences in Construction, Facilities, Equipment and Academic Achievement Among Ugandan Primary Schools

    Science.gov (United States)

    Heyneman, S. P.

    1977-01-01

    This study sets out to clarify two questions within the context of a non-industrial society's educational system: (1) In what areas would there be measurable variation in physical facilities between primary schools? (2) Is any of this variation statistically related to the academic performance of children on the national selection examination…

  3. Comparison of clinical features between primary and drug-induced sleep-related eating disorder

    Directory of Open Access Journals (Sweden)

    Komada Y

    2016-05-01

    Full Text Available Yoko Komada,1 Yoshikazu Takaesu,2 Kentaro Matsui,3 Masaki Nakamura,3 Shingo Nishida,3 Meri Kanno,3,† Akira Usui,3 Yuichi Inoue1,3 1Department of Somnology, 2Department of Psychiatry, Tokyo Medical University, 3Japan Somnology Center, Institute of Neuropsychiatry, Tokyo, Japan †Meri Kanno passed away on March 1, 2016 Purpose: The aim of this study was to ascertain the clinical characteristics of drug-induced sleep-related eating disorder (SRED. Patients and methods: We retrospectively reviewed the medical records of 30 patients with primary SRED (without any comorbid sleep disorders and who were not taking any possible causative medications, and ten patients with drug-induced SRED (occurrence of SRED episodes after starting nightly medication of sedative drugs, which completely resolved after dose reduction or discontinuation of the sedatives. Results: All patients with drug-induced SRED took multiple types of sedatives, such as benzodiazepines or benzodiazepine receptor agonists. Clinical features of drug-induced SRED compared with primary SRED were as follows: higher mean age of onset (40 years old in drug-induced SRED vs 26 years old in primary SRED, significantly higher rate of patients who had total amnesia during most of their SRED episodes (75.0% vs 31.8%, significantly lower rate of comorbidity of night eating syndrome (0% vs 63.3%, and significantly lower rate of history of sleepwalking (10.0% vs 46.7%. Increased doses of benzodiazepine receptor agonists may be responsible for drug-induced SRED. Conclusion: The clinical features of drug-induced SRED were different from those of primary SRED, possibly reflecting differences in the underlying mechanisms between these two categories of SREDs. Keywords: nocturnal eating syndrome, night eating, eating disorder, hypnotics, amnesia, sleepwalking, benzodiazepine

  4. Recruiting and retaining primary care physicians in urban underserved communities: the importance of having a mission to serve.

    Science.gov (United States)

    Odom Walker, Kara; Ryan, Gery; Ramey, Robin; Nunez, Felix L; Beltran, Robert; Splawn, Robert G; Brown, Arleen F

    2010-11-01

    We examined factors influencing physician practice decisions that may increase primary care supply in underserved areas. We conducted in-depth interviews with 42 primary care physicians from Los Angeles County, California, stratified by race/ethnicity (African American, Latino, and non-Latino White) and practice location (underserved vs nonunderserved area). We reviewed transcriptions and coded them into themes by using standard qualitative methods. Three major themes emerged in relation to selecting geographic- and population-based practice decisions: (1) personal motivators, (2) career motivators, and (3) clinic support. We found that subthemes describing personal motivators (e.g., personal mission and self-identity) for choosing a practice were more common in responses among physicians who worked in underserved areas than among those who did not. By contrast, physicians in nonunderserved areas were more likely to cite work hours and lifestyle as reasons for selecting their current practice location or for leaving an underserved area. Medical schools and shortage-area clinical practices may enhance strategies for recruiting primary care physicians to underserved areas by identifying key personal motivators and may promote long-term retention through work-life balance.

  5. Overview of the U.S. programs on properties of primary circuit materials

    International Nuclear Information System (INIS)

    Brinkman, C.R.; Sikka, V.K.; Booker, M.K.

    1977-01-01

    The objective of U.S. Breeder Reactor Programs associated with primary circuit structural materials is to develop the design data base and associated design technology on existing commercially available materials as well as new alloys. This will permit economic operation of components at acceptable levels of plant availability and at up to 40-year lifetimes for inaccessible components. Long-term component reliability, elevated-temperature service within the creep range, and resistance to sodium attack and irradiation damage, along with design in compliance with ASME Codes and RDT Specifications, have required that the U.S. programs be directed toward contributing knowledge in a number of areas. These areas, relating to material deformation, failure modes, compatibility, fabrication, long-term behavior, irradiation damage, and availability will be discussed. The U.S. Structural Material Programs concerned with primary-circuit components will be reviewed, and their current and future contributions to knowledge of these areas will be explained

  6. Behaviors Related to Mosquito-Borne Diseases among Different Ethnic Minority Groups along the China-Laos Border Areas

    Directory of Open Access Journals (Sweden)

    Chao Wu

    2017-10-01

    Full Text Available Background: In China, mosquito-borne diseases are most common in the sub-tropical area of Yunnan province. The objective of this study was to examine behaviors related to mosquito-borne diseases in different ethnic minority groups and different socioeconomic groups of people living in this region. Methods: A stratified two-stage cluster sampling technique with probability proportional to size was used in Mengla County, Xishuangbanna Prefecture, Yunnan. Twelve villages were used to recruit adult (≥18 years old and eight schools were used for children (<18 years old. A questionnaire on behaviors and environment variables related to mosquito-borne diseases was devised. Results: Multiple correspondence analysis (MCA grouped 20 behaviors into three domains, namely, environmental condition, bed net use behaviors, and repellent use behaviors, respectively. The Han ethnicity had the lowest odds of rearing pigs, their odds being significantly lower than those of Yi and Yao. For bed net use, Dai and other ethnic minority groups were less likely to use bed nets compared to Yi and Yao. The odds of repellent use in the Han ethnicity was lower than in Yi, but higher than in Dai. The Dai group was the most likely ethnicity to use repellents. Farmers were at a higher risk for pig rearing and not using repellents. Education of less than primary school held the lowest odds of pig rearing. Those with low income were at a higher risk for not using bed nets and repellent except in pig rearing. Those with a small family size were at a lower risk for pig rearing. Conclusion: Different ethnic and socioeconomic groups in the study areas require different specific emphases for the prevention of mosquito-borne diseases.

  7. Email communication at the medical primary-secondary care interface: a qualitative exploration.

    Science.gov (United States)

    Sampson, Rod; Barbour, Rosaline; Wilson, Philip

    2016-07-01

    There is little published research into the influence of email communication between primary and secondary care clinicians on patient care. To explore the use of email communication between clinicians across the primary- secondary care interface, and how this may relate to patient care. A qualitative study involving primary and secondary care services in the NHS Highland Health Board area, Scotland. Ten GPs and 12 hospital consultants were purposively sampled to reflect diversity. Eligible clinicians were invited to take part in a semi-structured interview. Data were analysed using a thematic analysis approach. Key themes that emerged for clinicians included general perceptions of email; using email in practice (managing workload, impact on patient journeys, and 'quick answers'); system issues (variability and governance); relational aspects; and email skills. Email communication between primary and secondary care clinicians generally has a positive impact on patient access to specialist expertise. Governance issues around the use of clinical email need to be defined. There may currently be a two-tier health service for those patients (and their GPs) requiring 'quick answers'. © British Journal of General Practice 2016.

  8. Traditional male circumcision-related fatalities in the Mthatha area of South Africa.

    Science.gov (United States)

    Meel, B L

    2010-10-01

    Traditional male circumcision is still widely practised by the Xhosa population throughout South Africa. Male circumcision is carried out mainly during summer and winter seasons. This is a retrospective record review of the male circumcision-related fatalities at Mthatha General Hospital during 2005 and 2006. The purpose of this study is to highlight the problem of circumcision-related deaths in the Mthatha area of South Africa. Twenty-five deaths related to traditional circumcisions were recorded over the period. The common causes of deaths were septicaemia (9 patients; 36%), pneumonia (5; 20%), dehydration (3; 12%), assault (3; 12%), thromboembolism (2; 8%), gangrene (2; 8%) and congestive heart failure (1; 4%). All fatalities were among black Africans with a median age of 17.56 (SD = 2.56) years. In seven deaths (28%) the young men came from the Libode District. The youngest victim was 12 years old. Most of the deaths (13; 52%) occurred in July 2006. The mortality associated with traditional male circumcision in the Mthatha area of South Africa is alarming.

  9. Straight and Curved Path Walking Among Older Adults in Primary Care: Associations With Fall-Related Outcomes.

    Science.gov (United States)

    Welch, Sarah A; Ward, Rachel E; Kurlinski, Laura A; Kiely, Dan K; Goldstein, Richard; VanSwearingen, Jessie; Brach, Jennifer S; Bean, Jonathan F

    2016-08-01

    Most falls among community-dwelling older adults occur while walking. Simple walking tests that require little resources and can be interpreted quickly are advocated as useful screening tools for fall prone patients. To investigate 2 clinically feasible walking tests consisting of straight- and curved-path walking and examine their associations with history of previous falls and fall-related outcomes among community-living older adults. A cross-sectional analysis was performed on baseline data from a longitudinal cohort study. Participants were recruited through primary care practices. Participants included 428 primary care patients ≥65 years of age at risk for mobility decline. Participants had a median age of 76.5 years, 67.8% were women, and 82.5% were white. Straight-path walking performance was measured as the time needed to walk a 4-meter straight path at usual pace from standstill using a stopwatch (timed to 0.1 second). Curved-path walking performance was timed while participants walked from standstill in a figure-of-8 pattern around two cones placed 5 feet apart. Multivariable negative binomial regression analyses were performed to assess the relationship between straight-path walking or curved-path walking and self-reported history of number of falls. For fall-related injuries, and fall-related hospitalizations, logistic regression models were used. In the fully adjusted model, an increase of 1 second in straight path walking time was associated with 26% greater rate of falls (rate ratio 1.26, 95% confidence interval 1.10-1.45). An increase in curved-path walking time was associated with 8% greater rate of falls (rate ratio 1.08, 95% confidence interval = 1.03-1.14). Neither walk test was associated with history of fall-related injuries or hospitalizations. Poor performance on straight- and curved-path walking performance was associated with a history of greater fall rates in the previous year but not with a history of fall-related injuries or

  10. [Poverty and disease: users of the primary care social services of a primary care center].

    Science.gov (United States)

    Doz Mora, J F; Mengual, L; Torné, M; Bonilla, P

    1994-06-15

    To find the individual and socio-family characteristics of that sector of the population which uses Primary Care Social Services (PCSS) at the Primary Care Centre (PCC) and the social problems which occasion demand. A retrospective descriptive study, based on checking over social work case files. A PCC situated in Barcelona's second industrial belt, serving a population with a low socio-economic level. The population group under study were the users with social work files open from January 1st 1985 to July 31st 1991 (a total of 690 case histories). A representative sample of 296 was selected. In comparison with the population of the basic Health Area, the user population of the PCSS at the PCC was predominantly women, and had an older average age, a higher proportion of divorce/separation and widowhood, and, in the labour context, higher unemployment and retirement. A high proportion of one-parent families (12.8%) was found. Analysis of the work situation showed that 50% of the workers were temporary and 75% of the unemployed received no benefit. 51% of the retired people received the minimum pension and 11% received no pension. Monthly family income, recorded for 46.5% of the cases, was 75,362 pesetas (SD 37,643). The most common problems were those related to the "HEALTH" section (61%). The user population of the PCSS at the PCC is, in socio-economic terms, deteriorated, a condition closely related to the development of chronic illnesses. Tackling health inequalities from Primary Care is under discussion.

  11. Multinomial logistic regression modelling of obesity and overweight among primary school students in a rural area of Negeri Sembilan

    Energy Technology Data Exchange (ETDEWEB)

    Ghazali, Amirul Syafiq Mohd; Ali, Zalila; Noor, Norlida Mohd; Baharum, Adam [Pusat Pengajian Sains Matematik, Universiti Sains Malaysia, 11800 USM, Pulau Pinang, Malaysia amirul@unisel.edu.my, zalila@cs.usm.my, norlida@usm.my, adam@usm.my (Malaysia)

    2015-10-22

    Multinomial logistic regression is widely used to model the outcomes of a polytomous response variable, a categorical dependent variable with more than two categories. The model assumes that the conditional mean of the dependent categorical variables is the logistic function of an affine combination of predictor variables. Its procedure gives a number of logistic regression models that make specific comparisons of the response categories. When there are q categories of the response variable, the model consists of q-1 logit equations which are fitted simultaneously. The model is validated by variable selection procedures, tests of regression coefficients, a significant test of the overall model, goodness-of-fit measures, and validation of predicted probabilities using odds ratio. This study used the multinomial logistic regression model to investigate obesity and overweight among primary school students in a rural area on the basis of their demographic profiles, lifestyles and on the diet and food intake. The results indicated that obesity and overweight of students are related to gender, religion, sleep duration, time spent on electronic games, breakfast intake in a week, with whom meals are taken, protein intake, and also, the interaction between breakfast intake in a week with sleep duration, and the interaction between gender and protein intake.

  12. Multinomial logistic regression modelling of obesity and overweight among primary school students in a rural area of Negeri Sembilan

    International Nuclear Information System (INIS)

    Ghazali, Amirul Syafiq Mohd; Ali, Zalila; Noor, Norlida Mohd; Baharum, Adam

    2015-01-01

    Multinomial logistic regression is widely used to model the outcomes of a polytomous response variable, a categorical dependent variable with more than two categories. The model assumes that the conditional mean of the dependent categorical variables is the logistic function of an affine combination of predictor variables. Its procedure gives a number of logistic regression models that make specific comparisons of the response categories. When there are q categories of the response variable, the model consists of q-1 logit equations which are fitted simultaneously. The model is validated by variable selection procedures, tests of regression coefficients, a significant test of the overall model, goodness-of-fit measures, and validation of predicted probabilities using odds ratio. This study used the multinomial logistic regression model to investigate obesity and overweight among primary school students in a rural area on the basis of their demographic profiles, lifestyles and on the diet and food intake. The results indicated that obesity and overweight of students are related to gender, religion, sleep duration, time spent on electronic games, breakfast intake in a week, with whom meals are taken, protein intake, and also, the interaction between breakfast intake in a week with sleep duration, and the interaction between gender and protein intake

  13. Treatment Effects of a Primary Care Intervention on Parenting Behaviors: Sometimes It's Relative.

    Science.gov (United States)

    Shaffer, Anne; Lindhiem, Oliver; Kolko, David

    2017-04-01

    The goal of this brief report is to demonstrate the utility of quantifying parental discipline practices as relative frequencies in measuring changes in parenting behavior and relations to child behavior following intervention. We explored comparisons across methodological approaches of assessing parenting behavior via absolute and relative frequencies in measuring improvements in parent-reported disciplinary practices (increases in positive parenting practices in response to child behavior; decreases in inconsistent discipline and use of corporal punishment) and child behavior problems. The current study was conducted as part of a larger clinical trial to evaluate the efficacy of a collaborative care intervention for behavior problems, ADHD, and anxiety in pediatric primary care practices (Doctor Office Collaborative Care; DOCC). Participants were 321 parent-child dyads (M child age = 8.00, 65 % male children) from eight pediatric practices that were cluster randomized to DOCC or enhanced usual care (EUC). Parents reported on their own discipline behaviors and child behavior problems. While treatment-related decreases in negative parenting were found using both the absolute and relative frequencies of parenting behaviors, results were different for positive parenting behaviors, which showed decreases when measured as absolute frequencies but increases when measured as relative frequencies. In addition, positive parenting was negatively correlated with child behavior problems when using relative frequencies, but not absolute frequencies, and relative frequencies of positive parenting mediated relations between treatment condition and outcomes. Our findings indicate that the methods used to measure treatment-related change warrant careful consideration.

  14. Group motivational intervention in overweight/obese patients in primary prevention of cardiovascular disease in the primary healthcare area.

    Science.gov (United States)

    Rodríguez Cristóbal, Juan José; Panisello Royo, Josefa Ma; Alonso-Villaverde Grote, Carlos; Pérez Santos, José Ma; Muñoz Lloret, Anna; Rodríguez Cortés, Francisca; Travé Mercadé, Pere; Benavides Márquez, Francisca; Martí de la Morena, Pilar; González Burgillos, Ma José; Delclós Baulies, Marta; Bleda Fernández, Domingo; Quillama Torres, Elida

    2010-03-18

    The global mortality caused by cardiovascular disease increases with weight. The Framingham study showed that obesity is a cardiovascular risk factor independent of other risks such as type 2 diabetes mellitus, dyslipidemia and smoking. Moreover, the main problem in the management of weight-loss is its maintenance, if it is achieved. We have designed a study to determine whether a group motivational intervention, together with current clinical practice, is more efficient than the latter alone in the treatment of overweight and obesity, for initial weight loss and essentially to achieve maintenance of the weight achieved; and, secondly, to know if this intervention is more effective for reducing cardiovascular risk factors associated with overweight and obesity. This 26-month follow up multi-centre trial, will include 1200 overweight/obese patients. Random assignment of the intervention by Basic Health Areas (BHA): two geographically separate groups have been created, one of which receives group motivational intervention (group intervention), delivered by a nurse trained by an expert phsychologist, in 32 group sessions, 1 to 12 fortnightly, and 13 to 32, monthly, on top of their standard program of diet, exercise, and the other (control group), receiving the usual follow up, with regular visits every 3 months. By addressing currently unanswered questions regarding the maintenance in weight loss in obesity/overweight, upon the expected completion of participant follow-up in 2012, the IMOAP trial should document, for the first time, the benefits of a motivational intervention as a treatment tool of weight loss in a primary care setting. ClinicalTrials.gov Identifier: NCT01006213.

  15. Sun-related knowledge and attitudes of primary and secondary schoolchildren in western Switzerland.

    Science.gov (United States)

    Vuadens, Anne; Ackermann, Simone; Levi, Fabio; Bulliard, Jean-Luc

    2017-09-01

    Switzerland, particularly its western region, has the highest incidence of melanoma in Europe. Although the risk of melanoma increases with sun overexposure during childhood, sun-related knowledge and attitudes of Swiss children are scarcely documented. We report the first investigation of the knowledge of the danger of ultraviolet radiation, attitudes towards a suntan and parental influence of schoolchildren in western Switzerland. All fifth, eighth and eleventh graders (average ages of 9, 12 and 15, respectively) in the 18 primary (fifth grade, n=431) and secondary (eighth and eleventh grades, n=837) public schools of La Chaux-de-Fonds were surveyed during regular school classes. The response rate was 91% (1154/1268). Sun-related knowledge was high overall. Eight out of 10 children knew about the risk of skin cancer and recognized the most susceptible phototype. Knowledge increased significantly with age. Girls, older children, fair-skinned participants and those who preferred a tanned skin obtained the highest knowledge score. The main source of information on ultraviolet radiation and sun protection was their parents (76%), followed by the school (11%) and the media (9%). Multivariate logistic regression analyses identified higher sun-related knowledge, lower familial socioprofessional status and skin phototypes III-IV to be associated with a tan-seeking attitude. Parental sensitization (56%) and encouragement (61%) towards sun protection were more common among fair-skinned children and those of higher familial socioprofessional status. The high awareness of the risk of skin cancer among Swiss schoolchildren does not translate into appropriate attitudes. Community-wide intervention programmes involving parents, teachers, peers and primary care clinicians could be considered for Swiss prevention campaigns to improve children's sun behaviour and change their current pro-tan attitude.

  16. Human factors and ergonomics for primary care.

    Science.gov (United States)

    Bowie, Paul; Jeffcott, Shelly

    2016-03-01

    In the second paper of this series, we provide a brief overview of the scientific discipline of human factors and ergonomics (HFE). Traditionally the HFE focus in healthcare has been in acute hospital settings which are perceived to exhibit characteristics more similar to other high-risk industries already applying related principles and methods. This paper argues that primary care is an area which could benefit extensively from an HFE approach, specifically in improving the performance and well-being of people and organisations. To this end, we define the purpose of HFE, outline its three specialist sub-domains (physical, cognitive and organisational HFE) and provide examples of guiding HFE principles and practices. Additionally, we describe HFE issues of significance to primary care education, improvement and research and outline early plans for building capacity and capability in this setting.

  17. Evaluation of primary immunization coverage of infants under universal immunization programme in an urban area of bangalore city using cluster sampling and lot quality assurance sampling techniques.

    Science.gov (United States)

    K, Punith; K, Lalitha; G, Suman; Bs, Pradeep; Kumar K, Jayanth

    2008-07-01

    Is LQAS technique better than cluster sampling technique in terms of resources to evaluate the immunization coverage in an urban area? To assess and compare the lot quality assurance sampling against cluster sampling in the evaluation of primary immunization coverage. Population-based cross-sectional study. Areas under Mathikere Urban Health Center. Children aged 12 months to 23 months. 220 in cluster sampling, 76 in lot quality assurance sampling. Percentages and Proportions, Chi square Test. (1) Using cluster sampling, the percentage of completely immunized, partially immunized and unimmunized children were 84.09%, 14.09% and 1.82%, respectively. With lot quality assurance sampling, it was 92.11%, 6.58% and 1.31%, respectively. (2) Immunization coverage levels as evaluated by cluster sampling technique were not statistically different from the coverage value as obtained by lot quality assurance sampling techniques. Considering the time and resources required, it was found that lot quality assurance sampling is a better technique in evaluating the primary immunization coverage in urban area.

  18. Relative value of computed tomography scanning and venous sampling in establishing the cause of primary hyperaldosteronism

    International Nuclear Information System (INIS)

    Sheaves, R.; Goldin, J.; Reznek, R.H.

    1996-01-01

    The purpose of this study was to evaluate the relative merits of the postural simulation test, adrenal computed tomography (CT) and venous sampling in the differential diagnosis of patients presenting with primary hyperaldosteronism. The records of 20 patients presenting with primary hyperaldosteronism were reviewed retrospectively. There were 15 patients with a unilateral aldosterone-producing adenoma (APA), 4 patients with idiopathic hyperaldosteronism (IHA) and 1 patient with primary adrenal hyperplasia (PAH). Bilateral venous sampling of adrenal veins was attempted in all patients and blood collected for aldosterone and cortisol assay. Plasma aldosterone concentration increased after 4 h of standing in all cases of hyperplasia, but was also demonstrated in 10/15 patients with a surgically-proven APA. CT scanning correctly identified all 15 cases of APA and also classified correctly the remaining 5 cases of hyperplasia. CT scanning may be used alone to confirm the cause of hyperaldosteronism where postural studies suggest an adrenal adenoma, and such patients may be considered for early surgery. 21 refs

  19. ASPECTS RELATED TO THE CONDUCT OF THE PHYSICAL EDUCATION CLASS IN PRIMARY SCHOOL

    Directory of Open Access Journals (Sweden)

    Dana Ioana CRISTEA

    2017-01-01

    Full Text Available Physical education, a subject included in the core curriculum in all educational cycles, with different number of hours, aims at training students attitudes and habits, specific to its field, also targeting other areas of education.The current pre-university education in Romania, including the physical education classes, joined the European standards of education.These require further reforms in both the organizational documents and the deployment methodology in the educational process in all university institutions.It is known that physical education lessons are conducted in dedicated facilities (sports court, gyms but what solution is there when we do not have these spaces?The classroom remains a loophole rescue, a space to be exploited with more creativity and motivation.This paper proposes a series of teaching strategies to achieve the objectives of physical education in primary school.

  20. External relations on the classroom: Experiences area Andina University Foundation

    OpenAIRE

    Belén Leal Hurtado; Ruth Betty Aragón Aguilar

    2017-01-01

    This article is the result of a research project conducted in the academic context. Its aim was to analyze how the students of the Area Andina University Foundation conceive relations of friendship, relationships and management of conflicts outside the classroom. It was developed under a psychosocial approach of qualitative and exploratory, not comparative, type with application of the method of mixed focus groups with a population of 48 students, between 18 and 25 years, enrolled in the thir...

  1. Medical Yoga for Patients with Stress-Related Symptoms and Diagnoses in Primary Health Care: A Randomized Controlled Trial

    Directory of Open Access Journals (Sweden)

    Monica Köhn

    2013-01-01

    Full Text Available An increasing number of patients are suffering from stress-related symptoms and diagnoses. The purpose of this study was to evaluate the medical yoga treatment in patients with stress-related symptoms and diagnoses in primary health care. A randomized controlled study was performed at a primary health care centre in Sweden from March to June, 2011. Patients were randomly allocated to a control group receiving standard care or a yoga group treated with medical yoga for 1 hour, once a week, over a 12-week period in addition to the standard care. A total of 37 men and women, mean age of 53±12 years were included. General stress level (measured using Perceived Stress Scale (PSS, burnout (Shirom-Melamed Burnout Questionnaire (SMBQ, anxiety and depression (Hospital Anxiety and Depression Scale (HADS, insomnia severity (Insomnia Severity Index (ISI, pain (visual analogue scale (VAS, and overall health status (Euro Quality of Life VAS (EQ-VAS were measured before and after 12 weeks. Patients assigned to the Yoga group showed significantly greater improvements on measures of general stress level (P<0.000, anxiety (P<0.019, and overall health status (P<0.018 compared to controls. Treatment with medical yoga is effective in reducing levels of stress and anxiety in patients with stress-related symptoms in primary health care.

  2. Medical yoga for patients with stress-related symptoms and diagnoses in primary health care: a randomized controlled trial.

    Science.gov (United States)

    Köhn, Monica; Persson Lundholm, Ulla; Bryngelsson, Ing-Liss; Anderzén-Carlsson, Agneta; Westerdahl, Elisabeth

    2013-01-01

    An increasing number of patients are suffering from stress-related symptoms and diagnoses. The purpose of this study was to evaluate the medical yoga treatment in patients with stress-related symptoms and diagnoses in primary health care. A randomized controlled study was performed at a primary health care centre in Sweden from March to June, 2011. Patients were randomly allocated to a control group receiving standard care or a yoga group treated with medical yoga for 1 hour, once a week, over a 12-week period in addition to the standard care. A total of 37 men and women, mean age of 53 ± 12 years were included. General stress level (measured using Perceived Stress Scale (PSS)), burnout (Shirom-Melamed Burnout Questionnaire (SMBQ)), anxiety and depression (Hospital Anxiety and Depression Scale (HADS)), insomnia severity (Insomnia Severity Index (ISI)), pain (visual analogue scale (VAS)), and overall health status (Euro Quality of Life VAS (EQ-VAS)) were measured before and after 12 weeks. Patients assigned to the Yoga group showed significantly greater improvements on measures of general stress level (P < 0.000), anxiety (P < 0.019), and overall health status (P < 0.018) compared to controls. Treatment with medical yoga is effective in reducing levels of stress and anxiety in patients with stress-related symptoms in primary health care.

  3. Re-Engineering Primary School Teachers for Sustainable ...

    African Journals Online (AJOL)

    engineer primary school teachers for sustainable development in Onitsha North Local Government Area. Three research questions and a hypothesis were formulated to guide the study. Descriptive survey research design was used. 300 primary ...

  4. Third sector primary care for vulnerable populations.

    Science.gov (United States)

    Crampton, P; Dowell, A; Woodward, A

    2001-12-01

    This paper aims to describe and explain the development of third sector primary care organisations in New Zealand. The third sector is the non-government, non-profit sector. International literature suggests that this sector fulfils an important role in democratic societies with market-based economies, providing services otherwise neglected by the government and private for-profit sectors. Third sector organisations provided a range of social services throughout New Zealand's colonial history. However, it was not until the 1980s that third sector organisations providing comprehensive primary medical and related services started having a significant presence in New Zealand. In 1994 a range of union health centres, tribally based Mäori health providers, and community-based primary care providers established a formal network -- Health Care Aotearoa. While not representing all third sector primary care providers in New Zealand, Health Care Aotearoa was the best-developed example of a grouping of third sector primary care organisations. Member organisations served populations that were largely non-European and lived in deprived areas, and tended to adopt population approaches to funding and provision of services. The development of Health Care Aotearoa has been consistent with international experience of third sector involvement -- there were perceived "failures" in government policies for funding primary care and private sector responses to these policies, resulting in lack of universal funding and provision of primary care and continuing patient co-payments. The principal policy implication concerns the role of the third sector in providing primary care services for vulnerable populations as a partial alternative to universal funding and provision of primary care. Such an alternative may be convenient for proponents of reduced state involvement in funding and provision of health care, but may not be desirable from the point of view of equity and social cohesion

  5. Phytoplankton variability and community structure in relation to hydrographic features in the NE Aegean frontal area (NE Mediterranean Sea)

    Science.gov (United States)

    Lagaria, A.; Mandalakis, M.; Mara, P.; Frangoulis, C.; Karatsolis, B.-Th.; Pitta, P.; Triantaphyllou, M.; Tsiola, A.; Psarra, S.

    2017-10-01

    The structure of phytoplankton community in the salinity-stratified Northeastern Aegean frontal area adjacent to the Dardanelles Straits was investigated on a seasonal basis (autumn, spring and summer) and in relation to circulating water masses: the modified Black Sea Water (BSW) and the Levantine Water (LW). By employing High Performance Liquid Chromatography (HPLC) for the analysis of phytoplankton pigments in conjunction with conventional cell counting methodologies (i.e. inverted light microscopy, flow cytometry) and primary production measurements, a comprehensive qualitative and quantitative characterization of phytoplankton community composition and its activity was conducted. Chlorophyll-a normalized production and estimated growth rates presented the highest values within the 'fresh' BSW mass during summer, though generally growth rates were low (production. Large cell organisms, and in particular diatoms, were closely associated with the surface BSW masses outflowing from the Straits. Our results showed that all phytoplankton size components were significant over time and space suggesting a rather multivorous food web functioning of the system.

  6. Use of a computerized decision support system for primary and secondary prevention of work-related MSD disability.

    Science.gov (United States)

    Womack, Sarah K; Armstrong, Thomas J

    2005-09-01

    The present study evaluates the effectiveness of a decision support system used to evaluate and control physical job stresses and prevent re-injury of workers who have experienced or are concerned about work-related musculoskeletal disorders. The software program is a database that stores detailed job information such as standardized work data, videos, and upper-extremity physical stress ratings for over 400 jobs in the plant. Additionally, the database users were able to record comments about the jobs and related control issues. The researchers investigated the utility and effectiveness of the software by analyzing its use over a 20-month period. Of the 197 comments entered by the users, 25% pertained to primary prevention, 75% pertained to secondary prevention, and 94 comments (47.7%) described ergonomic interventions. Use of the software tool improved primary and secondary prevention by improving the quality and efficiency of the ergonomic job analysis process.

  7. Functional magnetic resonance imaging of the primary motor cortex

    Indian Academy of Sciences (India)

    Functional magnetic resonance imaging (fMRI) studies have been performed on 20 right handed volunteers at 1.5 Tesla using echo planar imaging (EPI) protocol. Index finger tapping invoked localized activation in the primary motor area. Consistent and highly reproducible activation in the primary motor area was observed ...

  8. fMRI-vs-MEG evaluation of post-stroke interhemispheric asymmetries in primary sensorimotor hand areas.

    Science.gov (United States)

    Altamura, Claudia; Torquati, Kahtya; Zappasodi, Filippo; Ferretti, Antonio; Pizzella, Vittorio; Tibuzzi, Francesco; Vernieri, Fabrizio; Pasqualetti, Patrizio; Landi, Doriana; Del Gratta, Cosimo; Romani, Gian-Luca; Maria Rossini, Paolo; Tecchio, Franca

    2007-04-01

    Growing evidence emphasizes a positive role of brain ipsilesional (IL) reorganization in stroke patients with partial recovery. Ten patients affected by a monohemispheric stroke in the middle cerebral artery territory underwent functional magnetic resonance (fMRI) and magnetoencephalography (MEG) evaluation of the primary sensory (S1) activation via the same paradigm (median nerve galvanic stimulation). Four patients did not present S1 fMRI activation [Rossini, P.M., Altamura, C., Ferretti, A., Vernieri, F., Zappasodi, F., Caulo, M., Pizzella, V., Del Gratta, C., Romani, G.L., Tecchio, F., 2004. Does cerebrovascular disease affect the coupling between neuronal activity and local haemodynamics? Brain 127, 99-110], although inclusion criteria required bilateral identifiable MEG responses. Mean Euclidean distance between fMRI and MEG S1 activation Talairach coordinates was 10.1+/-2.9 mm, with a 3D intra-class correlation (ICC) coefficient of 0.986. Interhemispheric asymmetries, evaluated by an MEG procedure independent of Talairach transformation, were outside or at the boundaries of reference ranges in 6 patients. In 3 of them, the IL activation presented medial or lateral shift with respect to the omega-shaped post-rolandic area while in the other 3, IL areas were outside the peri-rolandic region. In conclusion, despite dissociated intensity, the MEG and fMRI activations displayed good spatial consistency in stroke patients, thus confirming excessive interhemispheric asymmetries as a suitable indicator of unusual recruitments in the ipsilesional hemisphere, within or outside the peri-rolandic region.

  9. Habitus and Flow in Primary School Musical Practice: Relations between Family Musical Cultural Capital, Optimal Experience and Music Participation

    Science.gov (United States)

    Valenzuela, Rafael; Codina, Nuria

    2014-01-01

    Based on Bourdieu's idea that cultural capital is strongly related to family context, we describe the relations between family musical cultural capital and optimal experience during compulsory primary school musical practice. We analyse whether children from families with higher levels of musical cultural capital, and specifically with regard to…

  10. Enhancing state-community relations through the ward development ...

    African Journals Online (AJOL)

    The primary responsibility of the government is to develop communities under its jurisdiction through community development projects. The development of the rural areas creates conditions conducive for community living, enhances the legitimacy of government and promotes state-community relations. But the political ...

  11. Primary Idiopathic Osteoarthropathy: Could It Be Related to Alcoholism?

    Directory of Open Access Journals (Sweden)

    Yanal Alnimer

    2017-01-01

    Full Text Available Background. Hypertrophic osteoarthropathy (HOA is a syndrome characterized by abnormal proliferation of the skin and bony structures at the distal extremities resulting in digital clubbing, periosteal bony reaction, and joint effusion. It can be primary (idiopathic without any clear identifiable etiology as well as secondary to variety of systemic diseases most notably lung pathology. Case Presentation. We describe a rare case of primary idiopathic osteoarthropathy in a male patient who presented with severe pain and tenderness in his legs. His history was significant for long standing alcoholism. Physical examination showed severe fingers and toes clubbing. He reported similar changes in his mother. Clinical and radiological findings were remarkable for distal leg tenderness and diffuse periosteal bony reactions, respectively. Computerized tomography scan failed to show any pathology apart from fatty liver infiltration. In the absence of obesity or diabetes, this was consistent with alcoholic steatosis. He was started on nonsteroidal anti-inflammatory drug which dramatically improved his symptoms. Conclusion. Primary hypertrophic osteoarthropathy should be considered in a previously healthy person presenting with bony pain and finger clubbing especially after ruling out the common secondary causes. Moreover, alteration of prostaglandin metabolism secondary to alcoholic consumption might be a contributing factor.

  12. An overview of the U.S. programs on properties of primary circuit materials

    International Nuclear Information System (INIS)

    Brinkman, C.R.; Sikka, V.K.; Booker, M.K.

    1977-01-01

    The objective of U.S. Breeder Reactor Programs associated with primary circuit structural materials is to develop the design data base and associated design technology on existing commercially available materials as well as new alloys. This will permit economic operation of components at acceptable levels of plant availability and at up to 40-yr lifetimes for inaccessible components. Long-term component reliability, elevated-temperature service within the creep range, and resistance to sodium attack and irradiation damage, along with design in compliance with ASME Codes and RDT Specifications, have required that the U.S. Programs be directed toward contributing knowledge in a number of areas. These areas, relating to material deformation, failure modes, compatibility, fabrication, long-term behavior, irradiation damage, and availability will be discussed. The U.S. Structural Material Programs concerned with primary-circuit components will be reviewed, and their current and future contributions to knowledge of these areas will be explained. (author)

  13. An overview of the U.S. programs on properties of primary circuit materials

    Energy Technology Data Exchange (ETDEWEB)

    Brinkman, C R; Sikka, V K; Booker, M K [Metals and Ceramics Division, Oak Ridge National Laboratory, Oak Ridge, TN (United States)

    1977-07-01

    The objective of U.S. Breeder Reactor Programs associated with primary circuit structural materials is to develop the design data base and associated design technology on existing commercially available materials as well as new alloys. This will permit economic operation of components at acceptable levels of plant availability and at up to 40-yr lifetimes for inaccessible components. Long-term component reliability, elevated-temperature service within the creep range, and resistance to sodium attack and irradiation damage, along with design in compliance with ASME Codes and RDT Specifications, have required that the U.S. Programs be directed toward contributing knowledge in a number of areas. These areas, relating to material deformation, failure modes, compatibility, fabrication, long-term behavior, irradiation damage, and availability will be discussed. The U.S. Structural Material Programs concerned with primary-circuit components will be reviewed, and their current and future contributions to knowledge of these areas will be explained. (author)

  14. Lead related behavioral and psychological performance changes in primary school children from industrial, urban and rural areas in Egypt. Verhalten und psychologische Leistungsfaehigkeit bei Grundschulkindern in industriellen, staedtischen und laendlichen Gebieten in Abhaengigkeit vom Bleigehalt im Blut, Haar und Urin

    Energy Technology Data Exchange (ETDEWEB)

    Faris, R.; Kamal, A.A.M.; Shoman, A. (Dept. of Community, Environmental and Occupational Medicine, Ain Shams Univ., Abbasia Cairo (Egypt)); Beshary, Z.; Massoud, A. (Dept. of Psychiatry, Ain Shams Univ., Abbasia Cairo (Egypt))

    1991-11-01

    We measured indicators of lead absorption (capillary blood lead, scalp hair lead and urine delta aminoleviolenic acid) as well as parameters of behavior and psychoperformance among three groups of children. These were 100, 100 and 76 children which constituted the total children of the fifth year of three primary schools from industrial, urban and rural areas respectively. The three indicators of lead absorption differed significantly between the three groups in the sense that: Indicators of those from industrial area > that of those from urban area > that of those from rural area. Psychological parameters showed a corresponding increased hyperactivity and lowered psychoperformance. The psychological parameters were significantly correlated with all the three indicators of lead absorption. In this domain hyperactivity scale was the most correlated one. The study confirms the opinion that environmental low lead level exposure constitutes a potential risk for behavioral and psycho-performance development among children with its possible negative consequences. (orig./MG).

  15. Evaluation of Articles Related to Program Development in Education Published in the Journal of Primary Education

    Science.gov (United States)

    Guclu, Mustafa

    2013-01-01

    The purpose of this study was to make an overall assessment of articles related to program development in education that appeared in the "Journal of Primary Education," which had been published between 1939 and 1966. For this purpose, the articles in the journal were analyzed by using content analysis, and evaluated in terms of program…

  16. Changes in Primary Students' Informal Reasoning during an Environment-Related Curriculum on Socio-Scientific Issues

    Science.gov (United States)

    Karpudewan, Mageswary; Roth, Wolff-Michael

    2018-01-01

    Recent studies emphasize the importance of learning science while considering multiple perspectives on environment, society, economy, and technology, which allows learners to relate what they do in the classroom to the world beyond. In this study, 68 12-year-old primary students from 1 Malaysian school were followed while they engaged in a science…

  17. Abnormal cortical synaptic plasticity in primary motor area in progressive supranuclear palsy.

    Science.gov (United States)

    Conte, Antonella; Belvisi, Daniele; Bologna, Matteo; Ottaviani, Donatella; Fabbrini, Giovanni; Colosimo, Carlo; Williams, David R; Berardelli, Alfredo

    2012-03-01

    No study has yet investigated whether cortical plasticity in primary motor area (M1) is abnormal in patients with progressive supranuclear palsy (PSP). We studied M1 plasticity in 15 PSP patients and 15 age-matched healthy subjects. We used intermittent theta-burst stimulation (iTBS) to investigate long-term potentiation (LTP) and continuous TBS (cTBS) to investigate long-term depression (LTD)-like cortical plasticity in M1. Ten patients underwent iTBS again 1 year later. We also investigated short-interval intracortical inhibition (SICI) and intracortical facilitation (ICF) in M1 with paired-pulse transcranial magnetic stimulation, tested H reflex from upper limb flexor muscles before and after iTBS, and measured motor evoked potential (MEP) input-output (I/O) curves before and after iTBS. iTBS elicited a significantly larger MEP facilitation after iTBS in patients than in healthy subjects. Whereas in healthy subjects, cTBS inhibited MEP, in patients it significantly facilitated MEPs. In patients, SICI was reduced, whereas ICF was normal. H reflex size remained unchanged after iTBS. Patients had steeper MEP I/O slopes than healthy subjects at baseline and became even more steeper after iTBS only in patients. The iTBS-induced abnormal MEP facilitation in PSP persisted at 1-year follow-up. In conclusion, patients with PSP have abnormal M1 LTP/LTD-like plasticity. The enhanced LTP-like cortical synaptic plasticity parallels disease progression.

  18. Cortical thickness development of human primary visual cortex related to the age of blindness onset.

    Science.gov (United States)

    Li, Qiaojun; Song, Ming; Xu, Jiayuan; Qin, Wen; Yu, Chunshui; Jiang, Tianzi

    2017-08-01

    Blindness primarily induces structural alteration in the primary visual cortex (V1). Some studies have found that the early blind subjects had a thicker V1 compared to sighted controls, whereas late blind subjects showed no significant differences in the V1. This implies that the age of blindness onset may exert significant effects on the development of cortical thickness of the V1. However, no previous research used a trajectory of the age of blindness onset-related changes to investigate these effects. Here we explored this issue by mapping the cortical thickness trajectory of the V1 against the age of blindness onset using data from 99 blind individuals whose age of blindness onset ranged from birth to 34 years. We found that the cortical thickness of the V1 could be fitted well with a quadratic curve in both the left (F = 11.59, P = 3 × 10 -5 ) and right hemispheres (F = 6.54, P = 2 × 10 -3 ). Specifically, the cortical thickness of the V1 thinned rapidly during childhood and adolescence and did not change significantly thereafter. This trend was not observed in the primary auditory cortex (A1), primary motor cortex (M1), or primary somatosensory cortex (S1). These results provide evidence that an onset of blindness before adulthood significantly affects the cortical thickness of the V1 and suggest a critical period for cortical development of the human V1.

  19. Primary schoolchildren’s self-reported sun-related knowledge, attitudes and behaviours: a South African school-based study

    CSIR Research Space (South Africa)

    Wright, C

    2013-09-01

    Full Text Available The objective of this paper is to describe the self-reported sun-related knowledge, attitudes and behaviours of a sample of South African multi-ethnic primary schoolchildren and consider the roles of sex and skin type as well as school sun...

  20. Sub-optimal patient and physician communication in primary care consultations: its relation to severe and difficult asthma

    NARCIS (Netherlands)

    Moffat, M.; Cleland, J.; Van der Molen, T.; Price, D.

