WorldWideScience

Sample records for primary factor driving

  1. Factors That Drive Youth Specialization.

    Science.gov (United States)

    Padaki, Ajay S; Popkin, Charles A; Hodgins, Justin L; Kovacevic, David; Lynch, Thomas Sean; Ahmad, Christopher S

    Specialization in young athletes has been linked to overuse injuries, burnout, and decreased satisfaction. Despite continued opposition from the medical community, epidemiological studies suggest the frequency is increasing. Extrinsic pressures in addition to individual aspirations drive this national trend in sports specialization. Descriptive epidemiology study. Level 3. A novel instrument assessing the driving factors behind youth specialization was generated by an interdisciplinary team of medical professionals. Surveys were administered to patients and athletes in the department's sports medicine clinic. The survey was completed by 235 athletes between 7 and 18 years of age, with a mean age of 13.8 ± 3.0 years. Athletes specialized at a mean age of 8.1 years, and 31% of athletes played a single sport while 58% played multiple sports but had a preferred sport. More than 70% of athletes had collegiate or professional ambitions, and 60% played their primary sport for 9 or more months per year, with players who had an injury history more likely to play year-round ( P specialized athletes reporting this significantly more often ( P = 0.04). Half of the athletes reported that sports interfered with their academic performance, with older players stating this more frequently ( P specializing in a single sport before starting high school. While intrinsic drive may identify healthy aspirations, extrinsic influences are prevalent in specialized athletes. Extrinsic factors contributing to youth specialization were identified and compounded the deleterious sequelae of youth athlete specialization.

  2. Short-term to seasonal variability in factors driving primary productivity in a shallow estuary: Implications for modeling production

    Science.gov (United States)

    Canion, Andy; MacIntyre, Hugh L.; Phipps, Scott

    2013-10-01

    The inputs of primary productivity models may be highly variable on short timescales (hourly to daily) in turbid estuaries, but modeling of productivity in these environments is often implemented with data collected over longer timescales. Daily, seasonal, and spatial variability in primary productivity model parameters: chlorophyll a concentration (Chla), the downwelling light attenuation coefficient (kd), and photosynthesis-irradiance response parameters (Pmchl, αChl) were characterized in Weeks Bay, a nitrogen-impacted shallow estuary in the northern Gulf of Mexico. Variability in primary productivity model parameters in response to environmental forcing, nutrients, and microalgal taxonomic marker pigments were analysed in monthly and short-term datasets. Microalgal biomass (as Chla) was strongly related to total phosphorus concentration on seasonal scales. Hourly data support wind-driven resuspension as a major source of short-term variability in Chla and light attenuation (kd). The empirical relationship between areal primary productivity and a combined variable of biomass and light attenuation showed that variability in the photosynthesis-irradiance response contributed little to the overall variability in primary productivity, and Chla alone could account for 53-86% of the variability in primary productivity. Efforts to model productivity in similar shallow systems with highly variable microalgal biomass may benefit the most by investing resources in improving spatial and temporal resolution of chlorophyll a measurements before increasing the complexity of models used in productivity modeling.

  3. Factors Driving Business Intelligence Culture

    Directory of Open Access Journals (Sweden)

    Rimvydas Skyrius

    2016-05-01

    Full Text Available The field of business intelligence (BI, despite rapid technology advances, continues to feature inadequate levels of adoption. The attention of researchers is shifting towards hu-man factors of BI adoption. The wide set of human factors influencing BI adoption con-tains elements of what we call BI culture – an overarching concept covering key managerial issues that come up in BI implementation. Research sources provide different sets of features pertaining to BI culture or related concepts – decision-making culture, analytical culture and others. The goal of this paper is to perform the review of research and practical sources to examine driving forces of BI – data-driven approaches, BI agility, maturity and acceptance – to point out culture-related issues that support BI adoption and to suggest an emerging set of factors influencing BI culture.

  4. Factors driving the spatial layout of distribution channels

    NARCIS (Netherlands)

    Onstein, A.T.C.; Ektesaby, M.; Rezaei, J.; Tavasszy, L.A.; van Damme, D.A.

    2017-01-01

    Research statement Our study analyses the factors that drive decision-making on distribution structures, including the layout of distribution channels and the locations of distribution centres. Distribution is a primary firm activity, which strongly influences logistics costs and logistics

  5. Sustainable Innovation - Driving Factors in Large Firms

    OpenAIRE

    Alderin, Clara; Do, Thao

    2016-01-01

    During recent years, there has been a growing interest in sustainable innovation both in academia and in practice. Our qualitative, multiple case study examines this emerging field in the context of large firms. By doing so, this thesis contributes to the understanding of the concept as well as the underlying factors driving sustainable innovation. Theory highlighted both external and internal factors in firms’ sustainable innovation engagement. The empirical evidence identifies five key fact...

  6. Factors affecting self-regulatory driving practices among older adults.

    Science.gov (United States)

    Molnar, Lisa J; Charlton, Judith L; Eby, David W; Langford, Jim; Koppel, Sjaan; Kolenic, Giselle E; Marshall, Shawn

    2014-01-01

    The primary objective of this study was to better understand how self-regulatory driving practices at multiple levels of driver decision making are influenced by various factors. Specifically, the study investigated patterns of tactical and strategic self-regulation among a sample of 246 Australian older drivers. Of special interest was the relative influence of several variables on the adoption of self-regulation, including self-perceptions of health, functioning, and abilities for safe driving and driving confidence and comfort. The research was carried out at the Monash University Accident Research Centre, as part of its Ozcandrive study, a partnership with the Canadian Driving Research Initiative for Vehicular Safety in the Elderly (Candrive), and in conjunction with the University of Michigan Transportation Research Institute (UMTRI). Candrive/Ozcandrive represents the first study to follow a large group of older drivers over several years and collect comprehensive self-reported and objectively derived data on health, functioning, and driving. This study used a subset of data from the Candrive/Ozcandrive study. Upon enrolling in the study, participants underwent a comprehensive clinical assessment during which data on visual, cognitive, and psychomotor functioning were collected. Approximately 4 months after study enrollment, participants completed the Advanced Driving Decisions and Patterns of Travel (ADDAPT) questionnaire, a computer-based self-regulation instrument developed and pilot-tested at UMTRI. Self-regulation among older adults was found to be a multidimensional concept. Rates of self-regulation were tied closely to specific driving situations, as well as level of decision making. In addition, self-regulatory practices at the strategic and tactical levels of decision making were influenced by different sets of factors. Continuing efforts to better understand the self-regulatory practices of older drivers at multiple levels of driver performance and

  7. Driving automation forward : human factors for limited-ability autonomous driving systems.

    Science.gov (United States)

    2010-01-01

    Over the past 100 years, there has been a : steady progression of innovations that : enhance the driving experience, in particular : the continuing trend toward automating more : driving tasks. Human Factors for Limited-Ability : Autonomous Drivin...

  8. Treeline advance - driving processes and adverse factors

    Directory of Open Access Journals (Sweden)

    F.-K. Holtmeier

    2007-06-01

    Full Text Available The general trend of climatically-driven treeline advance is modified by regional, local and temporal variations. Treelines will not advance in a closed front parallel to the shift of any isotherm to higher elevations and more northern latitudes. The effects of varying topography on site conditions and the after-effects of historical disturbances by natural and anthropogenic factors may override the effects of slightly higher average temperatures. Moreover, the varying treeline-forming species respond in different ways to a changing climate. Forest advance upwards and northwards primarily depends on successful regeneration and survival of young growth rather than on increasing growth rates of mature trees. Every assessment of treeline response to future climate change must consider the effects of local site conditions and feedbacks of in-creasing tree population in modulating the climatically-driven change. Treeline-shift will influence regional and local climates, pedogenesis, plant communities, animal populations and biodiversity as well as having a considerable effect on economic changes in primary production. A better understanding of the functional relationships between the many treeline-relevant factors and treeline dynamics can be achieved only by extensive research at different scales within different climatic regions supported by as many as possible experimental studies in the field together with laboratory and remote sensing techniques.

  9. PMBLDC motor drive with power factor correction controller

    DEFF Research Database (Denmark)

    George, G.J.; Ramachandran, Rakesh; Arun, N.

    2012-01-01

    reliability, and low maintenance requirements. The proposed Power Factor Controller topology improves power quality by improving performance of PMBLDCM drive, such as reduction of AC main current harmonics, near unity power factor. PFC converter forces the drive to draw sinusoidal supply current in phase...

  10. Dialling and driving: factors influencing intentions to use a mobile phone while driving.

    Science.gov (United States)

    Walsh, Shari P; White, Katherine M; Hyde, Melissa K; Watson, Barry

    2008-11-01

    Despite being identified as an unsafe (and, in some jurisdictions, illegal) driving practice, the psychological factors underlying people's decision to use their mobile phone while driving have received little attention. The present study utilised the theory of planned behaviour (TPB) to examine the role of attitudes, norms, control factors, and risk perceptions, in predicting people's intentions to use their mobile phone while driving. We examined the predictors of intentions to use a mobile phone while driving in general, and for calling and text messaging in 4 scenarios differing in descriptions of vehicle speed and time pressure. There was some support for the TPB given that attitudes consistently predicted intentions to drive while using a mobile phone and that pressure from significant others (norms) determined some phone use while driving intentions, although less support was found for the role of perceptions of control. Risk was not generally predictive of safer driving intentions. These findings indicate that different factors influence each form of mobile phone use while driving and, hence, a multi-strategy approach is likely to be required to address the issue.

  11. Automobile driving in older adults: factors affecting driving restriction in men and women.

    Science.gov (United States)

    Marie Dit Asse, Laetitia; Fabrigoule, Colette; Helmer, Catherine; Laumon, Bernard; Lafont, Sylviane

    2014-11-01

    To identify factors associated with driving restriction in elderly men and women. Prospective cohort study of French drivers from 2003 to 2009. The Three-City Cohort of Bordeaux, a prospective study of 2,104 people aged 65 and older. Five hundred twenty-three drivers with a mean age of 76 (273 male, 250 female). Sociodemographic characteristics, driving habits, health variables, cognitive evaluation and dementia diagnosis. Predementia was defined as no dementia at one follow-up and dementia at the next follow-up. Over the 6-year period, 54% of men and 63% of women stopped driving or reduced the distance they drove. Predementia, Parkinson's disease, older age, and a high number of kilometers previously driven were common restriction factors in both sexes. Prevalent dementia, depressive symptomatology, a decline in one or more instrumental activities of daily living, and poor visual working memory were specific factors in men. In women, low income, fear of falling, slow processing speed, and severe decline in global cognitive performance all affected driving restriction. Older women restricted their driving activity more than older men, regardless of the number of kilometers previously driven, physical health, and cognitive status. Factors affecting driving restriction differed according to sex, and women were more likely to stop driving than men in the period preceding a dementia diagnosis. © 2014, Copyright the Authors Journal compilation © 2014, The American Geriatrics Society.

  12. Exodus of male physicians from primary care drives shift to specialty practice.

    Science.gov (United States)

    Tu, Ha T; O'Malley, Ann S

    2007-06-01

    An exodus of male physicians from primary care is driving a marked shift in the U.S. physician workforce toward medical-specialty practice, according to a national study by the Center for Studying Health System Change (HSC). Two factors have helped mask the severity of the shift--a growing proportion of female physicians, who disproportionately choose primary care, and continued reliance on international medical graduates (IMGs), who now account for nearly a quarter of all U.S. primary care physicians. Since 1996-97, a 40 percent increase in the female primary care physician supply has helped to offset a 16 percent decline in the male primary care physician supply relative to the U.S. population. At the same time, primary care physicians' incomes have lost ground to both inflation and medical and surgical specialists' incomes. And women in primary care face a 22 percent income gap relative to men, even after accounting for differing characteristics. If real incomes for primary care physicians continue to decline, there is a risk that the migration of male physicians will intensify and that female physicians may begin avoiding primary care--trends that could aggravate a predicted shortage of primary care physicians.

  13. Factors driving physician-hospital alignment in orthopaedic surgery.

    Science.gov (United States)

    Page, Alexandra E; Butler, Craig A; Bozic, Kevin J

    2013-06-01

    The relationships between physicians and hospitals are viewed as central to the proposition of delivering high-quality health care at a sustainable cost. Over the last two decades, major changes in the scope, breadth, and complexities of these relationships have emerged. Despite understanding the need for physician-hospital alignment, identification and understanding the incentives and drivers of alignment prove challenging. Our review identifies the primary drivers of physician alignment with hospitals from both the physician and hospital perspectives. Further, we assess the drivers more specific to motivating orthopaedic surgeons to align with hospitals. We performed a comprehensive literature review from 1992 to March 2012 to evaluate published studies and opinions on the issues surrounding physician-hospital alignment. Literature searches were performed in both MEDLINE(®) and Health Business™ Elite. Available literature identifies economic and regulatory shifts in health care and cultural factors as primary drivers of physician-hospital alignment. Specific to orthopaedics, factors driving alignment include the profitability of orthopaedic service lines, the expense of implants, and issues surrounding ambulatory surgery centers and other ancillary services. Evolving healthcare delivery and payment reforms promote increased collaboration between physicians and hospitals. While economic incentives and increasing regulatory demands provide the strongest drivers, cultural changes including physician leadership and changing expectations of work-life balance must be considered when pursuing successful alignment models. Physicians and hospitals view each other as critical to achieving lower-cost, higher-quality health care.

  14. Analysis of Key Factors Driving Japan’s Military Normalization

    Science.gov (United States)

    2017-09-01

    no change to our policy of not giving in to terrorism.”40 Though the prime minister was democratically supported, Koizumi’s leadership style took...of the key driving factors of Japan’s normalization. The areas of prime ministerial leadership , regional security threats, alliance issues, and...analysis of the key driving factors of Japan’s normalization. The areas of prime ministerial leadership , regional security threats, alliance issues, and

  15. Factor Driving Consumer Intention in Online Shopping

    OpenAIRE

    Wanida Suwunniponth

    2014-01-01

    The objectives of this research paper was to study the influencing factors that contributed the willingness of consumers to purchase products online included quality of website, perceived ease of use, perceived usefulness, trust on online purchases, attitude towards online shopping and intentions to online purchases. The research was conducted in both quantitative and qualitative methods, by utilizing both questionnaire and in-depth interview. A questionnaire was used to collect data from 350...

  16. Factors affecting return to driving post-stroke.

    LENUS (Irish Health Repository)

    Tan, K M

    2012-02-01

    BACKGROUND: Stroke can affect a person\\'s ability to drive, an important means of transportation in the developed world. AIMS: To determine percentage of patients and factors associated with return to driving post-stroke in a service with emphasis on driver assessment. METHODS: Retrospective study of patients discharged from the Stroke Service of our 470-bed teaching hospital from 1998 to 2002. RESULTS: Of 72 drivers pre-stroke, 54% recalled a driving assessment and 68% returned to driving. Younger patients (58.6 +\\/- 12.0 vs. 66.5 +\\/- 10.5, p = 0.008) with lower Modified Rankin Score (median 1 vs. 2, p = 0.0001) and normal cognition (55 vs. 43%, p = 0.45) were more likely to resume driving. More patients who were assessed returned to driving than those who were not (74 vs. 61%, p = 0.31). CONCLUSIONS: A relatively high level of return to driving can be achieved post-stroke with a pro-active approach to driver assessment and rehabilitation. A structured assessment and referral programme should be offered where appropriate.

  17. Embryonic transcription factor SOX9 drives breast cancer endocrine resistance.

    Science.gov (United States)

    Jeselsohn, Rinath; Cornwell, MacIntosh; Pun, Matthew; Buchwalter, Gilles; Nguyen, Mai; Bango, Clyde; Huang, Ying; Kuang, Yanan; Paweletz, Cloud; Fu, Xiaoyong; Nardone, Agostina; De Angelis, Carmine; Detre, Simone; Dodson, Andrew; Mohammed, Hisham; Carroll, Jason S; Bowden, Michaela; Rao, Prakash; Long, Henry W; Li, Fugen; Dowsett, Mitchell; Schiff, Rachel; Brown, Myles

    2017-05-30

    The estrogen receptor (ER) drives the growth of most luminal breast cancers and is the primary target of endocrine therapy. Although ER blockade with drugs such as tamoxifen is very effective, a major clinical limitation is the development of endocrine resistance especially in the setting of metastatic disease. Preclinical and clinical observations suggest that even following the development of endocrine resistance, ER signaling continues to exert a pivotal role in tumor progression in the majority of cases. Through the analysis of the ER cistrome in tamoxifen-resistant breast cancer cells, we have uncovered a role for an RUNX2-ER complex that stimulates the transcription of a set of genes, including most notably the stem cell factor SOX9, that promote proliferation and a metastatic phenotype. We show that up-regulation of SOX9 is sufficient to cause relative endocrine resistance. The gain of SOX9 as an ER-regulated gene associated with tamoxifen resistance was validated in a unique set of clinical samples supporting the need for the development of improved ER antagonists.

  18. Factors associated with young adults delaying and forgoing driving licenses: results from Britain.

    Science.gov (United States)

    Le Vine, Scott; Polak, John

    2014-01-01

    To identify the reasons that young adults (age 17-29) in Britain delay or forgo driving license acquisition. Using year 2010 British National Travel Survey microdata, we first analyze self-reported reasons (including their prioritisation) for not holding a full car driving license and then estimate a logistic regression model for license-holding to investigate additional factors, several of which extend from previous studies. This study also employs a novel segmentation approach to analyze the sets of reasons that individual young adults cite for not driving. These results show that, despite the lack of a graduated driving license system at present, many young adults indicate that issues associated with the driving license acquisition process are the main reason they do not hold a full driving license. About 3 in 10 young adults can be interpreted as not viewing driving as a priority, though half of those without a license are either learning to drive or are deterred principally by the cost of learning. We calculate that after their 17th birthday (the age of eligibility for a full driving license) young adults spend a mean of 1.7 years learning to drive. Young adults citing the costs of insurance or car purchase are likely to cite them as secondary rather than the main reason for not driving, whereas those citing physical/health difficulties are very likely to cite this as the main reason they do not drive. Two distinct groups of young people are identified that both indicate that costs deter them from driving-one group that is less well off financially and that indicates that costs alone are the primary deterrent and one that reports that other reasons also apply and is better off. Status as an international migrant was found to be an important factor, net of confounding variables, for identifying that a young adult in Britain does not hold a driving license. Further research is needed to understand the relative saliency of plausible causal mechanisms for this

  19. Japanese customer service culture and driving factors behind it

    OpenAIRE

    Perolainen, Emma

    2014-01-01

    The subject of the thesis was Japanese customer service culture and the driving factors behind it. Fons Trompenaars’ and Geert Hofstedes culture studies were handled as the main part of the theoretical part of the thesis, which of only the applicable factors were introduced. The applicable factors were Trompenaars’ universal-ism/particularism, individualism/communitarianism, neutral/emotional, specific/diffuse and attitudes to environment and Hofstede’s individualism/collectivism, masculinity...

  20. [Role of some psycho-physiological factors on driving safety].

    Science.gov (United States)

    Bergomi, M; Vivoli, G; Rovesti, S; Bussetti, P; Ferrari, A; Vivoli, R

    2010-01-01

    Within a research project on the role played by human factors on road accidents, the aim of the present study is to evaluate, in young adults, the relationships between driver behaviour and personality factors as well as to assess the neuroendocrine correlates of psychological and behavioural factors investigated. Another aim is to estimate in what measure the performance levels are affected by demographic, psychological and chronobiological variables. It has been found a positive relation between highway code violations, extroversion trait of personality and Sensation Seeking scores, so confirming that this component of personality can affect risky behaviour. Furthermore the subjects more oriented to morningness chronotype were found to be prone to adopt safe driving behaviour. Regarding the relations of the neuroendocrine parameters and driving behaviour a positive correlation was observed between dopamine levels and frequency of driving violations while a negative relationship was found between adrenaline levels and frequency of driving errors. In conclusion the identification of psycho-physiological variables related to driving risky behaviour might be a useful instrument to design traffic safety programs tailored to high risk subjects.

  1. Factors That Drive RTO Performance: An Overview. Synthesis Report

    Science.gov (United States)

    Misko, Josie

    2017-01-01

    This paper provides an overview of recent research on the factors that drive the performance of registered training organisations (RTOs), with a view to identifying areas for future research. Initially it explores the drivers of RTO performance; then discusses findings from available literature from Australia and from overseas, and discusses some…

  2. Recruitment of bloom-forming cyanobacteria and its driving factors ...

    African Journals Online (AJOL)

    Based on most of the literature, this paper reviewed the progress made in following aspects: cognition to cyanobacteria recruitment, various traps for studying cyanobacteria recruitment in lakes, recruitment patterns of some species of cyanobacteria, and the driving factors for recruitment. Additionally, perspective studies of ...

  3. Revealing driving factors of China's PM2.5 pollution

    Science.gov (United States)

    Zheng, Y.; Zhao, H.; Zhang, Q.; Geng, G.; Tong, D.; Peng, L.; He, K.

    2017-12-01

    China's rapid economic development and intensive energy consumption are deteriorating the air quality significantly. Understanding the key driving factors behind China's growing emissions of air pollutants and the accompanying PM2.5 pollution is critical for the development of China's clean air policies and also provides insight into how other emerging economies may develop a clear sky future. Here we reveal the socioeconomic drivers of the variations of China's PM2.5 concentrations during 2002-2012 by using an interdisciplinary framework that integrates an emission inventory model, an index decomposition analysis model, and a regional air quality model. The decomposition results demostrate that the improvements in emission efficiency and energy efficiency failed to offset the increased emissions of both primary PM2.5 and gaseous PM2.5 precursors (including SO2 NOx, and volatile organic compounds) triggered by the surging economic growth during 2002-2012. During the same time, the effects of energy structure, production structure and population growth were relatively less significant to all pollutants, which indicates the potential of large emission abatements through energy structure and production structure adjustment. Sensitivity simulations by the air quality model based on the provincial decomposition results also show that the economic growth have outpaced efficiency improvements in the increments of PM2.5 concentrations during the study years. As China continues to develop rapidly, future policies should promote further improvements in efficiency and accelerate the adjustments toward clean energy and production structures, which are critical for reducing China's emissions and alleviating the severe PM2.5 pollution.

  4. Factors influencing the control strategy of hybrid drive of urban public transport buses

    International Nuclear Information System (INIS)

    Barta, Dalibor; Mruzek, Martin

    2015-01-01

    The efficiency of each drives is dependent on many factors. Hybrid drives and specially the drives of urban public transport may be affected by other factors given by transport infrastructure or operational conditions. These factors condition the suitable configuration of the individual elements of hybrid drive and the establishment of good control strategy of such drive. The study of influencing factors of the control strategy is the aim of this paper. (full text)

  5. Exploring the Driving Factors of Construction Industrialization Development in China

    Directory of Open Access Journals (Sweden)

    Xiaer Xiahou

    2018-03-01

    Full Text Available Construction industrialization (CI has been adopted worldwide because of its potential benefits. However, current research shows the incentives for adopting CI may differ in different regions. While the promotion of CI in China is still at the initial stage, a systematical analysis of the driving factors would help decision makers get a comprehensive understanding of CI development and select proper strategies to promote CI. This research combines qualitative and quantitative methods to explore the construction industrialization driving factors (CIDFs in China. The grounded theory method (GTM was employed to explore CI concepts among 182 CI-related articles published in 10 top-tier journals from 2000 to 2017. A total of 15 CIDFs were identified, including one suggested by professionals during a pre-test questionnaire survey. The analysis showed that the development of CI in China is pushed by macrodevelopment and pulled by the government and is also a self-driven process. The major driving factors for CI adoption in China are the transformation and upgrade of the conventional construction industry and the solution of development dilemmas. Our study also suggests that pilot programs are, currently, the most effective method to promote CI in China and to accumulate experience so to gain recognition by the society. This research is also of value for CI promotion in other developing countries.

  6. Exploring the Driving Factors of Construction Industrialization Development in China

    Science.gov (United States)

    Xiahou, Xiaer; Yuan, Jingfeng; Tang, Yuchun; Li, Qiming

    2018-01-01

    Construction industrialization (CI) has been adopted worldwide because of its potential benefits. However, current research shows the incentives for adopting CI may differ in different regions. While the promotion of CI in China is still at the initial stage, a systematical analysis of the driving factors would help decision makers get a comprehensive understanding of CI development and select proper strategies to promote CI. This research combines qualitative and quantitative methods to explore the construction industrialization driving factors (CIDFs) in China. The grounded theory method (GTM) was employed to explore CI concepts among 182 CI-related articles published in 10 top-tier journals from 2000 to 2017. A total of 15 CIDFs were identified, including one suggested by professionals during a pre-test questionnaire survey. The analysis showed that the development of CI in China is pushed by macrodevelopment and pulled by the government and is also a self-driven process. The major driving factors for CI adoption in China are the transformation and upgrade of the conventional construction industry and the solution of development dilemmas. Our study also suggests that pilot programs are, currently, the most effective method to promote CI in China and to accumulate experience so to gain recognition by the society. This research is also of value for CI promotion in other developing countries. PMID:29510507

  7. Factors influencing the prevalence of primary dysmenorrhoea ...

    African Journals Online (AJOL)

    ... of primary dysmenorrhoea amongst Abia State university medical students, South ... its impact on school and social activities and the students' management strategies. ... is high, and not consistently associated with demographic risk factors.

  8. Predictive Reliability Assessment of the Automatic Clutch on a Primary Sodium Pump Drive

    International Nuclear Information System (INIS)

    Westwell, P.

    1975-01-01

    This paper examines the reliability of a group of three clutch couplings each mounted between a pony motor and the main drive for the primary sodium pumps. The sodium pumps specification requires that continuously running AC pony motors be fitted to give a guaranteed 10% drive to the pumps in the event of a main supply failure. The drive to the main shaft is via 3 : 1 reduction gearing such that a six pole pony motor running at 300 rpm would drive the main shaft at 100 rpm i.e., 10% of its rated speed. In order that the pony motor drive could be permanently energised during normal operation a free wheeling clutch is fitted between the motor and the reduction gearing. The type of clutch chosen is. the Synchro-Self Shifting (SSS) clutch, shown in Figure 1. This type of clutch has proved itself under fairly onerous operating conditions, but is normally mounted on a horizontal driving shaft whereas in this case because of space limitations, it is necessary to mount it vertically. The reliability target set is that the chance of losing all three independent back-up pony motor drives on loss of main supplies should fall within the 10 -5 - 10 -6 band. Since the electrical supplies and other parts of the pony motor drives have been assessed within this target and some doubts expressed about the clutch it was now necessary to look at this in some detail

  9. The background factor of the driving compensation behavior among elderly drivers

    OpenAIRE

    Usui, Shinnosuke; Taishi, Nozomi

    2016-01-01

    The purpose of this study is to examine what factors lead to driving compensation behavior among elderly drivers, particularly focusing on the effect of self-reported driving performance, and to investigate the relationship between driving compensation behavior and traffic accidents or violations. After analyzing 237 elderly drivers, the results showed that whereas self-reported driving performances influenced driving compensation behaviors, the relationship between self-reported driving perf...

  10. Factors associated with driving in teens with autism spectrum disorders.

    Science.gov (United States)

    Huang, Patty; Kao, Trudy; Curry, Allison E; Durbin, Dennis R

    2012-01-01

    To compare the characteristics of driving and nondriving teens and explore the driving outcomes for teens with higher functioning autism spectrum disorders. Parents of teens aged 15 to 18 years with a parent-reported diagnosis of an autism spectrum disorder enrolled in Interactive Autism Network, an online research registry, were eligible for this cross-sectional study. An online survey was used for data collection. A total of 297 parents completed the survey. Sixty-three percent of teens currently drive or plan to drive. Twenty-nine percent of the teens who are age-eligible to drive currently drive. Compared with age-eligible but nondriving teens, a greater proportion of driving teens were in full-time regular education (p public transportation. Driving predictors included individualized education plans with driving goals, indicators of functional status (classroom placement, college aspiration, and job experience), and parent experience with teaching teens to drive. Twelve percent of teens received driving citations, and 12% of teens had been involved in a motor vehicle crash. Although a significant proportion of teens with higher functioning autism spectrum disorders were driving or learning to drive, the fact that most driving teens' individualized education plans did not include driving goals suggests an area of opportunity for improvement in transition planning. Driving teens were more frequently in regular education settings with college aspirations, which could help schools identify potential drivers.

  11. Conceptual Design on Primary Control Rod Drive Mechanism of a Prototype Gen-IV SFR

    International Nuclear Information System (INIS)

    Lee, Jae Han; Koo, Gyeong Hoi

    2013-01-01

    This paper describes the key concept of the drive mechanism, and suggests a required motor power and reducer gears to meet the functional design requirements, and a seismic response analysis of CRDM housing is performed to check its structural integrity. An AC servo motor is selected as a CRA driving power because it uses permanent magnets and is brushless type while DC motor needs a brush and a coil rotates. The control shim motor size is constrained by a housing diameter of 250mm. The driving system has several design requirements. To calculate the motor power, the drive shaft torque is needed. One part of the drive shaft has a lead screw, driving by a ball-nut. The ball screw driver torque (Tr) is calculated by some equations as follow; A servo motor with a nominal power of 100W, a nominal torque of 0.32 N-m (max. 0.48N-m) is selected considering a safety margin. Its diameter is about 50mm. The fast drive-in motor needs a strong power to insert enforcedly the stuck CRA into core within a required time. The motor sizes are calculated by the same procedure. The diameters are in the range of 80mm to 110mm by the insertion time (10 ∼ 24 seconds). The prototype Gen-IV SFR (sodium-cooled Fast Reactor) is of 150MWe capacity. The reactor has six primary control rod assemblies(CRAs). The primary control rod is used for power control, burn-up compensation and reactor shutdown in response to demands from the plant control or protection systems. The control rod drive mechanism (CRDM) consists of the drive motor assembly, the driveline, and its housing. The driveline consists of three concentric members of a drive shaft, a tension tube, and a position indicator rod, and it connects the drive motor assembly to the CRA. Main issue is that these many driving parts shall be enclosed within a limited housing diameter because the available pitch of CRDMs is limited by 300mm

  12. Conceptual Design on Primary Control Rod Drive Mechanism of a Prototype Gen-IV SFR

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jae Han; Koo, Gyeong Hoi [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

    2013-10-15

    This paper describes the key concept of the drive mechanism, and suggests a required motor power and reducer gears to meet the functional design requirements, and a seismic response analysis of CRDM housing is performed to check its structural integrity. An AC servo motor is selected as a CRA driving power because it uses permanent magnets and is brushless type while DC motor needs a brush and a coil rotates. The control shim motor size is constrained by a housing diameter of 250mm. The driving system has several design requirements. To calculate the motor power, the drive shaft torque is needed. One part of the drive shaft has a lead screw, driving by a ball-nut. The ball screw driver torque (Tr) is calculated by some equations as follow; A servo motor with a nominal power of 100W, a nominal torque of 0.32 N-m (max. 0.48N-m) is selected considering a safety margin. Its diameter is about 50mm. The fast drive-in motor needs a strong power to insert enforcedly the stuck CRA into core within a required time. The motor sizes are calculated by the same procedure. The diameters are in the range of 80mm to 110mm by the insertion time (10 ∼ 24 seconds). The prototype Gen-IV SFR (sodium-cooled Fast Reactor) is of 150MWe capacity. The reactor has six primary control rod assemblies(CRAs). The primary control rod is used for power control, burn-up compensation and reactor shutdown in response to demands from the plant control or protection systems. The control rod drive mechanism (CRDM) consists of the drive motor assembly, the driveline, and its housing. The driveline consists of three concentric members of a drive shaft, a tension tube, and a position indicator rod, and it connects the drive motor assembly to the CRA. Main issue is that these many driving parts shall be enclosed within a limited housing diameter because the available pitch of CRDMs is limited by 300mm.

  13. Improving Usefulness of Automated Driving by Lowering Primary Task Interference through HMI Design

    Directory of Open Access Journals (Sweden)

    Frederik Naujoks

    2017-01-01

    Full Text Available During conditionally automated driving (CAD, driving time can be used for non-driving-related tasks (NDRTs. To increase safety and comfort of an automated ride, upcoming automated manoeuvres such as lane changes or speed adaptations may be communicated to the driver. However, as the driver’s primary task consists of performing NDRTs, they might prefer to be informed in a nondistracting way. In this paper, the potential of using speech output to improve human-automation interaction is explored. A sample of 17 participants completed different situations which involved communication between the automation and the driver in a motion-based driving simulator. The Human-Machine Interface (HMI of the automated driving system consisted of a visual-auditory HMI with either generic auditory feedback (i.e., standard information tones or additional speech output. The drivers were asked to perform a common NDRT during the drive. Compared to generic auditory output, communicating upcoming automated manoeuvres additionally by speech led to a decrease in self-reported visual workload and decreased monitoring of the visual HMI. However, interruptions of the NDRT were not affected by additional speech output. Participants clearly favoured the HMI with additional speech-based output, demonstrating the potential of speech to enhance usefulness and acceptance of automated vehicles.

  14. UNIVERSITIES AND INCUBATORS: KEY FACTORS DRIVING ENTREPRENEURSHIP AND SOCIOECONOMIC DEVELOPMENT

    Directory of Open Access Journals (Sweden)

    Liane Mahlmann Kipper

    2014-12-01

    Full Text Available Economic diversification is an utterly important factor for regions that are directly or indirectly related to any productive mechanisms and seek to strengthen their foundations for the generation of jobs and income. Within this context, to invest in business preparation and maturation, especially in the ones related to the technological area, turns out to be an interesting mean of diversifying a regional economy that is facing the risk of stagnation. This study considers the importance of the role taken on by universities and their incubators in driving entrepreneurship and supporting the creation of new companies and the innovative capacity of a country through knowledge transfer amongst universities and companies, generating benefits and socioeconomic progress in a country. It also conducts a case study on a company of the information technology area, recently incubated and whose major objective consists in becoming part of this economic diversification basis.

  15. Interindividual Differences in Caffeine Metabolism and Factors Driving Caffeine Consumption.

    Science.gov (United States)

    Nehlig, Astrid

    2018-04-01

    Most individuals adjust their caffeine intake according to the objective and subjective effects induced by the methylxanthine. However, to reach the desired effects, the quantity of caffeine consumed varies largely among individuals. It has been known for decades that the metabolism, clearance, and pharmacokinetics of caffeine is affected by many factors such as age, sex and hormones, liver disease, obesity, smoking, and diet. Caffeine also interacts with many medications. All these factors will be reviewed in the present document and discussed in light of the most recent data concerning the genetic variability affecting caffeine levels and effects at the pharmacokinetic and pharmacodynamic levels that both critically drive the level of caffeine consumption. The pharmacokinetics of caffeine are highly variable among individuals due to a polymorphism at the level of the CYP1A2 isoform of cytochrome P450, which metabolizes 95% of the caffeine ingested. Moreover there is a polymorphism at the level of another critical enzyme, N -acetyltransferase 2. At the pharmacodynamic level, there are several polymorphisms at the main brain target of caffeine, the adenosine A2A receptor or ADORA2. Genetic studies, including genome-wide association studies, identified several loci critically involved in caffeine consumption and its consequences on sleep, anxiety, and potentially in neurodegenerative and psychiatric diseases. We start reaching a better picture on how a multiplicity of biologic mechanisms seems to drive the levels of caffeine consumption, although much more knowledge is still required to understand caffeine consumption and effects on body functions. Copyright © 2018 by The American Society for Pharmacology and Experimental Therapeutics.

  16. Cognitive, sensory and physical factors enabling driving safety in older adults.

    Science.gov (United States)

    Anstey, Kaarin J; Wood, Joanne; Lord, Stephen; Walker, Janine G

    2005-01-01

    We reviewed literature on cognitive, sensory, motor and physical factors associated with safe driving and crash risk in older adults with the goal of developing a model of factors enabling safe driving behaviour. Thirteen empirical studies reporting associations between cognitive, sensory, motor and physical factors and either self-reported crashes, state crash records or on-road driving measures were identified. Measures of attention, reaction time, memory, executive function, mental status, visual function, and physical function variables were associated with driving outcome measures. Self-monitoring was also identified as a factor that may moderate observed effects by influencing driving behavior. We propose that three enabling factors (cognition, sensory function and physical function/medical conditions) predict driving ability, but that accurate self-monitoring of these enabling factors is required for safe driving behaviour.

  17. Spatiotemporal Variations and Driving Factors of Air Pollution in China.

    Science.gov (United States)

    Zhan, Dongsheng; Kwan, Mei-Po; Zhang, Wenzhong; Wang, Shaojian; Yu, Jianhui

    2017-12-08

    In recent years, severe and persistent air pollution episodes in China have drawn wide public concern. Based on ground monitoring air quality data collected in 2015 in Chinese cities above the prefectural level, this study identifies the spatiotemporal variations of air pollution and its associated driving factors in China using descriptive statistics and geographical detector methods. The results show that the average air pollution ratio and continuous air pollution ratio across Chinese cities in 2015 were 23.1 ± 16.9% and 16.2 ± 14.8%. The highest levels of air pollution ratio and continuous air pollution ratio were observed in northern China, especially in the Bohai Rim region and Xinjiang province, and the lowest levels were found in southern China. The average and maximum levels of continuous air pollution show distinct spatial variations when compared with those of the continuous air pollution ratio. Monthly changes in both air pollution ratio and continuous air pollution ratio have a U-shaped variation, indicating that the highest levels of air pollution occurred in winter and the lowest levels happened in summer. The results of the geographical detector model further reveal that the effect intensity of natural factors on the spatial disparity of the air pollution ratio is greater than that of human-related factors. Specifically, among natural factors, the annual average temperature, land relief, and relative humidity have the greatest and most significant negative effects on the air pollution ratio, whereas human factors such as population density, the number of vehicles, and Gross Domestic Product (GDP) witness the strongest and most significant positive effects on air pollution ratio.

  18. Spatiotemporal Variations and Driving Factors of Air Pollution in China

    Directory of Open Access Journals (Sweden)

    Dongsheng Zhan

    2017-12-01

    Full Text Available In recent years, severe and persistent air pollution episodes in China have drawn wide public concern. Based on ground monitoring air quality data collected in 2015 in Chinese cities above the prefectural level, this study identifies the spatiotemporal variations of air pollution and its associated driving factors in China using descriptive statistics and geographical detector methods. The results show that the average air pollution ratio and continuous air pollution ratio across Chinese cities in 2015 were 23.1 ± 16.9% and 16.2 ± 14.8%. The highest levels of air pollution ratio and continuous air pollution ratio were observed in northern China, especially in the Bohai Rim region and Xinjiang province, and the lowest levels were found in southern China. The average and maximum levels of continuous air pollution show distinct spatial variations when compared with those of the continuous air pollution ratio. Monthly changes in both air pollution ratio and continuous air pollution ratio have a U-shaped variation, indicating that the highest levels of air pollution occurred in winter and the lowest levels happened in summer. The results of the geographical detector model further reveal that the effect intensity of natural factors on the spatial disparity of the air pollution ratio is greater than that of human-related factors. Specifically, among natural factors, the annual average temperature, land relief, and relative humidity have the greatest and most significant negative effects on the air pollution ratio, whereas human factors such as population density, the number of vehicles, and Gross Domestic Product (GDP witness the strongest and most significant positive effects on air pollution ratio.

  19. Reassessing SERS enhancement factors: using thermodynamics to drive substrate design.

    Science.gov (United States)

    Guicheteau, J A; Tripathi, A; Emmons, E D; Christesen, S D; Fountain, Augustus W

    2017-12-04

    Over the past 40 years fundamental and application research into Surface-Enhanced Raman Scattering (SERS) has been explored by academia, industry, and government laboratories. To date however, SERS has achieved little commercial success as an analytical technique. Researchers are tackling a variety of paths to help break through the commercial barrier by addressing the reproducibility in both the SERS substrates and SERS signals as well as continuing to explore the underlying mechanisms. To this end, investigators use a variety of methodologies, typically studying strongly binding analytes such as aromatic thiols and azarenes, and report SERS enhancement factor calculations. However a drawback of the traditional SERS enhancement factor calculation is that it does not yield enough information to understand substrate reproducibility, application potential with another analyte, or the driving factors behind the molecule-metal interaction. Our work at the US Army Edgewood Chemical Biological Center has focused on these questions and we have shown that thermodynamic principles play a key role in the SERS response and are an essential factor in future designs of substrates and applications. This work will discuss the advantages and disadvantages of various experimental techniques used to report SERS enhancement with planar SERS substrates and present our alternative SERS enhancement value. We will report on three types of analysis scenarios that all yield different information concerning the effectiveness of the SERS substrate, practical application of the substrate, and finally the thermodynamic properties of the substrate. We believe that through this work a greater understanding for designing substrates will be achieved, one that is based on both thermodynamic and plasmonic properties as opposed to just plasmonic properties. This new understanding and potential change in substrate design will enable more applications for SERS based methodologies including targeting

  20. Driving competences and neuropsychological factors associated to driving counseling in multiple sclerosis.

    Science.gov (United States)

    Badenes, Dolors; Garolera, Maite; Casas, Laura; Cejudo-Bolivar, Juan Carlos; de Francisco, Jorge; Zaragoza, Silvia; Calzado, Noemi; Aguilar, Miquel

    2014-05-01

    Multiple Sclerosis (MS) significantly impacts daily living activities, including car driving. To investigate driving difficulties experienced with MS, we compared 50 MS patients with minor or moderate disability and 50 healthy controls (HC) using computerized driving tests (the ASDE driver test and the Useful Field of View (UFOV) test) and neuropsychological tests. Inclusion criteria included being active drivers. We evaluated whether cognitive deterioration in MS is associated with the results of driving tests by comparing MS patients without cognitive deterioration with HC. The results indicated that the MS patients performed worse than the HCs in attention, information processing, working memory and visuomotor coordination tasks. Furthermore, MS patients with cognitive impairments experienced more difficulties in the driving tests than did the non-impaired MS patients. Motor dysfunction associated with MS also played an important role in this activity. The results of this study suggest that MS should be assessed carefully and that special emphasis should be placed on visuomotor coordination and executive functions because patients with minor motor disability and subtle cognitive impairments can pass measures predictive of driving safety.

  1. Socio-psychological factors driving adult vaccination: a qualitative study.

    Directory of Open Access Journals (Sweden)

    Ana Wheelock

    Full Text Available While immunization is one of the most effective and successful public health interventions, there are still up to 30,000 deaths in major developed economies each year due to vaccine-preventable diseases, almost all in adults. In the UK, despite comparatively high vaccination rates among ≥65 s (73% and, to a lesser extent, at-risk ≤65 s (52% in 2013/2014, over 10,000 excess deaths were reported the previous influenza season. Adult tetanus vaccines are not routinely recommended in the UK, but may be overly administered. Social influences and risk-perceptions of diseases and vaccines are known to affect vaccine uptake. We aimed to explore the socio-psychological factors that drive adult vaccination in the UK, specifically influenza and tetanus, and to evaluate whether these factors are comparable between vaccines.20 in-depth, face-to-face interviews were conducted with members of the UK public who represented a range of socio-demographic characteristics associated with vaccination uptake. We employed qualitative interviewing approaches to reach a comprehensive understanding of the factors influencing adult vaccination decisions. Thematic analysis was used to analyze the data.Participants were classified according to their vaccination status as regular, intermittent and non-vaccinators for influenza, and preventative, injury-led, mixed (both preventative and injury-led and as non-vaccinators for tetanus. We present our finding around five overarching themes: 1 perceived health and health behaviors; 2 knowledge; 3 vaccination influences; 4 disease appraisal; and 5 vaccination appraisal.The uptake of influenza and tetanus vaccines was largely driven by participants' risk perception of these diseases. The tetanus vaccine is perceived as safe and sufficiently tested, whereas the changing composition of the influenza vaccine is a cause of uncertainty and distrust. To maximize the public health impact of adult vaccines, policy should be better

  2. Trend Prediction and Decomposed Driving Factors of Carbon Emissions in Jiangsu Province during 2015–2020

    Directory of Open Access Journals (Sweden)

    Decai Tang

    2016-10-01

    Full Text Available According to the economic and energy consumption statistics in Jiangsu Province, we combined the GM (1, 1 grey model and polynomial regression to forecast carbon emissions. Historical and projected emissions were decomposed using the Logarithmic Mean Divisia Index (LMDI approach to assess the relative contribution of different factors to emission variability. The results showed that carbon emissions will continue to increase in Jiangsu province during 2015–2020 period and cumulative carbon emissions will increase by 39.5487 million tons within the forecast period. The growth of gross domestic product (GDP per capita plays the greatest positive role in driving carbon emission growth. Furthermore, the improvement of energy usage efficiency is the primary factor responsible for reducing carbon emissions. Factors of population, industry structure adjustment and the optimization of fuel mix also help to reduce carbon emissions. Based on the LMDI analysis, we provide some advice for policy-makers in Jiangsu and other provinces in China.

  3. Human factors of transitions in automated driving : A general framework and literature survey

    NARCIS (Netherlands)

    Lu, Z.; Happee, R.; Cabrall, C.D.D.; Kyriakidis, M.; de Winter, J.C.F.

    2016-01-01

    The topic of transitions in automated driving is becoming important now that cars are automated to ever greater extents. This paper proposes a theoretical framework to support and align human factors research on transitions in automated driving. Driving states are defined based on the allocation of

  4. Driving Factors of Understory Evapotranspiration within a Siberian Larch Forest

    Science.gov (United States)

    Tobio, A.; Loranty, M. M.; Kropp, H.; Pena, H., III; Alexander, H. D.; Natali, S.; Kholodov, A. L.; Spawn, S.; Farmer, S.

    2017-12-01

    Amplified rates of climate change are causing alterations in vegetation productivity, hydrologic cycling, and wildfire severity and intensity in arctic ecosystems. Boreal larch forests in northeastern Siberia are a critical but understudied ecosystem that are affected by these modifications. These forests cover 2.5 million km2 with densities ranging from spare to thick. The current average canopy cover is at around 17% and is expected to increase with the observed increases in vegetation productivity and wildfire. These projected changes in forest density can alter the proportional contributions of over- and understory vegetation to whole ecosystem evapotranspiration. Low density boreal forests have much higher rates of understory evapotranspiration and can contribute as much as 80% to total ecosystem evapotranspiration, while the understory in high density forests is responsible for only around 15% of total ecosystem evapotranspiration. The objective of this research is to understand why there are changes in understory evapotranspiration with varying overstory density by looking at light levels, biomass, vegetation, and air and soil differences. To better learn about these differences in understory evapotranspiration in boreal larch forests the driving factors of evapotranspiration were measured within a burn scar with varying densities of high, medium, and low. Water fluxes were conducted using the static chamber technique under different environmental conditions. Furthermore, controlling factors of evapotranspiration such as photosynethically active radiation, vapor pressure deficit, soil moisture, moss cover, biomass, and leaf area index were measured or derived. In general, we found that low density areas have highest rates of evapotranspiration due to larger amount of biomass, and increased access to light, despite low levels of soil moisture. These results can help us understand how and why total ecosystem water exchange will change in boreal larch forests

  5. 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.

  6. Empirical and dynamic primary energy factors

    International Nuclear Information System (INIS)

    Wilby, Mark Richard; Rodríguez González, Ana Belén; Vinagre Díaz, Juan José

    2014-01-01

    Current legislation, standards, and scientific research in the field of energy efficiency often make use of PEFs (primary energy factors). The measures employed are usually fixed and based on theoretical calculations. However given the intrinsically variable nature of energy systems, these PEFs should rely on empirical data and evolve in time. Otherwise the obtained efficiencies may not be representative of the actual energy system. In addition, incorrect PEFs may cause a negative effect on the energy efficiency measures. For instance, imposing a high value on the PEF of electricity may discourage the use of renewable energy sources, which have an actual value close to 1. In order to provide a solution to this issue, we propose an application of the Energy Networks (ENs), described in a previous work, to calculate dynamic PEFs based on empirical data. An EN represents an entire energy system both numerically and graphically, from its primary energy sources to their final energy forms, and consuming sectors. Using ENs we can calculate the PEF of any energy form and depict it in a simple and meaningful graph that shows the details of the contribution of each primary energy and the efficiency of the associated process. The analysis of these PEFs leads to significant conclusions regarding the energy models adopted among countries, their evolution in time, the selection of viable ways to improve efficiency, and the detection of best practices that could contribute to the overall energy efficiency targets. - Highlights: • Primary Energy Factors (PEFs) are foundation of much energy legislation and research. • Traditionally, they have been treated as geotemporally invariant. • This work provides a systematic and transparent methodology for adding variability. • It also shows the variability between regions due to market, policy, and technology. • Finally it demonstrates the utility of extended PEFs as a tool in their own right

  7. A systematic review of factors affecting driving and public transportation among youth and young adults with acquired brain injury.

    Science.gov (United States)

    Lindsay, Sally; Stoica, Andrei

    2017-01-01

    Although many people with an acquired brain injury (ABI) encounter difficulties with executive functioning and memory which could negatively affect driving, few people are assessed for fitness to drive after injury. The purpose of this systematic review was to synthesize the literature on factors affecting driving and public transportation among youth and young adults with ABI, post injury. Seven databases were systematically searched for articles from 1980 to 2016. Studies were screened independently by two researchers who performed the data extraction. Study quality was appraised using the Standard Quality Assessment Criteria (Kmet) for evaluating primary research from a variety of fields. Of the 6577 studies identified in the search, 25 met the inclusion criteria, which involved 1527 participants with ABI (mean age = 25.1) across eight countries. Six studies focused on driving assessment and fitness to drive, ten on driving performance or risk of accidents and nine studies explored issues related to accessing or navigating public transportation. Quality assessment of the included studies ranged from 0.60 to 0.95. Our findings highlight several gaps in clinical practice and research along with a critical need for enhanced fitness to drive assessments and transportation-related training for young people with ABI.

  8. Cognitive maps influence over driving strategies in Russia: analyzing Driving Anger Expression Inventory (DAX and Dula Dangerous Driving Index (DDDI factors

    Directory of Open Access Journals (Sweden)

    Chetverikova A.I.

    2017-12-01

    Full Text Available This article summarizes our investigation of drivers cognitive maps and its influence over their behavior. 182 subjects participated in our research, i.e. 97 professional drivers, 85 car enthusiasts, 156 men and 26 women, 20—66 years old, mileage about 3—150 thousands kilometers per year. Questionnaire “Dula Dangerous Driving Index” was used on Russian subjects for the first time ever. Our results show that subjects’ need for get their rocks off when they are angered (or suspicious, or failed to trust the world around and aggressive behavior during driving are correlated. Most drivers feel emotional tension during driving and use some self-regulation techniques to decrease the tension stabilize their emotional state. The following factors were found to correlate with one’s aggressive behavior on the road: feeling suspicious of world/self/others, low level of self-acceptance, external locus of control.

  9. Wellness Factors Decrease the Odds of Drinking and Driving among College Students

    Science.gov (United States)

    Lewis, Todd F.; Myers, Jane E.

    2012-01-01

    The authors examined holistic wellness factors and drinking and driving behaviors among undergraduate students. Two factors of the Indivisible Self Wellness Model, the Coping Self and the Physical Self, decreased the odds of engaging in drinking and driving behavior. (Contains 2 tables and 1 figure.)

  10. Factors associated with a primary surgical approach for sinonasal squamous cell carcinoma.

    Science.gov (United States)

    Cracchiolo, Jennifer R; Patel, Krupa; Migliacci, Jocelyn C; Morris, Luc T; Ganly, Ian; Roman, Benjamin R; McBride, Sean M; Tabar, Viviane S; Cohen, Marc A

    2018-03-01

    Primary surgery is the preferred treatment of T1-T4a sinonasal squamous cell carcinoma (SNSCC). Patients with SNSCC in the National Cancer Data Base (NCDB) were analyzed. Factors that contributed to selecting primary surgical treatment were examined. Overall survival (OS) in surgical patients was analyzed. Four-thousand seven hundred and seventy patients with SNSCC were included. In T1-T4a tumors, lymph node metastases, maxillary sinus location, and treatment at high-volume centers were associated with selecting primary surgery. When primary surgery was utilized, tumor factors and positive margin guided worse OS. Adjuvant therapy improved OS in positive margin resection and advanced T stage cases. Tumor and non-tumor factors are associated with selecting surgery for the treatment of SNSCC. When surgery is selected, tumor factors drive OS. Negative margin resection should be the goal of a primary surgical approach. When a positive margin resection ensues, adjuvant therapy may improve OS. © 2017 Wiley Periodicals, Inc.

  11. On the Drive Specificity of Freudian Drives for the Generation of SEEKING Activities: The Importance of the Underestimated Imperative Motor Factor

    Directory of Open Access Journals (Sweden)

    Michael Kirsch

    2018-05-01

    Full Text Available Doubters of Freud’s theory of drives frequently mentioned that his approach is outdated and therefore cannot be useful for solving current problems in patients with mental disorders. At present, many scientists believe that affects rather than drives are of utmost importance for the emotional life and the theoretical framework of affective neuroscience, developed by Panksepp, strongly underpinned this view. Panksepp evaluated seven so-called command systems and the SEEKING system is therein of central importance. Panksepp used Pankseppian drives as inputs for the SEEKING system but noted the missing explanation of drive-specific generation of SEEKING activities in his description. Drive specificity requires dual action of the drive: the activation of a drive-specific brain area and the release of the neurotransmitter dopamine. Noticeably, as Freud claimed drive specificity too, it was here analyzed whether a Freudian drive can evoke the generation of drive-specific SEEKING activities. Special importance was addressed to the imperative motor factor in Freud’s drive theory because Panksepp’s formulations focused on neural pathways without specifying underlying neurotransmitter/endocrine factors impelling motor activity. As Panksepp claimed sleep as a Pankseppian drive, we firstly had to classified sleep as a Freudian drive by using three evaluated criteria for a Freudian drive. After that it was possible to identify the imperative motor factors of hunger, thirst, sex, and sleep. Most importantly, all of these imperative motor factors can both activate a drive-specific brain area and release dopamine from dopaminergic neurons, i.e., they can achieve the so-called drive specificity. Surprisingly, an impaired Freudian drive can alter via endocrinological pathways the concentration of the imperative motor factor of a second Freudian drive, obviously in some independence to the level of the metabolic deficit, thereby offering the possibility to

  12. Energy saving opportunity with variable speed drive in primary air-handling unit

    International Nuclear Information System (INIS)

    Li, J.S.M.

    2007-01-01

    Air conditioners used in the court buildings in Kowloon City, Hong Kong were retrofitted with variable speed drives in the primary air handling unit (PAU) in an effort to reduce energy consumption. The initial effect of this retrofit was investigated along with the feasibility of using a carbon dioxide (CO 2 ) based demand control ventilation to reduce energy consumption while optimizing indoor air quality. The air flow in most air conditioning fans is either constant or controlled by motorized inlet guide vanes. Although this controls the flow and may reduce the load on the fan, this constriction adds an energy loss, resulting in inefficient operation. Variable speed drives should be used on the PAU in order to maintain system efficiency. As the speed of the fans are reduced, the flow will decrease proportionally, while the power required by the fan will reduce the cube of the speed. Therefore, if the fresh air supply can be controlled by reducing the speed of the fan motor, then flow control would be more efficient. The energy saving associated with variable fresh air supply flow rate was evaluated along with the cost to building owners. This paper presented the results of the potential energy and cost savings associated with this retrofit, and included implementation cost and pay back period. It was estimated that about 20 per cent of power consumption and electricity costs can be saved per year, with a simple payback period of 2 years. 7 refs., 3 tabs., 3 figs

  13. Using exploratory regression to identify optimal driving factors for cellular automaton modeling of land use change.

    Science.gov (United States)

    Feng, Yongjiu; Tong, Xiaohua

    2017-09-22

    Defining transition rules is an important issue in cellular automaton (CA)-based land use modeling because these models incorporate highly correlated driving factors. Multicollinearity among correlated driving factors may produce negative effects that must be eliminated from the modeling. Using exploratory regression under pre-defined criteria, we identified all possible combinations of factors from the candidate factors affecting land use change. Three combinations that incorporate five driving factors meeting pre-defined criteria were assessed. With the selected combinations of factors, three logistic regression-based CA models were built to simulate dynamic land use change in Shanghai, China, from 2000 to 2015. For comparative purposes, a CA model with all candidate factors was also applied to simulate the land use change. Simulations using three CA models with multicollinearity eliminated performed better (with accuracy improvements about 3.6%) than the model incorporating all candidate factors. Our results showed that not all candidate factors are necessary for accurate CA modeling and the simulations were not sensitive to changes in statistically non-significant driving factors. We conclude that exploratory regression is an effective method to search for the optimal combinations of driving factors, leading to better land use change models that are devoid of multicollinearity. We suggest identification of dominant factors and elimination of multicollinearity before building land change models, making it possible to simulate more realistic outcomes.

  14. Analysing Factors That Drives Customer Loyalty Of Shoes Laundry Quickcares Manado

    OpenAIRE

    Mawa, Maria; Tumbuan, Willem J.F.Alfa; Tielung, Maria V.J

    2017-01-01

    This research is to analyzing what are the factors that drive customer loyalty of shoe laundry Quickcares Manado. Shoe Laundry is the services that offer to clean and taking care shoe, Customer Loyalty is the result of consistently positive emotional experience, physical attribute-based satisfaction and perceived value of an experience, which includes the product or services. It is important to know factors that drive customer Loyalty in business, in order to guarantee business continuity and...

  15. Topographic changes and their driving factors after 2008 Wenchuan Earthquake

    Science.gov (United States)

    Li, C.; Wang, M.; Xie, J.; Liu, K.

    2017-12-01

    The Wenchuan Ms 8.0 Earthquake caused topographic change in the stricken areas because of the formation of numerous coseismic landslides. The emergence of new landslides and debris flows and movement of loose materials under the driving force of heavy rainfall could further shape the local topography. Dynamic topographic changes in mountainous areas stricken by major earthquakes have a strong linkage to the development and occurrence of secondary disasters. However, little attention has been paid to continuously monitoring mountain environment change after such earthquakes. A digital elevation model (DEM) is the main feature of the terrain surface, in our research, we extracted DEM in 2013 and 2015 of a typical mountainous area severely impacted by the 2008 Wenchuan earthquake from the ZY-3 stereo pair images with validation by field measurement. Combined with the elevation dataset in 2002 and 2010, we quantitatively assessed elevation changes in different years and qualitatively analyzed spatiotemporal variation of the terrain and mass movement across the study area. The results show that the earthquake stricken area experienced substantial elevation changes caused by seismic forces and subsequent rainfalls. Meanwhile, deposits after the earthquake are mainly accumulated on the river-channels and mountain ridges and deep gullies which increase the risk of other geo-hazards. And the heavy rainfalls after the earthquake have become the biggest driver of elevation reduction, which overwhelmed elevation increase during the major earthquake. Our study provided a better understanding of subsequent hazards and risks faced by residents and communities stricken by major earthquakes.

  16. Factors driving the location investment decision of South African MNEs

    African Journals Online (AJOL)

    kirstam

    best in foreign markets where consumer behaviour is most receptive ... sum of factors preventing or disturbing the flows of information between firms and markets”. Senior ..... Fast-moving consumer goods (FMCG) (8.6%), and oil and gas.

  17. Factors Driving Learner Success in Online Professional Development

    Directory of Open Access Journals (Sweden)

    Phu Vu

    2014-07-01

    Full Text Available This study examined factors that contributed to the success of online learners in an online professional development course. Research instruments included an online survey and learners’ activity logs in an online professional development course for 512 in-service teachers. The findings showed that there were several factors affecting online learners’ success in online professional development. In addition, there were also significant differences between successful and unsuccessful online learners in terms of course login frequency and learning activities viewed.

  18. Key factors driving corporate social responsibility of Vietnamese firms

    NARCIS (Netherlands)

    Kabir, Mohammed Rezaul; Thai Minh, H.

    2016-01-01

    We examine the impact of firm, corporate governance and managerial characteristics on the corporate social responsibility (CSR) activities of Vietnamese listed firms. Our results show that export-oriented firms engage in more CSR activities. As for corporate governance factors, we observe that

  19. Risk factors for adverse driving outcomes in Dutch adults with ADHD and controls.

    Science.gov (United States)

    Bron, Tannetje I; Bijlenga, Denise; Breuk, Minda; Michielsen, Marieke; Beekman, Aartjan T F; Kooij, J J Sandra

    2018-02-01

    To identify risk factors for adverse driving outcomes and unsafe driving among adults with and without ADHD in a Dutch sample. In this cross-sectional study, validated self-report questionnaires were used to compare driving history and current driving behavior between 330 adults diagnosed with ADHD and 330 controls. Adults with ADHD had significantly more adverse driving outcomes when compared to controls. Having an ADHD diagnosis significantly increased the odds for having had 3 or more vehicular crashes (OR = 2.72; p = .001). Driving frequency, male gender, age, high anxiety levels, high hostility levels, and alcohol use all significantly influenced the odds for unsafe driving behavior, for having had 12 or more traffic citations, and/or for having had 3 or more vehicular crashes. Alcohol use, and high levels of anxiety and hostility are highly prevalent among adults with ADHD, and they mediate the risk for negative driving outcomes in this group. Copyright © 2017 Elsevier Ltd. All rights reserved.