    2006-01-01

    Introduction: Asthma control can be influenced by a range of non-medical issues, including psychosocial factors. Little is known about the views of patients, particularly those with severe and/or difficult asthma, towards their asthma control and their asthma-related primary care consultations. Aims

  1. Community health worker in hard-to-reach rural areas of Myanmar: filling primary health care service gaps.

    Science.gov (United States)

    Sommanustweechai, Angkana; Putthasri, Weerasak; Nwe, Mya Lay; Aung, Saw Thetlya; Theint, Mya Min; Tangcharoensathien, Viroj; Wynn, San Shway

    2016-10-21

    Myanmar is classified as critical shortage of health workforce. In responses to limited number of trained health workforce in the hard-to-reach and remote areas, the MOH trained the Community Health Worker (CHW) as health volunteers serving these communities on a pro bono basis. This study aimed to assess the socio-economic profiles, contributions of CHW to primary health care services and their needs for supports to maintain their quality contributions in rural hard to reach areas in Myanmar. In 2013, cross-sectional census survey was conducted on all three groups of CHW classified by their training dates: (1) prior to 2000, (2) between 2000 and 2011, and (3) more recently trained in 2012, who are still working in 21 townships of 17 states and regions in Myanmar, using a self-administered questionnaire survey in the Burmese language. The total 715 CHWs from 21 townships had completely responded to the questionnaire. CHWs were trained to support the work of midwives in the sub-centres and health assistant and midwives in rural health centres (RHCs) such as community mobilization for immunization, advocates of safe water and sanitation, and general health education and health awareness for the citizens. CHWs were able to provide some of the services by themselves, such as treatment of simple illnesses, and they provided services to 62 patients in the last 6 months. Their contributions to primary health care services were well accepted by the communities as they are geographically and culturally accessible. However, supports from the RHC were inadequate in particular technical supervision, as well as replenishment of CHW kits and financial support for their work and transportation. In practice, 6 % of service provided by CHWs was funded by the community and 22 % by the patients. The CHW's confidence in providing health services was positively associated with their age, education, and more recent training. A majority of them intended to serve as a CHW for more than

  2. Clinical care of children with primary ciliary dyskinesia

    DEFF Research Database (Denmark)

    Lucas, Jane S; Alanin, Mikkel Christian; Collins, Samuel

    2017-01-01

    INTRODUCTION: Primary ciliary dyskinesia (PCD) is a rare heterogeneous disorder, usually inherited as an autosomal recessive condition but X-linked inheritance is also described. Abnormal ciliary function in childhood leads to neonatal respiratory distress in term infants, persistent wet cough...... is inappropriate since differences in pathophysiology, morbidity and prognosis risk treatment failure and lack of adherence. Areas covered: Review authors searched PubMed and Cochrane databases for publications relating to management of children with PCD. Because of the paucity of data, we emphasise the need...

  3. Primary ectopic frontotemporal extradural craniopharyngioma

    Directory of Open Access Journals (Sweden)

    Reza Pourkhalili

    2016-01-01

    Full Text Available We present a case of primary ectopic frontotemporal extradural craniopharyngioma. Primary ectopic craniopharyngiomas are very rare and have been reported involving the fourth ventricle, infrasellar region, lateral ventricle, temporal area, cerebellopontine angle, clivus, corpus callosum, and prepontine cistern. There was just 1 case of craniopharyngioma previously presented in the literature, with nearly same location as the presenting case.

  4. African Primary Care Research: qualitative interviewing in primary care.

    Science.gov (United States)

    Reid, Steve; Mash, Bob

    2014-06-05

    This article is part of a series on African Primary Care Research and focuses on the topic of qualitative interviewing in primary care. In particular it looks at issues of study design, sample size, sampling and interviewing in relation to individual and focus group interviews.There is a particular focus on helping postgraduate students at a Masters level to write their research proposals.

  5. Measuring the attractiveness of rural communities in accounting for differences of rural primary care workforce supply.

    Science.gov (United States)

    McGrail, Matthew R; Wingrove, Peter M; Petterson, Stephen M; Humphreys, John S; Russell, Deborah J; Bazemore, Andrew W

    2017-01-01

    Many rural communities continue to experience an undersupply of primary care doctor services. While key professional factors relating to difficulties of recruitment and retention of rural primary care doctors are widely identified, less attention has been given to the role of community and place aspects on supply. Place-related attributes contribute to a community's overall amenity or attractiveness, which arguably influence both rural recruitment and retention relocation decisions of doctors. This bi-national study of Australia and the USA, two developed nations with similar geographic and rural access profiles, investigates the extent to which variations in community amenity indicators are associated with spatial variations in the supply of rural primary care doctors. Measures from two dimensions of community amenity: geographic location, specifically isolation/proximity; and economics and sociodemographics were included in this study, along with a proxy measure (jurisdiction) of a third dimension, environmental amenity. Data were chiefly collated from the American Community Survey and the Australian Census of Population and Housing, with additional calculated proximity measures. Rural primary care supply was measured using provider-to-population ratios in 1949 US rural counties and in 370 Australian rural local government areas. Additionally, the more sophisticated two-step floating catchment area method was used to measure Australian rural primary care supply in 1116 rural towns, with population sizes ranging from 500 to 50 000. Associations between supply and community amenity indicators were examined using Pearson's correlation coefficients and ordinary least squares multiple linear regression models. It was found that increased population size, having a hospital in the county, increased house prices and affluence, and a more educated and older population were all significantly associated with increased workforce supply across rural areas of both countries

  6. Knowledge attitudes and practices of grade three primary schoolchildren in relation to schistosomiasis, soil transmitted helminthiasis and malaria in Zimbabwe

    Directory of Open Access Journals (Sweden)

    Brouwer Kimberly C

    2011-06-01

    Full Text Available Abstract Background Helminth infection rates in grade three children are used as proxy indicators of community infection status and to guide treatment strategies in endemic areas. However knowledge, attitudes and practices (KAP of this target age group (8-10 years in relation to schistosomiasis, soil transmitted helminthiasis (STHs and malaria is not known at a time when integrated plasmodium - helminth control strategies are being advocated. This study sought to assess KAP of grade 3 children in relation to schistosomiasis, STHs and malaria in order to establish an effective school based health education for disease transmission control. Methods Grade 3 children (n = 172 attending four randomly selected primary schools (one in rural and 3 in the commercial farming areas in Zimbabwe were interviewed using a pre-tested interviewer administered questionnaire. The urine filtration technique was used to determine S. haematobium infection status. Infection with S. mansoni and STHs was determined using a combination of results from the Kato Katz and formol ether concentration techniques. P. falciparum was diagnosed by examination of Giemsa stained thick blood smears. Results It was observed that 32.0%, 19.2% and 4.1% of the respondents had correct knowledge about the causes of schistosomiasis, malaria and STHs, respectively, whilst 22.1%, 19.2% and 5.8% knew correct measures to control schistosomiasis, malaria and STHs. Sixty-two percent and 44.8% did not use soap to wash hands after toilet and before eating food respectively, whilst 33.1% never wore shoes. There were no functional water points and soap for hand washing after toilet at all schools. There was a high prevalence distribution of all parasites investigated in this study at Msapa primary school - S. haematobium (77.8%, S. mansoni (33.3% hookworms (29.6% and P. falciparum (48.1%. Reports that participant had suffered from schistosomiasis and malaria before were significant predictors of

  7. Intestinal helminth infections among primary school pupils in ...

    African Journals Online (AJOL)

    A study was carried out to determine the prevalence of intestinal helminth infections among primary school pupils in Ekwulumili Community, Nnewi South Local Government Area, Anambra State, Nigeria, between April and July 2012. Five primary schools were involved in the study namely, Bethel Nursery and Primary ...

  8. Green tribology: principles, research areas and challenges.

    Science.gov (United States)

    Nosonovsky, Michael; Bhushan, Bharat

    2010-10-28

    In this introductory paper for the Theme Issue on green tribology, we discuss the concept of green tribology and its relation to other areas of tribology as well as other 'green' disciplines, namely, green engineering and green chemistry. We formulate the 12 principles of green tribology: the minimization of (i) friction and (ii) wear, (iii) the reduction or complete elimination of lubrication, including self-lubrication, (iv) natural and (v) biodegradable lubrication, (vi) using sustainable chemistry and engineering principles, (vii) biomimetic approaches, (viii) surface texturing, (ix) environmental implications of coatings, (x) real-time monitoring, (xi) design for degradation, and (xii) sustainable energy applications. We further define three areas of green tribology: (i) biomimetics for tribological applications, (ii) environment-friendly lubrication, and (iii) the tribology of renewable-energy application. The integration of these areas remains a primary challenge for this novel area of research. We also discuss the challenges of green tribology and future directions of research.

  9. [Clinical bioethics for primary health care].

    Science.gov (United States)

    González-de Paz, L

    2013-01-01

    The clinical decision making process with ethical implications in the area of primary healthcare differs from other healthcare areas. From the ethical perspective it is important to include these issues in the decision making model. This dissertation explains the need for a process of bioethical deliberation for Primary Healthcare, as well as proposing a method for doing so. The decision process method, adapted to this healthcare area, is flexible and requires a more participative Healthcare System. This proposal involves professionals and the patient population equally, is intended to facilitate the acquisition of responsibility for personal and community health. Copyright © 2012 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  10. Relative Food Prices and Obesity in U.S. Metropolitan Areas: 1976-2001

    Science.gov (United States)

    Xu, Xin; Variyam, Jayachandran N.; Zhao, Zhenxiang; Chaloupka, Frank J.

    2014-01-01

    This study investigates the impact of food price on obesity, by exploring the co-occurrence of obesity growth with relative food price reduction between 1976 and 2001. Analyses control for female labor participation and metropolitan outlet densities that might affect body weight. Both the first-difference and fixed effects approaches provide consistent evidence suggesting that relative food prices have substantial impacts on obesity and such impacts were more pronounced among the low-educated. These findings imply that relative food price reductions during the time period could plausibly explain about 18% of the increase in obesity among the U.S. adults in metropolitan areas. PMID:25502888

  11. Geostatistical and GIS analysis of the spatial variability of alluvial gold content in Ngoura-Colomines area, Eastern Cameroon: Implications for the exploration of primary gold deposit

    Science.gov (United States)

    Takodjou Wambo, Jonas Didero; Ganno, Sylvestre; Djonthu Lahe, Yannick Sthopira; Kouankap Nono, Gus Djibril; Fossi, Donald Hermann; Tchouatcha, Milan Stafford; Nzenti, Jean Paul

    2018-06-01

    Linear and nonlinear geostatistic is commonly used in ore grade estimation and seldom used in Geographical Information System (GIS) technology. In this study, we suggest an approach based on geostatistic linear ordinary kriging (OK) and Geographical Information System (GIS) techniques to investigate the spatial distribution of alluvial gold content, mineralized and gangue layers thicknesses from 73 pits at the Ngoura-Colomines area with the aim to determine controlling factors for the spatial distribution of mineralization and delineate the most prospective area for primary gold mineralization. Gold content varies between 0.1 and 4.6 g/m3 and has been broadly grouped into three statistical classes. These classes have been spatially subdivided into nine zones using ordinary kriging model based on physical and topographical characteristics. Both mineralized and barren layer thicknesses show randomly spatial distribution, and there is no correlation between these parameters and the gold content. This approach has shown that the Ngoura-Colomines area is located in a large shear zone compatible with the Riedel fault system composed of P and P‧ fractures oriented NE-SW and NNE-SSW respectively; E-W trending R fractures and R‧ fractures with NW-SE trends that could have contributed significantly to the establishment of this gold mineralization. The combined OK model and GIS analysis have led to the delineation of Colomines, Tissongo, Madubal and Boutou villages as the most prospective areas for the exploration of primary gold deposit in the study area.

  12. Relating Nimbus-7 37 GHz data to global land-surface evaporation, primary productivity and the atmospheric CO2 concentration

    Science.gov (United States)

    Choudhury, B. J.

    1988-01-01

    Global observations at 37 GHz by the Nimbus-7 SMMR are related to zonal variations of land surface evaporation and primary productivity, as well as to temporal variations of atmospheric CO2 concentration. The temporal variation of CO2 concentration and the zonal variations of evaporation and primary productivity are shown to be highly correlated with the satellite sensor data. The potential usefulness of the 37-GHz data for global biospheric and climate studies is noted.

  13. Assessment of Field Experience Related to Pressurized Water Reactor Primary System Leaks

    International Nuclear Information System (INIS)

    Ware, A.G.; Hsu, C.; Atwood, C.L.; Sattison, M.B.; Hartley, R.S.; Shah, V.N.

    1999-01-01

    This paper presents our assessment of field experience related to pressurized water reactor (PWR) primary system leaks in terms of their number and rates, how aging affects frequency of leak events, the safety significance of such leaks, industry efforts to reduce leaks, and effectiveness of current leak detection systems. We have reviewed the licensee event reports to identify the events that took place during 1985 to the third quarter of 1996, and reviewed related technical literature and visited PWR plants to analyze these events. Our assessment shows that USNRC licensees have taken effective actions to reduce the number of leak events. One main reason for this decreasing trend was the elimination or reportable leakages from valve stem packing after 1991. Our review of leak events related to vibratory fatigue reveals a statistically significant decreasing trend with age (years of operation), but not in calendar time. Our assessment of worldwide data on leakage caused by thermal fatigue cracking is that the fatigue of aging piping is a safety significant issue. Our review of leak events has identified several susceptible sites in piping having high safety significance; but the inspection of some of these sites is not required by the ASME Code. These sites may be included in the risk-informed inspection programs

  14. Assessment of Field Experience Related to Pressurized Water Reactor Primary System Leaks

    International Nuclear Information System (INIS)

    Shah, Vikram Naginbhai; Ware, Arthur Gates; Atwood, Corwin Lee; Sattison, Martin Blaine; Hartley, Robert Scott; Hsu, C.

    1999-01-01

    This paper presents our assessment of field experience related to pressurized water reactor (PWR) primary system leaks in terms of their number of rates, how aging affects frequency of leak events, the safety significance of such leaks, industry efforts to reduce leaks, and effectiveness of current leak detection systems. We have reviewed the licensee event reports to identify the events that took place during 1985 to the third quarter of 1996, and reviewed related technical literature and visited PWR plants to analyze these events. Our assessment shows that USNRC licensees have taken effective actions to reduce the number of leak events. One main reason for this decreasing trend was the elimination or reportable leakages from valve stem packing after 1991. Our review of leak events related to vibratory fatigue reveals a statistically significant decreasing trend with age (years of operation), but not in calendar time. Our assessment of worldwide data on leakage caused by thermal fatigue cracking is that the fatigue of aging piping is a safety significant issue. Our review of leak events has identified several susceptible sites in piping having high safety significance; but the inspection of some of these sites is not required by the ASME Code. These sites may be included in the risk-informed inspection programs

  15. Evaluation of primary immunization coverage of infants under universal immunization programme in an urban area of Bangalore city using cluster sampling and lot quality assurance sampling techniques

    Directory of Open Access Journals (Sweden)

    Punith K

    2008-01-01

    Full Text Available Research Question: Is LQAS technique better than cluster sampling technique in terms of resources to evaluate the immunization coverage in an urban area? Objective: To assess and compare the lot quality assurance sampling against cluster sampling in the evaluation of primary immunization coverage. Study Design: Population-based cross-sectional study. Study Setting: Areas under Mathikere Urban Health Center. Study Subjects: Children aged 12 months to 23 months. Sample Size: 220 in cluster sampling, 76 in lot quality assurance sampling. Statistical Analysis: Percentages and Proportions, Chi square Test. Results: (1 Using cluster sampling, the percentage of completely immunized, partially immunized and unimmunized children were 84.09%, 14.09% and 1.82%, respectively. With lot quality assurance sampling, it was 92.11%, 6.58% and 1.31%, respectively. (2 Immunization coverage levels as evaluated by cluster sampling technique were not statistically different from the coverage value as obtained by lot quality assurance sampling techniques. Considering the time and resources required, it was found that lot quality assurance sampling is a better technique in evaluating the primary immunization coverage in urban area.

  16. Application of smart phone and supporting set for fundus imaging in primary hospital of rural area

    Directory of Open Access Journals (Sweden)

    Yong-Feng Jing

    2018-01-01

    Full Text Available AIM: To describe the application of smart phone and supporting set for acquiring fundus images with slitlamp examination and non-contact lens in primary hospital of the rural area. METHODS: The supporting set for smart phone was purchased from taobao and securely connected to the ocular lens of slitlamp microscopy. The fundus photos were imaged with assistance of non-contact slitlamp lens from Volk. RESULTS: High quality images of various retinal diseases could be successfully taken with smart phone and supporting set by slitlamp examination. The fundus images were send to patients with Wechat as medical records or used for telconsultant. CONCLUSION: High resolution smart phones are wildly used nowadays and supporting sets are very accessible; thus high quality of images could be obtained with minimal cost in rural hospitals. The digital fundus images will be beneficial for medical record and rapid diagnosis with telconsultant.

  17. Participation of primary motor cortex area 4a in complex sensory processing: 3.0-T fMRI study.

    Science.gov (United States)

    Terumitsu, Makoto; Ikeda, Kotaro; Kwee, Ingrid L; Nakada, Tsutomu

    2009-05-06

    The precise movement of human fingers requires continuous and reciprocal interaction between motor and sensory systems. Similar to other primates, there is double representation of the digits and wrists within the human primary motor cortex (M1), which are generally referred to as area 4 anterior (M1-4a) and area 4 posterior (M1-4p). In this high-field (3.0 T) functional magnetic resonance imaging (fMRI) study, we hypothesized that M1-4p is more important for initiation of motion, whereas M1-4a is important for execution of a given motion involving more complex sensoriomotor interaction. We investigated M1-4a and M1-4p activation associated with two representative motor tasks, namely, finger tapping (voluntary motion, VM) and passive finger movement accomplished by continuous pressure (passive motor, PM), and two representative sensory stimulations, namely, simple stimulation of flutter vibration (simple sensory, SS), and complex stimulation by a row of pins moving either vertically or horizontally (complex sensory, CS). Both M1-4a and M1-4p were activated in both motor tasks, VM and PM. M1-4p was not activated by either of the two sensory tasks, whereas M1-4a was activated by CS but not by SS. Analysis of the center of gravities (COG) of the activated areas showed that VM and PM moved COG towards M1-4p and 3a. SS moved COG towards somatosensory cortex Brodmann areas 1, 2, and 3b, whereas CS towards M1-4a. The result clearly showed that M1-4a represents the area of secondary motor execution, which actively participates in CS processing.

  18. Contaminants in stream sediments from seven United States metropolitan areas: part I: distribution in relation to urbanization

    Science.gov (United States)

    Nowell, Lisa H.; Moran, Patrick W.; Gilliom, Robert J.; Calhoun, Daniel L.; Ingersoll, Christopher G.; Kemble, Nile E.; Kuivila, Kathryn; Phillips, Patrick J.

    2013-01-01

    Organic contaminants and trace elements were measured in bed sediments collected from streams in seven metropolitan study areas across the United States to assess concentrations in relation to urbanization. Polycyclic aromatic hydrocarbons, polychlorinated biphenyls, organochlorine pesticides, the pyrethroid insecticide bifenthrin, and several trace elements were significantly related to urbanization across study areas. Most contaminants (except bifenthrin, chromium, nickel) were significantly related to the total organic carbon (TOC) content of the sediments. Regression models explained 45–80 % of the variability in individual contaminant concentrations using degree of urbanization, sediment-TOC, and study-area indicator variables (which represent the combined influence of unknown factors, such as chemical use or release, that are not captured by available explanatory variables). The significance of one or more study-area indicator variables in all models indicates marked differences in contaminant levels among some study areas, even after accounting for the nationally modeled effects of urbanization and sediment-TOC. Mean probable effect concentration quotients (PECQs) were significantly related to urbanization. Trace elements were the major contributors to mean PECQs at undeveloped sites, whereas organic contaminants, especially bifenthrin, were the major contributors at highly urban sites. Pyrethroids, where detected, accounted for the largest share of the mean PECQ. Part 2 of this series (Kemble et al. 2012) evaluates sediment toxicity to amphipods and midge in relation to sediment chemistry.

  19. [Cortical Areas for Controlling Voluntary Movements].

    Science.gov (United States)

    Nakayama, Yoshihisa; Hoshi, Eiji

    2017-04-01

    The primary motor cortex is located in Brodmann area 4 at the most posterior part of the frontal lobe. The primary motor cortex corresponds to an output stage of motor signals, sending motor commands to the brain stem and spinal cord. Brodmann area 6 is rostral to Brodmann area 4, where multiple higher-order motor areas are located. The premotor area, which is located in the lateral part, is involved in planning and executing action based on sensory signals. The premotor area contributes to the reaching for and grasping of an object to achieve a behavioral goal. The supplementary motor area, which occupies the mesial aspect, is involved in planning and executing actions based on internalized or memorized signals. The supplementary motor area plays a central role in bimanual movements, organizing multiple movements, and switching from a routine to a controlled behavior. Thus, Brodmann areas 4 and 6 are considered as central motor areas in the cerebral cortex, in which the idea of an action is transformed to an actual movement in a variety of contexts.

  20. Development of a scoring system for differentiating IgG4-related sclerosing cholangitis from primary sclerosing cholangitis.

    Science.gov (United States)

    Moon, Sung-Hoon; Kim, Myung-Hwan; Lee, Jong Kyun; Baek, Seunghee; Woo, Young Sik; Cho, Dong Hui; Oh, Dongwook; Song, Tae Jun; Park, Do Hyun; Lee, Sang Soo; Seo, Dong Wan; Lee, Sung Koo

    2017-04-01

    Recent research has shown that a substantial number of patients with primary sclerosing cholangitis (PSC) can also have elevated serum/tissue IgG4. The aim of our study was to develop a simple scoring system for the discrimination of IgG4-related sclerosing cholangits (IgG4-SC) from PSC. Patients with IgG4-SC (n = 39) and PSC (n = 76) who had intrahepatic/hilar strictures were included. Candidate-differentiating variables included patient age, other organ involvement (OOI), inflammatory bowel disease, serum IgG4, and cholangiographic features. A scoring system was developed on the basis of these variables, and its performance was internally validated using a bootstrapping-based method. The scoring system in the final model included age (IgG4-SC. The discrimination between IgG4-SC and PSC using the scoring system was excellent (area under the receiver operating characteristic curve, 0.986). A reliable differentiation of IgG4-SC from PSC can be made using the scoring system presented here. We suggest the diagnosis of IgG4-SC at a cutoff of 7 points or higher and the indication of diagnostic steroid trial at 5 or 6 points. External validation of our scoring system is warranted.

  1. Development and evolution of the vertebrate primary mouth

    Science.gov (United States)

    Soukup, Vladimír; Horácek, Ivan; Cerny, Robert

    2013-01-01

    The vertebrate oral region represents a key interface between outer and inner environments, and its structural and functional design is among the limiting factors for survival of its owners. Both formation of the respective oral opening (primary mouth) and establishment of the food-processing apparatus (secondary mouth) require interplay between several embryonic tissues and complex embryonic rearrangements. Although many aspects of the secondary mouth formation, including development of the jaws, teeth or taste buds, are known in considerable detail, general knowledge about primary mouth formation is regrettably low. In this paper, primary mouth formation is reviewed from a comparative point of view in order to reveal its underestimated morphogenetic diversity among, and also within, particular vertebrate clades. In general, three main developmental modes were identified. The most common is characterized by primary mouth formation via a deeply invaginated ectodermal stomodeum and subsequent rupture of the bilaminar oral membrane. However, in salamander, lungfish and also in some frog species, the mouth develops alternatively via stomodeal collar formation contributed both by the ecto- and endoderm. In ray-finned fishes, on the other hand, the mouth forms via an ectoderm wedge and later horizontal detachment of the initially compressed oral epithelia with probably a mixed germ-layer derivation. A very intriguing situation can be seen in agnathan fishes: whereas lampreys develop their primary mouth in a manner similar to the most common gnathostome pattern, hagfishes seem to undergo a unique oropharyngeal morphogenesis when compared with other vertebrates. In discussing the early formative embryonic correlates of primary mouth formation likely to be responsible for evolutionary–developmental modifications of this area, we stress an essential role of four factors: first, positioning and amount of yolk tissue; closely related to, second, endoderm formation during

  2. Tech Area II: A history

    Energy Technology Data Exchange (ETDEWEB)

    Ullrich, R. [Ktech Corp., Albuquerque, NM (United States)

    1998-07-01

    This report documents the history of the major buildings in Sandia National Laboratories` Technical Area II. It was prepared in support of the Department of Energy`s compliance with Section 106 of the National Historic Preservation Act. Technical Area II was designed and constructed in 1948 specifically for the final assembly of the non-nuclear components of nuclear weapons, and was the primary site conducting such assembly until 1952. Both the architecture and location of the oldest buildings in the area reflect their original purpose. Assembly activities continued in Area II from 1952 to 1957, but the major responsibility for this work shifted to other sites in the Atomic Energy Commission`s integrated contractor complex. Gradually, additional buildings were constructed and the original buildings were modified. After 1960, the Area`s primary purpose was the research and testing of high-explosive components for nuclear weapons. In 1994, Sandia constructed new facilities for work on high-explosive components outside of the original Area II diamond-shaped parcel. Most of the buildings in the area are vacant and Sandia has no plans to use them. They are proposed for decontamination and demolition as funding becomes available.

  3. Traction-related problems after hip arthroscopy

    DEFF Research Database (Denmark)

    Frandsen, Lone; Lund, Bent; Grønbech Nielsen, Torsten

    2017-01-01

    . The questionnaire included questions on patients' perceptions of traction-related problems in the groin area, at the knee and ankle and how patients had coped with these problems. A total of 100 consecutive patients undergoing hip arthroscopy filled out the questionnaire. Primary findings of this study were that 74......% of patients reported some sort of traction-related problems after hip arthroscopy. About 32% of the patients had problems in the groin area and 49% of the patients complained of symptoms in the knee joint. A total of 37% of the patients had experienced problems from the traction boot in the ankle area....... The complications were found to be temporary and disappeared after 2-4 weeks. Five patients still had complaints after 3 months. All five patients had a pre-existing knee injury prior to undergoing hip arthroscopy. Traction-related problems after hip arthroscopy are a challenge and our study showed that 74...

  4. Combining Functional Neuroimaging with Off-Line Brain Stimulation: Modulation of Task-Related Activity in Language Areas

    Science.gov (United States)

    Andoh, Jamila; Paus, Tomas

    2011-01-01

    Repetitive TMS (rTMS) provides a noninvasive tool for modulating neural activity in the human brain. In healthy participants, rTMS applied over the language-related areas in the left hemisphere, including the left posterior temporal area of Wernicke (LTMP) and inferior frontal area of Broca, have been shown to affect performance on word…

  5. Preliminary study of the primary nozzle position of a supersonic air ejector with a constant-area mixing chamber

    Directory of Open Access Journals (Sweden)

    Kracik Jan

    2017-01-01

    Full Text Available This work aims at investigating the primary nozzle position in a proposed supersonic air ejector device. The ejector is primarily made up of a supersonic primary nozzle, which is located in the axis of the ejector, a suction chamber or secondary stream inlet, a mixing chamber and a diffuser. The ejector design allows to translate the primary nozzle in the axis direction and fix it in a chosen distance from the beginning of the mixing chamber and hence influence the secondary mass flow rate. In a limit case, it is possible to set the nozzle to such a position where no secondary flow occurs. If we ignore the case where no secondary flow occurs, five different nozzle distances have been investigated in this paper. Some cases seem to be alike and there are no significant dissimilarities between them. Courses of relative back-pressure ratio are carried out against the entrainment ratio and transition between on-design and off-design regimes is determined. Measurements of the mixed flow based on the standard ISO 5167 are performed by means of orifice plate method. In addition, a comparison between experiments and simulations performed by Ansys Fluent software is presented in order to indicate further improvements to the numerical model.

  6. Determinants of depression in primary caregivers of disabled older relatives: a path analysis

    Directory of Open Access Journals (Sweden)

    Rafael del -Pino-Casado

    2017-11-01

    Full Text Available Abstract Background Despite the large literature analysing factors related to depression, several factors such as caregiving obligation and the interrelationships among the different variables relating to depression have been little studied. The current study aimed to analyse the effect of caregiving obligation (beliefs regarding obligation and social pressure on depression, and the mediating effects of perceived burden on the relationship between stressors and depression, in primary caregivers of older relatives. Methods Cross-sectional study design. A probabilistic sample of caregivers from Spain (N = 200 was used. The data collection was conducted in 2013 through structured interviews in the caregivers’ homes. The measures included sense of obligation for caregiving, perceived burden, stressors and depression. Results Depression had a direct and positive association with perceived burden, behavioural problems, and social pressure, and it was indirectly related through perceived burden to behavioural problems, independence for the activities of daily living and beliefs of obligation. Conclusions Our results support the multidimensional concept of obligation, suggesting the existence of both an external obligation (social pressure and an internal obligation (beliefs of obligation; (b our findings support the hypothesis that external obligation is related to negative caregiving consequences, while internal obligation protects from these consequences; and (c our findings support the partial mediation of stressors on depression by perceived burden. The relevance of the research to clinical practice includes the importance of understanding the perceived obligation of caregiving related to both internal and external sources of obligation.

  7. Cross-sectional study of area-level disadvantage and glycaemic-related risk in community health service users in the Southern.IML Research (SIMLR) cohort.

    Science.gov (United States)

    Cross, Roger; Bonney, Andrew; Mayne, Darren J; Weston, Kathryn M

    2017-09-19

    Objectives The aim of the present study was to determine the association between area-level socioeconomic disadvantage and glycaemic-related risk in health service users in the Illawarra-Shoalhaven region of New South Wales, Australia. Methods HbA1c values recorded between 2010 and 2012 for non-pregnant individuals aged ≥18 years were extracted from the Southern.IML Research (SIMLR) database. Individuals were assigned quintiles of the Socioeconomic Indices for Australia (SEIFA) Index of Relative Socioeconomic Disadvantage (IRSD) according to their Statistical Area 1 of residence. Glycaemic risk categories were defined as HbA1c 5.0-5.99% (lowest risk), 6.0-7.49% (intermediate risk) and ≥7.5% (highest risk). Logistic regression models were fit with glycaemic risk category as the outcome variable and IRSD as the study variable, adjusting for age and sex. Results Data from 29064 individuals were analysed. Higher disadvantage was associated with belonging to a higher glycaemic risk category in the fully adjusted model (most disadvantaged vs least disadvantaged quintile; odds ratio 1.74, 95% confidence interval 1.58, 1.93; Pdisadvantage was a significant correlate of increased glycaemic-related risk. Geocoded clinical data can inform more targeted use of health service resources, with the potential for improved health care equity and cost-effectiveness. What is known about the topic? The rapid increase in the prevalence of Type 2 diabetes (T2D), both globally and nationally within Australia, is a major concern for the community and public health agencies. Individual socioeconomic disadvantage is a known risk factor for abnormal glucose metabolism (AGM), including T2D. Although small-area-level socioeconomic disadvantage is a known correlate of AGM in Australia, less is known of the association of area-level disadvantage and glycaemic-related risk in individuals with AGM. What does this paper add? This study demonstrates a robust association between small-area

  8. Preventing violence against women by challenging gender stereotypes in Scottish primary schools

    DEFF Research Database (Denmark)

    Fage-Butler, Antoinette Mary

    2016-01-01

    Gender violence is a major public health issue in Europe; it is normalized and partly legitimized by gender stereotypes. An example of a primary prevention education programme designed to challenge the attitudes that underpin gender violence, particularly violence against women, is the Zero...... Tolerance Respect (ZTR) programme developed for Scottish pupils. Given the importance of early preventative action in this area, this paper analyses how gender stereotypes were challenged in ZTR materials for primary pupils aged 10-12 years. Qualitative content analysis was used to analyse the content...... of the seven lessons in the ZTR primary school programme; the materials were also evaluated in relation to best practice within attitudinal change promotion. Analysis shows that ZTR empowers pupils to reflect on and confront gender stereotypes by developing pupils’ social awareness, as respect is characterized...

  9. Underserved Areas and Pediatric Resident Characteristics: Is There Reason for Optimism?

    Science.gov (United States)

    Laraque-Arena, Danielle; Frintner, Mary Pat; Cull, William L

    2016-01-01

    To examine whether resident characteristics and experiences are related to practice in underserved areas. Cross-sectional survey of a national random sample of pediatric residents (n = 1000) and additional sample of minority residents (n = 223) who were graduating in 2009 was conducted. Using weighted logistic regression, we examined relationships between resident characteristics (background, values, residency experiences, and practice goals) and reported 1) expectation to practice in underserved area and 2) postresidency position in underserved area. Response rate was 57%. Forty-one percent of the residents reported that they had an expectation of practicing in an underserved area. Of those who had already accepted postresidency positions, 38% reported positions in underserved areas. Service obligation in exchange for loans/scholarships and primary care/academic pediatrics practice goals were the strongest predictors of expectation of practicing in underserved areas (respectively, adjusted odds ratio 4.74, 95% confidence interval 1.87-12.01; adjusted odds ratio 3.48, 95% confidence interval 1.99-6.10). Other significant predictors include hospitalist practice goals, primary care practice goals, importance of racial/ethnic diversity of patient population in residency selection, early plan (before medical school) to care for underserved families, mother with a graduate or medical degree, and higher score on the Universalism value scale. Service obligation and primary care/academic pediatrics practice goal were also the strongest predictors for taking a postresidency job in underserved area. Trainee characteristics such as service obligations, values of humanism, and desire to serve underserved populations offer the hope that policies and public funding can be directed to support physicians with these characteristics to redress the maldistribution of physicians caring for children. Copyright © 2016 Academic Pediatric Association. Published by Elsevier Inc. All

  10. Bryophyte-Cyanobacteria Associations during Primary Succession in Recently Deglaciated Areas of Tierra del Fuego (Chile)

    Science.gov (United States)

    Arróniz-Crespo, María; Pérez-Ortega, Sergio; De los Ríos, Asunción; Green, T. G. Allan; Ochoa-Hueso, Raúl; Casermeiro, Miguel Ángel; de la Cruz, María Teresa; Pintado, Ana; Palacios, David; Rozzi, Ricardo; Tysklind, Niklas; Sancho, Leopoldo G.

    2014-01-01

    Bryophyte establishment represents a positive feedback process that enhances soil development in newly exposed terrain. Further, biological nitrogen (N) fixation by cyanobacteria in association with mosses can be an important supply of N to terrestrial ecosystems, however the role of these associations during post-glacial primary succession is not yet fully understood. Here, we analyzed chronosequences in front of two receding glaciers with contrasting climatic conditions (wetter vs drier) at Cordillera Darwin (Tierra del Fuego) and found that most mosses had the capacity to support an epiphytic flora of cyanobacteria and exhibited high rates of N2 fixation. Pioneer moss-cyanobacteria associations showed the highest N2 fixation rates (4.60 and 4.96 µg N g−1 bryo. d−1) very early after glacier retreat (4 and 7 years) which may help accelerate soil development under wetter conditions. In drier climate, N2 fixation on bryophyte-cyanobacteria associations was also high (0.94 and 1.42 µg N g−1 bryo. d−1) but peaked at intermediate-aged sites (26 and 66 years). N2 fixation capacity on bryophytes was primarily driven by epiphytic cyanobacteria abundance rather than community composition. Most liverworts showed low colonization and N2 fixation rates, and mosses did not exhibit consistent differences across life forms and habitat (saxicolous vs terricolous). We also found a clear relationship between cyanobacteria genera and the stages of ecological succession, but no relationship was found with host species identity. Glacier forelands in Tierra del Fuego show fast rates of soil transformation which imply large quantities of N inputs. Our results highlight the potential contribution of bryophyte-cyanobacteria associations to N accumulation during post-glacial primary succession and further describe the factors that drive N2-fixation rates in post-glacial areas with very low N deposition. PMID:24819926

  11. Bryophyte-cyanobacteria associations during primary succession in recently Deglaciated areas of Tierra del Fuego (Chile).

    Science.gov (United States)

    Arróniz-Crespo, María; Pérez-Ortega, Sergio; De Los Ríos, Asunción; Green, T G Allan; Ochoa-Hueso, Raúl; Casermeiro, Miguel Ángel; de la Cruz, María Teresa; Pintado, Ana; Palacios, David; Rozzi, Ricardo; Tysklind, Niklas; Sancho, Leopoldo G

    2014-01-01

    Bryophyte establishment represents a positive feedback process that enhances soil development in newly exposed terrain. Further, biological nitrogen (N) fixation by cyanobacteria in association with mosses can be an important supply of N to terrestrial ecosystems, however the role of these associations during post-glacial primary succession is not yet fully understood. Here, we analyzed chronosequences in front of two receding glaciers with contrasting climatic conditions (wetter vs drier) at Cordillera Darwin (Tierra del Fuego) and found that most mosses had the capacity to support an epiphytic flora of cyanobacteria and exhibited high rates of N2 fixation. Pioneer moss-cyanobacteria associations showed the highest N2 fixation rates (4.60 and 4.96 µg N g-1 bryo. d-1) very early after glacier retreat (4 and 7 years) which may help accelerate soil development under wetter conditions. In drier climate, N2 fixation on bryophyte-cyanobacteria associations was also high (0.94 and 1.42 µg N g-1 bryo. d-1) but peaked at intermediate-aged sites (26 and 66 years). N2 fixation capacity on bryophytes was primarily driven by epiphytic cyanobacteria abundance rather than community composition. Most liverworts showed low colonization and N2 fixation rates, and mosses did not exhibit consistent differences across life forms and habitat (saxicolous vs terricolous). We also found a clear relationship between cyanobacteria genera and the stages of ecological succession, but no relationship was found with host species identity. Glacier forelands in Tierra del Fuego show fast rates of soil transformation which imply large quantities of N inputs. Our results highlight the potential contribution of bryophyte-cyanobacteria associations to N accumulation during post-glacial primary succession and further describe the factors that drive N2-fixation rates in post-glacial areas with very low N deposition.

  12. Bidirectional relations between text reading prosody and reading comprehension in the upper primary school grades: A longitudinal perspective

    NARCIS (Netherlands)

    Veenendaal, N.J.; Groen, M.A.; Verhoeven, L.T.W.

    2016-01-01

    The purpose of this study was to examine the directionality of the relationship between text reading prosody and reading comprehension in the upper grades of primary school. We compared 3 theoretical possibilities: Two unidirectional relations from text reading prosody to reading comprehension and

  13. RELATIONS BETWEEN GENERAL MOTOR SKILLS AND HANDBALL SPECIFIC TEST "BALL SLALOM" IN STUDENTS OF THE IV GRADE OF PRIMARY SCHOOL

    Directory of Open Access Journals (Sweden)

    Dragan Branković

    2012-09-01

    Full Text Available Teaching physical education and physical training of children, should be appropriate to their age abilities and needs. Acquire the diversified movement experience is a priority of physical education in junior school age. Students fourth grade of primary school - age 10-11 years, in the sensitive period for developing coordination and speed capabilities. Sports game handball and mode of the game "mini-handball", which is adapted to students age abilities and spatial characteristics of the majority of primary schools, abundant with various tasks, specifically dominated by natural forms of movement - running, jumping, throwing. Therefore, handball has a significant role in solving the tasks of physical education. The specific motor tests and relations with the general motor skills are particularly important for continuous monitoring of motor development of children. The survey was conducted on 79 boys fourth grade of primary school who participated in the electoral sport of handball in the regular physical education classes. The results of the handball test "ball slalom" and its relation with general motor skills of students fourth grade of primary school, should contribute to the perception of the value of handball as the content of physical education, but also to contribute to the selection and forecast performance of children in handball.

  14. Within-digit functional parcellation of Brodmann areas of the human primary somatosensory cortex using functional magnetic resonance imaging at 7 tesla.

    Science.gov (United States)

    Sanchez-Panchuelo, Rosa M; Besle, Julien; Beckett, Alex; Bowtell, Richard; Schluppeck, Denis; Francis, Susan

    2012-11-07

    The primary somatosensory cortex (S1) can be subdivided cytoarchitectonically into four distinct Brodmann areas (3a, 3b, 1, and 2), but these areas have never been successfully delineated in vivo in single human subjects. Here, we demonstrate the functional parcellation of four areas of S1 in individual human subjects based on high-resolution functional MRI measurements made at 7 T using vibrotactile stimulation. By stimulating four sites along the length of the index finger, we were able to identify and locate map reversals of the base to tip representation of the index finger in S1. We suggest that these reversals correspond to the areal borders between the mirrored representations in the four Brodmann areas, as predicted from electrophysiology measurements in nonhuman primates. In all subjects, maps were highly reproducible across scanning sessions and stable over weeks. In four of the six subjects scanned, four, mirrored, within-finger somatotopic maps defining the extent of the Brodmann areas could be directly observed on the cortical surface. In addition, by using multivariate classification analysis, the location of stimulation on the index finger (four distinct sites) could be decoded with a mean accuracy of 65% across subjects. Our measurements thus show that within-finger topography is present at the millimeter scale in the cortex and is highly reproducible. The ability to identify functional areas of S1 in vivo in individual subjects will provide a framework for investigating more complex aspects of tactile representation in S1.

  15. Estimates of relative areas for the disposal in bedded salt of LWR wastes from alternative fuel cycles

    International Nuclear Information System (INIS)

    Lincoln, R.C.; Larson, D.W.; Sisson, C.E.

    1978-01-01

    The relative mine-level areas (land use requirements) which would be required for the disposal of light-water reactor (LWR) radioactive wastes in a hypothetical bedded-salt formation have been estimated. Five waste types from alternative fuel cycles have been considered. The relative thermal response of each of five different site conditions to each waste type has been determined. The fuel cycles considered are the once-through (no recycle), the uranium-only recycle, and the uranium and plutonium recycle. The waste types which were considered include (1) unreprocessed spent reactor fuel, (2) solidified waste derived from reprocessing uranium oxide fuel, (3) plutonium recovered from reprocessing spent reactor fuel and doped with 1.5% of the accompanying waste from reprocessing uranium oxide fuel, (4) waste derived from reprocessing mixed uranium/plutonium oxide fuel in the third recycle, and (5) unreprocessed spent fuel after three recycles of mixed uranium/plutonium oxide fuels. The relative waste-disposal areas were determined from a calculated value of maximum thermal energy (MTE) content of the geologic formations. Results are presented for each geologic site condition in terms of area ratios. Disposal area requirements for each waste type are expressed as ratios relative to the smallest area requirement (for waste type No. 2 above). For the reference geologic site condition, the estimated mine-level disposal area ratios are 4.9 for waste type No. 1, 4.3 for No. 3, 2.6 for No. 4, and 11 for No. 5

  16. Demineralization of Enamel in Primary Second Molars Related to Properties of the Enamel

    Directory of Open Access Journals (Sweden)

    N. Sabel

    2012-01-01

    Full Text Available Enamel structure is of importance in demineralization. Differences in porosity in enamel effect the rate of demineralization, seen between permanent and deciduous teeth. Individual differences have been shown in the mean mineral concentration values in enamel, the role of this in demineralization is not thoroughly investigated. The aim of this study was to study variations of depths of artificial lesions of demineralization and to analyze the depth in relation to variations in the chemical and mineral composition of the enamel. A demineralized lesion was created in second primary molars from 18 individuals. Depths of lesions were then related to individual chemical content of the enamel. Enamel responded to demineralization with different lesion depths and this was correlated to the chemical composition. The carbon content in sound enamel was shown to be higher where lesions developed deeper. The lesion was deeper when the degree of porosity of the enamel was higher.

  17. Primary progressive aphasia patients evaluated using diffusion tensor imaging and voxel based volumetry-preliminary results

    Directory of Open Access Journals (Sweden)

    Fábio Pascotto de Oliveira

    2011-06-01

    Full Text Available There are individuals who have a progressive language deficit without presenting cognitive deficits in other areas. One of the diseases related to this presentation is primary progressive aphasia (PPA. OBJECTIVE: Identify by means of diffusion tensor imaging (DTI and measurements of cortical volume, brain areas that lead to dysphasia when presenting signs of impaired connectivity or reduced volume. METHOD: Four patients with PPA were evaluated using DTI, and measurements of cortical volumes in temporal areas. These patients were compared with two normal volunteers. RESULTS: There is a trend to a difference in the number and volume of related fibers between control group and patients with PPA. Comparing cortical volumes in temporal areas between groups yielded a trend to a smaller volume in PPA patients. CONCLUSION: Patients with PPA have a trend to impairment in cortical and subcortical levels regarding relevant areas.

  18. Analysis on biomass and productivity of epilithic algae and their relations to environmental factors in the Gufu River basin, Three Gorges Reservoir area, China.

    Science.gov (United States)

    Ge, Jiwen; Wu, Shuyuan; Touré, Dado; Cheng, Lamei; Miao, Wenjie; Cao, Huafen; Pan, Xiaoying; Li, Jianfeng; Yao, Minmin; Feng, Liang

    2017-12-01

    The main purpose of this study conducted from August 2010 was to find biomass and productivity of epilithic algae and their relations to environmental factors and try to explore the restrictive factors affecting the growth of algae in the Gufu River, the one of the branches of Xiangxi River located in the Three Gorges Reservoir of the Yangtze River, Hubei Province, Central China. An improved method of in situ primary productivity measurement was utilized to estimate the primary production of the epilithic algae. It was shown that in rivers, lakes, and reservoirs, algae are the main primary producers and have a central role in the ecosystem. Chlorophyll a concentration and ash-free dry mass (AFDM) were estimated for epilithic algae of the Gufu River basin in Three Gorges Reservoir area. Environmental factors in the Gufu River ecosystem highlighted differences in periphyton chlorophyll a ranging from 1.49 mg m -2 (origin) to 69.58 mg m -2 (terminal point). The minimum and maximum gross primary productivity of epilithic algae were 96.12 and 1439.89 mg C m -2  day -1 , respectively. The mean net primary productivity was 290.24 mg C m -2  day -1 . The mean autotrophic index (AFDM:chlorophyll a) was 407.40. The net primary productivity, community respiration ratio (P/R ratio) ranged from 0.98 to 9.25 with a mean of 2.76, showed that autotrophic productivity was dominant in the river. Relationship between physicochemical characteristics and biomass was discussed through cluster and stepwise regression analysis which indicated that altitude, total nitrogen (TN), NO 3 - -N, and NH 4 + -N were significant environmental factors affecting the biomass of epilithic algae. However, a negative logarithmic relationship between altitude and the chlorophyll a of epilithic algae was high. The results also highlighted the importance of epilithic algae in maintaining the Gufu River basin ecosystems health.

  19. Implication for second primary cancer from visible oral and oropharyngeal premalignant lesions in betel-nut chewing related oral cancer.

    Science.gov (United States)

    Liu, Shyun-Yu; Feng, I-Jung; Wu, Yu-Wei; Chen, Ching-Yuan; Hsiung, Chao-Nan; Chang, Hsueh-Wei; Lin, Che-Yi; Chang, Min-Te; Yu, Hsi-Chien; Lee, Sheng-Yang; Yen, Ching-Yu

    2017-07-01

    Visible oral and oropharyngeal premalignant lesions may be used to monitor for a second primary oral cancer. To control for bias, we focused on the visible oral and oropharyngeal premalignant lesions of patients with oral cancer with a positive betel-nut chewing habit. Visible oral and oropharyngeal premalignant lesions that can predict second primary oral cancers were studied. Nine hundred ninety-seven patients with positive betel-nut chewing habits and oral cancer were enrolled in this retrospective cohort study. We analyzed the relevance of their visible oral and oropharyngeal premalignant lesion incidence and relative clinicopathological variables to the development of a second primary oral cancer. Second primary oral cancer risk was significantly higher in patients with positive visible oral and oropharyngeal premalignant lesions (P oral and oropharyngeal premalignant lesions make it a potentially valuable marker in follow-ups of patients with a positive betel-nut chewing habit with oral cancer, especially young patients with heterogeneous leukoplakia. © 2017 Wiley Periodicals, Inc.

  20. Solving some socio-economic relations in the area of the projected site of the Blahutovice nuclear power plant

    International Nuclear Information System (INIS)

    Uvirova, E.; Grosikova, B.

    1988-01-01

    Blahutovice nuclear power plant personnel will be accommodated in hostels and newly built appartments in Novy Jicin and in Hranice. Commuting of personnel to the plant from the two towns is discussed. A works health centre will be built in the nuclear power plant area delivering primary health care. A radiation medicine unit is also envisaged. The Beskydy Mts. in Northern Moravia are considered for recreation-rehabilitation facilities. (E.S.). 2 tabs., 5 refs

  1. F-Area Seepage Basins Groundwater Monitoring Report: Volume 1, Third and fourth quarters 1994

    International Nuclear Information System (INIS)

    Chase, J.A.

    1994-03-01

    Isoconcentration/isoactivity maps included in this report indicate both the concentration/activity and extent of the primary contaminants in each of the three hydrostratigraphic units. Geologic cross sections indicate both the extent and depth of contamination of the primary contaminants in all of the hydrostratigraphic units during the second half of 1994. Water-level maps indicate that the groundwater flow rates and directions at the F-Area Seepage Basins have remained relatively constant since the basins ceased to be active in 1988

  2. Assistance in chemistry and chemical processes related to primary, secondary and ancillary systems of nuclear power plants

    International Nuclear Information System (INIS)

    Chocron, Mauricio A.; Becquart, Elena T.; Iglesias, Alberto M.; La Gamma, Ana M.; Villegas, Marina

    2003-01-01

    Argentina is currently running two nuclear power plants: Atucha I (CNA I) and Embalse (CNE) operated by Nucleoelectrica Argentina (NASA) whereas the National Atomic Energy Commission (CNEA), among other activities, is responsible for research and development in the nuclear field, operates research reactors and carries out projects related to them. In particular, the Reactor Chemistry Section personnel (currently part of the Chemistry Dept.) has been working on the field of reactor water chemistry for more than 25 years, on research and support to the NPPs chemistry department. Though the most relevant tasks have been connected to primary and secondary circuits chemistry, ancillary systems show along the time unexpected problems or feasible improvements originated in the undergoing operating time as well as in phenomena not foreseen by the constructors. In the present paper are presented the tasks performed in relation to the following systems of Embalse NPP: 1) Heavy water upgrade column preliminary water treatment; 2) Liquid waste system preliminary water treatment; and 3) Primary heat transport system coolant crud composition. (author)

  3. Illness absenteeism rates in primary and secondary schools in 2013-2014 in England: was there any impact of vaccinating children of primary-school age against influenza?

    Science.gov (United States)

    Green, H K; Brousseau, N; Andrews, N; Selby, L; Pebody, R

    2016-09-09

    A phased introduction of routine influenza vaccination of healthy children was recommended in the UK in 2012, with the aim of protecting both vaccinated children and the wider population through reducing transmission. In the first year of the programme in 2013-2014, 4- to 11-year-olds were targeted in pilot areas across England. This study assesses if this was associated with school absenteeism, an important societal burden of influenza. During the spring 2014 term when influenza predominantly circulated, the proportion of absence sessions due to illness was compared between vaccination pilot and non-pilot areas for primary schools (to measure overall impact) and secondary schools (to measure indirect impact). A linear multilevel regression model was applied, adjusting for clustering within schools and potential school-level confounders, including deprivation, past absenteeism, and ethnicity. Low levels of influenza activity were reported in the community in 2013-2014. Primary schools in pilot areas had a significantly adjusted decrease in illness absenteeism of 0·05% relative to non-pilot schools; equivalent to an average of 4 days per school. In secondary schools, there was no significant indirect impact of being located in a pilot area on illness absenteeism. These insights can be used in conjunction with routine healthcare surveillance data to evaluate the full benefits of such a programme.

  4. Screening and Identification in Pediatric Primary Care

    Science.gov (United States)

    Simonian, Susan J.

    2006-01-01

    This article reviews issues related to behavioral screening in pediatric primary care settings. Structural-organizational issues affecting the use of pediatric primary care screening are discussed. This study also reviewed selected screening instruments that have utility for use in the primary care setting. Clinical and research issues related to…

  5. Clinical diagnostic model for sciatica developed in primary care patients with low back-related leg pain

    Science.gov (United States)

    Konstantinou, Kika; Ogollah, Reuben; Hay, Elaine M.; Dunn, Kate M.

    2018-01-01

    Background Identification of sciatica may assist timely management but can be challenging in clinical practice. Diagnostic models to identify sciatica have mainly been developed in secondary care settings with conflicting reference standard selection. This study explores the challenges of reference standard selection and aims to ascertain which combination of clinical assessment items best identify sciatica in people seeking primary healthcare. Methods Data on 394 low back-related leg pain consulters were analysed. Potential sciatica indicators were seven clinical assessment items. Two reference standards were used: (i) high confidence sciatica clinical diagnosis; (ii) high confidence sciatica clinical diagnosis with confirmatory magnetic resonance imaging findings. Multivariable logistic regression models were produced for both reference standards. A tool predicting sciatica diagnosis in low back-related leg pain was derived. Latent class modelling explored the validity of the reference standard. Results Model (i) retained five items; model (ii) retained six items. Four items remained in both models: below knee pain, leg pain worse than back pain, positive neural tension tests and neurological deficit. Model (i) was well calibrated (p = 0.18), discrimination was area under the receiver operating characteristic curve (AUC) 0.95 (95% CI 0.93, 0.98). Model (ii) showed good discrimination (AUC 0.82; 0.78, 0.86) but poor calibration (p = 0.004). Bootstrapping revealed minimal overfitting in both models. Agreement between the two latent classes and clinical diagnosis groups defined by model (i) was substantial, and fair for model (ii). Conclusion Four clinical assessment items were common in both reference standard definitions of sciatica. A simple scoring tool for identifying sciatica was developed. These criteria could be used clinically and in research to improve accuracy of identification of this subgroup of back pain patients. PMID:29621243

  6. Communication-related behavior change techniques used in face-to-face lifestyle interventions in primary care: A systematic review of the literature

    NARCIS (Netherlands)

    Noordman, J.; Weijden, T.T. van der; Dulmen, A.M. van

    2012-01-01

    OBJECTIVES: To systematically review the literature on the relative effectiveness of face-to-face communication-related behavior change techniques (BCTs) provided in primary care by either physicians or nurses to intervene on patients' lifestyle behavior. METHODS: PubMed, EMBASE, PsychINFO, CINAHL

  7. Communication-related behavior change techniques used in face-to-face lifestyle interventions in primary care: a systematic review of the literature.

    NARCIS (Netherlands)

    Noordman, J.; Weijden, T. van der; Dulmen, S. van

    2012-01-01

    Objectives: To systematically review the literature on the relative effectiveness of face-to-face communication-related behavior change techniques (BCTs) provided in primary care by either physicians or nurses to intervene on patients’ lifestyle behavior. Methods: PubMed, EMBASE, PsychINFO, CINAHL

  8. Risperidone-related reversal of primary enuresis: an unusual case report.

    Science.gov (United States)

    Mendhekar, D N; Andrade, C

    2010-03-01

    Occasional reports have documented treatment-emergent enuresis with medication regimens that include risperidone. In contrast to these reports, we present a 12-year-old girl with mild mental retardation and primary nocturnal enuresis who received risperidone (0.5 mg/day) for the isolated symptom of inappropriate smiling. Surprisingly, in addition to reduction in inappropriate smiling, risperidone also substantially decreased the frequency of enuresis. These benefits with risperidone were confirmed in an on-off-on treatment sequence. To our knowledge, this is the first case in literature of primary enuresis responding to low-dose risperidone. Low-dose risperidone may merit study in children with enuresis. Clinical implications and possible mechanisms are discussed.

  9. Glial tumors in brodmann area 6: spread pattern and relationships to motor areas.

    Science.gov (United States)

    Shah, Komal B; Hayman, L Anne; Chavali, Lakshmi S; Hamilton, Jackson D; Prabhu, Sujit S; Wangaryattawanich, Pattana; Kumar, Vinodh A; Kumar, Ashok J

    2015-01-01

    The posterior frontal lobe of the brain houses Brodmann area 4, which is the primary motor cortex, and Brodmann area 6, which consists of the supplementary motor area on the medial portion of the hemisphere and the premotor cortex on the lateral portion. In this area, safe resection is dependent on accurate localization of the motor cortex and the central sulcus, which can usually be achieved by using thin-section imaging and confirmed by using other techniques. The most reliable anatomic landmarks are the "hand knob" area and the marginal ramus of the cingulate sulcus. Postoperatively, motor deficits can occur not only because of injury to primary motor cortex but also because of injury to the supplementary motor area. Unlike motor cortex injury, the supplementary motor area syndrome is transient, if it occurs at all. On the lateral hemisphere, motor and language deficits can also occur because of premotor cortex injury, but a dense motor deficit would indicate subcortical injury to the corticospinal tract. The close relationship of the subcortical motor fibers and premotor cortex is illustrated. In contrast to the more constant landmarks of the central sulcus and marginal ramus, which aid in preoperative localization, the variable interruptions in the precentral and cingulate sulci of the posterior frontal lobe seem to provide "cortical bridges" for spread of infiltrating gliomas. (©)RSNA, 2015.

  10. Development of a Knowledge Management Model for the Development of a Quality Public Sector Management System for the Office of the Primary Educational Service Area

    Science.gov (United States)

    Khotbancha, Wijitra; Chantarasombat, Chalard; Sriampai, Anan

    2015-01-01

    The objectives of this research were: 1) to study the current situation and problem of Knowledge Management of the office of the primary education service area, 2) to develop a Knowledge Management model, 3) to study the success of the implementation of the Knowledge Management system. There were 25 persons in the target group. There were 2 kinds…

  11. DMSA scan nomograms for renal length and area: Related to patient age and to body weight, height or surface area

    International Nuclear Information System (INIS)

    Hassan, I.M.; Que, L.; Rutland, M.D.

    2002-01-01

    Aim: To create nomograms for renal size as measured from DMSA renal studies, and to test the nomograms for their ability to separate normal from abnormal kidneys. Method: Renal length was measured from posterior oblique views and renal area from posterior views. Results from 253 patients with bilateral normal kidneys were used to create nomograms for renal size relative to patient age, body height, weight or body surface area (BSA). The nomograms enclosed 95% of the normal kidneys, thus indicating the range for 95% confidence limits, and hence the specificity. Each nomogram was then tested against 46 hypertrophied kidneys and 46 damaged kidneys. Results: The results from nomograms of renal length and renal area, compared to age, body height, body weight and BSA are presented. For each nomogram, the range is presented as a fraction of the mean value, and the number of abnormal kidneys (hypertrophied or damaged) outside the normal range is presented as a percentage (indicating the sensitivity). Conclusion: Renal Area was no better than renal length for detecting abnormal kidneys. Patient age was the least useful method of normalisation. BSA normalisation produced the best results most frequently (narrower ranges and highest detection of abnormal kidneys)

  12. An Inquiry into the NEST Program in Relation to English Teaching and Learning in Taiwanese Primary Schools

    Science.gov (United States)

    Luo, Wen-Hsing

    2014-01-01

    This study aims to explore the Native English-Speaking Teacher (NEST) Program in relation to teachers' instruction and students' learning of English in primary schools in Taiwan. Inviting native English-speakers to teach English in the school system is not an unusual practice in the Asia-Pacific region. As the practice of including NESTs in the…

  13. Cancer Related-Knowledge - Small Area Estimates

    Science.gov (United States)

    These model-based estimates are produced using statistical models that combine data from the Health Information National Trends Survey, and auxiliary variables obtained from relevant sources and borrow strength from other areas with similar characteristics.

  14. Brain activity related to phonation in young patients with adductor spasmodic dysphonia.

    Science.gov (United States)

    Kiyuna, Asanori; Maeda, Hiroyuki; Higa, Asano; Shingaki, Kouta; Uehara, Takayuki; Suzuki, Mikio

    2014-06-01

    This study investigated the brain activities during phonation of young patients with adductor spasmodic dysphonia (ADSD) of relatively short disease duration (<10 years). Six subjects with ADSD of short duration (mean age: 24. 3 years; mean disease duration: 41 months) and six healthy controls (mean age: 30.8 years) underwent functional magnetic resonance imaging (fMRI) using a sparse sampling method to identify brain activity during vowel phonation (/i:/). Intragroup and intergroup analyses were performed using statistical parametric mapping software. Areas of activation in the ADSD and control groups were similar to those reported previously for vowel phonation. All of the activated areas were observed bilaterally and symmetrically. Intergroup analysis revealed higher brain activities in the SD group in the auditory-related areas (Brodmann's areas [BA] 40, 41), motor speech areas (BA44, 45), bilateral insula (BA13), bilateral cerebellum, and middle frontal gyrus (BA46). Areas with lower activation were in the left primary sensory area (BA1-3) and bilateral subcortical nucleus (putamen and globus pallidus). The auditory cortical responses observed may reflect that young ADSD patients control their voice by use of the motor speech area, insula, inferior parietal cortex, and cerebellum. Neural activity in the primary sensory area and basal ganglia may affect the voice symptoms of young ADSD patients with short disease duration. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  15. Prevalence of refractive error in malay primary school children in suburban area of Kota Bharu, Kelantan, Malaysia.

    Science.gov (United States)

    Hashim, Syaratul-Emma; Tan, Hui-Ken; Wan-Hazabbah, W H; Ibrahim, Mohtar

    2008-11-01

    Refractive error remains one of the primary causes of visual impairment in children worldwide, and the prevalence of refractive error varies widely. The objective of this study was to determine the prevalence of refractive error and study the possible associated factors inducing refractive error among primary school children of Malay ethnicity in the suburban area of Kota Bharu, Kelantan, Malaysia. A school-based cross-sectional study was performed from January to July 2006 by random selection on Standard 1 to Standard 6 students of 10 primary schools in the Kota Bharu district. Visual acuity assessment was measured using logMAR ETDRS chart. Positive predictive value of uncorrected visual acuity equal or worse than 20/40, was used as a cut-off point for further evaluation by automated refraction and retinoscopic refraction. A total of 840 students were enumerated but only 705 were examined. The prevalence of uncorrected visual impairment was seen in 54 (7.7%) children. The main cause of the uncorrected visual impairment was refractive error which contributed to 90.7% of the total, and with 7.0% prevalence for the studied population. Myopia is the most common type of refractive error among children aged 6 to 12 years with prevalence of 5.4%, followed by hyperopia at 1.0% and astigmatism at 0.6%. A significant positive correlation was noted between myopia development with increasing age (P <0.005), more hours spent on reading books (P <0.005) and background history of siblings with glasses (P <0.005) and whose parents are of higher educational level (P <0.005). Malays in suburban Kelantan (5.4%) have the lowest prevalence of myopia compared with Malays in the metropolitan cities of Kuala Lumpur (9.2%) and Singapore (22.1%). The ethnicity-specific prevalence rate of myopia was the lowest among Malays in Kota Bharu, followed by Kuala Lumpur, and is the highest among Singaporean Malays. Better socio-economic factors could have contributed to higher myopia rates in the

  16. The relative influence of nutrients and habitat on stream metabolism in agricultural streams

    Science.gov (United States)

    Frankforter, J.D.; Weyers, H.S.; Bales, J.D.; Moran, P.W.; Calhoun, D.L.

    2010-01-01

    Stream metabolism was measured in 33 streams across a gradient of nutrient concentrations in four agricultural areas of the USA to determine the relative influence of nutrient concentrations and habitat on primary production (GPP) and respiration (CR-24). In conjunction with the stream metabolism estimates, water quality and algal biomass samples were collected, as was an assessment of habitat in the sampling reach. When data for all study areas were combined, there were no statistically significant relations between gross primary production or community respiration and any of the independent variables. However, significant regression models were developed for three study areas for GPP (r 2 = 0.79-0.91) and CR-24 (r 2 = 0.76-0.77). Various forms of nutrients (total phosphorus and area-weighted total nitrogen loading) were significant for predicting GPP in two study areas, with habitat variables important in seven significant models. Important physical variables included light availability, precipitation, basin area, and in-stream habitat cover. Both benthic and seston chlorophyll were not found to be important explanatory variables in any of the models; however, benthic ash-free dry weight was important in two models for GPP. ?? 2009 The Author(s).

  17. Analysis of refractive status and related factors of pupils in Hetian Road primary school in Zhabei community, Shanghai, 2011

    Directory of Open Access Journals (Sweden)

    Wei Zhu

    2013-06-01

    Full Text Available AIM: To evaluate the refractive status of pupils of Hetian Road primary school in Zhabei community of Shanghai and analyze the relationships between visual acuity and relative factors. METHODS: All the in-school students of Hetian Road primary school in Zhabei community of Shanghai were involved in the study. Four hundred and sixty pupils out of 465 pupils were investigated(The rate was 98.9%. There were 445 pupils with fully data collection. Uncorrected visual acuity(UCVA, age, height(H, weight(W, body mass index(BMI, diopter of spherical(S, diopter of cylinder(C, spherical equivalent(SE, axial length(ALand corneal curvature(Kwere examined. The refractive status was described and the influence of relative factors was analyzed. UCVA measurement uses the standard logarithmic visual acuity chart, recording by decimal number, then transform into LogMar vision for statistical analysis. RESULTS: In total, the average age was 9.49±1.47 year, SE was -0.85±1.82D and UCVA was +0.09±0.28. The prevalence of myopia and astigmatism was 40.9% and 58.9%, respectively. With getting older, the prevalence of myopia increased with the average myopic SE developing significantly(P=0.000. UCVA and AL increased in the same time, SE decreased gradually(PPCONCLUSION: The prevalence of myopia and astigmatism was high in Hetian Road primary school in Zhabei community of Shanghai. Visual acuity is closely related to AL and growth factors.

  18. Pesticide-related illness reported to and diagnosed in Primary Care: implications for surveillance of environmental causes of ill-health

    Directory of Open Access Journals (Sweden)

    Mann Vera

    2009-07-01

    Full Text Available Abstract Background In Great Britain (GB, data collected on pesticide associated illness focuses on acute episodes such as poisonings caused by misuse or abuse. This study aimed to investigate the extent and nature of pesticide-related illness presented and diagnosed in Primary Care and the feasibility of establishing a routine monitoring system. Methods A checklist, completed by General Practitioners (GP for all patients aged 18+ who attended surgery sessions, identified patients to be interviewed in detail on exposures and events that occurred in the week before their symptoms appeared. Results The study covered 59320 patients in 43 practices across GB and 1335 detailed interviews. The annual incidence of illness reported to GPs because of concern about pesticide exposure was estimated to be 0.04%, potentially 88400 consultations annually, approximately 1700 per week. The annual incidence of consultations where symptoms were diagnosed by GPs as likely to be related to pesticide exposure was 0.003%, an annual estimate of 6630 consultations i.e. about 128 per week. 41% of interviewees reported using at least one pesticide at home in the week before symptoms occurred. The risk of having symptoms possibly related to pesticide exposure compared to unlikely was associated with home use of pesticides after adjusting for age, gender and occupational pesticide exposure (OR = 1.88, 95% CI 1.51 – 2.35. Conclusion GP practices were diverse and well distributed throughout GB with similar symptom consulting patterns as in the Primary Care within the UK. Methods used in this study would not be feasible for a routine surveillance system for pesticide related illness. Incorporation of environmental health into Primary Care education and practice is needed.

  19. Relative humidity impact on aerosol parameters in a Paris suburban area

    Directory of Open Access Journals (Sweden)

    H. Randriamiarisoa

    2006-01-01

    Full Text Available Measurements of relative humidity (RH and aerosol parameters (scattering cross section, size distributions and chemical composition, performed in ambient atmospheric conditions, have been used to study the influence of relative humidity on aerosol properties. The data were acquired in a suburban area south of Paris, between 18 and 24 July 2000, in the framework of the 'Etude et Simulation de la Qualité de l'air en Ile-de-France' (ESQUIF program. According to the origin of the air masses arriving over the Paris area, the aerosol hygroscopicity is more or less pronounced. The aerosol chemical composition data were used as input of a thermodynamic model to simulate the variation of the aerosol water mass content with ambient RH and to determine the main inorganic salt compounds. The coupling of observations and modelling reveals the presence of deliquescence processes with hysteresis phenomenon in the hygroscopic growth cycle. Based on the Hänel model, parameterisations of the scattering cross section, the modal radius of the accumulation mode of the size distribution and the aerosol water mass content, as a function of increasing RH, have been assessed. For the first time, a crosscheck of these parameterisations has been performed and shows that the hygroscopic behaviour of the accumulation mode can be coherently characterized by combined optical, size distribution and chemical measurements.

  20. Lung Parenchymal Assessment in Primary and Secondary Pneumothorax.

    Science.gov (United States)

    Bintcliffe, Oliver J; Edey, Anthony J; Armstrong, Lynne; Negus, Ian S; Maskell, Nick A

    2016-03-01

    The definition of primary spontaneous pneumothorax excludes patients with known lung disease; however, the assumption that the underlying lung is normal in these patients is increasingly contentious. The purpose of this study was to assess lung structure and compare the extent of emphysema in patients with primary versus secondary spontaneous pneumothorax and to patients with no pneumothorax in an otherwise comparable control group. We identified patients treated for pneumothorax by screening inpatient and outpatient medical records at one medical center in the United Kingdom. From this group, 20 patients had no clinically apparent underlying lung disease and were classified as having a primary spontaneous pneumothorax, and 20 patients were classified as having a secondary spontaneous pneumothorax. We assembled a control group composed of 40 subjects matched for age and smoking history who had a unilateral pleural effusion or were suspected to have a thoracic malignancy and had a chest computed tomography scan suitable for quantitative analysis. Demographics and smoking histories were collected. Quantitative evaluation of low-attenuation areas of the lung on computed tomography imaging was performed using semiautomated software, and the extent of emphysema-like destruction was assessed visually. The extent of emphysema and percentage of low-attenuation areas was greater for patients with primary spontaneous pneumothorax than for control subjects matched for age and smoking history (median, 0.25 vs. 0.00%; P = 0.019) and was also higher for patients with secondary pneumothorax than those with primary spontaneous pneumothorax (16.15 vs. 0.25%, P pneumothorax who smoked had significantly greater low-attenuation area than patients with primary pneumothorax who were nonsmokers (0.7 vs. 0.1%, P = 0.034). The majority of patients with primary spontaneous pneumothorax had quantifiable evidence of parenchymal destruction and emphysema. The exclusion of patients

  1. An Agent-Based Model for Addressing the Impact of a Disaster on Access to Primary Care Services.

    Science.gov (United States)

    Guclu, Hasan; Kumar, Supriya; Galloway, David; Krauland, Mary; Sood, Rishi; Bocour, Angelica; Hershey, Tina Batra; van Nostrand, Elizabeth; Potter, Margaret

    2016-06-01

    Hurricane Sandy in the Rockaways, Queens, forced residents to evacuate and primary care providers to close or curtail operations. A large deficit in primary care access was apparent in the immediate aftermath of the storm. Our objective was to build a computational model to aid responders in planning to situate primary care services in a disaster-affected area. Using an agent-based modeling platform, HAZEL, we simulated the Rockaways population, its evacuation behavior, and primary care providers' availability in the aftermath of Hurricane Sandy. Data sources for this model included post-storm and community health surveys from New York City, a survey of the Rockaways primary care providers, and research literature. The model then tested geospatially specific interventions to address storm-related access deficits. The model revealed that areas of high primary care access deficit were concentrated in the eastern part of the Rockaways. Placing mobile health clinics in the most populous census tracts reduced the access deficit significantly, whereas increasing providers' capacity by 50% reduced the deficit to a lesser degree. An agent-based model may be a useful tool to have in place so that policy makers can conduct scenario-based analyses to plan interventions optimally in the event of a disaster. (Disaster Med Public Health Preparedness. 2016;10:386-393).

  2. The Prevalence of Pediculosis Capitis and Factors Related to The Treatment Success in Primary School Children and Their Family Members in Kocaeli

    Directory of Open Access Journals (Sweden)

    Aysun Sikar Akturk

    2012-04-01

    Full Text Available Objective: The aim of the presented study was determine the prevalence of Pediculosis capitis and factors related to the treatment success in a public primary school situated in an area having a low socio-economic status in the city of Kocaeli. Materials and Methods: A total of 414 students attending at the first grade of a public primary school in Kocaeli and 267 family members of the students with head lice and/or nits were screened. Students and their family members were examined by visual inspection and dermoscopic examination whether they had head lice and/or nits. The data were collected about some socio demographic characteristics of children’ and those of their family members with active Pediculosis capitis and shampoos with 1% permethrin was used to get rid of Pediculosis capitis. After two weeks, people who had received treatment were re-examined and factors related to the successful treatment were evaluated. Results: The prevalence of pediculosis capitis was 14.3% in school children and 13% in their family members. The prevalence was statistically significant with education levels of the mothers and fathers, social security of family and by gender. The treatment was successful in 38 of school children (66%, and in 10 of their family members (29% with pediculosis capitis. The success of the treatment was no statistically significant in gender, education level of the mothers and fathers, having social security and income. It was noticed that successful treatment was correlated with proper use of the shampoo and proper mechanical cleaning. Conclusions: Head lice is a public health problem that concerns both the school children and their family members. School children who were infested with Pediculosis capitis and their families should be periodically screened and should be immediately and simultaneously treated to preventing reinfestation. [TAF Prev Med Bull 2012; 11(2.000: 181-190

  3. Health-related quality of life of patients of Brazilian primary health care

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    Bruna de Oliveira Ascef

    2017-11-01

    Full Text Available ABSTRACT OBJECTIVE To analyze the Health-Related Quality of Life (HRQoL of patients of the primary health care of the Brazilian Unified Health System (SUS and its associated factors. METHODS This is a cross-sectional study with data from the Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos – Serviços, 2015 (PNAUM – National Survey on Access, Use and Promotion of Rational Use of Medicines – Services, 2015. Data were collected with a questionnaire that included the EuroQol 5 Dimensions (EQ-5D instrument. Patients from the five regions of Brazil were interviewed. Multiple linear regression was used to analyze their Health-Related Quality of Life and its associated factors. RESULTS Of the total of 8,590 patients, the most frequent dimensions were pain/discomfort (50.7% and anxiety/depression (38.8%. About 10% of the patients reported extreme problems in these dimensions. The following factors were significantly associated with a worse quality of life: being female; having arthritis, osteoarthritis, or rheumatism; cerebrovascular accident; heart disease; depression; health self-assessment as poor or very poor; drinking alcoholic beverages once or more per month; dieting to lose weight, avoiding salt consumption, and reducing fat intake. Significant association was observed between a better quality of life and: living in the North and Southeast regions of Brazil; practicing physical activities; and having a higher educational level. No association was observed with factors related to the health services. CONCLUSIONS The Health-Related Quality of Life of patients was influenced by demographic and socioeconomic factors that were related to health conditions and lifestyle, being useful to guide specific actions for promoting health and the integral care to patients of the Brazilian Unified Health System.

  4. The Relationship Between Child Anxiety Related Disorders and Primary Nocturnal Enuresis.

    Science.gov (United States)

    Salehi, Bahman; Yousefichaijan, Parsa; Rafeei, Mohammad; Mostajeran, Mahssa

    2016-06-01

    Nocturnal enuresis, often called bedwetting or sleep wetting, is a common problem in children after the age of five and may lead to symptoms such as infection, incontinence and frequent urination. This problem refers to a state in which children after the age of five have no control of their urine for six continuous months and it cannot be attributed to any organic factors or drug use. In this study we aimed to study generalized anxiety disorder as one of the possible causes of primary nocturnal enuresis. In this case-control study 180 children with primary nocturnal enuresis and same number of healthy children with a mean age of 7 - 17 years old with the same demographic characteristics were selected. The study took place at Amir Kabir hospital of Arak, Iran during year 2014. After collecting the information, diagnosis was verified based on the diagnostic and statistical manual of mental disorders (DSM) IV-TR criteria. Results were analyzed using the SPSS software (IBM Corp. Released 2011. IBM SPSS Statistics for Windows, version 20.0. Armonk, NY: IBM Corp.). Frequency of generalized anxiety disorder, panic disorder, school phobia, social anxiety, separation anxiety, history of anxiety in mother, history of primary nocturnal enuresis in parent's family and body mass index had a significant difference between the two groups (P = 0.005). With the results obtained from this study we could say that there was a clear significant difference between the two control and patient groups for all subgroups of anxiety disorders such as generalized anxiety disorder and their relationship with primary nocturnal enuresis. Given the higher prevalence of generalized anxiety disorder, panic disorder, school phobia, social anxiety, separation anxiety and comparison with healthy children, it is recommended for all children with primary nocturnal enuresis to be investigated and treated for generalized anxiety disorder.

  5. Feasibility of a self-administered survey to identify primary care patients at risk of medication-related problems

    Directory of Open Access Journals (Sweden)

    Makowsky MJ

    2014-02-01

    Full Text Available Mark J Makowsky,1 Andrew J Cave,2 Scot H Simpson1 1Faculty of Pharmacy and Pharmaceutical Sciences, 2Department of Family Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada Background and objectives: Pharmacists working in primary care clinics are well positioned to help optimize medication management of community-dwelling patients who are at high risk of experiencing medication-related problems. However, it is often difficult to identify these patients. Our objective was to test the feasibility of a self-administered patient survey, to facilitate identification of patients at high risk of medication-related problems in a family medicine clinic. Methods: We conducted a cross-sectional, paper-based survey at the University of Alberta Hospital Family Medicine Clinic in Edmonton, Alberta, which serves approximately 7,000 patients, with 25,000 consultations per year. Adult patients attending the clinic were invited to complete a ten-item questionnaire, adapted from previously validated surveys, while waiting to be seen by the physician. Outcomes of interest included: time to complete the questionnaire, staff feedback regarding impact on workflow, and the proportion of patients who reported three or more risk factors for medication-related problems. Results: The questionnaire took less than 5 minutes to complete, according to the patient's report on the last page of the questionnaire. The median age (and interquartile range of respondents was 57 (45–69 years; 59% were women; 47% reported being in very good or excellent health; 43 respondents of 100 had three or more risk factors, and met the definition for being at high risk of a medication-related problem. Conclusions: Distribution of a self-administered questionnaire did not disrupt patients, or the clinic workflow, and identified an important proportion of patients at high risk of medication-related problems. Keywords: screening tool, pharmacists, primary

  6. Primary stabbing headache.

    Science.gov (United States)

    Pareja, Juan A; Sjaastad, Ottar

    2010-01-01

    Primary stabbing headache is characterized by transient, cephalic ultrashort stabs of pain. It is a frequent complaint with a prevalence of 35.2%, a female preponderance, and a mean age of onset of 28 years (Vågå study). Attacks are generally characterized by moderate to severe, jabbing or stabbing pain, lasting from a fraction of a second to 3s. Attack frequency is generally low, with one or a few attacks per day. The paroxysms generally occur spontaneously, during daytime. Most patients exhibit a sporadic pattern, with an erratic, unpredictable alternation between symptomatic and non-symptomatic periods. Paroxysms are almost invariably unilateral. Temporal and fronto-ocular areas are most frequently affected. Attacks tend to move from one area to another, in either the same or the opposite hemicranium. Jabs may be accompanied by a shock-like feeling and even by head movement - "jolts" -or vocalization. On rare occasions, conjunctival hemorrhage and monocular vision loss have been described as associated features. Primary stabbing headache may concur, synchronously or independently, with other primary headaches. In contrast to what is the case in adults, in childhood it is not usually associated with other headaches. Treatment is rarely necessary. Indomethacin, 75-150 mg daily, may seem to be of some avail. Celecoxib, nifedipine, melatonin, and gabapentin have been reported to be effective in isolated cases and small series of patients. The drug studies need corroboration. Copyright © 2011 Elsevier B.V. All rights reserved.

  7. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    2Primary Health Care Department, Ikpoba Okha Local Government Area, Benin City, ... selected from each of the ten wards in the LGA using multistage sampling technique. ..... Knowledge of HIV/AIDS Insurance Companies in Lagos State.

  8. Relationship between paraspinal muscle cross-sectional area and relative proprioceptive weighting ratio of older persons with lumbar spondylosis.

    Science.gov (United States)

    Ito, Tadashi; Sakai, Yoshihito; Nakamura, Eishi; Yamazaki, Kazunori; Yamada, Ayaka; Sato, Noritaka; Morita, Yoshifumi

    2015-07-01

    [Purpose] The purpose of this study was to examine the relationship between the paraspinal muscle cross-sectional area and the relative proprioceptive weighting ratio during local vibratory stimulation of older persons with lumbar spondylosis in an upright position. [Subjects] In all, 74 older persons hospitalized for lumbar spondylosis were included. [Methods] We measured the relative proprioceptive weighting ratio of postural sway using a Wii board while vibratory stimulations of 30, 60, or 240 Hz were applied to the subjects' paraspinal or gastrocnemius muscles. Back strength, abdominal muscle strength, and erector spinae muscle (L1/L2, L4/L5) and lumbar multifidus (L1/L2, L4/L5) cross-sectional areas were evaluated. [Results] The erector spinae muscle (L1/L2) cross-sectional area was associated with the relative proprioceptive weighting ratio during 60Hz stimulation. [Conclusion] These findings show that the relative proprioceptive weighting ratio compared to the erector spinae muscle (L1/L2) cross-sectional area under 60Hz proprioceptive stimulation might be a good indicator of trunk proprioceptive sensitivity.

  9. Is long-term exposure to traffic pollution associated with mortality? A small-area study in London

    International Nuclear Information System (INIS)

    Halonen, Jaana I.; Blangiardo, Marta; Toledano, Mireille B.; Fecht, Daniela; Gulliver, John; Ghosh, Rebecca; Anderson, H. Ross; Beevers, Sean D.; Dajnak, David; Kelly, Frank J.; Wilkinson, Paul; Tonne, Cathryn

    2016-01-01

    Long-term exposure to primary traffic pollutants may be harmful for health but few studies have investigated effects on mortality. We examined associations for six primary traffic pollutants with all-cause and cause-specific mortality in 2003–2010 at small-area level using linear and piecewise linear Poisson regression models. In linear models most pollutants showed negative or null association with all-cause, cardiovascular or respiratory mortality. In the piecewise models we observed positive associations in the lowest exposure range (e.g. relative risk (RR) for all-cause mortality 1.07 (95% credible interval (CI) = 1.00–1.15) per 0.15 μg/m"3 increase in exhaust related primary particulate matter ≤2.5 μm (PM_2_._5)) whereas associations in the highest exposure range were negative (corresponding RR 0.93, 95% CI: 0.91–0.96). Overall, there was only weak evidence of positive associations with mortality. That we found the strongest positive associations in the lowest exposure group may reflect residual confounding by unmeasured confounders that varies by exposure group. - Highlights: • Evidence of association between primary traffic pollutants and mortality is scarce. • We examined this in a large city using most recent small-area statistical methods. • Overall, there was only weak evidence of positive associations with mortality. - Overall, there was only weak evidence of positive associations between long-term exposure to primary traffic pollutants and mortality for all, cardiovascular or respiratory causes.

  10. A model of regional primary production for use with coarse resolution satellite data

    Science.gov (United States)

    Prince, S. D.

    1991-01-01

    A model of crop primary production, which was originally developed to relate the amount of absorbed photosynthetically active radiation (APAR) to net production in field studies, is discussed in the context of coarse resolution regional remote sensing of primary production. The model depends on an approximately linear relationship between APAR and the normalized difference vegetation index. A more comprehensive form of the conventional model is shown to be necessary when different physiological types of plants or heterogeneous vegetation types occur within the study area. The predicted variable in the new model is total assimilation (net production plus respiration) rather than net production alone or harvest yield.

  11. The impact of ethics and work-related factors on nurse practitioners' and physician assistants' views on quality of primary healthcare in the United States.

    Science.gov (United States)

    Ulrich, Connie M; Zhou, Qiuping Pearl; Hanlon, Alexandra; Danis, Marion; Grady, Christine

    2014-08-01

    Nurse practitioners (NPs) and physician assistants (PAs) provide primary care services for many American patients. Ethical knowledge is foundational to resolving challenging practice issues, yet little is known about the importance of ethics and work-related factors in the delivery of quality care. The aim of this study was to quantitatively assess whether the quality of the care that practitioners deliver is influenced by ethics and work-related factors. This paper is a secondary data analysis of a cross-sectional self-administered mailed survey of 1,371 primary care NPs and PAs randomly selected from primary care and primary care subspecialties in the United States. Ethics preparedness and confidence were significantly associated with perceived quality of care (pfactors. Investing in ethics education and addressing restrictive practice environments may improve collaborative practice, teamwork, and quality of care. Copyright © 2014 Elsevier Inc. All rights reserved.

  12. Gaucher disease: plasmalogen levels in relation to primary lipid abnormalities and oxidative stress.

    Science.gov (United States)

    Moraitou, Marina; Dimitriou, Evangelia; Dekker, Nick; Monopolis, Ioannis; Aerts, Johannes; Michelakakis, Helen

    2014-01-01

    Plasmalogens represent a unique class of phospholipids. Reduced red blood cell plasmalogen levels in Gaucher disease patients were reported, correlating to total disease burden. The relation between plasmalogen abnormalities in Gaucher disease patients and primary glycosphingolipid abnormalities, malonyldialdehyde levels, an indicator of lipid peroxidation, and the total antioxidant status was further investigated. Significant reduction of C16:0 and C18:0 plasmalogens in red blood cells of Gaucher disease patients was confirmed. In parallel, a significant increase in the glucosylceramide/ceramide ratio in red blood cell membranes, as well as an average 200-fold increase in plasma glucosylsphingosine levels was observed. Red blood cell malonyldialdehyde levels were significantly increased in patients, whereas their total antioxidant status was significantly reduced. A negative correlation between plasmalogen species and glucosylceramide, ceramide, glucosylceramide/ceramide ratio, glucosylsphingosine and malonyldialdehyde, significant for the C16:0 species and all the above parameters with the exception of malonyldialdehyde levels, was found along with a positive non-significant correlation with the total antioxidant status. Our results indicate that increased lipid peroxidation and reduced total antioxidant status exist in Gaucher disease patients. They demonstrate a clear link between plasmalogen levels and the primary glycolipid abnormalities characterizing the disorder and an association with the increased oxidative stress observed in Gaucher disease patients. Copyright © 2014 Elsevier Inc. All rights reserved.

  13. Development of Guidelines for Mentoring Internal Supervision for the Schools under Roi-Et Office of Primary Education Service Area 2

    Directory of Open Access Journals (Sweden)

    Natchana Sahunil

    2017-06-01

    Full Text Available The research aimed to 1 study the factors and indicators of mentoring internal supervision for schools, 2 study the current state and the desirable state of mentoring internal supervision for schools, and 3 study the guidelines on the operation of mentoring internal supervision for the schools under Roi-Et Office of Primary Education Service Area 2. The research was divided into 3 phases. In phase 1 the informants comprised 5 certified experts. In phase 2 the sample comprised 488 government teachers under Roi-Et Office of Primary Education Service Area 2, btained through multi-stage random sampling. In phase 3 the informants comprised school directors, school deputy directors and supervisor teachers under Roi-Et Office of Primary Education Service Area 2, totally 9 persons. The research instruments onsisted of 1 a questionnaire having the discrimination from 0.34 to 0.79 and the total reliability of 0.87, 2 a structured interview form, and 3 a suitability and feasibility assessment form for the guidelines on the operation of mentoring internal supervision. The analysis of data employed percentage, the mean and standard deviation. The results are as follows: 1. There are 4 factors of the guidelines on mentoring internal supervision for schools. They are: preparation of mentoring supervision, with 12 indicators ; management of mentoring supervision, with 12 indicators ; operation of mentoring supervision, with 14 indicators ; and evaluation of mentoring supervision, with 10 indicators, all of which had been evaluated by the experts as, on the whole, very suitable. 2. The current state of the mentoring internal supervision for schools, on the whole and factor by factor, was in the moderate level in every factor. Meanwhile, the desirable state of mentoring internal supervision for schools, on the whole, was in the high level. When considered factor by factor, the factor with the highest mean is management of mentoring supervision. The factor with

  14. Clonidine is effective for the treatment of primary idiopathic hyperhidrosis and hot flushes: a case report.

    Science.gov (United States)

    Albadrani, Ahmed

    2017-01-17

    While primary hyperhidrosis can be seen in men, accompanying hot flushes is rarely seen in men. Primary hyperhidrosis is thought to be related to overactivity of the sympathetic nervous system while hot flushes are believed to be related to altered peripheral vascular reactivity and a narrowed thermoregulatory zone. I report the case of a 29-year-old man of Arab origin who presented to a dermatology clinic with a complaint of generalized sweating, with heavier involvement of his inguinal region, axilla, and lower back. His complaint was associated with a transient hot sensation and erythema over the affected areas. He did not respond to topical antiperspirants containing aluminum chloride, topical aluminum chloride, or to botulinum toxin A injected in both inguinal areas. He was then referred to an endocrinology clinic to rule out secondary causes of hyperhidrosis and hot flushes; a primary diagnosis was confirmed. He did not respond to oral glycopyrrolate and additionally was complaining of its anticholinergic side effects. The glycopyrrolate was then replaced with oral clonidine 0.15 mg twice a day. Clonidine was well tolerated without remarkable side effects and he quickly started to feel marked improvement which was maintained for 2 years. I report an atypical presentation of primary hyperhidrosis and hot flushes that was effectively controlled by clonidine without remarkable side effects. Further research on a large number of patients may be required before recommending clonidine in similar conditions.