  20. Biological, Psychological, and Sociocultural Factors Contributing to the Drive for Muscularity in Weight-Training Men

    Science.gov (United States)

    Schneider, Catharina; Rollitz, Laura; Voracek, Martin; Hennig-Fast, Kristina

    2016-01-01

    The drive for muscularity and associated behaviors (e.g., exercising and dieting) are of growing importance for men in Western societies. In its extreme form, it can lead to body image concerns and harmful behaviors like over-exercising and the misuse of performance-enhancing substances. Therefore, investigating factors associated with the drive for muscularity, especially in vulnerable populations like bodybuilders and weight trainers can help identify potential risk and protective factors for body image problems. Using a biopsychosocial framework, the aim of the current study was to explore different factors associated with drive for muscularity in weight-training men. To this purpose, German-speaking male weight trainers (N = 248) completed an online survey to determine the extent to which biological, psychological, and sociocultural factors contribute to drive for muscularity and its related attitudes and behaviors. Using multiple regression models, findings showed that media ideal body internalization was the strongest positive predictor for drive for muscularity, while age (M = 25.9, SD = 7.4) held the strongest negative association with drive for muscularity. Dissatisfaction with muscularity, but not with body fat, was related to drive for muscularity. The fat-free mass index, a quantification of the actual degree of muscularity of a person, significantly predicted drive for muscularity-related behavior but not attitudes. Body-related aspects of self-esteem, but not global self-esteem, were significant negative predictors of drive for muscularity. Since internalization of media body ideals presented the highest predictive value for drive for muscularity, these findings suggest that media body ideal internalizations may be a risk factor for body image concerns in men, leading, in its most extreme form to disordered eating or muscle dysmorphia. Future research should investigate the relations between drive for muscularity, age, body composition

  1. Driving with Pets as a Risk Factor for Motor Vehicle Collisions among Older Drivers

    Science.gov (United States)

    Blunck, Hallie; Owsley, Cynthia; MacLennan, Paul A.; McGwin, Gerald

    2015-01-01

    Increasing rates of distraction-related motor vehicle collisions (MVCs) continue to raise concerns regarding driving safety. This study sought to evaluate a novel driving-related distraction, driving with a pet, as a risk factor for MVCs among older, community dwelling adults. Two thousand licensed drivers aged 70 and older were identified, of whom 691 reported pet ownership. Comparing pet owners who did and did not drive with their pets, neither overall MVC rates (rate ratio [RR] 0.97 95% confidence interval [CI] 0.75–1.26) nor at-fault MVC rates (RR 0.84 95% CI 0.57–1.24) were elevated. However, those who reported always driving with a pet in the vehicle had an elevated MVC rate (RR 1.89 95% CI 1.10–3.25), as compared to those who did not drive with a pet. The MVC rate was not increased for those reporting only sometimes or rarely driving with a pet in the vehicle. The current study demonstrates an increased risk of MVC involvement in those older drivers who always take a pet with them when they drive a vehicle. When confronted with an increased cognitive or physical workload while driving, elderly drivers in prior studies have exhibited slower cognitive performance and delayed response times in comparison to younger age groups. Further study of pet-related distracted driving behaviors among older drivers as well as younger populations with respect to driver safety and performance is warranted to appropriately inform the need for policy regulation on this issue. PMID:23708755

  2. Driving factors behind carbon dioxide emissions in China: A modified production-theoretical decomposition analysis

    International Nuclear Information System (INIS)

    Wang, Qunwei; Chiu, Yung-Ho; Chiu, Ching-Ren

    2015-01-01

    Research on the driving factors behind carbon dioxide emission changes in China can inform better carbon emission reduction policies and help develop a low-carbon economy. As one of important methods, production-theoretical decomposition analysis (PDA) has been widely used to understand these driving factors. To avoid the infeasibility issue in solving the linear programming, this study proposed a modified PDA approach to decompose carbon dioxide emission changes into seven drivers. Using 2005–2010 data, the study found that economic development was the largest factor of increasing carbon dioxide emissions. The second factor was energy structure (reflecting potential carbon), and the third factor was low energy efficiency. Technological advances, energy intensity reductions, and carbon dioxide emission efficiency improvements were the negative driving factors reducing carbon dioxide emission growth rates. Carbon dioxide emissions and driving factors varied significantly across east, central and west China. - Highlights: • A modified PDA used to decompose carbon dioxide emission changes into seven drivers. • Two models were proposed to ameliorate the infeasible occasions. • Economic development was the largest factor of increasing CO_2 emissions in China.

  3. Motivational factors associated with drowsy driving behavior: a qualitative investigation of college students.

    Science.gov (United States)

    Beck, Kenneth H; Lee, Clark J; Weiner, Talia

    2018-02-01

    This qualitative investigation sought to identify the motivational factors that contribute to drowsy driving in college students and to discover important messaging strategies that may help prevent or reduce this behavior in this population. Four focus groups of college students. A large university in the Washington, DC, metropolitan area during the Fall 2016 term. Twenty-six undergraduate students between the ages of 18 and 25 years. Notes and transcripts from the focus group sessions were analyzed to identify recurring themes regarding attitudes, motivations, experiences, influences, and potential preventive messaging strategies related to drowsy driving. Although most participants had heard of drowsy driving and were concerned about it, they did not associate it with legal risks and were more concerned about alcohol-impaired and distracted driving as crash risks. Participants viewed drowsy driving as a normal and unavoidable part of their lives over which they had little control. For potential anti-drowsy driving messaging strategies, participants preferred messages delivered via audiovisual or social media that featured graphic and emotional portrayals of crashes and their consequences. Participants also voiced strong support for preventive messaging strategies equating various degrees of sleep deprivation to known impairing levels of alcohol, as well as messages providing cues to action to actual drowsy drivers on roadways. Increased enforcement, education, and public messaging campaigns are needed to increase knowledge and influence attitudes and opinions among young drivers about the dangers and social unacceptability of drowsy driving. Copyright © 2018 National Sleep Foundation. Published by Elsevier Inc. All rights reserved.

  4. Screening Driving Transcription Factors in the Processing of Gastric Cancer

    Directory of Open Access Journals (Sweden)

    Guangzhong Xu

    2016-01-01

    Full Text Available Background. Construction of the transcriptional regulatory network can provide additional clues on the regulatory mechanisms and therapeutic applications in gastric cancer. Methods. Gene expression profiles of gastric cancer were downloaded from GEO database for integrated analysis. All of DEGs were analyzed by GO enrichment and KEGG pathway enrichment. Transcription factors were further identified and then a global transcriptional regulatory network was constructed. Results. By integrated analysis of the six eligible datasets (340 cases and 43 controls, a bunch of 2327 DEGs were identified, including 2100 upregulated and 227 downregulated DEGs. Functional enrichment analysis of DEGs showed that digestion was a significantly enriched GO term for biological process. Moreover, there were two important enriched KEGG pathways: cell cycle and homologous recombination. Furthermore, a total of 70 differentially expressed TFs were identified and the transcriptional regulatory network was constructed, which consisted of 566 TF-target interactions. The top ten TFs regulating most downstream target genes were BRCA1, ARID3A, EHF, SOX10, ZNF263, FOXL1, FEV, GATA3, FOXC1, and FOXD1. Most of them were involved in the carcinogenesis of gastric cancer. Conclusion. The transcriptional regulatory network can help researchers to further clarify the underlying regulatory mechanisms of gastric cancer tumorigenesis.

  5. MAIN FACTORS DRIVING SOCIAL PUBLIC SERVICES IN INTERNATIONAL CONTEXT

    Directory of Open Access Journals (Sweden)

    Mihaela, GHENTA

    2014-03-01

    Full Text Available Literature and the latest reports point out that not only in Europe, but all over the world there is a growing demand for social services. As social needs have diversified, the number of potential users of social services has increased and this has generated increased complexity of social services. This paper highlights some of the results of a study conducted by the author in the doctoral studies program. One of the aims of this study was to identify the main factors that cause the current configuration of social services at global level. The research analysed the demographic changes and the impact of the crisis in social services for Europe, the United States of America (USA and Japan based on statistical data provided by the national statistics institutes for the regions considered. The results highlight the necessity of continuous development and reconfiguration of social services in order to meet the social and economic demands and to ensure a better organisation of these type of services.

  6. Factors driving and influencing the development of serious games

    Directory of Open Access Journals (Sweden)

    Louise Møller

    2016-03-01

    Full Text Available There are a large variety of serious games aimed at infusing knowledge into both teams and organizations. Some games aims at supporting the team in a given project or development process, whereas others aim at widening the knowledge, skills and competences in an organization on a more general level. In the serious game literature most focus and attention is given to the design and development of digital games. However in Denmark, at least, there has been a growing industry of analogue serious games and serious game facilitation, which give evidence to the fact that not all development in the area of serious games happens in terms of the digital versions. This paper investigate these new analog serious games and learning tools in the Danish market with focus on the drivers and influencing factors during their development and the effort of making a business out of the serious games. Empirically, the paper is based on close interaction and semi-structured interviews with some of the key serious game developers in Denmark (plus one in the US, some of them with a portfolio of up to ten serious games. Besides from uncovering some of the basic motivations to design and develop serious games, the paper will show, how the game developers’ interaction with the end-users and their different business strategies, influences the way the game is developed.

  7. Risk factors for automobile accidents caused by falling asleep while driving in obstructive sleep apnea syndrome.

    Science.gov (United States)

    Arita, Aki; Sasanabe, Ryujiro; Hasegawa, Rika; Nomura, Atsuhiko; Hori, Reiko; Mano, Mamiko; Konishi, Noriyuki; Shiomi, Toshiaki

    2015-12-01

    We examined the risk factors for automobile accidents caused by falling asleep while driving in subjects with obstructive sleep apnea syndrome (OSAS). We asked licensed drivers with history of snoring and excessive daytime sleepiness who had undergone polysomnography (PSG) at the Department of Sleep Medicine/Sleep Disorders Center at Aichi Medical University Hospital to complete the questionnaires on accidents caused by falling asleep while driving. As a subjective measure of sleepiness, we used the Epworth sleepiness scale (ESS). Based on PSG results, 2387 subjects diagnosed with OSAS were divided into three groups according to apnea-hypopnea index (AHI): mild-to-moderate (5 ≤ AHI accidents in the past 5 years due to falling asleep. Our multivariate analysis suggests that scores on the ESS and patient-reported frequency of feeling drowsy while regular driving and working are related to automobile accidents caused by falling asleep while driving.

  8. The big five personality factors as predictors of driving status in older adults.

    Science.gov (United States)

    Gadbois, Emily A; Dugan, Elizabeth

    2015-02-01

    Although factors including cognitive and health status have been associated with driving cessation in older adults, the role of psychosocial variables is not well studied. Previous research on young adult drivers has suggested that personality may be related to driving behavior, but this study is among the first to explore the relationship between driving status and the Big Five Model of personality for older adults. Data are from the Health and Retirement Study (2008 wave, n = 4,028). Descriptive, bivariate, and multiple logistic regression analyses were conducted. Neuroticism (β = -0.4511, p Personality adds a unique contribution to the prediction of late-life driving status. © The Author(s) 2014.

  9. Comparison of the primary energy consumption and the CO2-emission of an urban vehicle with conventional and alternative drives

    International Nuclear Information System (INIS)

    Birnbreier, H.

    1992-01-01

    Based on a model car with its basic data corresponding to those of a series-produced small passenger car, conventional and alternative drives were compared. Cars shared the following features: same basic weight without tank, one energy storage system for the same driving range, same acceleration capacity from 0 to 50 km/h. Petrol and diesel were the conventional fuels; methanol, natural gas (pressurized, liquid), hydrogen (pressurized, liquid, hydride) and electric energy (NaS battery) were the alternative fuels. Both primary energy and CO 2 balancings take the different raw materials into account for the production of useful energies. (orig.) [de

  10. Sociodemographic factors associated with aggressive driving behaviors of 3-wheeler taxi drivers in Sri Lanka.

    Science.gov (United States)

    Akalanka, Ediriweera Chintana; Fujiwara, Takeo; Desapriya, Ediriweera; Peiris, Dinithi C; Scime, Giulia

    2012-01-01

    Little is known about the nature and scope of aggressive driving in developing countries. The objective of this study is to specifically examine the sociodemographic factors associated with aggressive driving behavior among 3-wheeler taxi drivers in Sri Lanka. Convenience samples of 3-wheeler taxi drivers from Rathnapura, Ahaliyagoda, Sri Lanka were surveyed from June to August 2006. Analyses included bivariate and multivariate logistic regression. Drivers with less than high school education were 3.5 times more likely to drive aggressively (odds ratio [OR] = 3.46; 95% confidence interval [CI] = 1.08, 11.1). Single drivers were 9 times more likely to run red lights (OR = 8.74; 95% CI = 2.18, 35.0), and being single was a major risk factor for drunk driving (OR = 4.80; 95% CI = 1.23, 18.7). Furthermore, high school completers were 4 times more likely to bribe a policeman (OR = 4.27; 95% CI = 1.23, 14.9) when caught violating the road rules. Aggressive driving and risk-taking behavior are amenable to policy initiatives, and preventive programs targeted at key groups could be used to improve road safety in Sri Lanka. This study demonstrates that aggressive driving behavior is associated with sociodemographic factors, including the level of education, marital status, and other socioeconomic factors. Hence, economic factors should be addressed to find solutions to traffic-related issues. It will be the government's and policy makers' responsibility to try and understand the economic factors behind risky road behavior and bribe-taking behavior prior to legislating or enforcing new laws.

  11. Driving factors of urban land growth in Guangzhou and its implications for sustainable development

    Science.gov (United States)

    Cui, Xuezhu; Li, Shaoying; Wang, Xuetong; Xue, Xiaolong

    2018-04-01

    Since 2000, China's urban land has expanded at a dramatic speed because of the country's rapid urbanization. The country has been experiencing unbalanced development between rural and urban areas, causing serious challenges such as agricultural security and land resources waste. Effectively evaluating the driving factors of urban land growth is essential for improving efficient land use management and sustainable urban development. This study established a principal component regression model based on eight indicators to identify their influences on urban land growth in Guangzhou. The results provided a grouping analysis of the driving factors, and found that economic growth, urban population, and transportation development are the driving forces of urban land growth of Guangzhou, while the tertiary industry has an opposite effect. The findings led to further suggestions and recommendations for urban sustainable development. Hence, local governments should design relevant policies for achieving the rational development of urban land use and strategic planning on urban sustainable development.

  12. ObStruct: a method to objectively analyse factors driving population structure using Bayesian ancestry profiles.

    Directory of Open Access Journals (Sweden)

    Velimir Gayevskiy

    Full Text Available Bayesian inference methods are extensively used to detect the presence of population structure given genetic data. The primary output of software implementing these methods are ancestry profiles of sampled individuals. While these profiles robustly partition the data into subgroups, currently there is no objective method to determine whether the fixed factor of interest (e.g. geographic origin correlates with inferred subgroups or not, and if so, which populations are driving this correlation. We present ObStruct, a novel tool to objectively analyse the nature of structure revealed in Bayesian ancestry profiles using established statistical methods. ObStruct evaluates the extent of structural similarity between sampled and inferred populations, tests the significance of population differentiation, provides information on the contribution of sampled and inferred populations to the observed structure and crucially determines whether the predetermined factor of interest correlates with inferred population structure. Analyses of simulated and experimental data highlight ObStruct's ability to objectively assess the nature of structure in populations. We show the method is capable of capturing an increase in the level of structure with increasing time since divergence between simulated populations. Further, we applied the method to a highly structured dataset of 1,484 humans from seven continents and a less structured dataset of 179 Saccharomyces cerevisiae from three regions in New Zealand. Our results show that ObStruct provides an objective metric to classify the degree, drivers and significance of inferred structure, as well as providing novel insights into the relationships between sampled populations, and adds a final step to the pipeline for population structure analyses.

  13. National young-driver survey: teen perspective and experience with factors that affect driving safety.

    Science.gov (United States)

    Ginsburg, Kenneth R; Winston, Flaura K; Senserrick, Teresa M; García-España, Felipe; Kinsman, Sara; Quistberg, D Alex; Ross, James G; Elliott, Michael R

    2008-05-01

    Motor vehicle crashes are the leading cause of fatality and acquired disability in adolescents. Young, inexperienced drivers are overrepresented in crashes. Our goal was to explore the adolescent perspective on driving safety to provide a better understanding of factors that influence safety and teenagers' exposure to driving hazards. Adolescents generated, prioritized, and explained their viewpoint by using the teen-centered method. These viewpoints were obtained from a school-based nationally representative survey of 9th-, 10th-, and 11th-graders (N = 5665) from 68 high schools, conducted in spring 2006, that included teen-generated items. The main outcome measures were rating of risk and prevalence of witnessing driving hazards. Drinking while driving was ranked as the greatest hazard (87% of the respondents reported that it made a lot of difference), although only 12% witnessed it often. Ranked next as dangers while driving were text-messaging, racing, impairment from marijuana, and road rage. Sixty percent viewed inexperience as a significant hazard, although only 15% reported seeing it often. Cell phone use was viewed as a significant hazard by 28%, although 57% witnessed it frequently. Only 10% viewed peer passengers as hazardous, but 64% frequently observed them. Distracting peer behaviors, among other distractions, were viewed as more dangerous. Subpopulations varied in the degree they perceived hazards. For example, black and Hispanic adolescents viewed substance use while driving as less hazardous than did white adolescents but witnessed it more frequently. Adolescents generally understand the danger of intoxicated driving. However, some groups need to better recognize this hazard. Distractions take teenagers' focus off the road, but not all are viewed as hazardous. Although inexperience is the key factor that interacts with other conditions to cause crashes, adolescents do not recognize what merits experience. Future research is needed to explore how to

  14. RANK rewires energy homeostasis in lung cancer cells and drives primary lung cancer.

    Science.gov (United States)

    Rao, Shuan; Sigl, Verena; Wimmer, Reiner Alois; Novatchkova, Maria; Jais, Alexander; Wagner, Gabriel; Handschuh, Stephan; Uribesalgo, Iris; Hagelkruys, Astrid; Kozieradzki, Ivona; Tortola, Luigi; Nitsch, Roberto; Cronin, Shane J; Orthofer, Michael; Branstetter, Daniel; Canon, Jude; Rossi, John; D'Arcangelo, Manolo; Botling, Johan; Micke, Patrick; Fleur, Linnea La; Edlund, Karolina; Bergqvist, Michael; Ekman, Simon; Lendl, Thomas; Popper, Helmut; Takayanagi, Hiroshi; Kenner, Lukas; Hirsch, Fred R; Dougall, William; Penninger, Josef M

    2017-10-15

    Lung cancer is the leading cause of cancer deaths. Besides smoking, epidemiological studies have linked female sex hormones to lung cancer in women; however, the underlying mechanisms remain unclear. Here we report that the receptor activator of nuclear factor-kB (RANK), the key regulator of osteoclastogenesis, is frequently expressed in primary lung tumors, an active RANK pathway correlates with decreased survival, and pharmacologic RANK inhibition reduces tumor growth in patient-derived lung cancer xenografts. Clonal genetic inactivation of KRas G12D in mouse lung epithelial cells markedly impairs the progression of KRas G12D -driven lung cancer, resulting in a significant survival advantage. Mechanistically, RANK rewires energy homeostasis in human and murine lung cancer cells and promotes expansion of lung cancer stem-like cells, which is blocked by inhibiting mitochondrial respiration. Our data also indicate survival differences in KRas G12D -driven lung cancer between male and female mice, and we show that female sex hormones can promote lung cancer progression via the RANK pathway. These data uncover a direct role for RANK in lung cancer and may explain why female sex hormones accelerate lung cancer development. Inhibition of RANK using the approved drug denosumab may be a therapeutic drug candidate for primary lung cancer. © 2017 Rao et al.; Published by Cold Spring Harbor Laboratory Press.

  15. Economic and policy factors driving adoption of institutional woody biomass heating systems in the United States

    Science.gov (United States)

    Jesse D. Young; Nathaniel M. Anderson; Helen T. Naughton; Katrina Mullan

    2018-01-01

    Abundant stocks of woody biomass that are associated with active forest management can be used as fuel for bioenergy in many applications. Though factors driving large-scale biomass use in industrial settings have been studied extensively, small-scale biomass combustion systems commonly used by institutions for heating have received less attention. A zero inflated...

  16. Hand on the wheel, mind on the mobile: an analysis of social factors contributing to texting while driving.

    Science.gov (United States)

    Seiler, Steven J

    2015-02-01

    In an era defined by social technology, mobile phones provide constant connection to others. However, they also present a very dangerous situation when people choose to use their mobile phones while driving. In particular, exchanging text messages while driving has resulted in numerous accidents and fatalities. The purpose of this study is to examine social factors that lead people to text while driving. Specifically, using a multivariate logistic regression analysis of data from a 2010 survey by the Pew Research Center, variables for general mobile talk, driving while talking on a mobile, using the Internet on a mobile, sexting, and various motivations for texting were examined to determine factors that increase the likelihood of texting while driving. The findings suggest that people engage in mobile multiplexing (i.e., communication using two or more media on the mobile) while driving. Additionally, exchanging text messages in public, and consequently texting while driving, has become normalized. Furthermore, people are socialized into such behaviors through observing others texting while driving and using a mobile recklessly while driving. Finally, a number of motivations for texting were found to increase the likelihood of texting while driving significantly. Ultimately, the author contends that texting while driving has become a cultural artifact in the United States, which conflicts with driver safety as well as laws prohibiting texting while driving. The findings of this study could inform future awareness campaigns and technology developers to help establish a safer driving environment within the multitasking culture.

  17. Spatial Characteristics and Driving Factors of Provincial Wastewater Discharge in China.

    Science.gov (United States)

    Chen, Kunlun; Liu, Xiaoqiong; Ding, Lei; Huang, Gengzhi; Li, Zhigang

    2016-12-09

    Based on the increasing pressure on the water environment, this study aims to clarify the overall status of wastewater discharge in China, including the spatio-temporal distribution characteristics of wastewater discharge and its driving factors, so as to provide reference for developing "emission reduction" strategies in China and discuss regional sustainable development and resources environment policies. We utilized the Exploratory Spatial Data Analysis (ESDA) method to analyze the characteristics of the spatio-temporal distribution of the total wastewater discharge among 31 provinces in China from 2002 to 2013. Then, we discussed about the driving factors, affected the wastewater discharge through the Logarithmic Mean Divisia Index (LMDI) method and classified those driving factors. Results indicate that: (1) the total wastewater discharge steadily increased, based on the social economic development, with an average growth rate of 5.3% per year; the domestic wastewater discharge is the main source of total wastewater discharge, and the amount of domestic wastewater discharge is larger than the industrial wastewater discharge. There are many spatial differences of wastewater discharge among provinces via the ESDA method. For example, provinces with high wastewater discharge are mainly the developed coastal provinces such as Jiangsu Province and Guangdong Province. Provinces and their surrounding areas with low wastewater discharge are mainly the undeveloped ones in Northwest China; (2) The dominant factors affecting wastewater discharge are the economy and technological advance; The secondary one is the efficiency of resource utilization, which brings about the unstable effect; population plays a less important role in wastewater discharge. The dominant driving factors affecting wastewater discharge among 31 provinces are divided into three types, including two-factor dominant type, three-factor leading type and four-factor antagonistic type. In addition, the

  18. 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.

  19. Factors affecting guidance and counseling programme in primary ...

    African Journals Online (AJOL)

    The objective of this study was to establish the factors that affect guidance and counseling in primary schools. Guidance and counseling seems not to be adequately helping pupils with physical and psychological problems in Nairobi province of Kenya. Many primary schools are faced with indiscipline and poor performance ...

  20. Spatiotemporal dataset on Chinese population distribution and its driving factors from 1949 to 2013

    Science.gov (United States)

    Wang, Lizhe; Chen, Lajiao

    2016-07-01

    Spatio-temporal data on human population and its driving factors is critical to understanding and responding to population problems. Unfortunately, such spatio-temporal data on a large scale and over the long term are often difficult to obtain. Here, we present a dataset on Chinese population distribution and its driving factors over a remarkably long period, from 1949 to 2013. Driving factors of population distribution were selected according to the push-pull migration laws, which were summarized into four categories: natural environment, natural resources, economic factors and social factors. Natural environment and natural resources indicators were calculated using Geographic Information System (GIS) and Remote Sensing (RS) techniques, whereas economic and social factors from 1949 to 2013 were collected from the China Statistical Yearbook and China Compendium of Statistics from 1949 to 2008. All of the data were quality controlled and unified into an identical dataset with the same spatial scope and time period. The dataset is expected to be useful for understanding how population responds to and impacts environmental change.

  1. Factors associated with self-reported inattentive driving at highway-rail grade crossings.

    Science.gov (United States)

    Zhao, Shanshan; Khattak, Aemal J

    2017-12-01

    This research identified factors associated with inattentive driving at Highway-Rail Grade Crossings (HRGCs) by investigating drivers' self-reported inattentive driving experiences and factors pertaining to their socioeconomic, personality, attitudinal, and other characteristics. A random selection of 2500 households in Nebraska received a survey questionnaire designed for licensed motor vehicle drivers; respondents returned 980 questionnaires. Factor analysis identified latent variables evaluating drivers' patience and inclination to wait for trains, attitudes toward new technology, law enforcement or education regarding HRGC safety, and the propensity to commit serious traffic violations at HRGCs. The investigation utilized a structural equation model for analysis. This model indicated that drivers with a higher risk of inattentive driving at HRGCs were: female, younger in age, from households with higher incomes, with shorter tenure (in years) in their current city of residence, more frequently used HRGCs, received less information on safety at HRGCs, had less patience to wait for trains to pass and had less interest in safety improvement technology, law enforcement or safety education at HRGCs. These research findings provide useful information for future research and to policy makers for improving public safety. Additionally, the results are useful for safety educational program providers for targeted program delivery to drivers that are more vulnerable to distracted driving at HRGCs. Copyright © 2017 Elsevier Ltd. All rights reserved.

  2. A winter dinoflagellate bloom drives high rates of primary production in a Patagonian fjord ecosystem

    Science.gov (United States)

    Montero, P.; Pérez-Santos, I.; Daneri, G.; Gutiérrez, M. H.; Igor, G.; Seguel, R.; Purdie, D.; Crawford, D. W.

    2017-12-01

    A dense winter bloom of the dinoflagellate Heterocapsa triquetra was observed at a fixed station (44°35.3‧S; 72°43.6‧W) in the Puyuhuapi Fjord in Chilean Patagonia during July 2015. H. triquetra dominated the phytoplankton community in the surface waters between 2 and 15 m (13-58 × 109 cell m-2), with abundances some 3 to 15 times higher than the total abundance of the diatom assemblage, which was dominated by Skeletonema spp. The high abundance of dinoflagellates was reflected in high rates of gross primary production (GPP; 0.6-1.6 g C m-2 d-1) and chlorophyll-a concentration (Chl-a; 70-199.2 mg m-2) that are comparable to levels reported in spring diatom blooms in similar Patagonian fjords. We identify the main forcing factors behind a pulse of organic matter production during the non-productive winter season, and test the hypothesis that low irradiance levels are a key factor limiting phytoplankton blooms and subsequent productivity during winter. Principal Component Analysis (PCA) indicated that GPP rates were significantly correlated (r = -0.8, p bloom. The bloom occurred under low surface irradiance levels characteristic of austral winter and was accompanied by strong northern winds, associated with the passage of a low-pressure system, and a water column dominated by double diffusive layering. To our knowledge, this is the first report of a dense dinoflagellate bloom during deep austral winter in a Patagonian fjord, and our data challenge the paradigm of light limitation as a factor controlling phytoplankton blooms in this region in winter.

  3. Factors driving public tolerance levels and information-seeking behaviour concerning insects in the household environment.

    Science.gov (United States)

    Schoelitsz, Bruce; Poortvliet, P Marijn; Takken, Willem

    2018-06-01

    The public's negative attitudes towards household insects drive tolerance for these insects and their control. Tolerance levels are important in integrated pest management (IPM), as are pest knowledge and information. The risk information seeking and processing (RISP) model describes the relationships between personal factors and information-seeking behaviour. We combined IPM and RISP to determine important relationships between factors driving insect tolerance levels and information-seeking behaviour through an online survey and tested whether this model is valid and generally applicable. Relationships between variables from both IPM and RISP models were tested for seven insect species. Tolerance levels were measured with two factors: willingness to pay for pest control and whether insects are tolerated. Willingness to pay for control was positively affected by age, experience, risk perception, insect characteristics, and negative emotions and affected behavioural intention, by influencing information sufficiency and information-seeking behaviour. Tolerability was influenced by perception of insect characteristics and determines whether control measures are taken. It was possible to combine the RISP and IPM models. Relevant driving factors were a person's age, experience, risk perception, negative affective responses, tolerance levels, relevant channel beliefs about online forums, information sufficiency and information-seeking behaviour. There was, however, variation in important factors between different insects. © 2017 The Authors. Pest Management Science published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry. © 2017 The Authors. Pest Management Science published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.

  4. Outcome evaluation of a peer-led drinking and driving primary ...

    African Journals Online (AJOL)

    The aim of this study was to evaluate a peer-led drinking and driving (DD) prevention programme among 111 University of the North (UNIN) undergraduate students aged 17 to 24 years using a pre-post test intervention design. The results showed that the programme was generally effective in bringing about statistically

  5. Low prevalence of cardiovascular risk factors among primary school ...

    African Journals Online (AJOL)

    Background: Identification of obesity and other risk factors for cardiovascular disease in childhood is strongly recommended for prevention of the diseases in adulthood. Objectives: To determine the prevalence of the conventional cardiovascular risk factors among primary school children aged 6-15 years in Urban Dar es ...

  6. Twin Specific Risk Factors in Primary School Achievements

    NARCIS (Netherlands)

    de Zeeuw, L.E.J.; van Beijsterveldt, C.E.M.; de Geus, E.J.C.; Boomsma, D.I.

    2012-01-01

    The main aim of this study was to examine twin specific risk factors that influence educational achievement in primary school. We included prenatal factors that are not unique to twins, except for zygosity, but show a higher prevalence in twins than in singletons. In addition, educational

  7. FED-A, an advanced performance FED based on low safety factor and current drive

    International Nuclear Information System (INIS)

    Peng, Y.K.M.; Rutherford, P.H.

    1983-08-01

    The FED-A study aims to quantify the potential improvement in cost-effectiveness of the Fusion Engineering Device (FED) by assuming low safety factor q (less than 2 as opposed to about 3) at the plasma edge and noninductive current drive (as opposed to only inductive current drive). The FED-A performance objectives are set to be : (1) ignition assuming International Tokamak Reactor (INTOR) plamsa confinement scaling, but still achieving a fusion power amplification Q greater than or equal to 5 when the confinement is degraded by a factor of 2; (2) neutron wall loading of about 1 MW/m 2 , with 0.5 MW/m 2 as a conservative lower bound; and (3) more clearly power-reactor-like operations, such as steady state

  8. Driving factors for the regional implementation of renewable energy ‐ A multiple case study on the German energy transition

    International Nuclear Information System (INIS)

    Lutz, Lotte Marie; Fischer, Lisa-Britt; Newig, Jens; Lang, Daniel Johannes

    2017-01-01

    Understanding what drives the regional implementation of renewable energy is a prerequisite for energy transitions toward a post-fossil-based energy economy. This paper presents an empirical analysis of driving factors for the regional implementation and use of renewable energy. We tested literature-derived driving factors in a comparative analysis of 18 selected study regions using Rough Set Analysis and performance analysis. We paid special attention to common combinations of driving factors, which we understand as established practices concerning the use and implementation of renewable energy. Our findings confirm most of the driving factors identified in the literature, for example the existence of key actors, knowledge exchange, or the use of goals and milestones. We also observe differences in key driving factors between highly successful and less successful regions, especially regarding funding opportunities. The results may support policy makers who aim to successfully implement renewable energy at a regional level. - Highlights: • We analyzed driving factors for RE implementation in 18 best-practice regions. • Most driving factors from transition and governance literature were confirmed. • We identified common successful practices concerning RE implementation.

  9. Studying Driving Risk Factors using Multi-Source Mobile Computing Data

    Directory of Open Access Journals (Sweden)

    Xianbiao Hu

    2015-09-01

    In this paper, the overall research framework used in this research is presented, which mainly includes data collection, data processing, calibration and analysis methodology. A preliminary case study — including data summary statistics and correlation analysis — is also presented. The results of our study will further existing knowledge about driving exposure factors that are closely linked to crash risk, and provide the foundation for advanced forms of Usage Based Insurance.

  10. INSOMNIA AND CORRELATION WITH PSYCHOSOCIAL FACTORS IN PRIMARY HEALTH CARE

    OpenAIRE

    Made Gede Cahyadi Permana

    2013-01-01

    Insomnia is regarded as sleep disorder that most often affects people in the world, both in primary and in the presence of comorbid conditions. Based on those facts, insomnia could be a serious problem at the level of primary health care. General Practitioner should be able to diagnose insomnia and able to perform the appropriate treatment for the patient. Psychosocial factors may related to the degree of severity of insomnia, among others are health status, depression, dysfunctional beliefs ...

  11. Organizational factors influencing successful primary care and public health collaboration.

    Science.gov (United States)

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

    2018-06-07

    Public health and primary care are distinct sectors within western health care systems. Within each sector, work is carried out in the context of organizations, for example, public health units and primary care clinics. Building on a scoping literature review, our study aimed to identify the influencing factors within these organizations that affect the ability of these health care sectors to collaborate with one another in the Canadian context. Relationships between these factors were also explored. We conducted an interpretive descriptive qualitative study involving in-depth interviews with 74 key informants from three provinces, one each in western, central and eastern Canada, and others representing national organizations, government, or associations. The sample included policy makers, managers, and direct service providers in public health and primary care. Seven major organizational influencing factors on collaboration were identified: 1) Clear Mandates, Vision, and Goals; 2) Strategic Coordination and Communication Mechanisms between Partners; 3) Formal Organizational Leaders as Collaborative Champions; 4) Collaborative Organizational Culture; 5) Optimal Use of Resources; 6) Optimal Use of Human Resources; and 7) Collaborative Approaches to Programs and Services Delivery. While each influencing factor was distinct, the many interactions among these influences are indicative of the complex nature of public health and primary care collaboration. These results can be useful for those working to set up new or maintain existing collaborations with public health and primary care which may or may not include other organizations.

  12. Psychiatric Disorders, Sociodemographic Features and Risk Factors in Children Driving to Committing Crime (Turkish

    Directory of Open Access Journals (Sweden)

    Murat Eyüboğlu

    2018-03-01

    Full Text Available Object: The aim of this study was to examine children driving to committing crime who were brought to psychiatry clinic for forensic evaluation because of the crimes they committed to. Additionally, evaluation of these children's psychiaytric disorders, crime characteristics, sociodemographic data, factors driving to committing crime and forensic reports arranged by the physician were other aims. Methods: In this study 204 children, who were brought to the clinic in order to be evaluated whether they perceive the legal meaning and consequences of that action or possess sufficient ability to channel their behaviors, were included. In order to diagnose any psychiatric disorder, a structured interrogation schedule for affective disorders and schizophrenia for present and lifetime was applied all children and families and sociodemographic data form was completed. Results: At least one psychiatric disorder was present in 47% (n =96 of children driving to committing crime. The most common disorders were Attention Deficit and Hyperactivity Disorder and Conduct Disorder. Almost none of them have been treated before. 45% of them dropped out their school, and 40% were smoking. Additionally, most of their parents who had low socioeconomical level also had very low education level. Discussion: It was determined that being male, living in a low socioeconomic family environment, living in large families, using drugs, smoking, not attending school and having parents with low education level were significant related factors for juvenile delinquency.

  13. Factors shaping intersectoral action in primary health care services.

    Science.gov (United States)

    Anaf, Julia; Baum, Fran; Freeman, Toby; Labonte, Ron; Javanparast, Sara; Jolley, Gwyn; Lawless, Angela; Bentley, Michael

    2014-12-01

    To examine case studies of good practice in intersectoral action for health as one part of evaluating comprehensive primary health care in six sites in South Australia and the Northern Territory. Interviews with primary health care workers, collaborating agency staff and service users (Total N=33); augmented by relevant documents from the services and collaborating partners. The value of intersectoral action for health and the importance of partner relationships to primary health care services were both strongly endorsed. Factors facilitating intersectoral action included sufficient human and financial resources, diverse backgrounds and skills and the personal rewards that sustain commitment. Key constraining factors were financial and time limitations, and a political and policy context which has become less supportive of intersectoral action; including changes to primary health care. While intersectoral action is an effective way for primary health care services to address social determinants of health, commitment to social justice and to adopting a social view of health are constrained by a broader health service now largely reinforcing a biomedical model. Effective organisational practices and policies are needed to address social determinants of health in primary health care and to provide a supportive context for workers engaging in intersectoral action. © 2014 Public Health Association of Australia.

  14. Road transport-related energy consumption: Analysis of driving factors in Tunisia

    International Nuclear Information System (INIS)

    Mraihi, Rafaa; Abdallah, Khaled ben; Abid, Mehdi

    2013-01-01

    The rapid growth of urban population and the development of road infrastructures in Tunisian cities have brought about many environmental and economic problems, including the rise scored in energy consumption and the increase in the quantity of gas emissions arising from road transport. Despite the critical nature of such problems, no policies have yet been adopted to improve energy efficiency in the transport sector. This paper aims to determine driving factors of energy consumption change for the road mode. It uses decomposition analysis to discuss the effects of economic, demographic and urban factors on the evolution of transport energy consumption. The main result highlighted in the present work is that vehicle fuel intensity, vehicle intensity, GDP per capita, urbanized kilometers and national road network are found to be the main drivers of energy consumption change in the road transport sector during 1990–2006 period. Consequently, several strategies can be elaborated to reduce road transport energy. Economic, fiscal and regulatory instruments can be applied in order to make road transport more sustainable. -- Highlights: •We are interested in determining driving factors of transport energy consumption growth in Tunisia. •We use decomposition analysis approach. •Vehicle fuel and road vehicle intensities are found to be principal factors. •Motorization and urbanization are also found to be responsible

  15. A review of the main driving factors of forest fire ignition over Europe.

    Science.gov (United States)

    Ganteaume, Anne; Camia, Andrea; Jappiot, Marielle; San-Miguel-Ayanz, Jesus; Long-Fournel, Marlène; Lampin, Corinne

    2013-03-01

    Knowledge of the causes of forest fires, and of the main driving factors of ignition, is an indispensable step towards effective fire prevention policies. This study analyses the factors driving forest fire ignition in the Mediterranean region including the most common human and environmental factors used for modelling in the European context. Fire ignition factors are compared to spatial and temporal variations of fire occurrence in the region, then are compared to results obtained in other areas of the world, with a special focus on North America (US and Canada) where a significant number of studies has been carried out on this topic. The causes of forest fires are varied and their distribution differs among countries, but may also differ spatially and temporally within the same country. In Europe, and especially in the Mediterranean basin, fires are mostly human-caused mainly due arson. The distance to transport networks and the distance to urban or recreation areas are among the most frequently used human factors in modelling exercises and the Wildland-Urban Interface is increasingly taken into account in the modelling of fire occurrence. Depending on the socio-economic context of the region concerned, factors such as the unemployment rate or variables linked to agricultural activity can explain the ignition of intentional and unintentional fires. Regarding environmental factors, those related to weather, fuel and topography are the most significant drivers of ignition of forest fires, especially in Mediterranean-type regions. For both human and lightning-caused fires, there is a geographical gradient of fire ignition, mainly due to variations in climate and fuel composition but also to population density for instance. The timing of fires depends on their causes. In populated areas, the timing of human-caused fires is closely linked to human activities and peaks in the afternoon whereas, in remote areas, the timing of lightning-caused fires is more linked to

  16. Factor structure of functional state of primary school age children

    Directory of Open Access Journals (Sweden)

    Davidenko O.V.

    2011-02-01

    Full Text Available The examination of primary school children to determine the ranking of significant factors that determine the structure of their functional state depending on the level of physical health. It is shown that the main factor in the structure of the functional state of younger schoolchildren in low-and lower-middle level of physical fitness is selected morpho-functional status, which characterizes the functions of the body at rest. For children with average or above average level of physical fitness is a leading factor in physical fitness of schoolchildren.

  17. Correlation Factors Describing Primary and Spatial Sensations of Sound Fields

    Science.gov (United States)

    ANDO, Y.

    2002-11-01

    The theory of subjective preference of the sound field in a concert hall is established based on the model of human auditory-brain system. The model consists of the autocorrelation function (ACF) mechanism and the interaural crosscorrelation function (IACF) mechanism for signals arriving at two ear entrances, and the specialization of human cerebral hemispheres. This theory can be developed to describe primary sensations such as pitch or missing fundamental, loudness, timbre and, in addition, duration sensation which is introduced here as a fourth. These four primary sensations may be formulated by the temporal factors extracted from the ACF associated with the left hemisphere and, spatial sensations such as localization in the horizontal plane, apparent source width and subjective diffuseness are described by the spatial factors extracted from the IACF associated with the right hemisphere. Any important subjective responses of sound fields may be described by both temporal and spatial factors.

  18. Questionnaire Based Assessment of Risk Factors for Primary Biliary Cirrhosis

    Science.gov (United States)

    Lammert, Craig; Nguyen, Douglas L.; Juran, Brian D.; Schlicht, Erik; Larson, Joseph J.; Atkinson, Elizabeth J.; Lazaridis, Konstantinos N.

    2013-01-01

    Background Primary Biliary Cirrhosis is a cholestatic liver disease characterized by immune-mediated destruction of bile ducts. Its pathogenesis is largely unknown, although complex interactions between environment and genetic predisposition are proposed. Aims Identify disease risk factors using a detailed patient questionnaire and compare study findings to 3 published reports. Methods Questionnaire data were prospectively collected from 522 cases and 616 controls of the Mayo Clinic Primary Biliary Cirrhosis Genetic Epidemiology Registry. Case and control responses were compared using logistic regression, adjusting for recruitment age, sex, and education level. Results Cases reported ever regularly smoking cigarettes more frequently than controls (P < 0.001). History of urinary tract infection (UTI) was similar between groups; however, cases reported multiple UTIs more commonly than controls (P < 0.001). Frequency of other autoimmune disease was higher in cases than controls (P < 0.001). As well, prevalence of primary biliary cirrhosis among first-degree relatives was higher in case families than control families (P < 0.001). Conclusions Our study confirms prior reported risk factors associated with disease risk. Given the potential importance of gene and environment interactions, further examination of environmental risk factors considering genetic background may provide new insight into primary biliary cirrhosis pathogenesis. PMID:23490343

  19. Self-Excited Single-Stage Power Factor Correction Driving Circuit for LED Lighting

    Directory of Open Access Journals (Sweden)

    Yong-Nong Chang

    2014-01-01

    Full Text Available This pa\tper proposes a self-excited single-stage high power factor LED lighting driving circuit. Being featured with power factor correction capability without needing any control devices, the proposed circuit structure is with low cost and suitable for commercial production. The power factor correction function is accomplished by using inductor in combination with a half-bridge quasi resonant converter to achieve active switching and yield out voltage regulation according to load requirement. Furthermore, the zero-voltage switching in the half-bridge converter can be attained to promote the overall performance efficiency of the proposed circuit. Finally, the validity and production availability of the proposed circuit will be verified as well.

  20. Risk factors of mobile phone use while driving in Queensland: Prevalence, attitudes, crash risk perception, and task-management strategies.

    Science.gov (United States)

    Oviedo-Trespalacios, Oscar; King, Mark; Haque, Md Mazharul; Washington, Simon

    2017-01-01

    Distracted driving is one of the most significant human factor issues in transport safety. Mobile phone interactions while driving may involve a multitude of cognitive and physical resources that result in inferior driving performance and reduced safety margins. The current study investigates characteristics of usage, risk factors, compensatory strategies in use and characteristics of high-frequency offenders of mobile phone use while driving. A series of questions were administered to drivers in Queensland (Australia) using an on-line questionnaire. A total of 484 drivers (34.9% males and 49.8% aged 17-25) participated anonymously. At least one of every two motorists surveyed reported engaging in distracted driving. Drivers were unable to acknowledge the increased crash risk associated with answering and locating a ringing phone in contrast to other tasks such as texting/browsing. Attitudes towards mobile phone usage were more favourable for talking than texting or browsing. Lowering the driving speed and increasing the distance from the vehicle in front were the most popular task-management strategies for talking and texting/browsing while driving. On the other hand, keeping the mobile phone low (e.g. in the driver's lap or on the passenger seat) was the favourite strategy used by drivers to avoid police fines for both talking and texting/browsing. Logistic regression models were fitted to understand differences in risk factors for engaging in mobile phone conversations and browsing/texting while driving. For both tasks, exposure to driving, driving experience, driving history (offences and crashes), and attitudes were significant predictors. Future mobile phone prevention efforts would benefit from development of safe attitudes and increasing risk literacy. Enforcement of mobile phone distraction should be re-engineered, as the use of task-management strategies to evade police enforcement seems to dilute its effect on the prevention of this behaviour. Some

  1. Risk factors of mobile phone use while driving in Queensland: Prevalence, attitudes, crash risk perception, and task-management strategies.

    Directory of Open Access Journals (Sweden)

    Oscar Oviedo-Trespalacios

    Full Text Available Distracted driving is one of the most significant human factor issues in transport safety. Mobile phone interactions while driving may involve a multitude of cognitive and physical resources that result in inferior driving performance and reduced safety margins. The current study investigates characteristics of usage, risk factors, compensatory strategies in use and characteristics of high-frequency offenders of mobile phone use while driving. A series of questions were administered to drivers in Queensland (Australia using an on-line questionnaire. A total of 484 drivers (34.9% males and 49.8% aged 17-25 participated anonymously. At least one of every two motorists surveyed reported engaging in distracted driving. Drivers were unable to acknowledge the increased crash risk associated with answering and locating a ringing phone in contrast to other tasks such as texting/browsing. Attitudes towards mobile phone usage were more favourable for talking than texting or browsing. Lowering the driving speed and increasing the distance from the vehicle in front were the most popular task-management strategies for talking and texting/browsing while driving. On the other hand, keeping the mobile phone low (e.g. in the driver's lap or on the passenger seat was the favourite strategy used by drivers to avoid police fines for both talking and texting/browsing. Logistic regression models were fitted to understand differences in risk factors for engaging in mobile phone conversations and browsing/texting while driving. For both tasks, exposure to driving, driving experience, driving history (offences and crashes, and attitudes were significant predictors. Future mobile phone prevention efforts would benefit from development of safe attitudes and increasing risk literacy. Enforcement of mobile phone distraction should be re-engineered, as the use of task-management strategies to evade police enforcement seems to dilute its effect on the prevention of this

  2. 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.

  3. [Modifiable risk factors for primary headache. A systematic review].

    Science.gov (United States)

    Albers, L; Ziebarth, S; von Kries, R

    2014-08-01

    Strategies to prevent primary headaches could be very beneficial, especially given that primary headaches can lead to the development of chronic headache. In order to establish headache prevention strategies, the modifiable risk factors for primary headaches need to be identified. A systematic literature search on the risk factors for primary headaches was conducted independently by two persons using the databases MEDLINE and Embase. Further inclusion criteria were observational studies in adult general populations or case-control studies, where the effect sizes were reported as odds ratios or where the odds ratios could be calculated from the given data. In all, 24 studies were included in the analysis. There was a large amount of heterogeneity among the studies concerning headache acquisition, headache classification, and risk factors for headache development. Independent of headache trigger and definition of headache, the association between headache and the risk factor "stress" was very high: The meta-analysis shows an overall effect of 2.26 (odds ratio; 95 %-CI = [1.79; 2.85]). Studies evaluating neck and shoulder pain also report a strong association with headache; however, these results could not be summarized in a meta-analysis. Equally, the overall effects of smoking and coffee consumption on headaches could not be verified because the effect sizes were rather small and predominantly noticeable only at higher doses. A strong association between headache and the risk factors stress and neck and shoulder pain was confirmed. The effect sizes of smoking and coffee consumption on headaches were rather small.

  4. Development and review of Euro 5 passenger car emission factors based on experimental results over various driving cycles

    OpenAIRE

    Fontaras, Georgios; Franco, Vicente; Dilara, Panagiota; Martini, Giorgio; Manfredi, Urbano

    2014-01-01

    The mass emissions of CO2 and regulated pollutants (NOX, HC, CO, PM) of thirteen Euro 5 compliant passenger cars (seven gasoline, six Diesel) were measured on a chassis dynamometer. The vehicles were driven repeatedly over the European type-approval driving cycle (NEDC) and the more dynamic WMTC and CADC driving cycles. Distance-specific emission factors were derived for each pollutant and sub-cycle which were subsequently compared to the corresponding emission factors provided by the referen...

  5. Assessing older drivers: a primary care protocol to evaluate driving safety risk.

    Science.gov (United States)

    Murden, Robert A; Unroe, Kathleen

    2005-08-01

    Most articles on elder drivers offer either general advice, or review testing protocols that divide drivers into two distinct groups: safe or unsafe. We believe it is unreasonable to expect any testing to fully separate drivers into just these two mutually exclusive groups, so we offer a protocol for a more practical approach. This protocol can be applied by primary care physicians. We review the justification for the many steps of this protocol, which have branches that lead to identifying drivers as low risk, high risk (for accidents) or needing further evaluation. Options for further evaluation are provided.

  6. Association of Psychologic and Nonpsychologic Factors With Primary Dysmenorrhea

    Science.gov (United States)

    Faramarzi, Mahbobeh; Salmalian, Hajar

    2014-01-01

    Background: Primary dysmenorrhea seems to be one the most common gynecologic condition in women of childbearing age. Objectives: The aim of this research was to evaluate psychologic and nonpsychologic risk factors of primary dysmenorrhea. Materials and Methods: A cross-sectional study was conducted on medical sciences students of Babol University of Medical Sciences. In this study, 180 females with dysmenorrhea and 180 females without dysmenorrhea were enrolled. Psychological risk factors were evaluated in four domains including affect, social support, personality, and alexithymia. Four questionnaires were used to assessed aforementioned domains, namely, Social Support Questionnaire (SSQ), depression, anxiety, stress (DAS-21), 20-item Toronto Alexithymia Scale (TAS-20), and NEO-Five Factor Inventory of Personality (NEO-FFI). In addition, nonpsychologic factors were evaluated in three domains including demographic characteristics, habits, and gynecologic factors. Data were analyzed using the χ2 test and multiple logistic regression analysis. Results: The strongest predictor of primary dysmenorrhea was low social support (OR = 4.25; 95% CI, 2.43-7.41). Risk of dysmenorrhea was approximately 3.3 times higher in women with alexithymia (OR = 3.26; 95% CI, 1.88-5.62), 3.1 times higher in women with menstrual bleeding duration ≥ 7 days (OR = 3.06; 95% CI, 1.73-5.41), 2.5 times higher in women with a neurotic character (OR = 2.53; 95% CI, 1.42-4.50), 2.4 times higher in women with a family history of dysmenorrhea (OR = 2.43; 95% CI, 1.42-4.50), and twice higher in women with high caffeine intake (OR = 1.97; 95% CI, 1.09-3.59). Conclusions: Low social support, alexithymia, neuroticism trait, long menstrual bleeding, family history of dysmenorrhea, and high-caffeine diet are important risk factors for women with primary dysmenorrhea. This study recommended considering psychologic factors as an adjuvant to medical risks in evaluation and treatment of primary dysmenorrhea

  7. Short primary linear drive designed for synchronous and induction operation mode with on-board energy storage

    Energy Technology Data Exchange (ETDEWEB)

    Fernandes Neto, Tobias Rafael

    2012-06-28

    The idea of a flexible industrial manufacturing system for the transfer of material, tooling, processing/filling, etc., in which several vehicles can travel with high speed, high degree of independency and high precision is proposed in this thesis. Such flexible systems show a meaningful economic potential for modern manufacturing systems. The basic concept is that a linear motor has the secondary part fixed to the track while the primary (moving winding) travels along the track (short primary topology). The same principle can work in the other way around, arranging the primary in segments and letting the secondary (carrier) to move from segment to segment (long primary topology). The concept's implementation involves technical issues, such as: the position measurement, the energy and information transfer, the individual position and speed control of the vehicle in which varying speeds increase the possibility of collision, and the smooth transition between segments or different types of the secondary. Finally, multiple vehicles traveling at high speed, high positioning repeatability and rapid acceleration rates increase the production throughout and the reliability compared to conventional manufacturing conveyor systems. As an example, a transporting and processing system based on linear drives is a continuous and closed structure with multiple loops, which permits the safe transport of fragile loads. Although such solutions often need higher investment costs, the lack of mechanical coupling parts and wearing elements in these motors greatly increases their reliability. The long primary topology allows a passive and lightweight vehicle (secondary), avoiding brushes and cables to transfer energy and information. For long distances, the primary is arranged in several electrical independent segments. On the other hand, the short primary configuration uses the winding mounted on the moving part (active vehicle) to produce the traveling wave, the secondary as

  8. Primary Hyperaldosteronism As A Risk Factor For Recurrent Nephrolithiasis

    Directory of Open Access Journals (Sweden)

    Ekamol Tantisattamo

    2012-06-01

    Hyperaldosteronism can cause hypercalciuria, phosphaturia, and hypocitraturia, all of which are risk factors for nephrolithiasis. Additionally, hyperaldosteronism and deoxycorticosterone mediated hypertension have been associated with hypocalcemia and secondary hyperparathyroidism. Our case augments earlier literature suggesting increased risk for nephrolithiasis in patients with hyperaldosteronism and suggests that hyperaldosteronism should be considered as a risk factor for patient with nephrolithiasis. It remains unclear if both primary and secondary hyperaldosteronism increase the relative risk for nephrolithiasis and the role of aldosterone receptor antagonist therapy for recurrent nephrolithiasis associated with hyperaldosteronism.

  9. Temporal-spatial variations and driving factors analysis of coastal reclamation in China

    Science.gov (United States)

    Meng, Weiqing; Hu, Beibei; He, Mengxuan; Liu, Baiqiao; Mo, Xunqiang; Li, Hongyuan; Wang, Zhongliang; Zhang, Yu

    2017-05-01

    Coastal reclamation is the gain of land from the sea or coastal wetlands for agricultural purposes, industrial use or port expansions. Large-scale coastal land reclamation can have adverse effects on the coastal environment, including loss of marine habitats and deterioration of coastal water quality. In recent decades, coastal land reclamation has occurred extensively to meet the increasing needs of rapid economic development and urbanization in China. The overall objective of this study is to understand the coastal reclamation status of China from 1979 to 2014 and analyzed its driving factors for mitigating negative ecological effects. The data of coastal reclamation were done with the ERDAS Imagine V9.2 platform and ArcGIS software based on remote images including Landsat, SPOT, ZY-2 and ZY-3. Potential driving factors for sea reclamation were selected based on statistics bulletins and the knowledge of experts in coastal management. In order to understand the relationships among possible impact factors and coastal reclamation, the Partial Least-Squares Regression models was constructed. The analysis results indicated that the total area of reclamation was 11162.89 km2 based on remote sensing images between 1979 and 2014. Shandong Province is the largest reclamation area, reaching 2736.54 km2, and the reclamation is mainly concentrated in Zhejiang, Jiangsu and Liaoning, where the reclamation areas were all more than 1000 km2. According to the remote sensing images, there are three coastal reclamation hotspot regions including Bohai bay (in which is located Liaoning, Tianjin and Hebei), Jiangsu province coastal area and Hangzhou bay (in Zhejiang province). A large scale land reclamation plan of more than 5880 km2 has been made by local government and 2469 km2 has approved by the State Council. From the analyzed results, there is a significant collinearity between these indicators, and no significant correlation between the area of reclamation and selected

  10. Nutrient limitation drives response of Calamagrostis epigejos to arbuscular mycorrhiza in primary succession

    Czech Academy of Sciences Publication Activity Database

    Rydlová, Jana; Püschel, David; Dostálková, M.; Janoušková, Martina; Frouz, J.

    2016-01-01

    Roč. 26, č. 7 (2016), s. 757-767 ISSN 0940-6360 R&D Projects: GA ČR GA13-10377S Institutional support: RVO:67985939 Keywords : chronosequence * mycorrhizal growth response * spoil banks Subject RIV: EF - Botanics Impact factor: 3.047, year: 2016

  11. Research on carbon emission driving factors of China’s provincial construction industry

    Science.gov (United States)

    Shang, Mei; Dong, Rui; Fu, Yujie; Hao, Wentao

    2018-03-01

    As a pillar industry of the national economy, the damage to the environment by construction industry can not be ignored. In the context of low carbon development, identifying the main driving factors for the carbon emission of the provincial construction industry are the key for the local government to formulate the development strategy for construction. In the paper, based on the Kaya factor decomposition method, the carbon intensity of the energy structure, energy intensity and the impact of the construction output on the carbon emission of provincial construction industry are studied, and relevant suggestions for low carbon development of provincial construction industry are proposed. The conclusion of this paper provides a theoretical basis for the early realization of low-carbon development in China’s provincial construction industry.

  12. Climatic factors driving vegetation declines in the 2005 and 2010 Amazon droughts.

    Directory of Open Access Journals (Sweden)

    Wenqian Zhao

    Full Text Available Along with global climate change, the occurrence of extreme droughts in recent years has had a serious impact on the Amazon region. Current studies on the driving factors of the 2005 and 2010 Amazon droughts has focused on the influence of precipitation, whereas the impacts of temperature and radiation have received less attention. This study aims to explore the climate-driven factors of Amazonian vegetation decline during the extreme droughts using vegetation index, precipitation, temperature and radiation datasets. First, time-lag effects of Amazonian vegetation responses to precipitation, radiation and temperature were analyzed. Then, a multiple linear regression model was established to estimate the contributions of climatic factors to vegetation greenness, from which the dominant climate-driving factors were determined. Finally, the climate-driven factors of Amazonian vegetation greenness decline during the 2005 and 2010 extreme droughts were explored. The results showed that (i in the Amazon vegetation greenness responded to precipitation, radiation and temperature, with apparent time lags for most averaging interval periods associated with vegetation index responses of 0-4, 0-9 and 0-6 months, respectively; (ii on average, the three climatic factors without time lags explained 27.28±21.73% (mean±1 SD of vegetation index variation in the Amazon basin, and this value increased by 12.22% and reached 39.50±27.85% when time lags were considered; (iii vegetation greenness in this region in non-drought years was primarily affected by precipitation and shortwave radiation, and these two factors altogether accounted for 93.47% of the total explanation; and (iv in the common epicenter of the two droughts, pixels with a significant variation in precipitation, radiation and temperature accounted for 36.68%, 40.07% and 10.40%, respectively, of all pixels showing a significant decrease in vegetation index in 2005, and 15.69%, 2.01% and 45.25% in

  13. Human resources in primary health care: investments and the driving force of production.

    Science.gov (United States)

    Maeda, Sayuri Tanaka; Moleiro, Priscilla Francescucci; Egry, Emiko Yoshikawa; Ciosak, Suely Itsuko

    2011-12-01

    The present study describes the composition, the qualification, the salary investment, the workforce produce, and discusses users' accessibility in terms of time at Basic Health Units (BHUs). The study was performed at two BHUs from January to December 2008, and developed by analyzing administrative documents. In both, the composition of professionals according to education level revealed: 21% with a university degree, 27% with a secondary education, and50% with a primary education; showing a positive salary variation. The medical and nursing conducts were the majority at both. The production indicators confirmed: 25 and 37 min/person/month for accessibility, respectively for BHU A and B; R$ 8.43 and R$ 12.11/person/month for the salary investment at both BHUs, and 0.07 appointments/person/month at both BHUs. The professionals' available time is scarce compared to the potential of the demand. The production indicated an opportunity of care < 1 per person/month at a reduced cost.

  14. Beyond job security and money: driving factors of motivation for government doctors in India.

    Science.gov (United States)

    Purohit, Bhaskar; Bandyopadhyay, Tathagata

    2014-02-21

    Despite many efforts from government to address the shortage of medical officers (MOs) in rural areas, rural health centres continue to suffer from severe shortage of MOs. Lack of motivation to join and continue service in rural areas is a major reason for such shortage. In the present study, we aimed to assess and rank the driving factors of motivation important for in-service MOs in their current job. The study participants included ninety two in-service government MOs from three states in India. The study participants were required to rank 14 factors of motivation important for them in their current job. The factors for the study were selected using Herzberg's two-factor theory of motivation and the data were collected using an instrument that has an established reliability and validity. Test of Kendall's coefficient of concordance (W) was carried out to assess the agreement in ranks assigned by participants to various motivation factors. Next, we studied the distributions of ranks of different motivating factors using standard descriptive statistics and box plots, which gave us interesting insights into the strength of agreement of the MOs in assigning ranks to various factors. And finally to assess whether MOs are more intrinsically motivated or extrinsically motivated, we used Kolmogorov-Smirnov test. The (W) test indicated statistically significant (P factors than to extrinsic factors. The study results indicate that job security was the most important factor related to motivation, closely followed by interesting work and respect and recognition. Among the top five preferred factors, three were intrinsic factors indicating a great importance given by MOs to factors beyond money and job security. To address the issue of motivation, the health departments need to pay close attention to devising management strategies that address not only extrinsic but also intrinsic factors of motivation. The study results may be useful to understand the complicated issue of

  15. Looking Past Primary Productivity: Benchmarking System Processes that Drive Ecosystem Level Responses in Models

    Science.gov (United States)

    Cowdery, E.; Dietze, M.

    2017-12-01

    As atmospheric levels of carbon dioxide levels continue to increase, it is critical that terrestrial ecosystem models can accurately predict ecological responses to the changing environment. Current predictions of net primary productivity (NPP) in response to elevated atmospheric CO2 concentration are highly variable and contain a considerable amount of uncertainty. Benchmarking model predictions against data are necessary to assess their ability to replicate observed patterns, but also to identify and evaluate the assumptions causing inter-model differences. We have implemented a novel benchmarking workflow as part of the Predictive Ecosystem Analyzer (PEcAn) that is automated, repeatable, and generalized to incorporate different sites and ecological models. Building on the recent Free-Air CO2 Enrichment Model Data Synthesis (FACE-MDS) project, we used observational data from the FACE experiments to test this flexible, extensible benchmarking approach aimed at providing repeatable tests of model process representation that can be performed quickly and frequently. Model performance assessments are often limited to traditional residual error analysis; however, this can result in a loss of critical information. Models that fail tests of relative measures of fit may still perform well under measures of absolute fit and mathematical similarity. This implies that models that are discounted as poor predictors of ecological productivity may still be capturing important patterns. Conversely, models that have been found to be good predictors of productivity may be hiding error in their sub-process that result in the right answers for the wrong reasons. Our suite of tests have not only highlighted process based sources of uncertainty in model productivity calculations, they have also quantified the patterns and scale of this error. Combining these findings with PEcAn's model sensitivity analysis and variance decomposition strengthen our ability to identify which processes

  16. Innate immunity drives the initiation of a murine model of primary biliary cirrhosis.

    Directory of Open Access Journals (Sweden)

    Chao-Hsuan Chang

    Full Text Available Invariant natural killer T (iNKT cells play complex roles in bridging innate and adaptive immunity by engaging with glycolipid antigens presented by CD1d. Our earlier work suggested that iNKT cells were involved in the initiation of the original loss of tolerance in primary biliary cirrhosis (PBC. To address this issue in more detail and, in particular, to focus on whether iNKT cells activated by a Th2-biasing agonist (2s,3s,4r-1-O-(α-D-galactopyranosyl-N-tetracosanoyl-2-amino-1,3,4-nonanetriol (OCH, can influence the development of PBC in a xenobiotic-induced PBC murine model. Groups of mice were treated with either OCH or, as a control, α-galactosylceramide (α-GalCer and thence serially followed for cytokine production, markers of T cell activation, liver histopathology and anti-mitochondrial antibody responses. Further, additional groups of CD1d deleted mice were similarly studied. Our data indicate that administration of OCH has a dramatic influence with exacerbation of portal inflammation and hepatic fibrosis similar to mice treated with α-GalCer. Further, iNKT cell deficient CD1d knockout mice have decreased inflammatory portal cell infiltrates and reduced anti-mitochondrial antibody responses. We submit that activation of iNKT cells can occur via overlapping and/or promiscuous pathways and highlight the critical role of innate immunity in the natural history of autoimmune cholangitis. These data have implications for humans with PBC and emphasize that therapeutic strategies must focus not only on suppressing adaptive responses, but also innate immunity.

  17. Dietary Factors Associated To Obesity In Ahwaz Primary School Pupils

    Directory of Open Access Journals (Sweden)

    Dorosty A.R; Tabatabaei M

    2005-05-01

    Full Text Available Background: Increase in obesity prevalence in recent years are associated to genetics as well environmental and behavioral factors. Change in dietary patterns including fatty and high density energy foods consumption have been reported to be very important. This study aimed to determine dietary factors (daily energy and macronutrient intakes, energy percentage of macronutrient, energy and macronutrient intakes per kilogram body weight, frequency of cola, natural fruit juice drinking, dairy products except cheese, tomato chips, puff, chocolate and fast food consumption and eating speed associated to obesity in Ahwaz primary school pupils. Materials and Methods: Using two stage cluster sampling from 35 Ahwaz primary schools, all 10-11y students who had a BMI 95th percentile of Hosseini et al. (1999 reference, were identified as obese (n=150 and 150 same age and gender pupils (having BMI0.05. macronutrient intakes per kilogram body weight were significantly lower in obese group (p0.05. Obese students used to eat faster (p<0.05. Conclusion: In conclusion, high intakes of energy, protein, carbohydrate, tomato chips and puff and high eating speed were associated to obesity in Ahwaz primary school pupils.

  18. Risk Factors for first time Drink-Driving Convictions among Young Males

    DEFF Research Database (Denmark)

    Christoffersen, Mogens; Soothill, Keith; Francis, Brian

    2008-01-01

    -driving conviction increased substantially in rural areas compared to metropolitan areas. The study concludes that disadvantages during adolescence, including parental substance abuse, having a teenage mother, and domestic violence, are associated with a first-time drink-driving conviction....

  19. Twin specific risk factors in primary school achievements.

    Science.gov (United States)

    de Zeeuw, Eveline L; van Beijsterveldt, Catherina E M; de Geus, Eco J C; Boomsma, Dorret I

    2012-02-01

    The main aim of this study was to examine twin specific risk factors that influence educational achievement in primary school. We included prenatal factors that are not unique to twins, except for zygosity, but show a higher prevalence in twins than in singletons. In addition, educational achievement was compared between twins and their nontwin siblings in a within-family design. Data were obtained from parents and teachers of approximately 10,000 twins and their nontwin siblings registered with the Netherlands Twin Register. Teachers rated the proficiency of the children on arithmetic, language, reading, and physical education, and reported a national educational achievement test score (CITO). Structural equation modeling showed that gestational age, birth weight, and sex were significant predictors of educational achievement, even after correction for socioeconomic status. Mode of delivery and zygosity did not have an effect, while parental age only influenced arithmetic. Mode of conception, incubator time, and birth complications negatively affected achievement in physical education. The comparison of educational achievement of twins and singletons showed significantly lower ratings on arithmetic, reading, and language in twins, compared to their older siblings, but not compared to their younger siblings. Low gestational age and low birth weight were the most important risk factors for lower educational achievement of twins in primary school. It seems that the differences observed between twins and their nontwin siblings in educational achievement can largely be explained by birth order within the family.

  20. Factors associated with primary care residents' satisfaction with their training.

    Science.gov (United States)

    Randall, C S; Bergus, G R; Schlechte, J A; McGuinness, G; Mueller, C W

    1997-01-01

    Satisfaction is known to impact work performance, learning, recruitment, and retention. This study identifies the factors associated with primary care residents' satisfaction with their training. We used a cross-sectional survey based on the Price-Mueller model of job satisfaction. The model included 14 job characteristics, four personal characteristics, and four demographic factors. Data were collected in February and March 1996 from residents in three primary care training programs (family practice, pediatrics, and internal medicine) at a large academic medical center. The same standardized, self-administered questionnaires were used in all three departments. Seventy-five percent (n = 119) of the residents returned questionnaires. Five job characteristics were positively associated with resident satisfaction: continuity of care, autonomy, collegiality, work that encourages professional growth, and work group loyalty. Role conflict, a sixth job characteristic, was negatively associated with satisfaction. The personal characteristic of having an optimistic outlook on life was also positively associated with satisfaction. The model explained 66% of the variation in self-reported satisfaction. The satisfaction of the residents was significantly associated with six job characteristics and one personal factor. Interventions based on these job characteristics may increase resident satisfaction and may lead to better patient outcomes, better work performance, greater patient satisfaction, and more success in recruiting top students into a residency.

  1. Factors associated with job satisfaction by Chinese primary care providers.

    Science.gov (United States)

    Shi, Leiyu; Song, Kuimeng; Rane, Sarika; Sun, Xiaojie; Li, Hui; Meng, Qingyue

    2014-01-01

    This study provides a snapshot of the current state of primary care workforce (PCW) serving China's grassroots communities and examines the factors associated with their job satisfaction. Data for the study were from the 2011 China Primary Care Workforce Survey, a nationally representative survey that provides the most current assessment of community-based PCW. Outcome measures included 12 items on job satisfaction. Covariates included intrinsic and extrinsic factors associated with job satisfaction. In addition, PCW type (i.e., physicians, nurses, public health, and village doctors) and practice setting (i.e., rural versus urban) were included to identify potential differences due to the type of PCW and practice settings. The overall satisfaction level is rather low with only 47.6% of the Chinese PCW reporting either satisfied or very satisfied with their job. PCW are least satisfied with their income level (only 8.6% are either satisfied or very satisfied), benefits (12.8%), and professional development (19.5%). They (particularly village doctors) are also dissatisfied with their workload (37.2%). Lower income and higher workload are the two major contributing factors toward job dissatisfaction. To improve the general satisfaction level, policymakers must provide better pay and benefits and more opportunities for career development, particularly for village doctors.

  2. Pain symptoms and stooling patterns do not drive diagnostic costs for children with functional abdominal pain and irritable bowel syndrome in primary or tertiary care.

    Science.gov (United States)

    Lane, Mariella M; Weidler, Erica M; Czyzewski, Danita I; Shulman, Robert J

    2009-03-01

    The objectives of this study were to (1) compare the cost of medical evaluation for children with functional abdominal pain or irritable bowel syndrome brought to a pediatric gastroenterologist versus children who remained in the care of their pediatrician, (2) compare symptom characteristics for the children in primary versus tertiary care, and (3) examine if symptom characteristics predicted the cost of medical evaluation. Eighty-nine children aged 7 to 10 years with functional abdominal pain or irritable bowel syndrome seen by a gastroenterologist (n = 46) or seen only by a pediatrician (n = 43) completed daily pain and stool diaries for 2 weeks. Mothers provided retrospective reports of their children's symptoms in the previous year. Cost of medical evaluation was calculated via chart review of diagnostic tests and application of prices as if the patients were self-pay. Child-reported diary data reflected no significant group differences with respect to pain, interference with activities, or stool characteristics. In contrast, mothers of children evaluated by a gastroenterologist viewed their children as having higher maximum pain intensity in the previous year. Excluding endoscopy costs, cost of medical evaluation was fivefold higher for children evaluated by a gastroenterologist, with higher cost across blood work, stool studies, breath testing, and diagnostic imaging. Symptom characteristics did not predict cost of care for either group. Despite the lack of difference in symptom characteristics between children in primary and tertiary care, a notable differential in cost of evaluation exists in accordance with level of care. Symptom characteristics do not seem to drive diagnostic evaluation in either primary or tertiary care. Given the lack of differences in child-reported symptoms and the maternal perspective that children evaluated by a gastroenterologist had more severe pain, we speculate that parent perception of child symptoms may be a primary factor in

  3. Driving factors of carbon dioxide emissions and the impact from Kyoto Protocol

    Energy Technology Data Exchange (ETDEWEB)

    Grunewald, Nicole [Goettingen Univ. (Germany). Dept. of Economics; Martinez-Zarzoso, Inmaculada [Jaume I Univ. (Spain). International Economics Institute

    2009-08-15

    In the last two decades increasing attention has been paid to the relationship between environmental degradation and economic development. According to the Environmental Kuznets Curve (EKC) hypothesis this relationship may be described by an inverted-U curve. However, recent evidence rejects the EKC hypothesis for GHG emissions in a broad sense. In this paper we aim to investigate whether the EKC behavior for CO2 emissions could be proved on the behalf of institutional regulations. We analyze the driving factors of CO2 for developed and developing countries to test the theory of the EKC in the context of environmental regulations using a static and dynamic panel data model. We consider the Kyoto Protocol and the Clean Development Mechanism (CDM). The results from this study indicate that the Kyoto obligations have a reducing effect on CO2 emissions in developed and developing countries. (orig.)

  4. Driving factors for torrential mass-movements occurrence in the Western Alps

    Directory of Open Access Journals (Sweden)

    Davide eTiranti

    2016-02-01

    Full Text Available To understand the behaviour of torrential processes in the alpine environment, the conditions mainly responsiblefor the occurrence of these phenomena have to be identified and distinguished(classified aspredisposing and triggering factors. In this regard, this study is aimed to understanding which factors lead to the occurrence of a given torrential processes in alpine catchments in the Western Alps, where information on past events are exhaustive and characterized by a long historical series. More than 769 documented torrential eventsoccurred from 1728 to 2015 within 78 catchments. Datasets concerning climate, geology and morphology, land use and the presence of historical landslide activity have been elaborated as input for multivariate statistical analysis to characterize the behaviour of the catchments. The results pinpoint the factors that mainly drive the type of torrential dominant process occurring in a given catchment, its occurrence probability, and its frequency. This study has demonstrated that catchments characterized by a significant percentage of outcropping rocks show a greater occurrence of torrential processes, especially hyperconcentrated flows and debris flows; on the contrary highly vegetated catchments are typically subject to water flows. This result can be a useful tool for the evaluation of hazards related to this specific phenomenon, making it possible to predict the most likely torrential processes that can be generated in a specific basin, given the characteristics of outcropping rock and vegetation cover.

  5. Development of real-world driving cycles and estimation of emission factors for in-use light-duty gasoline vehicles in urban areas.

    Science.gov (United States)

    Hwa, Mei-Yin; Yu, Tai-Yi

    2014-07-01

    This investigation adopts vehicle tracking manner to establish real-world driving patterns and estimates emission factors with dynamometers with 23 traffic-driving variables for 384 in-use light-duty passenger vehicles during non-rush hour. Adequate numbers of driving variables were decided with factor analysis and cluster analysis. The dynamometer tests were performed on FTP75 cycle and five local driving cycles derived from real-world speed profiles. Results presented that local driving cycles and FTP75 cycle were completely different in driving characteristic parameters of typical driving cycles and emission factors. The highest values of emission factor ratios of local driving cycle and FTP75 cycle for CO, NMHC, NO x , CH4, and CO2 were 1.38, 1.65, 1.58, 1.39, and 1.14, respectively.

  6. Infected primary knee arthroplasty: Risk factors for surgical treatment failure

    Directory of Open Access Journals (Sweden)

    Joao Gabriel Duarte Paes Pradella

    2013-09-01

    Full Text Available OBJECTIVE: To present epidemiological data and risk factors associated with surgical out-comes favorable or unfavorable for the treatment of infection in infected total knee arthroplasty. METHODS: We reviewed medical records of 48 patients who underwent treatment of primary total knee arthroplasty for infection between January 1994 and December 2008, in the Orthopedics and Traumatology Department of the Santa Casa de Misericórdia de São Paulo. The variables associated with favorable outcome of surgical treatment (debridement and retention or exchange arthroplasty in two days or unfavorable (arthrodesis or death infection. RESULTS: A total of 39 cases of infection after primary total knee arthroplasty, 22 progressed to 17 for a favorable outcome and unfavorable outcome. Early infections (OR: 14.0, 95% CI 1.5-133.2, p = 0.016 and diabetes (OR: 11.3, 95% CI 1.4-89.3, p = 0.032 were associated with arthrodesis joint and death respectively. CONCLUSION: Patients with early infection had a higher risk of developing surgical procedure with unfavorable outcome (arthrodesis and diabetics had higher odds of death after infection of primary knee arthroplasties.

  7. Platelet-Released Growth Factors Induce Differentiation of Primary Keratinocytes

    Science.gov (United States)

    Tohidnezhad, Mersedeh; Lammel, Justus; Lippross, Sebastian; Behrendt, Peter; Klüter, Tim; Pufe, Thomas; Jahr, Holger; Cremer, Jochen; Rademacher, Franziska; Gläser, Regine; Harder, Jürgen

    2017-01-01

    Autologous thrombocyte concentrate lysates, for example, platelet-released growth factors, (PRGFs) or their clinically related formulations (e.g., Vivostat PRF®) came recently into the physicians' focus as they revealed promising effects in regenerative and reparative medicine such as the support of healing of chronic wounds. To elucidate the underlying mechanisms, we analyzed the influence of PRGF and Vivostat PRF on human keratinocyte differentiation in vitro and on epidermal differentiation status of skin wounds in vivo. Therefore, we investigated the expression of early (keratin 1 and keratin 10) and late (transglutaminase-1 and involucrin) differentiation markers. PRGF treatment of primary human keratinocytes decreased keratin 1 and keratin 10 gene expression but induced involucrin and transglutaminase-1 gene expression in an epidermal growth factor receptor- (EGFR-) dependent manner. In concordance with these results, microscopic analyses revealed that PRGF-treated human keratinocytes displayed morphological features typical of keratinocytes undergoing terminal differentiation. In vivo treatment of artificial human wounds with Vivostat PRF revealed a significant induction of involucrin and transglutaminase-1 gene expression. Together, our results indicate that PRGF and Vivostat PRF induce terminal differentiation of primary human keratinocytes. This potential mechanism may contribute to the observed beneficial effects in the treatment of hard-to-heal wounds with autologous thrombocyte concentrate lysates in vivo. PMID:28808357

  8. Platelet-Released Growth Factors Induce Differentiation of Primary Keratinocytes

    Directory of Open Access Journals (Sweden)

    Andreas Bayer

    2017-01-01

    Full Text Available Autologous thrombocyte concentrate lysates, for example, platelet-released growth factors, (PRGFs or their clinically related formulations (e.g., Vivostat PRF® came recently into the physicians’ focus as they revealed promising effects in regenerative and reparative medicine such as the support of healing of chronic wounds. To elucidate the underlying mechanisms, we analyzed the influence of PRGF and Vivostat PRF on human keratinocyte differentiation in vitro and on epidermal differentiation status of skin wounds in vivo. Therefore, we investigated the expression of early (keratin 1 and keratin 10 and late (transglutaminase-1 and involucrin differentiation markers. PRGF treatment of primary human keratinocytes decreased keratin 1 and keratin 10 gene expression but induced involucrin and transglutaminase-1 gene expression in an epidermal growth factor receptor- (EGFR- dependent manner. In concordance with these results, microscopic analyses revealed that PRGF-treated human keratinocytes displayed morphological features typical of keratinocytes undergoing terminal differentiation. In vivo treatment of artificial human wounds with Vivostat PRF revealed a significant induction of involucrin and transglutaminase-1 gene expression. Together, our results indicate that PRGF and Vivostat PRF induce terminal differentiation of primary human keratinocytes. This potential mechanism may contribute to the observed beneficial effects in the treatment of hard-to-heal wounds with autologous thrombocyte concentrate lysates in vivo.

  9. [Job satisfaction and improvement factors in primary care professionals].

    Science.gov (United States)

    Pérez-Ciordia, I; Guillén-Grima, F; Brugos, A; Aguinaga, I

    2013-09-06

    The quality of services in a health system is related to the level of satisfaction of its professionals. The aim of this article is to determine job satisfaction in primary care professionals and rank those factors capable of improving it. Descriptive study carried out in Navarre in 2010. A validated questionnaire was sent by post to the population of the study: primary care doctors, pediatricians and nurses. Variables on socio-demographic data were collected and job satisfaction was self-evaluated on a scale of 1 to 10. Respondents were asked to rank 10 factors that could improve the previously mentioned satisfaction. Averages were compared and bivariate analysis was carried out using the chi-square test, studying the association between variables through the Odds Ratio (OR). The adjusted analysis was realized through unconditional logistic regression. We collected 432 questionnaires (77.5%). Average satisfaction was 6.7 (scale of 1 to 10), higher in nursing. Women showed a higher average than men (6.90:6.34). The workers at urban health centers (OR: 1.71; CI: 1.10-2.65) showed a higher risk of dissatisfaction with respect to professionals at rural centers. The training activities of the professional is the most highly valued item, followed by economic questions and questions of care pressure, with no differences found by profession. Job satisfaction is a dimension of quality management in primary care and its study enables identification of problems or opportunities for improvement with an impact on the quality of the services offered.

  10. Risk Factors for Blood Transfusion With Primary Posterior Lumbar Fusion.

    Science.gov (United States)

    Basques, Bryce A; Anandasivam, Nidharshan S; Webb, Matthew L; Samuel, Andre M; Lukasiewicz, Adam M; Bohl, Daniel D; Grauer, Jonathan N

    2015-11-01

    Retrospective cohort study. To identify factors associated with blood transfusion for primary posterior lumbar fusion surgery, and to identify associations between blood transfusion and other postoperative complications. Blood transfusion is a relatively common occurrence for patients undergoing primary posterior lumbar fusion. There is limited information available describing which patients are at increased risk for blood transfusion, and the relationship between blood transfusion and short-term postoperative outcomes is poorly characterized. The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database was used to identify patients undergoing primary posterior lumbar fusion from 2011 to 2013. Multivariate analysis was used to find associations between patient characteristics and blood transfusion, along with associations between blood transfusion and postoperative outcomes. Out of 4223 patients, 704 (16.7%) had a blood transfusion. Age 60 to 69 (relative risk [RR] 1.6), age greater than equal to 70 (RR 1.7), American Society of Anesthesiologists class greater than equal to 3 (RR 1.1), female sex (RR 1.1), pulmonary disease (RR 1.2), preoperative hematocrit less than 36.0 (RR 2.0), operative time greater than equal to 310 minutes (RR 2.9), 2 levels (RR 1.6), and 3 or more levels (RR 2.1) were independently associated with blood transfusion. Interbody fusion (RR 0.9) was associated with decreased rates of blood transfusion. Receiving a blood transfusion was significantly associated with any complication (RR 1.7), sepsis (RR 2.6), return to the operating room (RR 1.7), deep surgical site infection (RR 2.6), and pulmonary embolism (RR 5.1). Blood transfusion was also associated with an increase in postoperative length of stay of 1.4 days (P risk factors for these occurrences were characterized. Strategies to minimize blood loss might be considered in these patients to avoid the associated complications. 3.

  11. Dose rate determining factors of PWR primary water

    International Nuclear Information System (INIS)

    Terachi, Takumi; Kuge, Toshiharu; Nakano, Nobuo

    2014-01-01

    The relationship between dose rate trends and water chemistry has been studied to clarify the determining factors on the dose rates. Therefore dose rate trends and water chemistry of 11 PWR plants of KEPCO (Kansai Electric Power Co., Inc.) were summarized. It is indicated that the chemical composition of the oxide film, behaviour of corrosion products and Co-58/Co-60 ratio in the primary system have effected dose rate trends based on plant operation experiences for over 40 years. According to plant operation experiences, the amount of Co-58 has been decreasing with the increasing duration of SG (Steam Generator) usage. It is indicated that the stable oxide film formation on the inner surface of SG tubing, is a major beneficial factor for radiation sources reduction. On the other hand, the reduction of the amount of Co-60 for the long term has been not clearly observed especially in particular high dose plants. The primary water parameters imply that considering release and purification balance on Co-59 is important to prevent accumulation of source term in primary water. In addition, the effect of zinc injection, which relates to the chemical composition of oxide film, was also assessed. As the results, the amount of radioactive Co has been clearly decreased. The decreasing trend seems to correlate to the half-life of Co-60, because it is considered that the injected zinc prevents the uptake of radioactive Co into the oxide film on the inner surface of the components and piping. In this paper, the influence of water chemistry and the replacement experiences of materials on the dose rates were discussed. (author)

  12. Risk factors of mobile phone use while driving in Queensland: Prevalence, attitudes, crash risk perception, and task-management strategies

    Science.gov (United States)

    King, Mark; Haque, Md. Mazharul; Washington, Simon

    2017-01-01

    Distracted driving is one of the most significant human factor issues in transport safety. Mobile phone interactions while driving may involve a multitude of cognitive and physical resources that result in inferior driving performance and reduced safety margins. The current study investigates characteristics of usage, risk factors, compensatory strategies in use and characteristics of high-frequency offenders of mobile phone use while driving. A series of questions were administered to drivers in Queensland (Australia) using an on-line questionnaire. A total of 484 drivers (34.9% males and 49.8% aged 17–25) participated anonymously. At least one of every two motorists surveyed reported engaging in distracted driving. Drivers were unable to acknowledge the increased crash risk associated with answering and locating a ringing phone in contrast to other tasks such as texting/browsing. Attitudes towards mobile phone usage were more favourable for talking than texting or browsing. Lowering the driving speed and increasing the distance from the vehicle in front were the most popular task-management strategies for talking and texting/browsing while driving. On the other hand, keeping the mobile phone low (e.g. in the driver’s lap or on the passenger seat) was the favourite strategy used by drivers to avoid police fines for both talking and texting/browsing. Logistic regression models were fitted to understand differences in risk factors for engaging in mobile phone conversations and browsing/texting while driving. For both tasks, exposure to driving, driving experience, driving history (offences and crashes), and attitudes were significant predictors. Future mobile phone prevention efforts would benefit from development of safe attitudes and increasing risk literacy. Enforcement of mobile phone distraction should be re-engineered, as the use of task-management strategies to evade police enforcement seems to dilute its effect on the prevention of this behaviour. Some

  13. Relevant principal factors affecting the reproducibility of insect primary culture.

    Science.gov (United States)

    Ogata, Norichika; Iwabuchi, Kikuo

    2017-06-01

    The primary culture of insect cells often suffers from problems with poor reproducibility in the quality of the final cell preparations. The cellular composition of the explants (cell number and cell types), surgical methods (surgical duration and surgical isolation), and physiological and genetic differences between donors may be critical factors affecting the reproducibility of culture. However, little is known about where biological variation (interindividual differences between donors) ends and technical variation (variance in replication of culture conditions) begins. In this study, we cultured larval fat bodies from the Japanese rhinoceros beetle, Allomyrina dichotoma, and evaluated, using linear mixed models, the effect of interindividual variation between donors on the reproducibility of the culture. We also performed transcriptome analysis of the hemocyte-like cells mainly seen in the cultures using RNA sequencing and ultrastructural analyses of hemocytes using a transmission electron microscope, revealing that the cultured cells have many characteristics of insect hemocytes.

  14. Sensorimotor and postural control factors associated with driving safety in a community-dwelling older driver population.

    Science.gov (United States)

    Lacherez, Philippe; Wood, Joanne M; Anstey, Kaarin J; Lord, Stephen R

    2014-02-01

    To establish whether sensorimotor function and balance are associated with on-road driving performance in older adults. The performance of 270 community-living adults aged 70-88 years recruited via the electoral roll was measured on a battery of peripheral sensation, strength, flexibility, reaction time, and balance tests and on a standardized measure of on-road driving performance. Forty-seven participants (17.4%) were classified as unsafe based on their driving assessment. Unsafe driving was associated with reduced peripheral sensation, lower limb weakness, reduced neck range of motion, slow reaction time, and poor balance in univariate analyses. Multivariate logistic regression analysis identified poor vibration sensitivity, reduced quadriceps strength, and increased sway on a foam surface with eyes closed as significant and independent risk factors for unsafe driving. These variables classified participants into safe and unsafe drivers with a sensitivity of 74% and specificity of 70%. A number of sensorimotor and balance measures were associated with driver safety and the multivariate model comprising measures of sensation, strength, and balance was highly predictive of unsafe driving in this sample. These findings highlight important determinants of driver safety and may assist in developing efficacious driver safety strategies for older drivers.

  15. Advising on human factors for field trials with (partially) self-driving vehicles.

    NARCIS (Netherlands)

    Craen, S. de Boele, M.J. Duivenvoorden, C.W.A.E. & Hoekstra, A.T.G.

    2016-01-01

    Vehicles are increasingly equipped with systems that take over (elements of) the driving task. Eventually, this is expected to result in fully self-driving vehicles. The human role will shift from driver to supervisor, and ultimately to passenger. These systems are assumed to reduce the risk of

  16. Examining signs of driver sleepiness, usage of sleepiness countermeasures and the associations with sleepy driving behaviours and individual factors.

    Science.gov (United States)

    Watling, Christopher N; Armstrong, Kerry A; Radun, Igor

    2015-12-01

    The impairing effect from sleepiness is a major contributor to road crashes. The ability of a sleepy driver to perceive their level of sleepiness is an important consideration for road safety as well as the type of sleepiness countermeasure used by drivers as some sleepiness countermeasures are more effective than others. The aims of the current study were to determine the extent that the signs of driver sleepiness were associated with sleepy driving behaviours, as well as determining which individual factors (demographic, work, driving, and sleep-related factors) were associated with using a roadside or in-vehicle sleepiness countermeasure. A sample of 1518 Australian drivers from the Australian State of New South Wales and the neighbouring Australian Capital Territory took part in the study. The participants' experiences with the signs of sleepiness were reasonably extensive. A number of the early signs of sleepiness (e.g., yawning, frequent eye blinks) were related with continuing to drive while sleepy, with the more advanced signs of sleepiness (e.g., difficulty keeping eyes open, dreamlike state of consciousness) associated with having a sleep-related close call. The individual factors associated with using a roadside sleepiness countermeasure included age (being older), education (tertiary level), difficulties getting to sleep, not continuing to drive while sleepy, and having experienced many signs of sleepiness. The results suggest that these participants have a reasonable awareness and experience with the signs of driver sleepiness. Factors related to previous experiences with sleepiness were associated with implementing a roadside countermeasure. Nonetheless, the high proportions of drivers performing sleepy driving behaviours suggest that concerted efforts are needed with road safety campaigns regarding the dangers of driving while sleepy. Copyright © 2015 Elsevier Ltd. All rights reserved.

  17. Impact of Macro Environmental Factors on Garments Industry That Drives Export in Bangladesh

    Directory of Open Access Journals (Sweden)

    Islam Mohammad

    2017-08-01

    Full Text Available It goes without saying that Garments industry of Bangladesh has drawn a special attention to the mass people in the world because of being both cost leader and quality leader at the same time. The purpose of this research paper is to analyze the garments industry in Bangladesh which is going to be an emerging tiger in the world economy. It also aims to assess the impact of macro-environmental factors affecting the industry by PESTEL analysis. Again, five forces model has been analyzed to assess the impacts of competitive external factors on the Garments industry in Bangladesh. Furthermore, Garments sector competitive responses to the primary issues affecting the industry have been evaluated here. It also outlines the primary external influences to which this industry is subject. In this case, SWOT analysis has been conducted to assess the competitive position of this industry in comparison with the global perspective. The study suggests that total export is highly correlated with the exports of garments. It also finds that there is severe lacking in the safety and security compliance, wages and compensations and code of conduct of the current organizations. Moreover, GSP facility withdrawn can impact severely on the ready made garments of Bangladesh to compete with price in the international market with China, India and Vietnam etc. The ready made garments sector of Bangladesh is enjoying cost leadership as a source of completive advantage because of cheap labor. Finally, the study would like to recommend for further improvement of garment sector in Bangladesh.

  18. Factors influencing quality of patient interaction at community pharmacy drive-through and walk-in counselling areas.

    Science.gov (United States)

    Odukoya, Olufunmilola K; Chui, Michelle A; Pu, Jia

    2014-08-01

    To examine factors influencing the amount of time and information pharmacy personnel provide to patients at drive-through and walk-in counselling areas. On-site observational data collection in 22 community pharmacies by pharmacy students. Information included observable patient characteristics such as gender, age range, English proficiency and mobility impairment; encounter characteristics included type of prescription and whether the patient was acknowledged; and counselling characteristics included types of counselling information conveyed and length of time for each encounter. Patient-pharmacist encounters were documented at the drive-through and walk-in counselling areas 961 and 1098 times respectively. Pharmacists spent less time, and technicians more time, with patients at the drive-through counselling area. The amount of information provided to patients was significantly affected by whether the patient was receiving new versus refill prescriptions. Patients with a new prescription were twice as likely to receive more information from pharmacy personnel. There was a significant difference between the amount of counselling provided to patients at the drive-through and walk-in counselling area (rate ratio (RR) 0.92, 95% confidence interval (CI): 0.86-1.00). Patients at the drive-through received a lower amount of information relative to patients using the walk-in. Amount of information provided to patients was affected by the level of pharmacy busyness (RR 0.96, 95% CI: 0.95-0.99). Providing patient care at the drive-through counselling area may negatively influence quality of patient care. To improve quality of pharmacy drive-through services, standardization of drive-through services in pharmacies may be needed. © 2013 Royal Pharmaceutical Society.

  19. Electrical stimulation drives chondrogenesis of mesenchymal stem cells in the absence of exogenous growth factors

    Science.gov (United States)

    Kwon, Hyuck Joon; Lee, Gyu Seok; Chun, Honggu

    2016-01-01

    Electrical stimulation (ES) is known to guide the development and regeneration of many tissues. However, although preclinical and clinical studies have demonstrated superior effects of ES on cartilage repair, the effects of ES on chondrogenesis remain elusive. Since mesenchyme stem cells (MSCs) have high therapeutic potential for cartilage regeneration, we investigated the actions of ES during chondrogenesis of MSCs. Herein, we demonstrate for the first time that ES enhances expression levels of chondrogenic markers, such as type II collagen, aggrecan, and Sox9, and decreases type I collagen levels, thereby inducing differentiation of MSCs into hyaline chondrogenic cells without the addition of exogenous growth factors. ES also induced MSC condensation and subsequent chondrogenesis by driving Ca2+/ATP oscillations, which are known to be essential for prechondrogenic condensation. In subsequent experiments, the effects of ES on ATP oscillations and chondrogenesis were dependent on extracellular ATP signaling via P2X4 receptors, and ES induced significant increases in TGF-β1 and BMP2 expression. However, the inhibition of TGF-β signaling blocked ES-driven condensation, whereas the inhibition of BMP signaling did not, indicating that TGF-β signaling but not BMP signaling mediates ES-driven condensation. These findings may contribute to the development of electrotherapeutic strategies for cartilage repair using MSCs. PMID:28004813

  20. Factors driving collaboration in natural resource conflict management: Evidence from Romania.

    Science.gov (United States)

    Hossu, Constantina Alina; Ioja, Ioan Cristian; Susskind, Lawrence E; Badiu, Denisa L; Hersperger, Anna M

    2018-02-03

    A critical challenge in natural resource management is to bring all stakeholders together to negotiate solutions to critical problems. However, various collaborative approaches to heading off conflicts and resolving natural resource management disputes have been used. What drives these efforts, however, still needs further research. Our study provides a systematic look at the drivers likely to initiate collaborative problem-solving efforts in four cases in Romania. We use Emerson's et al. (2012) framework for collaborative governance and multi-value qualitative comparative analysis (mvQCA) to analyze cases involving endangered species, restrictions on forest harvest, conflicts associated with infrastructure development projects, and disputes over the management of environmentally sensitive areas. Our findings contribute to the already existing collaborative governance literature indicating which of the four factors: uncertainty, interdependence, consequential incentives, and leadership, in which combination, are necessary and sufficient to spur collaborative resource management efforts. Our results showed that in Romania the initiation of collaboration is best explained by positive consequential incentives (i.e., financial opportunities) which has determined leaders to take initiative. This study provides additional information for the complicated process of natural resource management which is often overriding collaboration by investigating what enables and constrains collaborative efforts in a country where natural resources were managed and used according to the principles of central planning.

  1. [Eco-efficiency change and its driving factors in Tongling City of Anhui Province].

    Science.gov (United States)

    Wang, Yi-Chen; Wang, Yuan; Zhu, Xiao-Dong; Wu, Xiao-Qing; Wang, Ke; Ren, Ke-Xiu; Lu, Gen-Fa

    2011-02-01

    This paper first applied material flow analysis (MFA) to construct three levels of regional eco-efficiency indicators, i.e., regional direct eco-efficiency (RDE), regional total eco-efficiency (RTE), and holistic eco-efficiency (HE), and adopted the newly developed data envelopment analysis (DEA) to evaluate the eco-efficiency of Tongling City during the period of 1990-2008. We also applied Malmquist productivity index (MPI) to explore the eco-efficiency change between two following years and its driving factors. The main results were summarized as 1) though the RDE of Tongling City in 1990-2008 kept an increasing trend, its mean eco-efficiency was not high (close to 0.8 in 80% of the years), being lower than that of the RTE and HE, and 2) the RDE change was closely relevant to the improvement in resource management and the technical input in environmental protection in recent years. In order to further improve the RDE of the City, it would be necessary to raise its eco-efficiency via expanding raw material input, reducing domestic extraction, promoting resources productivity, and taking more measures on environmental protection facilities construction.

  2. [Factors associated with influenza immunization in primary care health workers].

    Science.gov (United States)

    Montserrat-Capdevila, Josep; Godoy, Pere; Marsal, Josep Ramon; Barbé-Illa, Ferran

    2015-01-01

    To identify the influenza vaccination coverage in healthcare workers in primary care and to determine the factors associated with vaccination (2013-2014 season). A cross-sectional study was carried out among 287 healthcare workers who completed a questionnaire that included questions about knowledge, beliefs and attitudes to influenza and vaccination. We estimated the vaccine coverage and identified the variables associated with vaccination of healthcare workers by using non-conditional logistic regression models. The participation rate was 47.2%. Vaccination coverage was 60.3% and was higher in workers older than 55 years, women and pediatricians. The factors associated with healthcare worker vaccination were the perception that vaccination confers protection (aOR: 11.1; 95%CI: 3.41-35.9) and the perception that it is effective (aOR: 7.5; 95%CI: 0.9-59.3). No association was found between receiving the vaccine and knowledge of influenza or vaccination. However, an association was found with prescribing vaccination to pregnant women, to persons older than 65 years, and to immunosuppressed individuals. Strategies should be designed to increase coverage, based on changing negative attitudes of healthcare workers to vaccination. Copyright © 2014 SESPAS. Published by Elsevier Espana. All rights reserved.

  3. Driving and hindering factors for rural electrification in developing countries: Lessons from Bangladesh

    International Nuclear Information System (INIS)

    Rahman, Md. Mizanur; Paatero, Jukka V.; Poudyal, Aditya; Lahdelma, Risto

    2013-01-01

    Rural electrification is essential for bringing about social and economic developments, but the progress is distressingly slow in most developing countries. The Bangladesh Rural Electrification Program (BREP) has been highlighted as a positive case among developing countries, but from 2006 onwards there have been doubts about the program's chances of success. In this paper, we examine the rural electrification practices in Bangladesh and evaluate the claim that, whereas they were successful up to 2005, they then began to decline in terms of their performance. This study determines the factors behind the initial success of the program as well as those that account for the recent downturn in BREP. We found that the BREP was a clear success in terms of its growth and progress; however, its performance has been declining since 2006. The key driving factors for the success of this program had to do with prioritizing system investment, community involvement, anti-corruption features, standardized practices and performance-based incentives while excluding political parties. The major issues accounting for the decline were the lack of organizational autonomy, a shortage of funding, unrealistic tariffs, and power supply shortages. Renewable-based, off-grid technologies have been successfully supplementing the on-grid program in remote areas. - Highlights: • Rural electrification is essential for bringing about socio-economic developments. • The pace of rural electrification in the developing countries has been very slow. • A multitude of issues plays behind in making the task a success or a failure. • Lack of policy reforms, unrealistic tariffs are the main hinderers. • Rural electrification cannot be successful by sticking to a rigid model

  4. Acute disinhibiting effects of alcohol as a factor in risky driving behavior

    Science.gov (United States)

    Fillmore, Mark T.; Blackburn, Jaime S.; Harrison, Emily L. R.

    2008-01-01

    Automobile crash reports show that up to 40% of fatal crashes in the United States involve alcohol and that younger drivers are over-represented. Alcohol use among young drivers is associated with impulsive and risky driving behaviors, such as speeding, which could contribute to their over-representation in alcohol-related crash statistics. Recent laboratory studies show that alcohol increases impulsive behaviors by impairing the drinker’s ability to inhibit inappropriate actions and that this effect can be exacerbated in conflict situations where the expression and inhibition of behavior are equally motivating. The present study tested the hypothesis that this response conflict might also intensify the disruptive effects of alcohol on driving performance. Fourteen subjects performed a simulated driving and a cued go/no-go task that measured their inhibitory control. Conflict was motivated in these tasks by providing equal monetary incentives for slow, careful behavior (e.g., slow driving, inhibiting impulses) and for quick, abrupt behavior (fast driving, disinhibition). Subjects were tested under two alcohol doses (0.65 g/kg and a placebo) that were administered twice: when conflict was present and when conflict was absent. Alcohol interacted with conflict to impair inhibitory control and to increase risky and impaired driving behavior on the drive task. Also, individuals whose inhibitory control was most impaired by alcohol displayed the poorest driving performance under the drug. The study demonstrates potentially serious disruptions to driving performance as a function of alcohol intoxication and response conflict, and points to inhibitory control as an important underlying mechanism. PMID:18325693

  5. Common-mode Voltage Reduction in a Motor Drive System with a Power Factor Correction

    DEFF Research Database (Denmark)

    Adabi, J.; Boora, A.A.; Zare, F.

    2012-01-01

    Common-mode voltage generated by a power converter in combination with parasitic capacitive couplings is a potential source of shaft voltage in an AC motor drive system. In this study, a three-phase motor drive system supplied with a single-phase AC-DC diode rectifier is investigated in order...... to reduce shaft voltage in a three-phase AC motor drive system. In this topology, the AC-DC diode rectifier influences the common-mode voltage generated by the inverter because the placement of the neutral point is changing in different rectifier circuit states. A pulse width modulation technique...

  6. Factors affecting nutritional status of Malaysian primary school children.

    Science.gov (United States)

    Zaini, M Z Anuar; Lim, C T; Low, W Y; Harun, F

    2005-01-01

    This paper investigates the nutritional status of a randomly selected cohort of school children and the factors affecting it. This random survey was conducted in the state of Selangor, involving 1,405 primary students (aged 9-10 years from 54 national primary schools). Physical examination was carried out on all the students. Information on the students was also obtained from the parents. Blood samples were taken by using the finger pricking technique. Body mass index (BMI) was used as a measure of physical growth. The students were mainly from urban areas (82.9%). The mean age was 9.71 years and a higher proportion was females (51%). Malays constituted 83.6%, Indians 11.6% and Chinese 4.2% of the study population. The mean weight and height were 32.30 kg and 135.18 cm respectively. The mean BMI was 17.42 kg/m2, with 1.2% of the students underweight, 76.3% normal BMI, 16.3% overweight and 6.3% were obese. Nutritional status was significantly related to blood pressure, history of breast feeding, eating fast food, taking canned/bottled drinks, income and educational level of parents. Significant differences in nutritional status between sexes and locations (rural/urban) were also found. The prevalence of overweight and obese children was of concern. There is thus an urgent need for the School Health Program to periodically monitor the school children's eating habits and physical growth. Appropriate counselling on nutritional intake and physical activities should be given not only to schoolchildren but also to their teachers and parents or caregivers.

  7. Risk factors for dementia diagnosis in German primary care practices.

    Science.gov (United States)

    Booker, Anke; Jacob, Louis Ec; Rapp, Michael; Bohlken, Jens; Kostev, Karel

    2016-07-01

    Dementia is a psychiatric condition the development of which is associated with numerous aspects of life. Our aim was to estimate dementia risk factors in German primary care patients. The case-control study included primary care patients (70-90 years) with first diagnosis of dementia (all-cause) during the index period (01/2010-12/2014) (Disease Analyzer, Germany), and controls without dementia matched (1:1) to cases on the basis of age, sex, type of health insurance, and physician. Practice visit records were used to verify that there had been 10 years of continuous follow-up prior to the index date. Multivariate logistic regression models were fitted with dementia as a dependent variable and the potential predictors. The mean age for the 11,956 cases and the 11,956 controls was 80.4 (SD: 5.3) years. 39.0% of them were male and 1.9% had private health insurance. In the multivariate regression model, the following variables were linked to a significant extent with an increased risk of dementia: diabetes (OR: 1.17; 95% CI: 1.10-1.24), lipid metabolism (1.07; 1.00-1.14), stroke incl. TIA (1.68; 1.57-1.80), Parkinson's disease (PD) (1.89; 1.64-2.19), intracranial injury (1.30; 1.00-1.70), coronary heart disease (1.06; 1.00-1.13), mild cognitive impairment (MCI) (2.12; 1.82-2.48), mental and behavioral disorders due to alcohol use (1.96; 1.50-2.57). The use of statins (OR: 0.94; 0.90-0.99), proton-pump inhibitors (PPI) (0.93; 0.90-0.97), and antihypertensive drugs (0.96, 0.94-0.99) were associated with a decreased risk of developing dementia. Risk factors for dementia found in this study are consistent with the literature. Nevertheless, the associations between statin, PPI and antihypertensive drug use, and decreased risk of dementia need further investigations.

  8. The road to automated driving: Dual mode and human factors considerations

    NARCIS (Netherlands)

    Martens, M.H.; Beukel, A.P. van den

    2013-01-01

    Recent technological developments have shown a transition from informative driving support systems to more automated vehicles. Although automated vehicles are designed to overcome limitations in human perception, decision making and response, there may be a downside to introducing these

  9. The road to automated driving: dual mode and human factors considerations

    NARCIS (Netherlands)

    Martens, Marieke Hendrikje; van den Beukel, Arie Paul

    2013-01-01

    Recent technological developments have shown a transition from informative driving support systems to more automated vehicles. Although automated vehicles are designed to overcome limitations in human perception, decision making and response, there may be a downside to introducing these

  10. [Factors of the drive for thinness and dieting: from the viewpoint of impression management].

    Science.gov (United States)

    Suzuki, Tomohiro

    2012-12-01

    Thinness is considered as one type of adornment; as such, it has a psychological function for others. Thus the drive for thinness and dieting were investigated from the viewpoint of impression management. Study 1 investigated a model that the need for approval affects dieting through the outcome expectancies of others' evaluations and the drive for thinness. The results of structural equation modeling indicated high validity for this model. Study 2 investigated the moderating role of self-esteem in the relationship between positive/negative outcome expectancies of others' evaluations and the drive for thinness. The results showed that self-esteem did not act as a moderator between the two components and the drive for thinness.

  11. Human Factors of Automated Driving : Predicting the Effects of Authority Transitions on Traffic Flow Efficiency

    NARCIS (Netherlands)

    Varotto, S.F.; Hoogendoorn, R.G.; Van Arem, B.; Hoogendoorn, S.P.

    2014-01-01

    Automated driving potentially has a significant impact on traffic flow efficiency. Automated vehicles, which possess cooperative capabilities, are expected to reduce congestion levels for instance by increasing road capacity, by anticipating traffic conditions further downstream and also by

  12. Atmospheric evaporative demand observations, estimates and driving factors in Spain (1961-2011)

    KAUST Repository

    Azorin-Molina, Cesar

    2015-04-01

    We analyzed the spatio-temporal evolution of evaporation observations from Piché atmometers (1961-2011; 56 stations) and Pan evaporimeters (1984-2011; 21 stations) across Spain, and compared both measurements with evaporation estimates obtained by four physical models: i.e., Food and Agricultural Organization-56 Penman-Monteith, Food and Agricultural Organization-Pan, PenPan and Penman, based on climate data. In this study we observed a positive and statistically significant correlation between Piché and Pan evaporation measurements during the common period (1984-2011; 19 stations), mainly in summer. When evaporation observations and estimates were compared, we detected positive and statistically significant correlations with the four methods, except for winter. Among the four physical models, the FAO-Pan showed the best fitting to both Piché and Pan evaporation measurements; the PenPan model overestimated evaporation rates; and the FAO-Penman-Monteith and Penman methods underestimated evaporation observations. We also observed a better spatial agreement between Pan evaporation and estimates than that obtained by Piché measurements. Annual and seasonal trends of evaporation estimates show a statistically significant increase for 1961-2011, which do not agree with long-term Piché evaporation trends; e.g. a discontinuity was found around the 1980s. Radiative and aerodynamic driving factors suggest that this discontinuity, and the observed evaporation trends across Spain could be associated with the abrupt increase in air temperature observed during last few decades (i.e., global warming). Further investigations using available Piché evaporation observations for other regions are needed to better understand physical components influencing long-term trends of evaporation.

  13. Atmospheric evaporative demand observations, estimates and driving factors in Spain (1961-2011)

    KAUST Repository

    Azorin-Molina, Cesar; Vicente-Serrano, Sergio M.; Sanchez-Lorenzo, Arturo; McVicar, Tim R.; Morá n-Tejeda, Enrique; Revuelto, Jesú s; El Kenawy, Ahmed M.; Martí n-Herná ndez, Natalia; Tomà s, M.

    2015-01-01

    We analyzed the spatio-temporal evolution of evaporation observations from Piché atmometers (1961-2011; 56 stations) and Pan evaporimeters (1984-2011; 21 stations) across Spain, and compared both measurements with evaporation estimates obtained by four physical models: i.e., Food and Agricultural Organization-56 Penman-Monteith, Food and Agricultural Organization-Pan, PenPan and Penman, based on climate data. In this study we observed a positive and statistically significant correlation between Piché and Pan evaporation measurements during the common period (1984-2011; 19 stations), mainly in summer. When evaporation observations and estimates were compared, we detected positive and statistically significant correlations with the four methods, except for winter. Among the four physical models, the FAO-Pan showed the best fitting to both Piché and Pan evaporation measurements; the PenPan model overestimated evaporation rates; and the FAO-Penman-Monteith and Penman methods underestimated evaporation observations. We also observed a better spatial agreement between Pan evaporation and estimates than that obtained by Piché measurements. Annual and seasonal trends of evaporation estimates show a statistically significant increase for 1961-2011, which do not agree with long-term Piché evaporation trends; e.g. a discontinuity was found around the 1980s. Radiative and aerodynamic driving factors suggest that this discontinuity, and the observed evaporation trends across Spain could be associated with the abrupt increase in air temperature observed during last few decades (i.e., global warming). Further investigations using available Piché evaporation observations for other regions are needed to better understand physical components influencing long-term trends of evaporation.

  14. Size-resolved particle number emission patterns under real-world driving conditions using positive matrix factorization.

    Science.gov (United States)

    Domínguez-Sáez, Aida; Viana, Mar; Barrios, Carmen C; Rubio, Jose R; Amato, Fulvio; Pujadas, Manuel; Querol, Xavier

    2012-10-16

    A novel on-board system was tested to characterize size-resolved particle number emission patterns under real-world driving conditions, running in a EURO4 diesel vehicle and in a typical urban circuit in Madrid (Spain). Emission profiles were determined as a function of driving conditions. Source apportionment by Positive Matrix Factorization (PMF) was carried out to interpret the real-world driving conditions. Three emission patterns were identified: (F1) cruise conditions, with medium-high speeds, contributing in this circuit with 60% of total particle number and a particle size distribution dominated by particles >52 nm and around 60 nm; (F2) transient conditions, stop-and-go conditions at medium-high speed, contributing with 25% of the particle number and mainly emitting particles in the nucleation mode; and (F3) creep-idle conditions, representing traffic congestion and frequent idling periods, contributing with 14% to the total particle number and with particles in the nucleation mode (emissions depending on particle size and driving conditions. Differences between real-world emission patterns and regulatory cycles (NEDC) are also presented, which evidence that detecting particle number emissions real-world driving conditions.

  15. Development and review of Euro 5 passenger car emission factors based on experimental results over various driving cycles.

    Science.gov (United States)

    Fontaras, Georgios; Franco, Vicente; Dilara, Panagiota; Martini, Giorgio; Manfredi, Urbano

    2014-01-15

    The emissions of CO2 and regulated pollutants (NOx, HC, CO, PM) of thirteen Euro 5 compliant passenger cars (seven gasoline, six Diesel) were measured on a chassis dynamometer. The vehicles were driven repeatedly over the European type-approval driving cycle (NEDC) and the more dynamic WMTC and CADC driving cycles. Distance-specific emission factors were derived for each pollutant and sub-cycle, and these were subsequently compared to the corresponding emission factors provided by the reference European models used for vehicle emission inventory compilation (COPERT and HBEFA) and put in context with the applicable European emission limits. The measured emissions stayed below the legal emission limits when the type-approval cycle (NEDC) was used. Over the more dynamic cycles (considered more representative of real-world driving) the emissions were consistently higher but in most cases remained below the type-approval limit. The high NOx emissions of Diesel vehicles under real-world driving conditions remain the main cause for environmental concern regarding the emission profile of Euro 5 passenger cars. Measured emissions of NOx exceeded the type-approval limits (up to 5 times in extreme cases) and presented significantly increased average values (0.35 g/km for urban driving and 0.56 g/km for motorway driving). The comparison with the reference models showed good correlation in all cases, a positive finding considering the importance of these tools in emission monitoring and policy-making processes. © 2013. Published by Elsevier B.V. All rights reserved.

  16. Analysis of Driving Factors for Extended Producer Responsibility by Using Interpretative Structure Modelling (ISM and Analytic Network Process (ANP

    Directory of Open Access Journals (Sweden)

    Xiong Zheng

    2017-03-01

    Full Text Available The establishment of an efficient reverse supply chain is important, especially in the electronics industry, considering the environmental and resource pressures worldwide. Extended Producer Responsibility (EPR, an important environmental policy approach, has been adopted extensively in various countries, and the effectiveness of its implementation has been proven through practical application. However, the establishment and development of EPR are lacking in most developing countries where collection and recycling systems are underdeveloped. This study addresses this problem by exploring the hierarchical relationship among the driving factors of EPR in the electronics industry in China and by identifying and ranking the factors that are critical in EPR implementation. As important managerial conclusions, research results show that EPR-related laws and regulations, the consciousness of senior executives, and corporate image are the three most important driving factors of EPR implementation.

  17. Temporal Dynamics of the Driving Factors of Urban Landscape Change of Addis Ababa During the Past Three Decades.

    Science.gov (United States)

    Zewdie, Meskerem; Worku, Hailu; Bantider, Amare

    2018-01-01

    Mapping and quantifying urban landscape dynamics and the underlying driving factors are crucial for devising appropriate policies, especially in cities of developing countries where the change is rapid. This study analyzed three decades (1984-2014) of land use land cover change of Addis Ababa using Landsat imagery and examined the underlying factors and their temporal dynamics through expert interview using Analytic Hierarchy Process (AHP). Classification results revealed that urban area increased by 50%, while agricultural land and forest decreased by 34 and 16%, respectively. The driving factors operated differently during the pre and post-1991 period. The year 1991 was chosen because it marked government change in the country resulting in policy change. Policy had the highest influence during the pre-1991 period. Land use change in this period was associated with the housing sector as policies and institutional setups were permissive to this sector. Population growth and in-migration were also important factors. Economic factors played significant role in the post-1991 period. The fact that urban land has a market value, the growth of private investment, and the speculated property market were among the economic factors. Policy reforms since 2003 were also influential to the change. Others such as accessibility, demography, and neighborhood factors were a response to economic factors. All the above-mentioned factors had vital role in shaping the urban pattern of the city. These findings can help planners and policymakers to better understand the dynamic relationship of urban land use and the driving factors to better manage the city.

  18. Temporal Dynamics of the Driving Factors of Urban Landscape Change of Addis Ababa During the Past Three Decades

    Science.gov (United States)

    Zewdie, Meskerem; Worku, Hailu; Bantider, Amare

    2018-01-01

    Mapping and quantifying urban landscape dynamics and the underlying driving factors are crucial for devising appropriate policies, especially in cities of developing countries where the change is rapid. This study analyzed three decades (1984-2014) of land use land cover change of Addis Ababa using Landsat imagery and examined the underlying factors and their temporal dynamics through expert interview using Analytic Hierarchy Process (AHP). Classification results revealed that urban area increased by 50%, while agricultural land and forest decreased by 34 and 16%, respectively. The driving factors operated differently during the pre and post-1991 period. The year 1991 was chosen because it marked government change in the country resulting in policy change. Policy had the highest influence during the pre-1991 period. Land use change in this period was associated with the housing sector as policies and institutional setups were permissive to this sector. Population growth and in-migration were also important factors. Economic factors played significant role in the post-1991 period. The fact that urban land has a market value, the growth of private investment, and the speculated property market were among the economic factors. Policy reforms since 2003 were also influential to the change. Others such as accessibility, demography, and neighborhood factors were a response to economic factors. All the above-mentioned factors had vital role in shaping the urban pattern of the city. These findings can help planners and policymakers to better understand the dynamic relationship of urban land use and the driving factors to better manage the city.

  19. Ecological and spatial factors drive intra- and interspecific variation in exposure of subarctic predatory bird nestlings to persistent organic pollutants.

    Science.gov (United States)

    Eulaers, Igor; Jaspers, Veerle L B; Bustnes, Jan O; Covaci, Adrian; Johnsen, Trond V; Halley, Duncan J; Moum, Truls; Ims, Rolf A; Hanssen, Sveinn A; Erikstad, Kjell E; Herzke, Dorte; Sonne, Christian; Ballesteros, Manuel; Pinxten, Rianne; Eens, Marcel

    2013-07-01

    Top predators in northern ecosystems may suffer from exposure to persistent organic pollutants (POPs) as this exposure may synergistically interact with already elevated natural stress in these ecosystems. In the present study, we aimed at identifying biological (sex, body condition), ecological (dietary carbon source, trophic level) and spatial factors (local habitat, regional nest location) that may influence intra- and interspecific variation in exposure of subarctic predatory bird nestlings to polychlorinated biphenyl 153 (CB 153), polybrominated diphenyl ether 47 (BDE 47), dichlorodiphenyldichloroethylene (p,p'-DDE) and hexachlorobenzene (HCB). During three breeding seasons (2008-2010), we sampled body feathers from fully-grown nestlings of three ecologically distinct predatory bird species in subarctic Norway: Northern Goshawk (Accipiter gentilis), White-tailed Eagle (Haliaeetus albicilla) and Golden Eagle (Aquila chrysaetos). The present study analysed, for the first time, body feathers for both POPs and carbon (δ(13)C) and nitrogen (δ(15)N) stable isotopes, thus integrating the dietary carbon source, trophic level and POP exposure for the larger part of the nestling stage. Intraspecific variation in exposure was driven by a combination of ecological and spatial factors, often different for individual compounds. In addition, combinations for individual compounds differed among species. Trophic level and local habitat were the predominant predictors for CB 153, p,p'-DDE and BDE 47, indicating their biomagnification and decreasing levels according to coast>fjord>inland. Variation in exposure may also have been driven by inter-annual variation arisen from primary sources (e.g. p,p'-DDE) and/or possible revolatilisation from secondary sources (e.g. HCB). Interspecific differences in POP exposure were best explained by a combination of trophic level (biomagnification), dietary carbon source (food chain discrimination) and regional nest location (historical POP

  20. Psychological Factors related with Driving under the Influence of Alcohol and Substance Use

    Directory of Open Access Journals (Sweden)

    Ersin Budak

    2015-09-01

    Full Text Available Driving under the influence of alcohol and substance use is an important traffic problem that caused many people in the world to lose their lieves. Many features that are important in terms of driving adversely affected under the influence of alcohol and substance and therefore impaired driving behavior arises in drivers. The most effective way to fight for prevent this impaired driver behavier is the restrictions and regulations imposed on drivers in traffic related to alcohol and drug use. Nevertheless, in the literature, some drivers continue to impaired driving function with a risky traffic behavior, in which the driver personality (risk-taking, thrill-seeking, self-control, psychopathological (substance abuse, personality disorders, mood disorders, attention deficit hyperactivity disorder, post-traumatic stress disorder, anxiety, anger and aggression, and many other neuropsychological features are considered to have a relationship with this situation. In this article psychological, psychopathological and neuropsychological studies have examined regarding drive under the influence of alcohol and drug. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2015; 7(3.000: 333-347

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

    Science.gov (United States)

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

    2018-04-12

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

  2. Identification of factors associated with diagnostic error in primary care

    Science.gov (United States)

    2014-01-01

    Background Missed, delayed or incorrect diagnoses are considered to be diagnostic errors. The aim of this paper is to describe the methodology of a study to analyse cognitive aspects of the process by which primary care (PC) physicians diagnose dyspnoea. It examines the possible links between the use of heuristics, suboptimal cognitive acts and diagnostic errors, using Reason’s taxonomy of human error (slips, lapses, mistakes and violations). The influence of situational factors (professional experience, perceived overwork and fatigue) is also analysed. Methods Cohort study of new episodes of dyspnoea in patients receiving care from family physicians and residents at PC centres in Granada (Spain). With an initial expected diagnostic error rate of 20%, and a sampling error of 3%, 384 episodes of dyspnoea are calculated to be required. In addition to filling out the electronic medical record of the patients attended, each physician fills out 2 specially designed questionnaires about the diagnostic process performed in each case of dyspnoea. The first questionnaire includes questions on the physician’s initial diagnostic impression, the 3 most likely diagnoses (in order of likelihood), and the diagnosis reached after the initial medical history and physical examination. It also includes items on the physicians’ perceived overwork and fatigue during patient care. The second questionnaire records the confirmed diagnosis once it is reached. The complete diagnostic process is peer-reviewed to identify and classify the diagnostic errors. The possible use of heuristics of representativeness, availability, and anchoring and adjustment in each diagnostic process is also analysed. Each audit is reviewed with the physician responsible for the diagnostic process. Finally, logistic regression models are used to determine if there are differences in the diagnostic error variables based on the heuristics identified. Discussion This work sets out a new approach to studying the

  3. Identification of factors associated with diagnostic error in primary care.

    Science.gov (United States)

    Minué, Sergio; Bermúdez-Tamayo, Clara; Fernández, Alberto; Martín-Martín, José Jesús; Benítez, Vivian; Melguizo, Miguel; Caro, Araceli; Orgaz, María José; Prados, Miguel Angel; Díaz, José Enrique; Montoro, Rafael

    2014-05-12

    Missed, delayed or incorrect diagnoses are considered to be diagnostic errors. The aim of this paper is to describe the methodology of a study to analyse cognitive aspects of the process by which primary care (PC) physicians diagnose dyspnoea. It examines the possible links between the use of heuristics, suboptimal cognitive acts and diagnostic errors, using Reason's taxonomy of human error (slips, lapses, mistakes and violations). The influence of situational factors (professional experience, perceived overwork and fatigue) is also analysed. Cohort study of new episodes of dyspnoea in patients receiving care from family physicians and residents at PC centres in Granada (Spain). With an initial expected diagnostic error rate of 20%, and a sampling error of 3%, 384 episodes of dyspnoea are calculated to be required. In addition to filling out the electronic medical record of the patients attended, each physician fills out 2 specially designed questionnaires about the diagnostic process performed in each case of dyspnoea. The first questionnaire includes questions on the physician's initial diagnostic impression, the 3 most likely diagnoses (in order of likelihood), and the diagnosis reached after the initial medical history and physical examination. It also includes items on the physicians' perceived overwork and fatigue during patient care. The second questionnaire records the confirmed diagnosis once it is reached. The complete diagnostic process is peer-reviewed to identify and classify the diagnostic errors. The possible use of heuristics of representativeness, availability, and anchoring and adjustment in each diagnostic process is also analysed. Each audit is reviewed with the physician responsible for the diagnostic process. Finally, logistic regression models are used to determine if there are differences in the diagnostic error variables based on the heuristics identified. This work sets out a new approach to studying the diagnostic decision-making process

  4. Primary Tumor Thickness is a Prognostic Factor in Stage IV Melanoma: A Retrospective Study of Primary Tumor Characteristics.