  15. Amphibian and reptile communities in eleven Sites of Community Importance (SCI: relations between SCI area, heterogeneity and richness

    Directory of Open Access Journals (Sweden)

    Luca Canova

    2007-11-01

    Full Text Available Seven species of amphibians and reptiles were observed in eleven Sites of Community Importance (SCI of the Lodi Province (NW Italy. Distribution and relative abundance of amphibians appeared more variable than reptiles. Some species of conservation concern as R. latastei were influenced by habitat physiognomy, i.e. the surface of wooded areas are important in predict presence and relative abundance of this species. SCI with wider surfaces and higher habitat heterogeneity included higher number of species. Species richness, here considered as a raw index of biodiversity value and community quality, was significantly related to SCI area and habitat heterogeneity; since this significant positive relation is confirmed both for amphibians and reptiles we suggest that, in planning of natural areas, priority must be retained for biotopes able to host the higher number of species.

  16. Studies of Heterogenous Palladium and Related Catalysts for Aerobic Oxidation of Primary Alcohols

    Science.gov (United States)

    Ahmed, Maaz S.

    alcohol solvent and the surface of the catalyst: (listed in order of strength) lone pair-surface (heterocyclic primary alcohols) > pi-surface (aryl primary alcohols) > van der Waals-surface (alkyl primary alcohols). These interactions were previously underappreciated in condensed phase heterogeneously catalyzed aerobic oxidations. Bi and Te serve as synergistic promoters that enhance both the rate and yield of the reactions relative to reactions employing Pd alone or Pd in combination with Bi or with Te as the sole promoter. We report X-ray absorption spectroscopic studies of the heterogenous catalyst. These methods show that the promoters undergo oxidation in preference to Pd, maintaining the Pd surface in the active metallic state and preventing inhibition by surface Pd-oxide formation. The data also suggest formation of a Pd-Te alloy phase that modifies the electronic properties of the Pd catalyst. Collectively, these results provide valuable insights into the synergistic benefits of multiple promoters in heterogeneous catalytic oxidation reactions.

  17. CE: Original Research: Primary Care Providers and Screening for Military Service and PTSD.

    Science.gov (United States)

    Mohler, Kristin Michelle; Sankey-Deemer, Cydnee

    2017-11-01

    : Background: Most veterans have the option of receiving their health care from the Veterans Health Administration or through primary care providers in the private sector. However, there is some evidence that fewer than half of community-based, private sector primary care and mental health providers screen their patients for military service, particularly in rural areas, leaving these veterans less likely to be screened for posttraumatic stress disorder (PTSD) and other military service-related conditions. To determine whether primary care providers in the private sector are screening patients for military service and subsequent PTSD. We designed and piloted a survey to determine whether primary care providers in a rural Pennsylvania region routinely screen for military service and service-related PTSD. We distributed the survey to a convenience sample of more than 250 primary care providers in central and western Pennsylvania through the U.S. Postal Service, via Facebook, and via work e-mails for those who worked in a local health system. Among 50 eligible respondents, only four (8%) said they screen all their patients for military service, and 20 (40%) reported screening none; only two respondents (4%) screened all their patients who have served in the military for PTSD, and 30 (60%) screened none. Veterans who rely on private sector providers may not receive evidence-based care for military service-related health problems, including PTSD. To improve care for these patients, providers in the private sector should be educated on why all patients should be screened for military service, how to conduct such screening properly, and veterans' general health concerns.

  18. Environmental factors associated with primary care access among urban older adults.

    Science.gov (United States)

    Ryvicker, Miriam; Gallo, William T; Fahs, Marianne C

    2012-09-01

    Disparities in primary care access and quality impede optimal chronic illness prevention and management for older adults. Although research has shown associations between neighborhood attributes and health, little is known about how these factors - in particular, the primary care infrastructure - inform older adults' primary care use. Using geographic data on primary care physician supply and surveys from 1260 senior center attendees in New York City, we examined factors that facilitate and hinder primary care use for individuals living in service areas with different supply levels. Supply quartiles varied in primary care use (visit within the past 12 months), racial and socio-economic composition, and perceived neighborhood safety and social cohesion. Primary care use did not differ significantly after controlling for compositional factors. Individuals who used a community clinic or hospital outpatient department for most of their care were less likely to have had a primary care visit than those who used a private doctor's office. Stratified multivariate models showed that within the lowest-supply quartile, public transit users had a higher odds of primary care use than non-transit users. Moreover, a higher score on the perceived neighborhood social cohesion scale was associated with a higher odds of primary care use. Within the second-lowest quartile, nonwhites had a lower odds of primary care use compared to whites. Different patterns of disadvantage in primary care access exist that may be associated with - but not fully explained by - local primary care supply. In lower-supply areas, racial disparities and inadequate primary care infrastructure hinder access to care. However, accessibility and elder-friendliness of public transit, as well as efforts to improve social cohesion and support, may facilitate primary care access for individuals living in low-supply areas. Copyright © 2012 Elsevier Ltd. All rights reserved.

  19. Detection of mental disorders with the Patient Health Questionnaire in primary care settings in Nigeria

    Directory of Open Access Journals (Sweden)

    Michael O. Olatawura

    2010-01-01

    Full Text Available Mental disorders lead to difficulties in social, occupational and marital relations. Failure to detect mental disorder denies patients potentially effective treatment. This study aimed to assess the prevalence and nature of mental disorders at the primary care settings and the recognition of these disorders by the attending physicians. Over a period of eight weeks, consecutive and consenting patients who attended three randomly selected primary health care facilities in Sagamu Local Government Area of Ogun state were recruited and administered a questionnaire that included a socio-demographic section and Patient Health Questionnaire (PHQ. A total of 412 subjects took part in the study. Subject age ranged from 18-90 years with a mean age of 52.50±21.08 years. One hundred and seventy- six (42.7% of the subjects were males. A total of 120 (29.1% of the subjects had depressive disorder, 100 (24.3% had anxiety disorder, 196 (47.6% somatoform disorder and 104 (25.2% met the criteria for an alcohol related problem. The PHC physicians were only able to diagnose disorders relating to mental health in 52 (12.6% of the subjects. Health and work situations accounted for more than three-quarters of the causes of stress experienced by the subjects. We conclude that there is a high prevalence of mental disorders among patients seen in primary care settings and that a significant proportion of them are not recognized by the primary care physicians. Stress relating to health, work and financial problems is common among primary health care attendees. Physicians in primary health care should be alert to the possibility and the impact of undetected psychiatric morbidity.

  20. Primary productivity

    Digital Repository Service at National Institute of Oceanography (India)

    Verlecar, X.N.; Parulekar, A.H.

    Photosynthetic production in the oceans in relation to light, nutrients and mixing processes is discussed. Primary productivity in the estuarine region is reported to be high in comparison to coastal and oceanic waters. Upwelling phenomenon...

  1. Age-related effects on leaf area/sapwood area relationships, canopy transpiration and carbon gain of Norway spruce stands (Picea abies) in the Fichtelgebirge, Germany.

    Science.gov (United States)

    Köstner, B; Falge, E; Tenhunen, J D

    2002-06-01

    Stand age is an important structural determinant of canopy transpiration (E(c)) and carbon gain. Another more functional parameter of forest structure is the leaf area/sapwood area relationship, A(L)/A(S), which changes with site conditions and has been used to estimate leaf area index of forest canopies. The interpretation of age-related changes in A(L)/A(S) and the question of how A(L)/A(S) is related to forest functions are of current interest because they may help to explain forest canopy fluxes and growth. We conducted studies in mature stands of Picea abies (L.) Karst. varying in age from 40 to 140 years, in tree density from 1680 to 320 trees ha(-1), and in tree height from 15 to 30 m. Structural parameters were measured by biomass harvests of individual trees and stand biometry. We estimated E(c) from scaled-up xylem sap flux of trees, and canopy-level fluxes were predicted by a three-dimensional microclimate and gas exchange model (STANDFLUX). In contrast to pine species, A(L)/A(S) of P. abies increased with stand age from 0.26 to 0.48 m(2) cm(-2). Agreement between E(c) derived from scaled-up sap flux and modeled canopy transpiration was obtained with the same parameterization of needle physiology independent of stand age. Reduced light interception per leaf area and, as a consequence, reductions in net canopy photosynthesis (A(c)), canopy conductance (g(c)) and E(c) were predicted by the model in the older stands. Seasonal water-use efficiency (WUE = A(c)/E(c)), derived from scaled-up sap flux and stem growth as well as from model simulation, declined with increasing A(L)/A(S) and stand age. Based on the different behavior of age-related A(L)/A(S) in Norway spruce stands compared with other tree species, we conclude that WUE rather than A(L)/A(S) could represent a common age-related property of all species. We also conclude that, in addition to hydraulic limitations reducing carbon gain in old stands, a functional change in A(L)/A(S) that is related to

  2. Optimal catchment area and primary PCI centre volume revisited

    DEFF Research Database (Denmark)

    Schoos, Mikkel Malby; Pedersen, Frants; Holmvang, Lene

    2015-01-01

    AIMS: The currently stated optimal catchment population for a pPCI centre is 300,000-1,100,000, resulting in 200-800 procedures/year. pPCI centres are increasing in number even within small geographic areas. We describe the organisation and quality of care after merging two high-volume centres...

  3. Spotted hyaena space use in relation to human infrastructure inside a protected area.

    Science.gov (United States)

    Belton, Lydia E; Cameron, Elissa Z; Dalerum, Fredrik

    2016-01-01

    Increasing human population growth has led to elevated levels of human-carnivore conflict. However, some carnivore populations have adapted to urban environments and the resources they supply. Such associations may influence carnivore ecology, behaviour and life-history. Pockets of urbanisation sometimes occur within protected areas, so that anthropogenic influences on carnivore biology are not necessarily confined to unprotected areas. In this study we evaluated associations between human infrastructure and related activity and space use of spotted hyaenas within one of the largest protected areas in South Africa, the Kruger National Park. Home range size was smaller for the dominant female of a clan living in close proximity to humans than that of the dominant female of a clan without direct access to human infrastructure. The home range including human infrastructure was also used less evenly during the night, presumably when the animals were active. Within this home range, a village area was preferred during the night, when the least modified areas within the village were preferred and administration and highly modified areas were avoided. During the day, however, there were no preference or avoidance of the village area, but all habitats except unmodified habitats within the village area were avoided. We suggest that human infrastructure and associated activity influenced hyaena space use, primarily through alterations in the spatial distribution of food. However, these effects may have been indirectly caused by habitat modification that generated favourable hunting habitat rather than a direct effect caused by access to human food such as garbage. Because of the often pivotal effects of apex predators in terrestrial ecosystems, we encourage further work aimed to quantify how human presence influences large carnivores and associated ecosystem processes within protected areas.

  4. Direction of movement is encoded in the human primary motor cortex.

    Directory of Open Access Journals (Sweden)

    Carolien M Toxopeus

    Full Text Available The present study investigated how direction of hand movement, which is a well-described parameter in cerebral organization of motor control, is incorporated in the somatotopic representation of the manual effector system in the human primary motor cortex (M1. Using functional magnetic resonance imaging (fMRI and a manual step-tracking task we found that activation patterns related to movement in different directions were spatially disjoint within the representation area of the hand on M1. Foci of activation related to specific movement directions were segregated within the M1 hand area; activation related to direction 0° (right was located most laterally/superficially, whereas directions 180° (left and 270° (down elicited activation more medially within the hand area. Activation related to direction 90° was located between the other directions. Moreover, by investigating differences between activations related to movement along the horizontal (0°+180° and vertical (90°+270° axis, we found that activation related to the horizontal axis was located more anterolaterally/dorsally in M1 than for the vertical axis, supporting that activations related to individual movement directions are direction- and not muscle related. Our results of spatially segregated direction-related activations in M1 are in accordance with findings of recent fMRI studies on neural encoding of direction in human M1. Our results thus provide further evidence for a direct link between direction as an organizational principle in sensorimotor transformation and movement execution coded by effector representations in M1.

  5. Increased genetic divergence between two closely related fir species in areas of range overlap

    Science.gov (United States)

    Wang, Jing; Abbott, Richard J; Ingvarsson, Pär K; Liu, Jianquan

    2014-01-01

    Because of introgressive hybridization, closely related species can be more similar to each other in areas of range overlap (parapatry or sympatry) than in areas where they are geographically isolated from each other (allopatry). Here, we report the reverse situation based on nuclear genetic divergence between two fir species, Abies chensiensis and Abies fargesii, in China, at sites where they are parapatric relative to where they are allopatric. We examined genetic divergence across 126 amplified fragment length polymorphism (AFLP) markers in a set of 172 individuals sampled from both allopatric and parapatric populations of the two species. Our analyses demonstrated that AFLP divergence was much greater between the species when comparisons were made between parapatric populations than between allopatric populations. We suggest that selection in parapatry may have largely contributed to this increased divergence. PMID:24772279

  6. Observation and simulation of net primary productivity in Qilian Mountain, western China.

    Science.gov (United States)

    Zhou, Y; Zhu, Q; Chen, J M; Wang, Y Q; Liu, J; Sun, R; Tang, S

    2007-11-01

    We modeled net primary productivity (NPP) at high spatial resolution using an advanced spaceborne thermal emission and reflection radiometer (ASTER) image of a Qilian Mountain study area using the boreal ecosystem productivity simulator (BEPS). Two key driving variables of the model, leaf area index (LAI) and land cover type, were derived from ASTER and moderate resolution imaging spectroradiometer (MODIS) data. Other spatially explicit inputs included daily meteorological data (radiation, precipitation, temperature, humidity), available soil water holding capacity (AWC), and forest biomass. NPP was estimated for coniferous forests and other land cover types in the study area. The result showed that NPP of coniferous forests in the study area was about 4.4 tCha(-1)y(-1). The correlation coefficient between the modeled NPP and ground measurements was 0.84, with a mean relative error of about 13.9%.

  7. H-Area Seepage Basins Groundwater Monitoring Report: Volume 1, Third and Fourth quarters 1994

    International Nuclear Information System (INIS)

    Chase, J.A.

    1994-03-01

    Isoconcentration/isocactivity maps included in this report indicate both the concentration/activity and extent of the primary contaminants in each of the three hydrostratigraphic units during the second half of 1994. Geologic cross sections indicate both the extent and depth of contamination of the primary contaminants in all of the hydrostratigraphic units during the second half of 1994. Water-level maps indicate that the groundwater flow rates and directions at the H-Area Seepage Basins have remained relatively constant since the basins ceased to be active in 1988

  8. A Small Disc Area Is a Risk Factor for Visual Field Loss Progression in Primary Open-Angle Glaucoma: The Glaucoma Stereo Analysis Study.

    Science.gov (United States)

    Kitaoka, Yasushi; Tanito, Masaki; Yokoyama, Yu; Nitta, Koji; Katai, Maki; Omodaka, Kazuko; Nakazawa, Toru

    2018-01-01

    The Glaucoma Stereo Analysis Study, a cross-sectional multicenter collaborative study, used a stereo fundus camera (nonmyd WX) to assess various morphological parameters of the optic nerve head (ONH) in glaucoma patients. We compared the associations of each parameter between the visual field loss progression group and no-progression group. The study included 187 eyes of 187 patients with primary open-angle glaucoma or normal-tension glaucoma. We divided the mean deviation (MD) slope values of all patients into the progression group (field progression and patient characteristics or each ONH parameter were analyzed with Spearman's rank correlation coefficient. The MD slope averages in the progression group and no-progression group were -0.58 ± 0.28 dB/year and 0.05 ± 0.26 dB/year, respectively. Among disc parameters, vertical disc width (diameter), disc area, cup area, and cup volume in the progression group were significantly less than those in the no-progression group. Logistic regression analysis revealed a significant association between the visual field progression and disc area (odds ratio 0.49/mm 2 disc area). A smaller disc area may be associated with more rapid glaucomatous visual field progression.

  9. Design principles of water sensitive in settlement area on the river banks

    Science.gov (United States)

    Ryanti, E.; Hasriyanti, N.; Utami, W. D.

    2018-03-01

    This research will formulate the principle of designing settlement area of Kapuas River Pontianak with the approach of water sensitive concept of urban design (WSUD) the densely populated settlement area. By using a case study the approach that is a dense settlement area located on the banks of the river with literature study techniques to formulate the aspects considered and components that are set in the design, descriptive analysis with the rationalistic paradigm for identification characteristics of the settlement in the river banks areas with consideration of WSUD elements and formulate the principles of designing water-sensitive settlement areas. This research is important to do because the problems related to the water management system in the existing riverside settlement in Pontianak has not been maximal to do. So the primary of this research contains several objectives that will be achieved that is identifying the characteristics of riverside settlement area based on consideration of design aspects of the area that are sensitive to water and the principle of designing the area so that the existing problem structure will be formulated in relation to the community’s need for infrastructure in settlement environment and formulate and develop appropriate technology guidelines for integrated water management systems in riverside settlement areas and design techniques for water-sensitive settlements (WSUD).

  10. Influence of the Phytoplankton Community Structure on the Spring and Annual Primary Production in the Northwestern Mediterranean Sea

    Science.gov (United States)

    Mayot, Nicolas; D'Ortenzio, Fabrizio; Uitz, Julia; Gentili, Bernard; Ras, Joséphine; Vellucci, Vincenzo; Golbol, Melek; Antoine, David; Claustre, Hervé

    2017-12-01

    Satellite ocean color observations revealed that unusually deep convection events in 2005, 2006, 2010, and 2013 led to an increased phytoplankton biomass during the spring bloom over a large area of the northwestern Mediterranean Sea (NWM). Here we investigate the effects of these events on the seasonal phytoplankton community structure, we quantify their influence on primary production, and we discuss the potential biogeochemical impact. For this purpose, we compiled in situ phytoplankton pigment data from five ship surveys performed in the NWM and from monthly cruises at a fixed station in the Ligurian Sea. We derived primary production rates from a light photosynthesis model applied to these in situ data. Our results confirm that the maximum phytoplankton biomass during the spring bloom is larger in years associated with intense deep convection events (+51%). During these enhanced spring blooms, the contribution of diatoms to total phytoplankton biomass increased (+33%), as well as the primary production rate (+115%). The occurrence of a highly productive bloom is also related to an increase in the phytoplankton bloom area (+155%) and in the relative contribution of diatoms to primary production (+63%). Therefore, assuming that deep convection in the NWM could be significantly weakened by future climate changes, substantial decreases in the spring production of organic carbon and of its export to deep waters can be expected.

  11. A 3 T event-related functional magnetic resonance imaging (fMRI) study of primary and secondary gustatory cortex localization using natural tastants

    International Nuclear Information System (INIS)

    Smits, Marion; Peeters, Ronald R.; Hecke, Paul van; Sunaert, Stefan

    2007-01-01

    It is known that taste is centrally represented in the insula, frontal and parietal operculum, as well as in the orbitofrontal cortex (secondary gustatory cortex). In functional MRI (fMRI) experiments activation in the insula has been confirmed, but activation in the orbitofrontal cortex is only infrequently found, especially at higher field strengths (3 T). Due to large susceptibility artefacts, the orbitofrontal cortex is a difficult region to examine with fMRI. Our aim was to localize taste in the human cortex at 3 T, specifically in the orbitofrontal cortex as well as in the primary gustatory cortex. Event-related fMRI was performed at 3 T in seven healthy volunteers. Taste stimuli consisted of lemon juice and chocolate. To visualize activation in the orbitofrontal cortex a dedicated 3D SENSE EPI fMRI sequence was used, in addition to a 2D SENSE EPI fMRI sequence for imaging the entire brain. Data were analyzed using a perception-based model. The dedicated 3D SENSE EPI sequence successfully reduced susceptibility artefacts in the orbitofrontal area. Significant taste-related activation was found in the orbitofrontal and insular cortices. fMRI of the orbitofrontal cortex is feasible at 3 T, using a dedicated sequence. Our results corroborate findings from previous studies. (orig.)

  12. A 3 T event-related functional magnetic resonance imaging (fMRI) study of primary and secondary gustatory cortex localization using natural tastants

    Energy Technology Data Exchange (ETDEWEB)

    Smits, Marion [Erasmus MC, University Medical Center Rotterdam, Department of Radiology, P.O. Box 2040, CA Rotterdam (Netherlands); K.U.Leuven, Department of Radiology, University Hospitals, Leuven (Belgium); Peeters, Ronald R.; Hecke, Paul van; Sunaert, Stefan [K.U.Leuven, Department of Radiology, University Hospitals, Leuven (Belgium)

    2007-01-15

    It is known that taste is centrally represented in the insula, frontal and parietal operculum, as well as in the orbitofrontal cortex (secondary gustatory cortex). In functional MRI (fMRI) experiments activation in the insula has been confirmed, but activation in the orbitofrontal cortex is only infrequently found, especially at higher field strengths (3 T). Due to large susceptibility artefacts, the orbitofrontal cortex is a difficult region to examine with fMRI. Our aim was to localize taste in the human cortex at 3 T, specifically in the orbitofrontal cortex as well as in the primary gustatory cortex. Event-related fMRI was performed at 3 T in seven healthy volunteers. Taste stimuli consisted of lemon juice and chocolate. To visualize activation in the orbitofrontal cortex a dedicated 3D SENSE EPI fMRI sequence was used, in addition to a 2D SENSE EPI fMRI sequence for imaging the entire brain. Data were analyzed using a perception-based model. The dedicated 3D SENSE EPI sequence successfully reduced susceptibility artefacts in the orbitofrontal area. Significant taste-related activation was found in the orbitofrontal and insular cortices. fMRI of the orbitofrontal cortex is feasible at 3 T, using a dedicated sequence. Our results corroborate findings from previous studies. (orig.)

  13. The relationship between behavioural problems and academic achievement in Kuwait primary schools.

    OpenAIRE

    Almurtaji, Yousuf

    2016-01-01

    Abstract This thesis contains three related studies in the general field of educational psychology and in the specific area of behaviour, educational achievement and educational needs in mainstream schooling. The work investigated relationships between behaviour and achievement in the educational context of Kuwait, where poor behaviour has been argued to be a primary cause of low education achievement levels. Using a systemic approach, the first study sought to establish patterns of behav...

  14. Female Leadership Dilemmas in Primary Schools: A Case Study of ...

    African Journals Online (AJOL)

    Female Leadership Dilemmas in Primary Schools: A Case Study of Primary Schools in Harare Province in Zimbabwe. ... Zimbabwe Journal of Educational Research ... The study sought to explore dilemmas faced by female school leaders in primary schools in Kambuzuma, Warren Park and Kuwadzana areas of Harare ...

  15. [Neuroanatomy of the Parietal Association Areas].

    Science.gov (United States)

    Kobayashi, Yasushi

    2016-11-01

    The parietal association cortex comprises the superior and inferior parietal lobules, the precuneus and the cortices in the intraparietal, parietooccipital and lunate sulci. By processing somatic, visual, acoustic and vestibular sensory information, the parietal association cortex plays a pivotal role in spatial cognition and motor control of the eyes and the extremities. Sensory information from the primary and secondary somatosensory areas enters the superior parietal lobule and is transferred to the inferior parietal lobule. Visual information is processed through the dorsal visual pathway and it reaches the inferior parietal lobule, the intraparietal sulcus and the precuneus. Acoustic information is transferred posteriorly from the primary acoustic area, and it reaches the posterior region of the inferior parietal lobule. The areas in the intraparietal sulcus project to the premotor area, the frontal eye fields, and the prefrontal area. These areas are involved in the control of ocular movements, reaching and grasping of the upper extremities, and spatial working memory. The posterior region of the inferior parietal lobule and the precuneus both project either directly, or indirectly via the posterior cingulate gyrus, to the parahippocampal and entorhinal cortices. Both these areas are strongly associated with hippocampal functions for long-term memory formation.

  16. Visitation to Natural Areas on Campus and Its Relation to Place Identity and Environmentally Responsible Behaviors

    Science.gov (United States)

    Lawrence, Eva K.

    2012-01-01

    This study examined college students' visits to natural areas on campus and how these visits relate to place identity and environmentally responsible behaviors. The majority (76.5%) of the 115 participants visited the natural areas, and 55.7% of these students visited for a course requirement. Students who lived on campus, were younger, and…

  17. Predictors of work-related stress among nurses working in primary and secondary health care levels in Dammam, Eastern Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Huda M. Al-Makhaita

    2014-01-01

    Full Text Available Introduction: Work-related stress (WRS is an insidious and persistent part of everyday life related to the response of people to work environment. Nursing is a strenuous job and WRS is prevalent among nurses. The aim of this study was to estimate the prevalence of WRS among nurses working in primary and secondary health care levels in Dammam, Eastern Saudi Arabia. Materials and Methods: A cross-sectional epidemiological study was conducted in 17 primary health care centers (PHCCs representing the primary level of health care and  Medical Tower Complex (MTC representing the secondary health care level in Dammam city. The total number of nurses included in the study was 637 nurses (144 in PHCCs and (493 MTC. Data were collected using a self-administered questionnaire, which was developed based on the pertinent literature. It included two main parts: Sociodemographic and job characteristics of nurses and 31 WRS questions. Results: The overall prevalence of WRS among all studied nurses was 45.5%; 43.1% and 46.2% in primary and secondary levels, respectively. In the primary level, there was a statistical significant association between WRS and being married (85.5%, and having living three children and more (53.2%. Moreover, younger age group 20-<30 years (79.4%, Saudi nationality (86.8%, being married (74.6%, having nonbachelor degree (83.3%, work shifts (89.5%, and working in surgical department (46.5% were the significant associating factors with the occurrence of WRS among nurses in secondary levels. Young age was the only predicting factor for WRS in primary care level. While being female, Saudi, married, with work shifts, and working in surgical department were found to predict WRS in the secondary level. Recommendations: Appropriate strategy in health care organization to investigate stress in health care settings is recommended. Moreover, interventional programs to identify, and relieve sources and effects of stress should be developed.

  18. Task-related signal decrease on functional magnetic resonance imaging

    International Nuclear Information System (INIS)

    Hara, Yoshie; Nakamura, Mitsugu; Tamaki, Norihiko; Tamura, Shogo; Kitamura, Junji

    2001-01-01

    An atypical pattern of signal change was identified on functional magnetic resonance (fMR) imaging in pathologic patients. Three normal volunteers and 34 patients with pathologic lesions near the primary motor cortex underwent fMR imaging with echo-planar imaging while performing a hand motor task. Signal intensities were evaluated with the z-score method, and the time course and changes of the signal intensity were calculated. Nine of the 34 patients with pathologic lesions displayed a significant task-related signal reduction in motor-related areas. They also presented a conventional task-related signal increase in other motor-related areas. The time courses of the increase and decrease were the inverse of each other. There was no significant difference between rates of signal increase and decrease. Our findings suggest that this atypical signal decrease is clinically significant, and that impaired vascular reactivity and altered oxygen metabolism could contribute to the task-related signal reduction. Brain areas showing such task-related signal decrease should be preserved at surgery. (author)

  19. Analysis on Residents’ Travel Activity Pattern in Historic Urban Areas: A Case Study of Historic Urban Area of Yangzhou, China

    Directory of Open Access Journals (Sweden)

    Mao Ye

    2013-01-01

    Full Text Available Travel behaviors and activity patterns in the historic urban area of a city are expected to be different from the overall situations in the city area. The primary objective of this study is to analyze the residents’ travel activity patterns in historic urban area. Based on survey data conducted in the historic urban area of Yangzhou, the travel activities of local residents in a whole day were classified into five types of patterns. The multinomial logit (MNL model was developed to evaluate the impacts of explanatory variables on the choices of activity patterns. The results showed that the choice of activity pattern was significantly impacted by five contributing factors including the gender, age, occupation, car ownership, and number of electric bikes in household. The other variables, which were the family population, preschoolers, number of conventional bikes in household, motorcycle ownership, and income, were found to be not significantly related to the choice of activities. The results of this study from historic urban area were compared to findings of previous studies from overall urban area. The comparison showed that the impacts of factors on activity pattern in the historic urban area were different from those in the overall area. Findings of this study provide important suggestions for the policy makings to improve the traffic situations in historic urban areas of cities.

  20. Direct Numerical Simulations of Dynamic Drainage and Imbibition to Investigate Capillary Pressure-Saturation-Interfacial Area Relation

    Science.gov (United States)

    Konangi, S.; Palakurthi, N. K.; Karadimitriou, N.; Comer, K.; Ghia, U.

    2017-12-01

    We present results of pore-scale direct numerical simulations (DNS) of drainage and imbibition in a quasi-two-dimensional (40µm thickness) porous medium with a randomly distributed packing of cylindrical obstructions. The Navier-Stokes (NS) equations are solved in the pore space on an Eulerian mesh using the open-source finite-volume computational fluid dynamics (CFD) code, OpenFOAM. The Volume-of-Fluid (VOF) method is employed to track the evolution of the fluid-fluid interface; a static contact angle is used to account for wall adhesion. From the DNS data, we focus on the macroscopic capillary pressure-saturation (Pc-Sw) relation, which is known to be hysteretic, i.e., this relation is flow process (such as drainage, imbibition and scanning curves) and history dependent. In order to overcome the problem of hysteresis, extended theories of multiphase flow hypothesized that the inclusion of specific interfacial area as a state variable will result in a unique relation between capillary pressure, saturation and interfacial area (Pc-Sw-awn). We study the role of specific interfacial area on hysteresis in the macroscopic Pc-Sw relation under non-equilibrium (dynamic) conditions. Under dynamic conditions, capillary pressure depends on the rate of change of the wetting phase saturation, and the dynamic Pc-Sw relation includes the changes caused by viscous effects. Simulations of drainage and imbibition are performed for two capillary numbers by controlling the flow rate of the non-wetting (polydimenthlysiloxane oil) and wetting (water) fluids. From these simulations, the Pc-Sw curves will be estimated; the Pc-S-awn surface will be constructed to determine whether the data points from drainage and imbibition processes fall on a unique surface under transient conditions. Different macroscopic capillary pressure definitions based on phase-averaged pressures and interfacial area will be evaluated. Understanding macroscopic capillary pressure definitions and the uniqueness

  1. Essential drugs in primary health centres of north central Nigeria ...

    African Journals Online (AJOL)

    To assess the availability of essential drugs and the perceptions of clients on drugs situation in the primary health centres of Tafa Local Government Area, north central Nigeria. Checklist consisting ofminimum drugs expected in a generic primary health centre developed by the National Primary Health Care Development ...

  2. Diabetes management in an Australian primary care population.

    Science.gov (United States)

    Krass, I; Hebing, R; Mitchell, B; Hughes, J; Peterson, G; Song, Y J C; Stewart, K; Armour, C L

    2011-12-01

    Worldwide studies have shown that significant proportions of patients with type 2 diabetes (T2DM) do not meet targets for glycaemic control, blood pressure (BP) and lipids, putting them at higher risk of developing complications. However, little is known about medicines management in Australian primary care populations with T2DM. The aim of this study was to (i) describe the management of a large group of patients in primary care, (ii) identify areas for improvement in management and (iii) determine any relationship between adherence and glycaemic, BP and lipid control. This was a retrospective, epidemiological study of primary care patients with T2DM diabetes, with HbA(1c) of >7%, recruited in 90 Australian community pharmacies. Data collected included demographic details, diabetes history, current medication regimen, height, weight, BP, physical activity and smoking status. Of the 430 patients, 98% used antidiabetics, 80% antihypertensives, 73% lipid lowering drugs and 38% aspirin. BP and all lipid targets were met by only 21% and 14% of the treated patients and 21% and 12% of the untreated patients respectively. Medication adherence was related to better glycaemic control (P = 0.04). An evidence-base prescribing practice gap was seen in this Australian primary care population of T2DM patients. Patients were undertreated with antihypertensive and lipid lowering medication, and several subgroups with co-morbidities were not receiving the recommended pharmacotherapy. Interventions are required to redress the current evidence-base prescribing practice gap in disease management in primary care. © 2011 Blackwell Publishing Ltd.

  3. Characterizing a neurodegenerative syndrome: primary progressive apraxia of speech.

    Science.gov (United States)

    Josephs, Keith A; Duffy, Joseph R; Strand, Edythe A; Machulda, Mary M; Senjem, Matthew L; Master, Ankit V; Lowe, Val J; Jack, Clifford R; Whitwell, Jennifer L

    2012-05-01

    and increased mean diffusivity of the superior longitudinal fasciculus, particularly the premotor components. Statistical parametric mapping of the [(18)F]-fluorodeoxyglucose positron emission tomography scans revealed focal hypometabolism of superior lateral premotor cortex and supplementary motor area, although there was some variability across subjects noted with CortexID analysis. [(11)C]-Pittsburg compound B positron emission tomography binding was increased in only one of the 12 subjects, although it was unclear whether the increase was actually related to the primary progressive apraxia of speech. A syndrome characterized by progressive pure apraxia of speech clearly exists, with a neuroanatomic correlate of superior lateral premotor and supplementary motor atrophy, making this syndrome distinct from primary progressive aphasia.

  4. What components of chronic care organisation relate to better primary care for coronary heart disease patients? An observational study.

    Science.gov (United States)

    van Lieshout, Jan; Frigola Capell, Eva; Ludt, Sabine; Grol, Richard; Wensing, Michel

    2012-01-01

    Cardiovascular risk management (CVRM) received by patients shows large variation across countries. In this study we explored the aspects of primary care organisation associated with key components of CVRM in coronary heart disease (CHD) patients. Observational study. 273 primary care practices in Austria, Belgium, England, Finland, France, Germany, The Netherlands, Slovenia, Switzerland and Spain. A random sample of 4563 CHD patients identified by coded diagnoses in eight countries, based on prescription lists and while visiting the practice in one country each. We performed an audit in primary care practices in 10 European countries. We used six indicators to measure key components of CVRM: risk factor recording, antiplatelet therapy, influenza vaccination, blood pressure levels (systolic organisation based on 39 items. Using multilevel regression analyses we explored the effects of practice organisation on CVRM, controlling for patient characteristics. Better overall organisation of a primary care practice was associated with higher scores on three indicators: risk factor registration (B=0.0307, porganisation was not found to be related with recorded blood pressure or cholesterol levels. Only the organisational domains 'self-management support' and 'use of clinical information systems' were linked to three CVRM indicators. A better organisation of a primary care practice was associated with better scores on process indicators of CVRM in CHD patients, but not on intermediate patient outcome measures. Direct support for patients and clinicians seemed most influential.

  5. Evaluation of school health instruction in public primary schools in ...

    African Journals Online (AJOL)

    Evaluation of school health instruction in public primary schools in Bonny Local Government Area, Rivers state. ... PROMOTING ACCESS TO AFRICAN RESEARCH ... Background: Effective school health instruction in primary schools is ...

  6. Using Geographic Information Systems (GIS) to understand a community's primary care needs.

    Science.gov (United States)

    Dulin, Michael F; Ludden, Thomas M; Tapp, Hazel; Blackwell, Joshua; de Hernandez, Brisa Urquieta; Smith, Heather A; Furuseth, Owen J

    2010-01-01

    A key element for reducing health care costs and improving community health is increased access to primary care and preventative health services. Geographic information systems (GIS) have the potential to assess patterns of health care utilization and community-level attributes to identify geographic regions most in need of primary care access. GIS, analytical hierarchy process, and multiattribute assessment and evaluation techniques were used to examine attributes describing primary care need and identify areas that would benefit from increased access to primary care services. Attributes were identified by a collaborative partnership working within a practice-based research network using tenets of community-based participatory research. Maps were created based on socioeconomic status, population density, insurance status, and emergency department and primary care safety-net utilization. Individual and composite maps identified areas in our community with the greatest need for increased access to primary care services. Applying GIS to commonly available community- and patient-level data can rapidly identify areas most in need of increased access to primary care services. We have termed this a Multiple Attribute Primary Care Targeting Strategy. This model can be used to plan health services delivery as well as to target and evaluate interventions designed to improve health care access.

  7. The United States Chiropractic Workforce: An alternative or complement to primary care?

    Directory of Open Access Journals (Sweden)

    Davis Matthew A

    2012-11-01

    Full Text Available Abstract Background In the United States (US a shortage of primary care physicians has become evident. Other health care providers such as chiropractors might help address some of the nation’s primary care needs simply by being located in areas of lesser primary care resources. Therefore, the purpose of this study was to examine the distribution of the chiropractic workforce across the country and compare it to that of primary care physicians. Methods We used nationally representative data to estimate the per 100,000 capita supply of chiropractors and primary care physicians according to the 306 predefined Hospital Referral Regions. Multiple variable Poisson regression was used to examine the influence of population characteristics on the supply of both practitioner-types. Results According to these data, there are 74,623 US chiropractors and the per capita supply of chiropractors varies more than 10-fold across the nation. Chiropractors practice in areas with greater supply of primary care physicians (Pearson’s correlation 0.17, p-value  Conclusion These findings suggest that chiropractors practice in areas of greater primary care physician supply. Therefore chiropractors may be functioning in more complementary roles to primary care as opposed to an alternative point of access.

  8. Counting the cost of social disadvantage in primary care: retrospective analysis of patient data.

    Science.gov (United States)

    Worrall, A; Rea, J N; Ben-Shlomo, Y

    1997-01-04

    To cost the relation between socioeconomic status and various measures of primary care workload and assess the adequacy of current "deprivation" payments in relation to actual costings for patients living in qualifying areas. Retrospective data on primary care were collected over a 4.5 year period from both computerised and manually filed records. Standardised data on socioeconomic status were obtained by postal questionnaire. Inner city group practice with a socioeconomically diverse population. 382 male and female subjects of all ages, with a total of 1296 person years of observation. Primary care costs resulting from consultations with a general practitioner or a practice nurse and both new and repeat prescriptions. Morbidity, workload, and costs of drug treatment increased with decreasing socioeconomic status. The difference in cost for patients in social classes IV and V combined compared with those in I and II combined was about 150 Pounds per person year at risk (47 Pounds for workload and 103 Pounds for drugs). Deprivation payments met only half the extra workload cost for patients from qualifying wards. The greater workload caused by social disadvantage has been previously underestimated by simple consultation rates. The absolute difference in costs for socially disadvantaged patients increase as more detailed measures of workload and drug treatment are included. Current deprivation payments only partially offset the increased expenditure on workload. This shortfall will have to be addressed to attract general practitioners to, or retain them in, deprived areas.

  9. Anthropogenic climate change has altered primary productivity in Lake Superior.

    Science.gov (United States)

    O'Beirne, M D; Werne, J P; Hecky, R E; Johnson, T C; Katsev, S; Reavie, E D

    2017-06-09

    Anthropogenic climate change has the potential to alter many facets of Earth's freshwater resources, especially lacustrine ecosystems. The effects of anthropogenic changes in Lake Superior, which is Earth's largest freshwater lake by area, are not well documented (spatially or temporally) and predicted future states in response to climate change vary. Here we show that Lake Superior experienced a slow, steady increase in production throughout the Holocene using (paleo)productivity proxies in lacustrine sediments to reconstruct past changes in primary production. Furthermore, data from the last century indicate a rapid increase in primary production, which we attribute to increasing surface water temperatures and longer seasonal stratification related to longer ice-free periods in Lake Superior due to anthropogenic climate warming. These observations demonstrate that anthropogenic effects have become a prominent influence on one of Earth's largest, most pristine lacustrine ecosystems.

  10. Developing a universal reading comprehension intervention for mainstream primary schools within areas of social deprivation for children with and without language-learning impairment: a feasibility study.

    Science.gov (United States)

    McCartney, Elspeth; Boyle, James; Ellis, Sue

    2015-01-01

    Some children in areas of social deprivation in Scotland have lower reading attainment than neighbouring children in less deprived areas, and some of these also have lower spoken language comprehension skills than expected by assessment norms. There is a need to develop effective reading comprehension interventions that fit easily into the school curriculum and can benefit all pupils. A feasibility study of reading comprehension strategies with existing evidence of efficacy was undertaken in three mainstream primary schools within an area of social deprivation in west central Scotland, to decide whether further investigation of this intervention was warranted. Aims were to measure comprehension of spoken language and reading via standardised assessments towards the beginning of the school year (T1) in mainstream primary school classrooms within an area of social deprivation; to have teachers introduce previously-validated text comprehension strategies, and to measure change in reading comprehension outcome measures towards the end of the year (T2). A pre- and post-intervention cohort design was used. Reading comprehension strategies were introduced to staff in participating schools and used throughout the school year as part of on-going reading instruction. Spoken language comprehension was measured by TROG-2 at T1, and reading progress by score changes from T1 to T2 on the WIAT-II(UK) -T reading comprehension scale. Forty-seven pupils in five classes in three primary schools took part: 38% had TROG-2 scores below the 10(th) centile. As a group, children made good reading comprehension progress, with a medium effect size of 0.46. Children with TROG-2 scores below the 10(th) centile had lower mean reading scores than others at T1 and T2, although with considerable overlap. However, TROG-2 did not make a unique contribution to reading progress: children below the 10(th) centile made as much progress as other children. The intervention was welcomed by schools, and the

  11. Conceptual design and related R and D on ITER mechanical based primary pumping system

    International Nuclear Information System (INIS)

    Tanzawa, Sadamitsu; Hiroki, Seiji; Abe, Tetsuya; Shimizu, Katsusuke; Inoue, Masahiko; Watanabe, Mitsunori; Iguchi, Masashi; Sugimoto, Tomoko; Inohara, Takashi; Nakamura, Jun-ichi

    2008-12-01

    The primary vacuum pumping system of the International Thermonuclear Experimental Reactor (ITER) exhausts a helium (He) ash resulting from the DT-burn with excess DT fueling gas, as well as performing a variety of functions such as pump-down, leak testing and wall conditioning. A mechanical based vacuum pumping system has some merits of a continuous pumping, a much lower tritium inventory, a lower operational cost and easy maintenance, comparing with a cryopump system, although demerits of an indispensable magnetic shield and insufficient performance for hydrogen (H 2 ) pumping is are well recognized. To overcome the demerits, we newly fabricated and tested a helical grooved pump (HGP) unit suitable for H 2 pumping at the ITER divertor pressure of 0.1-10 Pa. Through this R and D, we successfully established many design and manufacturing databases of large HGP units for the lightweight gas pumping. Based on the databases, we conceptually designed the ITER vacuum pumping system mainly comprising the HGP with an optimal pump unit layout and a magnetic shield. We also designed conceptually the reduced cost (RC)-ITER pumping system, where a compound molecular pump combining turbine bladed rotors and helical grooved ones was mainly used. The ITER mechanical based primary pumping system proposed has eventually been a back-up solution, whereas a cryopump based one was formally selected to the ITER for construction. The mechanical pumps are increasingly used in many areas with well sophisticated performance, so we believe that fusion reactors of subsequent prototype ones will select the mechanical based pumping system due to primarily a high operational reliability and a cost melt. (author)

  12. Physician's self-perceived abilities at primary care settings in Indonesia.

    Science.gov (United States)

    Istiono, Wahyudi; Claramita, Mora; Ekawati, Fitriana Murriya; Gayatri, Aghnaa; Sutomo, Adi Heru; Kusnanto, Hari; Graber, Mark Alan

    2015-01-01

    Southeast Asian countries with better-skilled primary care physicians have been shown to have better health outcomes. However, in Indonesia, there has been a large number of inappropriate referrals, leading to suboptimal health outcomes. This study aimed to examine the reasons underlying the unnecessary referrals as related to Indonesian physicians' standard of abilities. This was a multiple-case study that explored physicians' self-evaluation of their abilities. Self-evaluation questionnaires were constructed from the Indonesian Standards of Physicians Competences of 2006-2012 (ISPC), which is a list of 155 diseases. This study was undertaken in three cities, three towns, and one "border-less developed" area during 2011-2014. The study involved 184 physicians in those seven districts. Data were collected using one-on-one, in-depth interviews, focus group discussions (FGDs), and clinical observations. This study found that primary care physicians in Indonesia felt that they were competent to handle less than one-third of "typical" primary care cases. The reasons were limited understanding of person-centered care principles and limited patient care services to diagnosis and treatment of common biomedical problems. Additionally, physical facilities in primary care settings are lacking. Strengthening primary health care in Indonesia requires upscaling doctors' abilities in managing health problems through more structured graduate education in family medicine, which emphasizes the bio-psycho-socio-cultural background of persons; secondly, standardizing primary care facilities to support physicians' performance is critical. Finally, a strong national health policy that recognizes the essential role of primary care physicians in health outcomes is an urgent need.