    Science.gov (United States)

    Luen, Stephen; Wong, Siew Wei; Mar, Victoria; Kelly, John W; McLean, Catriona; McArthur, Grant A; Haydon, Andrew

    2018-01-01

    Stage IV melanoma exhibits a diverse range of tumor biology from indolent to aggressive disease. Many important prognostic factors have already been identified. Despite this, the behavior of metastatic melanoma remains difficult to predict. We sought to determine if any primary tumor characteristics affect survival following the diagnosis of stage IV melanoma. All patients diagnosed with stage IV melanoma between January 2003 and December 2012 were identified from the Victorian Melanoma Service database. Retrospective chart review was performed to collect data on primary tumor characteristics (thickness, ulceration, mitotic rate, melanoma subtype, or occult primary). Known and suspected prognostic factors were additionally collected (time to diagnosis of stage IV disease, age, sex, stage, receipt of chemotherapy, and era of recurrence). The effect of primary tumor characteristics on overall survival from the date of diagnosis of stage IV disease was assessed. A total of 227 patients with a median follow-up of 5 years from diagnosis of stage IV disease were identified. Median overall survival of the cohort was 250 days.Of the primary tumor characteristics assessed, only tumor thickness affected survival from diagnosis of stage IV disease, hazard ratio=1.09 (1.02 to 1.16), P=0.008. This remained significant in multivariate analysis, P=0.007. Other primary tumor characteristics did not significantly influence survival. Primary tumor thickness is a significant prognostic factor in stage IV melanoma. Our data suggest that the biology of the primary melanoma may persist to influence the behavior of metastatic disease.

  5. Exploring the Factors Driving Seasonal Farmland Abandonment: A Case Study at the Regional Level in Hunan Province, Central China

    OpenAIRE

    Yu, Zhonglei; Liu, Lei; Zhang, Hua; Liang, Jinshe

    2017-01-01

    Farmland abandonment, including perennial and seasonal abandonment, is an important process of land use change that matters most to food security. Although there is a great deal of studies on farmland abandonment, seasonal abandonment, which is as serious as perennial abandonment, has attracted little academic attention. This paper takes Hunan Province in central China as its study area and uses a spatial regression model to examine the driving factors of seasonal farmland abandonment at the ...

  6. Factors driving public tolerance levels and information-seeking behaviour concerning insects in the household environment

    NARCIS (Netherlands)

    Schoelitsz, Bruce; Poortvliet, P.M.; Takken, Willem

    2018-01-01

    BACKGROUND: The public's negative attitudes towards household insects drive tolerance for these insects and their control. Tolerance levels are important in integrated pest management (IPM), as are pest knowledge and information. The risk information seeking and processing (RISP) model describes the

  7. Common factors drive disease and coarse woody debris dynamics in forests impacted by sudden oak death

    Science.gov (United States)

    Richard C. Cobb; Maggie N. Chan; Ross K. Meentemeyer; David M. Rizzo

    2011-01-01

    Disease ecology has made important steps in describing how epidemiological processes control the impact of pathogens on populations and communities but fewer field or theoretical studies address disease effects at the ecosystem level. We demonstrate that the same epidemiological mechanisms drive disease intensity and coarse woody debris (CWD) dynamics...

  8. Identifying the principal driving factors of water ecosystem dependence and the corresponding indicator species in a pilot City, China

    Science.gov (United States)

    Zhao, C. S.; Shao, N. F.; Yang, S. T.; Xiang, H.; Lou, H. Z.; Sun, Y.; Yang, Z. Y.; Zhang, Y.; Yu, X. Y.; Zhang, C. B.; Yu, Q.

    2018-01-01

    The world's aquatic ecosystems yield numerous vital services, which are essential to human existence but have deteriorated seriously in recent years. By studying the mechanisms of interaction between ecosystems and habitat processes, the constraining factors can be identified, and this knowledge can be used to improve the success rate of ecological restoration initiatives. At present, there is insufficient data on the link between hydrological, water quality factors and the changes in the structure of aquatic communities to allow any meaningful study of driving factors of aquatic ecosystems. In this study, the typical monitoring stations were selected by fuzzy clustering analysis based on the spatial and temporal distribution characteristics of water ecology in Jinan City, the first pilot city for the construction of civilized aquatic ecosystems in China. The dominant species identification model was used to identify the dominant species of the aquatic community. The driving effect of hydrological and water quality factors on dominant species was analyzed by Canonical Correspondence Analysis. Then, the principal factors of aquatic ecosystem dependence were selected. The results showed that there were 10 typical monitoring stations out of 59 monitoring sites, which were representative of aquatic ecosystems, 9 dominant fish species, and 20 dominant invertebrate species. The selection of factors for aquatic ecosystem dependence in Jinan were highly influenced by its regional conditions. Chemical environmental parameters influence the temporal and spatial variation of invertebrate much more than that of fish in Jinan City. However, the methodologies coupling typical monitoring stations selection, dominant species determination and driving factors identification were certified to be a cost-effective way, which can provide in-deep theoretical and technical directions for the restoration of aquatic ecosystems elsewhere.

  9. Validation of the Spanish version of the Drive for Muscularity Scale (DMS) among males: Confirmatory factor analysis.

    Science.gov (United States)

    Sepulveda, Ana R; Parks, Melissa; de Pellegrin, Yolanda; Anastasiadou, Dimitra; Blanco, Miriam

    2016-04-01

    Drive for Muscularity (DM) has been shown to be a relevant construct for measuring and understanding male body image. For this reason, it is important to have reliable and valid instruments with which to measure DM, and to date no such instruments exist in Spain. This study analyzes the psychometric and structural properties of the Drive for Muscularity Scale (DMS) in a sample of Spanish adolescent males (N=212), with the aim of studying the structural validity of the scale by using a confirmatory factor analysis (CFA), as well as analyzing the internal consistency and construct (convergent and discriminant) and concurrent validity of the instrument. After testing three models, results indicated that the best structure was a two-dimensional model, with the factors of muscularity-oriented body image (MBI) and muscularity behavior (MB). The scale showed good internal consistency (α=.90) and adequate construct validity. Furthermore, significant associations were found between DM and increased difficulties in emotional regulation (rho=.37) and low self-esteem (rho=-.19). Findings suggest that the two-factor structure may be used when assessing drive for muscularity among adolescent males in Spain. Copyright © 2016 Elsevier Ltd. All rights reserved.

  10. Factors affecting the referral of primary health care doctors toward ...

    African Journals Online (AJOL)

    Hend Al-Namash

    2011-06-08

    Jun 8, 2011 ... There is a worldwide epidemic of overweight, obesity, and morbid obesity ... the evolution of bariatric surgery.4 Controversy exists regard- ing the best ..... attitudes and practices among Israeli primary care physicians. Int J.

  11. Environmental Factors Associated with Primary Care Access Among Urban Older Adults

    OpenAIRE

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

    2012-01-01

    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 1,260 senior center attendees in New York City, we examined factors that facilitate and ...

  12. Factors Affecting the Ability of the Stroke Survivor to Drive Their Own Recovery outside of Therapy during Inpatient Stroke Rehabilitation

    Science.gov (United States)

    Brauer, Sandra G.; Kuys, Suzanne S.; Lord, Matthew; Hayward, Kathryn S.

    2014-01-01

    Aim. To explore factors affecting the ability of the stroke survivor to drive their own recovery outside of therapy during inpatient rehabilitation. Method. One-on-one, in-depth interviews with stroke survivors (n = 7) and their main carer (n = 6), along with two focus groups with clinical staff (n = 20). Data was thematically analysed according to group. Results. Stroke survivors perceived “dealing with loss,” whilst concurrently “building motivation and hope” for recovery affected their ability to drive their own recovery outside of therapy. In addition, they reported a “lack of opportunities” outside of therapy, with subsequent time described as “dead and wasted.” Main carers perceived stroke survivors felt “out of control … at everyone's mercy” and lacked knowledge of “what to do and why” outside of therapy. Clinical staff perceived the stroke survivor's ability to drive their own recovery was limited by the lack of “another place to go” and the “passive rehab culture and environment.” Discussion. To enable the stroke survivor to drive their own recovery outside of therapy, there is a need to increase opportunities for practice and promote active engagement. Suggested strategies include building the stroke survivor's motivation and knowledge, creating an enriched environment, and developing daily routines to provide structure outside of therapy time. PMID:24800104

  13. Factors Affecting the Ability of the Stroke Survivor to Drive Their Own Recovery outside of Therapy during Inpatient Stroke Rehabilitation

    Directory of Open Access Journals (Sweden)

    Xue Wen Eng

    2014-01-01

    Full Text Available Aim. To explore factors affecting the ability of the stroke survivor to drive their own recovery outside of therapy during inpatient rehabilitation. Method. One-on-one, in-depth interviews with stroke survivors (n=7 and their main carer (n=6, along with two focus groups with clinical staff (n=20. Data was thematically analysed according to group. Results. Stroke survivors perceived “dealing with loss,” whilst concurrently “building motivation and hope” for recovery affected their ability to drive their own recovery outside of therapy. In addition, they reported a “lack of opportunities” outside of therapy, with subsequent time described as “dead and wasted.” Main carers perceived stroke survivors felt “out of control … at everyone’s mercy” and lacked knowledge of “what to do and why” outside of therapy. Clinical staff perceived the stroke survivor’s ability to drive their own recovery was limited by the lack of “another place to go” and the “passive rehab culture and environment.” Discussion. To enable the stroke survivor to drive their own recovery outside of therapy, there is a need to increase opportunities for practice and promote active engagement. Suggested strategies include building the stroke survivor’s motivation and knowledge, creating an enriched environment, and developing daily routines to provide structure outside of therapy time.

  14. Driving skills after whiplash.

    Science.gov (United States)

    Gimse, R; Bjørgen, I A; Straume, A

    1997-09-01

    Previous studies have shown that some persons with longlasting problems after whiplash have changed eye movements. These changes have been related to disturbance of the posture control system. The question raised in the present study is whether such disturbances can influence daily life functions connected with balance, position and external movements, such as car driving. A group of 23 persons with disturbed eye movements due to whiplash injury, was tested in a driving simulator, together with a closely matched control group. The results revealed significant differences between the two groups with respect to response times to the traffic signs presented, identification of type of sign, as well as steering precision while the subjects' attention was directed to the process of identifying the signs. Alternative explanations such as driving experience, pain, medication or malingering are at least partly controlled for, but cannot completely be ruled out. A distorted posture control system leading to disturbance of eye movements seems to be the most likely primary causative factor, but these disturbances are most certainly complexly determined. Reduced attention capacity is considered to be a mediating secondary factor. Registration of eye movements may be a useful diagnostic tool to evaluate driving skill after whiplash.

  15. Governmental support for driving on natural gas. An outline of political factors

    International Nuclear Information System (INIS)

    Van der Knoop, J.; Overmars, P.

    2005-09-01

    Government support is crucial for the viability of the market for natural gas as engine fuel. This outlook focuses on the viewpoint of the government and the large political parties in this respect. At first this study was meant to be a brief outlook, but the study expanded in two directions. First of all, more attention was paid to the discussion on the use of natural gas as engine fuel and in line with the various incentivisation regulations in the context of more general greening taxes. The stimulation of driving on natural gas cannot be separated from similar measures for other (clean(er)) fuels. Secondly, based on the obtained insights, conclusions were drawn on the chances for government subsidy for driving on natural gas. Finally, attention has also been paid to the question if politicians recognise and acknowledge the intermediary role of natural gas in the transition towards sustainable fuels. If this is the case, the parliament will probably put more pressure on the government to stimulate driving on natural gas in view of the additional value of investments in the natural gas fuel infrastructure.[mk] [nl

  16. Analysis of Multi-Scale Changes in Arable Land and Scale Effects of the Driving Factors in the Loess Areas in Northern Shaanxi, China

    Directory of Open Access Journals (Sweden)

    Lina Zhong

    2014-04-01

    Full Text Available In this study, statistical data on the national economic and social development, including the year-end actual area of arable land, the crop yield per unit area and 10 factors, were obtained for the period between 1980 and 2010 and used to analyze the factors driving changes in the arable land of the Loess Plateau in northern Shaanxi, China. The following areas of arable land, which represent different spatial scales, were investigated: the Baota District, the city of Yan’an, and the Northern Shaanxi region. The scale effects of the factors driving the changes to the arable land were analyzed using a canonical correlation analysis and a principal component analysis. Because it was difficult to quantify the impact of the national government policies on the arable land changes, the contributions of the national government policies to the changes in arable land were analyzed qualitatively. The primary conclusions of the study were as follows: between 1980 and 2010, the arable land area decreased. The trends of the year-end actual arable land proportion of the total area in the northern Shaanxi region and Yan’an City were broadly consistent, whereas the proportion in the Baota District had no obvious similarity with the northern Shaanxi region and Yan’an City. Remarkably different factors were shown to influence the changes in the arable land at different scales. Environmental factors exerted a greater effect for smaller scale arable land areas (the Baota District. The effect of socio-economic development was a major driving factor for the changes in the arable land area at the city and regional scales. At smaller scales, population change, urbanization and socio-economic development affected the crop yield per unit area either directly or indirectly. Socio-economic development and the modernization of agricultural technology had a greater effect on the crop yield per unit area at the large-scales. Furthermore, the qualitative analysis

  17. Factor structure and psychometric properties of a Romanian translation of the drive for Muscularity Scale (DMS) in university men.

    Science.gov (United States)

    Swami, Viren; Vintila, Mona; Tudorel, Otilia; Goian, Cosmin; Barron, David

    2018-02-20

    We examined the psychometric properties of a Romanian translation of the 15-item Drive for Muscularity Scale (DMS). Male university students from Romania (N = 343) completed the DMS, as well as measures of self-esteem, body appreciation, and muscle discrepancy. Exploratory factor analysis indicated that DMS scores reduced to two factors that related to muscularity-oriented attitudes and behaviours, with both first-order factors loading onto a higher-order factor. However, confirmatory factor analysis indicated that a model with two first-order factors and a higher-order factor had poor fit. A two-factor model without a higher-order construct achieved acceptable but mediocre fit. Scores on the two-factor DMS model had adequate internal consistency and demonstrated acceptable convergent validity (significant correlations with self-esteem, body appreciation, and muscle discrepancy). These results provide support for a two-factor model of DMS scores in a Romanian-speaking sample and extends the availability of the DMS to a rarely-examined linguistic group. Copyright © 2018 Elsevier Ltd. All rights reserved.

  18. [Epidemiology, risk factors and molecular pathogenesis of primary liver cancer].

    Science.gov (United States)

    Hagymási, Krisztina; Tulassay, Zsolt

    2008-03-23

    Primary liver cancer is the fifth most common cancer worldwide. Hepatocellular carcinoma accounts for 85-90% of primary liver cancers. Distribution of hepatocellular carcinoma shows variations among geographic regions and ethnic groups. Males have higher liver cancer rates than females. Hepatocellular carcinoma occurs within an established background of chronic liver disease and cirrhosis (70-90%). Major causes (80%) of hepatocellular carcinoma are hepatitis B, C virus infection, and aflatoxin exposition. Its development is a multistep process. We have a growing understanding on the molecular pathogenesis. Genetic and epigenetic changes activate oncogenes, inhibit tumorsuppressor genes, which result in autonomous cell proliferation. The chromosomal instability caused by telomere dysfunction, the growth-retrained environment and the alterations of the micro- and macroenvironment help the expansion of the malignant cells. Understanding the molecular mechanisms could improve the screening of patients with chronic liver disease, or cirrhosis, and the prevention as well as treatment of hepatocellular carcinoma.

  19. Primary Commodity Dependency: A Limiting Factor for Achieving Democracy

    Science.gov (United States)

    2010-03-24

    two ~gricultural crops, minerals, petroleum, or fisheries can be considered primary commodity dependent. Tea, coffee, and cocoa ; peanuts and cotton...Rostow’s Development Model Pre-conditions for take-off mass consumption democracy. In 1960s, economists, associated democratization to a developmental...Commodities can be renewable or non-renewable. Petroleum, diamonds, cocoa , bananas, coffee, and timber are just a few of the commodities that have

  20. Thermo-hydraulic free piston engine as a primary propulsion unit in mobile hydraulic drives; Die thermohydraulische Freikolbenmaschine - ein neues Antriebskonzept fuer hydraulische angetriebene Fahrzeuge

    Energy Technology Data Exchange (ETDEWEB)

    Brunner, H. [Technische Univ. Dresden (Germany)

    2004-07-01

    The principle function of a free piston engine was tested on a test stand. The engine can drive hydraulic loads as a primary aggregate in a storage-based constant pressure network. Its power is independent of the loads. The engine is operated in intermittent operation and at the optimal operating point. There are no idle or part-load fractions. Measurements so far have shown that the performance of the new system equals that of a current combination of internal combustion engine and axial piston pump in their optimal operating point. In cyclic operation, the performance is even better. (orig.)

  1. Patient and carer identified factors which contribute to safety incidents in primary care: a qualitative study.

    Science.gov (United States)

    Hernan, Andrea L; Giles, Sally J; Fuller, Jeffrey; Johnson, Julie K; Walker, Christine; Dunbar, James A

    2015-09-01

    Patients can have an important role in reducing harm in primary-care settings. Learning from patient experience and feedback could improve patient safety. Evidence that captures patients' views of the various contributory factors to creating safe primary care is largely absent. The aim of this study was to address this evidence gap. Four focus groups and eight semistructured interviews were conducted with 34 patients and carers from south-east Australia. Participants were asked to describe their experiences of primary care. Audio recordings were transcribed verbatim and specific factors that contribute to safety incidents were identified in the analysis using the Yorkshire Contributory Factors Framework (YCFF). Other factors emerging from the data were also ascertained and added to the analytical framework. Thirteen factors that contribute to safety incidents in primary care were ascertained. Five unique factors for the primary-care setting were discovered in conjunction with eight factors present in the YCFF from hospital settings. The five unique primary care contributing factors to safety incidents represented a range of levels within the primary-care system from local working conditions to the upstream organisational level and the external policy context. The 13 factors included communication, access, patient factors, external policy context, dignity and respect, primary-secondary interface, continuity of care, task performance, task characteristics, time in the consultation, safety culture, team factors and the physical environment. Patient and carer feedback of this type could help primary-care professionals better understand and identify potential safety concerns and make appropriate service improvements. The comprehensive range of factors identified provides the groundwork for developing tools that systematically capture the multiple contributory factors to patient safety. Published by the BMJ Publishing Group Limited. For permission to use (where not

  2. Personality, Driving Behavior and Mental Disorders Factors as Predictors of Road Traffic Accidents Based on Logistic Regression

    Science.gov (United States)

    Alavi, Seyyed Salman; Mohammadi, Mohammad Reza; Souri, Hamid; Mohammadi Kalhori, Soroush; Jannatifard, Fereshteh; Sepahbodi, Ghazal

    2017-01-01

    Background: The aim of this study was to evaluate the effect of variables such as personality traits, driving behavior and mental illness on road traffic accidents among the drivers with accidents and those without road crash. Methods: In this cohort study, 800 bus and truck drivers were recruited. Participants were selected among drivers who referred to Imam Sajjad Hospital (Tehran, Iran) during 2013-2015. The Manchester driving behavior questionnaire (MDBQ), big five personality test (NEO personality inventory) and semi-structured interview (schizophrenia and affective disorders scale) were used. After two years, we surveyed all accidents due to human factors that involved the recruited drivers. The data were analyzed using the SPSS software by performing the descriptive statistics, t-test, and multiple logistic regression analysis methods. P values less than 0.05 were considered statistically significant. Results: In terms of controlling the effective and demographic variables, the findings revealed significant differences between the two groups of drivers that were and were not involved in road accidents. In addition, it was found that depression and anxiety could increase the odds ratio (OR) of road accidents by 2.4- and 2.7-folds, respectively (P=0.04, P=0.004). It is noteworthy to mention that neuroticism alone can increase the odds of road accidents by 1.1-fold (P=0.009), but other personality factors did not have a significant effect on the equation. Conclusion: The results revealed that some mental disorders affect the incidence of road collisions. Considering the importance and sensitivity of driving behavior, it is necessary to evaluate multiple psychological factors influencing drivers before and after receiving or renewing their driver’s license. PMID:28293047

  3. Personality, Driving Behavior and Mental Disorders Factors as Predictors of Road Traffic Accidents Based on Logistic Regression.

    Science.gov (United States)

    Alavi, Seyyed Salman; Mohammadi, Mohammad Reza; Souri, Hamid; Mohammadi Kalhori, Soroush; Jannatifard, Fereshteh; Sepahbodi, Ghazal

    2017-01-01

    The aim of this study was to evaluate the effect of variables such as personality traits, driving behavior and mental illness on road traffic accidents among the drivers with accidents and those without road crash. In this cohort study, 800 bus and truck drivers were recruited. Participants were selected among drivers who referred to Imam Sajjad Hospital (Tehran, Iran) during 2013-2015. The Manchester driving behavior questionnaire (MDBQ), big five personality test (NEO personality inventory) and semi-structured interview (schizophrenia and affective disorders scale) were used. After two years, we surveyed all accidents due to human factors that involved the recruited drivers. The data were analyzed using the SPSS software by performing the descriptive statistics, t-test, and multiple logistic regression analysis methods. P values less than 0.05 were considered statistically significant. In terms of controlling the effective and demographic variables, the findings revealed significant differences between the two groups of drivers that were and were not involved in road accidents. In addition, it was found that depression and anxiety could increase the odds ratio (OR) of road accidents by 2.4- and 2.7-folds, respectively (P=0.04, P=0.004). It is noteworthy to mention that neuroticism alone can increase the odds of road accidents by 1.1-fold (P=0.009), but other personality factors did not have a significant effect on the equation. The results revealed that some mental disorders affect the incidence of road collisions. Considering the importance and sensitivity of driving behavior, it is necessary to evaluate multiple psychological factors influencing drivers before and after receiving or renewing their driver's license.

  4. Personality, Driving Behavior and Mental Disorders Factors as Predictors of Road Traffic Accidents Based on Logistic Regression

    Directory of Open Access Journals (Sweden)

    Seyyed Salman Alavi

    2017-01-01

    Full Text Available Background: The aim of this study was to evaluate the effect of variables such as personality traits, driving behavior and mental illness on road traffic accidents among the drivers with accidents and those without road crash. Methods: In this cohort study, 800 bus and truck drivers were recruited. Participants were selected among drivers who referred to Imam Sajjad Hospital (Tehran, Iran during 2013-2015. The Manchester driving behavior questionnaire (MDBQ, big five personality test (NEO personality inventory and semi-structured interview (SADS were used. After two years, we surveyed all accidents due to human factors that involved the recruited drivers. The data were analyzed using the SPSS software by performing the descriptive statistics, t-test, and multiple logistic regression analysis methods. P values less than 0.05 were considered statistically significant. Results: In terms of controlling the effective and demographic variables, the findings revealed significant differences between the two groups of drivers that were and were not involved in road accidents. In addition, it was found that depression and anxiety could increase the odds ratio (OR of road accidents by 2.4- and 2.7-folds, respectively (P=0.04, P=0.004. It is noteworthy to mention that neuroticism alone can increase the odds of road accidents by 1.1-fold (P=0.009, but other personality factors did not have a significant effect on the equation. Conclusion: The results revealed that some mental disorders affect the incidence of road collisions. Considering the importance and sensitivity of driving behavior, it is necessary to evaluate multiple psychological factors influencing drivers before and after receiving or renewing their driver’s license.

  5. Risk factors for treatment failure in surgery for primary hyperparathyroidism

    DEFF Research Database (Denmark)

    Madsen, Anders Rørbæk; Rasmussen, Lars; Godballe, Christian

    2016-01-01

    Surgery for primary hyperparathyroidism (pHPT) has a high cure-rate and few complications. Preoperative localization procedures have permitted a dramatic shift from routine bilateral exploration to focused, minimally invasive procedures. At Odense University Hospital, Denmark, the introduction...... University hospital, Denmark, was analyzed. A shift in strategy was made in 2006 and at the same time new surgeons started training in parathyroid surgery. Biochemical-, clinical- and follow-up data were analyzed. Overall cure-rate was 90.7 %. Complication rates were 1.1 % for hemorrhage, 1.1 % for wound...

  6. Proneural transcription factor Atoh1 drives highly efficient differentiation of human pluripotent stem cells into dopaminergic neurons.

    Science.gov (United States)

    Sagal, Jonathan; Zhan, Xiping; Xu, Jinchong; Tilghman, Jessica; Karuppagounder, Senthilkumar S; Chen, Li; Dawson, Valina L; Dawson, Ted M; Laterra, John; Ying, Mingyao

    2014-08-01

    Human pluripotent stem cells (PSCs) are a promising cell resource for various applications in regenerative medicine. Highly efficient approaches that differentiate human PSCs into functional lineage-specific neurons are critical for modeling neurological disorders and testing potential therapies. Proneural transcription factors are crucial drivers of neuron development and hold promise for driving highly efficient neuronal conversion in PSCs. Here, we study the functions of proneural transcription factor Atoh1 in the neuronal differentiation of PSCs. We show that Atoh1 is induced during the neuronal conversion of PSCs and that ectopic Atoh1 expression is sufficient to drive PSCs into neurons with high efficiency. Atoh1 induction, in combination with cell extrinsic factors, differentiates PSCs into functional dopaminergic (DA) neurons with >80% purity. Atoh1-induced DA neurons recapitulate key biochemical and electrophysiological features of midbrain DA neurons, the degeneration of which is responsible for clinical symptoms in Parkinson's disease (PD). Atoh1-induced DA neurons provide a reliable disease model for studying PD pathogenesis, such as neurotoxin-induced neurodegeneration in PD. Overall, our results determine the role of Atoh1 in regulating neuronal differentiation and neuron subtype specification of human PSCs. Our Atoh1-mediated differentiation approach will enable large-scale applications of PD patient-derived midbrain DA neurons in mechanistic studies and drug screening for both familial and sporadic PD. ©AlphaMed Press.

  7. Study on Desertification Monitoring from 2000 TO 2014 and its Driving Factors Through Remote Sensing in Ningxia, China

    Science.gov (United States)

    Zhao, Z.; Wu, Q.

    2018-04-01

    Due to the implementation of national policy, the desertification in Ningxia has been gradually reduced, but the overall situation of desertification is still serious. Rainfall Use Efficiency(RUE) can make some improvement to the problem that the precipitation has a great influence on vegetation in arid area and fully reflect the dynamic characteristics of desertification. Using the MOD13Q1 data, land use classification map, as well as non-remote sensing data such as meteorological data and social statistics data, the paper carries out the evaluation of the status of desertification based on RUE through spatial trend analysis, gravity center migration model. The driving factors of desertification are quantitatively analyzed by using grey relational analysis. Our study demonstrated that RUE in most parts of Ningxia showed a trend of improvement, mainly located in central and southern Ningxia. The area where desertification occurred from 2000 to 2014 accounted for 7.79 %, mainly distributed in Helan Mountain, Liupan Mountain, Yinchuan Central. The proportion of desertification decreased gradually from 2005 to 2014, and the center of gravity of desertification had a tendency to migrate to northern Ningxia. By analyzing the driving factors, RUE had negative correlations with precipitation and relative humidity and there was no significant correlation between RUE and average temperature and sunshine hours. RUE was positively correlated with GDP, grain yield and number of sheep. On the basis of the results of grey relational analysis, it was found that sunshine hours, average temperature, relative humidity, population were the main influencing factors of desertification.

  8. [Evolution of burnout and associated factors in primary care physicians].

    Science.gov (United States)

    Matía Cubillo, Angel Carlos; Cordero Guevara, José; Mediavilla Bravo, José Javier; Pereda Riguera, Maria José; González Castro, Maria Luisa; González Sanz, Ana

    2012-09-01

    To analyse the course of burnout and develop an explanatory model. Prospective cohort dynamics. SITE: All primary health care centres in Burgos. All physicians except medical emergencies, paediatrics and residents. Anonymous self-report questionnaire: Maslach Burnout Inventory (MBI) and related variables. An analysis was performed using the Student-t, X(2) test and logistic regression. The response rate was 47.76% in 2007, which was lower than that of 2005. There were significant differences between 2005 and 2007, for increases in the percentage of physicians who smoked, postgraduate training, residency, and those who believe that coordination with nursing and specialist care and institutional communication is appropriate. There was an increase in the prevalence of burnout by almost one point compared with 2005, a decrease in maximum burnout and emotional exhaustion (EC), and an increase in depersonalisation (DP) and personal accomplishment (RP). The incidence density of burnout was 1/113. 5 primary care physicians per year. The existence of burnout is associated with the use of chronic medication and inadequate coordination between nursing and EC, and also with the high workload. The increase in the prevalence found is consistent with the idea of burnout as a dynamic development and the theoretical model described. Stable and quality employment is one way to indirectly mitigate (by encouraging internal communication) professional burnout. In the multivariate analysis, the most critical variable in the onset of burnout is the inadequate coordination with nursing. Copyright © 2008 Elsevier España, S.L. All rights reserved.

  9. Exploring Context and the Factors Shaping Team-Based Primary Healthcare Policies in Three Canadian Provinces: A Comparative Analysis.

    Science.gov (United States)

    Misfeldt, Renée; Suter, Esther; Mallinson, Sara; Boakye, Omenaa; Wong, Sabrina; Nasmith, Louise

    2017-08-01

    This paper discusses findings from a high-level scan of the contextual factors and actors that influenced policies on team-based primary healthcare in three Canadian provinces: British Columbia, Alberta and Saskatchewan. The team searched diverse sources (e.g., news reports, press releases, discussion papers) for contextual information relevant to primary healthcare teams. We also conducted qualitative interviews with key health system informants from the three provinces. Data from documents and interviews were analyzed qualitatively using thematic analysis. We then wrote narrative summaries highlighting pivotal policy and local system events and the influence of actors and context. Our overall findings highlight the value of reviewing the context, relationships and power dynamics, which come together and create "policy windows" at different points in time. We observed physician-centric policy processes with some recent moves to rebalance power and be inclusive of other actors and perspectives. The context review also highlighted the significant influence of changes in political leadership and prioritization in driving policies on team-based care. While this existed in different degrees in the three provinces, the push and pull of political and professional power dynamics shaped Canadian provincial policies governing team-based care. If we are to move team-based primary healthcare forward in Canada, the provinces need to review the external factors and the complex set of relationships and trade-offs that underscore the policy process. Copyright © 2017 Longwoods Publishing.

  10. Cardiovascular risk factors and primary selection into shift work

    DEFF Research Database (Denmark)

    Nabe-Nielsen, Kirsten; Garde, Anne Helene; Tüchsen, Finn

    2008-01-01

    OBJECTIVES: This study examined differences between future shift workers and future day workers as regards cardiovascular risk factors before they began different work schedules and the differences that remained after control for sociodemographic factors and general self-efficacy. METHODS......: In the unadjusted analyses, baseline obesity was associated with fixed evening work at follow-up. Minimal or light-to-moderate leisure-time physical activity was associated with a decrease in the odds ratio (OR) for two or three shifts including night work. Smoking status was associated with fixed evening work......, fixed night work, and two- or three- shift work including night work. After adjustment for sociodemographic factors and general self-efficacy, smoking was prospectively associated with fixed evening work [OR 1.56, 95% confidence interval (95% CI) 1.21-2.02] and fixed night work (OR 1.64, 95% CI 1...

  11. Original Article Blood Loss and Influencing Factors in Primary Total ...

    African Journals Online (AJOL)

    KIGZ

    aid the surgeon in the African region estimate the expected blood loss after total hip replacement. We conducted a study to quantify the blood loss following total hip arthroplasty and to determine the factors .... Hemoglobin European Overview (OSTHEO) study: blood management in elective knee and hip arthroplasty in ...

  12. Factors associated with enuresis among primary school children in ...

    African Journals Online (AJOL)

    of treatment in 89(41.6%), 42 (19.6%) and 6 (2.8%) children respectively. Conclusion: Arousal difficulty, positive family history of enuresis and family stress were common risk factors for enuresis. Also, enuretic children had higher rates of poor school performance compared with non-enuretic children. The inappropriate ...

  13. Factor Stability of Primary Scales of the General Organization Questionnaire

    Science.gov (United States)

    1980-10-01

    leadership , climate , and processes function optimally. The Leadership and Organizational Effectiveness Work Unit re- searches personal, small-group...the Litwin and Stringer (1968) Organizational Climate Questionnaire found a factor structure that was dif- ferent from the a priori structure...number) General Organization Questionnaire (GOQ) Organizational climate Organizational effectiveness 20. ATRACT (Cnm N eriwem7 d Iderntify by block numbst

  14. Analysis of the individual factors affecting mobile phone use while driving in France: socio-demographic characteristics, car and phone use in professional and private contexts.

    Science.gov (United States)

    Brusque, Corinne; Alauzet, Aline

    2008-01-01

    In France, as in many other countries, phoning while driving is legally restricted because of its negative impact on driving performance which increases accident risk. Nevertheless, it is still a frequently observed practice and one which has not been analyzed in detail. This study attempts to identify the profiles of those who use mobile phones while at the wheel and determine the forms taken by this use. A representative sample of 1973 French people was interviewed by phone on their driving practices and mobile phone use in everyday life and their mobile phone use while driving. Logistics regressions have been conducted to highlight the explanatory factors of phoning while driving. Strong differences between males and females have been shown. For the male population, age is the main explanatory factor of phoning while driving, followed by phone use for work-related reasons and extensive mobile phone use in everyday life. For females, high mileage and intensive use of mobile phone are the only two explanatory factors. We defined the intensive phone use at the wheel group as drivers who receive or send at least five or more calls per day while driving. There is no socio-demographic variable related to this practice. Car and phone uses in everyday life are the only explanatory factors for this intensive mobile use of the phone at the wheel.

  15. The Comparison and Modeling of the Driving Factors of Urban Expansion for Thirty-Five Big Cities in the Three Regions in China

    Directory of Open Access Journals (Sweden)

    Tian Guangjin

    2016-01-01

    Full Text Available This paper presents a national- and regional-scale urban growth model (NRUGM of China based on panel data analysis. Through the panel analysis, population growth, road construction, salary increment per capita, and secondary industry product increment were proven to be the major driving factors for national-scale urban expansion. According to Seventh Five-Year Plan, China had been divided into three regions, Eastern China, Middle China, and Western China, by their geographic position and economic development. We studied the relationship between urban expansion and the driving factors for the three regions between 1990 and 2010 in China. The driving factors of urban expansion were different for the different regions and periods. Population growth and road construction were identified as the two major factors driving urban expansion for Eastern China. Secondary industry and economic development had become the major driving factors for urban expansion over the last twenty years in Middle China. Over the same period, for Western China, economic growth had become the major driving factor for urban expansion. Our results have significant policy implications for China. The macrocontrol of the central government should utilize different policies to adjust urban expansion in the different regions.

  16. Platelet-Released Growth Factors Induce Differentiation of Primary Keratinocytes

    OpenAIRE

    Bayer, Andreas; Tohidnezhad, Mersedeh; Lammel, Justus; Lippross, Sebastian; Behrendt, Peter; Klüter, Tim; Pufe, Thomas; Jahr, Holger; Cremer, Jochen; Rademacher, Franziska; Gläser, Regine; Harder, Jürgen

    2017-01-01

    Autologous thrombocyte concentrate lysates, for example, platelet-released growth factors, (PRGFs) or their clinically related formulations (e.g., Vivostat PRF?) came recently into the physicians' focus as they revealed promising effects in regenerative and reparative medicine such as the support of healing of chronic wounds. To elucidate the underlying mechanisms, we analyzed the influence of PRGF and Vivostat PRF on human keratinocyte differentiation in vitro and on epidermal differentiatio...

  17. 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.

  18. Liver-derived systemic factors drive β-cell hyperplasia in insulin resistant states

    Energy Technology Data Exchange (ETDEWEB)

    El Ouaamari, Abdelfattah; Kawamori, Dan; Dirice, Ercument; Liew, Chong Wee; Shadrach, Jennifer L.; Hu, Jiang; Katsuta, Hitoshi; Hollister-Lock, Jennifer; Qian, Weijun; Wagers, Amy J.; Kulkarni, Rohit N.

    2013-02-21

    Integrative organ cross-talk regulates key aspects of energy homeostasis and its dysregulation may underlie metabolic disorders such as obesity and diabetes. To test the hypothesis that cross-talk between the liver and pancreatic islets modulates β-cell growth in response to insulin resistance, we used the Liver-specific Insulin Receptor Knockout (LIRKO) mouse, a unique model that exhibits dramatic islet hyperplasia. Using complementary in vivo parabiosis and transplantation assays, and in vitro islet culture approaches, we demonstrate that humoral, non-neural, non-cell autonomous factor(s) induce β-cell proliferation in LIRKO mice. Furthermore, we report that a hepatocyte-derived factor(s) stimulates mouse and human β-cell proliferation in ex vivo assays, independent of ambient glucose and insulin levels. These data implicate the liver as a critical source of β-cell growth factors in insulin resistant states.

  19. Gynecobstetric risk factors for cervical cancer in primary health care

    International Nuclear Information System (INIS)

    Dunan Cruz, Liam Kandel; Cala Calvinno, Leidys; Infante Tabio, Nadia Ines; Hernandez Lin, Tania

    2011-01-01

    A descriptive and cross-sectional study of 50 women with some kind of alteration in their Pap smear results in the last triennium, and who belong to the health area of 'Jose Marti Perez' University Polyclinic from Santiago de Cuba, was carried out during the first semester of 2008 in order to determine the gynecobstetric risk factors in the cervical cancer course. Multiparity and the intergenesic period over a year, as well as the beginning of sexual intercourse in adolescence, the use of hormonal contraceptives, and history of sexually transmitted infections were predominant among them. (author)

  20. Factors driving deforestation in common-pool resources in northern Mexico.

    Science.gov (United States)

    Perez-Verdin, Gustavo; Kim, Yeon-Su; Hospodarsky, Denver; Tecle, Aregai

    2009-01-01

    The theory of collective action has been extensively used to explain the relationship between common-based property regimes and the conservation of natural resources. However, there are two key components of the theory that literature reports as puzzles in which no consensus exists about their effect on the performance of common-pool resources. These are group size and heterogeneity. This study analyzes the effects of these two key components on the effectiveness of community-based forestry, called ejidos, to protect their forest resources in northern Mexico. We used a multinomial logit model to determine the contribution of 16 explanatory variables to the dependent variable, a measure of success of ejidos defined by the presence of deforested, degraded, or forested conditions. The results show that corn yield, marginality, percent of forest area, total population, a forest value index, distance to markets, roads and towns, were all statistically significant in driving deforested conditions. Deforestation becomes more attractive for poor communities and as corn yield and distance to towns, roads, and markets decrease. In general, group size and heterogeneity had no significant effects on the presence of deforested conditions. Deforestation is driven by resource-specific characteristics, such as location and soil productivity, not by ejidos' attributes, such as total area or number of members. We argue that current institutional policies focusing on the structure of property right arrangements should be shifted (1) to provide better technology for land cultivation; (2) to reduce the marginality problem in poor communities; and (3) to strengthen local institutions.

  1. Job Satisfaction and Affecting Factors in Primary Health Care Providers

    Directory of Open Access Journals (Sweden)

    Ferit Kaya

    2016-06-01

    Full Text Available Objective: The aim of this study is to assess the job sat­isfaction of the primary health care providers and the fac­tors affecting it. Methods: This cross-sectional and descriptive study was carried out among the staff in The Public Health Care Centers (PHCC by performing a questionnaire under di­rect observation. Results: Out of 310 people consisting of the study uni­verse, 282 participants (94% were reached. The par­ticipants were 104 doctors, 132 assistant health care providers and 46 others (janitors, drivers The mean age of the participants was 37.21±7.70; 60.6% of them were women, 80.1% married, 96.5% graduated from at least High school. The mean of the general job satisfac­tion point of the participants in the study is 63.24±13.63. While the mean of the general job satisfaction point of the physicians and the nurses is found higher, the mean of the general job satisfaction point of janitors and other staff was found lower. The mean of the general job sat­isfaction point was found higher among the permanent and contract employee, women, health care staff, those whose wife/husband works, who chose his job willingly, more educated; who has longer working hours, high in­come, has 3 or less children and finds his job suitable for his skills; however the marital status, having children and age do not affect the mean job satisfaction point. Conclusion: Subjects having high income, found his job suitable for his skills, chose his job willingly had higher job satisfaction scores. This implies that there should be a wage balance among the staff with the same status. The lower job satisfaction score in PHCC indicates the neces­sity of improving the conditions of these centers.

  2. Abiotic factors drives floristic variations of fern’s metacommunity in an Atlantic Forest remnant

    OpenAIRE

    L. E. N. Costa; R. P. Farias; A. C. P. Santiago; I. A. A. Silva; I. C. L. Barros

    2018-01-01

    Abstract We analyzed floristic variations in fern’s metacommunity at the local scale and their relationship with abiotic factors in an Atlantic Forest remnant of northeastern Brazil. Floristic and environmental variations were accessed on ten plots of 10 × 20 m. We performed cluster analyses, based on Bray-Curtis dissimilarity index to establish the floristic relationship. The influence of abiotic factors: luminosity, temperature, relative air humidity and relative soil moisture was evaluated...

  3. The development, factor structure and psychometric properties of driving self-regulation scales for older adults: Has self-regulation evolved in the last 15 years?

    Science.gov (United States)

    Wong, Ides Y; Smith, Simon S; Sullivan, Karen A

    2015-07-01

    The term driving self-regulation is typically used to describe the practice of drivers who avoid driving in situations that they regard as unsafe because of perceived physical impairment. Older adults report using this strategy to improve safety while retaining mobility. Self-regulation is typically assessed using the driving avoidance items from the driving habits questionnaire (DHQ) and the driver mobility questionnaire (DMQ-A). However, the psychometric properties of these measures are not well understood. Using data from 277 older drivers, exploratory factor analysis was used to test the homogeneity of three driving self-regulation scales: the DHQ, DMQ-A, and an extended DMQ-A. Good internal consistency for each of the scales was identified (all αs≥.9). A one factor solution was identified for two of the measures (DHQ, DMQ-A) and a two factor solution accounting for over 70% of the score variance was identified for the third measure. The two factors assessed situations that may be avoided while driving because of the "external" (e.g., weather-related) or "internal" (e.g., passenger-related) driving environments, respectively. The findings suggest that the interpretation of an overall summated scale score, or single-item interpretations, may not be appropriate. Instead, driving self-regulation may be a multifaceted construct comprised of distinct dimensions that have not been identified previously but can be reliably measured. These data have implications for our understanding of driving self-regulation by older adults and the way in which this behavior is measured. Copyright © 2015 Elsevier Ltd. All rights reserved.

  4. Epidermal growth factor receptor in primary human lung cancer

    International Nuclear Information System (INIS)

    Yu Xueyan; Hu Guoqiang; Tian Keli; Wang Mingyun

    1996-01-01

    Cell membranes were prepared from 12 human lung cancers for the study of the expression of epidermal growth factor receptors (EGFR). EGFR concentration was estimated by ligand binding studies using 125 I-radiolabeled EGF. The dissociation constants of the high affinity sites were identical, 1.48 nmol and 1.1 nmol in cancer and normal lung tissues, the EGFR contents were higher in lung cancer tissues (range: 2.25 to 19.39 pmol·g -1 membrane protein) than that in normal tissues from the same patients (range: 0.72 to 7.43 pmol·g -1 membrane protein). These results suggest that EGF and its receptor may play a role in the regulatory mechanisms in the control of lung cellular growth and tumor promotion

  5. Modeling of primary water stress corrosion cracking at control rod drive mechanism nozzles of pressurized water reactors

    International Nuclear Information System (INIS)

    Aly, Omar Fernandes

    2006-01-01

    One of the main failure mechanisms that cause risks to pressurized water reactors is the primary water stress corrosion cracking (PWSCC) occurring in alloys. It can occurs, besides another places, at the control reactor displacement mechanism nozzles. It is caused by the joint effect of tensile stress, temperature, susceptible metallurgical microstructure and environmental conditions of the primary water. These cracks can cause accidents that reduce nuclear safety by blocking the rod's displacement and may cause leakage of primary water, reducing the reactor's life. In this work it is proposed a study of the existing models and a modeling proposal to primary water stress corrosion cracking in these nozzles in a nickel based Alloy 600. It is been superposed electrochemical and fracture mechanics models, and validated using experimental and literature data. The experimental data were obtained at CDTN-Brazilian Nuclear Technology Development Center, in a recent installed slow strain rate testing equipment. In the literature it is found a diagram that indicates a thermodynamic condition for the occurrence of some PWSCC sub modes in Alloy 600: it was used potential x pH diagrams (Pourbaix diagrams), for Alloy 600 in high temperature primary water (300 deg C till 350 deg C). Over it, were located the PWSCC sub modes, using experimental data. It was added a third parameter called 'stress corrosion strength fraction'. However, it is possible to superpose to this diagram, other parameters expressing PWSCC initiation or growth kinetics from other models. Here is the proposition of the original contribution of this work: from an original experimental condition of potential versus pH, it was superposed, an empiric-comparative, a semi-empiric-probabilistic, an initiation time, and a strain rate damage models, to quantify respectively the PWSCC susceptibility, the failure time, and in the two lasts, the initiation time of stress corrosion cracking. It was modeling from our

  6. Museum specimens reveal loss of pollen host plants as key factor driving wild bee decline in The Netherlands

    Science.gov (United States)

    Scheper, Jeroen; Reemer, Menno; van Kats, Ruud; Ozinga, Wim A.; van der Linden, Giel T. J.; Schaminée, Joop H. J.; Siepel, Henk; Kleijn, David

    2014-01-01

    Evidence for declining populations of both wild and managed bees has raised concern about a potential global pollination crisis. Strategies to mitigate bee loss generally aim to enhance floral resources. However, we do not really know whether loss of preferred floral resources is the key driver of bee decline because accurate assessment of host plant preferences is difficult, particularly for species that have become rare. Here we examine whether population trends of wild bees in The Netherlands can be explained by trends in host plants, and how this relates to other factors such as climate change. We determined host plant preference of bee species using pollen loads on specimens in entomological collections that were collected before the onset of their decline, and used atlas data to quantify population trends of bee species and their host plants. We show that decline of preferred host plant species was one of two main factors associated with bee decline. Bee body size, the other main factor, was negatively related to population trend, which, because larger bee species have larger pollen requirements than smaller species, may also point toward food limitation as a key factor driving wild bee loss. Diet breadth and other potential factors such as length of flight period or climate change sensitivity were not important in explaining twentieth century bee population trends. These results highlight the species-specific nature of wild bee decline and indicate that mitigation strategies will only be effective if they target the specific host plants of declining species. PMID:25422416

  7. EBF factors drive expression of multiple classes of target genes governing neuronal development.

    Science.gov (United States)

    Green, Yangsook S; Vetter, Monica L

    2011-04-30

    Early B cell factor (EBF) family members are transcription factors known to have important roles in several aspects of vertebrate neurogenesis, including commitment, migration and differentiation. Knowledge of how EBF family members contribute to neurogenesis is limited by a lack of detailed understanding of genes that are transcriptionally regulated by these factors. We performed a microarray screen in Xenopus animal caps to search for targets of EBF transcriptional activity, and identified candidate targets with multiple roles, including transcription factors of several classes. We determined that, among the most upregulated candidate genes with expected neuronal functions, most require EBF activity for some or all of their expression, and most have overlapping expression with ebf genes. We also found that the candidate target genes that had the most strongly overlapping expression patterns with ebf genes were predicted to be direct transcriptional targets of EBF transcriptional activity. The identification of candidate targets that are transcription factor genes, including nscl-1, emx1 and aml1, improves our understanding of how EBF proteins participate in the hierarchy of transcription control during neuronal development, and suggests novel mechanisms by which EBF activity promotes migration and differentiation. Other candidate targets, including pcdh8 and kcnk5, expand our knowledge of the types of terminal differentiated neuronal functions that EBF proteins regulate.

  8. EBF factors drive expression of multiple classes of target genes governing neuronal development

    Directory of Open Access Journals (Sweden)

    Vetter Monica L

    2011-04-01

    Full Text Available Abstract Background Early B cell factor (EBF family members are transcription factors known to have important roles in several aspects of vertebrate neurogenesis, including commitment, migration and differentiation. Knowledge of how EBF family members contribute to neurogenesis is limited by a lack of detailed understanding of genes that are transcriptionally regulated by these factors. Results We performed a microarray screen in Xenopus animal caps to search for targets of EBF transcriptional activity, and identified candidate targets with multiple roles, including transcription factors of several classes. We determined that, among the most upregulated candidate genes with expected neuronal functions, most require EBF activity for some or all of their expression, and most have overlapping expression with ebf genes. We also found that the candidate target genes that had the most strongly overlapping expression patterns with ebf genes were predicted to be direct transcriptional targets of EBF transcriptional activity. Conclusions The identification of candidate targets that are transcription factor genes, including nscl-1, emx1 and aml1, improves our understanding of how EBF proteins participate in the hierarchy of transcription control during neuronal development, and suggests novel mechanisms by which EBF activity promotes migration and differentiation. Other candidate targets, including pcdh8 and kcnk5, expand our knowledge of the types of terminal differentiated neuronal functions that EBF proteins regulate.

  9. A decomposition analysis of the driving factors of CO_2 (Carbon dioxide) emissions from the power sector in the European Union countries

    International Nuclear Information System (INIS)

    Karmellos, M.; Kopidou, D.; Diakoulaki, D.

    2016-01-01

    The scope of this paper is to investigate the driving factors of CO_2 emissions from electricity generation in all European Union countries (EU-28) during the period 2000–2012. Particular emphasis is placed on the assessment of any potential association between the examined driving factors and major climate and energy policies implemented during the examined period. In addition, the analysis distinguishes two subperiods, namely 2000–2007 and 2007–2012 in order to detect the impact of the economic crisis on each distinct driving factor and, consequently, on the total level of CO_2 emissions from the power sector. The model developed to analyse the changes in CO_2 emissions from the power sector across EU-28, is based on LMDI-I method and takes into account five driving factors: level of activity, electricity intensity, electricity trade, efficiency of electricity generation and fuel mix. The obtained results show that in times of economic growth the main factor counterbalancing the activity effect was in most countries the decreasing electricity intensity, while the contribution of all other factors becomes apparent later, despite the economic crisis and in view of the Kyoto targets. - Highlights: • LMDI is used to identify driving forces of CO_2 emissions from EU's power sector. • Declining electricity intensity was the main restrictive factor before 2007. • Fuel shifts contributed to emissions fall mostly after 2007, despite the crisis. • Trade effect is notable and indicates growing carbon leakage in the power sector.

  10. Research on the Spatial Differentiation and Driving Factors of Tourism Enterprises’ Efficiency: Chinese Scenic Spots, Travel Agencies, and Hotels

    Directory of Open Access Journals (Sweden)

    Bing Xia

    2018-03-01

    Full Text Available Tourism is an important sustainable industry in the economy that optimizes the industrial structure. Thus, as a core part of this market, tourism enterprises perform a key role in the effective operation of this industry. This paper applies data envelopment analysis (DEA and Malmquist index (MI models to calculate the efficiency of Chinese tourism enterprises between 2005 and 2014. Results showed that: (1 The efficiency and the total factor productivity change index (TFPC of tourism enterprises remained low, and both have decreased. (2 The efficiency of regional tourism enterprises across China cloud be characterized as high in the east region, low in the central region, and high in both northeast and western regions. (3 The efficiency levels of the cities of Beijing and Shanghai were ahead of the country over the period of this study, while Chongqing, Tibet, Qinghai, and Ningxia all possess a number of obvious advantages in the western region. (4 Centers of overall tourism enterprise efficiency mainly moved in a southeast-to-northwest direction over the period of this research. (5 The spatial autocorrelation of tourism enterprise efficiencies is also assessed in this study, and the results show that the comprehensive efficiency (CE of tourism enterprises in southeastern coastal regions of China tended to a certain spatial agglomeration effect, while the correlation between the central region and northern China was not significant. (6 The Geodetector model is applied to analyze the key factors driving the spatial differentiation of tourism enterprise efficiencies, and the results show that the degree of opening to the outside world, potential human capital, and traffic conditions were the most important factors driving spatial differentiation in the efficiency of tourism enterprises.

  11. Why Do You Adopt Social Networking Sites? Investigating the Driving Factors through Structural Equation Modelling

    Science.gov (United States)

    Jan, Muhammad Tahir

    2017-01-01

    Purpose: The purpose of this paper is to investigate those factors that are associated with the adoption of social networking sites from the perspective of Muslim users residing in Malaysia. Design/methodology/approach: A complete self-administered questionnaire was collected from 223 Muslim users of social networking sites in Malaysia. Both…

  12. Driving factors behind the eutrophication signal in understorey plant communities of deciduous temperate forests

    Czech Academy of Sciences Publication Activity Database

    Verheyen, E.; Baeten, L.; De Frenne, P.; Brnhardt-Römermann, M.; Brunet, J.; Cornelis, J.; Decocq, G.; Dierschke, H.; Eriksson, O.; Hédl, Radim; Heinken, T.; Hermy, M.; Hommel, P.; Kirby, K.; Naaf, T.; Peterken, G.; Petřík, Petr; Pfadenhauer, J.; Van Calster, H.; Walther, G.-R.; Wulf, M.; Verstraeten, G.

    2012-01-01

    Roč. 100, č. 2 (2012), s. 352-365 ISSN 0022-0477 R&D Projects: GA AV ČR IAA600050812 Institutional research plan: CEZ:AV0Z60050516 Keywords : Ellenberg indicator values * forest management * large herbivores Subject RIV: EF - Botanics Impact factor: 5.431, year: 2012

  13. What Are the Social, Psychological, and Cognitive Factors That Drive Individuals to Entrepreneurship?

    Science.gov (United States)

    LaMattina, Lina M.

    2013-01-01

    The purpose of this study was two-fold; first, to uncover the social, psychological, and cognitive factors core to the entrepreneurial individual; and secondly, to provide accurate data to be used in curriculum development to fill the existing educational gap that exists in the current literature regarding understanding the inner workings of the…

  14. Insulin-Like Growth Factor I Does Not Drive New Bone Formation in Experimental Arthritis

    NARCIS (Netherlands)

    van Tok, Melissa N.; Yeremenko, Nataliya G.; Teitsma, Christine A.; Kream, Barbara E.; Knaup, Véronique L.; Lories, Rik J.; Baeten, Dominique L.; van Duivenvoorde, Leonie M.

    2016-01-01

    Insulin like growth factor (IGF)-I can act on a variety of cells involved in cartilage and bone repair, yet IGF-I has not been studied extensively in the context of inflammatory arthritis. The objective of this study was to investigate whether IGF-I overexpression in the osteoblast lineage could

  15. An explorative study of factors contributing to the job satisfaction of primary care midwives

    NARCIS (Netherlands)

    Warmelink, J.C.; Hoijtink, K.; Noppers, M.; Wiegers, T.A.; de Cock, T.P.; Klomp, T.; Hutton, E.K.

    2015-01-01

    Objective: the main objectives of our study was to gain an understanding of how primary care midwives in the Netherlands feel about their work and to identify factors associated with primary care midwives' job satisfaction and areas for improvement. Design: a qualitative analysis was used, based on

  16. An explorative study of factors contributing to the job satisfaction of primary care midwives.

    NARCIS (Netherlands)

    Warmelink, J.C.; Hoijtink, K.; Noppers, M.; Wiegers, T.A.; Cock, T.P. de; Klomp, T.; Hutton, E.K.

    2015-01-01

    Objective: the main objectives of our study was to gain an understanding of how primary care midwives in the Netherlands feel about their work and to identify factors associated with primary care midwives׳ job satisfaction and areas for improvement. Design: a qualitative analysis was used, based on

  17. Does positive selection drive transcription factor binding site turnover? A test with Drosophila cis-regulatory modules.

    Directory of Open Access Journals (Sweden)

    Bin Z He

    2011-04-01

    Full Text Available Transcription factor binding site(s (TFBS gain and loss (i.e., turnover is a well-documented feature of cis-regulatory module (CRM evolution, yet little attention has been paid to the evolutionary force(s driving this turnover process. The predominant view, motivated by its widespread occurrence, emphasizes the importance of compensatory mutation and genetic drift. Positive selection, in contrast, although it has been invoked in specific instances of adaptive gene expression evolution, has not been considered as a general alternative to neutral compensatory evolution. In this study we evaluate the two hypotheses by analyzing patterns of single nucleotide polymorphism in the TFBS of well-characterized CRM in two closely related Drosophila species, Drosophila melanogaster and Drosophila simulans. An important feature of the analysis is classification of TFBS mutations according to the direction of their predicted effect on binding affinity, which allows gains and losses to be evaluated independently along the two phylogenetic lineages. The observed patterns of polymorphism and divergence are not compatible with neutral evolution for either class of mutations. Instead, multiple lines of evidence are consistent with contributions of positive selection to TFBS gain and loss as well as purifying selection in its maintenance. In discussion, we propose a model to reconcile the finding of selection driving TFBS turnover with constrained CRM function over long evolutionary time.

  18. Spatially dependent biotic and abiotic factors drive survivorship and physical structure of green roof vegetation.

    Science.gov (United States)

    Aloisio, Jason M; Palmer, Matthew I; Giampieri, Mario A; Tuininga, Amy R; Lewis, James D

    2017-01-01

    Plant survivorship depends on biotic and abiotic factors that vary at local and regional scales. This survivorship, in turn, has cascading effects on community composition and the physical structure of vegetation. Survivorship of native plant species is variable among populations planted in environmentally stressful habitats like urban roofs, but the degree to which factors at different spatial scales affect survivorship in urban systems is not well understood. We evaluated the effects of biotic and abiotic factors on survivorship, composition, and physical structure of two native perennial species assemblages, one characterized by a mixture of C 4 grasses and forbs (Hempstead Plains, HP) and one characterized by a mixture of C 3 grasses and forbs (Rocky Summit, RS), that were initially sown at equal ratios of growth forms (5:1:4; grass, N-fixing forb and non-N-fixing forb) in replicate 2-m 2 plots planted on 10 roofs in New York City (New York, USA). Of 24 000 installed plants, 40% survived 23 months after planting. Within-roof factors explained 71% of variation in survivorship, with biotic (species identity and assemblage) factors accounting for 54% of the overall variation, and abiotic (growing medium depth and plot location) factors explaining 17% of the variation. Among-roof factors explained 29% of variation in survivorship and increased solar radiation correlated with decreased survivorship. While growing medium properties (pH, nutrients, metals) differed among roofs there was no correlation with survivorship. Percent cover and sward height increased with increasing survivorship. At low survivorship, cover of the HP assemblage was greater compared to the RS assemblage. Sward height of the HP assemblage was about two times greater compared to the RS assemblage. These results highlight the effects of local biotic and regional abiotic drivers on community composition and physical structure of green roof vegetation. As a result, initial green roof plant

  19. Modeling soil organic carbon dynamics and their driving factors in the main global cereal cropping systems

    Science.gov (United States)

    Wang, Guocheng; Zhang, Wen; Sun, Wenjuan; Li, Tingting; Han, Pengfei

    2017-10-01

    Changes in the soil organic carbon (SOC) stock are determined by the balance between the carbon input from organic materials and the output from the decomposition of soil C. The fate of SOC in cropland soils plays a significant role in both sustainable agricultural production and climate change mitigation. The spatiotemporal changes of soil organic carbon in croplands in response to different carbon (C) input management and environmental conditions across the main global cereal systems were studied using a modeling approach. We also identified the key variables that drive SOC changes at a high spatial resolution (0.1° × 0.1°) and over a long timescale (54 years from 1961 to 2014). A widely used soil C turnover model (RothC) and state-of-the-art databases of soil and climate variables were used in the present study. The model simulations suggested that, on a global average, the cropland SOC density increased at annual rates of 0.22, 0.45 and 0.69 Mg C ha-1 yr-1 under crop residue retention rates of 30, 60 and 90 %, respectively. Increasing the quantity of C input could enhance soil C sequestration or reduce the rate of soil C loss, depending largely on the local soil and climate conditions. Spatially, under a specific crop residue retention rate, relatively higher soil C sinks were found across the central parts of the USA, western Europe, and the northern regions of China. Relatively smaller soil C sinks occurred in the high-latitude regions of both the Northern and Southern hemispheres, and SOC decreased across the equatorial zones of Asia, Africa and America. We found that SOC change was significantly influenced by the crop residue retention rate (linearly positive) and the edaphic variable of initial SOC content (linearly negative). Temperature had weak negative effects, and precipitation had significantly negative impacts on SOC changes. The results can help guide carbon input management practices to effectively mitigate climate change through soil C

  20. Modeling soil organic carbon dynamics and their driving factors in the main global cereal cropping systems

    Directory of Open Access Journals (Sweden)

    G. Wang

    2017-10-01

    Full Text Available Changes in the soil organic carbon (SOC stock are determined by the balance between the carbon input from organic materials and the output from the decomposition of soil C. The fate of SOC in cropland soils plays a significant role in both sustainable agricultural production and climate change mitigation. The spatiotemporal changes of soil organic carbon in croplands in response to different carbon (C input management and environmental conditions across the main global cereal systems were studied using a modeling approach. We also identified the key variables that drive SOC changes at a high spatial resolution (0.1°  ×  0.1° and over a long timescale (54 years from 1961 to 2014. A widely used soil C turnover model (RothC and state-of-the-art databases of soil and climate variables were used in the present study. The model simulations suggested that, on a global average, the cropland SOC density increased at annual rates of 0.22, 0.45 and 0.69 Mg C ha−1 yr−1 under crop residue retention rates of 30, 60 and 90 %, respectively. Increasing the quantity of C input could enhance soil C sequestration or reduce the rate of soil C loss, depending largely on the local soil and climate conditions. Spatially, under a specific crop residue retention rate, relatively higher soil C sinks were found across the central parts of the USA, western Europe, and the northern regions of China. Relatively smaller soil C sinks occurred in the high-latitude regions of both the Northern and Southern hemispheres, and SOC decreased across the equatorial zones of Asia, Africa and America. We found that SOC change was significantly influenced by the crop residue retention rate (linearly positive and the edaphic variable of initial SOC content (linearly negative. Temperature had weak negative effects, and precipitation had significantly negative impacts on SOC changes. The results can help guide carbon input management practices to

  1. Interprofessional collaboration regarding patients' care plans in primary care : a focus group study into influential factors

    NARCIS (Netherlands)

    Stephanie Anna Lenzen; Trudy van der Weijden; Anna Beurskens; Marloes Amantia van Bokhoven; Ramon Daniëls; Jerôme Jean Jacques van Dongen

    2016-01-01

    Background: The number of people with multiple chronic conditions demanding primary care services is increasing. To deal with the complex health care demands of these people, professionals from different disciplines collaborate. This study aims to explore influential factors regarding

  2. Interprofessional collaboration regarding patients' care plans in primary care: a focus group study into influential factors

    NARCIS (Netherlands)

    Dongen, J.J. van; Lenzen, S.A.; Bokhoven, M.A. van; Daniels, R.; Weijden, T.T. van der; Beurskens, A.

    2016-01-01

    BACKGROUND: The number of people with multiple chronic conditions demanding primary care services is increasing. To deal with the complex health care demands of these people, professionals from different disciplines collaborate. This study aims to explore influential factors regarding

  3. Policies and market factors driving wind power development in the United States

    International Nuclear Information System (INIS)

    Bird, Lori; Bolinger, Mark; Gagliano, Troy; Wiser, Ryan; Brown, Matthew; Parsons, Brian

    2005-01-01

    In the United States, there has been substantial recent growth in wind energy generating capacity, with growth averaging 24 percent annually during the past five years. About 1700 MW of wind energy capacity was installed in 2001, while another 410 MW became operational in 2002. During 2003, development activity has remained strong, with an estimated 1600 MW of capacity installed. With this growth, an increasing number of States are experiencing investment in wind energy projects: currently about half of all States host at least one wind power project. This paper explores the key factors at play in the 12 States in which a substantial amount of wind energy capacity has been developed or planned. Some of the factors that are examined include policy drivers, such as Renewable Portfolio Standards (RPS), Federal and State financial incentives; as well as market drivers, such as consumer demand for green power, natural gas price volatility, and wholesale market rules

  4. What factors drive interest rate spread of commercial banks? Empirical evidence from Kenya

    Directory of Open Access Journals (Sweden)

    Maureen Were

    2014-12-01

    Full Text Available The paper empirically investigates the determinants of interest rate spread in Kenya's banking sector based on panel data analysis. The findings show that bank-specific factors play a significant role in the determination of interest rate spreads. These include bank size, credit risk as measured by non-performing loans to total loans ratio, return on average assets and operating costs, all of which positively influence interest rate spreads. On the other hand, higher bank liquidity ratio has a negative effect on the spreads. On average, big banks have higher spreads compared to small banks. The impact of macroeconomic factors such as real economic growth is insignificant. The effect of the monetary policy rate is positive but not highly significant. The results largely reflect the structure of the banking industry, in which a few big banks control a significant share of the market.

  5. Abiotic factors drives floristic variations of fern's metacommunity in an Atlantic Forest remnant.

    Science.gov (United States)

    Costa, L E N; Farias, R P; Santiago, A C P; Silva, I A A; Barros, I C L

    2018-02-15

    We analyzed floristic variations in fern's metacommunity at the local scale and their relationship with abiotic factors in an Atlantic Forest remnant of northeastern Brazil. Floristic and environmental variations were accessed on ten plots of 10 × 20 m. We performed cluster analyses, based on Bray-Curtis dissimilarity index to establish the floristic relationship. The influence of abiotic factors: luminosity, temperature, relative air humidity and relative soil moisture was evaluated from a redundancy analysis. We found 24 species belonging to 20 genera and 12 families. The fern's flora showed high floristic heterogeneity (>75% for most of the plot's associations). The fern's metacommunity was structured along an abiotic gradient modulated by temperature, luminosity, and relative soil moisture.

  6. Abiotic factors drives floristic variations of fern’s metacommunity in an Atlantic Forest remnant

    Directory of Open Access Journals (Sweden)

    L. E. N. Costa

    2018-02-01

    Full Text Available Abstract We analyzed floristic variations in fern’s metacommunity at the local scale and their relationship with abiotic factors in an Atlantic Forest remnant of northeastern Brazil. Floristic and environmental variations were accessed on ten plots of 10 × 20 m. We performed cluster analyses, based on Bray-Curtis dissimilarity index to establish the floristic relationship. The influence of abiotic factors: luminosity, temperature, relative air humidity and relative soil moisture was evaluated from a redundancy analysis. We found 24 species belonging to 20 genera and 12 families. The fern’s flora showed high floristic heterogeneity (>75% for most of the plot’s associations. The fern’s metacommunity was structured along an abiotic gradient modulated by temperature, luminosity, and relative soil moisture.

  7. Relationship between Power Factors of Mixer Drive and Selected Technological Parameters

    OpenAIRE

    R. Wrona; E. Ziółkowski; K. Smyksy

    2008-01-01

    Thc paper summarizes the selected results of tcsts pcrforrncd to find thc relationship bctwcca thc tcchnological and operational paramctcrsand power consumption by a mixcr drivc. Major tcchnological pammetcrs of moulding sand to considcr arc: mixing lime. moisturecontent. pan load. EIectric power demand is cxprcsscd by crfcctivc valucs, assuming thc bnlanccd tod. Thc propcrtics of moulding sandare shown to be correlated with pwcr factors. As thc mixing lcvcts changc, thc tcchnologicnl pararna...

  8. Identifying driving factors for the establishment of cooperative GMO-free zones in Germany

    OpenAIRE

    Consmuller, Nicola; Beckmann, Volker; Petrick, Martin

    2012-01-01

    Since the end of the quasi-moratorium on genetically modified organisms (GMO) in the European Union in 2004, the establishment of GMO-free zones has become an EU wide phenomenon. In contrast to other European countries, Germany follows the concept of cooperative GMO-free zones where neighbouring farmers contractually refrain from GMO cultivation. In this article, we address the question which underlying factors could account for the establishment of cooperative GMO-free zones in Germany. Draw...

  9. Plasmodium falciparum malaria importation from Africa to China and its mortality: an analysis of driving factors

    Science.gov (United States)

    Lai, Shengjie; Wardrop, Nicola A.; Huang, Zhuojie; Bosco, Claudio; Sun, Junling; Bird, Tomas; Wesolowski, Amy; Zhou, Sheng; Zhang, Qian; Zheng, Canjun; Li, Zhongjie; Tatem, Andrew J.; Yu, Hongjie

    2016-12-01

    Plasmodium falciparum malaria importation from Africa to China is rising with increasing Chinese overseas investment and international travel. Identifying networks and drivers of this phenomenon as well as the contributors to high case-fatality rate is a growing public health concern to enable efficient response. From 2011-2015, 8653 P. falciparum cases leading to 98 deaths (11.3 per 1000 cases) were imported from 41 sub-Saharan countries into China, with most cases (91.3%) occurring in labour-related Chinese travellers. Four strongly connected groupings of origin African countries with destination Chinese provinces were identified, and the number of imported cases was significantly associated with the volume of air passengers to China (P = 0.006), parasite prevalence in Africa (P investment in resource extraction having the strongest relationship with parasite importation. Risk factors for deaths from imported cases were related to the capacity of malaria diagnosis and diverse socioeconomic factors. The spatial heterogeneity uncovered, principal drivers explored, and risk factors for mortality found in the rising rates of P. falciparum malaria importation to China can serve to refine malaria elimination strategies and the management of cases, and high risk groups and regions should be targeted.

  10. Factors driving the seasonal distribution of planktonic and epiphytic ciliates in a eutrophicated Mediterranean Lagoon

    Energy Technology Data Exchange (ETDEWEB)

    Dhib, Amel [Université de Franche-Comté, Laboratoire de Chrono-Environnement, UMR CNRS 6249 (France); Institut National des Sciences et Technologies de la Mer (INSTM), Laboratoire Milieu Marin, Centre la Goulette (Tunisia); Brahim, Mounir Ben; Ziadi, Boutheina; Akrout, Fourat; Turki, Souad [Institut National des Sciences et Technologies de la Mer (INSTM), Laboratoire Milieu Marin, Centre la Goulette (Tunisia); Aleya, Lotfi [Université de Franche-Comté, Laboratoire de Chrono-Environnement, UMR CNRS 6249 (France)

    2013-09-15

    Highlights: • Distribution of planktonic and epiphytic ciliates at five stations in Ghar El Melh Lagoon. • 28 planktonic ciliates were identified with spring-early autumn peaks. • 4 epiphytic ciliates of the seagrass Ruppia cirrhosa were recorded with high density. • Significant correlations were found between ciliate assemblages, environmental factors and harmful dinoflagellates. -- Abstract: We studied the distribution of planktonic and epiphytic ciliates coupled with environmental factors and microalgae abundance at five stations in Ghar El Melh Lagoon (Tunisia). Planktonic ciliates were monitored for a year and epiphytic ciliates were sampled during summer 2011 in concordance with the proliferation of the seagrass Ruppia cirrhosa. Ciliate assemblage was largely dominated by Spirotrichea followed respectively by Tintinnida of and Strombidiida. No significant difference was found in the distribution of ciliate species among the stations. Redundancy analysis indicates that abiotic factors (temperature and nutriments) have a significant effect on the dynamics of certain ciliates. For epiphytic ciliates, 4 species were identified: Tintinnopsis campanula, Aspidisca sp., Strombidium acutum and Amphorides amphora. Based on PERMANOVA analyses, ciliates exhibit significant correlations among months and stations. According to ACP, epiphyte distribution follows roughly those of R. cirrhosa and pH. Significant correlations were found between harmful dinoflagellates and both planktonic and epiphytic ciliates.

  11. Factors driving the seasonal distribution of planktonic and epiphytic ciliates in a eutrophicated Mediterranean Lagoon

    International Nuclear Information System (INIS)

    Dhib, Amel; Brahim, Mounir Ben; Ziadi, Boutheina; Akrout, Fourat; Turki, Souad; Aleya, Lotfi

    2013-01-01

    Highlights: • Distribution of planktonic and epiphytic ciliates at five stations in Ghar El Melh Lagoon. • 28 planktonic ciliates were identified with spring-early autumn peaks. • 4 epiphytic ciliates of the seagrass Ruppia cirrhosa were recorded with high density. • Significant correlations were found between ciliate assemblages, environmental factors and harmful dinoflagellates. -- Abstract: We studied the distribution of planktonic and epiphytic ciliates coupled with environmental factors and microalgae abundance at five stations in Ghar El Melh Lagoon (Tunisia). Planktonic ciliates were monitored for a year and epiphytic ciliates were sampled during summer 2011 in concordance with the proliferation of the seagrass Ruppia cirrhosa. Ciliate assemblage was largely dominated by Spirotrichea followed respectively by Tintinnida of and Strombidiida. No significant difference was found in the distribution of ciliate species among the stations. Redundancy analysis indicates that abiotic factors (temperature and nutriments) have a significant effect on the dynamics of certain ciliates. For epiphytic ciliates, 4 species were identified: Tintinnopsis campanula, Aspidisca sp., Strombidium acutum and Amphorides amphora. Based on PERMANOVA analyses, ciliates exhibit significant correlations among months and stations. According to ACP, epiphyte distribution follows roughly those of R. cirrhosa and pH. Significant correlations were found between harmful dinoflagellates and both planktonic and epiphytic ciliates

  12. Factors associated with professional satisfaction in primary care: Results from EUprimecare project.

    Science.gov (United States)

    Sanchez-Piedra, Carlos Alberto; Jaruseviciene, Lina; Prado-Galbarro, Francisco Javier; Liseckiene, Ida; Sánchez-Alonso, Fernando; García-Pérez, Sonia; Sarria Santamera, Antonio

    2017-12-01

    Given the importance of primary care to healthcare systems and population health, it seems crucial to identify factors that contribute to the quality of primary care. Professional satisfaction has been linked with quality of primary care. Physician dissatisfaction is considered a risk factor for burnout and leaving medicine. This study explored factors associated with professional satisfaction in seven European countries. A survey was conducted among primary care physicians. Estonia, Finland, Germany and Hungary used a web-based survey, Italy and Lithuania a telephone survey, and Spain face to face interviews. Sociodemographic information (age, sex), professional experience and qualifications (years since graduation, years of experience in general practice), organizational variables related to primary care systems and satisfaction were included in the final version of the questionnaire. A logistic regression analysis was performed to assess the factors associated with satisfaction among physicians. A total of 1331 primary care physicians working in primary care services responded to the survey. More than half of the participants were satisfied with their work in primary care services (68.6%). We found significant associations between satisfaction and years of experience (OR = 1.01), integrated network of primary care centres (OR = 2.8), patients having direct access to specialists (OR = 1.3) and professionals having access to data on patient satisfaction (OR = 1.3). Public practice, rather than private practice, was associated with lower primary care professional satisfaction (OR = 0.8). Elements related to the structure of primary care are associated with professional satisfaction. At the individual level, years of experience seems to be associated with higher professional satisfaction.

  13. The Role of Driving Factors in Historical and Projected Carbon Dynamics in Wetland Ecosystems of Alaska

    Science.gov (United States)

    Lyu, Z.; Helene, G.; He, Y.; Zhuang, Q.; McGuire, A. D.; Bennett, A.; Breen, A. L.; Clein, J.; Euskirchen, E. S.; Johnson, K. D.; Kurkowski, T. A.; Pastick, N. J.; Rupp, S. T.; Wylie, B. K.; Zhu, Z.

    2017-12-01

    Wetlands are important terrestrial ecosystems in Alaska. It is important to understand and assess their role in the regional carbon dynamics in response to historical and projected environmental conditions. A coupled modeling framework that incorporates a fire disturbance model and two biogeochemical models was used to assess the relative influence of changing climate, atmospheric carbon dioxide (CO2) concentration, and fire regime on the historical and future carbon balance in wetland ecosystems of the four main Landscape Conservation Cooperatives (LCCs) of Alaska. Simulations were conducted for the historical period (1950-2009) and future projection period (2010-2099). These simulations estimate that the total carbon (C) storage in wetland ecosystems of Alaska is 5556 Tg C in 2009, with 89% of the C stored in soils. An estimated 175 Tg C was lost during the historical period, which is attributed to greater C lost from the Northwest Boreal LCC than C gained from the other three LCCs. The simulations for the projection period were conducted for six different scenarios driven by climate forcings from two different climate models for each of three CO2 emission scenarios. The mean total carbon storage increased 3.94 Tg C/yr by 2099, with variability among the simulations ranging from 2.02 Tg C/yr to 4.42 Tg C/yr. Across the four LCCs, the largest relative C storage increase occurred in the Arctic and North Pacific LCCs. These increases were primarily driven by increases in net primary production (NPP) that were greater than increases in heterotrophic respiration and fire emissions. Our analysis further indicates that NPP increase was primarily driven by CO2 fertilization ( 5% per 100 ppmv increase) as well as by increases in air temperature ( 1% per ° increase). Increases air temperature were estimated to be the primary cause for a projected 47.7% mean increase in wetlands biogenic CH4 emissions among the simulations ( 15% per ° increase). The combined effects of

  14. Driving and dementia: Efficient approach to driving safety concerns in family practice.

    Science.gov (United States)

    Lee, Linda; Molnar, Frank

    2017-01-01

    To provide primary care physicians with an approach to driving safety concerns when older persons present with memory difficulties. The approach is based on an accredited memory clinic training program developed by the Centre for Family Medicine Primary Care Collaborative Memory Clinic. One of the most challenging aspects of dementia care is the assessment of driving safety. Drivers with dementia are at higher risk of motor vehicle collisions, yet many drivers with mild dementia might be safely able to continue driving for several years. Because safe driving is dependent on multiple cognitive and functional skills, clinicians should carefully consider many factors when determining if cognitive concerns affect driving safety. Specific findings on corroborated history and office-based cognitive testing might aid in the physician's decisions to refer for comprehensive on-road driving evaluation and whether to notify transportation authorities in accordance with provincial reporting requirements. Sensitive communication and a person-centred approach are essential. Primary care physicians must consider many factors when determining if cognitive concerns might affect driving safety in older drivers. Copyright© the College of Family Physicians of Canada.

  15. To Communicate or Not to Communicate: Factors Predicting Passengers' Intentions to Ask a Driver to Stop Text Messaging While Driving.

    Science.gov (United States)

    Wang, Xiao

    2016-01-01

    Interpersonal communication is important in health campaigns. This research examined factors that are associated with passengers' intentions to communicate no texting with a texting driver in a scenario where the driver is their friend. Based on survey data collected from 546 college students, results showed that students' attitudes toward communication about no texting while driving were predicted by their utilitarian (i.e., safety), value-expressive, and ego-defensive motivations, in addition to being predicted by self-efficacy and norms. Additional results revealed that empathic concern was correlated with the value-expressive motivation and anticipated guilt. Anticipated guilt, together with attitudes, norms, and efficacy, predicted communication intentions. Results revealed that including attitude functions (motivations) in the reasoned action model could help propose and test theory-based predictions in interpersonal communication and health behaviors.

  16. Risk assessment and driving factors for artificial topography on element heterogeneity: Case study at Jiangsu, China.

    Science.gov (United States)

    Hong, Hualong; Dai, Minyue; Lu, Haoliang; Liu, Jingchun; Zhang, Jie; Yan, Chongling

    2018-02-01

    The rapid expansion of construction related to coastal development evokes great concern about environmental risks. Recent attention has been focused mainly on factors related to the effects of waterlogging, but there is urgent need to address the potential hazard caused by artificial topography: derived changes in the elemental composition of the sediments. To reveal possible mechanisms and to assess the environmental risks of artificial topography on transition of elemental composition in the sediment at adjoining zones, a nest-random effects-combined investigation was carried out around a semi-open seawall. The results implied great changes induced by artificial topography. Not only did artificial topography alter the sediment elemental composition at sites under the effect of artificial topography, but also caused a coupling pattern transition of elements S and Cd. The biogeochemical processes associated with S were also important, as suggested by cluster analysis. The geo-accumulation index shows that artificial topography triggered the accumulation of C, N, S, Cu, Fe, Mn, Zn, Ni, Cr, Pb, As and Cd, and increased the pollution risk of C, N, S, Cu, As and Cd. Enrichment factors reveal that artificial topography is a new type of human-activity-derived Cu contamination. The heavy metal Cu was notably promoted on both the geo-accumulation index and the enrichment factor under the influence of artificial topography. Further analysis showed that the Cu content in the sediment could be fitted using equations for Al and organic carbon, which represented clay mineral sedimentation and organic matter accumulation, respectively. Copper could be a reliable indicator of environmental degradation caused by artificial topography. Copyright © 2017 Elsevier Ltd. All rights reserved.

  17. Factors driving territory size and breeding success in a threatened migratory songbird, the Canada Warbler

    Directory of Open Access Journals (Sweden)

    D. T. Tyler Flockhart

    2016-12-01

    Full Text Available Successful conservation of migratory birds demands we understand how habitat factors on the breeding grounds influences breeding success. Multiple factors are known to directly influence breeding success in territorial songbirds. For example, greater food availability and fewer predators can have direct effects on breeding success. However, many of these same habitat factors can also result in higher conspecific density that may ultimately reduce breeding success through density dependence. In this case, there is a negative indirect effect of habitat on breeding success through its effects on conspecific density and territory size. Therefore, a key uncertainty facing land managers is whether important habitat attributes directly influence breeding success or indirectly influence breeding success through territory size. We used radio-telemetry, point-counts, vegetation sampling, predator observations, and insect sampling over two years to provide data on habitat selection of a steeply declining songbird species, the Canada Warbler (Cardellina canadensis. These data were then applied in a hierarchical path modeling framework and an AIC model selection approach to determine the habitat attributes that best predict breeding success. Canada Warblers had smaller territories in areas with high shrub cover, in the presence of red squirrels (Tamiasciurus hudsonicus, at shoreline sites relative to forest-interior sites and as conspecific density increased. Breeding success was lower for birds with smaller territories, which suggests competition for limited food resources, but there was no direct evidence that food availability influenced territory size or breeding success. The negative relationship between shrub cover and territory size in our study may arise because these specific habitat conditions are spatially heterogeneous, whereby individuals pack into patches of preferred breeding habitat scattered throughout the landscape, resulting in reduced

  18. Factors driving mortality and growth at treeline: a 30-year experiment of 92 000 conifers.

    Science.gov (United States)

    Barbeito, Ignacio; Dawes, Melissa A; Rixen, Christian; Senn, Josef; Bebi, Peter

    2012-02-01

    Understanding the interplay between environmental factors contributing to treeline formation and how these factors influence different life stages remains a major research challenge. We used an afforestation experiment including 92 000 trees to investigate the spatial and temporal dynamics of tree mortality and growth at treeline in the Swiss Alps. Seedlings of three high-elevation conifer species (Larix decidua, Pinus mugo ssp. uncinata, and Pinus cembra) were systematically planted along an altitudinal gradient at and above the current treeline (2075 to 2230 m above sea level [a.s.l.]) in 1975 and closely monitored during the following 30 years. We used decision-tree models and generalized additive models to identify patterns in mortality and growth along gradients in elevation, snow duration, wind speed, and solar radiation, and to quantify interactions between the different variables. For all three species, snowmelt date was always the most important environmental factor influencing mortality, and elevation was always the most important factor for growth over the entire period studied. Individuals of all species survived at the highest point of the afforestation for more than 30 years, although mortality was greater above 2160 m a.s.l., 50-100 m above the current treeline. Optimal conditions for height growth differed from those for survival in all three species: early snowmelt (ca. day of year 125-140 [where day 1 is 1 January]) yielded lowest mortality rates, but relatively later snowmelt (ca. day 145-150) yielded highest growth rates. Although snowmelt and elevation were important throughout all life stages of the trees, the importance of radiation decreased over time and that of wind speed increased. Our findings provide experimental evidence that tree survival and height growth require different environmental conditions and that even small changes in the duration of snow cover, in addition to changes in temperature, can strongly impact tree survival and

  19. A fast automatic power control circuit for a small form-factor pluggable laser diode drive

    Energy Technology Data Exchange (ETDEWEB)

    Wang Huan; Wang Zhigong; Xu Jian; Miao Peng; Li Wei [Institute of RF- and OE-ICs, Southeast University, Nanjing 210096 (China); Luo Yin; Yang Siyong, E-mail: wanghuan@seu.edu.c [Jiangsu Sino-Chip OE-IC Co. Ltd, Nanjing 210016 (China)

    2010-06-15

    A fast automatic power control (APC) circuit for a laser diode driver (LDD) has been implemented in a 0.6-{mu}m BiCMOS process. The APC circuit adopts double-loops and variable-bandwidth techniques to achieve a turn-on time of < 400 {mu}s for most kinds of TOSAs. Thus, it meets the small form-factor pluggable (SFP) agreement. Such techniques make a good tradeoff between stability, accuracy, turn-on time, noise and convenience. The measured results indicate that the APC circuit is suitable for SFP LDD. (semiconductor integrated circuits)

  20. Impact of Macro Environmental Factors on Garments Industry That Drives Export in Bangladesh

    OpenAIRE

    Islam Mohammad; Pattak Dulal Chandra

    2017-01-01

    It goes without saying that Garments industry of Bangladesh has drawn a special attention to the mass people in the world because of being both cost leader and quality leader at the same time. The purpose of this research paper is to analyze the garments industry in Bangladesh which is going to be an emerging tiger in the world economy. It also aims to assess the impact of macro-environmental factors affecting the industry by PESTEL analysis. Again, five forces model has been analyzed to asse...

  1. Community Drive

    DEFF Research Database (Denmark)

    Magnussen, Rikke

    2018-01-01

    Schools and educational institutions are challenged by not adequately educating students for independent knowledge collaboration and solving of complex societal challenges (Bundsgaard & Hansen, 2016; Slot et al., 2017). As an alternative strategy to formal learning has Community-driven research...... opportunity to break boundaries between research institutions and surrounding communities through the involvement of new types of actors, knowledge forms and institutions (OECD, 2011). This paper presents the project Community Drive a three year cross disciplinary community-driven game– and data-based project....... In the paper we present how the project Community Drive initiated in May 2018 is based on results from pilot projects conducted from 2014 – 2017. Overall these studies showed that it is a strong motivational factor for students to be given the task to change their living conditions through redesign...

  2. A meta-analytic study of the factors driving the purchase of organic food.

    Science.gov (United States)

    Massey, Maria; O'Cass, Aron; Otahal, Petr

    2018-06-01

    Interest in the consumption of organic food has steadily risen over the past two decades. Yet after considerable research addressing a range of issues related to organic food consumption no research systematically examines which factors explain consumers' perceptions and purchase of organics. Through a meta-analysis we examine factors underpinning the purchase of organic food using a sample of 124,353 consumers reported in 150 manuscripts over the period from 1991 to 2016. The results demonstrate that credence attributes of organic food are valued more than search and experience attributes. This shows that the market is guided by the perceived benefits of organic over conventionally grown food. These findings do not diminish the importance of search and experience attributes, but suggest that credence attributes have a prominent role in consumer organic food purchases. From the perspective of organic producers and sellers an understanding of consumer perceptions, set within search, experience and credence attributes, has the potential to offer a unique selling proposition and point of differentiation in the market. Copyright © 2018 Elsevier Ltd. All rights reserved.

  3. Profile of a drunk driver and risk factors for drunk driving. Findings in roadside testing in the province of Uusimaa in Finland 1990-2008.

    Science.gov (United States)

    Portman, M; Penttilä, A; Haukka, J; Rajalin, S; Eriksson, C J P; Gunnar, T; Koskimaa, H; Kuoppasalmi, K

    2013-09-10

    The aim of the present study was to define the profile of a drunk driver and to determine risk factors for drunk driving by analyzing data on both sober and drunk drivers. Systematic roadside surveys have been carried out in Southern Finland for over 18 years, with 20,000-30,000 drivers breath tested annually. During the study period, 1241 drunk drivers were caught (legal blood alcohol limit 0.50‰). The comparison material consisted of 3407 sober drivers. The surveys were designed to further investigate demographic features and driving habits of drivers. The prevalence of drunk driving has been 0.2% over the time period, with only random variations. According to the data, a typical drunk driver is a man aged 40-49 who has a valid driving license and drives his own car, usually alone, with a blood alcohol concentration (BAC) of 1.0‰. He has a job and is married or cohabiting. The profile remained consistent throughout the study period. The risk of drunk driving was found to be five times higher for men than for women. Divorcees and widow(er)s had a substantially higher risk factor for being caught drunk driving than married drivers. Drunk drivers are most likely to be caught by roadside testing on Saturday mornings. During the study period the blood alcohol limit for aggravated drunk driving was lowered in 1994 from 1.5 to 1.2‰. In 2004 the taxation of alcohol beverages was reduced by 30%. Neither of these measures affected the prevalence of drunk driving or the mean BAC of drunk drivers (p=0.63). Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  4. Electron Flux Dropouts at L ˜ 4.2 From Global Positioning System Satellites: Occurrences, Magnitudes, and Main Driving Factors

    Science.gov (United States)

    Boynton, R. J.; Mourenas, D.; Balikhin, M. A.

    2017-11-01

    Dropouts in electron fluxes at L ˜ 4.2 were investigated for a broad range of energies from 120 keV to 10 MeV, using 16 years of electron flux data from Combined X-ray Dosimeter on board Global Positioning System (GPS) satellites. Dropouts were defined as flux decreases by at least a factor 4 in 12 h, or 24 h during which a decrease by at least a factor of 1.5 must occur during each 12 h time bin. Such fast and strong dropouts were automatically identified from the GPS electron flux data and statistics of dropout magnitudes, and occurrences were compiled as a function of electron energy. Moreover, the Error Reduction Ratio analysis was employed to search for nonlinear relationships between electron flux dropouts and various solar wind and geomagnetic activity indices, in order to identify potential external causes of dropouts. At L ˜ 4.2, the main driving factor for the more numerous and stronger 1-10 MeV electron dropouts turns out to be the southward interplanetary magnetic field Bs, suggesting an important effect from precipitation loss due to combined electromagnetic ion cyclotron and whistler mode waves in a significant fraction of these events, supplementing magnetopause shadowing and outward radial diffusion which are also effective at lower energies.

  5. A New Power-Factor-Based Vector Control Method for Sensorless Drive of Permanent-Magnet Synchronous Motors

    Science.gov (United States)

    Shinnaka, Shinji

    As a simple vector control method for sensorless drives of permanent-magnet synchronous motors, the so-called “Power-Factor-Based (PFB) Vector Control Method” has been proposed. The conventional PFB method directly estimates the phase of the quasi-optimal stator current through a control of the power factor phase, instead of the estimation of the rotor phase. The stator current is controlled in the current reference frame whose secondary axis phase is the same as the stator current phase. This paper proposes a new PEB method where the stator current is controlled in the voltage reference frame whose secondary axis phase is the same as the voltage phase rather than the current phase. It is shown that the similar quasi-optimal stator current control can be attained through the current control with appropriate current commands taking the power factor phase into account. This paper also shows a practical method for generating the current commands and a practical guideline for the design parameters of the new PFB method.

  6. Factors driving changes in freshwater mussel (Bivalvia, Unionida) diversity and distribution in Peninsular Malaysia.

    Science.gov (United States)

    Zieritz, Alexandra; Lopes-Lima, Manuel; Bogan, Arthur E; Sousa, Ronaldo; Walton, Samuel; Rahim, Khairul Adha A; Wilson, John-James; Ng, Pei-Yin; Froufe, Elsa; McGowan, Suzanne

    2016-11-15

    Freshwater mussels (Bivalvia, Unionida) fulfil important ecosystem functions and are one of the most threatened freshwater taxa globally. Knowledge of freshwater mussel diversity, distribution and ecology in Peninsular Malaysia is extremely poor, and the conservation status of half of the species presumed to occur in the region has yet to be assessed. We conducted the first comprehensive assessment of Peninsular Malaysia's freshwater mussels based on species presence/absence and environmental data collected from 155 sites spanning all major river catchments and diverse habitat types. Through an integrative morphological-molecular approach we recognised nine native and one widespread non-native species, i.e. Sinanodonta woodiana. Two species, i.e. Pilsbryoconcha compressa and Pseudodon cambodjensis, had not been previously recorded from Malaysia, which is likely a result of morphological misidentifications of historical records. Due to their restriction to single river catchments and declining distributions, Hyriopsis bialata, possibly endemic to Peninsular Malaysia, Ensidens ingallsianus, possibly already extinct in the peninsula, and Rectidens sumatrensis, particularly require conservation attention. Equally, the Pahang, the Perak and the north-western river catchments are of particular conservation value due to the presence of a globally unique freshwater mussel fauna. Statistical relationships of 15 water quality parameters and mussel presence/absence identified acidification and nutrient pollution (eutrophication) as the most important anthropogenic factors threatening freshwater mussel diversity in Peninsular Malaysia. These factors can be linked to atmospheric pollution, deforestation, oil-palm plantations and a lack of functioning waste water treatment, and could be mitigated by establishing riparian buffers and improving waste water treatment for rivers running through agricultural and residential land. Copyright © 2016 Elsevier B.V. All rights reserved.

  7. What factors drive copepod community distribution in the Gulf of Gabes, Eastern Mediterranean Sea?

    Science.gov (United States)

    Drira, Zaher; Bel Hassen, Malika; Ayadi, Habib; Aleya, Lotfi

    2014-02-01

    The spatial and temporal variations in copepod communities were investigated during four oceanographic cruises conducted between July 2005 and March 2007 aboard the R/V Hannibal. A close relationship was observed between the temperature, salinity, hydrographic properties and water masses characterising the Gulf of Gabes. Indeed, water thermal stratification began in May-June, and a thermocline was established at a 20-m depth, but ranged from 25 m in July to more than 30 m in September. The zooplankton community is dominated by copepods representing 69 % to 83 % of total zooplankton. Spatial and temporal variation of copepods in relation to environmental factors shows their close relationship with the hydrodynamic features of the water column. Thermal stratification in the column, established in summer, supports copepod development. In fact, copepod abundance increases gradually with rising water temperature and salinity, starting from the beginning of thermal stratification (May-June 2006) and lasting until its completion (July 2005 and September 2006). When the water column is well mixed (March 2007), copepod abundance decreased. Our finding shows that temperature and salinity seem to be the most important physical factors and thus strongly influence the taxonomic diversity and distribution of the copepod population. They are characterised by the dominance of Oithona nana, representing 75-86 % of total cyclopoid abundance. The most abundant species during the stratification period were O. nana, Acartia clausi and Stephos marsalensis in July 2005 and September 2006. However, during the mixing period, Euterpina acutifrons was more abundant, representing 21 % of the total. Unlike the copepod community, which is more abundant during the period of high stratification, phytoplankton proliferates during semi-mixed conditions.

  8. Interacting factors driving a major loss of large trees with cavities in a forest ecosystem.

    Directory of Open Access Journals (Sweden)

    David B Lindenmayer

    Full Text Available Large trees with cavities provide critical ecological functions in forests worldwide, including vital nesting and denning resources for many species. However, many ecosystems are experiencing increasingly rapid loss of large trees or a failure to recruit new large trees or both. We quantify this problem in a globally iconic ecosystem in southeastern Australia--forests dominated by the world's tallest angiosperms, Mountain Ash (Eucalyptus regnans. Tree, stand and landscape-level factors influencing the death and collapse of large living cavity trees and the decay and collapse of dead trees with cavities are documented using a suite of long-term datasets gathered between 1983 and 2011. The historical rate of tree mortality on unburned sites between 1997 and 2011 was >14% with a mortality spike in the driest period (2006-2009. Following a major wildfire in 2009, 79% of large living trees with cavities died and 57-100% of large dead trees were destroyed on burned sites. Repeated measurements between 1997 and 2011 revealed no recruitment of any new large trees with cavities on any of our unburned or burned sites. Transition probability matrices of large trees with cavities through increasingly decayed condition states projects a severe shortage of large trees with cavities by 2039 that will continue until at least 2067. This large cavity tree crisis in Mountain Ash forests is a product of: (1 the prolonged time required (>120 years for initiation of cavities; and (2 repeated past wildfires and widespread logging operations. These latter factors have resulted in all landscapes being dominated by stands ≤72 years and just 1.16% of forest being unburned and unlogged. We discuss how the features that make Mountain Ash forests vulnerable to a decline in large tree abundance are shared with many forest types worldwide.

  9. Factors driving inequality in prostate cancer survival: a population based study.

    Directory of Open Access Journals (Sweden)

    Richéal M Burns

    Full Text Available PURPOSE: As cancer control strategies have become more successful, issues around survival have become increasingly important to researchers and policy makers. The aim of this study was to examine the role of a range of clinical and socio-demographic variables in explaining variations in survival after a prostate cancer diagnosis, paying particular attention to the role of healthcare provider(s i.e. private versus public status. METHODS: Data were extracted from the National Cancer Registry Ireland, for patients diagnosed with prostate cancer from 1998-2009 (N = 26,183. A series of multivariate Cox and logistic regression models were used to examine the role of healthcare provider and socio-economic status (area-based deprivation on survival, controlling for age, stage, Gleason grade, marital status and region of residence. Survival was based on all-cause mortality. RESULTS: Older individuals who were treated in a private care setting were more likely to have survived than those who had not, when other factors were controlled for. Differences were evident with respect to marital status, region of residence, clinical stage and Gleason grade. The effect of socio-economic status was modified by healthcare provider, such that risk of death was higher in those men of lower socio-economic status treated by public, but not private providers in the Cox models. The logistic models revealed a socio-economic gradient in risk of death overall; the gradient was larger for those treated by public providers compared to those treated by private providers when controlling for a range of other confounding factors. CONCLUSION: The role of healthcare provider and socio-economic status in survival of men with prostate cancer may give rise to concerns that warrant further investigation.

  10. Interacting Factors Driving a Major Loss of Large Trees with Cavities in a Forest Ecosystem

    Science.gov (United States)

    Lindenmayer, David B.; Blanchard, Wade; McBurney, Lachlan; Blair, David; Banks, Sam; Likens, Gene E.; Franklin, Jerry F.; Laurance, William F.; Stein, John A. R.; Gibbons, Philip

    2012-01-01

    Large trees with cavities provide critical ecological functions in forests worldwide, including vital nesting and denning resources for many species. However, many ecosystems are experiencing increasingly rapid loss of large trees or a failure to recruit new large trees or both. We quantify this problem in a globally iconic ecosystem in southeastern Australia – forests dominated by the world's tallest angiosperms, Mountain Ash (Eucalyptus regnans). Tree, stand and landscape-level factors influencing the death and collapse of large living cavity trees and the decay and collapse of dead trees with cavities are documented using a suite of long-term datasets gathered between 1983 and 2011. The historical rate of tree mortality on unburned sites between 1997 and 2011 was >14% with a mortality spike in the driest period (2006–2009). Following a major wildfire in 2009, 79% of large living trees with cavities died and 57–100% of large dead trees were destroyed on burned sites. Repeated measurements between 1997 and 2011 revealed no recruitment of any new large trees with cavities on any of our unburned or burned sites. Transition probability matrices of large trees with cavities through increasingly decayed condition states projects a severe shortage of large trees with cavities by 2039 that will continue until at least 2067. This large cavity tree crisis in Mountain Ash forests is a product of: (1) the prolonged time required (>120 years) for initiation of cavities; and (2) repeated past wildfires and widespread logging operations. These latter factors have resulted in all landscapes being dominated by stands ≤72 years and just 1.16% of forest being unburned and unlogged. We discuss how the features that make Mountain Ash forests vulnerable to a decline in large tree abundance are shared with many forest types worldwide. PMID:23071486

  11. Interacting factors driving a major loss of large trees with cavities in a forest ecosystem.

    Science.gov (United States)

    Lindenmayer, David B; Blanchard, Wade; McBurney, Lachlan; Blair, David; Banks, Sam; Likens, Gene E; Franklin, Jerry F; Laurance, William F; Stein, John A R; Gibbons, Philip

    2012-01-01

    Large trees with cavities provide critical ecological functions in forests worldwide, including vital nesting and denning resources for many species. However, many ecosystems are experiencing increasingly rapid loss of large trees or a failure to recruit new large trees or both. We quantify this problem in a globally iconic ecosystem in southeastern Australia--forests dominated by the world's tallest angiosperms, Mountain Ash (Eucalyptus regnans). Tree, stand and landscape-level factors influencing the death and collapse of large living cavity trees and the decay and collapse of dead trees with cavities are documented using a suite of long-term datasets gathered between 1983 and 2011. The historical rate of tree mortality on unburned sites between 1997 and 2011 was >14% with a mortality spike in the driest period (2006-2009). Following a major wildfire in 2009, 79% of large living trees with cavities died and 57-100% of large dead trees were destroyed on burned sites. Repeated measurements between 1997 and 2011 revealed no recruitment of any new large trees with cavities on any of our unburned or burned sites. Transition probability matrices of large trees with cavities through increasingly decayed condition states projects a severe shortage of large trees with cavities by 2039 that will continue until at least 2067. This large cavity tree crisis in Mountain Ash forests is a product of: (1) the prolonged time required (>120 years) for initiation of cavities; and (2) repeated past wildfires and widespread logging operations. These latter factors have resulted in all landscapes being dominated by stands ≤72 years and just 1.16% of forest being unburned and unlogged. We discuss how the features that make Mountain Ash forests vulnerable to a decline in large tree abundance are shared with many forest types worldwide.

  12. The role of driving factors in historical and projected carbon dynamics of upland ecosystems in Alaska

    Science.gov (United States)

    Genet, Hélène; He, Yujie; Lyu, Zhou; McGuire, A. David; Zhuang, Qianlai; Clein, Joy S.; D'Amore, David; Bennett, Alec; Breen, Amy; Biles, Frances; Euskirchen, Eugénie S.; Johnson, Kristofer; Kurkowski, Tom; Schroder, Svetlana (Kushch); Pastick, Neal J.; Rupp, T. Scott; Wylie, Bruce K.; Zhang, Yujin; Zhou, Xiaoping; Zhu, Zhiliang

    2018-01-01

    It is important to understand how upland ecosystems of Alaska, which are estimated to occupy 84% of the state (i.e., 1,237,774 km2), are influencing and will influence state‐wide carbon (C) dynamics in the face of ongoing climate change. We coupled fire disturbance and biogeochemical models to assess the relative effects of changing atmospheric carbon dioxide (CO2), climate, logging and fire regimes on the historical and future C balance of upland ecosystems for the four main Landscape Conservation Cooperatives (LCCs) of Alaska. At the end of the historical period (1950–2009) of our analysis, we estimate that upland ecosystems of Alaska store ~50 Pg C (with ~90% of the C in soils), and gained 3.26 Tg C/yr. Three of the LCCs had gains in total ecosystem C storage, while the Northwest Boreal LCC lost C (−6.01 Tg C/yr) because of increases in fire activity. Carbon exports from logging affected only the North Pacific LCC and represented less than 1% of the state's net primary production (NPP). The analysis for the future time period (2010–2099) consisted of six simulations driven by climate outputs from two climate models for three emission scenarios. Across the climate scenarios, total ecosystem C storage increased between 19.5 and 66.3 Tg C/yr, which represents 3.4% to 11.7% increase in Alaska upland's storage. We conducted additional simulations to attribute these responses to environmental changes. This analysis showed that atmospheric CO2 fertilization was the main driver of ecosystem C balance. By comparing future simulations with constant and with increasing atmospheric CO2, we estimated that the sensitivity of NPP was 4.8% per 100 ppmv, but NPP becomes less sensitive to CO2increase throughout the 21st century. Overall, our analyses suggest that the decreasing CO2 sensitivity of NPP and the increasing sensitivity of heterotrophic respiration to air temperature, in addition to the increase in C loss from wildfires weakens the C sink from upland

  13. The role of driving factors in historical and projected carbon dynamics of upland ecosystems in Alaska.

    Science.gov (United States)

    Genet, Hélène; He, Yujie; Lyu, Zhou; McGuire, A David; Zhuang, Qianlai; Clein, Joy; D'Amore, David; Bennett, Alec; Breen, Amy; Biles, Frances; Euskirchen, Eugénie S; Johnson, Kristofer; Kurkowski, Tom; Kushch Schroder, Svetlana; Pastick, Neal; Rupp, T Scott; Wylie, Bruce; Zhang, Yujin; Zhou, Xiaoping; Zhu, Zhiliang

    2018-01-01

    It is important to understand how upland ecosystems of Alaska, which are estimated to occupy 84% of the state (i.e., 1,237,774 km 2 ), are influencing and will influence state-wide carbon (C) dynamics in the face of ongoing climate change. We coupled fire disturbance and biogeochemical models to assess the relative effects of changing atmospheric carbon dioxide (CO 2 ), climate, logging and fire regimes on the historical and future C balance of upland ecosystems for the four main Landscape Conservation Cooperatives (LCCs) of Alaska. At the end of the historical period (1950-2009) of our analysis, we estimate that upland ecosystems of Alaska store ~50 Pg C (with ~90% of the C in soils), and gained 3.26 Tg C/yr. Three of the LCCs had gains in total ecosystem C storage, while the Northwest Boreal LCC lost C (-6.01 Tg C/yr) because of increases in fire activity. Carbon exports from logging affected only the North Pacific LCC and represented less than 1% of the state's net primary production (NPP). The analysis for the future time period (2010-2099) consisted of six simulations driven by climate outputs from two climate models for three emission scenarios. Across the climate scenarios, total ecosystem C storage increased between 19.5 and 66.3 Tg C/yr, which represents 3.4% to 11.7% increase in Alaska upland's storage. We conducted additional simulations to attribute these responses to environmental changes. This analysis showed that atmospheric CO 2 fertilization was the main driver of ecosystem C balance. By comparing future simulations with constant and with increasing atmospheric CO 2 , we estimated that the sensitivity of NPP was 4.8% per 100 ppmv, but NPP becomes less sensitive to CO 2 increase throughout the 21st century. Overall, our analyses suggest that the decreasing CO 2 sensitivity of NPP and the increasing sensitivity of heterotrophic respiration to air temperature, in addition to the increase in C loss from wildfires weakens the C sink from upland

  14. The Theory of Planned Behavior, Past Behavior, Situational Factors, and Self-Identity Factors Drive Indonesian Enterpreneurs to Be Indebtedness

    Directory of Open Access Journals (Sweden)

    Shine Pintor S. Patiro

    2016-06-01

    Full Text Available This study investigates the factors affecting borrowing intention among young entrepreneur of Indonesia TDA community based on the Theory of Planned Behavior (TPB. About 100 questionnaires were accepted and analyzed using structural equation modeling (SEM in determining the relationships. The results show that borrowing intention amongst young entrepreneur of Indonesia TDA community is influenced by attitude, subjective norms, perceived behavior control, self identity, situational temptation, and past behavior. The young entrepreneur of Indonesia TDA community believe that they have complete control of their behavior in borrowing as they perceived to be equipped with the knowledge about the personal financing. In addition, because of their experience in students’ loans since undergraduates’ level, the result explains why situational temptation were found to be a significant predictor. The findings offer implications for researchers and government.

  15. Factors Influencing Belize District Primary School Teachers' Attitudes toward Inclusive Education

    Science.gov (United States)

    McKay, Maxine

    2012-01-01

    Inclusive education continues to be a reoccurring challenge as various factors affect to what extent teachers or educators are willing to educate children with disabilities in the regular education setting alongside their non-disabled peers. This quantitative study examined factors influencing Belize District Primary School teachers' attitudes…

  16. Drive Stands

    Data.gov (United States)

    Federal Laboratory Consortium — The Electrical Systems Laboratory (ESL)houses numerous electrically driven drive stands. A drive stand consists of an electric motor driving a gearbox and a mounting...

  17. Solar wind: A possible factor driving the interannual sea surface temperature tripolar mode over North Atlantic

    Science.gov (United States)

    Xiao, Ziniu; Li, Delin

    2016-06-01

    The effect of solar wind (SW) on the North Atlantic sea surface temperature (SST) in boreal winter is examined through an analysis of observational data during 1964-2013. The North Atlantic SSTs show a pronounced meridional tripolar pattern in response to solar wind speed (SWS) variations. This pattern is broadly similar to the leading empirical orthogonal function (EOF) mode of interannual variations in the wintertime SSTs over North Atlantic. The time series of this leading EOF mode of SST shows a significant interannual period, which is the same as that of wintertime SWS. This response also appears as a compact north-south seesaw of sea level pressure and a vertical tripolar structure of zonal wind, which simultaneously resembles the North Atlantic Oscillation (NAO) in the overlying atmosphere. As compared with the typical low SWS winters, during the typical high SWS winters, the stratospheric polar night jet (PNJ) is evidently enhanced and extends from the stratosphere to the troposphere, even down to the North Atlantic Ocean surface. Notably, the North Atlantic Ocean is an exclusive region in which the SW signal spreads downward from the stratosphere to the troposphere. Thus, it seems that the SW is a possible factor for this North Atlantic SST tripolar mode. The dynamical process of stratosphere-troposphere coupling, together with the global atmospheric electric circuit-cloud microphysical process, probably accounts for the particular downward propagation of the SW signal.

  18. Factors driving the spatiotemporal variability in phytoplankton in the Northern South China Sea

    Science.gov (United States)

    Wei, Na; Satheeswaran, Thangaraj; Jenkinson, Ian R.; Xue, Bing; Wei, Yuqiu; Liu, Haijiao; Sun, Jun

    2018-06-01

    The influence of oceanographic processes on phytoplankton diversity and community structure was examined during a cruise conducted from July to August 2012 in the northern South China Sea (nSCS). One hundred ninety seven seawater samples were collected and analyzed from 41 stations in the nSCS. A total of 215 species were identified belonging to 67 genera, mostly dominated by diatoms (67.36%) followed by dinoflagellates (28.16%). The mean cell abundance of diatoms and dinoflagellates were 1.954 × 103 cells L-1 and 0.817 × 103 cells L-1, respectively. Diatoms mainly distributed in coastal region whereas dianoflaglletes in the open sea. Margalaf's species richness (dMa) was maximum (3.96) at SQD1 station (Depth 15 m), whereas it was minimum (0.07) at SS1 (Depth 200 m). Further, Box-Whisker plot displayed that dissolved inorganic nutrients incresed with depth. Nevertheless, redundacy analysis reveled that phytoplankton density has a negative relationship with nutrients. Overall the presesant study provides latest in-depth information about how the factors influencing the phytoplankton density and diversity in the (nSCS) during summer based on the cruise data which could serve as a reference for the similar study.

  19. Factors driving semi-aquatic predator occurrence in traditional cattle drinking pools: conservation issues

    Directory of Open Access Journals (Sweden)

    Raoul Manenti

    2016-08-01

    Full Text Available In several cases, human impact on water bodies and on their freshwater communities is detrimental, but in some cases the human activity may favour and enhance the biodiversity of small water bodies, as traditional cattle drinking pools. Despite their small size, small water bodies may constitute hot spot of biodiversity often representing the only lentic aquatic biotope in landscapes where superficial water lacks or flows in lotic environments like creeks and streams. Predators are good indicators of biodiversity in ponds and give information of food chain web complexity. In particular, semi-aquatic predators like amphibians and dragonflies may account for a substantial percentage of energy flow between aquatic and terrestrial ecosystems. In this study, we evaluated the conservation value of traditional cattle drinking pools building by assessing the factors determining the occurrence and distribution of the semi-aquatic predators. From April to August 2015, we investigated 30 distinct pools recording several abiotic and biotic environmental variables. We detected 4 semi-aquatic predators: Salamandra salamandra larvae, Triturus carnifex, Aeshna sp. larvae and Libellula sp. larvae. Abiotic features played a major role in shaping the predator community that resulted linked to stable, with no dryness period, and large drinking pools. Invertebrate prey biomass was not particularly important, while vegetation cover and occurrence of unpalatable tadpoles were the most important biotic features of the pools. Our study provides novel evidence on the importance of cattle drinking pools management to preserve biodiversity especially in areas where traditional pastoral activity is disappearing.

  20. Alternative splicing of a single transcription factor drives selfish reproductive behavior in honeybee workers (Apis mellifera).

    Science.gov (United States)

    Jarosch, Antje; Stolle, Eckart; Crewe, Robin M; Moritz, Robin F A

    2011-09-13

    In eusocial insects the production of daughters is generally restricted to mated queens, and unmated workers are functionally sterile. The evolution of this worker sterility has been plausibly explained by kin selection theory [Hamilton W (1964) J Theor Biol 7:1-52], and many traits have evolved to prevent conflict over reproduction among the females in an insect colony. In honeybees (Apis mellifera), worker reproduction is regulated by the queen, brood pheromones, and worker policing. However, workers of the Cape honeybee, Apis mellifera capensis, can evade this control and establish themselves as social parasites by activating their ovaries, parthenogenetically producing diploid female offspring (thelytoky) and producing queen-like amounts of queen pheromones. All these traits have been shown to be strongly influenced by a single locus on chromosome 13 [Lattorff HMG, et al. (2007) Biol Lett 3:292-295]. We screened this region for candidate genes and found that alternative splicing of a gene homologous to the gemini transcription factor of Drosophila controls worker sterility. Knocking out the critical exon in a series of RNAi experiments resulted in rapid worker ovary activation-one of the traits characteristic of the social parasites. This genetic switch may be controlled by a short intronic splice enhancer motif of nine nucleotides attached to the alternative splice site. The lack of this motif in parasitic Cape honeybee clones suggests that the removal of nine nucleotides from the altruistic worker genome may be sufficient to turn a honeybee from an altruistic worker into a parasite.

  1. Hepatocyte growth factor signaling in intrapancreatic ductal cells drives pancreatic morphogenesis.

    Directory of Open Access Journals (Sweden)

    Ryan M Anderson

    Full Text Available In a forward genetic screen for regulators of pancreas development in zebrafish, we identified donut(s908 , a mutant which exhibits failed outgrowth of the exocrine pancreas. The s908 mutation leads to a leucine to arginine substitution in the ectodomain of the hepatocyte growth factor (HGF tyrosine kinase receptor, Met. This missense mutation impedes the proteolytic maturation of the receptor, its trafficking to the plasma membrane, and diminishes the phospho-activation of its kinase domain. Interestingly, during pancreatogenesis, met and its hgf ligands are expressed in pancreatic epithelia and mesenchyme, respectively. Although Met signaling elicits mitogenic and migratory responses in varied contexts, normal proliferation rates in donut mutant pancreata together with dysmorphic, mislocalized ductal cells suggest that met primarily functions motogenically in pancreatic tail formation. Treatment with PI3K and STAT3 inhibitors, but not with MAPK inhibitors, phenocopies the donut pancreatic defect, further indicating that Met signals through migratory pathways during pancreas development. Chimera analyses showed that Met-deficient cells were excluded from the duct, but not acinar, compartment in the pancreatic tail. Conversely, wild-type intrapancreatic duct and "tip cells" at the leading edge of the growing pancreas rescued the donut phenotype. Altogether, these results reveal a novel and essential role for HGF signaling in the intrapancreatic ducts during exocrine morphogenesis.

  2. Insulin-Like Growth Factor I Does Not Drive New Bone Formation in Experimental Arthritis.

    Directory of Open Access Journals (Sweden)

    Melissa N van Tok

    Full Text Available Insulin like growth factor (IGF-I can act on a variety of cells involved in cartilage and bone repair, yet IGF-I has not been studied extensively in the context of inflammatory arthritis. The objective of this study was to investigate whether IGF-I overexpression in the osteoblast lineage could lead to increased reparative or pathological bone formation in rheumatoid arthritis and/or spondyloarthritis respectively.Mice overexpressing IGF-I in the osteoblast lineage (Ob-IGF-I+/- line 324-7 were studied during collagen induced arthritis and in the DBA/1 aging model for ankylosing enthesitis. Mice were scored clinically and peripheral joints were analysed histologically for the presence of hypertrophic chondrocytes and osteocalcin positive osteoblasts.90-100% of the mice developed CIA with no differences between the Ob-IGF-I+/- and non-transgenic littermates. Histological analysis revealed similar levels of hypertrophic chondrocytes and osteocalcin positive osteoblasts in the ankle joints. In the DBA/1 aging model for ankylosing enthesitis 60% of the mice in both groups had a clinical score 1<. Severity was similar between both groups. Histological analysis revealed the presence of hypertrophic chondrocytes and osteocalcin positive osteoblasts in the toes in equal levels.Overexpression of IGF-I in the osteoblast lineage does not contribute to an increase in repair of erosions or syndesmophyte formation in mouse models for destructive and remodeling arthritis.

  3. Transforming Growth FactorDrives the Transendothelial Migration of Hepatocellular Carcinoma Cells.

    Science.gov (United States)

    Koudelkova, Petra; Costina, Victor; Weber, Gerhard; Dooley, Steven; Findeisen, Peter; Winter, Peter; Agarwal, Rahul; Schlangen, Karin; Mikulits, Wolfgang

    2017-10-10

    The entry of malignant hepatocytes into blood vessels is a key step in the dissemination and metastasis of hepatocellular carcinoma (HCC). The identification of molecular mechanisms involved in the transmigration of malignant hepatocytes through the endothelial barrier is of high relevance for therapeutic intervention and metastasis prevention. In this study, we employed a model of hepatocellular transmigration that mimics vascular invasion using hepatic sinusoidal endothelial cells and malignant hepatocytes evincing a mesenchymal-like, invasive phenotype by transforming growth factor (TGF)-β. Labelling of respective cell populations with various stable isotopes and subsequent mass spectrometry analyses allowed the "real-time" detection of molecular changes in both transmigrating hepatocytes and endothelial cells. Interestingly, the proteome profiling revealed 36 and 559 regulated proteins in hepatocytes and endothelial cells, respectively, indicating significant changes during active transmigration that mostly depends on cell-cell interaction rather than on TGF-β alone. Importantly, matching these in vitro findings with HCC patient data revealed a panel of common molecular alterations including peroxiredoxin-3, epoxide hydrolase, transgelin-2 and collectin 12 that are clinically relevant for the patient's survival. We conclude that hepatocellular plasticity induced by TGF-β is crucially involved in blood vessel invasion of HCC cells.

  4. Transforming Growth FactorDrives the Transendothelial Migration of Hepatocellular Carcinoma Cells

    Directory of Open Access Journals (Sweden)

    Petra Koudelkova

    2017-10-01

    Full Text Available The entry of malignant hepatocytes into blood vessels is a key step in the dissemination and metastasis of hepatocellular carcinoma (HCC. The identification of molecular mechanisms involved in the transmigration of malignant hepatocytes through the endothelial barrier is of high relevance for therapeutic intervention and metastasis prevention. In this study, we employed a model of hepatocellular transmigration that mimics vascular invasion using hepatic sinusoidal endothelial cells and malignant hepatocytes evincing a mesenchymal-like, invasive phenotype by transforming growth factor (TGF-β. Labelling of respective cell populations with various stable isotopes and subsequent mass spectrometry analyses allowed the “real-time” detection of molecular changes in both transmigrating hepatocytes and endothelial cells. Interestingly, the proteome profiling revealed 36 and 559 regulated proteins in hepatocytes and endothelial cells, respectively, indicating significant changes during active transmigration that mostly depends on cell–cell interaction rather than on TGF-β alone. Importantly, matching these in vitro findings with HCC patient data revealed a panel of common molecular alterations including peroxiredoxin-3, epoxide hydrolase, transgelin-2 and collectin 12 that are clinically relevant for the patient’s survival. We conclude that hepatocellular plasticity induced by TGF-β is crucially involved in blood vessel invasion of HCC cells.

  5. Hot regions of labile and stable soil organic carbon in Germany - Spatial variability and driving factors

    Science.gov (United States)

    Vos, Cora; Jaconi, Angélica; Jacobs, Anna; Don, Axel

    2018-06-01

    Atmospheric carbon dioxide levels can be mitigated by sequestering carbon in the soil. Sequestration can be facilitated by agricultural management, but its influence is not the same on all soil carbon pools, as labile pools with a high turnover may be accumulated much faster but are also more vulnerable to losses. The aims of this study were to (1) assess how soil organic carbon (SOC) is distributed among SOC fractions on a national scale in Germany, (2) identify factors influencing this distribution and (3) identify regions with high vulnerability to SOC losses. The SOC content and proportion of two different SOC fractions were estimated for more than 2500 mineral topsoils (soil texture, bulk soil C / N ratio, total SOC content and pH. For some regions, the drivers were linked to the land-use history of the sites. Arable topsoils in central and southern Germany were found to contain the highest proportions and contents of stable SOC fractions, and therefore have the lowest vulnerability to SOC losses. North-western Germany contains an area of sandy soils with unusually high SOC contents and high proportions of light SOC fractions, which are commonly regarded as representing a labile carbon pool. This is true for the former peat soils in this area, which have already lost and are at high risk of losing high proportions of their SOC stocks. Those black sands can, however, also contain high amounts of stable SOC due to former heathland vegetation and need to be treated and discussed separately from non-black sand agricultural soils. Overall, it was estimated that, in large areas all over Germany, over 30 % of SOC is stored in easily mineralisable forms. Thus, SOC-conserving management of arable soils in these regions is of great importance.

  6. Effectiveness of enforcement levels of speed limit and drink driving laws and associated factors – Exploratory empirical analysis using a bivariate ordered probit model

    Directory of Open Access Journals (Sweden)

    Behram Wali

    2017-06-01

    Full Text Available The contemporary traffic safety research comprises little information on quantifying the simultaneous association between drink driving and speeding among fatally injured drivers. Potential correlation between driver's drink driving and speeding behavior poses a substantial methodological concern which needs investigation. This study therefore focused on investigating the simultaneous impact of socioeconomic factors, fatalities, vehicle ownership, health services and highway agency road safety policies on enforcement levels of speed limit and drink driving laws. The effectiveness of enforcement levels of speed limit and drink driving laws has been investigated through development of bivariate ordered probit model using data extricated from WHO's global status report on road safety in 2013. The consistent and intuitive parameter estimates along with statistically significant correlation between response outcomes validates the statistical supremacy of bivariate ordered probit model. The results revealed that fatalities per thousand registered vehicles, hospital beds per hundred thousand population and road safety policies are associated with a likely medium or high effectiveness of enforcement levels of speed limit and drink driving laws, respectively. Also, the model encapsulates the effect of several other agency related variables and socio-economic status on the response outcomes. Marginal effects are reported for analyzing the impact of such factors on intermediate categories of response outcomes. The results of this study are expected to provide necessary insights to elemental enforcement programs. Also, marginal effects of explanatory variables may provide useful directions for formulating effective policy countermeasures for overcoming driver's speeding and drink driving behavior.