  13. Relating normalization to neuronal populations across cortical areas.

    Science.gov (United States)

    Ruff, Douglas A; Alberts, Joshua J; Cohen, Marlene R

    2016-09-01

    Normalization, which divisively scales neuronal responses to multiple stimuli, is thought to underlie many sensory, motor, and cognitive processes. In every study where it has been investigated, neurons measured in the same brain area under identical conditions exhibit a range of normalization, ranging from suppression by nonpreferred stimuli (strong normalization) to additive responses to combinations of stimuli (no normalization). Normalization has been hypothesized to arise from interactions between neuronal populations, either in the same or different brain areas, but current models of normalization are not mechanistic and focus on trial-averaged responses. To gain insight into the mechanisms underlying normalization, we examined interactions between neurons that exhibit different degrees of normalization. We recorded from multiple neurons in three cortical areas while rhesus monkeys viewed superimposed drifting gratings. We found that neurons showing strong normalization shared less trial-to-trial variability with other neurons in the same cortical area and more variability with neurons in other cortical areas than did units with weak normalization. Furthermore, the cortical organization of normalization was not random: neurons recorded on nearby electrodes tended to exhibit similar amounts of normalization. Together, our results suggest that normalization reflects a neuron's role in its local network and that modulatory factors like normalization share the topographic organization typical of sensory tuning properties. Copyright © 2016 the American Physiological Society.

  14. Health-Related Quality of Life in Primary Care: Which Aspects Matter in Multimorbid Patients with Type 2 Diabetes Mellitus in a Community Setting?

    Science.gov (United States)

    Kamradt, Martina; Krisam, Johannes; Kiel, Marion; Qreini, Markus; Besier, Werner; Szecsenyi, Joachim; Ose, Dominik

    2017-01-01

    Knowledge about predictors of health-related quality of life for multimorbid patients with type 2 diabetes mellitus in primary care could help to improve quality and patient-centeredness of care in this specific group of patients. Thus, the aim of this study was to investigate the impact of several patient characteristics on health-related quality of life of multimorbid patients with type 2 diabetes mellitus in a community setting. A cross-sectional study with 32 primary care practice teams in Mannheim, Germany, and randomly selected multimorbid patients with type 2 diabetes mellitus (N = 495) was conducted. In order to analyze associations of various patient characteristics with health-related quality of life (EQ-5D index) a multilevel analysis was applied. After excluding patients with missing data, the cohort consisted of 404 eligible patients. The final multilevel model highlighted six out of 14 explanatory patient variables which were significantly associated with health-related quality of life: female gender (r = -0.0494; p = .0261), school education of nine years or less (r = -0.0609; p = .0006), (physical) mobility restrictions (r = -0.1074; p = .0003), presence of chronic pain (r = -0.0916; p = .0004), diabetes-related distress (r = -0.0133; p diabetes-related distress, chronic pain, restrictions in (physical) mobility, female gender, as well as lower education and, increased BMI have a noteworthy impact on health-related quality of life in multimorbid patients with type 2 diabetes mellitus seen in primary care practices in a community setting. The highlighted aspects should gain much more attention when treating multimorbid patients with type 2 diabetes mellitus.

  15. Patients with Revision Modern Megaprostheses of the Distal Femur Have Improved Disease-Specific and Health-Related Outcomes Compared to Those with Primary Replacements.

    Science.gov (United States)

    Heyberger, Clémence; Auberger, Guillaume; Babinet, Antoine; Anract, Philippe; Biau, David J

    2017-12-21

    We asked whether there would be any difference between primary and revision modern cemented fixed hinge megaprosthesis of the distal femur in function and activity-related outcomes following treatment of a bone tumor. An identical custom-made fixed hinge cemented megaprosthesis with a hydroxyapatite collar was used in all cases. The main outcomes were joint-specific function, disease-specific activity, and health-related quality of life. Implant survival was also evaluated. Patients in the revision group performed slightly better than patients in the primary group on disease-specific (Toronto Extremity Salvage Score, p  = 0.033; Musculoskeletal Tumor Society, p  = 0.072) and health-related outcomes (Short Form 36 [SF-36] physical component, p  = 0.085; SF-36 mental component, p  = 0.069) but not on joint-specific outcomes (Knee Society Score, p  = 0.94). The cumulative probabilities of revision for any reason were 14.5% (7-25%) at 5 years with no statistically significant difference between primary and revision procedures ( p  = 0.77). In conclusion, patients undergoing a revision have similar joint-specific functional outcome but improved disease-specific and health-related outcomes. Implant survival are similar between groups. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  16. Telemedicine and primary health: The virtual doctor project Zambia

    OpenAIRE

    Mupela, Evans; Mustarde, Paul; Jones, Huw

    2011-01-01

    This paper is a commentary on a project application of telemedicine to alleviate primary health care problems in Lundazi district in the Eastern province of Zambia. The project dubbed 'The Virtual Doctor Project' will use hard body vehicles fitted with satellite communication devices and modern medical equipment to deliver primary health care services to some of the neediest areas of the country. The relevance and importance of the project lies in the fact that these areas are hard-to-reach d...

  17. Constructing Assessment Model of Primary and Secondary Educational Quality with Talent Quality as the Core Standard

    Science.gov (United States)

    Chen, Benyou

    2014-01-01

    Quality is the core of education and it is important to standardization construction of primary and secondary education in urban (U) and rural (R) areas. The ultimate goal of the integration of urban and rural education is to pursuit quality urban and rural education. Based on analysing the related policy basis and the existing assessment models…

  18. Multiple primary cancer

    International Nuclear Information System (INIS)

    Jung, Gyu Sik; Lee, Ouk; Kim, So Sun; Kim, Ho Joon; Chun, Byung Hee; Joh, Young Duck

    1989-01-01

    It is rare for one human being to be afflicted with more than one cancer. However with further advances in therapeutic regimens, histopathologic observation, diagnostic modalities, and increased curiosity, there are increasing number of case reports of multiple primary cancer. The present study evaluates 25 histologically confirmed cases of multiple primary cancer from 1974 to 1988 at Kosin Medical Center. The most frequent site of the first primary cancer in male was stomach and in female, uterine cervix. The first primary cancer in female occurred in endocrine-related organs (breast, uterus and thyroid) in 63.6 percent. Synchronous cancers are diagnosed simultaneously or within an interval of about six months and synchronous cancers were 16 out of 25 cases. Metachronous cancers are diagnosed at interval of more than six months. There were 9 metachronous cancers and average interval between the first and second primary cancer was 22.8 months. The incidence of multiple primary cancer was 0.11 percent. The average age was 51.9 years at the time of the first primary cancer (53.1 years in male and 50.3 years in female). CT scan was most helpful in early detection of multiple primary cancers facilitating biopsy and surgery. Multiple primary cancers are beyond the medical curiosity. Early diagnosis of the disease and careful follow-up study, based on an awareness of the possibility of second cancers, will substantially increase the survival of these patients

  19. Measurements and simulation of forest leaf area index and net primary productivity in Northern China.

    Science.gov (United States)

    Wang, P; Sun, R; Hu, J; Zhu, Q; Zhou, Y; Li, L; Chen, J M

    2007-11-01

    Large scale process-based modeling is a useful approach to estimate distributions of global net primary productivity (NPP). In this paper, in order to validate an existing NPP model with observed data at site level, field experiments were conducted at three sites in northern China. One site is located in Qilian Mountain in Gansu Province, and the other two sites are in Changbaishan Natural Reserve and Dunhua County in Jilin Province. Detailed field experiments are discussed and field data are used to validate the simulated NPP. Remotely sensed images including Landsat Enhanced Thematic Mapper plus (ETM+, 30 m spatial resolution in visible and near infrared bands) and Advanced Spaceborne Thermal Emission and Reflection Radiometer (ASTER, 15m spatial resolution in visible and near infrared bands) are used to derive maps of land cover, leaf area index, and biomass. Based on these maps, field measured data, soil texture and daily meteorological data, NPP of these sites are simulated for year 2001 with the boreal ecosystem productivity simulator (BEPS). The NPP in these sites ranges from 80 to 800 gCm(-2)a(-1). The observed NPP agrees well with the modeled NPP. This study suggests that BEPS can be used to estimate NPP in northern China if remotely sensed images of high spatial resolution are available.

  20. Relative importance of habitat area and isolation for bird occurrence patterns in a naturally patchy landscape

    Science.gov (United States)

    Wilson, T.L.; Johnson, E.J.; Bissonette, J.A.

    2009-01-01

    There is debate among ecologists about whether total habitat area or patch arrangement contributes most to population and/or community responses to fragmented or patchy landscapes. We tested the relative effects of patch area and isolation for predicting bird occurrence in a naturally patchy landscape in the Bear River Mountains of Northern Utah, USA. We selected focal patches (mountain meadows) ranging in elevation from 1,920 to 2,860 m and in size from 0.6 to 182 ha. Breeding birds were sampled in each focal meadow during the summers of 2003 and 2004 using variable-distance point transects. Logistic regression and likelihood-based model selection were used to determine the relationship between likelihood of occurrence of three bird species (Brewer's sparrow, vesper sparrow, and white-crowned sparrow) and area, isolation, and proximity metrics. We used model weights and model-averaged confidence intervals to assess the importance of each predictor variable. Plots of area versus isolation were used to evaluate complex relationships between the variables. We found that meadow area was the most important variable for explaining occurrence for two species, and that isolation was the most important for the other. We also found that the absolute distance was more appropriate for evaluating isolation responses than was the species-specific proximity metric. Our findings add clarity to the debate between ecologists regarding the relative importance of area and isolation in species responses to patchy landscapes.

  1. Primary healthcare system capacities for responding to storm and flood-related health problems: a case study from a rural district in central Vietnam.

    Science.gov (United States)

    Van Minh, Hoang; Tuan Anh, Tran; Rocklöv, Joacim; Bao Giang, Kim; Trang, Le Quynh; Sahlen, Klas-Göran; Nilsson, Maria; Weinehall, Lars

    2014-01-01

    As a tropical depression in the East Sea, Vietnam is greatly affected by climate change and natural disasters. Knowledge of the current capacity of the primary healthcare system in Vietnam to respond to health issues associated with storms and floods is very important for policy making in the country. However, there has been little scientific research in this area. This research was to assess primary healthcare system capacities in a rural district in central Vietnam to respond to such health issues. This was a cross-sectional descriptive study using quantitative and qualitative approaches. Quantitative methods used self-administered questionnaires. Qualitative methods (in-depth interviews and focus groups discussions) were used to broaden understanding of the quantitative material and to get additional information on actions taken. 1) Service delivery: Medical emergency services, especially surgical operations and referral systems, were not always available during the storm and flood seasons. 2) Governance: District emergency plans focus largely on disaster response rather than prevention. The plans did not clearly define the role of primary healthcare and had no clear information on the coordination mechanism among different sectors and organizations. 3) Financing: The budget for prevention and control of flood and storm activities was limited and had no specific items for healthcare activities. Only a little additional funding was available, but the procedures to get this funding were usually time-consuming. 4) Human resources: Medical rescue teams were established, but there were no epidemiologists or environmental health specialists to take care of epidemiological issues. Training on prevention and control of climate change and disaster-related health issues did not meet actual needs. 5) Information and research: Data that can be used for planning and management (including population and epidemiological data) were largely lacking. The district lacked a disease

  2. Primary healthcare system capacities for responding to storm and flood-related health problems: a case study from a rural district in central Vietnam

    Directory of Open Access Journals (Sweden)

    Hoang Van Minh

    2014-12-01

    Full Text Available Background: As a tropical depression in the East Sea, Vietnam is greatly affected by climate change and natural disasters. Knowledge of the current capacity of the primary healthcare system in Vietnam to respond to health issues associated with storms and floods is very important for policy making in the country. However, there has been little scientific research in this area. Objective: This research was to assess primary healthcare system capacities in a rural district in central Vietnam to respond to such health issues. Design: This was a cross-sectional descriptive study using quantitative and qualitative approaches. Quantitative methods used self-administered questionnaires. Qualitative methods (in-depth interviews and focus groups discussions were used to broaden understanding of the quantitative material and to get additional information on actions taken. Results: 1 Service delivery: Medical emergency services, especially surgical operations and referral systems, were not always available during the storm and flood seasons. 2 Governance: District emergency plans focus largely on disaster response rather than prevention. The plans did not clearly define the role of primary healthcare and had no clear information on the coordination mechanism among different sectors and organizations. 3 Financing: The budget for prevention and control of flood and storm activities was limited and had no specific items for healthcare activities. Only a little additional funding was available, but the procedures to get this funding were usually time-consuming. 4 Human resources: Medical rescue teams were established, but there were no epidemiologists or environmental health specialists to take care of epidemiological issues. Training on prevention and control of climate change and disaster-related health issues did not meet actual needs. 5 Information and research: Data that can be used for planning and management (including population and epidemiological

  3. Increased 3H-spiperone binding sites in mesolimbic area related to methamphetamine-induced behavioral hypersensitivity

    International Nuclear Information System (INIS)

    Akiyama, K.; Sato, M.; Otsuki, S.

    1982-01-01

    The specific 3 H-spiperone binding to membrane homogenates of the striatum, mesolimbic area, and frontal cortex was examined in two groups of rats pretreated once daily with saline or 4 mg/kg of methamphetamine (MAP) for 14 days. At 7 days following cessation of chronic pretreatment, all rats received an injection of 4 mg/kg of MAP and were decapitated 1 hr after the injection. In the chronic saline-pretreatment group, the single administration of MAP induced significant changes in the number (Bmax) of specific 3 H-spiperone binding sites (a decrease in the striatum and an increase in the mesolimbic area and frontal cortex), but no significant changes in the affinity (KD) in any brain area. The chronic MAP pretreatment markedly augmented the changes in Bmax in the striatum and mesolimbic area. The increase in specific 3 H-spiperone binding sites in the mesolimbic area is discussed in relation to MAP-induced behavioral hypersensitivity

  4. CARCINOMA OF UNKNOWN PRIMARY WITH SECONDARY METASTASIS TO NECKANALYSIS OF PATIENT AND DISEASE RELATED FACTORS PREDICTING SUPERIOR PATIENT OUTCOMES IN CUPS NECK

    Directory of Open Access Journals (Sweden)

    Preeti Singh

    2017-11-01

    Full Text Available BACKGROUND Carcinoma of unknown primary with secondary metastasis to neck (CUPS Neck is involvement of cervical nodes with squamous cell carcinoma without identifiable primary lesion in oral cavity, oropharynx and upper aerodigestive tract. Most commonly affects older male with history of tobacco and alcohol abuse. Commonly involved neck nodes are level II and III. Metastasis to these nodes usually comes from head and neck tumours. The aims of this study are to evaluate the factors (relating to patient and disease associated with improved outcomes following treatment in patients with metastatic squamous cell carcinoma of neck with unknown primary site. MATERIALS AND METHODS Study was done in ENT and Head Neck Centre, Base Hospital, Delhi Cantt. The investigation and treatment of such cases aim to detect a primary lesion, if possible in the upper aerodigestive tract (UADT and in any case to institute the optimal management protocol. Many factors impact the outcomes of treatment in terms of survival and quality of life. RESULTS After followup of 0.5 to 2 years data were compared among various groups, various disease related factors like volume of disease, staging of neck node, extracapsular spread in final HPE report and various patient related factors like age and sex of patient, performance status of patient, and presence of comorbidities were compared with final outcome in terms of recurrence or disease free survival with less complications. CONCLUSION 1. Most prominent tumour related prognostic factors were low volume nodal disease in the neck and absence of extracapsular spread. Patients with TNM stage I (T0N1M0 were associated with lower recurrence and less complication postoperatively as compared to advanced stage disease (T0N2M0 and T0N3M0. 2. In our study, patient related variables associated with superior patient outcomes in terms of locoregional recurrence or disease free survival were good performance status, females, young age

  5. [Introduction of capillary glycosylated haemoglobin determination in a Primary Care Health Area: Multicentre study of the evolution of patients with type 2 diabetes mellitus].

    Science.gov (United States)

    Núñez-Sánchez, M Á; Cervantes-Cuesta, M Á; Brocal-Ibañez, P; Salmeron-Arjona, E; León-Martínez, L P; Cerezo-Sanmartin, M

    The aim of this study was to evaluate the efficiency of a joint intervention that included educational components, self-assessment, and information to optimise diabetes control through the introduction of instant capillary glycosylated haemoglobin (HbA1c) determination in Primary Care. A multicentre prospective descriptive study was carried out over 3years in 10Primary Care Centres of the Area VII Murcia East. At the end of the study there were 804 patients with type 2 diabetes (DM2). Patients were divided into 4 groups based on initial values of HbA1c, and if changes in their treatment were needed. HbA1c, body mass index, and blood pressure were monitored. A financial assessment was also performed on the impact of the implementation of a protocol to measure instant capillary RESULTS: A significant reduction was observed in HbA1c values. The initial HbA1c mean value was 7.4±1.4%, which decreased to a final value of 6.9±1.0% (P<.001). At the end of the study, 71.4% of patients included reached diabetic control objectives. In addition, the financial assessment demonstrated that the implementation of this diabetes control system led to a decrease of the 24.7% in spending on glucose strips after the first year of study in Area VII Murcia Health Service. The introduction of capillary HbA1c determination in Primary Care has demonstrated to improve diabetes control and the efficiency of the health personnel. Furthermore, a reduction in the health costs of patients with DM2 was also shown. Copyright © 2016 SECA. Publicado por Elsevier España, S.L.U. All rights reserved.

  6. Effects of a Psychological Intervention in a Primary Health Care Center for Caregivers of Dependent Relatives: A Randomized Trial

    Science.gov (United States)

    Rodriguez-Sanchez, Emiliano; Patino-Alonso, Maria C.; Mora-Simon, Sara; Gomez-Marcos, Manuel A.; Perez-Penaranda, Anibal; Losada-Baltar, Andres; Garcia-Ortiz, Luis

    2013-01-01

    Purpose: To assess, in the context of Primary Health Care (PHC), the effect of a psychological intervention in mental health among caregivers (CGs) of dependent relatives. Design and Methods: Randomized multicenter, controlled clinical trial. The 125 CGs included in the trial were receiving health care in PHC. Inclusion criteria: Identifying…

  7. Work related characteristics, work-home and home-work interference and burnout among primary healthcare physicians: a gender perspective in a Serbian context.

    Science.gov (United States)

    Putnik, Katarina; Houkes, Inge

    2011-09-23

    Little information exists on work and stress related health of medical doctors in non-EU countries. Filling this knowledge gap is needed to uncover the needs of this target population and to provide information on comparability of health related phenomena such as burnout across countries. This study examined work related characteristics, work-home and home-work interference and burnout among Serbian primary healthcare physicians (PHPs) and compared burnout levels with other medical doctors in EU countries. Data were collected via surveys which contained Maslach Burnout Inventory and other validated instruments measuring work and home related characteristics. The sample consisted of 373 PHPs working in 12 primary healthcare centres. Data were analysed using t-tests and Chi square tests. No gender differences were detected on mean scores of variables among Serbian physicians, who experience high levels of personal accomplishment, workload, job control and social support, medium to high levels of emotional exhaustion, medium levels of depersonalisation and work-home interference, and low levels of home-work interference. There were more women than men who experienced low job control and high depersonalisation. Serbian physicians experienced significantly higher emotional exhaustion and lower depersonalisation than physicians in some other European countries. To diminish excessive workload, the number of physicians working in primary healthcare centres in Serbia should be increased. Considering that differences between countries were detected on all burnout subcomponents, work-related interventions for employees should be country specific. The role of gender needs to be closely examined in future studies as well.

  8. Work related characteristics, work-home and home-work interference and burnout among primary healthcare physicians: A gender perspective in a Serbian context

    Directory of Open Access Journals (Sweden)

    Houkes Inge

    2011-09-01

    Full Text Available Abstract Background Little information exists on work and stress related health of medical doctors in non-EU countries. Filling this knowledge gap is needed to uncover the needs of this target population and to provide information on comparability of health related phenomena such as burnout across countries. This study examined work related characteristics, work-home and home-work interference and burnout among Serbian primary healthcare physicians (PHPs and compared burnout levels with other medical doctors in EU countries. Methods Data were collected via surveys which contained Maslach Burnout Inventory and other validated instruments measuring work and home related characteristics. The sample consisted of 373 PHPs working in 12 primary healthcare centres. Data were analysed using t-tests and Chi square tests. Results No gender differences were detected on mean scores of variables among Serbian physicians, who experience high levels of personal accomplishment, workload, job control and social support, medium to high levels of emotional exhaustion, medium levels of depersonalisation and work-home interference, and low levels of home-work interference. There were more women than men who experienced low job control and high depersonalisation. Serbian physicians experienced significantly higher emotional exhaustion and lower depersonalisation than physicians in some other European countries. Conclusions To diminish excessive workload, the number of physicians working in primary healthcare centres in Serbia should be increased. Considering that differences between countries were detected on all burnout subcomponents, work-related interventions for employees should be country specific. The role of gender needs to be closely examined in future studies as well.

  9. Multicentric primary extramammary Paget disease: a Toker cell disorder?

    Science.gov (United States)

    Hashemi, Pantea; Kao, Grace F; Konia, Thomas; Kauffman, Lisa C; Tam, Christine C; Sina, Bahram

    2014-07-01

    Toker cells are epithelial clear cells found in the areolar and nipple areas of the breast, vulvar region, and other apocrine gland-bearing areas of the skin. Toker cells have been implicated in the pathogenesis of clear cell papulosis, cutaneous hamartoma with pagetoid cells, and rare cases of primary extramammary Paget disease (EMPD) but not in secondary EMPD with underlying adenocarcinoma. The pathogenesis of primary EMPD is not well defined. We report a case of multicentric primary EMPD with evidence of Toker cell proliferation and nonaggressive biologic behavior in a 63-year-old white man. A detailed description of the morphologic and biologic features of Toker cells and their possible carcinogenetic links also are discussed. Based on the observation and follow-up of our patient, we hypothesize that multicentric primary EMPD starts with Toker cell hyperplasia and can potentially evolve to carcinoma in the genital region.

  10. Evaluation of factors inhibiting effective performance of primary ...

    African Journals Online (AJOL)

    Therefore, the following are the factors that are inhibiting the productivity of the primary school teachers in Oyo state, Nigeria, viz: lack of motivation on the ... Headmasters or the local government education area officers in cash or kind and illegal deduction from primary school teacher's salary on the account of bank charges.

  11. Quality Assessment in the Primary care

    Directory of Open Access Journals (Sweden)

    Muharrem Ak

    2013-04-01

    Full Text Available -Quality Assessment in the Primary care Dear Editor; I have read the article titled as “Implementation of Rogi Kalyan Samiti (RKS at Primary Health Centre Durvesh” with great interest. Shrivastava et all concluded that assessment mechanism for the achievement of objectives for the suggested RKS model was not successful (1. Hereby I would like to emphasize the importance of quality assessment (QA especially in the era of newly established primary care implementations in our country. Promotion of quality has been fundamental part of primary care health services. Nevertheless variations in quality of care exist even in the developed countries. Accomplishment of quality in the primary care has some barriers like administration and directorial factors, absence of evidence-based medicine practice lack of continuous medical education. Quality of health care is no doubt multifaceted model that covers all components of health structures and processes of care. Quality in the primary care set up includes patient physician relationship, immunization, maternal, adolescent, adult and geriatric health care, referral, non-communicable disease management and prescribing (2. Most countries are recently beginning the implementation of quality assessments in all walks of healthcare. Organizations like European society for quality and safety in family practice (EQuiP endeavor to accomplish quality by collaboration. There are reported developments and experiments related to the methodology, processes and outcomes of quality assessments of health care. Quality assessments will not only contribute the accomplishment of the program / project but also detect the areas where obstacles also exist. In order to speed up the adoption of QA and to circumvent the occurrence of mistakes, health policy makers and family physicians from different parts of the world should share their experiences. Consensus on quality in preventive medicine implementations can help to yield

  12. [Use of indicators of geographical accessibility to primary health care centers in addressing inequities].

    Science.gov (United States)

    De Pietri, Diana; Dietrich, Patricia; Mayo, Patricia; Carcagno, Alejandro; de Titto, Ernesto

    2013-12-01

    Characterize geographical indicators in relation to their usefulness in measuring regional inequities, identify and describe areas according to their degree of geographical accessibility to primary health care centers (PHCCs), and detect populations at risk from the perspective of access to primary care. Analysis of spatial accessibility using geographic information systems (GIS) involved three aspects: population without medical coverage, distribution of PHCCs, and the public transportation network connecting them. The development of indicators of demand (real, potential, and differential) and analysis of territorial factors affecting population mobility enabled the characterization of PHCCs with regard to their environment, thereby contributing to local and regional analysis and to the detection of different zones according to regional connectivity levels. Indicators developed in a GIS environment were very useful in analyzing accessibility to PHCCs by vulnerable populations. Zoning the region helped identify inequities by differentiating areas of unmet demand and fragmentation of spatial connectivity between PHCCs and public transportation.

  13. Restoration thinning and influence of tree size and leaf area to sapwood area ratio on water relations of Pinus ponderosa.

    Science.gov (United States)

    Simonin, K; Kolb, T E; Montes-Helu, M; Koch, G W

    2006-04-01

    Ponderosa pine (Pinus ponderosa Dougl. ex P. Laws) forest stand density has increased significantly over the last century (Covington et al. 1997). To understand the effect of increased intraspecific competition, tree size (height and diameter at breast height (DBH)) and leaf area to sapwood area ratio (A(L):A(S)) on water relations, we compared hydraulic conductance from soil to leaf (kl) and transpiration per unit leaf area (Q(L)) of ponderosa pine trees in an unthinned plot to trees in a thinned plot in the first and second years after thinning in a dense Arizona forest. We calculated kl and Q(L) based on whole- tree sap flux measured with heat dissipation sensors. Thinning increased tree predawn water potential within two weeks of treatment. Effects of thinning on kl and Q(L) depended on DBH, A(L):A(S) and drought severity. During severe drought in the first growing season after thinning, kl and Q(L) of trees with low A(L):A(S) (160-250 mm DBH; 9-11 m height) were lower in the thinned plot than the unthinned plot, suggesting a reduction in stomatal conductance (g(s)) or reduced sapwood specific conductivity (K(S)), or both, in response to thinning. In contrast kl and Q(L) were similar in the thinned plot and unthinned plot for trees with high A(L):A(S) (260-360 mm DBH; 13-16 m height). During non-drought periods, kl and Q(L) were greater in the thinned plot than in the unthinned plot for all but the largest trees. Contrary to previous studies of ponderosa pine, A(L):A(S) was positively correlated with tree height and DBH. Furthermore, kl and Q(L) showed a weak negative correlation with tree height and a strong negative correlation with A(S) and thus A(L):A(S) in both the thinned and unthinned plots, suggesting that trees with high A(L):A(S) had lower g(s). Our results highlight the important influence of stand competitive environment on tree-size-related variation in A(L):A(S) and the roles of A(L):A(S) and drought on whole-tree water relations in response to

  14. Type of primary education is associated with condom use at sexual debut among Chilean adolescents.

    Science.gov (United States)

    Huneeus, Andrea; Deardorff, Julianna; Lahiff, Maureen; Guendelman, Sylvia

    2014-05-01

    Although condom use in adolescence is related to higher lifetime educational attainment, the association between primary education (from kindergarten to eighth grade) and adolescent sexual behavior is not well understood. This study examined the association between type of school in which primary education was completed-public, charter, or private-and condom use at sexual debut among Chilean adolescents. Drawing on the 2009 Chilean National Youth Survey, a population-based sample of general community youth aged 15 to 29 years, we conducted a study of the 4217 participants who reported onset of sexual activity during adolescence. Bivariate and multple logistic regression was used to examine the relationship between type of primary school attended (60.1% public, 30.3% charter, and 9.6% private) and condom use at sexual debut while controlling for sociodemographic characteristics and sexual behavior. Compared with students who completed their primary education in private or charter schools, students who completed their primary education in public schools had 1.85 (95% confidence interval, 1.12-3.04) and 1.67 (95% confidence interval, 1.26-2.23) higher odds, respectively, of not using condoms at sexual debut. Odds were similar for students living in urban settings, whereas there were too few students attending private schools in rural areas to allow meaningful estimates. Independent of household income, primary schooling is associated with sexual health behaviors among Chilean adolescents living in urban areas and can serve as a target for public health interventions designed to prevent sexually transmitted infections in adolescence.

  15. Temporal envelope processing in the human auditory cortex: response and interconnections of auditory cortical areas.

    Science.gov (United States)

    Gourévitch, Boris; Le Bouquin Jeannès, Régine; Faucon, Gérard; Liégeois-Chauvel, Catherine

    2008-03-01

    Temporal envelope processing in the human auditory cortex has an important role in language analysis. In this paper, depth recordings of local field potentials in response to amplitude modulated white noises were used to design maps of activation in primary, secondary and associative auditory areas and to study the propagation of the cortical activity between them. The comparison of activations between auditory areas was based on a signal-to-noise ratio associated with the response to amplitude modulation (AM). The functional connectivity between cortical areas was quantified by the directed coherence (DCOH) applied to auditory evoked potentials. This study shows the following reproducible results on twenty subjects: (1) the primary auditory cortex (PAC), the secondary cortices (secondary auditory cortex (SAC) and planum temporale (PT)), the insular gyrus, the Brodmann area (BA) 22 and the posterior part of T1 gyrus (T1Post) respond to AM in both hemispheres. (2) A stronger response to AM was observed in SAC and T1Post of the left hemisphere independent of the modulation frequency (MF), and in the left BA22 for MFs 8 and 16Hz, compared to those in the right. (3) The activation and propagation features emphasized at least four different types of temporal processing. (4) A sequential activation of PAC, SAC and BA22 areas was clearly visible at all MFs, while other auditory areas may be more involved in parallel processing upon a stream originating from primary auditory area, which thus acts as a distribution hub. These results suggest that different psychological information is carried by the temporal envelope of sounds relative to the rate of amplitude modulation.

  16. CY15 Livermore Computing Focus Areas

    Energy Technology Data Exchange (ETDEWEB)

    Connell, Tom M. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Cupps, Kim C. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); D' Hooge, Trent E. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Fahey, Tim J. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Fox, Dave M. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Futral, Scott W. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Gary, Mark R. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Goldstone, Robin J. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Hamilton, Pam G. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Heer, Todd M. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Long, Jeff W. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Mark, Rich J. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Morrone, Chris J. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Shoopman, Jerry D. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Slavec, Joe A. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Smith, David W. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Springmeyer, Becky R [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Stearman, Marc D. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Watson, Py C. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)

    2015-01-20

    The LC team undertook a survey of primary Center drivers for CY15. Identified key drivers included enhancing user experience and productivity, pre-exascale platform preparation, process improvement, data-centric computing paradigms and business expansion. The team organized critical supporting efforts into three cross-cutting focus areas; Improving Service Quality; Monitoring, Automation, Delegation and Center Efficiency; and Next Generation Compute and Data Environments In each area the team detailed high level challenges and identified discrete actions to address these issues during the calendar year. Identifying the Center’s primary drivers, issues, and plans is intended to serve as a lens focusing LC personnel, resources, and priorities throughout the year.

  17. Basic occupational health services (BOHS) in community primary care: the MSF (Dhaka) model.

    Science.gov (United States)

    Muralidhar, Venkiteswaran; Ahasan, Md Faizul; Khan, Ahad Mahmud; Alam, Mohammad Shariful

    2017-03-20

    The Médecins Sans Frontiérs (MSF) established basic occupational health services to diagnose and treat work-related diseases among tannery, metal, plastics and garment workers and families in one of the more polluted areas of the world populated by 600 000 people. In spite of project limitations, an analysis of the 6-month data showed that of the original cohort of 5000, 3200 (64%) came for at least 1 consultation. Among them, 468 (14.6%) were diagnosed with suspected work-related diseases as per defined protocols. Follow-up consultation was performed for 1447 cases of occupational diseases and work-related injuries. The MSF experience begs the need for replication of such services in densely populated urban areas in developing nations like Bangladesh and India, where no specialty occupational health clinics exist in primary care but are desperately needed and where occupational health clinics on factory premises are exclusive to industry workers and are not accessible to communities. 2017 BMJ Publishing Group Ltd.

  18. Age- and Gender-related Disparities in Primary Percutaneous Coronary Interventions for Acute ST-segment elevation Myocardial Infarction.

    Directory of Open Access Journals (Sweden)

    Thomas Pilgrim

    Full Text Available Previous analyses reported age- and gender-related differences in the provision of cardiac care. The objective of the study was to compare circadian disparities in the delivery of primary percutaneous coronary intervention (PCI for acute myocardial infarction (AMI according to the patient's age and gender.We investigated patients included into the Acute Myocardial Infarction in Switzerland (AMIS registry presenting to one of 11 centers in Switzerland providing primary PCI around the clock, and stratified patients according to gender and age.A total of 4723 patients presented with AMI between 2005 and 2010; 1319 (28% were women and 2172 (54% were ≥65 years of age. More than 90% of patients 90 minutes was found in elderly males (adj HR 1.66 (95% CI 1.40-1.95, p<0.001 and females (adj HR 1.57 (95% CI 1.27-1.93, p<0.001, as well as in females <65 years (adj HR 1.47 (95% CI 1.13-1.91, p = 0.004 as compared to males <65 years of age, with significant differences in circadian patterns during on- and off-duty hours.In a cohort of patients with AMI in Switzerland, we observed discrimination of elderly patients and females in the circadian provision of primary PCI.

  19. [Internal Exposure Levels of PAHs of Primary School Students in Guangzhou].

    Science.gov (United States)

    Su, Hui; Zhao, Bo; Zhang, Su-kun; Liu, Shan; Ren, Ming-zhong; Li, Jie; Shi, Xiao-xia

    2015-12-01

    In order to investigate the internal exposure levels of polycyclic aromatic hydrocarbons (PAHs) in primary school students of Guangzhou, the research collected urine of 78 and 86 primary school students from two primary schools in the summer of 2014, one school located in the ordinary residential area and the other in the industrial area. The contents of 10 kinds of OH-PAHs were tested by the rapid liquid chromatography coupled to triple quadruple tandem mass spectrometry. The results showed that the concentrations of total OH-PAHs in primary school students in the residential zone ranged from 0.83 µmol · mol⁻¹ to 80.63 µmol · mol⁻¹, while those in industrial area ranged from 1.06 µmol · mol⁻¹ to 72.47 µmol · mol⁻¹. The geometric average concentrations were 6.18 µmol · mol⁻¹ and 6.47 µmol · mol⁻¹, respectively, and there was no statistical significance between them (P > 0.05). Comparison of the exposure levels of different components of PAHs in the two areas found that all the OH-PAHs had no significant difference except for the levels of 1- OHP (P transportation emissions.

  20. Dorsiflexor muscle-group thickness in children with cerebral palsy: Relation to cross-sectional area

    DEFF Research Database (Denmark)

    Bandholm, Thomas; Magnusson, Peter; Jensen, Bente Rona

    2009-01-01

    If the thickness and cross-sectional area of the dorsiflexor muscle group are related in children with cerebral palsy, measurements of muscle thickness may be used to monitor changes in muscle size due to training or immobilisation in these patients. We assessed the validity and reliability.......001), and the reliability of the muscle-thickness measurements was high in the healthy subjects (ICC_{2.1} = 0.94, standard error of measurement = 0.04 cm). The dorsiflexor muscle-thickness was 22% less in the affected compared to the non-affected leg in children with hemiplegic cerebral palsy (P ..., the dorsiflexor cross-sectional area was 32% less in the affected compared to the non-affected leg (P = 0.002). Measurements of dorsiflexor muscle-thickness can be reliably obtained, and they reflect dorsiflexor cross-sectional area in children with cerebral palsy....

  1. Primary Headaches and School Performance-Is There a Connection?

    Science.gov (United States)

    Genizi, J; Guidetti, V; Arruda, M A

    2017-07-01

    Headache is a common complaint among children and adolescents. School functioning is one of the most important life domains impacted by chronic pain in children. This review discusses the epidemiological and pathophysiological connections between headaches and school functioning including a suggested clinical approach. The connection between recurrent and chronic headache and learning disabilities might be psychosocial (fear of failure) or anatomical (malfunctioning of the frontal and prefrontal areas). Only few population-based and clinical studies were done and good studies are still needed in order to understand the complex relationship better. However, relating to our patients' learning and school performance, history is crucial when a child with primary headaches is evaluated. Learning disabilities seem to have a high prevalence among children with primary headache syndromes especially migraine. The connection between the two is complex and might be either part of a common brain pathophysiology and/or a consequence of poor quality of life.

  2. Initiatives towards Carbon Neutrality in the Helsinki Metropolitan Area

    Directory of Open Access Journals (Sweden)

    Karna Dahal

    2016-07-01

    Full Text Available Carbon neutrality represents one climate strategy adopted by many cities, including the city of Helsinki and the Helsinki metropolitan area in Finland. This study examines initiatives adopted by the Helsinki metropolitan area aimed at reducing energy-related carbon emissions and achieving carbon neutrality through future actions. Various sectorial energy consumption rates per year and carbon emissions from various sectors within the city of Helsinki and the metropolitan area were extracted from an online database and re-calculated (in GWh, MWh/inhabitant and MtCO2e, KtCO2e/inhabitant. We employed a backcasting scenario method to explore the various carbon reduction measures in the Helsinki metropolitan area. About 96% of the emissions produced in the Helsinki metropolitan area are energy-based. District heating represents the primary source of emissions, followed by transportation and electricity consumption, respectively. We also found that accomplishing the carbon reduction strategies of the Helsinki metropolitan area by 2050 remains challenging. Technological advancement for clean and renewable energy sources, smart policies and raising awareness resulting in behavioral changes greatly affect carbon reduction actions. Thus, strong political commitments are also required to formulate and implement stringent climate actions.

  3. The lining of the gut in the developing rat embryo. Its relation to the hypoblast (primary endoderm) and the notochord

    NARCIS (Netherlands)

    Lamers, W. H.; Spliet, W. G.; Langemeyer, R. A.

    1987-01-01

    A light microscopical study of the morphogenesis of the gut in the rat embryo was undertaken to provide a careful map of temporal changes in the topographical relations of the (definitive) endoderm, the notochord and the hypoblast (primary endoderm). The borderline between the (definitive) endoderm

  4. Effect of a primary health-care-based controlled trial for cardiorespiratory fitness in refugee women

    Directory of Open Access Journals (Sweden)

    Johansson Sven-Erik

    2010-08-01

    Full Text Available Abstract Background Refugee women have a high risk of coronary heart disease with low physical activity as one possible mediator. Furthermore, cultural and environmental barriers to increasing physical activity have been demonstrated. The aim of the study was to evaluate the combined effect of an approximate 6-month primary health care- and community-based exercise intervention versus an individual written prescription for exercise on objectively assessed cardiorespiratory fitness in low-active refugee women. Methods A controlled clinical trial, named "Support for Increased Physical Activity", was executed among 243 refugee women recruited between November 2006 and April 2008 from two deprived geographic areas in southern Stockholm, Sweden. One geographic area provided the intervention group and the other area the control group. The control group was on a higher activity level at both baseline and follow-up, which was taken into consideration in the analysis by applying statistical models that accounted for this. Relative aerobic capacity and fitness level were assessed as the two main outcome measures. Results The intervention group increased their relative aerobic capacity and the percentage with an acceptable fitness level (relative aerobic capacity > 23 O2ml·kg·min-1 to a greater extent than the control group between baseline and the 6-month follow-up, after adjusting for possible confounders (P = 0.020. Conclusions A combined primary health-care and community-based exercise programme (involving non-profit organizations can be an effective strategy to increase cardiorespiratory fitness among low-active refugee women. Trial Registration ClinicalTrials.gov ID: NCT00747942

  5. Electromigration of cadmium in contaminated soils driven by single and multiple primary cells

    International Nuclear Information System (INIS)

    Yuan Songhu; Wu Chan; Wan Jinzhong; Lu Xiaohua

    2008-01-01

    This study tentatively used an iron (Fe) and carbon (C) primary cell, instead of dc electric power, to drive the electromigration of cadmium in contaminated soils. The addition of acid to C compartment increased the electric potential, while the addition of acid to Fe compartment had a slight influence on the potential. It was feasible using the primary cell to drive the electromigration of cadmium in kaolin. The electromigration efficiencies were highly related to the soil pH. Lower pH led to greater migration efficiency. The mechanisms involved the desorption of cadmium from soils to pore solution and the electromigration of cadmium in the pore solution. The desorption was critical to the electromigration process. The series of primary cells could expand the treatment area, but the electromigration efficiencies of cadmium in each cell were less than that achieved by single primary cell. Since the potential gradient produced by the primary cell was rather low, the electromigration rate of pollutants was very low and remediation duration was long. The application would be acceptable in some specific sites, such as acidic soils or artificially controlled acid conditions so that heavy metals have been desorbed from soils

  6. Dorsal and ventral working memory-related brain areas support distinct processes in contextual cueing.

    Science.gov (United States)

    Manginelli, Angela A; Baumgartner, Florian; Pollmann, Stefan

    2013-02-15

    Behavioral evidence suggests that the use of implicitly learned spatial contexts for improved visual search may depend on visual working memory resources. Working memory may be involved in contextual cueing in different ways: (1) for keeping implicitly learned working memory contents available during search or (2) for the capture of attention by contexts retrieved from memory. We mapped brain areas that were modulated by working memory capacity. Within these areas, activation was modulated by contextual cueing along the descending segment of the intraparietal sulcus, an area that has previously been related to maintenance of explicit memories. Increased activation for learned displays, but not modulated by the size of contextual cueing, was observed in the temporo-parietal junction area, previously associated with the capture of attention by explicitly retrieved memory items, and in the ventral visual cortex. This pattern of activation extends previous research on dorsal versus ventral stream functions in memory guidance of attention to the realm of attentional guidance by implicit memory. Copyright © 2012 Elsevier Inc. All rights reserved.

  7. Non-traditional Manifestations of Primary Hyperparathyroidism

    Science.gov (United States)

    Walker, Marcella Donovan; Rubin, Mishaela; Silverberg, Shonni J.

    2012-01-01

    Classical primary hyperparathyroidism was previously a multi-systemic, symptomatic disorder not only with overt skeletal and renal complications, but also with neuropsychological, cardiovascular, gastrointestinal and rheumatic effects. The presentation of primary hyperparathyroidism has evolved and today most patients are “asymptomatic”. Osteitis fibrosa cystica is rarely seen today and nephrolithiasis is less common. Gastrointestinal and rheumatic symptoms are not part of the clinical spectrum of modern PHPT. It remains unclear whether neuropsychological symptoms and cardiovascular disease, neither of which are currently indications for recommending parathyroidectomy, are part of the modern phenotype of primary hyperparathyroidism. A number of observational studies suggest that mild PHPT is associated with depression, decreased quality of life, and changes in cognition but limited data from randomized, controlled trials have not indicated consistent benefits after surgery. The increased cardiovascular morbidity and mortality in severe PHPT has not been definitively demonstrated in mild disease, though there is some evidence for more subtle cardiovascular abnormalities, such as increased vascular stiffness, among others. Results from observational studies that have assessed the effect of parathyroidectomy upon cardiovascular health have been conflicting. The single randomized controlled trial in this area did not demonstrate that parathyroidectomy was beneficial. Despite recent progress in these areas, more data from rigorously designed studies are needed in order to better inform the clinical management of patients with asymptomatic primary hyperparathyroidism. PMID:23374740

  8. Total belowground carbon flux in subalpine forests is related to leaf area index, soil nitrogen, and tree height

    Science.gov (United States)

    Berryman, Erin Michele; Ryan, Michael G.; Bradford, John B.; Hawbaker, Todd J.; Birdsey, R.