  7. Exploring driving factors of energy-related CO2 emissions in Chinese provinces: A case of Liaoning

    International Nuclear Information System (INIS)

    Geng, Yong; Zhao, Hongyan; Liu, Zhu; Xue, Bing; Fujita, Tsuyoshi; Xi, Fengming

    2013-01-01

    In order to uncover driving forces for provincial CO 2 emission in China, a case study was undertaken to shed light on the CO 2 emission growth in such a region. Liaoning province was selected due to its typical features as one industrial province. The environmental input–output analysis and structure decomposing analysis have been conducted in order to provide a holistic picture on Liaoning's CO 2 emissions during 1997–2007. Research outcomes indicate that rapid increase of per capita consumption activities is the main driver for Liaoning to have a significant CO 2 emission growth, followed by consumption structure, production structure and population size. Energy intensity and energy structure partly offset the CO 2 emission increase. Electricity power and heat supply and construction sectors caused the most CO 2 emission, indicating that more specific mitigation policies for these two sectors should be prepared. From final demand point of view, it is clear that trade plays a leading role in regional CO 2 emission, followed by fixed capital investment and urban household consumption which become increasingly important over time. Consequently, in order to realize low carbon development, local governments should consider all these factors so that appropriate mitigation policies can be raised by considering the local realities. - Highlights: • Driving forces for Liaoning's CO 2 emission have been uncovered through the use of IO-SDA model. • Construction and electricity power/heat supply sectors have the highest embodied emissions. • Trade plays a key role on regional CO 2 emission in Chinese old industrial base. • Fixed capital investment and urban households generated more CO 2 emissions

  8. Untangling Risk in Water Supply Systems: What Factors Drive Long-term Adaptation?

    Science.gov (United States)

    Zeff, H. B.; Lin, L.; Band, L. E.; Reed, P. M.; Characklis, G. W.

    2016-12-01

    Deeply uncertain factors like climate change, the hydrologic impacts of urbanization, forest evolution, and long-term demand forecasts make water supply planning a `wicked' problem. The traditional technique of assessing risk based on historical observations can be inadequate in the face of environmental non-stationarity. However, competing models and limited observational data make it difficult for decision makers and experts to agree on how much uncertainty should be built into analyses of risk, particularly at the timescales relevant to long-term investments in water infrastructure. Further, the physical connectivity of these deeply uncertain processes create inter-related systems, amplifying the challenges of a `worst case scenario'. The development of adaptive systems and planning processes provide solutions that have been shown to meet technical, environmental, and social objectives at lower costs. Instead of developing plans with fixed targets for the timing of actions, adaptive plans develop risk metrics and thresholds that are able to integrate new information to determine when conditions reach a `tipping point' which necessitates action. It is an open question as to how new information can be best integrated into the decision-making process (i.e. how much weight do we give new observations relative to the historical record), but a better understanding of the way the relevant systems are expected to evolve and change over time could inform these decisions. In this study, we use linked, dynamic models of temperature and precipitation changes, forest evolution, urbanization, hydrology, and water demand to develop scenarios for an adaptive water management framework that uses risk-based metrics to make short- and long-term decisions. The impact of individual environmental processes on the adaptive capability of this management framework is evaluated through problem formulations that successively increase the complexity of the uncertainty scenarios. Although

  9. Teens' distracted driving behavior: Prevalence and predictors.

    Science.gov (United States)

    Gershon, Pnina; Zhu, Chunming; Klauer, Sheila G; Dingus, Tom; Simons-Morton, Bruce

    2017-12-01

    Teen drivers' over-involvement in crashes has been attributed to a variety of factors, including distracted driving. With the rapid development of in-vehicle systems and portable electronic devices, the burden associated with distracted driving is expected to increase. The current study identifies predictors of secondary task engagement among teenage drivers and provides basis for interventions to reduce distracted driving behavior. We described the prevalence of secondary tasks by type and driving conditions and evaluated the associations between the prevalence of secondary task engagement, driving conditions, and selected psychosocial factors. The private vehicles of 83 newly-licensed teenage drivers were equipped with Data Acquisition Systems (DAS), which documented driving performance measures, including secondary task engagement and driving environment characteristics. Surveys administered at licensure provided psychosocial measures. Overall, teens engaged in a potentially distracting secondary task in 58% of sampled road clips. The most prevalent types of secondary tasks were interaction with a passenger, talking/singing (no passenger), external distraction, and texting/dialing the cell phone. Secondary task engagement was more prevalent among those with primary vehicle access and when driving alone. Social norms, friends' risky driving behaviors, and parental limitations were significantly associated with secondary task prevalence. In contrast, environmental attributes, including lighting and road surface conditions, were not associated with teens' engagement in secondary tasks. Our findings indicated that teens engaged in secondary tasks frequently and poorly regulate their driving behavior relative to environmental conditions. Practical applications: Peer and parent influences on secondary task engagement provide valuable objectives for countermeasures to reduce distracted driving among teenage drivers. Copyright © 2017 National Safety Council and

  10. Factors that drive the gap in diabetes rates between Aboriginal and non-Aboriginal people in non-remote NSW.

    Science.gov (United States)

    Reeve, Rebecca; Church, Jody; Haas, Marion; Bradford, Wylie; Viney, Rosalie

    2014-10-01

    To identify factors underpinning the gap in diabetes rates between Aboriginal and non-Aboriginal people in non-remote NSW. This will indicate appropriate target areas for policy and for monitoring progress towards reducing the gap. Data from the 2004-05 National Health Survey and National Aboriginal and Torres Strait Islander Health Survey were used to estimate differences in self-reported diabetes rates and risk/prevention factors between Aboriginal and non-Aboriginal people in non-remote NSW. Logistic regression models were used to investigate the contribution of each factor to predicting the probability of diabetes. Risk factors for diabetes are more prevalent and diabetes rates 2.5 to 4 times higher in Aboriginal compared to non-Aboriginal adults in non-remote NSW. The odds of (known) diabetes for both groups are significantly higher for older people, those with low levels of education and those who are overweight or obese. In the Aboriginal sample, the odds of diabetes are significantly higher for people reporting forced removal of their relatives. Differences in BMI and education appear to be driving the diabetes gap, together with onset at younger ages in the Aboriginal population. Psychological distress, indicated by removal of relatives, may contribute to increased risk of diabetes in the Aboriginal population. The results imply that improved nutrition and exercise, capacity to access and act upon health care information and early intervention are required to reduce the diabetes gap. Current strategies appear to be appropriately aligned with the evidence; however, further research is required to determine whether implementation methods are effective. © 2014 Public Health Association of Australia.

  11. DRIVING AND LIMITING FACTORS IN THE FARM MANAGEMENT BY YOUNG FARMERS IN THE CONTEXT OF SURVEY RESEARCH

    Directory of Open Access Journals (Sweden)

    Barbara Kiełbasa

    2016-03-01

    Full Text Available The purpose of the study was to identify driving and limiting factors of farm management in a region of fragmented agriculture. The paper presents the results of the research conducted in the South-Eastern Poland (Macroregion of Małopolska and Pogórze. The survey was conducted in 2014 in the farms managed by young farmers, i.e. the benefi ciaries of the measure “Setting up of young farmers” from the RDP 2007–2013, with the use of a survey method with a questionnaire interview. The research was empirical, and its main goal was to present a case study of the farm management by young farmers in terms of specifi c management barriers. The results of the studies pointed to the fragmented agrarian structure as the one of the biggest barriers of the eff ective farm management. The young farmers pointed that fragmented agrarian structure signifi cantly impedes the purchase or lease of agricultural land, and the farm development in the same way. The survey pointed to the factors that contribute to the young farmers: the entrepreneurial attitude, activity and creativity, training, the management knowledge and better access to the Common Agricultural Policy instruments.

  12. Extended driving impairs nocturnal driving performances.

    Directory of Open Access Journals (Sweden)

    Patricia Sagaspe

    Full Text Available Though fatigue and sleepiness at the wheel are well-known risk factors for traffic accidents, many drivers combine extended driving and sleep deprivation. Fatigue-related accidents occur mainly at night but there is no experimental data available to determine if the duration of prior driving affects driving performance at night. Participants drove in 3 nocturnal driving sessions (3-5 am, 1-5 am and 9 pm-5 am on open highway. Fourteen young healthy men (mean age [+/-SD] = 23.4 [+/-1.7] years participated Inappropriate line crossings (ILC in the last hour of driving of each session, sleep variables, self-perceived fatigue and sleepiness were measured. Compared to the short (3-5 am driving session, the incidence rate ratio of inappropriate line crossings increased by 2.6 (95% CI, 1.1 to 6.0; P<.05 for the intermediate (1-5 am driving session and by 4.0 (CI, 1.7 to 9.4; P<.001 for the long (9 pm-5 am driving session. Compared to the reference session (9-10 pm, the incidence rate ratio of inappropriate line crossings were 6.0 (95% CI, 2.3 to 15.5; P<.001, 15.4 (CI, 4.6 to 51.5; P<.001 and 24.3 (CI, 7.4 to 79.5; P<.001, respectively, for the three different durations of driving. Self-rated fatigue and sleepiness scores were both positively correlated to driving impairment in the intermediate and long duration sessions (P<.05 and increased significantly during the nocturnal driving sessions compared to the reference session (P<.01. At night, extended driving impairs driving performances and therefore should be limited.

  13. 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

  14. Primary care in the United States: practice-based innovations and factors that influence adoption.

    Science.gov (United States)

    Goldberg, Debora Goetz

    2012-01-01

    This study aims to explore the use of specific innovations in primary care practices. The research seeks to examine whether a relationship exists between environmental factors and organizational characteristics and the level of innovation in primary care practices in Virginia. The study utilized multiple secondary data sets and an organizational survey of primary care practices to define the external environment and the level of innovation. Institutional theory was used to explain the connection between innovations in primary care practices and institutional forces within the environment. Resource dependency theory was used to explain motivators for change based on a dependence on scarce financial, human, and information resources. Results show a positive association between organizational size, organizational relationships, and stakeholder expectations on the level of innovation. A negative association was found between competition and the level of innovation. No relationship was found between degree of Medicare and managed care penetration and innovation, nor between knowledge of, and difficulty complying with, payer organization requirements and innovation. Primary care physician practices exist in a market-driven environment characterized by high pressure from regulatory sources, decreasing reimbursement levels, increasing rate of change in technologies, and increasing patient and community expectations. This study contributes new information on the relationship between organizational characteristics, the external environment and specific innovations in primary care practices. Information on the contributing factors to innovation in primary care is important for improving delivery of health care services and the ability of these practices to survive.

  15. Driving factors of retention in care among HIV-positive MSM and transwomen in Indonesia: A cross-sectional study

    Science.gov (United States)

    Erasmus, Vicki; Coulter, Robert W. S.; Koirala, Sushil; Nampaisan, Oranuch; Pamungkas, Wirastra; Richardus, Jan Hendrik

    2018-01-01

    Little is known about the prevalence of and factors that influence retention in HIV-related care among Indonesian men who have sex with men (MSM) and transgender women (transwomen, or waria in Indonesian term). Therefore, we explored the driving factors of retention in care among HIV-positive MSM and waria in Indonesia. This cross-sectional study involved 298 self-reported HIV-positive MSM (n = 165) and waria (n = 133). Participants were recruited using targeted sampling and interviewed using a structured questionnaire. We applied a four-step model building process using multivariable logistic regression to examine how sociodemographic, predisposing, enabling, and reinforcing factors were associated with retention in care. Overall, 78.5% of participants were linked to HIV care within 3 months after diagnosis or earlier, and 66.4% were adequately retained in care (at least one health care visit every three months once a person is diagnosed with HIV). Being on antiretroviral therapy (adjusted odds ratio [AOR] = 6.00; 95% confidence interval [CI]: 2.93–12.3), using the Internet to find HIV-related information (AOR = 2.15; 95% CI: 1.00–4.59), and having medical insurance (AOR = 2.84; 95% CI: 1.27–6.34) were associated with adequate retention in care. Involvement with an HIV-related organization was associated negatively with retention in care (AOR = 0.47; 95% CI: 0.24–0.95). Future interventions should increase health insurance coverage and utilize the Internet to help MSM and waria to remain in HIV-related care, thereby assisting them in achieving viral suppression. PMID:29342172

  16. Dementia & Driving

    Science.gov (United States)

    ... have to give up driving. Many people associate driving with self-reliance and freedom; the loss of driving privileges ... familiar roads and avoid long distances. Avoid heavy traffic and heavily traveled roads. Avoid driving at night and in bad weather. Reduce the ...

  17. Course, risk factors, and prognostic factors in elderly primary care patients with mild depression: a two-year observational study.

    Science.gov (United States)

    Magnil, Maria; Janmarker, Lena; Gunnarsson, Ronny; Björkelund, Cecilia

    2013-03-01

    The aim of this study was to observe course, risk factors, and prognostic factors in a primary care cohort aged > 60 with mild to moderate depression during two-year follow-up. Observational study. Primary care. During an 11-month period all (n = 302) consecutive patients aged 60 and above attending a primary care centre in Gothenburg, Sweden were screened by a nurse for depressive symptoms with the Primary Care Evaluation of Mental Disorders, Patient Questionnaire (PRIME-MD PQ) and the Montgomery-Åsberg Depression Rating Scale, self-rated version (MADRS-S) and by a GP with a patient-centred consultation model. In the second step, the GPs diagnosed depression in screen-positives by use of the PRIME-MD Clinical Evaluation Guide (PRIME-MD CEG). All patients with mild to moderate depression were followed up for two years to assess course with several MADRS-S score assessments. Main outcome measures. Risk factors, prognostic factors, and symptoms at baseline and after two years were tested with logistic regression, using the DSM-IV and MADRS-S (cut-off > 13) respectively. Course patterns were observed and described. A total of 54 patients were diagnosed with depression. Follow-up revealed declining median MADRS-S scores and three course patterns: remitting, stable, and fluctuating. History of depression, significant life events, lacking leisure activities, and use of sedatives were risk factors for depression, all previously known. An important finding was that lacking leisure activities also increased the risk of depressive symptoms after two years (odds ratio 12, confidence interval 1.1-136). It is desirable to identify elderly individuals with less severe depression. Three course patterns were observed; this finding requires further study of the clinical characteristics related to the different patterns. Awareness of risk factors may facilitate identification of those at highest risk of poor prognosis.

  18. Size-resolved particle number emission patterns under real-world driving conditions using positive matrix factorization

    NARCIS (Netherlands)

    Domínguez-Sáez, A.; Viana, M.; Barrios, C.C.; Rubio, J.R.; Amato, F.; Pujadas, M.; Querol, X.

    2012-01-01

    A novel on-board system was tested to characterize size-resolved particle number emission patterns under real-world driving conditions, running in a EURO4 diesel vehicle and in a typical urban circuit in Madrid (Spain). Emission profiles were determined as a function of driving conditions. Source

  19. Belongingness in Early Secondary School: Key Factors that Primary and Secondary Schools Need to Consider.

    Directory of Open Access Journals (Sweden)

    Sharmila Vaz

    Full Text Available It is unknown if, and how, students redefine their sense of school belongingness after negotiating the transition to secondary school. The current study used longitudinal data from 266 students with, and without, disabilities who negotiated the transition from 52 primary schools to 152 secondary schools. The study presents the 13 most significant personal student and contextual factors associated with belongingness in the first year of secondary school. Student perception of school belongingness was found to be stable across the transition. No variability in school belongingness due to gender, disability or household-socio-economic status (SES was noted. Primary school belongingness accounted for 22% of the variability in secondary school belongingness. Several personal student factors (competence, coping skills and school factors (low-level classroom task-goal orientation, which influenced belongingness in primary school, continued to influence belongingness in secondary school. In secondary school, effort-goal orientation of the student and perception of their school's tolerance to disability were each associated with perception of school belongingness. Family factors did not influence belongingness in secondary school. Findings of the current study highlight the need for primary schools to foster belongingness among their students at an early age, and transfer students' belongingness profiles as part of the hand-over documentation. Most of the factors that influenced school belongingness before and after the transition to secondary are amenable to change.

  20. Failed anterior cruciate ligament reconstruction: analysis of factors leading to instability after primary surgery.

    Science.gov (United States)

    Ma, Yong; Ao, Ying-Fang; Yu, Jia-Kuo; Dai, Ling-Hui; Shao, Zhen-Xing

    2013-01-01

    Revision anterior cruciate ligament (ACL) surgery can be expected to become more common as the number of primary reconstruction keeps increasing. This study aims to investigate the factors causing instability after primary ACL reconstruction, which may provide an essential scientific base to prevent surgical failure. One hundred and ten revision ACL surgeries were performed at our institute between November 2001 and July 2012. There were 74 men and 36 women, and the mean age at the time of revision was 27.6 years (range 16 - 56 years). The factors leading to instability after primary ACL reconstruction were retrospectively reviewed. Fifty-one knees failed because of bone tunnel malposition, with too anterior femoral tunnels (20 knees), posterior wall blowout (1 knee), vertical femoral tunnels (7 knees), too posterior tibial tunnels (12 knees), and too anterior tibial tunnels (10 knees). There was another knee performed with open surgery, where the femoral tunnel was drilled through the medial condyle and the tibial tunnel was too anterior. Five knees were found with malposition of the fixation. One knee with allograft was suspected of rejection and a second surgery had been made to take out the graft. Three knees met recurrent instability after postoperative infection. The other factors included traumatic (48 knees) and unidentified (12 knees). Technical errors were the main factors leading to instability after primary ACL reconstructions, while attention should also be paid to the risk factors of re-injury and failure of graft incorporation.

  1. Driving factors of interactions between the exchange rate market and the commodity market: A wavelet-based complex network perspective

    Science.gov (United States)

    Wen, Shaobo; An, Haizhong; Chen, Zhihua; Liu, Xueyong

    2017-08-01

    In traditional econometrics, a time series must be in a stationary sequence. However, it usually shows time-varying fluctuations, and it remains a challenge to execute a multiscale analysis of the data and discover the topological characteristics of conduction in different scales. Wavelet analysis and complex networks in physical statistics have special advantages in solving these problems. We select the exchange rate variable from the Chinese market and the commodity price index variable from the world market as the time series of our study. We explore the driving factors behind the behavior of the two markets and their topological characteristics in three steps. First, we use the Kalman filter to find the optimal estimation of the relationship between the two markets. Second, wavelet analysis is used to extract the scales of the relationship that are driven by different frequency wavelets. Meanwhile, we search for the actual economic variables corresponding to different frequency wavelets. Finally, a complex network is used to search for the transfer characteristics of the combination of states driven by different frequency wavelets. The results show that statistical physics have a unique advantage over traditional econometrics. The Chinese market has time-varying impacts on the world market: it has greater influence when the world economy is stable and less influence in times of turmoil. The process of forming the state combination is random. Transitions between state combinations have a clustering feature. Based on these characteristics, we can effectively reduce the information burden on investors and correctly respond to the government's policy mix.

  2. Exploring the Factors Driving Seasonal Farmland Abandonment: A Case Study at the Regional Level in Hunan Province, Central China

    Directory of Open Access Journals (Sweden)

    Zhonglei Yu

    2017-01-01

    Full Text Available Farmland abandonment, including perennial and seasonal abandonment, is an important process of land use change that matters most to food security. Although there is a great deal of studies on farmland abandonment, seasonal abandonment, which is as serious as perennial abandonment, has attracted little academic attention. This paper takes Hunan Province in central China as its study area and uses a spatial regression model to examine the driving factors of seasonal farmland abandonment at the county level. Our results show that farmland abandonment has striking spatial relativity, and there are two clustering zones with a high index of farmland abandonment (IFA in the Dongting plain and the basin in south-central Hunan, while a clustering zone of low IFA can be found in the mountains of southwest Hunan. Farmland abandonment at the regional level is negatively affected by the land productive potentialities, proportion of mechanized planting, ratio of effective irrigation, and distance to provincial capital, while it is positively associated with the variables mountainous terrain, per capita farmland area, and labor shortage. Additionally, farmland abandonment is also affected by adjacent areas through its spatial dependence. In short, seasonal farmland abandonment is also driven integratedly by the socioeconomic and environmental dimensions and spatial interaction of farm abandonment.

  3. Global Rice Watch: Spatial-temporal dynamics, driving factors, and impacts of paddy rice agriculture in the world

    Science.gov (United States)

    Xiao, X.; Dong, J.; Zhang, G.; Xin, F.; Li, X.

    2017-12-01

    Paddy rice croplands account for more than 12% of the global cropland areas, and provide food to feed more than 50% of the world population. Spatial patterns and temporal dynamics of paddy rice croplands have changed remarkably in the past decades, driven by growing human population and their changing diet structure, land use (e.g., urbanization, industrialization), climate, markets, and technologies. In this presentation, we will provide a comprehensive review of our current knowledge on (1) the spatial patterns and temporal dynamics of paddy rice croplands from agricultural statistics data and remote sensing approaches; (2) major driving factors for the observed changes in paddy rice areas, including social, economic, climate, land use, markets, crop breeding technology, and farming technology; and (3) major impacts on atmospheric methane concentration, land surface temperature, water resources and use, and so on. We will highlight the results from a few case studies in China and monsoon Asia. We will also call for a global synthesis analysis of paddy rice agriculture, and invite researchers to join the effort to write and edit a book that provides comprehensive and updated knowledge on paddy rice agriculture.

  4. Factor analysis of the Children's Behaviour Questionnaire in a Nigerian paediatric primary care population

    Directory of Open Access Journals (Sweden)

    O O Omigbodun

    2004-04-01

    Full Text Available Objective. This paper examines the factor structure of the Yoruba translation of the Children’s Behaviour Questionnaire for Completion by Parents (CBQ administered in a Nigerian paediatric primary care population. Design. A cross-sectional questionnaire survey. Subjects. Four hundred and seventy-eight children aged 7 - 14 years who attended a primary care clinic in Ibadan, Nigeria, over a 3-month period. Methods. Parents’ ratings of the children were obtained using the Yoruba translation of the CBQ. The factor structure of this instrument was examined using principal component analysis with varimax rotation. Only factors with eigenvalues of greater than 1 were examined further. Results. The first seven dimensions were readily conceptu- alised. These factors are conduct problem, hyperactivity, emotional problem, irritability, problems with elimination, a somatic complaint and a school problem dimension. Conclusion. These factors are similar to what has been observed in other studies involving populations of children with psychopathology, with the exception of the somatic com- plaint and school problem dimension. The emergence of these two factors, which are quite different from what has been observed in other studies, may demonstrate differences that reflect the influence of language, culture and the peculiarities of a primary care setting. On the other hand the similarity of most of the factors to those found in previous studies con- firms the broad similarities in the behaviour of children across different cultures.

  5. Study protocol for a matter of heart: a qualitative study of patient factors driving overuse of cardiac catheterisation.

    Science.gov (United States)

    Herwig, Anna; Weltermann, Birgitta

    2017-09-03

    Overuse of cardiac catheterisation (CC) for stable coronary artery disease (CAD) is documented in Germany and other regions, although percutaneous coronary interventions do not provide a benefit over medical therapy for stable patients. Various studies investigated health system, physician and patient factors driving non-adherence to guidelines which recommend a stepwise approach with invasive procedures only in case of signs of ischaemia in non-invasive testing. In a larger-scale project, we aim to better understand the patients' perspective in order to develop an intervention that enhances patient's acceptance of this stepwise diagnostic approach for stable CAD. As a first step, this qualitative study aims to identify patient factors that prevent and promote the described overuse. The exploratory qualitative interview study will include about 20 patients with stable CAD and a history of acute coronary syndrome from two German teaching practices. Narrative, structured interviews designed to last 30 to 90 min will be conducted. The interviews will be analysed using qualitative content analysis by Mayring. The analysis will address the following questions: (1) What are reasons for stable patients to undergo CC? (2) How do patients deal with their heart disease (secondary prevention)? (3) Which processes do patients describe regarding decision-making for non-invasive and invasive coronary procedures? (4) What information needs exist on behalf of patients to better understand the stepwise diagnostic approach outlined in guidelines and thereby avoid low-appropriate CCs? Based on these data, empirical typification will be conducted. Ethical approval for the study was obtained. All participants will provide written informed consent. Data will be pseudonymised for analysis. The findings will contribute to the development of an appropriate intervention. Results will be disseminated by conference presentations and journal publications. © Article author(s) (or their

  6. Granulocyte-colony-stimulating factor (G-CSF) signaling in spinal microglia drives visceral sensitization following colitis.

    Science.gov (United States)

    Basso, Lilian; Lapointe, Tamia K; Iftinca, Mircea; Marsters, Candace; Hollenberg, Morley D; Kurrasch, Deborah M; Altier, Christophe

    2017-10-17

    Pain is a main symptom of inflammatory diseases and often persists beyond clinical remission. Although we have a good understanding of the mechanisms of sensitization at the periphery during inflammation, little is known about the mediators that drive central sensitization. Recent reports have identified hematopoietic colony-stimulating factors as important regulators of tumor- and nerve injury-associated pain. Using a mouse model of colitis, we identify the proinflammatory cytokine granulocyte-colony-stimulating factor (G-CSF or Csf-3) as a key mediator of visceral sensitization. We report that G-CSF is specifically up-regulated in the thoracolumbar spinal cord of colitis-affected mice. Our results show that resident spinal microglia express the G-CSF receptor and that G-CSF signaling mediates microglial activation following colitis. Furthermore, healthy mice subjected to intrathecal injection of G-CSF exhibit pronounced visceral hypersensitivity, an effect that is abolished by microglial depletion. Mechanistically, we demonstrate that G-CSF injection increases Cathepsin S activity in spinal cord tissues. When cocultured with microglia BV-2 cells exposed to G-CSF, dorsal root ganglion (DRG) nociceptors become hyperexcitable. Blocking CX3CR1 or nitric oxide production during G-CSF treatment reduces excitability and G-CSF-induced visceral pain in vivo. Finally, administration of G-CSF-neutralizing antibody can prevent the establishment of persistent visceral pain postcolitis. Overall, our work uncovers a DRG neuron-microglia interaction that responds to G-CSF by engaging Cathepsin S-CX3CR1-inducible NOS signaling. This interaction represents a central step in visceral sensitization following colonic inflammation, thereby identifying spinal G-CSF as a target for treating chronic abdominal pain.

  7. [Risk factors and burnout levels in Primary Care nurses: A systematic review].

    Science.gov (United States)

    Gómez-Urquiza, Jose L; Monsalve-Reyes, Carolina S; San Luis-Costas, Concepción; Fernández-Castillo, Rafael; Aguayo-Estremera, Raimundo; Cañadas-de la Fuente, Guillermo A

    2017-02-01

    To determine the risk factors and levels of burnout in Primary Care nurses. A systematic review was performed. CINAHL, CUIDEN, LILACS, PubMed, ProQuest, ScienceDirect and Scopus databases were consulted. Search equations were 'burnout AND community health nursing' and 'burnout AND primary care nursing'. The search was performed in October 2015. The final sample was n=12 studies. Quantitative primary studies that used Maslach Burnout Inventory for burnout assessment in Primary Care nurses were included without restriction by publication date. The main variables were the mean and standard deviation of the three burnout dimensions, high, medium and low prevalence rates of each dimension, and socio-demographic, occupational and psychological variables that potentially influence burnout level. Studies show high prevalence rates, generally between 23% and 31%, of emotional exhaustion. The prevalence rates of high depersonalisation and low personal accomplishment show heterogeneity, varying between 8%-32% and 4%-92% of the sample, respectively. Studies show that older nurses with more seniority, anxiety and depression, among other variables, have higher burnout levels, while nurses with higher salary, high job satisfaction, organisational support, and good self-concept have less burnout. High emotional exhaustion is the main affected dimension of burnout in Primary Care nursing. There is heterogeneity in depersonalisation and personal accomplishment. Burnout must be prevented in these professionals, by increasing protective factors and monitoring its appearance in those with risk factors. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

  8. Stress-related psychosocial factors at work, fatigue, and risky driving behavior in bus rapid transport (BRT) drivers.

    Science.gov (United States)

    Useche, Sergio A; Ortiz, Viviola Gómez; Cendales, Boris E

    2017-07-01

    There is consistent scientific evidence that professional drivers constitute an occupational group that is highly exposed to work related stressors. Furthermore, several recent studies associate work stress and fatigue with unsafe and counterproductive work behaviors. This study examines the association between stress-related work conditions of Bus Rapid Transport (BRT) drivers and risky driving behaviors; and examines whether fatigue is a mechanism that mediates the association between the two. A sample of 524 male Bus Rapid Transit (BRT) operators were drawn from four transport companies in Bogotá, Colombia. The participants answered a survey which included an adapted version of the Driver Behavior Questionnaire (DBQ) for BRT operators, as well as the Effort-Reward Imbalance and Job Content Questionnaires, the Subjective Fatigue subscale of the Checklist Individual Strength (CIS) and the Need for Recovery after Work Scale (NFR). Utilizing Structural Equation Models (SEM) it was found that risky driving behaviors in BRT operators could be predicted through job strain, effort-reward imbalance and social support at work. It was also found that fatigue and need for recovery fully mediate the associations between job strain and risky driving, and between social support and risky driving, but not the association between effort/reward imbalance (ERI) and risky driving. The results of this study suggest that a) stress related working conditions (Job Strain, Social Support and ERI) are relevant predictors of risky driving in BRT operators, and b) that fatigue is the mechanism which links another kind of stress related to working conditions (job strain and low social support) with risky driving. The mechanism by which ERI increases risky driving in BRT operators remains unexplained. This research suggests that in addition to the individual centered stress-reduction occupational programs, fatigue management interventions aimed to changing some working conditions may reduce

  9. Primary Neuroendocrine Carcinoma of the Breast: Histopathological Criteria, Prognostic Factors, and Review of the Literature

    Science.gov (United States)

    Marinova, Lena; Vicheva, Snezhinka

    2016-01-01

    We present here a case of a 42-year-old woman diagnosed with primary neuroendocrine carcinoma of the breast (NECB). We discuss the importance of histological criteria for primary neuroendocrine mammary carcinoma, established by WHO in 2003 and 2012. After an overview of different cases of primary neuroendocrine carcinoma of the breast published in the literature, we present information about differential diagnosis, prognostic factors, and surgical and adjuvant treatment. Prognosis of NECB is not different from that of other invasive breast carcinomas and the most important prognostic factor is tumor grade (G). There is no standard treatment and patients should be treated similarly to patients with invasive ductal carcinoma, NOS (not otherwise specified), whose choice of therapy depends on tumor's size, degree of differentiation, clinical stage, and hormonal status. PMID:27840759

  10. Main Factors of Job Satisfaction among Primary School Educators: Factor Analysis of the Greek Reality

    Science.gov (United States)

    Saiti, Anna

    2007-01-01

    Job satisfaction is an important issue, but remains a complex one as it is difficult to measure. A wide range of factors such as the working environment, its manner of organisation, demography and individual circumstances, etc., can substantially affect the level of job satisfaction attained by individuals. Job satisfaction and the teaching…

  11. Diversity in Primary Teacher Education Gender Differences in Student Factors and Curriculum Perception

    Science.gov (United States)

    Geerdink, Gerda; Bergen, Theo; Dekkers, Hetty

    2011-01-01

    In the Netherlands only a small number of male students opt for primary school teaching and a relatively large percentage of them leave without graduating. A small-scale research project was set up to explore the question: Can gender-specific student factors be identified in relation to the initial teacher education curriculum that leads to the…

  12. Patient factors associated with guideline-concordant treatment of anxiety and depression in primary care.

    NARCIS (Netherlands)

    Prins, M.A.; Verhaak, P.F.; Smolders, M.; Laurant, M.G.H.; Meer, K. de; Spreeuwenberg, P.; Marwijk, H.W.J. van; Penninx, B.W.J.H.; Bensing, J.M.

    2010-01-01

    OBJECTIVE: To identify associations of patient characteristics (predisposing, enabling and need factors) with guideline-concordant care for anxiety and depression in primary care. DESIGN: Analysis of data from the Netherlands Study of Depression and Anxiety (NESDA). PARTICIPANTS: Seven hundred and

  13. Patient factors associated with guideline-concordant treatment of anxiety and depression in primary care

    NARCIS (Netherlands)

    Prins, M.A.; Verhaak, P.; Smolders, M.; Laurant, M.G.H.; van der Meer, K; Spreeuwenberg, P.; van Marwijk, H.W.J.; Penninx, B.W.J.H.; Bensing, J.M.

    2010-01-01

    Objective: To identify associations of patient characteristics (predisposing, enabling and need factors) with guideline-concordant care for anxiety and depression in primary care. Design: Analysis of data from the Netherlands Study of Depression and Anxiety (NESDA). Participants: Seven hundred and

  14. Patient Factors Associated with Guideline-concordant Treatment of Anxiety and Depression in Primary Care

    NARCIS (Netherlands)

    Prins, Marijn A.; Verhaak, Peter F. M.; Smolders, Mirrian; Laurant, Miranda G. H.; van der Meer, Klaas; Spreeuwenberg, Peter; van Marwijk, Harm W. J.; Penninx, Brenda W. J. H.; Bensing, Jozien M.

    To identify associations of patient characteristics (predisposing, enabling and need factors) with guideline-concordant care for anxiety and depression in primary care. Analysis of data from the Netherlands Study of Depression and Anxiety (NESDA). Seven hundred and twenty-one patients with a current

  15. Diversity in Primary Teacher Education : Gender differences in Student Factors and Curriculum perception

    NARCIS (Netherlands)

    Gerda Geerdink; H. Dekkers; T. Bergen

    2011-01-01

    In the Netherlands only a small number of male students opt for primary school teaching and a relatively large percentage of them leave without graduating. A small-scale research project was set up to explore the question: Can gender-specific student factors be identified in relation to the initial

  16. Diversity in primary teacher education gender differences in student factors and curriculum perception

    NARCIS (Netherlands)

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

    2011-01-01

    In the Netherlands only a small number of male students opt for primary school teaching and a relatively large percentage of them leave without graduating. A small-scale research project was set up to explore the question: Can genderspecific student factors be identified in relation to the initial

  17. 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.

  18. Modeling the Factors Associated with Children's Mental Health Difficulties in Primary School: A Multilevel Study

    Science.gov (United States)

    Humphrey, Neil; Wigelsworth, Michael

    2012-01-01

    The current study explores some of the factors associated with children's mental health difficulties in primary school. Multilevel modeling with data from 628 children from 36 schools was used to determine how much variation in mental health difficulties exists between and within schools, and to identify characteristics at the school and…

  19. Employing the Five-Factor Mentoring Instrument: Analysing Mentoring Practices for Teaching Primary Science

    Science.gov (United States)

    Hudson, Peter; Usak, Muhammet; Savran-Gencer, Ayse

    2009-01-01

    Primary science education is a concern around the world and quality mentoring within schools can develop pre-service teachers' practices. A five-factor model for mentoring has been identified, namely, personal attributes, system requirements, pedagogical knowledge, modelling, and feedback. Final-year pre-service teachers (mentees, n = 211) from…

  20. Diversity in primary teacher education gender differences in student factors and curriculum perception

    NARCIS (Netherlands)

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

    2010-01-01

    In the Netherlands only a small number of male students opt for primary school teaching and a relatively large percentage of them leave without graduating. A small-scale research project was set up to explore the question: Can gender-specific student factors be identified in relation to the initial

  1. Investigation of Primary Education Second Level Students' Motivations toward Science Learning in Terms of Various Factors

    Science.gov (United States)

    Sert Çibik, Ayse

    2014-01-01

    The purpose of this research was to investigate the primary education second level students' motivations towards science learning in terms of various factors. Within the research, the variation of the total motivational scores in science learning according to the gender, class, socio-economic levels, success in science-technology course and…

  2. The driving factors behind coal demand in China from 1997 to 2012: An empirical study of input-output structural decomposition analysis

    International Nuclear Information System (INIS)

    Wu, Ya; Zhang, Wanying

    2016-01-01

    With the rapid development of economy, especially the constant progress in industrialisation and urbanisation, China's energy consumption has increased annually. Coal consumption, which accounts for about 70% of total energy consumption, is of particular concern. Hence, it is crucial to study the driving factors behind coal demand in China. This work uses an input-output structural decomposition analysis (I-O SDA) model to decompose the increments of coal demand in China from 1997 to 2012 into the sum of the weighted average for eight driving factors from three aspects, including: domestic demand, foreign trade and industrial upgrading. Results show that: during the research period, the demand for coal increases by 153.3%, which is increased by 185.4% and 76.4% respectively due to the driving forces of domestic demand and foreign trade; in addition, industrial upgrading can effectively restrain the growth in coal demand with a contribution rate of −108.6%. On this basis, we mainly studied the driving factors of coal demand in six high energy-consuming industries, namely the electrical power, energy processing, metals, mining, building materials and chemical industries. Finally, we proposed targeted policy suggestions for the realisation of energy conservation and emissions reduction in China. - Highlights: •The driving factors behind coal demand in China from 1997 to 2012 are studied. •An input-output structural decomposition analysis is developed. •A fresh perspective of domestic demand, foreign trade, and industrial upgrading is employed. •The influences of these affecting factors on China's coal demand from six high energy-consuming industries are investigated. •Targeted policy suggestions for energy conservation and emissions reduction are suggested.

  3. The relationship of drive for muscularity to sociocultural factors, self-esteem, physical attributes gender role, and social comparison in middle school boys.

    Science.gov (United States)

    Smolak, Linda; Stein, Jonathan A

    2006-06-01

    This study examines the relationship of three sociocultural factors-media influence, peer teasing, and parent teasing/comments and three potential moderator variables-self-esteem, social comparison, and endorsement of male strength and athleticism-to drive for muscularity in middle school boys. There were 287 seventh and eighth grade boys who completed a questionnaire measuring these variables as well as body mass index (BMI) and pubertal status. Results indicated that media influence and male physical attributes endorsement were particularly important correlates of drive for muscularity. These findings have implications for programs designed to prevent body dissatisfaction among adolescent boys.

  4. Predictive factors for postoperative visual function of primary chronic rhegmatogenous retinal detachment after scleral buckling.

    Science.gov (United States)

    Fang, Wei; Li, Jiu-Ke; Jin, Xiao-Hong; Dai, Yuan-Min; Li, Yu-Min

    2016-01-01

    To evaluate predictive factors for postoperative visual function of primary chronic rhegmatgenous retinal detachment (RRD) after sclera buckling (SB). Totally 48 patients (51 eyes) with primary chronic RRD were included in this prospective interventional clinical cases study, which underwent SB alone from June 2008 to December 2014. Age, sex, symptoms duration, detached extension, retinal hole position, size, type, fovea on/off, proliferative vitreoretinopathy (PVR), posterior vitreous detachment (PVD), baseline best corrected visual acuity (BCVA), operative duration, follow up duration, final BCVA were measured. Pearson correlation analysis, Spearman correlation analysis and multivariate linear stepwise regression were used to confirm predictive factors for better final visual acuity. Student's t-test, Wilcoxon two-sample test, Chi-square test and logistic stepwise regression were used to confirm predictive factors for better vision improvement. Baseline BCVA was 0.8313±0.6911 logMAR and final BCVA was 0.4761±0.4956 logMAR. Primary surgical success rate was 92.16% (47/51). Correlation analyses revealed shorter symptoms duration (r=0.3850, P=0.0053), less detached area (r=0.5489, Ppredictive factors were better baseline BCVA [partial R-square (PR(2))=0.5316, Ppredictive factors for better vision improvement were better baseline vision [odds ratio (OR) =50.369, P=0.0041] and longer follow up duration (OR=1.144, P=0.0067). Independent predictive factors for better visual outcome of primary chronic RRD after SB are better baseline BCVA, shorter symptoms duration, shorter operative duration and longer follow up duration, while independent predictive factors for better vision improvement after operation are better baseline vision and longer follow up duration.

  5. ALCOHOL AND DISTRACTION INTERACT TO IMPAIR DRIVING PERFORMANCE

    Science.gov (United States)

    Harrison, Emily L. R.; Fillmore, Mark T.

    2011-01-01

    Background Recognition of the risks associated with alcohol intoxication and driver distraction has led to a wealth of simulated driving research aimed at studying the adverse effects of each of these factors. Research on driving has moved beyond the individual, separate examination of these factors to the examination of potential interactions between alcohol intoxication and driver distraction. In many driving situations, distractions are commonplace and might have little or no disruptive influence on primary driving functions. Yet, such distractions might become disruptive to a driver who is intoxicated. Methods The present study examined the interactive impairing effects of alcohol intoxication and driver distraction on simulated driving performance in 40 young adult drivers using a divided attention task as a distracter activity. The interactive influence of alcohol and distraction was tested by having drivers perform the driving task under four different conditions: 0.65 g/kg alcohol; 0.65 g/kg alcohol + divided attention; placebo; and placebo + divided attention. Results As hypothesized, divided attention had no impairing effect on driving performance in sober drivers. However, under alcohol, divided attention exacerbated the impairing effects of alcohol on driving precision. Conclusions Alcohol and distraction continue to be appropriate targets for research into ways to reduce the rates of driving-related fatalities and injuries. Greater consideration of how alcohol and distraction interact to impair aspects of driving performance can further efforts to create prevention and intervention measures to protect drivers, particularly young adults. PMID:21277119

  6. Alcohol and distraction interact to impair driving performance.

    Science.gov (United States)

    Harrison, Emily L R; Fillmore, Mark T

    2011-08-01

    Recognition of the risks associated with alcohol intoxication and driver distraction has led to a wealth of simulated driving research aimed at studying the adverse effects of each of these factors. Research on driving has moved beyond the individual, separate examination of these factors to the examination of potential interactions between alcohol intoxication and driver distraction. In many driving situations, distractions are commonplace and might have little or no disruptive influence on primary driving functions. Yet, such distractions might become disruptive to a driver who is intoxicated. The present study examined the interactive impairing effects of alcohol intoxication and driver distraction on simulated driving performance in 40 young adult drivers using a divided attention task as a distracter activity. The interactive influence of alcohol and distraction was tested by having drivers perform the driving task under four different conditions: 0.65 g/kg alcohol; 0.65 g/kg alcohol+divided attention; placebo; and placebo+divided attention. As hypothesized, divided attention had no impairing effect on driving performance in sober drivers. However, under alcohol, divided attention exacerbated the impairing effects of alcohol on driving precision. Alcohol and distraction continue to be appropriate targets for research into ways to reduce the rates of driving-related fatalities and injuries. Greater consideration of how alcohol and distraction interact to impair aspects of driving performance can further efforts to create prevention and intervention measures to protect drivers, particularly young adults. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  7. Effects of cutbacks on motivating factors among nurses in primary health care.

    Science.gov (United States)

    Halldorsdottir, Sigridur; Einarsdottir, Emilia J; Edvardsson, Ingi Runar

    2018-03-01

    When financial cuts are made, staff redundancies and reorganisation in the healthcare system often follow. Little is known how such cutbacks affect work motivation of nurses in primary health care. Examine the effects of cutbacks on motivating factors among nurses in primary health care. A phenomenological approach involving a purposeful sample of ten nurses in primary health care. Average age 44. The participants identified the job itself, autonomy, independence, good communication with co-workers, and the potential for professional training, learning and development as the main internal motivational factors related to their work. However, increased stress and uncertainty, growing fatigue and understaffing were starting to have a negative impact on these internal motivational factors. Moreover, reduced opportunities for professional training and development had negative effects on the participants. Many saw these opportunities as a vital part of recognition for their job performance. Regarding external motivation, the factors identified were job security, salaries and rewards, and interaction with management. The participants expressed their interest in more consultation with managers and most preferred an increased flow of information from managers to staff members during cutbacks. Salaries, professional training opportunities and appreciation were rewards named by participants for a job well done. All agreed that salaries are stronger motivational factors than before cutbacks. In the case of cutbacks, nursing managers should increase consultations with staff and make sure that nurses maintain their independence, autonomy, opportunities for professional training as well as appreciation for job well done. © 2017 Nordic College of Caring Science.

  8. Mutations in the Primary Sigma Factor σA and Termination Factor Rho That Reduce Susceptibility to Cell Wall Antibiotics

    Science.gov (United States)

    Lee, Yong Heon

    2014-01-01

    Combinations of glycopeptides and β-lactams exert synergistic antibacterial activity, but the evolutionary mechanisms driving resistance to both antibiotics remain largely unexplored. By repeated subculturing with increasing vancomycin (VAN) and cefuroxime (CEF) concentrations, we isolated an evolved strain of the model bacterium Bacillus subtilis with reduced susceptibility to both antibiotics. Whole-genome sequencing revealed point mutations in genes encoding the major σ factor of RNA polymerase (sigA), a cell shape-determining protein (mreB), and the ρ termination factor (rho). Genetic-reconstruction experiments demonstrated that the G-to-C substitution at position 336 encoded by sigA (sigAG336C), in the domain that recognizes the −35 promoter region, is sufficient to reduce susceptibility to VAN and works cooperatively with the rhoG56C substitution to increase CEF resistance. Transcriptome analyses revealed that the sigAG336C substitution has wide-ranging effects, including elevated expression of the general stress σ factor (σB) regulon, which is required for CEF resistance, and decreased expression of the glpTQ genes, which leads to fosfomycin (FOS) resistance. Our findings suggest that mutations in the core transcriptional machinery may facilitate the evolution of resistance to multiple cell wall antibiotics. PMID:25112476

  9. A Primary Human Critical Success Factors Model for the ERP System Implementation

    Directory of Open Access Journals (Sweden)

    Jenko Aleksander

    2016-08-01

    Full Text Available Background and Purpose: Many researchers have investigated various Critical success factors (CSFs and the different causes of ERP implementation project failures. Despite a detailed literature preview, we were unable to find an appropriate research with a comprehensive overview of the true causes behind CSFs, observed from a human factors perspective. The objective of this research was therefore to develop and evaluate the Primary human factors (PHFs model and to confirm the significant impact of PHFs on traditional CSFs and on the project success.

  10. Distracted driving

    Science.gov (United States)

    ... including maps) The Dangers of Talking on the Phone While Driving You are four times more likely to get ... of reach. If you are caught using a phone while driving, you may risk a ticket or fine. Most ...

  11. Distracted Driving

    Science.gov (United States)

    ... and increased awareness of distracted driving using radio advertisements, news stories, and similar media. After the projects ... available at www.trafficsafetymarketing.gov . Distracted Driving Enforcement – TV Ads (Paid). For re-tagging, go to: www. ...

  12. Mechanisms Driving Galling Success in a Fragmented Landscape: Synergy of Habitat and Top-Down Factors along Temperate Forest Edges.

    Directory of Open Access Journals (Sweden)

    Nina-S Kelch

    Full Text Available Edge effects play key roles in the anthropogenic transformation of forested ecosystems and their biota, and are therefore a prime field of contemporary fragmentation research. We present the first empirical study to address edge effects on the population level of a widespread galling herbivore in a temperate deciduous forest. By analyzing edge effects on abundance and trophic interactions of beech gall midge (Mikiola fagi Htg., we found 30% higher gall abundance in the edge habitat as well as lower mortality rates due to decreased top-down control, especially by parasitoids. Two GLM models with similar explanatory power (58% identified habitat specific traits (such as canopy closure and altitude and parasitism as the best predictors of gall abundance. Further analyses revealed a crucial influence of light exposure (46% on top-down control by the parasitoid complex. Guided by a conceptual framework synthesizing the key factors driving gall density, we conclude that forest edge proliferation of M. fagi is due to a complex interplay of abiotic changes and trophic control mechanisms. Most prominently, it is caused by the microclimatic regime in forest edges, acting alone or in synergistic concert with top-down pressure by parasitoids. Contrary to the prevailing notion that specialists are edge-sensitive, this turns M. fagi into a winner species in fragmented temperate beech forests. In view of the increasing proportion of edge habitats and the documented benefits from edge microclimate, we call for investigations exploring the pest status of this galling insect and the modulators of its biological control.

  13. Costs and cost-driving factors for acute treatment of adults with status epilepticus: A multicenter cohort study from Germany.

    Science.gov (United States)

    Kortland, Lena-Marie; Alfter, Anne; Bähr, Oliver; Carl, Barbara; Dodel, Richard; Freiman, Thomas M; Hubert, Kristina; Jahnke, Kolja; Knake, Susanne; von Podewils, Felix; Reese, Jens-Peter; Runge, Uwe; Senft, Christian; Steinmetz, Helmuth; Rosenow, Felix; Strzelczyk, Adam

    2016-12-01

    To provide first data on inpatient costs and cost-driving factors due to nonrefractory status epilepticus (NSE), refractory status epilepticus (RSE), and super-refractory status epilepticus (SRSE). In 2013 and 2014, all adult patients treated due to status epilepticus (SE) at the university hospitals in Frankfurt, Greifswald, and Marburg were analyzed for healthcare utilization. We evaluated 341 admissions in 316 patients (65.7 ± [standard deviation]18.2 years; 135 male) treated for SE. Mean costs of hospital treatment were €14,946 (median €5,278, range €776-€152,911, €787 per treatment day) per patient per admission, with a mean length of stay (LOS) of 19.0 days (median 14.0, range 1-118). Course of SE had a significant impact on mean costs, with €8,314 in NSE (n = 137, median €4,597, €687 per treatment day, 22.3% of total inpatient costs due to SE), €13,399 in RSE (n = 171, median €7,203, €638/day, 45.0% of total costs, p 14 days. Overall mortality at discharge was 14.4% and significantly higher in RSE/SRSE (20.1%) than in NSE (5.8%). Acute treatment of SE, and particularly SRSE and ventilation, are associated with high hospital costs and prolonged LOS. Extrapolation to the whole of Germany indicates that SE causes hospital costs of >€200 million per year. Along with the demographic change, incidence of SE will increase and costs for hospital treatment and sequelae of SE will rise. Wiley Periodicals, Inc. © 2016 International League Against Epilepsy.

  14. Psychiatric disorders in children attending a Nigerian primary care unit: functional impairment and risk factors

    Directory of Open Access Journals (Sweden)

    Tunde-Ayinmode Mosunmola

    2012-07-01

    Full Text Available Abstract Background There is dearth of data on the level of functional impairment and risk factors for psychiatric morbidity in children attending primary care services in developing countries like Nigeria. The risk factors for psychiatric morbidity and functional impairment in children attending the primary care unit of a teaching hospital in Ilorin, Nigeria was therefore investigated to obtain data that could be used in improving service provision by primary care physicians. Methods A cross-sectional two-stage design was employed for the study. The first stage involved administration of the Child Behavior Questionnaire (CBQ to 350 children while the children’s version of the schedule for affective disorders and schizophrenia was used for the second stage involving 157 children, all high scorers on CBQ (score of ≥ 7 and 30% of low scorers (score  In addition, the Children Global Assessment Scale was used to assess the functional status of the children (score of ≤ 70 indicates functional impairment while the mothers’ mental health status was assessed with the 12-item version of the General Health Questionnaire, a score of 3 or more on this instrument indicate presence of mental morbidity. Results It was observed that 11.4% of the children had diagnosable psychiatric disorders and 7.1% were functionally impaired; and those with psychiatric disorders were more functionally impaired than those without. Thus, significant negative correlation was noted between CBQ scores and CGAS (r = 0.53; p  Conclusions Child psychiatric disorders are prevalent in the primary care unit studied. Many of the risk factors identified in the study population are modifiable. Collaborative efforts between psychiatrists and primary care physicians could therefore help to reduce level of risk and functional impairment and psychiatric morbidity among children attending the primary care unit studied. It could also help improve referral rates of

  15. Long-term primary patency prognostic factors after endovascular therapy for acute lower limb ischemia

    International Nuclear Information System (INIS)

    Zhang Di; Gu Jianping; Lou Wensheng; He Xu; Chen Liang; Chen Guoping; Su Haobo; Song Jinhua; Wang Tao

    2012-01-01

    Objective: To assess prognostic factors regarding long-term primary patency for patients who underwent intra-arterial thrombolysis and/or adjuvant endovascular techniques due to acute lower limb ischemia. Methods: Consecutive patients with ALI of the lower extremities treated via interventional methods between January 2005 and June 2010 were identified and reviewed (exclude patient suffered from aortic dissection involved artery of lower extremity or trauma). Analyze the potential variables with univariable analysis and only factors associated with long-term primary patency with a P value less than 0.1 in univariable analysis were introduced into the Cox regression mode. Total long-term primary patency and grouped primary patency were assessed using Kaplan-Meier estimation. Results: The analyzed dataset included 107 limbs treated in 101 patients presenting with ALI (class Ⅰ 15, class Ⅱ A 36, class Ⅱ B to Ⅲ 56, according to Rutherford classification). Eight nine limbs were enrolled in follow-up.The mean followup was 34 months (range: 1 to 53 months). Primary patency at 12, 24 and 36 months was 87%, 68% and 55%, respectively. Multivariable analyses identified patients presenting with diabetes mellitus (P=0.00), PAOD (P<0.02) and thrombolysis time (P<0.02) were associated with primary patency. Compare the patency rate of patients with different thrombolysis time, the results showed that the patency rate of the patients thrombolysis time less than 4 d was higher than those more than 4 c. Conclusions: Interventional therapy remains an effective treatment option for patients presenting with lower extremity ALI. Diabetes mellitus and PAOD negatively affect the rates of limb primary patency. Thrombolysis should be limited to <4 days. (authors)

  16. Identification of transcriptional factors and key genes in primary osteoporosis by DNA microarray.

    Science.gov (United States)

    Xie, Wengui; Ji, Lixin; Zhao, Teng; Gao, Pengfei

    2015-05-09

    A number of genes have been identified to be related with primary osteoporosis while less is known about the comprehensive interactions between regulating genes and proteins. We aimed to identify the differentially expressed genes (DEGs) and regulatory effects of transcription factors (TFs) involved in primary osteoporosis. The gene expression profile GSE35958 was obtained from Gene Expression Omnibus database, including 5 primary osteoporosis and 4 normal bone tissues. The differentially expressed genes between primary osteoporosis and normal bone tissues were identified by the same package in R language. The TFs of these DEGs were predicted with the Essaghir A method. DAVID (The Database for Annotation, Visualization and Integrated Discovery) was applied to perform the GO (Gene Ontology) and KEGG (Kyoto Encyclopedia of Genes and Genomes) pathway enrichment analysis of DEGs. After analyzing regulatory effects, a regulatory network was built between TFs and the related DEGs. A total of 579 DEGs was screened, including 310 up-regulated genes and 269 down-regulated genes in primary osteoporosis samples. In GO terms, more up-regulated genes were enriched in transcription regulator activity, and secondly in transcription factor activity. A total 10 significant pathways were enriched in KEGG analysis, including colorectal cancer, Wnt signaling pathway, Focal adhesion, and MAPK signaling pathway. Moreover, total 7 TFs were enriched, of which CTNNB1, SP1, and TP53 regulated most up-regulated DEGs. The discovery of the enriched TFs might contribute to the understanding of the mechanism of primary osteoporosis. Further research on genes and TFs related to the WNT signaling pathway and MAPK pathway is urgent for clinical diagnosis and directing treatment of primary osteoporosis.

  17. Organizational factors and depression management in community-based primary care settings

    Directory of Open Access Journals (Sweden)

    Kilbourne Amy M

    2009-12-01

    Full Text Available Abstract Background Evidence-based quality improvement models for depression have not been fully implemented in routine primary care settings. To date, few studies have examined the organizational factors associated with depression management in real-world primary care practice. To successfully implement quality improvement models for depression, there must be a better understanding of the relevant organizational structure and processes of the primary care setting. The objective of this study is to describe these organizational features of routine primary care practice, and the organization of depression care, using survey questions derived from an evidence-based framework. Methods We used this framework to implement a survey of 27 practices comprised of 49 unique offices within a large primary care practice network in western Pennsylvania. Survey questions addressed practice structure (e.g., human resources, leadership, information technology (IT infrastructure, and external incentives and process features (e.g., staff performance, degree of integrated depression care, and IT performance. Results The results of our survey demonstrated substantial variation across the practice network of organizational factors pertinent to implementation of evidence-based depression management. Notably, quality improvement capability and IT infrastructure were widespread, but specific application to depression care differed between practices, as did coordination and communication tasks surrounding depression treatment. Conclusions The primary care practices in the network that we surveyed are at differing stages in their organization and implementation of evidence-based depression management. Practical surveys such as this may serve to better direct implementation of these quality improvement strategies for depression by improving understanding of the organizational barriers and facilitators that exist within both practices and practice networks. In addition

  18. Primary graft dysfunction of the liver: definitions, diagnostic criteria and risk factors.

    Science.gov (United States)

    Neves, Douglas Bastos; Rusi, Marcela Balbo; Diaz, Luiz Gustavo Guedes; Salvalaggio, Paolo

    2016-01-01

    Primary graft dysfunction is a multifactorial syndrome with great impact on liver transplantation outcomes. This review article was based on studies published between January 1980 and June 2015 and retrieved from PubMed database using the following search terms: "primary graft dysfunction", "early allograft dysfunction", "primary non-function" and "liver transplantation". Graft dysfunction describes different grades of graft ischemia-reperfusion injury and can manifest as early allograft dysfunction or primary graft non-function, its most severe form. Donor-, surgery- and recipient-related factors have been associated with this syndrome. Primary graft dysfunction definition, diagnostic criteria and risk factors differ between studies. RESUMO A disfunção primária do enxerto hepático é uma síndrome multifatorial com grande impacto no resultado do transplante de fígado. Foi realizada uma ampla revisão da literatura, consultando a base de dados PubMed, em busca de estudos publicados entre janeiro de 1980 e junho de 2015. Os termos descritivos utilizados foram: "primary graft dysfunction", "early allograft dysfunction", "primary non-function" e "liver transplantation". A disfunção traduz graus diferentes da lesão de isquemia e reperfusão do órgão, e pode se manifestar como disfunção precoce ou, na forma mais grave, pelo não funcionamento primário do enxerto. Fatores relacionados ao doador, ao transplante e ao receptor contribuem para essa síndrome. Existem definições diferentes na literatura quanto ao diagnóstico e aos fatores de risco associados à disfunção primária.

  19. Risk factors leading to mucoperiosteal flap necrosis after primary palatoplasty in patents with cleft palate.

    Science.gov (United States)

    Rossell-Perry, Percy; Figallo-Hudtwalcker, Olga; Vargas-Chanduvi, Roberto; Calderon-Ayvar, Yvette; Romero-Narvaez, Carolina

    2017-10-01

    Few studies have been published reporting risk factors for flap necrosis after primary palatoplasty in patients with cleft palate. This complication is rare, and the event is a disaster for both the patient and the surgeon. This study was performed to explore the associations between different risk factors and the development of flap necrosis after primary palatoplasty in patients with cleft palate. This is a case-control study. A 20 years retrospective analysis (1994-2015) of patients with nonsyndromic cleft palate was identified from medical records and screening day registries). Demographical and risk factor data were collected using a patient´s report, including information about age at surgery, gender, cleft palate type, and degree of severity. Odds ratios and 95% confident intervals were derived from logistic regression analysis. All cases with diagnoses of flap necrosis after primary palatoplasty were included in the study (48 patients) and 156 controls were considered. In multivariate analysis, female sex, age (older than 15 years), cleft type (bilateral and incomplete), and severe cleft palate index were associated with significantly increased risk for flap necrosis. The findings suggest that female sex, older age, cleft type (bilateral and incomplete), and severe cleft palatal index may be associated with the development of flap necrosis after primary palatoplasty in patients with cleft palate.

  20. Burnout among primary school teachers in Iraq: prevalence and risk factors.

    Science.gov (United States)

    Al-Asadi, Jasim; Khalaf, Shukrya; Al-Waaly, Aqeel; Abed, Alaa; Shami, Sabah

    2018-06-10

    Studies from various parts of the world have shown that teachers are likely to suffer from burnout. So far, there has been no research on burnout among primary school teachers in Basrah, Iraq. We aimed to determine the prevalence and predisposing factors of self-reported burnout among primary school teachers in Basrah. This was a cross-sectional study in 32 governmental primary schools during November 2014-February 2015. A self-administered questionnaire was used to collect sociodemographic and work-related data using the Oldenburg Burnout Inventory. Of 800 questionnaires distributed, 706 (88.3%) were completed; 58.4% were from women. The prevalence of burnout was 24.5% (95% CI: 21.5-27.8). A statistically significant association was found between burnout and age, sex and marital status. Work-related factors that showed significant association with burnout were: work overload, problems related to career advancement, high number of students per class and student misbehaviour. Burnout is an important health problem among primary school teachers in Basrah. A number of risk factors, particularly those related to work, are amenable to modification since they are related to the education policy. Copyright © World Health Organization (WHO) 2018. Some rights reserved. This work is available under the CC BY-NC-SA 3.0 IGO license (https://creativecommons.org/licenses/by-nc-sa/3.0/igo).

  1. Growth hormone-releasing factor induces c-fos expression in cultured primary pituitary cells

    DEFF Research Database (Denmark)

    Billestrup, Nils; Mitchell, R L; Vale, W

    1987-01-01

    GH-releasing factor (GRF) and somatostatin regulates the secretion and biosynthesis of GH as well as the proliferation of GH-producing cells. In order to further characterize the mitogenic effect of GRF, we studied the expression of the proto-oncogene c-fos in primary pituitary cells. Maximal...... induction of c-fos mRNA was observed 20-60 min after stimulation with 5 nM GRF, returning to basal levels after 2 h. Somatostatin-14 (5 nM) partially inhibited the GRF induced c-fos expression. Forskolin and phorbol 12, 13 dibutyrate induced c-fos gene in cultured primary pituitary cells with similar...

  2. 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

  3. Rate and Risk Factors for Periprosthetic Joint Infection Among 36,494 Primary Total Hip Arthroplasties.

    Science.gov (United States)

    Triantafyllopoulos, Georgios K; Soranoglou, Vasileios G; Memtsoudis, Stavros G; Sculco, Thomas P; Poultsides, Lazaros A

    2018-04-01

    As periprosthetic joint infections (PJIs) can have tremendous health and socioeconomic implications, recognizing patients at risk before surgery is of great importance. Therefore, we sought to determine the rate of and risk factors for deep PJI in patients undergoing primary total hip arthroplasty (THA). Clinical characteristics of patients treated with primary THA between January 1999 and December 2013 were retrospectively reviewed. These included patient demographics, comorbidities (including the Charlson/Deyo comorbidity index), length of stay, primary diagnosis, total/allogeneic transfusion rate, and in-hospital complications, which were grouped into local and systemic (minor and major). We determined the overall deep PJI rate, as well as the rates for early-onset (occurring within 2 years after index surgery) and late-onset PJI (occurring more than 2 years after surgery). A Cox proportional hazards regression model was constructed to identify risk factors for developing deep PJI. Significance level was set at 0.05. A deep PJI developed in 154 of 36,494 primary THAs (0.4%) during the study period. Early onset PJI was found in 122 patients (0.3%), whereas late PJI occurred in 32 patients (0.1%). Obesity, coronary artery disease, and pulmonary hypertension were identified as independent risk factors for deep PJI after primary THA. The rate of deep PJIs of the hip is relatively low, with the majority occurring within 2 years after THA. If the optimization of modifiable risk factors before THA can reduce the rate of this complication remains unknown, but should be attempted as part of good practice. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Growing health partnerships in rural and remote communities: what drives the joint efforts of primary schools and universities in maintaining service learning partnerships?

    Science.gov (United States)

    Kirby, Sue; Held, Fabian P; Jones, Debra; Lyle, David

    2018-01-10

    Aim This study explored the partnership between universities and local primary schools to deliver a classroom-based paediatric communication impairment service provided by undergraduate speech pathology students. It aimed to understand how partnerships work to facilitate programme replication. The partners included universities sending students on rural clinical placement, local host academic units and primary schools who worked together to provide paediatric speech and language services in primary schools in three sites in Australia. Rural and remote communities experience poorer health outcomes because of chronic workforce shortages, social disadvantage and high Aboriginality, poor access to services and underfunding. The study was in twofold: qualitative analysis of data from interviews/focus group with the partners in the university and education sectors, and quantitative social network analysis of data from an electronic survey of the partners. Findings Factors supporting partnerships were long-term, work and social relationships, commitment to community, trust and an appetite for risk-taking. We postulate that these characteristics are more likely to exist in rural communities.

  5. Interplay among Drosophila transcription factors Ets21c, Fos and Ftz-F1 drives JNK-mediated tumor malignancy

    Directory of Open Access Journals (Sweden)

    Eva Külshammer

    2015-10-01

    Full Text Available Cancer initiation and maintenance of the transformed cell state depend on altered cellular signaling and aberrant activities of transcription factors (TFs that drive pathological gene expression in response to cooperating genetic lesions. Deciphering the roles of interacting TFs is therefore central to understanding carcinogenesis and for designing cancer therapies. Here, we use an unbiased genomic approach to define a TF network that triggers an abnormal gene expression program promoting malignancy of clonal tumors, generated in Drosophila imaginal disc epithelium by gain of oncogenic Ras (RasV12 and loss of the tumor suppressor Scribble (scrib1. We show that malignant transformation of the rasV12scrib1 tumors requires TFs of distinct families, namely the bZIP protein Fos, the ETS-domain factor Ets21c and the nuclear receptor Ftz-F1, all acting downstream of Jun-N-terminal kinase (JNK. Depleting any of the three TFs improves viability of tumor-bearing larvae, and this positive effect can be enhanced further by their combined removal. Although both Fos and Ftz-F1 synergistically contribute to rasV12scrib1 tumor invasiveness, only Fos is required for JNK-induced differentiation defects and Matrix metalloprotease (MMP1 upregulation. In contrast, the Fos-dimerizing partner Jun is dispensable for JNK to exert its effects in rasV12scrib1 tumors. Interestingly, Ets21c and Ftz-F1 are transcriptionally induced in these tumors in a JNK- and Fos-dependent manner, thereby demonstrating a hierarchy within the tripartite TF network, with Fos acting as the most upstream JNK effector. Of the three TFs, only Ets21c can efficiently substitute for loss of polarity and cooperate with RasV12 in inducing malignant clones that, like rasV12scrib1 tumors, invade other tissues and overexpress MMP1 and the Drosophila insulin-like peptide 8 (Dilp8. While rasV12ets21c tumors require JNK for invasiveness, the JNK activity is dispensable for their growth. In conclusion, our

  6. Trends in the breeding population and driving factors of Adélie penguin in the Ross Sea

    Science.gov (United States)

    He, H.; Li, X.; Cheng, X.

    2017-12-01

    Ross Sea regions have been characterized by high penguin-chick-rearing habitat suitability in the recent past. Many studies have been done to study the Adélie penguins in the Ross Sea. However, the data they used both had advantages and drawbacks. Besides, little quantitative analysis were carried out to study the impact factors on the penguin population change. In this study, penguin population data from MAPPPD (Mapping application for penguin populations and projected dynamics) and IBA (Important bird areas in Antarctica) were integrated and analyzed to study the distribution and trends in the breeding population of Adélie penguin over time in the Ross Sea. In addition, linear fitting method for spatial data in time series were used to study the driving factors such as 2m-temperature, sea ice cover and chlorophyll-a concentration which can quantify phytoplankton blooms. Results indicated that there were 45 Adélie penguin colonies in the Ross Sea. Cape Adare and Cape Crozier were two biggest colonies on which current Adélie penguin abundance were 428516 and 280787 breeding pairs, respectively. Among these colonies, penguin population on 28 colonies increased, on 5 colonies decreased and on 5 colonies remained no change over time, and there were also 5 new colonies and one colony which were extinct. It was found that Adélie penguin population in most of colonies in the Ross Sea increased, which meant that Adélie penguins in the Ross Sea were "climate change winners". The main reasons for the increase in Adélie penguin population in the Ross Sea might be the rise in 2m-temperature and the increase in sea ice cover and phytoplankton. Higher temperatures have resulted in glacial retreat and snow melting, which leads to an increase in available habitat for penguins. The increased sea ice and phytoplankton might positively affect the abundance of Antarctic krill that was the major prey item for Adélie penguins in Antarctic.

  7. The prevalence and risk factors of stunting among primary school children in North Sumatera, Indonesia

    Science.gov (United States)

    Lestari, S.; Fujiati, I. I.; Keumalasari, D.; Daulay, M.

    2018-03-01

    Stunting in primary school-aged children is a kind of health and nutrition problem in Indonesia which has an impact on the human quality resources degradation. This research aimed to determine the stunting prevalence and the risk factors associated with stunting in primary school children in North Sumatra Province. This research is an analysis of cross-sectional approach. The total sampleis 400 children aged 8-13 years old were in the study from the Medan city and Langkat regency in July - October 2017. Data collected by using questionnaire and anthropometric assessment. Stunting (<-2 SD of height-for-age Z-score) were defined by using the World Health Organization reference 2007. Chi-square analysis and logistic regression were used toassess the association between risk factors and stunting. The prevalence of stunting in primary school children was 38.87%. The factors associated with stunting school children were theeducation of mother (OR=1.53), income (OR=2.27), work of mother (OR=1.39), energy intake (OR=2.66) and protein intake (OR=2.02). The dominant factor that influences stunting in school children was energy intake. The conclusion of this study is stunting prevalence in school children in NorthSumatra higher.

  8. Risk factors for revision of primary total hip arthroplasty: a systematic review

    Directory of Open Access Journals (Sweden)

    Prokopetz Julian JZ

    2012-12-01

    Full Text Available Abstract Background Numerous papers have been published examining risk factors for revision of primary total hip arthroplasty (THA, but there have been no comprehensive systematic literature reviews that summarize the most recent findings across a broad range of potential predictors. Methods We performed a PubMed search for papers published between January, 2000 and November, 2010 that provided data on risk factors for revision of primary THA. We collected data on revision for any reason, as well as on revision for aseptic loosening, infection, or dislocation. For each risk factor that was examined in at least three papers, we summarize the number and direction of statistically significant associations reported. Results Eighty-six papers were included in our review. Factors found to be associated with revision included younger age, greater comorbidity, a diagnosis of avascular necrosis (AVN as compared to osteoarthritis (OA, low surgeon volume, and larger femoral head size. Male sex was associated with revision due to aseptic loosening and infection. Longer operating time was associated with revision due to infection. Smaller femoral head size was associated with revision due to dislocation. Conclusions This systematic review of literature published between 2000 and 2010 identified a range of demographic, clinical, surgical, implant, and provider variables associated with the risk of revision following primary THA. These findings can inform discussions between surgeons and patients relating to the risks and benefits of undergoing total hip arthroplasty.

  9. Interprofessional collaboration regarding patients' care plans in primary care: a focus group study into influential factors.

    Science.gov (United States)

    van Dongen, Jerôme Jean Jacques; Lenzen, Stephanie Anna; van Bokhoven, Marloes Amantia; Daniëls, Ramon; van der Weijden, Trudy; Beurskens, Anna

    2016-05-28

    The number of people with multiple chronic conditions demanding primary care services is increasing. To deal with the complex health care demands of these people, professionals from different disciplines collaborate. This study aims to explore influential factors regarding interprofessional collaboration related to care plan development in primary care. A qualitative study, including four semi-structured focus group interviews (n = 4). In total, a heterogeneous group of experts (n = 16) and health care professionals (n = 15) participated. Participants discussed viewpoints, barriers, and facilitators regarding interprofessional collaboration related to care plan development. The data were analysed by means of inductive content analysis. The findings show a variety of factors influencing the interprofessional collaboration in developing a care plan. Factors can be divided into 5 key categories: (1) patient-related factors: active role, self-management, goals and wishes, membership of the team; (2) professional-related factors: individual competences, domain thinking, motivation; (3) interpersonal factors: language differences, knowing each other, trust and respect, and motivation; (4) organisational factors: structure, composition, time, shared vision, leadership and administrative support; and (5) external factors: education, culture, hierarchy, domain thinking, law and regulations, finance, technology and ICT. Improving interprofessional collaboration regarding care plan development calls for an integral approach including patient- and professional related factors, interpersonal, organisational, and external factors. Further, the leader of the team seems to play a key role in watching the patient perspective, organising and coordinating interprofessional collaborations, and guiding the team through developments. The results of this study can be used as input for developing tools and interventions targeted at executing and improving interprofessional

  10. Electric drives

    CERN Document Server

    Boldea, Ion

    2005-01-01

    ENERGY CONVERSION IN ELECTRIC DRIVESElectric Drives: A DefinitionApplication Range of Electric DrivesEnergy Savings Pay Off RapidlyGlobal Energy Savings Through PEC DrivesMotor/Mechanical Load MatchMotion/Time Profile MatchLoad Dynamics and StabilityMultiquadrant OperationPerformance IndexesProblemsELECTRIC MOTORS FOR DRIVESElectric Drives: A Typical ConfigurationElectric Motors for DrivesDC Brush MotorsConventional AC MotorsPower Electronic Converter Dependent MotorsEnergy Conversion in Electric Motors/GeneratorsPOWER ELECTRONIC CONVERTERS (PECs) FOR DRIVESPower Electronic Switches (PESs)The

  11. Clinical outcome after pulmonary metastasectomy from primary hepatocellular carcinoma: Analysis of prognostic factors

    Science.gov (United States)

    Kwon, Jong-Bum; Park, Khun; Kim, Young-Du; Seo, Jong-Hee; Moon, Seok-Whan; Cho, Deog-Gon; Kim, Yong-Whan; Kim, Dong-Goo; Yoon, Seung-Kew; Lim, Hyeon-Woo

    2008-01-01

    AIM: To review the surgical outcomes in terms of the surgical indications and relevant prognostic factors. METHODS: Sixteen patients underwent therapeutic lung surgery between March 1999 and May 2006. The observation period was terminated on May 31, 2007. The surgical outcomes and the clinicopathological factors were compared. RESULTS: There was no mortality or major morbidity encountered in this study. The mean follow-up period after metastasectomy was 26.7 ± 28.2 (range: 1-99 mo), and the median survival time was 20 mo. The 1- and 5-year survival rates were 56% and 26%, respectively. At the end of the follow-up, 1 patient died from hepatic failure without recurrence, 6 died from hepatic failure with a recurrent hepatocellular carcinoma (HCC), and 4 died from recurrent HCC with cachexia. Among several clinical factors, Kaplan-Meier analysis revealed that liver transplantation as a treatment for the primary lesion, grade of cell differentiation, and negative evidence HBV infection were independent predictive factors. On Cox’s proportional hazard model, there were no significant factors affecting survival after pulmonary metastasectomy in patients with HCC. CONCLUSION: A metastasectomy should be performed before other treatments in selected patients. Although not significant, patients with liver transplantation of a primary HCC survived longer. Liver transplantation might be the most beneficial modality that can offer patients better survival. A multi-institutional and collaborative study would be needed for identifying clinical prognostic factors predicting survival in patients with HCC and lung metastasis. PMID:18837090

  12. Selection of unusual actinomycetal primary sigma70 factors by plant-colonizing Frankia strains.

    Science.gov (United States)

    Lavire, Céline; Blaha, Didier; Cournoyer, Benoit

    2004-02-01

    Functional adaptations of sigma70 transcriptional factors led to the emergence of several paralogous lineages, each one being specialized for gene transcription under particular growth conditions. Screening of a Frankia strain EaI-12 gene library by sigma70 DNA probing allowed the detection and characterization of a novel actinomycetal primary (housekeeping) sigma70 factor. Phylogenetic analysis positioned this factor in the RpoD cluster of proteobacterial and low-G+C-content gram-positive factors, a cluster previously free of any actinobacterial sequences. sigma70 DNA probing of Frankia total DNA blots and PCR screening detected one or two rpoD-like DNA regions per species. rpoD matched the conserved region in all of the species tested. The other region was found to contain sigA, an alternative primary factor. sigA appeared to be strictly distributed among Frankia species infecting plants by the root hair infection process. Both genes were transcribed by Frankia strain ACN14a grown in liquid cultures. The molecular phylogeny of the sigma70 family determined with Frankia sequences showed that the alternative actinomycetal factors and the essential ones belonged to the same radiation. At least seven distinct paralogous lineages were observed among this radiation, and gene transfers were detected in the HrdB actinomycetal lineage.

  13. An explorative study of factors contributing to the job satisfaction of primary care midwives.

    Science.gov (United States)

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

    2015-04-01

    the main objectives of our study was to gain an understanding of how primary care midwives in the Netherlands feel about their work and to identify factors associated with primary care midwives׳ job satisfaction and areas for improvement. a qualitative analysis was used, based on the constructivist/interpretative paradigm. Three open-ended questions in written or online questionnaire, analysed to identify factors that are linked with job satisfaction, were as follows: 'What are you very satisfied with, in your work as a midwife?', 'What would you most like to change about your work as a midwife?' and 'What could be improved in your work?'. 20 of the 519 primary care practices in the Netherlands in May 2010 were included. at these participating practices 99 of 108 midwives returned a written or online questionnaire. in general, most of the participating primary care midwives were satisfied with their job. The factors positively associated with their job satisfaction were their direct contact with clients, the supportive co-operation and teamwork with immediate colleagues, the organisation of and innovation within their practice group and the independence, autonomy, freedom, variety and opportunities that they experienced in their work. Regarding improvements, the midwives desired a reduction in non-client-related activities, such as paperwork and meetings. They wanted a lower level of work pressure, and a reduced case-load in order to have more time to devote to individual clients׳ needs. Participants identified that co-operation with other partners in the health care system could also be improved. our knowledge, our study is the first explorative study on factors associated with job satisfaction of primary care midwives. While there are several studies on job satisfaction in health care; little is known about the working conditions of midwives in primary care settings. Although the participating primary care midwives in the Netherlands were satisfied with their

  14. Ovarian metastases resection from extragenital primary sites: outcome and prognostic factor analysis of 147 patients

    International Nuclear Information System (INIS)

    Li, Wenhua; Wang, Huaying; Wang, Jian; LV, Fangfang; Zhu, Xiaodong; Wang, Zhonghua

    2012-01-01

    To explore the outcomes and prognostic factors of ovarian metastasectomy intervention on overall survival from extragenital primary cancer. Patients with ovarian metastases from extragenital primary cancer confirmed by laparotomy surgery and ovarian metastases resection were retrospectively collected in a single institution during an 8-year period. A total of 147 cases were identified and primary tumor sites were colorectal region (49.0%), gastric (40.8%), breast (8.2%), biliary duct (1.4%) and liver (0.7%). The pathological and clinical features were evaluated. Patients’ outcome with different primary tumor sites and predictive factors for overall survival were also investigated by univariate and multivariate analysis. Metachronous ovarian metastasis occurred in 92 (62.6%) and synchronous in 55 (37.4%) patients. Combined metastases occurred in 40 (27.2%). Bilateral metastasis was found in 97 (66%) patients. The median ovarian metastasis tumor size was 9 cm. There were 39 (26.5%) patients with massive ascites ≥ 1000 mL on intraoperative evaluation. With a median follow-up of 48 months, the median OS after ovarian metastasectomy for all patients was 8.2 months (95% CI 7.2-9.3 months). In univariate analyses, there is significant (8.0 months vs. 41.0 months, P = 0.000) difference in OS between patients with gastrointestinal cancer origin from breast origin, and between patients with gastric origin from colorectal origin (7.4 months vs. 8.8 months, P = 0.036). In univariate analyses, synchronous metastases, locally invasion, massive intraoperative ascites (≥ 1000 mL), and combined metastasis, were identified as significant poor prognostic factors. In multivariate analyses combined metastasis (RR, 1.72; 95% CI, 1.09-2.69, P = 0.018), locally invasion (RR, 1.62; 95% CI, 1.03-2.54, P = 0.038) and massive intraoperative ascites (RR, 1.58; 95% CI, 1.02-2.49, P = 0.04) were independent factors for predicting unfavorable overall survival. Ovarian metastases are more

  15. Primary Candida guilliermondii Infection of the Knee in a Patient without Predisposing Factors

    Directory of Open Access Journals (Sweden)

    Gun Woo Lee

    2012-01-01

    Full Text Available Isolated primary candidal infection of joint is extremely rare, with only a few reported cases. It occurs as a result of accidental implantations of fungus during traumatic procedures, such as surgery, and is usually reported in patients with predisposing factors such as immunosuppression, malignancy, and drug abuse. If left untreated, irreversible deformity and pain with severe osteoarticular destruction occur. Thus, early diagnosis and treatment are important. This paper presents a case of 72-year-old man with primary C. guilliermondii infection of knee joint without predisposing factors and previous traumatic procedures, who was misdiagnosed with advanced degenerative osteoarthritis. Our case is the second case of primary C. guilliermondii arthritis of knee to be reported in the English-language literature and the first to be successfully treated with total knee arthroplasty following IV amphotericin B and oral fluconazole. Primary candidal infection of joint is generally asymptomatic or involves only mild pain and swelling in the affected knee. Thus, although the majority of knee joint infections are of a pyogenic or tuberculous origin, if a patient complains of mild pain and swelling in the knee and has mild signs of infection, the possibility of fungal infection should be considered.

  16. Factors Associated with Primary School Teachers' Attitudes Towards the Inclusion of Students with Disabilities.

    Science.gov (United States)

    Vaz, Sharmila; Wilson, Nathan; Falkmer, Marita; Sim, Angela; Scott, Melissa; Cordier, Reinie; Falkmer, Torbjörn

    2015-01-01

    Teachers' attitudes toward inclusion are often based on the practical implementation of inclusive education rather than a specific ideology and understanding of inclusiveness. This study aimed to identify the factors associated with primary school teachers' attitudes towards inclusion of students with all disabilities in regular schools. Seventy four primary school teachers participated in a cross-sectional survey conducted in Western Australia. Teachers' attitudes and efficacy toward integration of students with disabilities were measured using the Opinions Relative to Integration of Students with Disabilities scale and Bandura's Teacher Efficacy scale respectively. Four teacher attributes-age, gender, teaching self-efficacy and training collectively explained 42% of the variability in teachers' attitude toward including students with disabilities. The current study further contributes to the accumulation of knowledge that can unpack the complex pattern of factors that should be considered to promote positive attitudes towards inclusive schools.

  17. Depression screening and management among adolescents in primary care: factors associated with best practice.

    Science.gov (United States)

    Taliaferro, Lindsay A; Hetler, Joel; Edwall, Glenace; Wright, Catherine; Edwards, Anne R; Borowsky, Iris W

    2013-06-01

    To compare depression identification and management perceptions and practices between professions and disciplines in primary care and examine factors that increase the likelihood of administering a standardized depression screening instrument, asking about patients' depressive symptoms, and using best practice when managing depressed adolescents. Data came from an online survey of clinicians in Minnesota (20% response rate). Analyses involved bivariate tests and linear regressions. The analytic sample comprised 260 family medicine physicians, 127 pediatricians, 96 family nurse practitioners, and 54 pediatric nurse practitioners. Overall, few differences emerged between physicians and nurse practitioners or family and pediatric clinicians regarding addressing depression among adolescents. Two factors associated with administering a standardized instrument included having clear protocols for follow-up after depression screening and feeling better prepared to address depression among adolescents. Enhancing clinicians' competence to address depression and developing postscreening protocols could help providers implement universal screening in primary care.

  18. Factors Associated with Primary School Teachers' Attitudes Towards the Inclusion of Students with Disabilities.

    Directory of Open Access Journals (Sweden)

    Sharmila Vaz

    Full Text Available Teachers' attitudes toward inclusion are often based on the practical implementation of inclusive education rather than a specific ideology and understanding of inclusiveness. This study aimed to identify the factors associated with primary school teachers' attitudes towards inclusion of students with all disabilities in regular schools.Seventy four primary school teachers participated in a cross-sectional survey conducted in Western Australia. Teachers' attitudes and efficacy toward integration of students with disabilities were measured using the Opinions Relative to Integration of Students with Disabilities scale and Bandura's Teacher Efficacy scale respectively.Four teacher attributes-age, gender, teaching self-efficacy and training collectively explained 42% of the variability in teachers' attitude toward including students with disabilities.The current study further contributes to the accumulation of knowledge that can unpack the complex pattern of factors that should be considered to promote positive attitudes towards inclusive schools.

  19. Factors Associated with Primary School Teachers’ Attitudes Towards the Inclusion of Students with Disabilities

    Science.gov (United States)

    Vaz, Sharmila; Wilson, Nathan; Falkmer, Marita; Sim, Angela; Scott, Melissa; Cordier, Reinie; Falkmer, Torbjörn

    2015-01-01

    Objective Teachers' attitudes toward inclusion are often based on the practical implementation of inclusive education rather than a specific ideology and understanding of inclusiveness. This study aimed to identify the factors associated with primary school teachers' attitudes towards inclusion of students with all disabilities in regular schools. Method Seventy four primary school teachers participated in a cross-sectional survey conducted in Western Australia. Teachers' attitudes and efficacy toward integration of students with disabilities were measured using the Opinions Relative to Integration of Students with Disabilities scale and Bandura's Teacher Efficacy scale respectively. Results Four teacher attributes—age, gender, teaching self-efficacy and training collectively explained 42% of the variability in teachers' attitude toward including students with disabilities. Conclusion The current study further contributes to the accumulation of knowledge that can unpack the complex pattern of factors that should be considered to promote positive attitudes towards inclusive schools. PMID:26317862

  20. Tumor Necrosis Factor Inhibitor Primary Failure Predicts Decreased Ustekinumab Efficacy in Psoriasis Patients.

    Science.gov (United States)

    Sorensen, Eric P; Fanucci, Kristina A; Saraiya, Ami; Volf, Eva; Au, Shiu-chung; Argobi, Yahya; Mansfield, Ryan; Gottlieb, Alice B

    2015-08-01

    Additional studies are needed to examine the efficacy of ustekinumab in psoriasis patients who have previously been exposed to tumor necrosis factor inhibitors (TNFi). To examine the predictive effect of TNFi primary failure and the number of TNFi exposures on the efficacy of ustekinumab in psoriasis treatment. This retrospective study examined 44 psoriasis patients treated at the Tufts Medical Center Department of Dermatology between January 2008 and July 2014. Patients were selected if they were treated with ustekinumab and had ≥ 1 previous TNFi exposure. The following subgroups were compared: patients with vs without a previous TNFi primary failure, and patients with one vs multiple previous TNFi exposures. The efficacy measure used was the previously validated Simple Measure for Assessing Psoriasis Activity (S-MAPA), which is calculated by the product of the body surface area and physician global assessment. The primary outcome was the percentage improvement S-MAPA from course baseline at week 12 of ustekinumab treatment. Secondary outcomes were the psoriasis clearance, primary failure, and secondary failure rates with ustekinumab treatment. Patients with a previous TNFi primary failure had a significantly lower percentage improvement in S-MAPA score at week 12 of ustekinumab treatment compared with patients without TNFi primary failure (36.2% vs 61.1%, P=.027). Multivariate analysis demonstrated that this relationship was independent of patient demographics and medical comorbidities. Patients with multiple TNFi exposures had a non-statistically significant lower percentage S-MAPA improvement at week 12 (40.5% vs 52.9%, P=.294) of ustekinumab treatment compared with patients with a single TNFi exposure. Among psoriasis patients previously exposed to TNFi, a history of a previous TNFi primary failure predicts a decreased response to ustekinumab independent of patient demographics and medical comorbidities.

  1. What should primary health care practitioners know about factors influencing young people’s food choices?

    OpenAIRE

    Louise Holmberg; John Coveney; Julie Henderson; Samantha Meyer

    2010-01-01

    BackgroundTo identify factors that determine the nature and extent ofyoung consumers trust in food; sources of information whichinfluence young consumer food choices; and how trustimpacts on young people’s food choices.MethodIn-depth qualitative research interviews were conducted withyoung women and men, who are the primary food purchasersin their household (n=8)ResultsFood choices of young adults were generally determined bycost and convenience. The overall perception was thatAustralian food...

  2. Analysis of the correlative factors for velopharyngeal closure of patients with cleft palate after primary repair.

    Science.gov (United States)

    Chen, Qi; Li, Yang; Shi, Bing; Yin, Heng; Zheng, Guang-Ning; Zheng, Qian

    2013-12-01

    The objective of this study was to analyze the correlative factors for velopharyngeal closure of patients with cleft palate after primary repair. Ninety-five nonsyndromic patients with cleft palate were enrolled. Two surgical techniques were applied in the patients: simple palatoplasty and combined palatoplasty with pharyngoplasty. All patients were assessed 6 months after the operation. The postoperative velopharyngeal closure (VPC) rate was compared by χ(2) test and the correlative factors were analyzed with logistic regression model. The postoperative VPC rate of young patients was higher than that of old patients, the group with incomplete cleft palate was higher than the group with complete cleft palate, and combined palatoplasty with pharyngoplasty was higher than simple palatoplasty. Operative age, cleft type, and surgical technique were the contributing factors for postoperative VPC rate. Operative age, cleft type, and surgical technique were significant factors influencing postoperative VPC rate of patients with cleft palate. Copyright © 2013 Elsevier Inc. All rights reserved.

  3. Head Lice Infestation (Pediculosis and Associated Factors among Primary School Girls in Sirik County, Southern Iran

    Directory of Open Access Journals (Sweden)

    Alireza Sanei-Dehkordi

    2017-12-01

    Full Text Available Background Head lice infestation (pediculosis is a serious health problem that can cause a high level of anxiety and psychological frustration, especially in developing countries.Socio-demographic factors are important determinants of the occurrence of head lice infestation. This study aimed to determine the head lice infestations and the factors affecting the rate of infestationin primary school girls.   Materials and Methods In this cross-sectional study, a total of 358 school girls from two urban and three rural primary school girls in Sirik County, Southern Iran, were randomly selected. For the diagnosis of head lice infestation, students were examined carefully by visual inspection of the scalp and hair for the presence of lice. Self-administered questionnaire was used to collect data on socio-demographic and associated factors of head lice infestation. SPSS version 21.0 was used to analyze the data. Results The prevalence of head lice infestation among primary school girls was 56.15%. There were significant associations between head lice infestation and age (p

  4. Impact of socioeconomic factors on nutritional status in primary school children

    International Nuclear Information System (INIS)

    Babar, N.F.; Khan, M.A.

    2010-01-01

    Child malnutrition is a major public health and development concern in most of the poor communities leading to high morbidity and mortality. Various studies have highlighted the factors involved. The present study focuses on socioeconomic inequality resulting in malnutrition. Objectives of the Study were to find the Impact of socio-economic factors on nutritional status in primary school children. Methods: It was a cross sectional survey conducted at Lahore from February to August 2005 among primary schools from public and private sectors to assess the nutritional status of primary school going children age 5-11 years belonging to different socio economic classes of the society. Systematic random sampling technique was applied to collect the sample. Body Mass Index in relation to NHANES reference population was used for assessing nutritional status. Results: The nutritional status of children from lower socio economic class was poor as compared to their counter parts in upper socio economic class. Children with BMI <5 percentile were 41% in lower class while in upper class it was 19.28%. Prevalence of malnutrition was 42.3% among children of illiterate mothers as compare to 20% in those of literate mothers. Conclusion: Poverty, low literacy rate, large families, food insecurity, food safety, women's education appears to be the important underlying factors responsible for poor health status of children from low socioeconomic class. It requires economic, political and social changes as well as changes for personal advancement mainly through educational opportunities to improve the nutritional status of the children. (author)

  5. Impact of socioeconomic factors on nutritional status in primary school children.

    Science.gov (United States)

    Babar, Nabeela Fazal; Muzaffar, Rizwana; Khan, Muhammad Athar; Imdad, Seema

    2010-01-01

    Child malnutrition is a major public health and development concern in most of the poor communities leading to high morbidity and mortality. Various studies have highlighted the factors involved. The present study focuses on socioeconomic inequality resulting in malnutrition. Objectives of the Study were to find the Impact of socio-economic factors on nutritional status in primary school children. It was a cross sectional survey conducted at Lahore from February to August 2005 among primary schools from public and private sectors to assess the nutritional status of primary school going children age 5-11 years belonging to different socio economic classes of the society. Systematic random sampling technique was applied to collect the sample. Body Mass Index in relation to NHANES reference population was used for assessing nutritional status. The nutritional status of children from lower socio economic class was poor as compared to their counter parts in upper socio economic class. Children with BMI children of illiterate mothers as compare to 20% in those of literate mothers. Poverty, low literacy rate, large families, food insecurity, food safety, women's education appears to be the important underlying factors responsible for poor health status of children from low socioeconomic class. It requires economic, political and social changes as well as changes for personal advancement mainly through educational opportunities to improve the nutritional status of the children.

  6. Factors influencing the adoption, implementation, and continuation of physical activity interventions in primary health care: A Delphi study

    NARCIS (Netherlands)

    Huijg, J.M.; Crone, M.R.; Verheijden, M.W.; Zouwe, N. van der; Middelkoop, B.J.; Gebhardt, W.A.

    2013-01-01

    Background: The introduction of efficacious physical activity interventions in primary health care is a complex process. Understanding factors influencing the process can enhance the development of effective introduction strategies. This Delphi study aimed to identify factors most relevant for the

  7. A Review of Electronic Inductor Technique for Power Factor Correction in Three-Phase Adjustable Speed Drives

    DEFF Research Database (Denmark)

    Davari, Pooya; Yang, Yongheng; Zare, Firuz

    2016-01-01

    (SiC) power devices. Moreover, the influence of partial loading on component sizing in Adjustable Speed Drives (ASDs) is studied. Finally the analytical loss modelling of power switches is utilized for efficiency measurement. The theoretical analyses are verified by experimental benchmarking in an ASD...

  8. Development of emission factors for motorcycles and shared auto-rickshaws using real-world driving cycle for a typical Indian city.

    Science.gov (United States)

    Adak, Prasenjit; Sahu, Ravi; Elumalai, Suresh Pandian

    2016-02-15

    Vehicular emission is one of the most important contributors of urban air pollution. To quantify the impact of traffic on urban air quality, it is necessary to quantify vehicular emission. In many cities of India, such as Dhanbad, shared auto-rickshaw is the pre-dominant mode of transportation. Indian Driving Cycle (IDC) and Modified Indian Driving Cycle (MIDC) are used for emission testing of motorcycles, shared auto-rickshaws and passenger cars in India for regulatory purposes. IDC used for motorcycles and shared auto-rickshaws does not recognize the difference in two vehicle classes in terms of driving pattern. In real world, shared auto-rickshaws, behave differently than motorcycles. To quantify the impact of shared auto-rickshaws on urban air quality accurately, emission factors (EFs) are required to derive from real-world driving cycles (DCs). In heterogeneous traffic, vehicles of one class affect the behavior of vehicles of other classes. To estimate the emissions from different vehicle classes accurately, EFs for motorcycles and passenger cars are also required to be revised. In this study, real-world DCs were developed for motorcycles, shared auto-rickshaws and passenger cars in Dhanbad. Developed DCs were used to calculate EFs for respective classes. Shared auto-rickshaws were found to have the highest deviation from EFs derived using IDC. Copyright © 2015 Elsevier B.V. All rights reserved.

  9. Not all minds wander equally: The influence of traits, states and road environment factors on self-reported mind wandering during everyday driving.

    Science.gov (United States)

    Burdett, Bridget R D; Charlton, Samuel G; Starkey, Nicola J

    2016-10-01

    Inattention is a road safety problem, but few studies have focused specifically on mind wandering during everyday driving. This paper explores differences in self-reported mind wandering according to driver demographic characteristics (including age and gender), cognitive traits (such as tendency toward cognitive failure or mindful attention), states (such as feeling tired or stressed) and road environment factors (such as route familiarity). Five hundred and two participants (113 male, average age 44.4 years, SD=14.0years) completed a series of questionnaires (Mindful Attention and Awareness Scale (MAAS), Cognitive Failures Questionnaire (CFQ) and Driver Behaviour Questionnaire (DBQ)), as well as study-specific questions about mind wandering during different personal states and across a range of road and traffic situations. All respondents reported mind wandering during driving at least some of the time. Mind wandering was more likely to be reported on familiar roads than on unfamiliar roads and when drivers are tired. Drivers who reported relatively more mind wandering were younger, reported less mindful attention in daily life, more cognitive failures, and more driving violations and lapses. Together, the findings suggest that mind wandering is common in everyday driving, however any link with crash risk remains unclear. Future research using self-report and naturalistic methods could provide more insight into relationships between mind wandering, error and crash risk. Copyright © 2016 Elsevier Ltd. All rights reserved.

  10. Factors influencing primary health care professionals' physical activity promotion behaviors: a systematic review.

    Science.gov (United States)

    Huijg, Johanna M; Gebhardt, Winifred A; Verheijden, Marieke W; van der Zouwe, Nicolette; de Vries, Juriena D; Middelkoop, Barend J C; Crone, Mathilde R

    2015-02-01

    Despite the promising findings related to the efficacy of interventions aimed at promoting physical activity (PA) in primary health care (PHC), the translation of these interventions to PHC practice does not always happen as desired. To help understand why efficacious PHC-based PA interventions are not effectively translated to practice, this study systematically reviewed the literature on factors influencing PHC professionals' PA promotion practices. Literature searches were conducted in Web of Science, PubMed, and PsycINFO for peer-reviewed articles published in English from 1990 onwards. Studies were included that met the following criteria: (1) involving PHC-based PA interventions, and (2) reporting factors influencing PHC professionals' PA promotion behaviors. Two researchers independently screened studies and extracted data. A narrative synthesis using thematic analysis was conducted to identify factors. Of the 4,469 identified articles, 59 were included in the review. Factors were identified by qualitative methods, barrier/facilitator ratings, and the examination of the relationship between factors and PA promotion, and the effectiveness of introduction strategies. Many factors related to the development, delivery, and effects of the innovation, the sociopolitical and organizational culture, resources, and support, patient and PHC professional characteristics, and innovation strategies were identified as potential influences on PHC professionals' PA promotion practices. However, the lack of evidence on the relationship between factors and PA promotion indicated insufficient evidence on PA promotion determinants. This extensive overview of potential factors can inform intervention developers and implementers on which factors may play a role when introducing PA interventions in PHC. Future research should further investigate relationships between factors and PA promotion, which should be guided by qualitative in-depth knowledge on influencing factors.

  11. Differences in cardiovascular disease risk factor management in primary care by sex of physician and patient.

    Science.gov (United States)

    Tabenkin, Hava; Eaton, Charles B; Roberts, Mary B; Parker, Donna R; McMurray, Jerome H; Borkan, Jeffrey

    2010-01-01

    The purpose of this study was to evaluate differences in the management of cardiovascular disease (CVD) risk factors based upon the sex of the patient and physician and their interaction in primary care practice. We evaluated CVD risk factor management in 4,195 patients cared for by 39 male and 16 female primary care physicians in 30 practices in southeastern New England. Many of the sex-based differences in CVD risk factor management on crude analysis are lost once adjusted for confounding factors found at the level of the patient, physician, and practice. In multilevel adjusted analyses, styles of CVD risk factor management differed by the sex of the physician, with more female physicians documenting diet and weight loss counseling for hypertension (odds ratio [OR] = 2.22; 95% confidence interval [CI], 1.12-4.40) and obesity (OR = 2.14; 95% CI, 1.30-3.51) and more physical activity counseling for obesity (OR = 2.03; 95% CI, 1.30-3.18) and diabetes (OR = 6.55; 95% CI, 2.01-21.33). Diabetes management differed by the sex of the patient, with fewer women receiving glucose-lowering medications (OR = 0.49; 95% CI, 0.25-0.94), angiotensin-converting enzyme inhibitor therapy (OR = 0.39; 95% CI, 0.22-0.72), and aspirin prophylaxis (OR = 0.30; 95% CI, 0.15-0.58). Quality of care as measured by patients meeting CVD risk factors treatment goals was similar regardless of the sex of the patient or physician. Selected differences were found in the style of CVD risk factor management by sex of physician and patient.

  12. Prevalence and Risk Factors of Voice Problems Among Primary School Teachers in India.

    Science.gov (United States)

    Devadas, Usha; Bellur, Rajashekhar; Maruthy, Santosh

    2017-01-01

    Teachers are more prone to develop voice problems (VPs) when compared with other professional voice users. The aim of present study was to investigate the prevalence and risk factors of VPs among primary school teachers in India. Epidemiological cross-sectional survey. Self-reporting questionnaire data were collected from 1082 teachers. Out of 1082 teachers who participated in the present study, 188 teachers reported VPs that account for a prevalence rate of 17.4%. Tired voice after long hours of talking was the most frequently reported symptom, followed by sore/dry throat, strain in voice, neck muscle tension, and difficulty in projecting voice. The adjusted odds ratio values showed number of years of teaching, high background noise levels in the classroom, experiencing psychological stress while teaching classes, improper breath management (holding breath while speaking), poor focus of the tone (clenching jaw/teeth while speaking), upper respiratory tract infection, thyroid problems, and acid reflux as significant risk factors for the development of VPs in the current cohort of teachers. Current results suggest that teachers develop VPs due to multiple risk factors. These factors may be either biological, psychomotor, or environment-related factors. A holistic approach (which could include educating teachers about voice care during their training, and if they develop VP during their career, then managing the VP by taking into consideration different risk factors) addressing all these factors needs to be adopted to prevent VPs in primary school teachers. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  13. Pile Driving

    Science.gov (United States)

    1987-01-01

    Machine-oriented structural engineering firm TERA, Inc. is engaged in a project to evaluate the reliability of offshore pile driving prediction methods to eventually predict the best pile driving technique for each new offshore oil platform. Phase I Pile driving records of 48 offshore platforms including such information as blow counts, soil composition and pertinent construction details were digitized. In Phase II, pile driving records were statistically compared with current methods of prediction. Result was development of modular software, the CRIPS80 Software Design Analyzer System, that companies can use to evaluate other prediction procedures or other data bases.

  14. The importance of motivation factors in career development of primary and secondary school professionals

    Directory of Open Access Journals (Sweden)

    Petra Stepišnik

    2017-03-01

    Full Text Available This research examines the career motivation factors among Slovene teachers. They go hand in hand with two other processes: the psycho-social development of individuals and their family life. We present the results of the empirical research that was carried out on a sample of 360 professionals from primary and secondary schools. We established a scale for determining the importance of motivation factors by asking the professionals to grade their level of agreement with the statements considering the following motivational factors: the legislation and the organization of files in the context of school, the organisational climate and culture at schools, the school management, schools as learning organisations, the need of individuals for career development. We were interested if there exist any differences in the opinions of professionals in primary and secondary schools regarding the importance of individual motivation factors. We were also interested if there exists an interdependence between the final results and the individual variables. The findings are important for professionals and school management in schools that encourage career development. It would be sensible to take these findings into consideration when planning, as well as monitoring career development of school professionals.

  15. Occupational low back pain in primary and high school teachers: prevalence and associated factors.

    Science.gov (United States)

    Mohseni Bandpei, Mohammad A; Ehsani, Fatemeh; Behtash, Hamid; Ghanipour, Marziyeh

    2014-01-01

    The purposes of this study were to investigate the prevalence of and risk factors for low back pain (LBP) in teachers and to evaluate the association of individual and occupational characteristics with the prevalence of LBP. In this cross-sectional study, 586 asymptomatic teachers were randomly selected from 22 primary and high schools in Semnan city of Iran. Data on the personal, occupational characteristics, pain intensity, and functional disability as well as the prevalence and risk factors of LBP were collected using different questionnaires. Point, last month, last 6 months, annual, and lifetime prevalence rates of LBP were 21.8%, 26.3%, 29.6%, 31.1%, and 36.5%, respectively. The highest prevalence was obtained for the high school teachers. The prevalence of LBP was significantly associated with age, body mass index, job satisfaction, and length of employment (P teachers appears to be high. High school teachers were more likely to experience LBP than primary school teachers. Factors such as age, body mass index, length of employment, job satisfaction, and work-related activities were significant factors associated with LBP in this teacher population. Copyright © 2014 National University of Health Sciences. Published by Elsevier Inc. All rights reserved.

  16. Platelet-released growth factors inhibit proliferation of primary keratinocytes in vitro.

    Science.gov (United States)

    Bayer, Andreas; Tohidnezhad, Mersedeh; Berndt, Rouven; Lippross, Sebastian; Behrendt, Peter; Klüter, Tim; Pufe, Thomas; Jahr, Holger; Cremer, Jochen; Rademacher, Franziska; Simanski, Maren; Gläser, Regine; Harder, Jürgen

    2018-01-01

    Autologous thrombocyte concentrate lysates as platelet-released growth factors (PRGF) or Vivostat Platelet Rich Fibrin (PRF ® ) represent important tools in modern wound therapy, especially in the treatment of chronic, hard-to-heal or infected wounds. Nevertheless, underlying cellular and molecular mechanisms of the beneficial clinical effects of a local wound therapy with autologous thrombocyte concentrate lysates are poorly understood. Recently, we have demonstrated that PRGF induces antimicrobial peptides in primary keratinocytes and accelerates keratinocytes' differentiation. In the present study we analyzed the influence of PRGF on primary human keratinocytes' proliferation. Using the molecular proliferation marker Ki-67 we observed a concentration- and time dependent inhibition of Ki-67 gene expression in PRGF treated primary keratinocytes. These effects were independent from the EGFR- and the IL-6-R pathway. Inhibition of primary keratinocytes' proliferation by PRGF treatment was confirmed in colorimetric cell proliferation assays. Together, these data indicate that the clinically observed positive effects of autologous thrombocytes concentrates in the treatment of chronic, hard-to-heal wounds are not based on an increased keratinocytes proliferation. Copyright © 2017 Elsevier GmbH. All rights reserved.

  17. [Analysis of prevalence of self-reported hearing loss and associated factors: primary versus proxy informant].

    Science.gov (United States)

    Quevedo, André Luis Alves de; Leotti, Vanessa Bielefeldt; Goulart, Bárbara Niegia Garcia de

    2017-07-03

    The objective was to evaluate differences between prevalence rates for self-reported hearing loss and associated factors, obtained from responses by primary and proxy informants in a Population-Based Study on Human Communication Disorders (DCH-POP in Portuguese). This was a study on epidemiological methods using data from a cross-sectional household survey with a sample of 1,253 individuals from Southern Brazil. To verify differences between prevalence rates comparing primary informants and proxy informants, we used the chi-square or Fisher's exact test for categorical variables and Mann-Whitney for continuous variables. The log-binomial model was adjusted for hearing loss as the dependent variable, considering three datasets: the entire sample, only primary informants, and only proxy informants, estimating association by prevalence ratios. In the final models, only the independent variables age and dizziness were associated with hearing loss, independently of the dataset that was used. Proxy informants generally underestimated the prevalence rates for the target outcomes, when compared to primary informants.

  18. 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.

  19. Predictive Factors for Natural Pregnancy after Microsurgical Reconstruction in Patients with Primary Epididymal Obstructive Azoospermia

    Directory of Open Access Journals (Sweden)

    Mihai Harza

    2014-01-01

    Full Text Available Primary epididymal obstructive azoospermia (OA is the most prevalent form of OA in nonvasectomized patients and has been less studied. We aim to assess the results with microsurgical vasoepididymostomy used in the treatment of men diagnosed with primary epididymal obstructive azoospermia and to identify the factors associated with natural pregnancy occurring after microsurgical reconstruction. This prospective study included consecutive patients with epididymal OA who underwent microsurgical reconstruction in our center. Clinical and biological data were obtained every three months during follow-up. Occurrence of natural pregnancy was the primary study outcome. In total, 36 patients underwent microsurgical reconstruction. The mean age was 34±4.5 years (range 24–46 years. Median follow-up time was 15 [IQR 12–21] months. The total patency rate was 77.7% (n=28. During follow-up, 8 (22.2% natural pregnancies occurred. The overall live birth rate was 100%. Low FSH levels (HR: 0.22; 95% CI: 0.052–0.88; P=0.032 and higher total motile sperm count (TMSC (HR: 1.001; 95% CI 1–1.001; P=0.012 were associated with a higher rate of natural pregnancy. Our data suggest that microsurgical vasoepididymostomy is an effective therapy of primary epididymal OA. Baseline lower FSH and higher TMSC were independent predictors for natural pregnancy occurrence.

  20. Predictive factors for natural pregnancy after microsurgical reconstruction in patients with primary epididymal obstructive azoospermia.

    Science.gov (United States)

    Harza, Mihai; Voinea, Sebastian; Ismail, Gener; Gagiu, Cristian; Baston, Catalin; Preda, Adrian; Manea, Ioan; Priporeanu, Tiberiu; Sinescu, Ioanel

    2014-01-01

    Primary epididymal obstructive azoospermia (OA) is the most prevalent form of OA in nonvasectomized patients and has been less studied. We aim to assess the results with microsurgical vasoepididymostomy used in the treatment of men diagnosed with primary epididymal obstructive azoospermia and to identify the factors associated with natural pregnancy occurring after microsurgical reconstruction. This prospective study included consecutive patients with epididymal OA who underwent microsurgical reconstruction in our center. Clinical and biological data were obtained every three months during follow-up. Occurrence of natural pregnancy was the primary study outcome. In total, 36 patients underwent microsurgical reconstruction. The mean age was 34 ± 4.5 years (range 24-46 years). Median follow-up time was 15 [IQR 12-21] months. The total patency rate was 77.7% (n = 28). During follow-up, 8 (22.2%) natural pregnancies occurred. The overall live birth rate was 100%. Low FSH levels (HR: 0.22; 95% CI: 0.052-0.88; P = 0.032) and higher total motile sperm count (TMSC) (HR: 1.001; 95% CI 1-1.001; P = 0.012) were associated with a higher rate of natural pregnancy. Our data suggest that microsurgical vasoepididymostomy is an effective therapy of primary epididymal OA. Baseline lower FSH and higher TMSC were independent predictors for natural pregnancy occurrence.

  1. Variability in operation-based NO(x) emission factors with different test routes, and its effects on the real-driving emissions of light diesel vehicles.

    Science.gov (United States)

    Lee, Taewoo; Park, Junhong; Kwon, Sangil; Lee, Jongtae; Kim, Jeongsoo

    2013-09-01

    The objective of this study is to quantify the differences in NO(x) emissions between standard and non-standard driving and vehicle operating conditions, and to estimate by how much NO(x) emissions exceed the legislative emission limits under typical Korean road traffic conditions. Twelve Euro 3-5 light-duty diesel vehicles (LDDVs) manufactured in Korea were driven on a chassis dynamometer over the standard New European Driving Cycle (NEDC) and a representative Korean on-road driving cycle (KDC). NO(x) emissions, average speeds and accelerations were calculated for each 1-km trip segment, so called averaging windows. The results suggest that the NO(x) emissions of the tested vehicles are more susceptible to variations in the driving cycles than to those in the operating conditions. Even under comparable operating conditions, the NO(x) control capabilities of vehicles differ from each other, i.e., NO(x) control is weaker for the KDC than for the NEDC. The NO(x) emissions over the KDC for given vehicle operating conditions exceed those over the NEDC by more than a factor of 8. Consequently, on-road NO(x) emission factors are estimated here to exceed the Euro 5 emission limit by up to a factor of 8, 4 and 3 for typical Korean urban, rural, and motorway road traffic conditions, respectively. Our findings support the development of technical regulations for supplementary real-world emission tests for emission certification and the corresponding research actions taken by automotive industries. Copyright © 2013 Elsevier B.V. All rights reserved.

  2. Role of Anatomic and Salivary Factors in Dental Calculus Formation in Primary and Mixed Dentition Stages.

    Science.gov (United States)

    Afshar, Hossein; Ghandehari, Mehdi; Khorsand, Afshin; Ansari, Ghassem; Nahvi, Azam; Baniameri, Zahra

    2016-01-01

    Clinical experience shows that formation of calculus is a very rare phenomenon in primary teeth, but it increases as the permanent teeth erupt. The purpose of this study was to assess the relationship between dental calculus, dental anatomy, and salivary factors in primary and mixed dentition stages. A cross-sectional study was carried out to determine the buccolingual dimensions of the most concave and the most convex surfaces of the lingual aspect of mandibular central incisor crowns in a sample group of 120 three- to five-old children and 120 eight- to 10-year old children. Saliva samples were collected from 20 in each group. Data were analyzed using t tests. Significant differences were found between the ratio of the buccolingual dimensions of the most convex to the most concave areas of the lingual surfaces in primary and permanent incisors (P=0.028). Saliva analysis revealed significant differences in total protein (P=0.002), sodium (P=0.037), bicarbonate (P=0.003), and ammonia (P=0.025) between the two age groups. Anatomic and salivary factors may be important reasons for the differences in calculus formation.

  3. Cardiovascular risk factor assessment after pre-eclampsia in primary care

    Directory of Open Access Journals (Sweden)

    Numans Mattijs E

    2009-12-01

    Full Text Available Abstract Background Pre-eclampsia is associated with an increased risk of development of cardiovascular disease later in life. It is not known how general practitioners in the Netherlands care for these women after delivery with respect to cardiovascular risk factor management. Methods Review of medical records of 1196 women in four primary health care centres, who were registered from January 2000 until July 2007 with an International Classification of Primary Care (ICPC code indicating pregnancy. Records were searched for indicators of pre-eclampsia. Of those who experienced pre-eclampsia and of a random sample of 150 women who did not, the following information on cardiovascular risk factor management after pregnancy was extracted from the records: frequency and timing of blood pressure, cholesterol and glucose measurements - and vascular diagnoses. Additionally the sensitivity and specificity of ICPC coding for pre-eclampsia were determined. Results 35 women experienced pre-eclampsia. Blood pressure was more often checked after pregnancy in these women than in controls (57.1% vs. 12.0%, p Conclusion Despite the evidence of increased risk of future cardiovascular disease in women with a history of pre-eclampsia, follow-up of these women is insufficient and undeveloped in primary care in the Netherlands.

  4. Factors affecting job satisfaction among primary and secondary school teachers in the autonomous province of Vojvodina

    Directory of Open Access Journals (Sweden)

    Majstorović Nebojša Z.

    2017-01-01

    Full Text Available The study presented in this paper analyses the impact of the individual factors of mental and physical health and life satisfaction, as well as the importance of some organizational factors such as the climate in schools, the composition of classes in the case of class teachers, and certain demographic characteristics on primary and secondary school teachers' job satisfaction. The data were collected from a convenience sample of 176 teachers of primary and secondary schools in Serbia's autonomous province of Vojvodina, of different ages, genders, and years of service. The principal results indicate that job satisfaction is higher among teachers who perceive the climate in their school as positive, among teachers with higher life satisfaction, and among teachers who are in good health and, most importantly, lacking depressive reactions. When it comes to perceptions of the climate, the best predictor of job satisfaction is the degree of respondents' satisfaction with collaboration with colleagues and with decision making processes. The results also indicate that secondary school teachers report a higher level of overall job satisfaction, specifically, a higher level of satisfaction with school governance, co-workers and communication than primary school teachers. As regards demographic characteristics, the results suggest that there are no significant gender differences in job satisfaction levels and that job satisfaction declines with the number of years of service, with respondents who had between 21 and 30 years of service reporting the lowest levels of job satisfaction, which tended to rise towards the end of the teaching career.

  5. PWSCC Growth Assessment Model Considering Stress Triaxiality Factor for Primary Alloy 600 Components

    Directory of Open Access Journals (Sweden)

    Jong-Sung Kim

    2016-08-01

    Full Text Available We propose a primary water stress corrosion cracking (PWSCC initiation model of Alloy 600 that considers the stress triaxiality factor to apply to finite element analysis. We investigated the correlation between stress triaxiality effects and PWSCC growth behavior in cold-worked Alloy 600 stream generator tubes, and identified an additional stress triaxiality factor that can be added to Garud's PWSCC initiation model. By applying the proposed PWSCC initiation model considering the stress triaxiality factor, PWSCC growth simulations based on the macroscopic phenomenological damage mechanics approach were carried out on the PWSCC growth tests of various cold-worked Alloy 600 steam generator tubes and compact tension specimens. As a result, PWSCC growth behavior results from the finite element prediction are in good agreement with the experimental results.

  6. Factors of Innate and Adaptive Local Immunity in Children with Primary Deficiencies of Antibody Formation

    Directory of Open Access Journals (Sweden)

    L.I. Chernyshova

    2013-10-01

    Full Text Available In 40 children with various types of primary immunodeficiencies (PID of antibody formation we examined factors of local immunity in saliva. It is found that in the saliva of children with PID of antibody formation in comparison with immunocompetent children the concentration of factors of adaptive immunity is significantly reduced. Lack of adaptive immunity in the PID of antibody formation to some extent is compensated by increased concentrations of innate immune factors on the mucous membranes — the free Sc, as well as lactoferrin in selective immunodeficiency of IgA. At PID of antibody formation we observed increased TNF-α level in the saliva, which may indicate the persistence of local inflammation on the membranes of the respiratory tract.

  7. Occupational and environmental risk factors of adult primary brain cancers: a systematic review.

    Science.gov (United States)

    Gomes, J; Al Zayadi, A; Guzman, A

    2011-04-01

    The incidence of brain neoplasm has been progressively increasing in recent years in the industrialized countries. One of the reasons for this increased incidence could be better access to health care and improved diagnosis in the industrialized countries. It also appears that Caucasians have a higher incidence than blacks or Hispanics or Asians. A number of risk factors have been identified and described including the genetic, ethnic and age-based factors. Certain occupational and environmental factors are also believed to influence the risk of primary adult brain tumors. Potential occupational and environmental factors include exposure to diagnostic and therapeutic radiations, electromagnetic radiation from cellular phones and other wireless devices, infectious agents, air pollution and residence near landfills and high-voltage power lines and jobs as firefighters, farmers, physician, chemists and jobs in industries such as petrochemical, power generation, synthetic rubber manufacturing, agricultural chemicals manufacturing. The purpose of this systematic review is to examine occupational and environmental risk factors of brain neoplasm. A range of occupational and environmental exposures are evaluated for significance of their relationship with adult primary brain tumors. On the basis of this review we suggest a concurrent evaluation of multiple risk factors both within and beyond occupational and environmental domains. The concurrent approach needs to consider better exposure assessment techniques, lifetime occupational exposures, genotypic and phenotypic characteristics and lifestyle and dietary habits. This approach needs to be interdisciplinary with contributions from neurologists, oncologists, epidemiologists and molecular biologists. Conclusive evidence that has eluded multitude of studies with single focus and single exposure needs to multifaceted and multidisciplinary.

  8. Factors associated with student learning processes in primary health care units: a questionnaire study.

    Science.gov (United States)

    Bos, Elisabeth; Alinaghizadeh, Hassan; Saarikoski, Mikko; Kaila, Päivi

    2015-01-01

    Clinical placement plays a key role in education intended to develop nursing and caregiving skills. Studies of nursing students' clinical learning experiences show that these dimensions affect learning processes: (i) supervisory relationship, (ii) pedagogical atmosphere, (iii) management leadership style, (iv) premises of nursing care on the ward, and (v) nursing teachers' roles. Few empirical studies address the probability of an association between these dimensions and factors such as student (a) motivation, (b) satisfaction with clinical placement, and (c) experiences with professional role models. The study aimed to investigate factors associated with the five dimensions in clinical learning environments within primary health care units. The Swedish version of Clinical Learning Environment, Supervision and Teacher, a validated evaluation scale, was administered to 356 graduating nursing students after four or five weeks clinical placement in primary health care units. Response rate was 84%. Multivariate analysis of variance is determined if the five dimensions are associated with factors a, b, and c above. The analysis revealed a statistically significant association with the five dimensions and two factors: students' motivation and experiences with professional role models. The satisfaction factor had a statistically significant association (effect size was high) with all dimensions; this clearly indicates that students experienced satisfaction. These questionnaire results show that a good clinical learning experience constitutes a complex whole (totality) that involves several interacting factors. Supervisory relationship and pedagogical atmosphere particularly influenced students' satisfaction and motivation. These results provide valuable decision-support material for clinical education planning, implementation, and management. Copyright © 2014 Elsevier Ltd. All rights reserved.

  9. Repressive coping among British college women: A potential protective factor against body image concerns, drive for thinness, and bulimia symptoms.

    Science.gov (United States)

    Mohiyeddini, Changiz

    2017-09-01

    Repressive coping, as a means of preserving a positive self-image, has been widely explored in the context of dealing with self-evaluative cues. The current study extends this research by exploring whether repressive coping is associated with lower levels of body image concerns, drive for thinness, bulimic symptoms, and higher positive rational acceptance. A sample of 229 female college students was recruited in South London. Repressive coping was measured via the interaction between trait anxiety and defensiveness. The results of moderated regression analysis with simple slope analysis show that compared to non-repressors, repressors reported lower levels of body image concerns, drive for thinness, and bulimic symptoms while exhibiting a higher use of positive rational acceptance. These findings, in line with previous evidence, suggest that repressive coping may be adaptive particularly in the context of body image. Copyright © 2017 Elsevier Ltd. All rights reserved.

  10. The concept of the death drive: a clinical perspective.

    Science.gov (United States)

    Kernberg, Otto

    2009-10-01

    This paper discusses Freud 's theory of the death drive in the light of clinical experience with severely self-destructive personality disorders, and contemporary object relations theory. Repetition compulsion, sadism and masochism, negative therapeutic reaction, suicide in depressed and in non-depressed patients, and destructive group processes are explored from this perspective. The paper concludes that the concept of the death drive is clinically relevant, but that this condition needs to be traced to the general dominance of aggressive affects as the primary etiological factor; only under severely pathological circumstances does this dominance lead to a focused drive to self-destruct.

  11. Q-factor of coolant flow in the primary circuit of NPP with pressurised water reactors

    International Nuclear Information System (INIS)

    Proskuryakov, K.N.; Belikov, S.O.; Novikov, K.S.

    2011-01-01

    Systems of preoperational vibration dynamic monitoring in of WWER are presented. The results of measurements during commission of NPP with WWER are presented. The paper provides the result of the research, that estimation of coolant fluctuations caused by pulse perturbation of pressure in the primary circuit NPP. It is shown that results could be received at known value of a Q - factor of acoustical oscillatory system only. The research demonstrates the results of dependence of the sound speed from the mass steam content in the coolant flow thru reactor core. The worked out results can be used for identification of the reasons of abnormal growth of level of vibrations of fuel assembly, fuel rod, equipment and internals, and for forecasting the operation conditions which provide of vibration - acoustical resonances in the primary loop equipment. (author)

  12. Primary care specialty career choice among Canadian medical students: Understanding the factors that influence their decisions.