    2016-01-01

    In forests, total belowground carbon (C) flux (TBCF) is a large component of the C budget and represents a critical pathway for delivery of plant C to soil. Reducing uncertainty around regional estimates of forest C cycling may be aided by incorporating knowledge of controls over soil respiration and TBCF. Photosynthesis, and presumably TBCF, declines with advancing tree size and age, and photosynthesis increases yet C partitioning to TBCF decreases in response to high soil fertility. We hypothesized that these causal relationships would result in predictable patterns of TBCF, and partitioning of C to TBCF, with natural variability in leaf area index (LAI), soil nitrogen (N), and tree height in subalpine forests in the Rocky Mountains, USA. Using three consecutive years of soil respiration data collected from 22 0.38-ha locations across three 1-km2 subalpine forested landscapes, we tested three hypotheses: (1) annual soil respiration and TBCF will show a hump-shaped relationship with LAI; (2) variability in TBCF unexplained by LAI will be related to soil nitrogen (N); and (3) partitioning of C to TBCF (relative to woody growth) will decline with increasing soil N and tree height. We found partial support for Hypothesis 1 and full support for Hypotheses 2 and 3. TBCF, but not soil respiration, was explained by LAI and soil N patterns (r2 = 0.49), and the ratio of annual TBCF to TBCF plus aboveground net primary productivity (ANPP) was related to soil N and tree height (r2 = 0.72). Thus, forest C partitioning to TBCF can vary even within the same forest type and region, and approaches that assume a constant fraction of TBCF relative to ANPP may be missing some of this variability. These relationships can aid with estimates of forest soil respiration and TBCF across landscapes, using spatially explicit forest data such as national inventories or remotely sensed data products.

  9. Development of microbial community during primary succession in areas degraded by mining activities

    Czech Academy of Sciences Publication Activity Database

    Harantová, L.; Mudrák, Ondřej; Kohout, Petr; Elhottová, D.; Frouz, J.; Baldrian, J.

    2017-01-01

    Roč. 28, č. 8 (2017), s. 2574-2584 ISSN 1085-3278 Institutional support: RVO:67985939 Keywords : plant‐soil interactions * postmining sites * primary succession Subject RIV: EH - Ecology, Behaviour OBOR OECD: Ecology Impact factor: 9.787, year: 2016

  10. A novel approach for monitoring writing interferences during navigated transcranial magnetic stimulation mappings of writing related cortical areas.

    Science.gov (United States)

    Rogić Vidaković, Maja; Gabelica, Dragan; Vujović, Igor; Šoda, Joško; Batarelo, Nikolina; Džimbeg, Andrija; Zmajević Schönwald, Marina; Rotim, Krešimir; Đogaš, Zoran

    2015-11-30

    It has recently been shown that navigated repetitive transcranial magnetic stimulation (nTMS) is useful in preoperative neurosurgical mapping of motor and language brain areas. In TMS mapping of motor cortices the evoked responses can be quantitatively monitored by electromyographic (EMG) recordings. No such setup exists for monitoring of writing during nTMS mappings of writing related cortical areas. We present a novel approach for monitoring writing during nTMS mappings of motor writing related cortical areas. To our best knowledge, this is the first demonstration of quantitative monitoring of motor evoked responses from hand by EMG, and of pen related activity during writing with our custom made pen, together with the application of chronometric TMS design and patterned protocol of rTMS. The method was applied in four healthy subjects participating in writing during nTMS mapping of the premotor cortical area corresponding to BA 6 and close to the superior frontal sulcus. The results showed that stimulation impaired writing in all subjects. The corresponding spectra of measured signal related to writing movements was observed in the frequency band 0-20 Hz. Magnetic stimulation affected writing by suppressing normal writing frequency band. The proposed setup for monitoring of writing provides additional quantitative data for monitoring and the analysis of rTMS induced writing response modifications. The setup can be useful for investigation of neurophysiologic mechanisms of writing, for therapeutic effects of nTMS, and in preoperative mapping of language cortical areas in patients undergoing brain surgery. Copyright © 2015 Elsevier B.V. All rights reserved.

  11. Relative position and extent of the nasal and orbital openings in Gorilla, Pan and the human species from the study of their areas and centres of area.

    Science.gov (United States)

    Schmittbuhl, M; Le Minor, J M; Schaaf, A

    1996-01-01

    In order to quantify the relative position and extent of the nasal and orbital openings in hominoid primates, a new methodology based on image analysis was developed and applied to a series of 134 hominoid skulls (52 Gorilla gorilla; 30 Pan troglodytes; 44 Homo sapiens, and, as comparison material, 8 Pongo pygmaeus). The areas and the centres of area of the orbital and nasal openings were determined automatically. The orbitonasal triangle connecting these three centres of area was then constructed. This triangle was used to quantify the elongation of the face. It was most elongated in gorilla, shortest in the human species and intermediate in Pan; the elongation in Pongo was close to that in Gorilla. The proportions of the areas of the orbital and nasal openings in the face were related to the extent of the bony structures of the midface and were thus used to quantify the facial robustness. A robust face was demonstrated in Gorilla, but a gracile face in the human species. Robusticity in Pan was intermediate.

  12. Primary Geography in Australia: Pre-Service Primary Teachers' Understandings of Weather and Climate

    Science.gov (United States)

    Lane, Rod

    2015-01-01

    Recent curriculum introductions and revisions on a global scale have highlighted the importance of primary teachers' content knowledge in geography and the lack of research in this area (Catling, 2014). This has become a particular focus in Australia with the introduction of the "Australian Curriculum: Geography" in 2013 and the…

  13. Assessment of Patient Safety Culture in Primary Health Care Settings in Kuwait

    Directory of Open Access Journals (Sweden)

    Maha Mohamed Ghobashi

    2014-01-01

    Full Text Available Background Patient safety is critical component of health care quality. We aimed to assess the awareness of primary healthcare staff members about patient safety culture and explore the areas of deficiency and opportunities for improvement concerning this issue.Methods: This descriptive cross sectional study surveyed 369 staff members in four primary healthcare centers in Kuwait using self-administered “Hospital Survey on Patient Safety Culture” adopted questionnaire. The total number of respondents was 276 participants (response rate = 74.79%.Results: Five safety dimensions with lowest positivity (less than 50% were identified and these are; the non – punitive response to errors, frequency of event reporting, staffing, communication openness, center handoffs and transitions with the following percentages of positivity 24%, 32%, 41%, 45% and 47% respectively. The dimensions of highest positivity were teamwork within the center’s units (82% and organizational learning (75%.Conclusion: Patient safety culture in primary healthcare settings in Kuwait is not as strong as improvements for the provision of safe health care. Well-designed patient safety initiatives are needed to be integrated with organizational policies, particularly the pressing need to address the bioethical component of medical errors and their disclosure, communication openness and emotional issues related to them and investing the bright areas of skillful organizational learning and strong team working attitudes.    

  14. Factors influencing turnover intention among primary care doctors: a cross-sectional study in Chongqing, China.

    Science.gov (United States)

    Wen, Tong; Zhang, Yan; Wang, Xue; Tang, Guo

    2018-02-13

    The intention to leave a job, known as turnover intention, among primary care doctors has a significant impact on primary health care service delivery. We investigated primary care doctors' turnover intention and analysed associated factors involved in primary health facilities in Chongqing, China. A total of 440 doctors were interviewed, they were selected using a multi-stage stratified random sampling method. The survey instrument was a self-administered questionnaire which assessed socio-demographic and work-related characteristics, job satisfaction and turnover intention. The data were analysed using χ 2 test, one-way analysis of variance, exploratory factor analysis and linear regression analysis. Our study found that 42.3% of the primary care doctors we sampled in Chongqing, China, intended to resign. Location, age, job title, doctor's position level, work pressure and job satisfaction were associated with turnover intention. Job satisfaction included both employment-related job satisfaction (including "your chance of promotion", "your rate of pay" and two other items) and satisfaction with the job itself (including "the freedom to choose your own method of working", "your job safety" and two other items). Improving job satisfaction, in terms of salary, promotion and job safety, is crucial for reducing turnover intention among primary care doctors. Therefore, we suggest that the government increase its financial investment in primary care facilities, especially in less-developed areas, and reform incentive mechanisms to improve the job satisfaction of primary care doctors. The government should consider policies such as establishing a social pension programme for village-level doctors and providing more opportunities for job promotion among primary care doctors, especially township-level doctors. Attention should also be paid to the impact of rapid urbanization, which could lead to increased workload or increased opportunities for career development, thus

  15. Relative professional roles in antenatal care: results of a survey in Scottish rural general practice.

    Science.gov (United States)

    Farmer, Jane; Stimpson, Paul; Tucker, Janet

    2003-11-01

    There is evidence of variation and some ambiguity about self-perceived relative professional roles in antenatal care in the UK. There is little information about models of antenatal care provision in UK rural areas. In rural areas, in particular, women have limited choice in accessing health care professionals or alternative primary care delivery settings. In the light of a recent review of Scottish maternity services, it is important and timely to examine models of care and interprofessional working in antenatal care in rural areas. This study explores midwives' and GPs' perceptions about their relative professional roles in remote and rural general practice in Scotland. A questionnaire survey involving all 174 Scottish remote and rural general practices (using one definition of rurality) was conducted, followed by 20 interviews. At least one professional returned a completed questionnaire from 91% of rural practices. A number of areas of dissonance were noted between GPs' and midwives' perceptions of their roles in maternity care and, given the context of service provision, these may impact upon rural patients. Findings are relevant to wider debates on extending the primary care team and strengthening inter-disciplinary working, particularly in rural areas.

  16. Osteopathic Manipulative Treatment of Primary Dysmenorrhea and Related Factors: A Randomized Controlled Trial

    Directory of Open Access Journals (Sweden)

    Dario Zecchillo

    2017-11-01

    Full Text Available Objectives: This study is aimed to evaluate if the osteopathic manipulative treatment (OMT is effective in patients with primary dysmenorrhea (PD. Methods: Randomized single-blinded controlled trial with OMT group and lighttouch treatment (LTT group. Recruited women were 18-40 years (mean age 27 years, with regular menstrual cycle, normal body mass index (BMI, and a medical diagnosis of PD. Intervention: Patients received five OMT or five LTT over a menstrual cycle. The primary outcomes were average menstrual pain assessed by the numeric rating scale (NRS, the duration of pain, and quality of life (QoL assessed by the SF-12 Short Form Health Survey and Patient Global Impression Change (PGIC. The secondary outcomes were NSAIDs intake, hours of absence from school/work, and menstrual-related symptoms. Results: 31 subjects were enrolled, of which five were excluded and the remaining 26 were randomized. Patients in OMT group had significant improvement in every outcome, including the average menstrual pain that decreased from 5.35 ± 0.28 to 1.98 ± 0.24 (-63.0%; p<0.001. The mean SF-12 physical component score (PCS improved from 31.35 ± 1.70 to 49.56 ± 1.92 (+58.1%, p<0.001, the mean SF-12 mental component score (MCS improved from 38.36 ± 1.16 to 52.04 ± 0.94 (+35.7%; p<0.001. LTT group showed no improvements. Conclusion: OMT was effective in reducing menstrual pain and improving Quality of Life of dysmenorrheic women.

  17. Strengthening "the Foundations" of the Primary School Curriculum

    Science.gov (United States)

    Duncombe, Rebecca; Cale, Lorraine; Harris, Jo

    2018-01-01

    The low status of the foundation subjects (e.g. Music and Physical Education (PE)) in English primary schools is well documented. Using PE as an illustrative example, a thematic analysis of 51 PE trainee students' assignments, based on their perceptions of a two-week experience in a primary school, highlighted a number of areas of concern (e.g.…

  18. Dynamic functional coupling of high resolution EEG potentials related to unilateral internally triggered one-digit movements.

    Science.gov (United States)

    Urbano, A; Babiloni, C; Onorati, P; Babiloni, F

    1998-06-01

    Between-electrode cross-covariances of delta (0-3 Hz)- and theta (4-7 Hz)-filtered high resolution EEG potentials related to preparation, initiation. and execution of human unilateral internally triggered one-digit movements were computed to investigate statistical dynamic coupling between these potentials. Significant (P planning, starting, and performance of unilateral movement. The involvement of these cortical areas is supported by the observation that averaged spatially enhanced delta- and theta-bandpassed potentials were computed from the scalp regions where task-related electrical activation of primary sensorimotor areas and supplementary motor area was roughly represented.

  19. Cancer risk in relatives of patients with a primary disorder of lymphocyte cytotoxicity: a retrospective cohort study.

    Science.gov (United States)

    Löfstedt, Alexandra; Chiang, Samuel C C; Onelöv, Erik; Bryceson, Yenan T; Meeths, Marie; Henter, Jan-Inge

    2015-12-01

    Mutations in genes for perforin-dependent lymphocyte cytotoxicity are associated with haemophagocytic lymphohistiocytosis, a rare disease of severe hyperinflammation that typically becomes evident in early childhood. It has been suggested that individuals with hypomorphic biallelic mutations in genes associated with haemophagocytic lymphohistiocytosis are at increased risk of developing haematological malignancies. We aimed to assess whether relatives of patients with primary haemophagocytic lymphohistiocytosis (ie, heterozygous carriers of these mutated genes) were more likely to develop cancer. In this retrospective cohort study, we used a multigeneration registry to identify relatives (parents and grandparents) of 79 Swedish children (Karolinska Institutet Research Foundation, Stockholm County Council (ALF-project). Copyright © 2015 Elsevier Ltd. All rights reserved.

  20. [Psychosocial aspects associated with excessive attendance in primary care paediatric clinics].

    Science.gov (United States)

    Martín Martín, Raquel; Sánchez Bayle, Marciano; Teruel de Francisco, Carmen

    2018-04-20

    Hyper-attendance is a significant problem in paediatric Primary Care clinics. The aim of our study was to analyse the level of attendance in these clinics and its relationship with certain psychosocial aspects of the families attending them. Observational descriptive study was conducted using questionnaires collected during a period of 6months, as well as recording the frequency of attendance in the previous 6months. A total of 346 questionnaires of children between 6months and 13years of age belonging to 2 urban Primary Care clinics in Madrid were completed. The raw data was analysed, and comparisons between groups and multivariate analysis were performed. The mean number of consultations in the last 6months, of the total included in the study, was 3.06 in the Primary Care centre, and 0.77 in the emergency services. It was considered over-frequent for those who had attended the Primary Care health centre 6 or more times in this period (>p90), of which there were 33 children (9.53%). In the multivariate analysis, the variables related to being frequent users of Primary Care clinics were: the presence of high level of anxiety in the parents (OR=5.50; 95%CI: 2.49-12.17, P<.0001), and the age of the children (OR=0.73; 95%CI: 0.58-0.91, P=.005). The model presented an area under the curve of 0.761 (95%CI: 0.678-0.945, P<.0001). The frequency of visits in paediatric Primary Care clinics is directly related to the high level of anxiety of the parents, and inversely to the age of the children. It would be advisable to detect and, if possible, intervene in cases of high parental anxiety in order to try to reduce the over-frequency in the paediatric primary health care. Copyright © 2018. Publicado por Elsevier España, S.L.U.

  1. A Cursory Look at Primary School Libraries and Utilization in Ado ...

    African Journals Online (AJOL)

    The study is a survey of primary school libraries and usage in Ado- EkitiLocal Government Area of Ekiti State, Nigeria. Ten primary schools wereselected for the study. They represented three categories of primary schoolsin the State as follows: Government owned Public Schools State UniversalBasic Education Board ...

  2. Brain-Derived Neurotrophic Factor in Patients with Primary Open-Angle Glaucoma and Age-related Cataract.

    Science.gov (United States)

    Shpak, Alexander A; Guekht, Alla B; Druzhkova, Tatiana A; Kozlova, Ksenia I; Gulyaeva, Natalia V

    2018-02-01

    To study brain-derived neurotrophic factor (BDNF) content in aqueous humor (AH), lacrimal fluid (LF), and blood serum (BS) in patients with age-related cataract and primary open-angle glaucoma (POAG). BDNF was studied in 57 patients with age-related cataract, 55 patients with POAG combined with cataract, and 29 healthy controls (one eye in each person). AH was sampled during cataract surgery. The levels of BDNF in LF and BS did not differ in cataract patients and controls. The concentration of BDNF (pg/mL) in patients with POAG and cataract was lower than in cataract patients in AH (35.2 ± 14.2 vs. 54.6 ± 29.6, P early POAG and relatively increased in the next stages of the disease, inversely correlating with visual field index (Pearson's correlation coefficient r = -0.404, P = 0.002) and average retinal nerve fiber layer thickness (r = -0.322, P = 0.018). BDNF contents in LF and BS were also the lowest in early POAG. BDNF in AH strongly correlated with its content in LF (r = 0.66, P early POAG and relative increase in the next stages of the disease. A strong correlation exists between BDNF contents in AH and LF.

  3. Does quality influence utilization of primary health care? Evidence from Haiti.

    Science.gov (United States)

    Gage, Anna D; Leslie, Hannah H; Bitton, Asaf; Jerome, J Gregory; Joseph, Jean Paul; Thermidor, Roody; Kruk, Margaret E

    2018-06-20

    Expanding coverage of primary healthcare services such as antenatal care and vaccinations is a global health priority; however, many Haitians do not utilize these services. One reason may be that the population avoids low quality health facilities. We examined how facility infrastructure and the quality of primary health care service delivery were associated with community utilization of primary health care services in Haiti. We constructed two composite measures of quality for all Haitian facilities using the 2013 Service Provision Assessment survey. We geographically linked population clusters from the Demographic and Health Surveys to nearby facilities offering primary health care services. We assessed the cross-sectional association between quality and utilization of four primary care services: antenatal care, postnatal care, vaccinations and sick child care, as well as one more complex service: facility delivery. Facilities performed poorly on both measures of quality, scoring 0.55 and 0.58 out of 1 on infrastructure and service delivery quality respectively. In rural areas, utilization of several primary cares services (antenatal care, postnatal care, and vaccination) was associated with both infrastructure and quality of service delivery, with stronger associations for service delivery. Facility delivery was associated with infrastructure quality, and there was no association for sick child care. In urban areas, care utilization was not associated with either quality measure. Poor quality of care may deter utilization of beneficial primary health care services in rural areas of Haiti. Improving health service quality may offer an opportunity not only to improve health outcomes for patients, but also to expand coverage of key primary health care services.

  4. Workplace phobia, workplace problems, and work ability among primary care patients with chronic mental disorders.

    Science.gov (United States)

    Muschalla, Beate; Linden, Michael

    2014-01-01

    Work-related anxieties are frequent and have a negative effect on the occupational performance of patients and absence due to sickness. Most important is workplace phobia, that is, panic when approaching or even thinking of the workplace. This study is the first to estimate the prevalence of workplace phobia among primary care patients suffering from chronic mental disorders and to describe which illness-related or workplace-specific context factors are associated with workplace phobia. A convenience sample of 288 primary care patients with chronic mental disorders (70% women) seen by 40 primary care clinicians in Germany were assessed using a standardized diagnostic interview about mental disorders and workplace problems. Workplace phobia was assessed by the Workplace Phobia Scale and a structured Diagnostic and Statical Manual of Mental Disorders-based diagnostic interview. In addition, capacity and participation restrictions, illness severity, and sick leave were assessed. Workplace phobia was found in 10% of patients with chronic mental disorders, that is, approximately about 3% of all general practice patients. Patients with workplace phobia had longer durations of sick leave than patients without workplace phobia and were impaired to a higher degree in work-relevant capacities. They also had a higher degree of restrictions in participation in other areas of life. Workplace phobia seems to be a frequent problem in primary care. It may behoove primary care clinicians to consider workplace-related anxiety, including phobia, particularly when patients ask for a work excuse for nonspecific somatic complaints. © Copyright 2014 by the American Board of Family Medicine.

  5. MR findings of primary scalp mass

    International Nuclear Information System (INIS)

    Kim, Jee Eun; Hwang, Hee Young; Park, Sung Hye; Kim, Young Chae; Lee, Young Suk

    1996-01-01

    To evaluate the diagnostic value of MRI, we compared MR images of primary scalp mass with pathological findings. Eight cases in seven patients who had presented primary scalp mass during the previous three years were evaluated by MRI and confirmed with surgical excision and pathologic evaluation. 0.38T(Resonex 4000, USA) MRI was used and all MR images were analysed retrospectively. Eight pathologically confirmed cases consisted of three cases of epidermal cysts, one of steatocystoma simplex, three of neurofibromatosis and one of lymphangioma. All epidermal cysts were located in the occipital area and showed a higher signal intensity than CSF in T1WI, and proton density and variable signal intensity in T2WI. The Steatocystoma showed a signal iniensity similar to fat in T1WI and proton density and a lower signal intensity than fat in T2WI. Neurofibromatosis accounted for three cases in two neurofibromatosis patients;one was located in the right parieto-occipital area and accompanied by hematoma and skull defect; two cases were located in the occipital and posterior cervical area of the same patient. The masses showed a higher signal intensity than muscle in T1WI and hyper or isointensity in T2WI with well enhancement. The lymphangioma showed a signal intensity similar to CSF in all pulse sequences and contained a fat component. MRI is a useful modality for evaluating primary scalp mass

  6. Structure of receptive fields in a computational model of area 3b of primary sensory cortex.

    Science.gov (United States)

    Detorakis, Georgios Is; Rougier, Nicolas P

    2014-01-01

    In a previous work, we introduced a computational model of area 3b which is built upon the neural field theory and receives input from a simplified model of the index distal finger pad populated by a random set of touch receptors (Merkell cells). This model has been shown to be able to self-organize following the random stimulation of the finger pad model and to cope, to some extent, with cortical or skin lesions. The main hypothesis of the model is that learning of skin representations occurs at the thalamo-cortical level while cortico-cortical connections serve a stereotyped competition mechanism that shapes the receptive fields. To further assess this hypothesis and the validity of the model, we reproduced in this article the exact experimental protocol of DiCarlo et al. that has been used to examine the structure of receptive fields in area 3b of the primary somatosensory cortex. Using the same analysis toolset, the model yields consistent results, having most of the receptive fields to contain a single region of excitation and one to several regions of inhibition. We further proceeded our study using a dynamic competition that deeply influences the formation of the receptive fields. We hypothesized this dynamic competition to correspond to some form of somatosensory attention that may help to precisely shape the receptive fields. To test this hypothesis, we designed a protocol where an arbitrary region of interest is delineated on the index distal finger pad and we either (1) instructed explicitly the model to attend to this region (simulating an attentional signal) (2) preferentially trained the model on this region or (3) combined the two aforementioned protocols simultaneously. Results tend to confirm that dynamic competition leads to shrunken receptive fields and its joint interaction with intensive training promotes a massive receptive fields migration and shrinkage.

  7. Structure of Receptive Fields in a Computational Model of Area 3b of Primary Sensory Cortex

    Directory of Open Access Journals (Sweden)

    Georgios eDetorakis

    2014-07-01

    Full Text Available In a previous work, we introduced a computational model of area 3b which is built upon the neural field theory and receives input from a simplified model of the index distal finger pad populated by a random set of touch receptors(Merkell cells. This model has been shown to be able to self-organize following the random stimulation of the finger pad model and to cope, to some extent, with cortical or skin lesions. The main hypothesis of the model is that learning of skin representations occurs at the thalamo-cortical level while cortico-cortical connections serve a stereotyped competition mechanism that shapes the receptive fields. To further assess this hypothesis and the validity of the model, we reproduced in this article the exact experimental protocol of DiCarlo et al. that has been used to examine the structure of receptive fields in area 3b of the primary somatosensory cortex. Using the same analysis toolset, the model yields consistent results, having most of the receptive fields to contain a single region of excitation and one to severalregions of inhibition. We further proceeded our study using a dynamic competition that deeply influences the formation of the receptive fields. We hypothesized this dynamic competition to correspond to some form of somatosensory attention that may help to precisely shape the receptive fields. To test this hypothesis, we designed a protocol where an arbitrary region of interest is delineated on the index distal finger pad and we either (1 instructed explicitly the model to attend to this region (simulating an attentional signal (2 preferentially trained the model on this region or (3combined the two aforementioned protocols simultaneously. Results tend to confirm that dynamic competition leads to shrunken receptive fields and its joint interaction with intensive training promotes a massive receptive fields migration and shrinkage.

  8. Healthcare is primary

    Directory of Open Access Journals (Sweden)

    Raman Kumar

    2015-01-01

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

  9. Fruit and vegetables on prescription: a brief intervention in primary care.

    Science.gov (United States)

    Buyuktuncer, Z; Kearney, M; Ryan, C L; Thurston, M; Ellahi, B

    2014-04-01

    Increasing fruit and vegetable consumption is a goal for the U.K. Therefore, the effectiveness of a fruit and vegetable voucher scheme coupled with key 'five-a-day' consumption messages as a brief intervention in primary care consultations was assessed in the present study. One thousand one hundred and eighty-eight vouchers as a prescription for fruits and vegetables were routinely distributed to patients attending a primary healthcare centre in a deprived area, and 124 volunteer patients routinely attending the centre were included. Telephone-based questionnaires were used to examine changes in consumption over the short and medium term. Other key aspects assessed in the evaluation related to fruit and vegetable purchasing behaviour, knowledge relating to what constitutes a portion size, the relationship between food and health, and barriers to consumption. Although 76.2% of participants used the prescription vouchers when purchasing fruits and vegetables, a significant change in the consumption or purchasing behaviour was not observed (P > 0.05). Participants' level of knowledge relating to the number of portions recommended and the portion size of different fruits and vegetables showed a moderate increase from baseline over the short and medium term. The primary barriers to fruit and vegetable consumption were reported as 'the quality of fresh fruits and vegetables' and 'the money available to spend on food'. The use of 'the fruit and vegetable on prescription' scheme was an effective method of engaging participants in improving awareness of key diet-related health messages. However, further intervention is required to produce a significant impact on the actual behaviour change. © 2013 The Authors Journal of Human Nutrition and Dietetics © 2013 The British Dietetic Association Ltd.

  10. A Small Disc Area Is a Risk Factor for Visual Field Loss Progression in Primary Open-Angle Glaucoma: The Glaucoma Stereo Analysis Study

    Directory of Open Access Journals (Sweden)

    Yasushi Kitaoka

    2018-01-01

    Full Text Available Purpose. The Glaucoma Stereo Analysis Study, a cross-sectional multicenter collaborative study, used a stereo fundus camera (nonmyd WX to assess various morphological parameters of the optic nerve head (ONH in glaucoma patients. We compared the associations of each parameter between the visual field loss progression group and no-progression group. Methods. The study included 187 eyes of 187 patients with primary open-angle glaucoma or normal-tension glaucoma. We divided the mean deviation (MD slope values of all patients into the progression group (<−0.3 dB/year and no-progression group (≧−0.3 dB/year. ONH morphological parameters were calculated with prototype analysis software. The correlations between glaucomatous visual field progression and patient characteristics or each ONH parameter were analyzed with Spearman’s rank correlation coefficient. Results. The MD slope averages in the progression group and no-progression group were −0.58 ± 0.28 dB/year and 0.05 ± 0.26 dB/year, respectively. Among disc parameters, vertical disc width (diameter, disc area, cup area, and cup volume in the progression group were significantly less than those in the no-progression group. Logistic regression analysis revealed a significant association between the visual field progression and disc area (odds ratio 0.49/mm2 disc area. Conclusion. A smaller disc area may be associated with more rapid glaucomatous visual field progression.

  11. Primary care staff's views and experiences related to routinely advising patients about physical activity. A questionnaire survey

    Directory of Open Access Journals (Sweden)

    Meloni Serena

    2006-05-01

    Full Text Available Abstract Background United Kingdom public health policy has recently re-emphasised the role of primary health care professionals in tackling increasing levels of physical inactivity within the general population. However, little is known about the impact that this has had in practice. This study explores Scottish primary care staff's knowledge, attitudes and experiences associated with advising patients about physical activity during routine consultations. Methods A cross-sectional questionnaire survey of general practitioners (or family physicians, practice nurses and health visitors based in four health regions was conducted during 2004. The main outcome measures included: (i health professionals' knowledge of the current physical activity recommendations; (ii practice related to routine physical activity advising; and (iii associated attitudes. Results Questionnaires were returned by 757 primary care staff (response rate 54%. Confidence and enthusiasm for giving advice was generally high, but knowledge of current physical activity recommendations was low. In general, respondents indicated that they routinely discuss and advise patients about physical activity regardless of the presenting condition. Health visitors and practice nurses were more likely than general practitioners to offer routine advice. Lack of time and resources were more likely to be reported as barriers to routine advising by general practitioners than other professional groups. However, health visitors and practice nurses were also more likely than general practitioners to believe that patients would follow their physical activity advice giving. Conclusion If primary health care staff are to be fully motivated and effective in encouraging and supporting the general population to become more physically active, policymakers and health professionals need to engage in efforts to: (1 improve knowledge of current physical activity recommendations and population trends amongst

  12. Match-derived relative pitch area changes the physical and team tactical performance of elite soccer players in small-sided soccer games.

    Science.gov (United States)

    Olthof, Sigrid B H; Frencken, Wouter G P; Lemmink, Koen A P M

    2018-07-01

    Small-sided games (SSGs) are used in training sessions to prepare for full-sized matches. For the same number of players, smaller pitch sizes result in decreased physical performance and shorter interpersonal distances. A relative pitch area derived from the full-sized match results in larger pitch sizes and this may increase the fit between SSGs and full-sized matches. This study aimed to investigate SSGs with a traditional small pitch and a match-derived relative pitch area in youth elite soccer players. Four age categories (under-13, under-15, under-17 and under-19) played 4 vs. 4 plus goalkeepers on a small (40x30m, 120m 2 relative pitch area) and large pitch (68x47m, 320m 2 relative pitch area). The number of games per age category ranged 15-30. Positional data (LPM-system) were collected to determine physical (total distance covered, high intensity distance and number of sprints) and team tactical (inter-team distance, LPW-ratio, surface area, stretch indices, goalkeeper-defender distance) performance measures and tactical variability. On a large pitch, physical performance significantly increased, inter-team and intra-team distances were significantly larger and tactical variability of intra-team distance measures significantly increased. The match-derived relative pitch area is an important training manipulation and leads to changes in physical and tactical performance 4 vs. 4 plus goalkeepers.

  13. Larval and small juvenile cod Gadus morhua concentrated in the highly productive areas of a shelf break front

    DEFF Research Database (Denmark)

    Munk, Peter; Larsson, P.O.; Danielsen, D.

    1995-01-01

    describe the identified nursery areas of larvae/juveniles and analyse the connection between the distribution of cod and hydrographical (frontal) characteristics of the areas. A total area of 67000 km(2) was covered by stations in a 10 x 10 nautical mile grid. Salinity, temperature, NO3+NO2 and chlorophyll...... part of the investigation area, and within the zone of the front we observed enhanced primary production and abundance of both phyto- and zooplankton. The distribution of larval and juvenile cod was also related to the hydrography, the abundance of cod peaked within a restricted zone...

  14. Role of medial premotor areas in action language processing in relation to motor skills.

    Science.gov (United States)

    Courson, Melody; Macoir, Joël; Tremblay, Pascale

    2017-10-01

    The literature reports that the supplementary motor area (SMA) and pre-supplementary motor area (pre-SMA) are involved in motor planning and execution, and in motor-related cognitive functions such as motor imagery. However, their specific role in action language processing remains unclear. In the present study, we investigated the impact of repetitive transcranial magnetic stimulation (rTMS) over SMA and pre-SMA during an action semantic analogy task (SAT) in relation with fine motor skills (i.e., manual dexterity) and motor imagery abilities in healthy non-expert adults. The impact of rTMS over SMA (but not pre-SMA) on reaction times (RT) during SAT was correlated with manual dexterity. Specifically, results show that rTMS over SMA modulated RT for those with lower dexterity skills. Our results therefore demonstrate a causal involvement of SMA in action language processing, as well as the existence of inter-individual differences in this involvement. We discuss these findings in light of neurolinguistic theories of language processing. Copyright © 2017 Elsevier Ltd. All rights reserved.

  15. Subsecond Sensory Modulation of Serotonin Levels in a Primary Sensory Area and Its Relation to Ongoing Communication Behavior in a Weakly Electric Fish.

    Science.gov (United States)

    Fotowat, Haleh; Harvey-Girard, Erik; Cheer, Joseph F; Krahe, Rüdiger; Maler, Leonard

    2016-01-01

    Serotonergic neurons of the raphe nuclei of vertebrates project to most regions of the brain and are known to significantly affect sensory processing. The subsecond dynamics of sensory modulation of serotonin levels and its relation to behavior, however, remain unknown. We used fast-scan cyclic voltammetry to measure serotonin release in the electrosensory system of weakly electric fish, Apteronotus leptorhynchus . These fish use an electric organ to generate a quasi-sinusoidal electric field for communicating with conspecifics. In response to conspecific signals, they frequently produce signal modulations called chirps. We measured changes in serotonin concentration in the hindbrain electrosensory lobe (ELL) with a resolution of 0.1 s concurrently with chirping behavior evoked by mimics of conspecific electric signals. We show that serotonin release can occur phase locked to stimulus onset as well as spontaneously in the ELL region responsible for processing these signals. Intense auditory stimuli, on the other hand, do not modulate serotonin levels in this region, suggesting modality specificity. We found no significant correlation between serotonin release and chirp production on a trial-by-trial basis. However, on average, in the trials where the fish chirped, there was a reduction in serotonin release in response to stimuli mimicking similar-sized same-sex conspecifics. We hypothesize that the serotonergic system is part of an intricate sensory-motor loop: serotonin release in a sensory area is triggered by sensory input, giving rise to motor output, which can in turn affect serotonin release at the timescale of the ongoing sensory experience and in a context-dependent manner.

  16. Study of the mobility, surface area, and sintering behavior of agglomerates in the transition regime by tandem differential mobility analysis

    International Nuclear Information System (INIS)

    Cho, Kuk; Hogan, Christopher J.; Biswas, Pratim

    2007-01-01

    The surface area of nanosized agglomerates is of great importance as the reactivity and health effects of such particles are highly dependent on surface area. Changes in surface area through sintering during nanoparticle synthesis processes are also of interest for precision control of synthesised particles. Unfortunately, information on particle surface area and surface area dynamics is not readily obtainable through traditional particle mobility sizing techniques. In this study, we have experimentally determined the mobility diameter of transition regime agglomerates with 3, 4, and 5 primary particles. Agglomerates were produced by spray drying well-characterised polystyrene latex particles with diameters of 55, 67, 76, and 99 nm. Tandem differential mobility analysis was used to determine agglomerate mobility diameter by selecting monodisperse agglomerates with the same number of primary particles in the first DMA, and subsequently completely sintering the agglomerates in a furnace aerosol reactor. The size distribution of the completely sintered particles was measured by an SMPS system, which allowed for the determination of the number of primary particles in the agglomerates. A simple power law regression was used to express mobility diameter as a function of primary particle size and the number of primary particles, and had an excellent correlation (R 2 = 0.9971) with the experimental data. A scaling exponent was determined from the experimental data to relate measured mobility diameter to surface area for agglomerates. Using this relationship, the sintering characteristics of agglomerates were also examined for varying furnace temperatures and residence times. The sintering data agreed well with the geometric sintering model (GSM) model proposed by Cho and Biswas (2006a) as well as with the model proposed Koch and Friedlander (1990) for sintering by viscous flow

  17. Increasing inequality in childhood obesity in primary schools in a northern English town.

    Science.gov (United States)

    Black, M; Joseph, V; Mott, L; Maheswaran, R

    2018-05-01

    To undertake an analysis of National Child Measurement Programme (NCMP) data to quantify the obesity prevalence gap over time between children in primary schools in the most and least deprived areas of Doncaster. The research design for this study was retrospective quantitative analysis of secondary data. The study undertook secondary analysis of NCMP data on obesity prevalence in children in Reception Year and Year 6 in primary schools in Doncaster for the period 2006-2007 to 2014-2015. Data were combined into three 3-year periods (2006-2007 to 2008-2009; 2009-2010 to 2011-2012; and 2012-2013 to 2014-2015), and schools were grouped by deprivation based on the national Indices of Multiple Deprivation 2015. Analysis was undertaken to assess whether there is a difference in obesity prevalence for Reception Year and Year 6 children in schools in the most deprived areas compared with the least deprived (prevalence gap), over time. The difference in obesity prevalence between children attending schools in the most and least deprived areas has increased over time. For Reception Year children, the prevalence gap has widened from a difference of 1.01% higher in the most deprived schools in 2006-2007 to 2008-2009 to 3.64% higher in 2012-2013 to 2014-2015. In the same time periods, for Year 6 children, the obesity prevalence gap has also increased over time from 2.82% to 5.08%. There is inequality in relation to obesity in primary school children in Doncaster with those in schools in the most deprived areas carrying the greatest burden. Research is needed to understand why the plateau seen nationally is not reaching the most deprived children. Copyright © 2018 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  18. Health-Related Quality of Life in Primary Care: Which Aspects Matter in Multimorbid Patients with Type 2 Diabetes Mellitus in a Community Setting?

    Directory of Open Access Journals (Sweden)

    Martina Kamradt

    Full Text Available Knowledge about predictors of health-related quality of life for multimorbid patients with type 2 diabetes mellitus in primary care could help to improve quality and patient-centeredness of care in this specific group of patients. Thus, the aim of this study was to investigate the impact of several patient characteristics on health-related quality of life of multimorbid patients with type 2 diabetes mellitus in a community setting.A cross-sectional study with 32 primary care practice teams in Mannheim, Germany, and randomly selected multimorbid patients with type 2 diabetes mellitus (N = 495 was conducted. In order to analyze associations of various patient characteristics with health-related quality of life (EQ-5D index a multilevel analysis was applied.After excluding patients with missing data, the cohort consisted of 404 eligible patients. The final multilevel model highlighted six out of 14 explanatory patient variables which were significantly associated with health-related quality of life: female gender (r = -0.0494; p = .0261, school education of nine years or less (r = -0.0609; p = .0006, (physical mobility restrictions (r = -0.1074; p = .0003, presence of chronic pain (r = -0.0916; p = .0004, diabetes-related distress (r = -0.0133; p < .0001, and BMI (r = -0.0047; p = .0045.The findings of this study suggest that increased diabetes-related distress, chronic pain, restrictions in (physical mobility, female gender, as well as lower education and, increased BMI have a noteworthy impact on health-related quality of life in multimorbid patients with type 2 diabetes mellitus seen in primary care practices in a community setting. The highlighted aspects should gain much more attention when treating multimorbid patients with type 2 diabetes mellitus.

  19. Computerized tomographic evaluation of primary brain tumors

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Jin Ok; Lee, Jong Soon; Jeon, Doo Sung; Kim, Hong Soo; Rhee, Hak Song [Presbyterian Mediacal center, Cheonju (Korea, Republic of); Kim, Jong Deok [Inje Medical College, Paik Hospital, Pusan (Korea, Republic of)

    1985-10-15

    In a study of primary brain tumors 104 cases having satisfactory clinical, operative and histological proofs were analyzed by computerized tomography at Presbyterian Medical Center from May, 1982 to April 1985. The results were as follows: 1. The male to female ratio of primary brain tumor was 54 : 46. 2. The 2nd decade group (26%) was the most prevalent age group, followed by the 5th decade (16.3%), 1st decade (14.4%) , 3rd decade (12.5%), 4th decade (11.5%), 6th decade (10.6%), 7th decade (8.7%) in that order. 3. The incidence of primary brain tumors was found to be: glioma 64 cases (61.6%) among the GM, the most frequent 17 cases (16.3%), followed by meningioma 12 cases (11.5%), pituitary adenoma 10 cases (9.6%), craniopharyngioma 6 cases (5.8%), pinealoma and germinoma 3 cases (2.9%) respectively, and dermoid cyst 2 cases (1.9%) in that order. 4. The location of the primary brain tumors were as follows: cb. hemisphere (49%) of these 24.5% in parietal region, 11.9% in temporal region, 9.7% in frontal region, 3.0% in occipital region: juxtasella area (16.3%), cerebellar hemisphere (8.7%), parapineal and intraventricle (7.7%) respectively, cerebello-pontine angle area (5.8%), vermis and 4th ventricular region (4.8%). 5. There were no remarkable differences in the findings of pre- and post-contrast CT scanning of primary brain tumors computed with others.

  20. Usability requirements for buildings: a case study on primary schools.

    Science.gov (United States)

    Duca, Gabriella

    2012-01-01

    This paper concerns an applied research aimed at applying the concept of usability, as derived form the standard ISO 9241/11, in the filed of building design, namely primary schools. Starting from the concept that space characteristics play a very relevant role in learning performances, the study presented here developed an original methodology for the assessment of effectiveness, efficiency and satisfaction of buildings hosting primary schools, in order to create a school environment better supporting users in their tasks. Research core is the framework of usability requirements and their related markers, indicators and technical specification that has been formulated in order to check compliance of urban area, building, rooms and architectural details with users needs. Therefore, a detailed task analysis of pupils and teacher tasks has been carried out and two questionnaires addressed to a significant users panel have been formulated for satisfaction survey. Lastly, a matrix for an overall reading of gathered data has been set-up and criteria for usability assessment based on that data has been defined. The whole study has been developed within the case study of a primary school in the Naples city centre, whose contents and results are discussed.

  1. Primary production of tropical marine ecosystems

    Digital Repository Service at National Institute of Oceanography (India)

    Bhattathiri, P.M.A.

    Among tropical marine ecosystems estuaries are one of the highly productive areas and act as a nursery to large number of organisms. The primary production in most of the estuaries is less during the monsoon period. Post-monsoon period shows...

  2. Preliminary assessment of the computer-based Taenia solium educational program 'The Vicious Worm' on knowledge uptake in primary school students in rural areas in eastern Zambia.

    Science.gov (United States)

    Hobbs, Emma C; Mwape, Kabemba Evans; Van Damme, Inge; Berkvens, Dirk; Zulu, Gideon; Mambwe, Moses; Chembensofu, Mwelwa; Phiri, Isaac Khozozo; Masuku, Maxwell; Bottieau, Emmanuel; Devleesschauwer, Brecht; Speybroeck, Niko; Colston, Angela; Dorny, Pierre; Willingham, Arve Lee; Gabriël, Sarah

    2018-03-01

    The zoonotic helminth Taenia solium is endemic in Zambia, causing human (taeniasis and (neuro)cysticercosis) and pig (porcine cysticercosis) diseases with high health, social and economic burdens. We aimed to evaluate the impact of a health educational program intended to lead to powerful and cumulative improvements in knowledge, attitudes and practices that decrease parasite transmission and disease occurrence. Half-day health education workshops were conducted in three primary schools in the highly endemic Eastern Province of Zambia, using the computer-based T. solium educational program 'The Vicious Worm'. Questionnaires were administered before and after the educational component to determine the program's impact on knowledge uptake in primary school students. In total, 99 students participated: 38 males and 61 females, with a median age of 14 years (range 10-18 years). Baseline general knowledge of T. solium, including awareness of the different human and pig disease states, and disease diagnosis, treatment and prevention, was quite high (average score 62%) and consistent across all three study areas. Participants' knowledge had significantly increased after the educational component, particularly regarding parasite transmission and disease prevention. Preliminary assessment of 'The Vicious Worm' indicates it is an effective tool for the short-term T. solium education of primary school students in Zambia. Follow-up studies are planned to assess the longer term impact of the program on knowledge uptake in the study neighbourhoods. Inclusion of tailored 'The Vicious Worm' educational workshops should be considered in integrated cysticercosis control programs in endemic areas of sub-Saharan Africa. © 2018 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.

  3. Device for extracting steam or gas from the primary coolant line leading from a reactor pressure vessel to a straight through boiler or from the top primary boiler chamber of a water-cooled nuclear reactor

    International Nuclear Information System (INIS)

    Schatz, K.

    1982-01-01

    In such a nuclear reactor, a steam or gas cushion can form when the primary system is refilled, which can cause blocking of the natural circulation or filling of the system in the area of the hot primary coolant pipe or in the top primary boiler chamber. In order to remove such a steam or gas cushion, a ventilation pipe starting from the bend of the primary coolant line is connected to the feed pipe for introducing water into the primary system. The feed pipe is designed on the principle of the vacuum pump in the area of the opening of the ventilation pipe. There is a sub-pressure in the ventilation pipe, which makes it possible to extract the steam or gas. After mixing in the area of the opening, the steam condenses or is distributed with the gas in the primary coolant. (orig.) [de

  4. Effect of education of primary health care workers on HIV-related oral lesions in Nairobi East district

    Directory of Open Access Journals (Sweden)

    Lucina N. Koyio

    2012-04-01

    Full Text Available Background. An estimated 90% of HIV-infected people are likely to develop oral lesions in the course of HIV infection. Oro-pharyngeal candidiasis (OPC, an early marker for HIV-infection, can be diagnosed during an oral examination (OE. Primary healthcare (PHC providers in Kenya are neither trained nor sufficiently equipped to perform this simple, cheap and non-invasive examination. The PHC system in Kenya offers an opportunity to integrate early recognition and management of oral lesions into general health care. This study aims to estimate the effect of a multifaceted intervention for PHC providers in training them to perform an OE. Specifically, our primary objective is to establish whether the intervention is effective in increasing: i the frequency of early detection of HIV-related oral lesions; and ii referral rates for HIV-testing. Design and methods. The study has been designed in two parts: a retrospective clinical data record study and a prospective cohort study with pre-post control group design, carried out in 2 administrative divisions in Nairobi East district. The intervention group will receive one day of training on recognition of HIV-related oral lesions and other common oral conditions. Reminder sessions will be held at individual health facilities. Routine tally sheets will be used to record all patients with HIV-related oral lesions, dental caries and periodontal disease. A convenience sample of all the PHC in a division will be used. It will not be possible to blind investigators or assessors. Expected impact of the study for Public Health. Early recognition and treatment of HIV infection influences long-term survival rates and will reduce healthcare expenditure.

  5. Are some areas more equal than others? Socioeconomic inequality in potentially avoidable emergency hospital admissions within English local authority areas.

    Science.gov (United States)

    Sheringham, Jessica; Asaria, Miqdad; Barratt, Helen; Raine, Rosalind; Cookson, Richard

    2017-04-01

    Objectives Reducing health inequalities is an explicit goal of England's health system. Our aim was to compare the performance of English local administrative areas in reducing socioeconomic inequality in emergency hospital admissions for ambulatory care sensitive chronic conditions. Methods We used local authority area as a stable proxy for health and long-term care administrative geography between 2004/5 and 2011/12. We linked inpatient hospital activity, deprivation, primary care, and population data to small area neighbourhoods (typical population 1500) within administrative areas (typical population 250,000). We measured absolute inequality gradients nationally and within each administrative area using neighbourhood-level linear models of the relationship between national deprivation and age-sex-adjusted emergency admission rates. We assessed local equity performance by comparing local inequality against national inequality to identify areas significantly more or less equal than expected; evaluated stability over time; and identified where equity performance was steadily improving or worsening. We then examined associations between change in socioeconomic inequalities and change in within-area deprivation (gentrification). Finally, we used administrative area-level random and fixed effects models to examine the contribution of primary care to inequalities in admissions. Results Data on 316 administrative areas were included in the analysis. Local inequalities were fairly stable between consecutive years, but 32 areas (10%) showed steadily improving or worsening equity. In the 21 improving areas, the gap between most and least deprived fell by 3.9 admissions per 1000 (six times the fall nationally) between 2004/5 and 2011/12, while in the 11 areas worsening, the gap widened by 2.4. There was no indication that measured improvements in local equity were an artefact of gentrification or that changes in primary care supply or quality contributed to changes in

  6. Eye Injuries among Primary School Children in Enugu, Nigeria: Rural vs Urban

    Directory of Open Access Journals (Sweden)

    Nonso Ejikeme Okpala

    2015-01-01

    Full Text Available A cross-sectional survey of the prevalence of eye injuries among primary school children in two noncontiguous local government areas of Enugu State of Nigeria was undertaken. One of the local government areas was urban, while the other one was rural. Children who were <15 years in two randomly selected primary schools in the urban area and three randomly selected schools in the rural area were interviewed and examined with Snellen chart, pen torch, head loupe, and direct ophthalmoscope. The findings were recorded using a semi-structured questionnaire and the World Health Organization Programme for Prevention of Blindness (WHO/PBL eye examination form. Training on visual acuity measurement was done for each of the class teachers. A total of 1,236 children <15 years of age were studied and analyzed. Slightly more females, 652 (52.8%, than males, 584 (47.2%, constituted the sample population giving a female/male ratio of 1.1:1. A total of 98 (7.93% children had evidence of injury to the eye or its adnexa. Eyelid scar was the commonest (5.34% followed by eyebrow scar (2.10%. Canthal scar was the next (0.32%. Two girls had monocular blindness from eye trauma (0.16%. One had leucoma, while the other had a dislocated lens. All the monocular blind children of this study were from the urban area. The home was the commonest environment for an eye injury (69.39% followed by the school (20.41%. The farm was next in frequency (7.14%, especially among boys in the rural area. The church and the road/street constituted the remainder. Regarding persons causing the injury, the child's playmate was the commonest (55.10% followed by self (27.55%. Parents and guardians were the next (9.18%. These were injuries associated with corporal punishment. Corporal punishment-related eye injury, according to this study, appears to be common in the rural area and affects boys predominantly. Other human intermediary agents that cause an eye injury include passersby (2.04%, RTA

  7. Does risk-adjusted payment influence primary care providers’ decision on where to set up practices?

    DEFF Research Database (Denmark)

    Anell, Anders; Dackehag, Margareta; Dietrichson, Jens

    2018-01-01

    Background: Providing equal access to healthcare is an important objective in most health care systems. It is especially pertinent in systems like the Swedish primary care market, where private providers are free to establish themselves in any part of the country. To improve equity in access...... to care, 15 out 21 county councils in Sweden have implemented risk-adjusted capitation based on the Care Need Index, which increases capitation to primary care centers with a large share of patients with unfavorable socioeconomic and demographic characteristics. Our aim is to estimate the effects of using...... Index values. Results: Risk-adjusted capitation significantly increases the number of private primary care centers in areas with relatively high Care Need Index values. The adjustment results in a changed distribution of private centers within county councils; the total number of private centers does...

  8. Health-related quality-of-life effects of radical prostatectomy and primary radiotherapy for screen-detected or clinically diagnosed localized prostate cancer

    NARCIS (Netherlands)

    Madalinska, J. B.; Essink-Bot, M. L.; de Koning, H. J.; Kirkels, W. J.; van der Maas, P. J.; Schröder, F. H.

    2001-01-01

    PURPOSE: The current study was undertaken within the framework of a screening trial to compare the health-related quality-of-life (HRQOL) outcomes of two primary treatment modalities for localized prostate cancer: radical prostatectomy and external-beam radiotherapy. PATIENTS AND METHODS: We

  9. BURNOUT SYNDROME, JOB SATISFACTION LEVELS AND RELATED FACTORS IN CENTRAL TRABZON PROVINCE PRIMARY HEALTH CENTER WORKERS

    Directory of Open Access Journals (Sweden)

    Asuman YAVUZYILMAZ

    2007-02-01

    Full Text Available Burnout manifests itself in individuals working in professions involving face-to-face contact with the public in depersonalization towards others, feelings of emotional exhaustion, and reduced feelings of personal achievement and adequacy. The objective in this study was to determine burnout and job satisfaction levels and related factors in primary health center personnel in the central part of the Turkish province of Trabzon. A total of 227 people working in central Trabzon province primary health centers participated in this cross-sectional study, a level of 90.4%. The Maslach Burnout Inventory was used to determine burnout level and the Job Satisfaction Inventory for job satisfaction. Burnout levels in health personnel were high among women (15.06±5.57, married individuals (14.80±5.65 and those dissatisfied with their working conditions (16.80±5.81; physicians (5.00±2.79, those without children (5.19±2.54, those whose spouses were not working (4.69±2.70 and smokers (4.71±3.29 had a high level of depersonalization; and married individuals were determined to have a low personal achievement level (10.24±4.14 (p=0.020, p=0.028, p=0.011, p=0.038, p=0.028, p=0.012 and p=0.010, respectively. In conclusion, gender, marital status, age, satisfaction with working conditions and income level were determined to be related to burnout and job satisfaction. [TAF Prev Med Bull 2007; 6(1.000: 41-50

  10. BURNOUT SYNDROME, JOB SATISFACTION LEVELS AND RELATED FACTORS IN CENTRAL TRABZON PROVINCE PRIMARY HEALTH CENTER WORKERS

    Directory of Open Access Journals (Sweden)

    Murat TOPBAS

    2007-02-01

    Full Text Available Burnout manifests itself in individuals working in professions involving face-to-face contact with the public in depersonalization towards others, feelings of emotional exhaustion, and reduced feelings of personal achievement and adequacy. The objective in this study was to determine burnout and job satisfaction levels and related factors in primary health center personnel in the central part of the Turkish province of Trabzon. A total of 227 people working in central Trabzon province primary health centers participated in this cross-sectional study, a level of 90.4%. The Maslach Burnout Inventory was used to determine burnout level and the Job Satisfaction Inventory for job satisfaction. Burnout levels in health personnel were high among women (15.06±5.57, married individuals (14.80±5.65 and those dissatisfied with their working conditions (16.80±5.81; physicians (5.00±2.79, those without children (5.19±2.54, those whose spouses were not working (4.69±2.70 and smokers (4.71±3.29 had a high level of depersonalization; and married individuals were determined to have a low personal achievement level (10.24±4.14 (p=0.020, p=0.028, p=0.011, p=0.038, p=0.028, p=0.012 and p=0.010, respectively. In conclusion, gender, marital status, age, satisfaction with working conditions and income level were determined to be related to burnout and job satisfaction. [TAF Prev Med Bull. 2007; 6(1: 41-50

  11. [Prevalence of burnout syndrome and its associated factors in Primary Care staff].

    Science.gov (United States)

    Navarro-González, D; Ayechu-Díaz, A; Huarte-Labiano, I

    2015-01-01

    Burnout syndrome is an emerging disease among health professionals. The aim of this study is to determine the prevalence of occupational burnout among Primary Care staff, as well as to determine the differences in prevalence between family doctors, paediatricians, nurses, administrative-officers, and social-workers, and to evaluate the different related factors. A cross-sectional, descriptive study was conducted on 178 professionals from 5 different occupational groups in 54 Primary Care centres in Navarre from September to December 2010. An anonymous, self-administered questionnaire that included: the Maslach Burnout Inventory and a questionnaire on socio-demographic and work-related factors. Burnout was detected in 39.3% of staff. Those with higher levels are administrative-officers and family doctors, with an OR compared to nurses of 4.58 and 5.37, respectively in the dimension of emotional exhaustion, 4.98 and 2.87 in depersonalization, and 8.37 for administrative-officers in personal accomplishment. An association was found between burnout and the following factors: to be a male (for the dimensions of emotional exhaustion and depersonalization, 25.5 and 31.9%, respectively), to be employed in an urban area (for emotional exhaustion and depersonalization, 20 and 27.8%, respectively), use of psychiatric medication (for emotional exhaustion, 30%), size of patient-quota (for depersonalization, with an average of 1,565 patients), and welfare pressure (for emotional exhaustion and depersonalization, averages of 170.35 and 153.54 patients/week, respectively). About one-third of Primary Care professionals have a high level of burnout, which is mainly associated with the working area, the size of the quota, and professional group, with higher prevalence in administrative-officers and family doctors. Copyright © 2013 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  12. [Antibiotic susceptibility of Staphylococcus aureus and Streptococcus pneumoniae in healthy carrier individuals in primary care in Barcelona area].

    Science.gov (United States)

    Llor, Carles; Boada, Albert; Pons-Vigués, Mariona; Grenzner, Elisabet; Juvé, Rosa; Almeda, Jesús

    2018-01-01

    The information available on antibiotic resistance patterns are generally based on specimens from hospitalised individuals. This study was aimed at evaluating the antibiotic resistance rate of nasal carriage strains of Staphylococcus aureus and Streptococcus pneumoniae in healthy individuals, in accordance with age and gender, attended in Primary Care Centres (PCC). Cross-sectional study. Seven PCC in the Barcelona area. Healthy nasal carriers aged 4years or more who did not present with any sign of infectious disease, and had not taken any antibiotic or had been hospitalised in the previous 3months. A total of 3,969 nasal swabs valid for identification were collected between 2010 and 2011 and were sent to one central microbiological laboratory for isolation of both pathogens. Resistance to common antibiotics was determined on the basis of the current European Committee on Antimicrobial Susceptibility Testing guidelines on cut-off points. The prevalence of methicillin-resistant S.aureus was 1.3% (95%CI: 0.5-2.1%), with resistance rates of 87.1% to phenoxymethylpenicillin and 11.6% to azithromycin, with no significant differences with age and gender. A total of 2.4% (95CI%: 0.1-4.7%) of the pneumococcal strains were highly resistant to both phenoxymethylpenicillin and macrolides, whereas the highest resistance rates were to cefaclor (53.3%), followed by tetracycline (20%) and cefuroxime (12.1%). These pathogens have lower resistance rates in the community than in the hospital setting. Primary Care physicians must be more aware of the current antimicrobial resistance, in order to ensure prudent use of antibiotics. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  13. Intermittent θ burst stimulation over primary motor cortex enhances movement-related β synchronisation.

    Science.gov (United States)

    Hsu, Ya-Fang; Liao, Kwong-Kum; Lee, Po-Lei; Tsai, Yun-An; Yeh, Chia-Lung; Lai, Kuan-Lin; Huang, Ying-Zu; Lin, Yung-Yang; Lee, I-Hui

    2011-11-01

    The objective of this study is to investigate how transcranial magnetic intermittent theta burst stimulation (iTBS) with a prolonged protocol affects human cortical excitability and movement-related oscillations. Using motor-evoked potentials (MEPs) and movement-related magnetoencephalography (MEG), we assessed the changes of corticospinal excitability and cortical oscillations after iTBS with double the conventional stimulation time (1200 pulses, iTBS1200) over the primary motor cortex (M1) in 10 healthy subjects. Continuous TBS (cTBS1200) and sham stimulation served as controls. iTBS1200 facilitated MEPs evoked from the conditioned M1, while inhibiting MEPs from the contralateral M1 for 30 min. By contrast, cTBS1200 inhibited MEPs from the conditioned M1. Importantly, empirical mode decomposition-based MEG analysis showed that the amplitude of post-movement beta synchronisation (16-26 Hz) was significantly increased by iTBS1200 at the conditioned M1, but was suppressed at the nonconditioned M1. Alpha (8-13 Hz) and low gamma-ranged (35-45 Hz) rhythms were not notably affected. Movement kinetics remained consistent throughout. TBS1200 modulated corticospinal excitability in parallel with the direction of conventional paradigms with modestly prolonged efficacy. Moreover, iTBS1200 increased post-movement beta synchronisation of the stimulated M1, and decreased that of the contralateral M1, probably through interhemispheric interaction. Our results provide insight into the underlying mechanism of TBS and reinforce the connection between movement-related beta synchronisation and corticospinal output. Copyright © 2011 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

  14. STUDY ON THERMAL DEFORMATIONS OF THE PRIMARY SEALING OF FRONT SEALING

    Directory of Open Access Journals (Sweden)

    Mihaela ISTRATE

    2015-05-01

    Full Text Available The thermal phenomena appear at the level of the film within the primary sealing interstitium. An important temperature gradient is performed in the stator and in the rotor, which produces thermoelastic deformations. These deformations are of the order of film width and affect essentially the interstitium geometry. According to the temperature increase direction the repartition in the friction ring is different. The farthest areas from the temperature drops or the nearest to the heat sources will have he highest temperature. These dilate more that the rest of the areas and modify the interstitium form. From the calculation relations it comes out that deformations depend also on certain operating conditions, which can be modified through time (pressure, temperature, the sealing efficiency being thus different in time.

  15. Contextual Teaching and Learning Approach of Mathematics in Primary Schools

    Science.gov (United States)

    Selvianiresa, D.; Prabawanto, S.

    2017-09-01

    The Contextual Teaching and Learning (CTL) approach is an approach involving active students in the learning process to discover the concepts learned through to knowledge and experience of the students. Similar to Piaget’s opinion that learning gives students an actives trying to do new things by relating their experiences and building their own minds. When students to connecting mathematics with real life, then students can looking between a conceptual to be learned with a concept that has been studied. So that, students can developing of mathematical connection ability. This research is quasi experiment with a primary school in the city of Kuningan. The result showed that CTL learning can be successful, when learning used a collaborative interaction with students, a high level of activity in the lesson, a connection to real-world contexts, and an integration of science content with other content and skill areas. Therefore, CTL learning can be applied by techer to mathematics learning in primary schools.

  16. Multiple neoplasms, single primaries, and patient survival

    International Nuclear Information System (INIS)

    Amer, Magid H

    2014-01-01

    Multiple primary neoplasms in surviving cancer patients are relatively common, with an increasing incidence. Their impact on survival has not been clearly defined. This was a retrospective review of clinical data for all consecutive patients with histologically confirmed cancer, with emphasis on single versus multiple primary neoplasms. Second primaries discovered at the workup of the index (first) primary were termed simultaneous, if discovered within 6 months of the index primary were called synchronous, and if discovered after 6 months were termed metachronous. Between 2005 and 2012, of 1,873 cancer patients, 322 developed second malignancies; these included two primaries (n=284), and three or more primaries (n=38). Forty-seven patients had synchronous primaries and 275 had metachronous primaries. Patients with multiple primaries were predominantly of Caucasian ancestry (91.0%), with a tendency to develop thrombosis (20.2%), had a strong family history of similar cancer (22.3%), and usually presented with earlier stage 0 through stage II disease (78.9%). When compared with 1,551 patients with a single primary, these figures were 8.9%, 15.6%, 18.3%, and 50.9%, respectively (P≤0.001). Five-year survival rates were higher for metachronous cancers (95%) than for synchronous primaries (59%) and single primaries (59%). The worst survival rate was for simultaneous concomitant multiple primaries, being a median of 1.9 years. The best survival was for patients with three or more primaries (median 10.9 years) and was similar to the expected survival for the age-matched and sex-matched general population (P=0.06991). Patients with multiple primaries are usually of Caucasian ancestry, have less aggressive malignancies, present at earlier stages, frequently have a strong family history of similar cancer, and their cancers tend to have indolent clinical behavior with longer survival rates, possibly related to genetic predisposition

  17. Primary Geography Education in China: Past, Current and Future

    Science.gov (United States)

    Xuan, Xiaowei; Duan, Yushan; Sun, Yue

    2015-01-01

    In China, geography education in primary schools (grades 1 to 6) has not been emphasized, although some scholars have done research in this area. In order to deepen the understanding of primary geography education in China, this paper examines its history, current situation, and future trends. The authors used the method of document analysis and…

  18. Targeted prevention of lifestyle related diseases in the primary care sector – results from the TOF pilot project

    DEFF Research Database (Denmark)

    Bruun Larsen, Lars; Thilsing, Trine

    This abstract reports on the results of a non-randomized pilot study carried out to test the acceptability, feasibility and short-term effects of a healthcare intervention in primary care. The intervention is designed to systematically identify persons at risk of developing lifestyle-related dise...... is facilitated by a digital support system. The pilot makes use of both quantitative and qualitative research methods....... prevention and health promotion is required. This has been attempted in past efforts by offering individual preventive health checks to the general population. However, the evidence on the effectiveness of this approach is mixed. Several systematic reviews, on the other hand, suggest that health checks......This abstract reports on the results of a non-randomized pilot study carried out to test the acceptability, feasibility and short-term effects of a healthcare intervention in primary care. The intervention is designed to systematically identify persons at risk of developing lifestyle...

  19. Effectiveness of health tourism application as the basis of health related recreational technology in primary school pupils’ physical education

    Directory of Open Access Journals (Sweden)

    V.O. Kashuba

    2016-04-01

    Full Text Available Purpose: to search effective methods of health tourism application in physical education of primary school age pupils. Матеріал: in the research 40 children participated, who were divided into control (9 boys and 11 girls and experimental (10 boys and 10 girls groups. We registered physical fitness, physical health, adaptation-reserve potentials and psychological state of primary school pupils. Results: specificities of health tourism means’ application as the basis of health-related recreational technology were determined. We found improvement of children’s health by 10%. Besides, we observed prevailing improvement of organism’s resistance to environmental unfavorable factors and indicators of psycho-emotional state. Conclusions: application of health tourism means increases organism’s functional potentials, physical health and psycho-emotional state of schoolchildren.

  20. Pre-surgical evaluation of the cerebral tumor in the left language related areas by functional MRI

    International Nuclear Information System (INIS)

    Zou Zhitong; Ma Lin; Weng Xuchu

    2010-01-01

    Objective: To evaluate the application of combination of BOLD-fMRI and diffusion tensor tractography (DTT) in pre-operative evaluation of cerebral tumors located at the left language related areas. Methods: A non-vocal button pressing semantic judging paradigm was developed and validated in 10 right-handed volunteers at 3 T. After validation, this protocol combined with DTI were applied to 15 patients with left cerebral tumor prior to surgical resection, and 3 of them had aphasia. fMRI data analysis was on subject-specific basis by one-sampled t-test. The distance from the tumor to Broca area and pre-central 'hand-knot' area were measured separately. Functional language laterality index (LI) was calculated by taking out Broca area and Wernicke area. Three dimensional architecture of frontal lobe white matter fibers, especially arcuate fasciculus, were visualized using diffusion tensor tractography on Volume-one software. The images demonstrating relationship among tumor, language activation areas and white matter fibers were reviewed by neurosurgeons as part of pre-operative planning. One year after the operation, patients were followed up with MRI and language function test. Results: The non-vocal semantic judging paradigm successfully detect Broca area, Wernicke area and pre-central 'hand-knot' area. In 12 of 15 patients, the relationship of Broca area and pre-central motor area to the left brain tumor in language related areas was identified, which make the pre-operative neurosurgical plan applicable to minimize the disruption of language and motor. 8 patients had the left language dominant hemisphere, 3 patients with the right language dominant hemisphere and 1 patient with bilateral dominance. The other 3 patients' fMRI data were corrupted by patients' motion. Diffusion tensor images were corrupted by motion in 1 patient but demonstrated the impact of tumor on left accouter fasciculus in 14 patients. Diffusion tensor tractography showed disruption of left

  1. Characteristics of fibromyalgia in Muslim Bedouin women in a primary care clinic.

    Science.gov (United States)

    Peleg, Roni; Ablin, Jacob N; Peleg, Aya; Neumann, Lily; Rabia, Rasmia Abu; Buskila, Dan

    2008-06-01

    Fibromyalgia (FM) has been described and studied in various sociocultural settings in both developed and developing countries. To study the clinical manifestations of FM and to describe its effect on quality of life in the unique setting of Muslim Bedouin women in the southern Israel Negev desert area. One hundred two Bedouin women were recruited from a primary health care clinic in the Negev area. All patients fulfilled American College of Rheumatology criteria for the diagnosis of FM. Tenderness was assessed by manual dolorimetry and the fibromyalgia impact questionnaire was utilized to estimate the severity of FM symptoms. Anxiety and depression were assessed by the Arthritis Impact Measurement Scales subscales and quality of life was evaluated by the SF-36 questionnaire. The study population was characterized by a low educational level, a high rate of consanguinity, a high number of children per mother, and a high rate of polygamy. There was a high frequency of classic FM symptoms such as pain and fatigue, as well as anxiety and depression. The overall impact of FM on quality of life was exceedingly high (8.9 on a scale of 0 to 10). FM is relatively common in the unique setting of Muslim Bedouin women and has a very significant impact on their quality of life as well as on their dependents. Physicians involved in the primary care of this population should be attentive to the manifestations of FM and related disorders.

  2. Effects of age-related increases in sapwood area, leaf area, and xylem conductivity on height-related hydraulic costs in two contrasting coniferous species

    Science.gov (United States)

    Jean-Christophe Domec; Barbara Lachenbruch; Michele L. Pruyn; Rachel Spicer

    2012-01-01

    Introduction: Knowledge of vertical variation in hydraulic parameters would improve our understanding of individual trunk functioning and likely have important implications for modeling water movement to the leaves. Specifically, understanding how foliage area (Al), sapwood area (As), and hydraulic specific...

  3. Risk management of infrastructure development in border area Indonesia - Malaysia

    Science.gov (United States)

    Fitri, Suryani; Trikariastoto, Reinita, Ita

    2017-11-01

    Border area is geographically adjacent to neighboring countries with the primary function of maintaining state sovereignty and public welfare. Area in question is part of the provinces, districts or cities that directly intersect with national boundaries (or territory) and / or that have a functional relationship (linkage) and has a strategic value for the state. The border area is considered strategic because it involves the national lives of many people in terms of the interests of political, economic, social and cultural as well as defense and security (poleksosbudhankam) both located on land, sea or air. The border area is geographically adjacent to neighboring countries with the primary function of maintaining state sovereignty and public welfare. Area in question is part of the provinces, districts or cities that directly intersect with national boundaries (or territory) and / or that have a functional relationship (linkage) and has a strategic value for the state. To realize the necessary research on the development of the area, based on good practices from other countries some of the city that can meet all these challenges and at least can be applied with minor changes / adjustments. Furthermore, the application must be supported by the availability of funds. This study to discuss about any problems either obstacles or things that drive to develop function becomes an ideal border area with major support infrastructure for housing, transportation, energy availability, and distribution of clean water which will strengthen in its function which consists of five pillars, namely: central community service; trade and distribution center; financial center; tourism center; related to the field of community development. Articulation between key stakeholders such as government, private, and community is a major concern in this study, including in determining the appropriate financing schemes. The results of this study will be recommended to the government to improve

  4. Traction-related problems after hip arthroscopy

    Science.gov (United States)

    Lund, Bent; Grønbech Nielsen, Torsten; Lind, Martin

    2017-01-01

    Abstract Traction-related problems are poorly described in the existing literature. The purpose of this prospective study was to describe traction-related problems and how patients perceive these problems. The study was a descriptive cohort study and data were collected from questionnaires and patient files. The questionnaire included questions on patients’ perceptions of traction-related problems in the groin area, at the knee and ankle and how patients had coped with these problems. A total of 100 consecutive patients undergoing hip arthroscopy filled out the questionnaire. Primary findings of this study were that 74% of patients reported some sort of traction-related problems after hip arthroscopy. About 32% of the patients had problems in the groin area and 49% of the patients complained of symptoms in the knee joint. A total of 37% of the patients had experienced problems from the traction boot in the ankle area. The complications were found to be temporary and disappeared after 2–4 weeks. Five patients still had complaints after 3 months. All five patients had a pre-existing knee injury prior to undergoing hip arthroscopy. Traction-related problems after hip arthroscopy are a challenge and our study showed that 74% of the patients reported traction-related problems. This is significantly higher than previously reported. The present study found a high rate of complaints from the knee and ankle joints that have not previously been reported. The presented data suggest the need for more pre-surgery patient information about possible traction-related problems. PMID:28630721

  5. Key Performance Indicators for Primary Schools.

    Science.gov (United States)

    Strand, Steve

    Focusing mostly on their application for primary schools, this document describes the educational key performance indicators (KPI) employed by the Wendsworth, England, Local Educational Authority (LEA). Indicators are divided into 3 areas, educational context, resource development, and outcomes. Contextual indicators include pupil mobility, home…

  6. Leaders, leadership and future primary care clinical research

    Directory of Open Access Journals (Sweden)

    Qureshi Nadeem

    2008-09-01

    Full Text Available Abstract Background A strong and self confident primary care workforce can deliver the highest quality care and outcomes equitably and cost effectively. To meet the increasing demands being made of it, primary care needs its own thriving research culture and knowledge base. Methods Review of recent developments supporting primary care clinical research. Results Primary care research has benefited from a small group of passionate leaders and significant investment in recent decades in some countries. Emerging from this has been innovation in research design and focus, although less is known of the effect on research output. Conclusion Primary care research is now well placed to lead a broad re-vitalisation of academic medicine, answering questions of relevance to practitioners, patients, communities and Government. Key areas for future primary care research leaders to focus on include exposing undergraduates early to primary care research, integrating this early exposure with doctoral and postdoctoral research career support, further expanding cross disciplinary approaches, and developing useful measures of output for future primary care research investment.

  7. [Infestation status Aedes albopictus and related mosquito-borne infectious disease risk in central urban area in Shanghai].

    Science.gov (United States)

    Gao, Q; Xiong, C L; Zhou, Y B; Cao, H; Jiang, Q W

    2016-05-01

    To evaluate Aedes albopictus infestation status in the central urban area of Shanghai, and analyze the related epidemic risk of mosquito-borne infectious disease. Consecutive mosquito surveillance was conducted in the green lands and residential areas in the central urban area of Shanghai during 2012-2014, the Aedes albopictus density and its seasonal fluctuation were observed; the sequence of Aedes albopictus in Shanghai was aligned with that in other epidemic area abroad, and the susceptibility of Aedes albopictus to mosquito-borne virus and endemic risk were analyzed. No Aedes aegypti was found in the central urban area of Shanghai. As predominant species in both the residential area and the green lands, the proportion of Aedes albopictus in the residential area was significantly higher than that in the green lands(78.53% vs. 19.99%, χ(2) =15 525.168, PAedes albopictus in Shanghai and Aedes albopictus in Africa was quite far. No Aedes aegypti was found in Shanghai and its surrounding areas, while Aedes albopictus infestation in the central urban area of Shanghai was serious. Strict measures should be taken to reduce the Aedes albopictus density for the effective control Zika virus spread.

  8. Health-related quality-of-life effects of radical prostatectomy and primary radiotherapy for screen-detected or clinically diagnosed localized prostate cancer.

    Science.gov (United States)

    Madalinska, J B; Essink-Bot, M L; de Koning, H J; Kirkels, W J; van der Maas, P J; Schröder, F H

    2001-03-15

    The current study was undertaken within the framework of a screening trial to compare the health-related quality-of-life (HRQOL) outcomes of two primary treatment modalities for localized prostate cancer: radical prostatectomy and external-beam radiotherapy. We conducted a prospective longitudinal cohort study among 278 patients with early screen-detected (59%) or clinically diagnosed (41%) prostate cancer using both generic and disease-specific HRQOL measures (SF-36, UCLA Prostate Cancer Index [urinary and bowel modules] and items relating to sexual functioning) at three points in time: t1 (baseline), t2 (6 months later), and t3 (12 months after t1). Questionnaires were completed by 88% to 93% of all initially enrolled patients. Patients referred for primary radiotherapy were significantly older than prostatectomy patients (63 v 68 years, P screen-detected and clinically diagnosed cancer reported similar posttreatment HRQOL. Prostatectomy and radiotherapy differed in the type of HRQOL impairment. Because the HRQOL effects may be valued differently at the individual level, patients should be made fully aware of the potential benefits and adverse consequences of therapies for early prostate cancer. Differences in posttreatment HRQOL were not related to the method of cancer detection.

  9. Plutonium focus area: Technology summary

    International Nuclear Information System (INIS)

    1996-03-01

    To ensure research and development programs focus on the most pressing environmental restoration and waste management problems at the U.S. Department of Energy (DOE), the Assistant Secretary for the Office of Environmental Management (EM) established a working group in August 1993 to implement a new approach to research and technology development. As part of this approach, EM developed a management structure and principles that led to creation of specific focus areas. These organizations were designed to focus scientific and technical talent throughout DOE and the national scientific community on major environmental restoration and waste management problems facing DOE. The focus area approach provides the framework for inter-site cooperation and leveraging of resources on common problems. After the original establishment of five major focus areas within the Office of Technology Development (EM-50), the Nuclear Materials Stabilization Task Group (NMSTG, EM-66) followed EM-50's structure and chartered the Plutonium Focus Area (PFA). NMSTG's charter to the PFA, described in detail later in this book, plays a major role in meeting the EM-66 commitments to the Defense Nuclear Facilities Safety Board (DNFSB). The PFA is a new program for FY96 and as such, the primary focus of revision 0 of this Technology Summary is an introduction to the Focus Area; its history, development, and management structure, including summaries of selected technologies being developed. Revision 1 to the Plutonium Focus Area Technology Summary is slated to include details on all technologies being developed, and is currently planned for release in August 1996. The following report outlines the scope and mission of the Office of Environmental Management, EM-60, and EM-66 organizations as related to the PFA organizational structure

  10. Primary black holes

    International Nuclear Information System (INIS)

    Novikov, I.; Polnarev, A.

    1981-01-01

    Proves are searched for of the formation of the so-called primary black holes at the very origin of the universe. The black holes would weigh less than 10 13 kg. The formation of a primary black hole is conditional on strong fluctuations of the gravitational field corresponding roughly to a half of the fluctuation maximally permissible by the general relativity theory. Only big fluctuations of the gravitational field can overcome the forces of the hot gas pressure and compress the originally expanding matter into a black hole. Low-mass black holes have a temperature exceeding that of the black holes formed from stars. A quantum process of particle formation, the so-called evaporation takes place in the strong gravitational field of a black hole. The lower the mass of the black hole, the shorter the evaporation time. The analyses of processes taking place during the evaporation of low-mass primary black holes show that only a very small proportion of the total mass of the matter in the universe could turn into primary black holes. (M.D.)

  11. Physician′s self-perceived abilities at primary care settings in Indonesia

    Directory of Open Access Journals (Sweden)

    Wahyudi Istiono

    2015-01-01

    Full Text Available Background: Southeast Asian countries with better-skilled primary care physicians have been shown to have better health outcomes. However, in Indonesia, there has been a large number of inappropriate referrals, leading to suboptimal health outcomes. This study aimed to examine the reasons underlying the unnecessary referrals as related to Indonesian physicians′ standard of abilities. Materials and Methods: This was a multiple-case study that explored physicians′ self-evaluation of their abilities. Self-evaluation questionnaires were constructed from the Indonesian Standards of Physicians Competences of 2006-2012 (ISPC, which is a list of 155 diseases. This study was undertaken in three cities, three towns, and one "border-less developed" area during 2011-2014. The study involved 184 physicians in those seven districts. Data were collected using one-on-one, in-depth interviews, focus group discussions (FGDs, and clinical observations. Results: This study found that primary care physicians in Indonesia felt that they were competent to handle less than one-third of "typical" primary care cases. The reasons were limited understanding of person-centered care principles and limited  patient care services to diagnosis and treatment of common biomedical problems. Additionally, physical facilities in primary care settings are lacking. Discussions and Conclusions: Strengthening primary health care in Indonesia requires upscaling doctors′ abilities in managing health problems through more structured graduate education in family medicine, which emphasizes the bio-psycho-socio-cultural background of persons; secondly, standardizing primary care facilities to support physicians′ performance is critical. Finally, a strong national health policy that recognizes the essential role of primary care physicians in health outcomes is an urgent need.

  12. Relations, interactions and networks of cultural tourism stakeholders in rural areas of Vojvodina

    Directory of Open Access Journals (Sweden)

    Pavlović Nataša

    2015-01-01

    Full Text Available Contemporary trends, which are characterized by a very strong level of competition and the maturity of the market, become more than ever essential for success of tourist destinations. Rural areas in Vojvodina, because of its authentic atmosphere and multiculturalism, have significant advantages for cultural tourism. Each participant who creates a tourism product in toda y's competitive environment aims to have a strong focus on customer satisfaction, which indicates the necessity of adopting the concept of total relationship marketing. The aim of this paper is to show how cultural institutions, souvenir craftsmen, tourism organizations, travel agencies and other stakeholders achieve cooperation and apply modern concept of total relationship marketing for the purposes of satisfying the needs of tourists. The paper will explore the fundamental postulates of relationship marketing applied by key stakeholders of cultural tourism in rural areas, and will get reference results on relations, interactions and networks.

  13. CLASSIFICATION OF TRAFFIC RELATED SHORT TEXTS TO ANALYSE ROAD PROBLEMS IN URBAN AREAS

    Directory of Open Access Journals (Sweden)

    A. M. M. Saldana-Perez

    2017-09-01

    Full Text Available The Volunteer Geographic Information (VGI can be used to understand the urban dynamics. In the classification of traffic related short texts to analyze road problems in urban areas, a VGI data analysis is done over a social media’s publications, in order to classify traffic events at big cities that modify the movement of vehicles and people through the roads, such as car accidents, traffic and closures. The classification of traffic events described in short texts is done by applying a supervised machine learning algorithm. In the approach users are considered as sensors which describe their surroundings and provide their geographic position at the social network. The posts are treated by a text mining process and classified into five groups. Finally, the classified events are grouped in a data corpus and geo-visualized in the study area, to detect the places with more vehicular problems.

  14. Classification of Traffic Related Short Texts to Analyse Road Problems in Urban Areas

    Science.gov (United States)

    Saldana-Perez, A. M. M.; Moreno-Ibarra, M.; Tores-Ruiz, M.

    2017-09-01

    The Volunteer Geographic Information (VGI) can be used to understand the urban dynamics. In the classification of traffic related short texts to analyze road problems in urban areas, a VGI data analysis is done over a social media's publications, in order to classify traffic events at big cities that modify the movement of vehicles and people through the roads, such as car accidents, traffic and closures. The classification of traffic events described in short texts is done by applying a supervised machine learning algorithm. In the approach users are considered as sensors which describe their surroundings and provide their geographic position at the social network. The posts are treated by a text mining process and classified into five groups. Finally, the classified events are grouped in a data corpus and geo-visualized in the study area, to detect the places with more vehicular problems.

  15. Water pollution in relation to mineral exploration: a case study from Alayi-Ovim area of southeastern Nigeria.

    Science.gov (United States)

    Ibe, Kalu K; Akaolisa, Casmir C Zanders

    2012-05-01

    Water samples from rivers, streams, springs, and shallow wells in Alayi-Ovim area of southeast Nigeria have been analyzed for Pb, Ca, Mg, Fe, Mg, PO(4), NO(3), CO(3), SO(4), Cl, and pH. The analyses were carried out using atomic absorption spectrometer and Hach Direct Reading Equipment. Results of the analyses from the area conform to the WHO (1995) standards for drinking water. However, the results show relative enrichment of Ca, pH, Mg, CO(3), and Cl. Low values were obtained for Fe, SO(4), and NO(3). While the Cl and Pb enrichment in the area north of Alayi-Ovim axis is attributed to proximity to the lead-zinc and chloride-rich formations of the Turonian Eze-Aku and the Albian Asu River; the Ca, Mg, SO(4), and CO(3) enrichment in Southern part of Alayi-Ovim is due to the limestone-bearing Late Maastrichtian Nsukka Formation. Furthermore, the very low values of less than 5 ppm for these characters in water in the central region correlate well with the relatively clean Maastrichtian quartz arenite Ajali Sandstone Formation. The Pb-Zn and Cl incursions into the water system from the Older Albian Asu River/Turonian Eze-Aku Formations in the northern part of Alayi-Ovim area and the leaching of Mg, and Ca into the water system in the Maastrichtian limestone area in the south thus constitute geochemical indices for chemical pollution and mineral exploration for brine and dolomitic limestone in the area.

  16. A statistical analysis of the characteristics of the intended curriculum for Japanese primary science and its relationship to the attained curriculum

    Directory of Open Access Journals (Sweden)

    Kenji Matsubara

    2016-08-01

    Full Text Available Abstract This study statistically investigates the characteristics of the intended curriculum for Japanese primary science, focusing on the learning content. The study used the TIMSS 2011 Grade 4 Curriculum Questionnaire data as a major source for the learning content prescribed at the national level. Confirmatory factor analysis was used to determine the extent to which a topic area was covered, as compared to the average among the 59 TIMSS 2011 participating countries. The study revealed that the topic areas of “Human Health” and “Changes in Environments,” both in the life science domain, showed statistically less coverage in the Japanese primary science curriculum when compared to the international average. Furthermore, in discussion, the study relates the characteristics found in the intended curriculum to those in the attained curriculum, examining the percent correct statistics for relevant items from the science assessment. Based on these findings, the study proposes two recommendations for revision of the Japanese primary science curriculum.

  17. Eye Injuries Among Primary School Children in Enugu, Nigeria: Rural vs Urban.

    Science.gov (United States)

    Okpala, Nonso Ejikeme; Umeh, Rich Enujioke; Onwasigwe, Ernest Nnemeka

    2015-01-01

    A cross-sectional survey of the prevalence of eye injuries among primary school children in two noncontiguous local government areas of Enugu State of Nigeria was undertaken. One of the local government areas was urban, while the other one was rural. Children who were children children had evidence of injury to the eye or its adnexa. Eyelid scar was the commonest (5.34%) followed by eyebrow scar (2.10%). Canthal scar was the next (0.32%). Two girls had monocular blindness from eye trauma (0.16%). One had leucoma, while the other had a dislocated lens. All the monocular blind children of this study were from the urban area. The home was the commonest environment for an eye injury (69.39%) followed by the school (20.41%). The farm was next in frequency (7.14%), especially among boys in the rural area. The church and the road/street constituted the remainder. Regarding persons causing the injury, the child's playmate was the commonest (55.10%) followed by self (27.55%). Parents and guardians were the next (9.18%). These were injuries associated with corporal punishment. Corporal punishment-related eye injury, according to this study, appears to be common in the rural area and affects boys predominantly. Other human intermediary agents that cause an eye injury include passersby (2.04%), RTA (2.04%), siblings (2.04%), and others (1.02%). The primary agents that caused an eye injury were sticks/wood, 29 (29.60%); stone, 21 (21.43%); pieces of metal, 19 (19.39%); fall, 10 (10.20%); fight/fist blow, 9 (9.918%); plastic, 2 (2.04%); fingernails, 2 (2.04%); farm tools/fruits, 2 (2.04%); and RTA, glass, and headbutt, each 1.02%. Farm implements/fruits as well as fingernails appear to be fairly common primary agents that cause an eye injury in the rural Enugu, Nigeria. In terms of prevalence, there was no significant difference between the urban and rural areas. The findings from this study showed a high prevalence of eye injury among primary school children. In terms of

  18. FFTBM and primary pressure acceptance criterion

    International Nuclear Information System (INIS)

    Prosek, A.

    2004-01-01

    When thermalhydraulic computer codes are used for simulation in the area of nuclear engineering the question is how to conduct an objective comparison between the code calculation and measured data. To answer this the fast Fourier transform based method (FFTBM) was developed. When the FFTBM method was developed the acceptance criteria for primary pressure and total accuracy were set. In the recent study the FFTBM method was used for accuracy quantification of RD-14M large LOCA test B9401 calculations. The blind accuracy analysis indicated good total accuracy while the primary pressure criterion was not fulfilled. The objective of the study was therefore to investigate the reasons for not fulfilling the primary pressure acceptance criterion and the applicability of the criterion to experimental facilities simulating heavy water reactor. The results of the open quantitative analysis showed that sensitivity analysis for influence parameters provide sufficient information to judge in which calculation the accuracy of primary pressure is acceptable. (author)

  19. Health care in rural areas.

    Science.gov (United States)

    Nath, L M

    1994-02-01

    In India, although the health care system infrastructure is extensive, the people often regard government facilities as family planning (FP) centers instead of primary health care centers. This problem has been compounded by the separation of health care and FP at all stages, even down to the storage of the same medication in two different locations depending upon whether it is to be used for "health" or for "FP." In rural areas where the government centers are particularly desolate, the community has chosen to erect its own health care system of private practitioners of all sorts and qualifications. Even in rural areas where a comprehensive health service is provided, with each household visited regularly by health workers, and where this service has resulted in a lowering of the crude death rate from 14.6 to 7 and the maternal mortality rate from 4.7 to 0.5/1000, people depend upon practitioners of various types. Upon analysis, it was discovered that the reason for using this multiplicity of practitioners had nothing to do with the level of satisfaction with the government service or with the accessibility of the services. Rather, when ill, the people make a diagnosis and then go to the proper place for treatment. If, for instance, they believe their malady was caused by the evil eye, they consult a magico-religious practitioner. These various types of practitioners flourish in areas with the best primary health care because they fulfill a need not met by the primary health care staff. If government agencies work with the local practitioners and afford them the proper respect, their skills can be upgraded in selected areas and the whole community will benefit.

  20. FLOODPLAIN, STEWART COUNTY (AND INCORPORATED AREAS)

    Data.gov (United States)

    Federal Emergency Management Agency, Department of Homeland Security — The Floodplain Mapping/Redelineation study deliverables depict and quantify the flood risks for the study area. The primary risk classifications used are the...

  1. FLOODPLAIN, PUTNAM COUNTY (AND INCORPORATED AREAS)

    Data.gov (United States)

    Federal Emergency Management Agency, Department of Homeland Security — The Floodplain Mapping/Redelineation study deliverables depict and quantify the flood risks for the study area. The primary risk classifications used are the...

  2. FLOODPLAIN, FRANKLIN PARISH (AND INCORPORATED AREAS)

    Data.gov (United States)

    Federal Emergency Management Agency, Department of Homeland Security — The Floodplain Mapping/Redelineation study deliverables depict and quantify the flood risks for the study area. The primary risk classifications used are the...

  3. FLOODPLAIN, VERNON PARISH (AND INCORPORATED AREAS)

    Data.gov (United States)

    Federal Emergency Management Agency, Department of Homeland Security — The Floodplain Mapping/Redelineation study deliverables depict and quantify the flood risks for the study area. The primary risk classifications used are the...

  4. FLOODPLAIN, DEKALB COUNTY (AND INCORPORATED AREAS)

    Data.gov (United States)

    Federal Emergency Management Agency, Department of Homeland Security — The Floodplain Mapping/Redelineation study deliverables depict and quantify the flood risks for the study area. The primary risk classifications used are the...

  5. Low incidence rate of overt hypothyroidism compared with hyperthyroidism in an area with moderately low iodine intake

    DEFF Research Database (Denmark)

    Laurberg, P; Bülow Pedersen, I; Pedersen, K M

    1999-01-01

    In areas with relatively high iodine intake, the incidence rate of hypothyroidism is several-fold higher than that of hyperthyroidism. Recently, we found a similarly high prevalence rate of subclinical hypothyroidism compared with hyperthyroidism in a high iodine intake area, while a relatively low...... prevalence of subclinical hypothyroidism was observed in a low iodine intake area. In the present study we compared the incidence rate (newly diagnosed in primary care and at hospital) of overt hypothyroidism with that of hyperthyroidism in a well-defined geographical area in Jutland, Denmark, with an iodine...... intake around 60 microg/day. The number of personsxyears studied was 569,108. Data on hyperthyroidism have been published previously. The overall incidence of hypothyroidism was 13.5/100,000 per year (F/M 22.9/3.6), hyperthyroidism 38.7/100.000 per year (F/M 63.0/13.0). The incidence of hypothyroidism...

  6. Mixed Waste Focus Area - Waste form initiative

    International Nuclear Information System (INIS)

    Nakaoka, R.; Waters, R.; Pohl, P.; Roach, J.

    1998-01-01

    The mission of the US Department of Energy's (DOE) Mixed Waste Focus Area (MWFA) is to provide acceptable technologies that enable implementation of mixed waste treatment systems which are developed in partnership with end-users, stakeholders, tribal governments, and regulators. To accomplish this mission, a technical baseline was established in 1996 and revised in 1997. The technical baseline forms the basis for determining which technology development activities will be supported by the MWFA. The primary attribute of the technical baseline is a set of prioritized technical deficiencies or roadblocks related to implementation of mixed waste treatment systems. The Waste Form Initiative (WFI) was established to address an identified technical deficiency related to waste form performance. The primary goal of the WFI was to ensure that the mixed low-level waste (MLLW) treatment technologies being developed, currently used, or planned for use by DOE would produce final waste forms that meet the waste acceptance criteria (WAC) of the existing and/or planned MLLW disposal facilities. The WFI was limited to an evaluation of the disposal requirements for the radioactive component of MLLW. Disposal requirements for the hazardous component are dictated by the Resource Conservation and Recovery Act (RCRA), and were not addressed. This paper summarizes the technical basis, strategy, and results of the activities performed as part of the WFI

  7. Acquired immunodeficiency syndrome-related primary cerebral lymphoma: response to irradiation

    International Nuclear Information System (INIS)

    Khoo, V.S.; Wilson, P.C.; Sexton, M.J.; Liew, K.H.

    2000-01-01

    Acquired immunodeficiency syndrome-related primary cerebral lymphoma (AIDS-PCL) is uncommon. Fourteen cases of presumed AIDS-PCL between 1986 and 1995 were reviewed retrospectively in order to characterize the natural history, and the response to radiotherapy. The median age was 38 years (range 24-65). The median interval between seropositive diagnosis of HIV and AIDS-PCL was 28 months (range 5-113). The median duration of symptoms was 2 weeks (range 0.2-12). At presentation, the Eastern Cooperative Oncology Group performance status (PS) was PS1 (2/14 patients), PS2 (6/14) and PS3 (6/14). The symptoms and signs were non-specific and depended on the site and extent of cerebral involvement. There was no characteristic pattern of brain imaging in terms of size, number, location or pattern of contrast enhancement of the cerebral lesions. Nine patients received various fractionation-dose schedules (range 8-50 Gy). Complete and partial responses were seen in 2/9 and 3/9 cases, respectively. Clinical stabilization of neurological symptoms was noted in 3/9 cases and disease progression in 1/9. The median survival times (MST) from presentation for irradiated and non-irradiated patients were 9.3 and 2.1 weeks, respectively (range 0.9-43.1). Although patient selection introduced bias, there appears to be a modest improvement in MST for treated patients. The MST with radiotherapy alone remains poor, but radiotherapy may provide palliation. For some selected patients, a prolonged response is possible. Copyright (1999) Blackwell Science Pty Ltd

  8. Inconsistent approaches of the G-BA regarding acceptance of primary study endpoints as being relevant to patients - an analysis of three disease areas: oncological, metabolic, and infectious diseases

    Directory of Open Access Journals (Sweden)

    Thomas Staab

    2016-11-01

    Full Text Available Abstract Background Previous evaluations of oncological medicines in the German early benefit assessment (EBA procedure have demonstrated inconsistent acceptance of endpoints by regulatory authorities and the Federal Joint Committee (G-BA. Accepted standard endpoints for regulatory purposes are frequently not considered as patient-relevant in the German EBA system. In this study the acceptance of clinically acknowledged primary endpoints (PEPs from regulatory trials in EBAs conducted by the G-BA was evaluated across three therapeutic areas. Methods Medicines for oncological, metabolic and infectious diseases with EBAs finalised before 25 January 2016 were evaluated. Respective manufacturer’s dossiers, regulatory assessments, G-BA appraisals and oral hearing minutes were reviewed, and PEPs were examined to determine whether they were considered relevant to patients by the G-BA. Furthermore, the acceptance of symptomatic vs asymptomatic PEPs was also analysed. Results A total of 65 EBAs were evaluated. Mortality PEPs were widely accepted as patient-relevant but were only used in a minority of EBAs and exclusively in oncological diseases. Morbidity PEPs constituted around 72 % of assessed PEPs, but were excluded from the EBA in over half of the corresponding assessments as they were not considered patient-relevant. Symptomatic endpoints were largely deemed patient-relevant, whereas acceptance of asymptomatic endpoints varied between therapeutic areas. Conclusions This evaluation identified inconsistencies in patient relevance of morbidity-related PEPs as well as in acceptance of asymptomatic endpoints by the G-BA in all three disease areas examined. Better harmonisation between the regulatory authorities and the G-BA is still required after 5 years of AMNOG health technology assessment in Germany.

  9. Primary care in Switzerland gains strength.

    Science.gov (United States)

    Djalali, Sima; Meier, Tatjana; Hasler, Susann; Rosemann, Thomas; Tandjung, Ryan

    2015-06-01

    Although there is widespread agreement on health- and cost-related benefits of strong primary care in health systems, little is known about the development of the primary care status over time in specific countries, especially in countries with a traditionally weak primary care sector such as Switzerland. The aim of our study was to assess the current strength of primary care in the Swiss health care system and to compare it with published results of earlier primary care assessments in Switzerland and other countries. A survey of experts and stakeholders with insights into the Swiss health care system was carried out between February and March 2014. The study was designed as mixed-modes survey with a self-administered questionnaire based on a set of 15 indicators for the assessment of primary care strength. Forty representatives of Swiss primary and secondary care, patient associations, funders, health care authority, policy makers and experts in health services research were addressed. Concordance between the indicators of a strong primary care system and the real situation in Swiss primary care was rated with 0-2 points (low-high concordance). A response rate of 62.5% was achieved. Participants rated concordance with five indicators as 0 (low), with seven indicators as 1 (medium) and with three indicators as 2 (high). In sum, Switzerland achieved 13 of 30 possible points. Low scores were assigned because of the following characteristics of Swiss primary care: inequitable local distribution of medical resources, relatively low earnings of primary care practitioners compared to specialists, low priority of primary care in medical education and training, lack of formal guidelines for information transfer between primary care practitioners and specialists and disregard of clinical routine data in the context of medical service planning. Compared to results of an earlier assessment in Switzerland, an improvement of seven indicators could be stated since 1995. As a

  10. Immunolocalization of RANK and RANKL along the root surface and in the periodontal membrane of human primary and permanent teeth

    DEFF Research Database (Denmark)

    Bille, Marie-Louise Bastholm; Thomsen, Bjarke; Andersen, Thomas Levin

    2012-01-01

    Abstract Objective. Root resorption, impaired tooth eruption and early tooth loss have been described in relation to diseases that involve defects in the RANK-RANKL-OPG-expression. The aim of the present immunhistochemical study was to localize and compare the reactions for RANK and membrane...... in odontoblasts and in cells along denticles in one primary tooth. RANK was located in mononuclear cells in the pulp and in multinucleated odontoclasts along resorbed root surfaces and along resorbed dentin surfaces in the pulp in primary teeth and one permanent tooth. Conclusions. This study demonstrated RANK...... positivity in resorption areas in primary and permanent teeth. RANKL was positive in the pulp of one primary tooth. RANK expression in odontoclasts and RANKL expression in the pulp may indicate that RANK/RANKL play a role during resorption....

  11. Psychosocial and professional characteristics of burnout in Swiss primary care practitioners: a cross-sectional survey.

    Science.gov (United States)

    Goehring, Catherine; Bouvier Gallacchi, Martine; Künzi, Beat; Bovier, Patrick

    2005-02-19

    To measure the prevalence of burnout and explore its professional and psychosocial predictors among Swiss primary care practitioners. A cross-sectional postal survey was conducted to measure burnout, work-related stressors, professional and psychosocial characteristics among a representative sample of primary care practitioners. Answers to the Maslach burnout inventory were used to categorize respondents into moderate and high degree of burnout. 1784 physicians responded to the survey (65% response rate) and 1755 questionnaires could be analysed. 19% of respondents had a high score for emotional exhaustion, 22% had a high score for depersonalisation/cynicism and 16% had a low score for professional accomplishment; 32% had a high score on either the emotional exhaustion or the depersonalisation/cynicism scale (moderate degree of burnout) and 4% had scores in the range of burnout in all three scales (high degree of burnout). Predictors of moderate burnout were male sex, age 45-55 years and excessive perceived stress due to global workload, health-insurance-related work, difficulties to balance professional and private life, changes in the health care system and medical care uncertainty. A high degree of burnout was associated with male sex, practicing in a rural area, and excessive perceived stress due to global workload, patient's expectations, difficulties to balance professional and private life, economic constraints in relation to the practice, medical care uncertainty and difficult relations with non-medical staff at the practice. About one third of Swiss primary care practitioners presented a moderate or a high degree of burnout, which was mainly associated with extrinsic work-related stressors. Medical doctors and politicians in charge of redesigning the health care system should address this phenomenon to maintain an efficient Swiss primary care physician workforce in the future.

  12. Development of microbial community during primary succession in areas degraded by mining activities

    Czech Academy of Sciences Publication Activity Database

    Harantová, Lenka; Mudrák, O.; Kohout, Petr; Elhottová, Dana; Frouz, J.; Baldrian, Petr

    2017-01-01

    Roč. 28, č. 8 (2017), s. 2574-2584 ISSN 1085-3278 R&D Projects: GA ČR(CZ) GA15-11635S Institutional support: RVO:61388971 ; RVO:60077344 Keywords : plant-soil interactions * postmining sites * primary succession Subject RIV: EE - Microbiology, Virology; EE - Microbiology, Virology (BC-A) OBOR OECD: Microbiology; Microbiology (BC-A) Impact factor: 9.787, year: 2016

  13. Exploring Simple Algorithms for Estimating Gross Primary Production in Forested Areas from Satellite Data

    Directory of Open Access Journals (Sweden)

    Ramakrishna R. Nemani

    2012-01-01

    Full Text Available Algorithms that use remotely-sensed vegetation indices to estimate gross primary production (GPP, a key component of the global carbon cycle, have gained a lot of popularity in the past decade. Yet despite the amount of research on the topic, the most appropriate approach is still under debate. As an attempt to address this question, we compared the performance of different vegetation indices from the Moderate Resolution Imaging Spectroradiometer (MODIS in capturing the seasonal and the annual variability of GPP estimates from an optimal network of 21 FLUXNET forest towers sites. The tested indices include the Normalized Difference Vegetation Index (NDVI, Enhanced Vegetation Index (EVI, Leaf Area Index (LAI, and Fraction of Photosynthetically Active Radiation absorbed by plant canopies (FPAR. Our results indicated that single vegetation indices captured 50–80% of the variability of tower-estimated GPP, but no one index performed universally well in all situations. In particular, EVI outperformed the other MODIS products in tracking seasonal variations in tower-estimated GPP, but annual mean MODIS LAI was the best estimator of the spatial distribution of annual flux-tower GPP (GPP = 615 × LAI − 376, where GPP is in g C/m2/year. This simple algorithm rehabilitated earlier approaches linking ground measurements of LAI to flux-tower estimates of GPP and produced annual GPP estimates comparable to the MODIS 17 GPP product. As such, remote sensing-based estimates of GPP continue to offer a useful alternative to estimates from biophysical models, and the choice of the most appropriate approach depends on whether the estimates are required at annual or sub-annual temporal resolution.

  14. Indoor Temperatures in Patient Waiting Rooms in Eight Rural Primary Health Care Centers in Northern South Africa and the Related Potential Risks to Human Health and Wellbeing

    Directory of Open Access Journals (Sweden)

    Caradee Y. Wright

    2017-01-01

    Full Text Available Increased temperatures affect human health and vulnerable groups including infants, children, the elderly and people with pre-existing diseases. In the southern African region climate models predict increases in ambient temperature twice that of the global average temperature increase. Poor ventilation and lack of air conditioning in primary health care clinics, where duration of waiting time may be as long as several hours, pose a possible threat to patients seeking primary health care. Drawing on information measured by temperature loggers installed in eight clinics in Giyani, Limpopo Province of South Africa, we were able to determine indoor temperatures of waiting rooms in eight rural primary health care facilities. Mean monthly temperature measurements inside the clinics were warmer during the summer months of December, January and February, and cooler during the autumn months of March, April and May. The highest mean monthly temperature of 31.4 ± 2.7 °C was recorded in one clinic during February 2016. Maximum daily indoor clinic temperatures exceeded 38 °C in some clinics. Indoor temperatures were compared to ambient (outdoor temperatures and the mean difference between the two showed clinic waiting room temperatures were higher by 2–4 °C on average. Apparent temperature (AT incorporating relative humidity readings made in the clinics showed ‘realfeel’ temperatures were >4 °C higher than measured indoor temperature, suggesting a feeling of ‘stuffiness’ and discomfort may have been experienced in the waiting room areas. During typical clinic operational hours of 8h00 to 16h00, mean ATs fell into temperature ranges associated with heat–health impact warning categories of ‘caution’ and ‘extreme caution’.

  15. Indoor Temperatures in Patient Waiting Rooms in Eight Rural Primary Health Care Centers in Northern South Africa and the Related Potential Risks to Human Health and Wellbeing.

    Science.gov (United States)

    Wright, Caradee Y; Street, Renée A; Cele, Nokulunga; Kunene, Zamantimande; Balakrishna, Yusentha; Albers, Patricia N; Mathee, Angela

    2017-01-06

    Increased temperatures affect human health and vulnerable groups including infants, children, the elderly and people with pre-existing diseases. In the southern African region climate models predict increases in ambient temperature twice that of the global average temperature increase. Poor ventilation and lack of air conditioning in primary health care clinics, where duration of waiting time may be as long as several hours, pose a possible threat to patients seeking primary health care. Drawing on information measured by temperature loggers installed in eight clinics in Giyani, Limpopo Province of South Africa, we were able to determine indoor temperatures of waiting rooms in eight rural primary health care facilities. Mean monthly temperature measurements inside the clinics were warmer during the summer months of December, January and February, and cooler during the autumn months of March, April and May. The highest mean monthly temperature of 31.4 ± 2.7 °C was recorded in one clinic during February 2016. Maximum daily indoor clinic temperatures exceeded 38 °C in some clinics. Indoor temperatures were compared to ambient (outdoor) temperatures and the mean difference between the two showed clinic waiting room temperatures were higher by 2-4 °C on average. Apparent temperature (AT) incorporating relative humidity readings made in the clinics showed 'realfeel' temperatures were >4 °C higher than measured indoor temperature, suggesting a feeling of 'stuffiness' and discomfort may have been experienced in the waiting room areas. During typical clinic operational hours of 8h00 to 16h00, mean ATs fell into temperature ranges associated with heat-health impact warning categories of 'caution' and 'extreme caution'.

  16. Restructuring primary care for performance improvement.

    Science.gov (United States)

    Fawcett, Kenneth J; Brummel, Stacy; Byrnes, John J

    2009-01-01

    Primary care practices can no longer consider ongoing quality assessment and management processes to be optional. There are ever-increasing demands from any number of interested parties for objectively measured proof of outcomes and quality of care. Primary Care Partners (PCP), a 16-site ambulatory affiliate of the Spectrum Health system in Grand Rapids, Michigan, began such a continuous quality improvement (CQI) effort in 2005. The intent was to develop an ongoing systematic process that would raise its performance potential and improve patient outcomes in the areas of chronic disease management and preventive services. This article describes the partnerships PCP established, specific benchmarks and measurements used, processes utilized, and results to date. This could be used as a roadmap for other primary care systems that are working to establish CQI in their daily operations.

  17. Multiple neoplasms, single primaries, and patient survival

    Directory of Open Access Journals (Sweden)

    Amer MH

    2014-03-01

    Full Text Available Magid H Amer Department of Medicine, St Rita's Medical Center, Lima, OH, USA Background: Multiple primary neoplasms in surviving cancer patients are relatively common, with an increasing incidence. Their impact on survival has not been clearly defined. Methods: This was a retrospective review of clinical data for all consecutive patients with histologically confirmed cancer, with emphasis on single versus multiple primary neoplasms. Second primaries discovered at the workup of the index (first primary were termed simultaneous, if discovered within 6 months of the index primary were called synchronous, and if discovered after 6 months were termed metachronous. Results: Between 2005 and 2012, of 1,873 cancer patients, 322 developed second malignancies; these included two primaries (n=284, and three or more primaries (n=38. Forty-seven patients had synchronous primaries and 275 had metachronous primaries. Patients with multiple primaries were predominantly of Caucasian ancestry (91.0%, with a tendency to develop thrombosis (20.2%, had a strong family history of similar cancer (22.3%, and usually presented with earlier stage 0 through stage II disease (78.9%. When compared with 1,551 patients with a single primary, these figures were 8.9%, 15.6%, 18.3%, and 50.9%, respectively (P≤0.001. Five-year survival rates were higher for metachronous cancers (95% than for synchronous primaries (59% and single primaries (59%. The worst survival rate was for simultaneous concomitant multiple primaries, being a median of 1.9 years. The best survival was for patients with three or more primaries (median 10.9 years and was similar to the expected survival for the age-matched and sex-matched general population (P=0.06991. Conclusion: Patients with multiple primaries are usually of Caucasian ancestry, have less aggressive malignancies, present at earlier stages, frequently have a strong family history of similar cancer, and their cancers tend to have indolent

  18. A comparison of research into cachexia, wasting and related skeletal muscle syndromes in three chronic disease areas.

    Science.gov (United States)

    Stewart Coats, Andrew J; Shewan, Louise G

    2017-05-15

    We compared the frequency of cancer, heart and lung related cachexia and cachexia-related research articles in the specialist journal, Journal of Cachexia, Sarcopenia and Muscle (JCSM) to those seen in a leading European journal in each specialist area during 2015 and 2016 to assess whether work on cachexia and related fields is relatively over or under represented in each specialist area. In the dedicated journal, Journal of Cachexia, Sarcopenia and Muscle, there were 44 references related to cancer, 5 related to respiratory disease, 5 related to heart failure, and 21 related to more than one of these chronic diseases. Despite this cancer preponderance, in the European Journal of Cancer in the two publication years, there were only 5 relevant publications (0.67% of the journal output), compared to 16 (1.41%) in the European Respiratory Journal and 10 (2.19%) in the European Journal of Heart Failure. There is considerable under-representation of cancer cachexia-related papers in the major European Cancer journal despite a high proportion in the dedicated cachexia journal. The under-representation is even more marked when expressed as a percentage, 0.67%, compared to 1.41% and 2.19% of the lung and heart journals respectively. These results are consistent with a worrying lack of interest in, or publication of, cachexia and related syndromes research in the cancer literature in Europe compared to its importance as a clinical syndrome. Greater interest is shown in lung and cardiology journals. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

  19. Health Service Areas (HSAs) - Small Area Estimates

    Science.gov (United States)

    Health Service Areas (HSAs) are a compromise between the 3000 counties and the 50 states. An HSA may be thought of as an area that is relatively self-contained with respect to hospital care and may cross over state boundries.

  20. Factors that influence the success of conservation programs in communal property areas in Mexico

    Directory of Open Access Journals (Sweden)

    Verónica Bunge-Vivier

    2017-03-01

    Full Text Available More than half of the natural vegetation in Mexico is managed collectively within common property systems. The appropriation and continuity of government programs related to the conservation of land that is communally used is proposed to depend on the level of organization of the communities and the interaction between the local and governmental institutions, as well as the benefits derived from conservation projects. Patterns of what drives the conservation of common natural resources were analyzed in order to propose improvements to conservation policy. Changes in primary and secondary vegetation cover in common and private properties were identified by performing a historical spatial analysis. Questionnaires were used to survey 32 populations of seven states of the Mexican Republic to determine the conservation status of common property resources, as well as the ability of the community to continue conservation activities initially undertaken by government programs. Some 53% of the primary and secondary vegetation in Mexico is found in common property areas, but the change from primary and secondary vegetation to other uses is the same for common and private property. Communities with a high level of conservation of communal areas and with the ability to continue conservation projects were those that had dedicated the areas to recreation and conservation, had stronger community organization and were less marginalized. A recognition of the heterogeneity of the socioeconomic and cultural context of communities with common property is necessary to design governmental conservation programs that achieve long-term conservation. To meet the needs of a region that is both degraded and marginalized, the creation of synergies between programs that combat poverty and programs that promote conservation is needed. In addition, the continuation of payments with public funds for work that preserves or rehabilitates natural areas is needed, thereby

  1. INCA project for investigation of primary cosmic radiation spectrum

    International Nuclear Information System (INIS)

    Aleksandrov, K.V.; Erlykin, A.D.; Zhdanov, G.B.

    2002-01-01

    The scientific purposes of the INCA project and application of the ionization-neutron calorimeter for direct measurements of the cosmic rays spectrum and composition in the knee area and the primary electrons spectrum by 10 14 - 10 13 eV are discussed. The new effective method for the primary electrons and protons separation with the complex rejection coefficient of 10 -5 - 10 -6 is proposed for studying the primary electrons spectrum by E e > 1 TeV. The experimental and calculation data are in good agreement [ru

  2. Primary production in the Kattegat - past and present

    DEFF Research Database (Denmark)

    Richardson, K.; Heilmann, Jens

    1995-01-01

    data collected during the period 1984-1993 are calculated using the method employed in the 1950s. It is concluded that primary production in the Kattegat has increased from less than 100 g C m(-2) y(- 1) to about 200 g C m(-2) y(-1) since the 1950s. This increase is not seen during the winter months...... to be responses to increases in primary production. However, for most areas, there are insufficient data to demonstrate whether or not increases in primary production have actually occurred. In this study, the evidence for increased primary production in the Kattegat is examined by comparing primary production...... measurements from the 1950s and measurements made in the period 1984-1993. The methods employed during the two periods differ considerably. These differences and how they may affect the validity of a comparison of the results from the studies carried out in two periods are addressed. The primary production...

  3. State Primary Stroke Center Policies in the US: Rural Health Issues.

    NARCIS (Netherlands)

    Slade, C.; O'Toole, Laurence J.; Rho, E.

    2012-01-01

    Objective: To explore the relationship between state primary stroke center (PSC) designation policy implementation and access to optimal stroke care for residents of rural areas. Materials and Methods: Primary data were collected during the period September 2008–August 2009. Following content

  4. External relations on the classroom: Experiences area Andina University Foundation

    Directory of Open Access Journals (Sweden)

    Belén Leal Hurtado

    2017-09-01

    Full Text Available This article is the result of a research project conducted in the academic context. Its aim was to analyze how the students of the Area Andina University Foundation conceive relations of friendship, relationships and management of conflicts outside the classroom. It was developed under a psychosocial approach of qualitative and exploratory, not comparative, type with application of the method of mixed focus groups with a population of 48 students, between 18 and 25 years, enrolled in the third semester of the Faculty of Health Sciences: Nursing, Respiratory Therapy Optometry programs and the School of Design, Communication and Fine Arts, with programs: Graphic Design, Fashion Design, Culinary and Gastronomy in Bogotá. It was divided in three investigation phases. The first phase is about, conceptual approach to the subject. The second phase is about, analysis and interpretation of results decanted through the voices of young people, determining the categories of friendship, family and conflict management. In the last phase, discussion, conclusions and recommendations.

  5. Lessons learnt from a primary care asthma improvement project.

    Science.gov (United States)

    Lenney, Warren; Clayton, Sadie; Gilchrist, Francis J; Price, David; Small, Iain; Smith, Judy; Sutton, Emma J

    2016-01-07

    Asthma is a very common disease that can occur at any age. In the UK and in many other countries it is mainly managed in primary care. The published evidence suggests that the key to improving diagnosis and management lies in better training and education rather than in the discovery of new medications. An asthma improvement project managed through the British Lung Foundation is attempting to do this. The project has three pilot sites: two in England supported by the Department of Health and one in Scotland supported by the Scottish Government. If the project is successful it will be rolled out to other health areas within the UK. The results of this project are not yet available. This article highlights the challenges encountered in setting up the project and may well be applicable to other areas in the UK and to other countries where similar healthcare systems exist. The encountered challenges reflect the complex nature of healthcare systems and electronic data capture in primary care. We discuss the differences between general practices in their ability and willingness to support the project, the training and education of their staff on asthma management, governance issues in relation to information technology systems, and the quality of data capture. Virtually all the challenges have now been overcome, but discussing them should ensure that others become aware of them at an early stage should they wish to undertake similar projects in the future.

  6. Evaluation of effectiveness and safety of a herbal compound in primary insomnia symptoms and sleep disturbances not related to medical or psychiatric causes.

    Science.gov (United States)

    Palmieri, Giancarlo; Contaldi, Paola; Fogliame, Giuseppe

    2017-01-01

    Sleep disturbances and related daytime activities impairment are common diseases nowadays. General practitioners are often the first health care professional asked to alleviate sleep disturbances and primary insomnia symptoms. Beyond a wide class of hypnotic drugs, botanicals can represent an alternative treatment for those kinds of symptoms. The scope of the present study is to evaluate safety and effectiveness of a herbal compound composed of valerian, hop, and jujube (Vagonotte ® ) on primary insomnia symptoms and sleep disturbances not related to medical or psychiatric causes. One hundred and twenty subjects with sleep disturbances symptoms were randomized in two branches of 60 persons each, receiving the herbal compound or placebo at dosage of two pills per day 30 minutes before their scheduled bedtime. All subjects were screened for precise items related to sleep quality and daytime activity at the beginning, after 10 days, and after 20 days of consecutive dietary supplement (or placebo) consumption. The participants remained blind to group assignment until all of them completed the trial. Sleep onset, numbers of nocturnal awakenings, and overall nocturnal slept time were assessed. A statistically significant difference between the two groups emerged. The group receiving the herbal compound showed a lower time of sleep onset compared to placebo group, the same result was obtained for total slept time and night awakenings frequency ( p Botanicals dietary supplement with relaxing and soothing properties can help practitioner to treat primary insomnia, especially when the risk/benefit profile of a patient does not sustain hypnotic drugs prescription. This clinical investigation on safety and effectiveness of a herbal compound made of valerian, hop, and jujube opens interesting perspectives on usage of herbal compound to manage primary insomnia. Further investigations could help in understanding herbal compounds' effectiveness on sleep disturbances.

  7. Cinema Sessions in Primary Care

    Directory of Open Access Journals (Sweden)

    Francisco Ignacio MORETA-VELAYOS

    2016-04-01

    Full Text Available For a long time films have been used in teaching and at various levels of professional training  and more specifically in the medical area. In this case, through the description of a project developed in a Primary Care Health Center, we intend to justify the use of movies as a tool that could ease, the sometimes difficult task of continued education among Primary Care professionals. We propose different aspects of everyday practice in which cinema can be potentially useful, as well as the way to include it in the Plan of Continued Education of the Centre and its accreditation.Films and issues discussed in each session, and the project evaluation, are detailed.

  8. Primary Breast Tuberculosis Presenting as a Lump: A Rare Modern ...

    African Journals Online (AJOL)

    mammary area. A 25. year.old female, presented with a lump in the breast and infra.mammary area. She was having off and on fever without any other complaints. There was no positive family history. Primary breast tuberculosis was diagnosed on fine ...

  9. How does transcranial DC stimulation of the primary motor cortex alter regional neuronal activity in the human brain?

    Science.gov (United States)

    Lang, Nicolas; Siebner, Hartwig R; Ward, Nick S; Lee, Lucy; Nitsche, Michael A; Paulus, Walter; Rothwell, John C; Lemon, Roger N; Frackowiak, Richard S

    2005-07-01

    Transcranial direct current stimulation (tDCS) of the primary motor hand area (M1) can produce lasting polarity-specific effects on corticospinal excitability and motor learning in humans. In 16 healthy volunteers, O positron emission tomography (PET) of regional cerebral blood flow (rCBF) at rest and during finger movements was used to map lasting changes in regional synaptic activity following 10 min of tDCS (+/-1 mA). Bipolar tDCS was given through electrodes placed over the left M1 and right frontopolar cortex. Eight subjects received anodal or cathodal tDCS of the left M1, respectively. When compared to sham tDCS, anodal and cathodal tDCS induced widespread increases and decreases in rCBF in cortical and subcortical areas. These changes in rCBF were of the same magnitude as task-related rCBF changes during finger movements and remained stable throughout the 50-min period of PET scanning. Relative increases in rCBF after real tDCS compared to sham tDCS were found in the left M1, right frontal pole, right primary sensorimotor cortex and posterior brain regions irrespective of polarity. With the exception of some posterior and ventral areas, anodal tDCS increased rCBF in many cortical and subcortical regions compared to cathodal tDCS. Only the left dorsal premotor cortex demonstrated an increase in movement related activity after cathodal tDCS, however, modest compared with the relatively strong movement-independent effects of tDCS. Otherwise, movement related activity was unaffected by tDCS. Our results indicate that tDCS is an effective means of provoking sustained and widespread changes in regional neuronal activity. The extensive spatial and temporal effects of tDCS need to be taken into account when tDCS is used to modify brain function.

  10. [Morbidity observed in a health area: Impact on professionals and funding].

    Science.gov (United States)

    de Miguel, Pablo; Caballero, Isabel; Rivas, Francisco Javier; Manera, Jaime; de Vicente, María Auxiliadora; Gómez, Ángel

    2015-05-01

    To analyze morbidity, in the context of a health area, and broken down by health centre, of patients who made contact with healthcare services, in order to propose an adjustment to finance the payment per capita. A descriptive study of morbidity observed in citizens assigned a health area during year 2010. SITE: Health Area 9. Autonomous Community of Madrid. Formed by the municipalities of Fuenlabrada, Humanes, and Moraleja de Enmedio. All levels of health care included. All citizens with health card assigned to a health center in the area who has maintained contact with the public health service's own area. Coded contact of patients are grouped using the Population Grouping Clinical Risk 3M TM Software (CRG). Each patient is included in a homogeneous and exclusive group with a numerical morbidity and clinical sense. Through the health card is known primary care centre, physician, age and sex. The distribution of morbidity is obtained by primary care centre, primary care physician, age and sex analyzing differences and combinations. It was found that the average values of the population morbidity are different in each primary care centre. In order to maintain the principle of equity in health care, it is suggested that an adjustment is made to the per capita payment based on the morbidity rate of the population. Copyright © 2013 Elsevier España, S.L.U. All rights reserved.

  11. Small-area Variation in Hypertension Prevalence among Black and White Medicaid Enrollees.

    Science.gov (United States)

    White, Kellee; Stewart, John E; Lòpez-DeFede, Ana; Wilkerson, Rebecca C

    2016-07-21

    To examine within-state geographic heterogeneity in hypertension prevalence and evaluate associations between hypertension prevalence and small-area contextual characteristics for Black and White South Carolina Medicaid enrollees in urban vs rural areas. Ecological. South Carolina, United States. Hypertension prevalence. Data representing adult South Carolina Medicaid recipients enrolled in fiscal year 2013 (N=409,907) and ZIP Code Tabulation Area (ZCTA)-level contextual measures (racial segregation, rurality, poverty, educational attainment, unemployment and primary care physician adequacy) were linked in a spatially referenced database. Optimized Getis-Ord hotspot mapping was used to visualize geographic clustering of hypertension prevalence. Spatial regression was performed to examine the association between hypertension prevalence and small-area contextual indicators. Significant (alpha=.05) hotspot spatial clustering patterns were similar for Blacks and Whites. Black isolation was significantly associated with hypertension among Blacks and Whites in both urban (Black, b=1.34, P<.01; White, b=.66, P<.01) and rural settings (Black, b=.71, P=.02; White, b=.70, P<.01). Primary care physician adequacy was associated with hypertension among urban Blacks (b=-2.14, P<.01) and Whites (b=-1.74, P<.01). The significant geographic overlap of hypertension prevalence hotspots for Black and White Medicaid enrollees provides an opportunity for targeted health intervention. Provider adequacy findings suggest the value of ACA network adequacy standards for Medicaid managed care plans in ensuring health care accessibility for persons with hypertension and related chronic conditions.

  12. Prevalence of geohelminth in soil and primary school children in ...

    African Journals Online (AJOL)

    A study of geohelminthes infections among primary school children aged 8 to 13 years was conducted in four selected primary schools in Panda Development Area, Karu LGA, Nasarawa State, Nigeria. Out of four hundred and eighty (480) soil samples collected from the four schools, 314 (82.63) were found to be positive ...

  13. Prevalence of stuttering in primary school children in Cairo-Egypt.

    Science.gov (United States)

    Abou Ella, Mahmoud; Saleh, Marwa; Habil, Ihab; El Sawy, Mohammed; El Assal, Lamia

    2015-01-01

    To determine the prevalence of stuttering among primary school children in Cairo. A cross-sectional design was employed. Using a multi-stage random sample from 10 schools in Cairo, a total of 8765 primary school students were enrolled in the study. The teacher referring method was initially used to detect stuttering students, which was then confirmed by a Speech Language Pathologist (SLP) using Diagnostic and Statistical Manual for Mental Disorders-Fourth Edition (DSM-IV) criteria. Personal data were collected for all students and separate questionnaires were administered to the parents of each stuttering child, inquiring about consanguinity, family history, presence of other disorders and family attitudes towards the child. Prevalence of stuttering among primary school children in Cairo was 1.03%. The prevalence of stuttering showed a declining trend in the older age group. Stuttering was 7-fold more prevalent among left-handed students. Males had a higher prevalence of stuttering, but didn't reach statistical significance. Anxiety was expressed in 25% of the families of affected children. Positive family history was found in 28% of cases, mainly among first-degree relatives. The current study showed a prevalence of stuttering comparable to other areas of the world with some evidence of hereditary background, although lower than that reported by other studies.

  14. Tracing trade-related telecouplings in the global land-system using the embodied human appropriation of net primary production framework

    Science.gov (United States)

    Haberl, H.; Kastner, T.; Schaffartzik, A.; Erb, K. H.

    2015-12-01

    Global land-system change is influenced by a complex set of drivers that transcend spatial, institutional and temporal scales. The notion of "telecouplings" is gaining importance in Land System Science as a framework to address that complexity of drivers. One of them is the trade in land-based products, which forges connections between different geographic regions. Trade in land-based products is growing rapidly, thereby creating an increasing spatial disconnect between the locations where primary products (e.g. crops, fodder or timber) are grown and harvested and where the related environmental pressures occur, and the locations where final products (e.g. food, fiber or bioenergy) are consumed. Governing land-related sustainability issues such as GHG emissions or pressures on biodiversity and ecosystems related with land-use changes requires information on trade-related telecouplings, e.g. in order to avoid leakage effects. However, tracing land use (change) related with flows of traded products is challenging, among others due to (a) the lack of easily implementable metrics to account for differences in land quality and land-use intensity, and (b) the lack of satisfactory methods to allocate land to products that are traded and consumed. Drawing from a database derived from FAO statistics that allows tracing bilateral trade flows between ~200 countries at a resolution of ~500 products for the time period 1986-2006, this presentation will discuss how the framework of embodied human appropriation of net primary production (eHANPP) can help tackling these difficult issues. The HANPP framework allows to consistently represent important aspects of land quality and land-use intensity, e.g. natural productivity potential or land-use efficiency. In terms of allocation of land to products, eHANPP is a factor-based approach, and the presentation will discuss differences to alternative methods such as environmentally extended input-output analysis. We will use the available

  15. An improved model of heat-induced hyperalgesia--repetitive phasic heat pain causing primary hyperalgesia to heat and secondary hyperalgesia to pinprick and light touch.

    Science.gov (United States)

    Jürgens, Tim P; Sawatzki, Alexander; Henrich, Florian; Magerl, Walter; May, Arne

    2014-01-01

    This study tested a modified experimental model of heat-induced hyperalgesia, which improves the efficacy to induce primary and secondary hyperalgesia and the efficacy-to-safety ratio reducing the risk of tissue damage seen in other heat pain models. Quantitative sensory testing was done in eighteen healthy volunteers before and after repetitive heat pain stimuli (60 stimuli of 48°C for 6 s) to assess the impact of repetitive heat on somatosensory function in conditioned skin (primary hyperalgesia area) and in adjacent skin (secondary hyperalgesia area) as compared to an unconditioned mirror image control site. Additionally, areas of flare and secondary hyperalgesia were mapped, and time course of hyperalgesia determined. After repetitive heat pain conditioning we found significant primary hyperalgesia to heat, and primary and secondary hyperalgesia to pinprick and to light touch (dynamic mechanical allodynia). Acetaminophen (800 mg) reduced pain to heat or pinpricks only marginally by 11% and 8%, respectively (n.s.), and had no effect on heat hyperalgesia. In contrast, the areas of flare (-31%) and in particular of secondary hyperalgesia (-59%) as well as the magnitude of hyperalgesia (-59%) were significantly reduced (all pheat pain induces significant peripheral sensitization (primary hyperalgesia to heat) and central sensitization (punctate hyperalgesia and dynamic mechanical allodynia). These findings are relevant to further studies using this model of experimental heat pain as it combines pronounced peripheral and central sensitization, which makes a convenient model for combined pharmacological testing of analgesia and anti-hyperalgesia mechanisms related to thermal and mechanical input.

  16. An Improved Model of Heat-Induced Hyperalgesia—Repetitive Phasic Heat Pain Causing Primary Hyperalgesia to Heat and Secondary Hyperalgesia to Pinprick and Light Touch

    Science.gov (United States)

    Henrich, Florian; Magerl, Walter; May, Arne

    2014-01-01

    This study tested a modified experimental model of heat-induced hyperalgesia, which improves the efficacy to induce primary and secondary hyperalgesia and the efficacy-to-safety ratio reducing the risk of tissue damage seen in other heat pain models. Quantitative sensory testing was done in eighteen healthy volunteers before and after repetitive heat pain stimuli (60 stimuli of 48°C for 6 s) to assess the impact of repetitive heat on somatosensory function in conditioned skin (primary hyperalgesia area) and in adjacent skin (secondary hyperalgesia area) as compared to an unconditioned mirror image control site. Additionally, areas of flare and secondary hyperalgesia were mapped, and time course of hyperalgesia determined. After repetitive heat pain conditioning we found significant primary hyperalgesia to heat, and primary and secondary hyperalgesia to pinprick and to light touch (dynamic mechanical allodynia). Acetaminophen (800 mg) reduced pain to heat or pinpricks only marginally by 11% and 8%, respectively (n.s.), and had no effect on heat hyperalgesia. In contrast, the areas of flare (−31%) and in particular of secondary hyperalgesia (−59%) as well as the magnitude of hyperalgesia (−59%) were significantly reduced (all pheat pain induces significant peripheral sensitization (primary hyperalgesia to heat) and central sensitization (punctate hyperalgesia and dynamic mechanical allodynia). These findings are relevant to further studies using this model of experimental heat pain as it combines pronounced peripheral and central sensitization, which makes a convenient model for combined pharmacological testing of analgesia and anti-hyperalgesia mechanisms related to thermal and mechanical input. PMID:24911787

  17. Verbal communication among Alzheimer's disease patients, their caregivers, and primary care physicians during primary care office visits.

    Science.gov (United States)

    Schmidt, Karen L; Lingler, Jennifer H; Schulz, Richard

    2009-11-01

    Primary care visits of patients with Alzheimer's disease (AD) often involve communication among patients, family caregivers, and primary care physicians (PCPs). The objective of this study was to understand the nature of each individual's verbal participation in these triadic interactions. To define the verbal communication dynamics of AD care triads, we compared verbal participation (percent of total visit speech) by each participant in patient/caregiver/PCP triads. Twenty-three triads were audio taped during a routine primary care visit. Rates of verbal participation were described and effects of patient cognitive status (MMSE score, verbal fluency) on verbal participation were assessed. PCP verbal participation was highest at 53% of total visit speech, followed by caregivers (31%) and patients (16%). Patient cognitive measures were related to patient and caregiver verbal participation, but not to PCP participation. Caregiver satisfaction with interpersonal treatment by PCP was positively related to caregiver's own verbal participation. Caregivers of AD patients and PCPs maintain active, coordinated verbal participation in primary care visits while patients participate less. Encouraging verbal participation by AD patients and their caregivers may increase the AD patient's active role and caregiver satisfaction with primary care visits.

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

    Directory of Open Access Journals (Sweden)

    Konôpka Bohdan

    2015-09-01

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

  19. Carbon Capture Methods and Relative Competitiveness of Primary Energies

    International Nuclear Information System (INIS)

    Amigues, Jean-Pierre; Lafforgue, Gilles; Moreaux, Michel

    2016-01-01

    We characterise the optimal exploitation paths of two primary energies (coal and solar) that supply the energy needs of two sectors. Sector 1 can reduce its carbon emissions at a reasonable cost thanks to a CCS device. Sector 2 has access only to air capture technology, but at a significantly higher cost. We assume that the atmospheric carbon stock cannot exceed a given ceiling. We show that the optimal approach consists in, first, fully capturing sector-1 emissions before the ceiling is reached and, second, deploying air capture to partially abate sector-2 emissions. The optimal carbon tax should increase in the pre-ceiling phase then decline in stages to zero

  20. Outcomes from the regional Co-operation in the Area of the Safety Analysis Methodology

    International Nuclear Information System (INIS)

    D'Auria, F.; Mavko, B.; Prosek, A.; Debrecin, N.; Bajs, T.

    2000-01-01

    International Atomic Energy Agency (IAEA) carried out the Co-ordinated Research Program (CRP) ON V alidation of Accident and Safety Analysis Methodology'' in the period between 1995 and 1998. Three areas of interest identified by the participants referred to the pressurised water reactors of Western and Eastern type (PWR and WWER type). The specific areas of attention were: system behaviour of the primary and secondary loops (PS area), the containment response (CO area) and the severe accidents (SA area). During the CRP it became clear that the technology advancements, the available tools (i.e. codes) and the experimental databases in the above areas are quite different. At the conclusion of the CRP, all objectives of the program have been reached. This paper presents the summary of the regional co-operation in this framework. The CRP activities focused on the codes and expertise available at the participating organisations. This overview therefore summarises their experience related to the state-of-the-art in the field of computational accident analysis. In addition, the paper proposes the recommendations for future activities related to the code usage, the user effects and code development. In pursuing of these goals special attention is given to the importance of the international co-operation. (author)