    Science.gov (United States)

    Osborn, Heather Ann; Glicksman, Jordan T; Brandt, Michael G; Doyle, Philip C; Fung, Kevin

    2017-02-01

    To identify which factors influence medical students' decision to choose a career in family medicine and pediatrics, and which factors influence their decision to choose careers in non-front-line specialties. Survey that was created based on a comprehensive literature review to determine which factors are considered important when choosing practice specialty. Ontario medical school. An open cohort of medical students in the graduating classes of 2008 to 2011 (inclusive). The main factors that influenced participants' decision to choose a career in primary care or pediatrics, and the main factors that influenced participants' decision to choose a career in a non-front-line specialty. A total of 323 participants were included in this study. Factors that significantly influenced participants' career choice in family medicine or pediatrics involved work-life balance (acceptable hours of practice [ P = .005], acceptable on-call demands [ P = .012], and lifestyle flexibility [ P = .006]); a robust physician-patient relationship (ability to promote individual health promotion [ P = .014] and the opportunity to form long-term relationships [ P  < .001], provide comprehensive care [ P = .001], and treat patients and their families [ P = .006]); and duration of residency program ( P = .001). The career-related factors that significantly influenced participants' decision to choose a non-front-line specialty were as follows: becoming an expert ( P  < .001), maintaining a focused scope of practice ( P  < .001), having a procedure-focused practice ( P = .001), seeing immediate results from one's actions ( P  < .001), potentially earning a high income ( P  < .001), and having a perceived status among colleagues ( P  < .001). In this study, 8 factors were found to positively influence medical students' career choice in family medicine and pediatrics, and 6 factors influenced the decision to choose a career in a non-front-line specialty. Medical students can be

  13. A STUDY ON PLASMA 25 - HYDROXY VITAMIN D LEVELS AS A RISK FACTOR IN PRIMARY HYPERTENSION

    Directory of Open Access Journals (Sweden)

    Ravinandana Gowda

    2015-07-01

    Full Text Available BACKGROUND: Recent research shows that vitamin D deficiency could be a risk factor in many chronic diseases like hypertension, diabetes mellitus, dyslipidemia, cardiovascular disease, some cancers, auto immune disease and tuberculosis. AIMS AND OBJECTIVES: To determine serum 25 - hydroxy vitamin D levels in patients with primary hypertension. This study also attempts to demonstrate an inverse co - relation between vitamin D levels and primary hypertension. MATERIALS AND METHOD S: 30 patients who are primary hype rtensive were selected, their vitamin D levels measured and the vitamin D levels were compared to age and sex matched non hypertensive controls. STATISTICAL METHODS: Descriptive and inferential statistical analysis has been carried out in the present study . ANOVA test and Chi - square test was applied for quantitative and qualitative data respectively to find significant associations between two variables. RESULTS: It is seen from this study that serum vitamin D levels was lower in hypertensive patients when compared to non - hypertensive controls. Hypertensive patients had lower levels of vitamin D with vitamin D status of deficiency in 50% of the cases and insufficiency in 43.3% of the cases and normal levels in 6.7% of the cases. Non hypertensive controls sho wed vitamin D status of normal in 66.7% of controls and insufficiency in 33.3% of the controls without deficiency. Age of the cases, duration of hypertension, systolic blood pressure and diastolic blood pressure inversely correlated to vitamin D levels. Bo dy mass index, diet of the patient, alcohol consumption, number of anti - hypertensive drugs, drug compliance, family history of hypertension and fundus status did not correlate to vitamin D levels. CONCLUSIONS: Based on the observations of the study, Vitami n D is an independent risk factor that is associated with primary or essential hypertension. The level of vitamin D also correlated inversely to age, duration of

  14. Factors associated with strabismus after cataract extraction and primary intraocular lens implantation in congenital cataracts

    Directory of Open Access Journals (Sweden)

    Soo Jung Lee

    2014-06-01

    Full Text Available AIM: To evaluate factors associated with the development of strabismus after cataract extraction and primary intraocular lens implantation.METHODS: The medical records of 122 patients, aged 1.5mo to 9y, who had undergone cataract extraction with primary intraocular lens implantation between January 1993 and August 2011 were reviewed. Fourteen patients (17 eyes with strabismus before cataract surgery were excluded. Patients were divided into those with congenital bilateral cataracts (64 patients, 128 eyes and those with unilateral cataracts (44 patients, 44 eyes. The associations between the development of strabismus and age at cataract surgery, pre- and post-cataract extraction corrected distance visual acuity (CDVA, interocular CDVA difference, nystagmus, surgical method, and secondary cataract were evaluated.RESULTS: Factors significantly associated with the development of strabismus included age at cataract surgery (≤1y, preoperative mean CDVA ≤20/100, presence of nystagmus in the bilateral cataract group and postoperative interocular CDVA difference >20/70 in the unilateral group. Postoperative CDVA ≤20/100 and preservation of posterior capsule, and presence of secondary cataract were significant factors in both groups.CONCLUSION: Children with congenital cataracts should be monitored carefully after cataract surgery for the development of strabismus, especially when they underwent surgery at age ≤1y, and they have nystagmus, large postoperative interocular CDVA difference, poor preoperative and postoperative CDVA, preservation of the posterior capsule, or secondary cataract.

  15. [Relevant factors of early puberty timing in urban primary schools in Chongqing].

    Science.gov (United States)

    Luo, Yan; Liu, Qin; Wen, Yi; Liu, Shudan; Lei, Xun; Wang, Hong

    2016-05-01

    To investigate the status of puberty timing and relevant factors of early puberty timing in children from grade one to four in urban primary schools of Chongqing. According to the purposive sample method, four urban primary schools in Chongqing were selected and of which 1471 children from grade one to four who have obtained informed consent were recruited. Questionnaire survey on social-demographic characteristics and family environment (e.g., age, parents' relationship, diet and lifestyle, etc), and Pubertal Development Scale (PDS) survey and physical examination (measurements of height, weight, pubertal development status, etc) were conducted. P25, P50, P75 ages of each important pubertal event were calculated by probit regression. Univariate and multivariate analysis were used to analyze relevant factors. The detection rate of early puberty timing was 17.7%, and the median ages of the onset of breast and testicular development were 10.77 and 11.48 years old, respectively. Multivariate logistic regression showed that early puberty timing occurred more likely in girls than in boys (OR = 0.561, 95% CI 0.406-0.774), and bad relationship between parents (OR = 1.320, 95% CI 1.007-1.729) and hair-products-use (OR = 1.685, 95%, CI 1.028-2.762) were risk factors of early puberty timing. Early onset of puberty in urban Chongqing is still exist. Gender, parents' relationship, and hair-products-use have an essential impact on early puberty timing.

  16. Local environment and social factors in primary school children's afterschool commute in China

    Directory of Open Access Journals (Sweden)

    John Zacharias

    2017-09-01

    Full Text Available The rapid decline in young children's active commutes to and from school has prompted investigations into ways to raise activity levels. The period after school is recognized as very important in the daily activity regime of primary school children. In this study, we examine the relative effects of local environmental factors and socio-economic status on children's after-school commute mode choice. Environmental factors are pedestrian priority streets, street intersection density, motorways, shops, and play spaces. Property values are used as a proxy for income. Twenty-four school districts are selected using intersection density and motorway length as criteria. All children's exit behaviors were film-recorded on October weekdays and extracted as four choices–alone, in a group of children, on foot with a parent or guardian, on e-bike driven by an adult. A multinomial logistic regression reveals that gated communities, higher priced housing, motorways and bus stops are associated with children accompanied by adults. The presence of pedestrian streets is associated with children travelling alone and in groups. Greater travel distance is also associated with parents accompanying children on foot or on e-bike. The amount of play space is associated with children leaving school in groups. Overall, social and environmental factors are influential in the independent travel of primary school children after the school day ends in south China.

  17. Predictive factors of user acceptance on the primary educational mathematics aids product

    Science.gov (United States)

    Hidayah, I.; Margunani; Dwijanto

    2018-03-01

    Mathematics learning in primary schools requires instructional media. According to Piaget's theory, students are still in the concrete operational stage. For this reason, the development of the primary level mathematics aids is needed to support the development of successful mathematics learning. The stages of this research are the stages of commercialization with preparatory, marketing, and measurement analysis procedures. Promotion as part of marketing is done by doing a demonstration to the teacher. Measurements were performed to explore the predictive factors of user feasibility in adopting the product. Measurements were conducted using the concept of Technology Acceptance Model (TAM). Measurement variables include external variables, perceived usefulness, perceived ease of use, attitude, intention to use, and actual use. The result of this research shows that the contribution of predictive factors of mathematics teachers on the teaching aids product as follows: the external variable and perceived ease of use at 74%, perceived usefulness at 72%, intention to use (behavioral) at 58%, attitude at 52%, and the consequence factor (actual use) at 42%.

  18. [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.

  19. Do in-car devices affect experienced users' driving performance?

    Directory of Open Access Journals (Sweden)

    Allert S. Knapper

    2015-07-01

    Full Text Available Distracted driving is considered to be an important factor in road safety. To investigate how experienced user's driving behaviour is affected by in-vehicle technology, a fixed-base driving simulator was used. 20 participants drove twice in a rich simulated traffic environment while performing secondary, i.e. mobile phone and navigation system tasks. The results show that mean speed was lower in all experimental conditions, compared to baseline driving, while subjective effort increased. Lateral performance deteriorated only during visual–manual tasks, i.e. texting and destination entry, in which the participants glanced off the forward road for a substantial amount of time. Being experienced in manipulating in-car devices does not solve the problem of dual tasking when the primary task is a complex task like driving a moving vehicle. The results and discussion may shed some light on the current debate regarding phone use hazards.

  20. Control rod drive

    International Nuclear Information System (INIS)

    Hawke, B.C.

    1986-01-01

    A reactor core, one or more control rods, and a control rod drive are described for selectively inserting and withdrawing the one or more control rods into and from the reactor core, which consists of: a support structure secured beneath the reactor core; control rod positioning means supported by the support structure for movably supporting the control rod for movement between a lower position wherein the control rod is located substantially beneath the reactor core and an upper position wherein at least an upper portion of the control rod extends into the reactor core; transmission means; primary drive means connected with the control rod positioning means by the transmission means for positioning the control rod under normal operating conditions; emergency drive means for moving the control rod from the lower position to the upper position under emergency conditions, the emergency drive means including a weight movable between an upper and a lower position, means for movably supporting the weight, and means for transmitting gravitational force exerted on the weight to the control rod positioning means to move the control rod upwardly when the weight is pulled downwardly by gravity; the transmission means connecting the control rod positioning means with the emergency drive means so that the primary drive means effects movement of the weight and the control rod in opposite directions under normal conditions, thus providing counterbalancing to reduce the force required for upward movement of the control rod under normal conditions; and restraint means for restraining the fall of the weight under normal operating conditions and disengaging the primary drive means to release the weight under emergency conditions

  1. Electric-Drive Vehicles

    Energy Technology Data Exchange (ETDEWEB)

    Septon, Kendall K [National Renewable Energy Laboratory (NREL), Golden, CO (United States)

    2017-09-11

    Electric-drive vehicles use electricity as their primary fuel or to improve the efficiency of conventional vehicle designs. These vehicles can be divided into three categories: Hybrid electric vehicles (HEVs), Plug-in hybrid electric vehicles (PHEVs), All-electric vehicles (EVs). Together, PHEVs and EVs can also be referred to as plug-in electric vehicles (PEVs).

  2. Electric-Drive Vehicles

    Energy Technology Data Exchange (ETDEWEB)

    None

    2017-09-01

    Electric-drive vehicles use electricity as their primary fuel or to improve the efficiency of conventional vehicle designs. These vehicles can be divided into three categories: Hybrid electric vehicles (HEVs), Plug-in hybrid electric vehicles (PHEVs), All-electric vehicles (EVs). Together, PHEVs and EVs can also be referred to as plug-in electric vehicles (PEVs).

  3. Socioeconomic status and geographical factors associated with active listing in primary care: a cross-sectional population study accounting for multimorbidity, age, sex and primary care.

    Science.gov (United States)

    Ranstad, Karin; Midlöv, Patrik; Halling, Anders

    2017-06-09

    Socioeconomic status and geographical factors are associated with health and use of healthcare. Well-performing primary care contributes to better health and more adequate healthcare. In a primary care system based on patient's choice of practice, this choice (listing) is a key to understand the system. To explore the relationship between population and practices in a primary care system based on listing. Cross-sectional population-based study. Logistic regressions of the associations between active listing in primary care, income, education, distances to healthcare and geographical location, adjusting for multimorbidity, age, sex and type of primary care practice. Population over 15 years (n=123 168) in a Swedish county, Blekinge (151 731 inhabitants), in year 2007, actively or passively listed in primary care. The proportion of actively listed was 68%. Actively listed in primary care on 31 December 2007. Highest ORs for active listing in the model including all factors according to income had quartile two and three with OR 0.70 (95% CI 0.69 to 0.70), and those according to education less than 9 years of education had OR 0.70 (95% CI 0.68 to 0.70). Best odds for geographical factors in the same model had municipality C with OR 0.85 (95% CI 0.85 to 0.86) for active listing. Akaike's Information Criterion (AIC) was 124 801 for a model including municipality, multimorbidity, age, sex and type of practice and including all factors gave AIC 123 934. Higher income, shorter education, shorter distance to primary care or longer distance to hospital is associated with active listing in primary care.Multimorbidity, age, geographical location and type of primary care practice are more important to active listing in primary care than socioeconomic status and distance to healthcare. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  4. Factors associated with integrating self-management support into primary care.

    Science.gov (United States)

    Crespo, Richard; Shrewsberry, Molly

    2007-06-01

    The purpose of this article is to expand the understanding of self-management support by describing factors that contribute to implementing a comprehensive self-management program in primary care. Four rural health centers in medically underserved areas participated in a study to document the implementation of a self-management program. This program consisted of a social marketing plan and decision-making tools to guide patients in making self-management behavior changes. The stages of change constructs of the transtheoretical model were used to design the social marketing plan. Key informant interviews were conducted at 6-month and 9-month intervals to document the implementation process. A standardized set of questions was used in the interviews. The data from the interviews were analyzed using content analysis techniques. One of the principle findings is that self-management support requires putting a system in place, not just adding a new component to primary care. The health centers that fully implemented the self-management program made an organizational commitment to keep self-management on the agenda in management meetings, clinical staff set the example by adopting self-management behaviors, and patient self-management support was implemented in multiple patient care venues. Primary care centers with limited financial resources are able to integrate self-management support into their system of chronic illness care.

  5. FACTORS THAT INFLUENCE THE SELECTION OF LEARNING OPPORTUNITIES FOR STUDENT NURSES IN PRIMARY HEALTH CARE

    Directory of Open Access Journals (Sweden)

    H. lita

    2002-11-01

    The study therefore focused on the following objective: To identify the factors that influence the selection of learning opportunities for primary health care in hospital units. A qualitative research design utilising focus group discussions were used. The population consisted of conveniently selected lecturers, student nurses and registered nurses. The same initial question was asked in each focus group to initiate the discussions. The data were analysed according to Tesch's method. The results indicated that there is positive commitment from the lecturers and registered nurses to be involved in selecting appropriate learning opportunities. The student nurses also demonstrated a willingness to learn and to be exposed to learning opportunities in primary health care. There were however certain constraints that emerged as themes, namely: • Managerial constraints • Educational constraints Under the theme "managerial constraints" categories such as workload, nursing staff shortages and communication problems were identified. Under the theme "educational constraints" categories such as a lack of guidance, and the correlation of theory and practice emerged. Recommendations based on this research report include improvement of in-service education on managerial and educational aspects to facilitate the primary health care approach in hospitals.

  6. Nuclear Power and Resource Efficiency—A Proposal for a Revised Primary Energy Factor

    Directory of Open Access Journals (Sweden)

    Ola Eriksson

    2017-06-01

    Full Text Available Measuring resource efficiency can be achieved using different methods, of which primary energy demand is commonly used. The primary energy factor (PEF is a figure describing how much energy from primary resources is being used per unit of energy delivered. The PEF for nuclear power is typically 3, which refers to thermal energy released from fission in relation to electricity generated. Fuel losses are not accounted for. However; nuclear waste represents an energy loss, as current plans for nuclear waste management mostly include final disposal. Based on a literature review and mathematical calculations of the power-to-fuel ratio for nuclear power, PEF values for the open nuclear fuel cycle (NFC option of nuclear power and different power mixes are calculated. These calculations indicate that a more correct PEF for nuclear power would be 60 (range 32–88; for electricity in Sweden (41% nuclear power PEF would change from 1.8 to 25.5, and the average PEF for electricity in the European Union (EU would change from 2.5 to 18. The results illustrate the poor resource efficiency of nuclear power, which paves the way for the fourth generation of nuclear power and illustrates the policy implication of using PEFs which are inconsistent with current waste management plans.

  7. Investigation of the Psychosocial Factors Affecting High Risk Driving Behaviors in Adolescents in the City of Tehran, 2014

    Directory of Open Access Journals (Sweden)

    Seyyed Mohammad Hossein Javadi

    2017-10-01

    Conclusion: Among predictor variables aggression, law breaking behavior, and national religious identity can better predict driving accidents, attitude toward law, and high risk behaviors. Aggression, attitude, and law breaking behavior are considered as abnormal behaviors that lead to legal problems, delinquencies, substance abuse and other destructive behaviors among adolescents and consequently cause damage, injury and disabilities in themselves and others. Moreover, involvement in aggressive behaviors can play a critical role in creating and exacerbating new behavioral problems in adolescents, and those problems are carried over immutably at the later stages of their life.

  8. Factors associated with motor performance among overweight and nonoverweight Tyrolean primary school children.

    Science.gov (United States)

    Ruedl, Gerhard; Greier, Klaus; Kirschner, Werner; Kopp, Martin

    2016-01-01

    The increasing prevalence of overweight and obesity among children is often associated with motor deficits. Motor performance among children partly depends on modifiable factors, for example, weight status, electronic media use, sports club participation, and on nonmodifiable factors, for example, sex, age, migration background, or socio-economic status. To evaluate factors associated with motor performance among overweight and nonoverweight Tyrolean primary school children. Height, weight, and sport motor performance of primary school children were measured using the German motor performance test DMT 6-18. In addition, children were asked about migration background, sports club participation, and electronic media use in their room. A total of 304 children (48.7% girls) with a mean age of 8.0 ± 1.2 years were tested. In total, 61 (20.1%) children were overweight or obese. Regarding motor performance, nonoverweight children showed significantly higher total z-scores (106.8 ± 5.7 vs. 102.4 ± 6.8). For the total cohort, results of the multiple linear regression analysis (R (2) = 0.20) revealed that factors male sex (β = 0.12), nonoverweight children (β = 0.28), higher school grade (β = 0.23), sports club participation (β = 0.18),and > 2 weekly lessons of physical education (β = 0.26) were associated with an increased motor performance. For nonoverweight children results of the multiple linear regression analysis (R (2) = 0.09) found that a higher school grade (β = 0.17), sports club participation (β = 0.16),and more than 2 weekly lessons of physical education (β = 0.22) were associated with an increased motor performance. For the overweight children, results of the multiple linear regression analysis (R (2) = 0 .43) showed that no migration background (β = 0.23), a higher school grade (β = 0.55), sports club participation (β = 0.33) and more than 2 weekly lessons of physical

  9. Impact of remuneration and organizational factors on completing preventive manoeuvres in primary care practices.

    Science.gov (United States)

    Dahrouge, Simone; Hogg, William E; Russell, Grant; Tuna, Meltem; Geneau, Robert; Muldoon, Laura K; Kristjansson, Elizabeth; Fletcher, John

    2012-02-07

    Several jurisdictions attempting to reform primary care have focused on changes in physician remuneration. The goals of this study were to compare the delivery of preventive services by practices in four primary care funding models and to identify organizational factors associated with superior preventive care. In a cross-sectional study, we included 137 primary care practices in the province of Ontario (35 fee-for-service practices, 35 with salaried physicians [community health centres], 35 practices in the new capitation model [family health networks] and 32 practices in the established capitation model [health services organizations]). We surveyed 288 family physicians. We reviewed 4108 randomly selected patient charts and assigned prevention scores based on the proportion of eligible preventive manoeuvres delivered for each patient. A total of 3284 patients were eligible for at least one of six preventive manoeuvres. After adjusting for patient profile and contextual factors, we found that, compared with prevention scores in practices in the new capitation model, scores were significantly lower in fee-for-service practices (β estimate for effect on prevention score = -6.3, 95% confidence interval [CI] -11.9 to -0.6) and practices in the established capitation model (β = -9.1, 95% CI -14.9 to -3.3) but not for those with salaried remuneration (β = -0.8, 95% CI -6.5 to 4.8). After accounting for physician characteristics and organizational structure, the type of funding model was no longer a statistically significant factor. Compared with reference practices, those with at least one female family physician (β = 8.0, 95% CI 4.2 to 11.8), a panel size of fewer than 1600 patients per full-time equivalent family physician (β = 6.8, 95% CI 3.1 to 10.6) and an electronic reminder system (β = 4.6, 95% CI 0.4 to 8.7) had superior prevention scores. The effect of these three factors was largely but not always consistent across the funding models; it was largely

  10. Prognostic factors for survival among patients with primary bone sarcomas of small bones

    Directory of Open Access Journals (Sweden)

    Wang Z

    2018-05-01

    predictors of CSS. However, no significant differences were observed in OS and CSS among patients with different primary tumor locations and tumor subtypes. Additionally, the most significant prognostic factor was whether metastasis had occurred at the time of initial diagnosis. Conclusion: Among patients with primary bone sarcomas of the hands or feet, younger age (<40 years, localized stage, low grade, surgical treatment, and first primary tumor are favorable factors for prolonging survival. Keywords: chondrosarcoma, Ewing sarcoma, osteosarcoma, short bone, prognosis

  11. Risk factors for perioperative hyperglycemia in primary hip and knee replacements

    Science.gov (United States)

    Jämsen, Esa; Nevalainen, Pasi I; Eskelinen, Antti; Kalliovalkama, Jarkko; Moilanen, Teemu

    2015-01-01

    Background and purpose Background and purpose — Perioperative hyperglycemia has been associated with adverse outcomes in several fields of surgery. In this observational study, we identified factors associated with an increased risk of hyperglycemia following hip and knee replacement. Patients and methods Patients and methods — We prospectively monitored changes in glucose following primary hip and knee replacements in 191 patients with osteoarthritis. Possible associations of patient characteristics and operation-related factors with hyperglycemia (defined as glucose > 7.8 mmol/L in 2 consecutive measurements) and severe hyperglycemia (glucose > 10 mmol/L) were analyzed using binary logistic regression with adjustment for age, sex, operated joint, and anesthesiological risk score. Results Results — 76 patients (40%) developed hyperglycemia, and 48 of them (25% of the whole cohort) had severe hyperglycemia. Glycemic responses were similar following hip replacement and knee replacement. Previously diagnosed diabetes was associated with an increased risk of hyperglycemia and severe hyperglycemia, compared to patients with normal glucose metabolism, whereas newly diagnosed diabetes and milder glucose metabolism disorders had no effect. In patients without previously diagnosed diabetes, increased values of preoperative glycosylated hemoglobin (HbA1c) and fasting glucose on the day of operation were associated with hyperglycemia. Higher anesthesiological risk score—but none of the operation-related factors analyzed—was associated with an increased risk of hyperglycemia. Interpretation Interpretation — Perioperative hyperglycemia is common in primary hip and knee replacements. Previously diagnosed diabetes is the strongest risk factor for hyperglycemia. In patients with no history of diabetes, preoperative HbA1c and fasting glucose on the day of operation can be used to stratify the risk of hyperglycemia. PMID:25409255

  12. Risk factors and outcome in patients with primary sclerosing cholangitis with persistent biliary candidiasis.

    Science.gov (United States)

    Rupp, Christian; Bode, Konrad Alexander; Chahoud, Fadi; Wannhoff, Andreas; Friedrich, Kilian; Weiss, Karl-Heinz; Sauer, Peter; Stremmel, Wolfgang; Gotthardt, Daniel Nils

    2014-10-23

    Candidiasis is commonly observed in patients with primary sclerosing cholangitis (PSC), but the clinical risk factors associated with its presence have not been fully investigated. In this study, we aimed to analyse the incidence, risk factors, and transplantation-free survival in primary sclerosing cholangitis (PSC) patients with persistent biliary candidiasis. We retrospectively analysed patients diagnosed with PSC who were admitted to our department during 2002 to 2012. One-hundred fifty patients whose bile cultures were tested for fungal species were selected, and their clinical and laboratory parameters were investigated. The results of endoscopic retrograde cholangiography (ERC) and bile cultures were analysed using chart reviews. The cases of biliary candidiasis were sub-classified as transient or persistent. Thirty out of 150 (20.0%) patients had biliary candidiasis. Although all patients demonstrated comparable baseline characteristics, those with biliary candidiasis showed significantly reduced transplantation-free survival (p candidiasis. A subgroup analysis showed reduced survival with a greater necessity for orthotopic liver transplantation (OLT) only in patients with persistence of Candida (p = 0.007). The survival in the patients with transient biliary candidiasis was comparable to that in candidiasis-free patients. In a multivariate regression analysis that included Mayo risk score (MRS), sex, age, dominant stenosis, inflammatory bowel disease, autoimmune hepatitis overlap syndrome, and number of times ERC was performed, biliary candidiasis was an independent risk factor for reduced survival (p = 0.008). Risk factors associated with acquisition of biliary candidiasis were age at PSC diagnosis and number of ERCs. The persistence of biliary candidiasis is associated with markedly reduced transplantation-free survival in PSC patients. By contrast, actuarial survival in patients with transient biliary candidiasis approaches that for patients without any

  13. Failure Prediction for Autonomous Driving

    OpenAIRE

    Hecker, Simon; Dai, Dengxin; Van Gool, Luc

    2018-01-01

    The primary focus of autonomous driving research is to improve driving accuracy. While great progress has been made, state-of-the-art algorithms still fail at times. Such failures may have catastrophic consequences. It therefore is important that automated cars foresee problems ahead as early as possible. This is also of paramount importance if the driver will be asked to take over. We conjecture that failures do not occur randomly. For instance, driving models may fail more likely at places ...

  14. [What factors help to explain satisfaction with Primary Health care in Spain?].

    Science.gov (United States)

    Arrazola-Vacas, M; de Hevia-Payá, J; Rodríguez-Esteban, L

    2015-01-01

    To find out the factors that determine satisfaction with public primary health care in Spain. The work has considered a wide group of potential determining factors of that satisfaction, which are organised into 3 blocks of variables: Those related to the perceived quality in the care received, socioeconomic, and those relative to the state of health. The micro data of the Barómetro Sanitario (BS) of 2013, which are representative at a national level, were employed. After a prior first descriptive analysis, 2 multivariate models were estimated: One in which satisfaction is considered as being of a cardinal nature (regression model), and another in which it is contemplated as being of an ordinal nature (ordered probit model). There were practically no differences between the results obtained with one or other of the multivariate models. Not all the variables considered were statistically significant. Of the 3 blocks of variables studied, the one related to the perceived quality in the care received in the health centre exerts the greatest relevance in the explanation of satisfaction. The results obtained show that, by means of the management of the variables related to the perception of quality of care in health centres, public administrators and health professionals may have a highly favourable influence on the levels of satisfaction of primary health care patients. Copyright © 2015 SECA. Published by Elsevier Espana. All rights reserved.

  15. Primary prophylaxis for children with severe congenital factor VII deficiency - Clinical and laboratory assessment.

    Science.gov (United States)

    Kuperman, A A; Barg, A A; Fruchtman, Y; Shaoul, E; Rosenberg, N; Kenet, G; Livnat, T

    2017-09-01

    Severe congenital factor VII (FVII) deficiency is a rare bleeding disorder. Prophylaxis with replacement therapy has been suggested to patients, yet the most beneficial dosing regimens and therapy intervals are still to be defined. Due to the lack of evidence-based data, we hereby present our experience with long-term administration and monitoring primary prophylaxis in children with severe FVII deficiency and an extremely high bleeding risk. Four children with familial FVII deficiency, treated by prophylactic recombinant activated factor VII (rFVIIa), 15-30μg/kg/dose, given 2-3 times weekly since infancy, are discussed. Clinical follow up and monitoring laboratory assays, including thrombin generation, measured at various time points after prophylactic rFVIIa administration are presented. Among our treated patients neither FVII activity nor thrombin generation parameters (both already declined 24h post rFVIIa administration) were able to predict the impact of prophylaxis, and could not be used as surrogate markers in order to assess the most beneficial treatment frequency. However, the long clinical follow-up and comprehensive laboratory assessment performed, have shown that early primary prophylaxis as administered in our cohort was safe and effective. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Trichostatin A, a critical factor in maintaining the functional differentiation of primary cultured rat hepatocytes

    International Nuclear Information System (INIS)

    Henkens, Tom; Papeleu, Peggy; Elaut, Greetje; Vinken, Mathieu; Rogiers, Vera; Vanhaecke, Tamara

    2007-01-01

    Histone deacetylase inhibitors (HDI) have been shown to increase differentiation-related gene expression in several tumor-derived cell lines by hyperacetylating core histones. Effects of HDI on primary cultured cells, however, have hardly been investigated. In the present study, the ability of trichostatin A (TSA), a prototype hydroxamate HDI, to counteract the loss of liver-specific functions in primary rat hepatocyte cultures has been investigated. Upon exposure to TSA, it was found that the cell viability of the cultured hepatocytes and their albumin secretion as a function of culture time were increased. TSA-treated hepatocytes also better maintained cytochrome P450 (CYP)-mediated phase I biotransformation capacity, whereas the activity of phase II glutathione S-transferases (GST) was not affected. Western blot and qRT-PCR analysis of CYP1A1, CYP2B1 and CYP3A11 protein and mRNA levels, respectively, further revealed that TSA acts at the transcriptional level. In addition, protein expression levels of the liver-enriched transcription factors (LETFs) hepatic nuclear factor 4 alpha (HNF4α) and CCAAT/enhancer binding protein alpha (C/EBPα) were accordingly increased by TSA throughout culture time. In conclusion, these findings indicate that TSA plays a major role in the preservation of the differentiated hepatic phenotype in culture. It is suggested that the effects of TSA on CYP gene expression are mediated via controlling the expression of LETFs

  17. The role of growth differentiation factor 15 in the pathogenesis of primary myelofibrosis

    International Nuclear Information System (INIS)

    Uchiyama, Tatsuki; Kawabata, Hiroshi; Miura, Yasuo; Yoshioka, Satoshi; Iwasa, Masaki; Yao, Hisayuki; Sakamoto, Soichiro; Fujimoto, Masakazu; Haga, Hironori; Kadowaki, Norimitsu; Maekawa, Taira; Takaori-Kondo, Akifumi

    2015-01-01

    Growth differentiation factor 15 (GDF15) is a pleiotropic cytokine that belongs to the transforming growth factor-β superfamily. Elevated serum concentrations of this cytokine have been reported in patients with various malignancies. To assess the potential roles of GDF15 in hematologic malignancies, we measured its serum levels in patients with these diseases. We found that serum GDF15 levels were elevated in almost all these patients, particularly in patients with primary myelofibrosis (PMF). Immunohistochemical staining of bone marrow (BM) specimens revealed that GDF15 was strongly expressed by megakaryocytes, which may be sources of increased serum GDF15 in PMF patients. Therefore, we further assessed the contribution of GDF15 to the pathogenesis of PMF. Recombinant human (rh) GDF15 enhanced the growth of human BM mesenchymal stromal cells (BM-MSCs), and it enhanced the potential of these cells to support human hematopoietic progenitor cell growth in a co-culture system. rhGDF15 enhanced the growth of human primary fibroblasts, but it did not affect their expression of profibrotic genes. rhGDF15 induced osteoblastic differentiation of BM-MSCs in vitro, and pretreatment of BM-MSCs with rGDF15 enhanced the induction of bone formation in a xenograft mouse model. These results suggest that serum levels of GDF15 in PMF are elevated, that megakaryocytes are sources of this cytokine in BM, and that GDF15 may modulate the pathogenesis of PMF by enhancing proliferation and promoting osteogenic differentiation of BM-MSCs

  18. Advantages and disadvantages of unstructured cardiovascular risk factor screening for follow-up in primary care.

    Science.gov (United States)

    de Boer, Anna W; de Mutsert, Renée; den Heijer, Martin; Rosendaal, Frits R; Jukema, Johan W; Blom, Jeanet W; Numans, Mattijs E

    2016-07-01

    In contrast to structured, integrated risk assessment in primary care, unstructured risk factor screening outside primary care and corresponding recommendations to consult a general practitioner (GP) are often based on one abnormal value of a single risk factor. This study investigates the advantages and disadvantages of unstructured screening of blood pressure and cholesterol outside primary care. After the baseline visit of the Netherlands Epidemiology of Obesity study (population-based prospective cohort study in persons aged 45-65 years, recruited 2008-2012) all participants received a letter with results of blood pressure and cholesterol, and a recommendation to consult a GP if results were abnormal. Four years after the start of the study, participants received a questionnaire about the follow-up of their results. The study population consisted of 6343 participants, 48% men, mean age 56 years, mean body mass index 30 kg/m(2). Of all participants 66% had an abnormal result and, of these, 49% had a treatment indication based on the risk estimation system SCORE-NL 2006. Of the 25% of the participants who did not consult a GP, 40% had a treatment indication. Of the participants with an abnormal result 19% were worried, of whom 60% had no treatment indication. In this population 51% of the participants with an abnormal result had unnecessarily received a recommendation to consult a GP, and 10% were unnecessarily worried. GPs should be informed about the complete risk assessment, and only participants at intermediate or high risk should receive a recommendation to consult a GP. © The European Society of Cardiology 2015.

  19. Analysis of Trends and Factors in Breast Multiple Primary Malignant Neoplasms

    Directory of Open Access Journals (Sweden)

    Igor Motuzyuk

    2018-02-01

    Full Text Available Background: The study aims to evaluate the current state and tendencies in multiple primary breast cancer incidence, behavior, and treatment in Ukraine. Methods: A total of 2032 patients who received special treatment at the Department of Breast Tumors and Reconstructive Surgery of the National Cancer Institute from 2008 to 2015 were included in the study. Among them, there were 195 patients with multiple primary malignant neoplasms: 54.9% patients with synchronous cancer and 45.1% patients with metachronous cancer. The average age of patients was 46.6 years, and the percentage of postmenopausal women was 63.1%. Among patients with synchronous cancer, there were 56.1% patients with only breast localizations and 43.9% with combination of breast and other localizations, and among patients with metachronous cancer, there were 46.6% patients with only breast localizations and 53.4% with combination of breast and other localizations. All the patients were evaluated in terms of aggressiveness of the disease, survival rates, as well as risk factors and treatment options. Results: A more aggressive course of breast cancer is observed in patients exposed to radiation from the Chernobyl accident under the age of 30 years ( P  < .01. The clinical course of disease in patients with synchronous cancer is worse and prognostically unfavorable compared with metachronous cancer ( P  < .01. The course of the disease in patients who underwent mastectomy is worse compared with patients who underwent breast-conserving surgery ( P  < .01. Plastic and reconstructive surgery in patients with synchronous cancer was proven to be reasonable in terms of increase in survival ( P  < .01. Conclusions: The patients with multiple primary breast cancer should have attentive management and treatment. Multidisciplinary team should concern all the risk factors and provide the most sufficient option of management. This is crucial to continue research in this

  20. Frequency and predictive factors for overlap syndrome between autoimmune hepatitis and primary cholestatic liver disease.

    Science.gov (United States)

    Gheorghe, Liana; Iacob, Speranta; Gheorghe, Cristian; Iacob, Razvan; Simionov, Iulia; Vadan, Roxana; Becheanu, Gabriel; Parvulescu, Iuliana; Toader, Cristina

    2004-06-01

    To evaluate the frequency of cholestatic pattern in patients with autoimmune hepatitis (AIH) and to identify predictive factors associated with the development of the overlap syndrome. Eighty-two consecutive patients diagnosed with AIH at the referral centre between January 1998 and June 2002 were included in the study. The new scoring system modified by the International Autoimmune Hepatitis Group was used to classify patients as definite/probable. Overlap syndrome was considered when the patient had clinical, serological and histological characteristics of two conditions: AIH and primary biliary cirrhosis (PBC) or AIH and primary sclerosing cholangitis (PSC). From the 82 AIH patients (76 female and six male), 84.1% presented definite AIH (> 15 points) and 15.9% probable AIH (10 - 15 points). The frequency of the overlap syndrome was 20%: 13% with PBC and 7% with PSC. In the univariate analysis the overlap syndrome was associated with male gender (P = 0.01), age < 35 years (P < 0.0001), histopathological aspect of cholestasis (P < 0.0001), suboptimal response to treatment (P < 0.0001) and probable AIH (P < 0.0001). Age < 35 years, probable AIH and the absence of anti-nuclear antibody (ANA) have been identified as independent indicators of the overlap diagnosis by the logistic regression analysis. Patients with overlap syndrome between AIH and primary cholestatic liver disease are frequently diagnosed in clinical practice, representing 20% of AIH cases in our study. The independent predictive factors associated with the diagnosis of overlap syndrome are young age, ANA(-) profile, and probable diagnosis according with the scoring system for AIH.

  1. Impaired Driving

    Science.gov (United States)

    ... Get the Facts What Works: Strategies to Increase Car Seat and Booster Seat ... narcotics. 3 That’s one percent of the 111 million self-reported episodes of alcohol-impaired driving among U.S. ...

  2. Microcystins: Potential risk factors in carcinogenesis of primary liver cancer in Serbia

    Directory of Open Access Journals (Sweden)

    Drobac Damjana

    2011-01-01

    Full Text Available The Primary Liver Carcinoma (PLC is one of the most common malignant diseases in the world. In Central Serbia during the period from 2000 to 2006 the average incidence was 16.9/100 000 that complies to the European epidemiology. The main risk factors for PLC are considered to be cirrhosis of liver and viral chronic Hepatitis B and C. The goal of this research was to analyze epidemiological data of these diseases and to state the correlation between PLC, liver cirrhosis and Hepatitis B and C in Serbia. During the research period of 6 years the correlations between PLC and the corresponding risk factors were negative. For this reason it was necessary to examine other risk factors. The high incidence of PLC in Nišavski, Toplički and Šumadijski region correlate with emerging blooms of Cyanobacteria in water reservoirs supplying these areas with drinking water. Since we examined only 7 years span and have no completed cyanotoxin analysis, it is necessary to complete more research in this field. The identification of cyanotoxins as risk factors that contribute to the development of liver cancer will help in the prevention of this disease.

  3. Risk factors for renal scarring in children with primary vesicoureteral reflux disease

    Directory of Open Access Journals (Sweden)

    Sevgi Mir

    2013-01-01

    Full Text Available To determine the incidence of renal scarring among patients with primary vesicoureteral reflux (VUR and the possible risk factor(s, we studied 90 children (60 girls and 30 boys with VUR followed in the Pediatric Nephrology Unit at the Ege University Hospital from 1998 to 2003. All the patients were assessed for VUR grade by voiding cystoureterography and for presence of renal scarring by (99 m technetium dimercapto-succinic acid scintigraphy. All infants with VUR were given low-dose prophylactic antibiotics and followed-up until resolution of the reflux. Grade of reflux and number of urinary tract infection (UTI episodes (≥3 were found to be statistically significant risk factors for renal scarring (P 0.05. Similarly, there was no statistically significant difference of frequency of renal scarring among the different age groups (P >0.05. We conclude that recurrences of UTI and VUR severity are significant risk factors for renal scarring in children with VUR. Therefore, identification of VUR at an early age may offer the opportunity to prevent episodes of UTI and possible formation of renal scars that may result in end-stage renal failure.

  4. Factors Associated with Increased Pain in Primary Dysmenorrhea: Analysis Using a Multivariate Ordered Logistic Regression Model.

    Science.gov (United States)

    Tomás-Rodríguez, María I; Palazón-Bru, Antonio; Martínez-St John, Damian R J; Navarro-Cremades, Felipe; Toledo-Marhuenda, José V; Gil-Guillén, Vicente F

    2017-04-01

    In the literature about primary dysmenorrhea (PD), either a pain gradient has been studied just in women with PD or pain was assessed as a binary variable (presence or absence). Accordingly, we decided to carry out a study in young women to determine possible factors associated with intense pain. A cross-sectional observational study. A Spanish University in 2016. A total of 306 women, aged 18-30 years. A questionnaire was filled in by the participants to assess associated factors with dysmenorrhoea. Our outcome measure was the Andersch and Milsom scale (grade from 0 to 3). grade 0 (menstruation is not painful and daily activity is unaffected), grade 1 (menstruation is painful but seldom inhibits normal activity, analgesics are seldom required, and mild pain), grade 2 (daily activity affected, analgesics required and give relief so that absence from work or school is unusual, and moderate pain), and grade 3 (activity clearly inhibited, poor effect of analgesics, vegetative symptoms and severe pain). Factors significantly associated with more extreme pain: a higher menstrual flow (odds ratio [OR], 2.11; P < .001), a worse quality of life (OR, 0.97; P < .001) and use of medication for PD (OR, 8.22; P < .001). We determined factors associated with extreme pain in PD in a novel way. Further studies are required to corroborate our results. Copyright © 2016 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

  5. Factors associated with primary care prescription of opioids for joint pain.

    Science.gov (United States)

    Green, D J; Bedson, J; Blagojevic-Burwell, M; Jordan, K P; van der Windt, D

    2013-02-01

    Opioids are commonly prescribed in primary care and can offer pain relief but may also have adverse effects. Little is known about the characteristics of people likely to receive an opioid prescription in primary care. The aim is to identify what factors are associated with primary care prescribing of high-strength analgesics in a community sample of older people with joint pain. A prospective two-stage postal survey completed at baseline and 3-year follow-up in a population aged 50 and over registered with eight general practitioner (GP) practices in North Staffordshire (North Staffordshire Osteoarthritis Project cohorts) linked with data from medical records. Participants were selected who reported joint pain in one or more joints at baseline. Outcome measures were the number of prescriptions for high-strength pain medication (opioids) in the following 3 years. Socio-demographic and health status factors associated with prescription were assessed using a zero-inflated Poisson model. 873 (19%) people were prescribed opioids (out of 4652 providing complete data) ranging from 1 to 76 prescriptions over 3 years. Baseline factors significantly associated with increased rates of prescription were younger age group [65-74 group: incidence rate ratio (IRR) = 1.26 (1.18-1.35)], male gender [IRR = 1.17 (1.12-1.23)], severe joint pain [IRR = 1.19 (1.12-1.26)] poor physical function [IRR = 0.99 (0.99-0.99)] and lower frequency of alcohol consumption [once/twice a year: IRR = 1.13 (1.06-1.21), never: IRR = 1.14 (1.06-1.22)]. Restricting the analysis to those without prior prescriptions for strong opioids showed similar results. Poor physical function and participation restrictions were strongly associated with prescriptions of stronger opioids in addition to several socio-demographic and lifestyle factors. Given the uncertainties over the effectiveness and risks of opioid use, future research could investigate decision making of GPs, exploring reasons for prescribing them.

  6. [Chronic kidney disease in Primary Health Care: prevalence and associated risk factors].

    Science.gov (United States)

    Salvador González, Betlem; Rodríguez Pascual, Mercedes; Ruipérez Guijarro, Laura; Ferré González, Antonia; Cunillera Puertolas, Oriol; Rodríguez Latre, Luisa M

    2015-04-01

    To determine the prevalence of chronic kidney disease and associated risk factors in subjects over 60 years of age, as well as its staging by determining the glomerular filtration rate (GFR). Cross-sectional observational study. Primary Health Care. Patients≥60 years of age who were seen in 40 Primary Health Care centres with serum creatinine measured in a central laboratory between January 1 and December 31, 2010. kidney transplant, home care. Social-demographic and anthropometric data, cardiovascular risk factors, and diseases established according to electronic clinical records. Serum creatinine was measured using standardised Jaffe kinetic method, and GFR estimated with MDRD-4-IDMS and CKD-EPI. A total of 97,665 subjects (57.3% women, median age 70.0 years [Q1: 65.0, Q3: 77.0]). GFR-MDRD prevalence<60=15.1% (16.6% in women, 13.2% in men; P<.001) and increased with age. Multivariate analysis showed a positive association between GFR-MDRD<60 and age (OR=1.74; 95% CI 1.70 to 1.77), hypertension (OR=2.18; 95% CI 2.08 to 2.30), heart failure (OR=2.03; 95% CI 1.83 to 2.25), atrial fibrillation (OR=1.57; 95% CI 1.41 to 1.76), ischaemic heart disease (OR=1.40; 95% CI 1.30 to 1.50), peripheral arterial disease (OR=1.31; 95% CI 1.09 to 1.57), dyslipidaemia (OR=1.28; 95% CI 1.23 to 1.33), diabetes (OR=1.26; 95% CI 1.17 to 1.34), and stroke (OR=1.17; 95% CI 1.09 to 1.25). The GFR-CKD-EPI model showed an increase in OR with age and male sex, that became significant as a chronic kidney disease risk factor. Chronic kidney disease has considerable prevalence in subjects≥60 years seen in Primary Health Care, more in women, and increasing with age. Hypertension, more than diabetes, was the main associated cardiovascular risk factor. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

  7. Factors influencing the introduction of physical activity interventions in primary health care: a qualitative study.

    Science.gov (United States)

    Huijg, Johanna M; van der Zouwe, Nicolette; Crone, Mathilde R; Verheijden, Marieke W; Middelkoop, Barend J C; Gebhardt, Winifred A

    2015-06-01

    The introduction of efficacious physical activity (PA) interventions in routine primary health care (PHC) is a complex process. Understanding factors influencing the process can enhance the development of successful introduction strategies. The aim of this qualitative study was to explore stakeholders' perceptions on factors influencing the introduction, i.e., adoption, implementation, and continuation, of PA interventions in PHC. Twenty-eight semistructured interviews were held with intervention managers, PHC advisors, intervention providers, and referring general practitioners of five PA interventions delivered in PHC. A theoretical framework on the introduction of innovations in health care was used to guide the data collection. Influencing factors were identified using thematic analysis. Stakeholders reported preconditions for the introduction of PA interventions in PHC (e.g., support, resources, and networks and collaborations), in addition to characteristics of PA interventions (e.g., compatibility, flexibility, and intervention materials) and characteristics of PHC professionals (e.g., knowledge, positive attitudes, and beliefs about capabilities) perceived to enhance the introduction process. Furthermore, they proposed strategies for the development of PA interventions (e.g., involvement of future stakeholders, full development, and refinement) and strategies to introduce PA interventions in PHC (e.g., training, assistance, and reinforcement). The majority of the influencing factors were discussed specifically in relation to one or two stages. This study presents an overview of factors that are perceived to influence the introduction of PA interventions in PHC. It underscores the importance of taking these factors into account when designing introduction strategies and of giving special attention to the distinct stages of the process.

  8. Using driving simulators to assess driving safety.

    Science.gov (United States)

    Boyle, Linda Ng; Lee, John D

    2010-05-01

    Changes in drivers, vehicles, and roadways pose substantial challenges to the transportation safety community. Crash records and naturalistic driving data are useful for examining the influence of past or existing technology on drivers, and the associations between risk factors and crashes. However, they are limited because causation cannot be established and technology not yet installed in production vehicles cannot be assessed. Driving simulators have become an increasingly widespread tool to understand evolving and novel technologies. The ability to manipulate independent variables in a randomized, controlled setting also provides the added benefit of identifying causal links. This paper introduces a special issue on simulator-based safety studies. The special issue comprises 25 papers that demonstrate the use of driving simulators to address pressing transportation safety problems and includes topics as diverse as neurological dysfunction, work zone design, and driver distraction. Copyright (c) 2010 Elsevier Ltd. All rights reserved.

  9. Patient factors associated with guideline-concordant treatment of anxiety and depression in primary care.

    Science.gov (United States)

    Prins, Marijn A; Verhaak, Peter F M; Smolders, Mirrian; Laurant, Miranda G H; van der Meer, Klaas; Spreeuwenberg, Peter; van Marwijk, Harm W J; Penninx, Brenda W J H; Bensing, Jozien M

    2010-07-01

    To identify associations of patient characteristics (predisposing, enabling and need factors) with guideline-concordant care for anxiety and depression in primary care. Analysis of data from the Netherlands Study of Depression and Anxiety (NESDA). Seven hundred and twenty-one patients with a current anxiety or depressive disorder, recruited from 67 general practitioners (GPs), were included. Diagnoses according to the Diagnostic and Statistic Manual of Mental Disorders, fourth edition (DSM-IV) were made using a structured and widely validated assessment. Socio-demographic and enabling characteristics, severity of symptoms, disability, (under treatment for) chronic somatic conditions, perceived need for care, beliefs and evaluations of care were measured by questionnaires. Actual care data were derived from electronic medical records. Criteria for guideline-concordant care were based on general practice guidelines, issued by the Dutch College of General Practitioners. Two hundred and eighty-one (39%) patients received guideline-concordant care. High education level, accessibility of care, comorbidity of anxiety and depression, and severity and disability scores were positively associated with receiving guideline-concordant care in univariate analyses. In multivariate multi-level logistic regression models, significant associations with the clinical need factors disappeared. Positive evaluations of accessibility of care increased the chance (OR = 1.31; 95%-CI = 1.05-1.65; p = 0.02) of receiving guideline-concordant care, as well as perceiving any need for medication (OR = 2.99; 95%-CI = 1.84-4.85; p depression than clinical need factors. Initiatives to improve GPs' communication skills around mental health issues, and to improve recognition of people suffering from anxiety disorders, could increase the number of patients receiving treatment for depression and anxiety in primary care.

  10. [Detection of intimate partner violence in primary care and related factors].

    Science.gov (United States)

    Rodríguez-Blanes, Gloria M; Vives-Cases, Carmen; Miralles-Bueno, Juan José; San Sebastián, Miguel; Goicolea, Isabel

    Intimate partner violence (IPV) against women is a significant public health and human rights problem. Primary care professionals play a key role in detecting and addressing this issue. The aim of this study is to determine the frequency of IPV and its associated factors in primary care by means of a screening questionnaire and to describe the main actions taken in identified cases. Cross-sectional study in 15 health centres in four autonomous regions of Spain with a total of 265 health professionals. The information was collected through the self-administered PREMIS questionnaire (Physician Readiness to Manage Intimate Partner Violence Survey), which includes variables concerning screening questions, sociodemographic factors, level of training/knowledge about IPV, perceptions and actions. A descriptive and analytical study was conducted. 67.2% of participants said they ask about IPV during consultations. The most frequent actions were: referring patients to other departments, individual counselling and information delivery. ≥21hours of training, an advanced training level, knowledge of policies and programmes and the implementation of an appropriate protocol and reference resources were all factors that increased the likelihood of investigating IPV. The asking of questions increases in line with professionals' perceived level of training in IPV and the provision of a case management protocol. Two thirds of health professional respondents said they inquire about IPV. Given the influence of training in IPV and awareness of the resources to address the issue, it is essential to continue investing in the IPV training of healthcare personnel. Copyright © 2017 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

  11. Factors Predictive of Sentinel Lymph Node Involvement in Primary Breast Cancer.

    Science.gov (United States)

    Malter, Wolfram; Hellmich, Martin; Badian, Mayhar; Kirn, Verena; Mallmann, Peter; Krämer, Stefan

    2018-06-01

    Sentinel lymph node biopsy (SLNB) has replaced axillary lymph node dissection (ALND) for axillary staging in patients with early-stage breast cancer. The need for therapeutic ALND is the subject of ongoing debate especially after the publication of the ACOSOG Z0011 trial. In a retrospective trial with univariate and multivariate analyses, factors predictive of sentinel lymph node involvement should be analyzed in order to define tumor characteristics of breast cancer patients, where SLNB should not be spared to receive important indicators for adjuvant treatment decisions (e.g. thoracic wall irradiation after mastectomy with or without reconstruction). Between 2006 and 2010, 1,360 patients with primary breast cancer underwent SLNB with/without ALND with evaluation of tumor localization, multicentricity and multifocality, histological subtype, tumor size, grading, lymphovascular invasion (LVI), and estrogen receptor, progesterone receptor and human epidermal growth factor receptor 2 status. These characteristics were retrospectively analyzed in univariate and multivariate logistic regression models to define significant predictive factors for sentinel lymph node involvement. The multivariate analysis demonstrated that tumor size and LVI (pbreast cancer. Because of the increased risk for metastatic involvement of axillary sentinel nodes in cases with larger breast cancer or diagnosis of LVI, patients with these breast cancer characteristics should not be spared from SLNB in a clinically node-negative situation in order to avoid false-negative results with a high potential for wrong indication of primary breast reconstruction or wrong non-indication of necessary post-mastectomy radiation therapy. The prognostic impact of avoidance of axillary staging with SLNB is analyzed in the ongoing prospective INSEMA trial. Copyright© 2018, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

  12. Socio-Economic Factors Affecting Parents' Involvement in Homework: Practices and Perceptions from Eight Johannesburg Public Primary Schools

    Science.gov (United States)

    Ndebele, Misheck

    2015-01-01

    This paper examines socio-economic factors influencing parental involvement in homework at the Foundation Phase in eight Johannesburg public primary schools. The research was conducted among over 600 parents from schools in different geographical and socio-economic areas such as the inner city, suburban and township. Two primary schools were…

  13. Francisella tularensis elicits IL-10 via a PGE₂-inducible factor, to drive macrophage MARCH1 expression and class II down-regulation.

    Directory of Open Access Journals (Sweden)

    Danielle Hunt

    Full Text Available Francisella tularensis is a bacterial pathogen that uses host-derived PGE₂ to subvert the host's adaptive immune responses in multiple ways. Francisella-induced PGE₂ acts directly on CD4 T cells to blunt production of IFN-γ. Francisella-induced PGE₂ can also elicit production of a >10 kDa soluble host factor termed FTMØSN (F. tularensismacrophage supernatant, which acts on IFN-γ pre-activated MØ to down-regulate MHC class II expression via a ubiquitin-dependent mechanism, blocking antigen presentation to CD4 T cells. Here, we report that FTMØSN-induced down-regulation of MØ class II is the result of the induction of MARCH1, and that MØ expressing MARCH1 "resistant" class II molecules are resistant to FTMØSN-induced class II down-regulation. Since PGE₂ can induce IL-10 production and IL-10 is the only reported cytokine able to induce MARCH1 expression in monocytes and dendritic cells, these findings suggested that IL-10 is the active factor in FTMØSN. However, use of IL-10 knockout MØ established that IL-10 is not the active factor in FTMØSN, but rather that Francisella-elicited PGE₂ drives production of a >10 kDa host factor distinct from IL-10. This factor then drives MØ IL-10 production to induce MARCH1 expression and the resultant class II down-regulation. Since many human pathogens such as Salmonella typhi, Mycobacterium tuberculosis and Legionella pneumophila also induce production of host PGE₂, these results suggest that a yet-to-be-identified PGE₂-inducible host factor capable of inducing IL-10 is central to the immune evasion mechanisms of multiple important human pathogens.

  14. Combination of recombinant factor VIIa and fibrinogen corrects clot formation in primary immune thrombocytopenia at very low platelet counts

    DEFF Research Database (Denmark)

    Larsen, Ole H; Stentoft, Jesper; Radia, Deepti

    2013-01-01

    Haemostatic treatment modalities alternative to platelet transfusion are desirable to control serious acute bleeds in primary immune thrombocytopenia (ITP). This study challenged the hypothesis that recombinant activated factor VII (rFVIIa) combined with fibrinogen concentrate may correct whole b...

  15. Primary ventriculoperitoneal shunting outcomes: a multicentre clinical audit for shunt infection and its risk factors.

    Science.gov (United States)

    Woo, P Ym; Wong, H T; Pu, J Ks; Wong, W K; Wong, L Yw; Lee, M Wy; Yam, K Y; Lui, W M; Poon, W S

    2016-10-01

    To determine the frequency of primary ventriculoperitoneal shunt infection among patients treated at neurosurgical centres of the Hospital Authority and to identify underlying risk factors. This multicentre historical cohort study included consecutive patients who underwent primary ventriculoperitoneal shunting at a Hospital Authority neurosurgery centre from 1 January 2009 to 31 December 2011. The primary endpoint was shunt infection, defined as: (1) the presence of cerebrospinal fluid or shunt hardware culture that yielded the pathogenic micro-organism with associated compatible symptoms and signs of central nervous system infection or shunt malfunction; or (2) surgical incision site infection requiring shunt reinsertion (even in the absence of positive culture); or (3) intraperitoneal pseudocyst formation (even in the absence of positive culture). Secondary endpoints were shunt malfunction, defined as unsatisfactory cerebrospinal fluid drainage that required shunt reinsertion, and 30-day mortality. A primary ventriculoperitoneal shunt was inserted in 538 patients during the study period. The mean age of patients was 48 years (range, 13-88 years) with a male-to-female ratio of 1:1. Aneurysmal subarachnoid haemorrhage was the most common aetiology (n=169, 31%) followed by intracranial tumour (n=164, 30%), central nervous system infection (n=42, 8%), and traumatic brain injury (n=27, 5%). The mean operating time was 75 (standard deviation, 29) minutes. Shunt reinsertion and infection rates were 16% (n=87) and 7% (n=36), respectively. The most common cause for shunt reinsertion was malfunction followed by shunt infection. Independent predictors for shunt infection were: traumatic brain injury (adjusted odds ratio=6.2; 95% confidence interval, 2.3-16.8), emergency shunting (2.3; 1.0-5.1), and prophylactic vancomycin as the sole antibiotic (3.4; 1.1-11.0). The 30-day all-cause mortality was 6% and none were directly procedure-related. This is the first Hong Kong

  16. [Human ecology and interdisciplinary cooperation for primary prevention of environmental risk factors for public health].

    Science.gov (United States)

    Dobrowolski, Jan W

    2007-01-01

    training activity in ecologically-based primary prevention. Training in this important field is not adequate in medical, technological, and also natural subjects of studies. There is not enough opportunity for education of the students and graduates toward the application of integrated system approach of new achievements in different sciences and technologies. Interesting are experiences connected with long-term case studies in highly polluted regions in Poland, Japan, India, as well as exchange of methodological experiences during the series of International Summer Schools on the Human Environment from 1972, as well as during series of 11 International Conferences on Sustainable Development organized at AGH-UST from 1989 to 2006 and Polish Conferences in 2004 and 2007. It seems necessary not only to develop a training of experts that would be adequate to present needs, but also education of the whole society (including formal activities at all levels of education) as well as informal education (e.g. at Open Universities and Distance Education, based on the Internet) to achieve the integration of activity of scientists, practitioners and the whole society. It would be useful to focus this activity on crucial problems and selected regions. Let me propose as the top priority for inhabitants of Tarnow region as well as pilot projects for Poland; utilization of all possible achievements of science and technology for primary prevention of health hazard for inhabitants of Gmina Szczucin that is very polluted by asbestos, and also model management reducing risk factors for the natural environment and health of inhabitants in the regions of new motor-ways, as well as better primary prevention against flood accidents and connected with their effects (higher humidity of housing environment and its contamination by toxinogenic moulds) risk factors for health of communities living in rivers regions. For the purpose of optimisation of preventive action, it is necessary not only to

  17. Antenatal risk factors for symptomatic congenital CMV disease following primary maternal CMV infection.

    Science.gov (United States)

    Hadar, Eran; Salzer, Liat; Dorfman, Elizabeta; Amir, Jacob; Pardo, Joseph

    2016-04-01

    This study aimed to evaluate antenatal risk factors associated with symptomatic congenital cytomegalovirus (CMV) disease, following in utero vertical infection. This study included a retrospective cohort of 155 neonates with congenital CMV infection, following primary maternal CMV infection during pregnancy, and were divided to symptomatic (n=95) and asymptomatic (n=60) newborns. Young maternal age (29.1±5.12 vs. 31.6±5.36 years, P=0.005), high risk occupation for viral exposure (20.0% vs. 11.7%, P=0.04), CMV IgG seroconversion at diagnosis (83.1% vs. 63.3%, P=0.005) and abnormal fetal MRI (11.6% vs. 0%, P=0.003) were found to be prognostic risk factors associated with symptomatic CMV disease of the newborn. Maternal febrile illness at diagnosis, IgG avidity, US findings and the timing of maternal infection were not associated with the occurrence of neonatal symptoms. Knowledge of the reported risk factors may assist in counseling parents with intra uterine CMV infection.

  18. On aging factors, aging mechanisms and their combinations in the primary circuit of NPPs

    International Nuclear Information System (INIS)

    Varga, T.; Brumovsky, M.

    1993-01-01

    Ageing is the dominating problem of elder nuclear power plant (NPP) components but still can not be neglected even for the newest ones. Ageing may express itself in different ways: irradiated steel parts may become embrittled, chromium alloy steels may decompose, fatigue life may become exhausted so that cracks may be formed and finally, corrosion attack may result in stress corrosion cracking. However, even synthetics and rubber parts may become inelastic, swell, shrink or crack, electric contacts may be oxydised, or isolations may lose their high electric resistance. Therefore, experts in the different components and their materials have collected and published not only plenty of observations, but also a number of more or less systematic approaches. A general picture, however, still seems to be lacking, due to the fact that ageing factors and mechanisms are not defined and used properly, i.e. - ageing factors act because of the service conditions of the components, as well as the characteristics of the materials which provoke ageing mechanisms - ageing mechanisms cause the changing of properties of the materials involved - combinations of single ageing mechanisms, which can be double, triple or multiple, change and accelerate the ageing process - the consequence of ageing mechanisms is the altering of the properties of the material depending on the lifetime. In this paper we shall try to show a systematic approach to a potential ageing analysis concerning the main metallic components of primary circuits of NPP's - connection between ageing factors, ageing mechanisms and their consequences/effects on component behaviour

  19. Risk factors associated with diabesity in primary school students in the Amazon region of Brazil

    Directory of Open Access Journals (Sweden)

    Maria Virgínia Filgueiras de Assis Mello

    2013-12-01

    Full Text Available Objective. Identifying risk factors for diabesity (diabetes plus obesity in primary students in the Brazilian Amazon. Methodology. Descriptive study carried out in 2009 with the participation of 1218 students. A questionnaire from the Ministry of Health of Brazil was employed with the question ''How is your diet?'' and a form was created to record the socio-demographic, clinical, anthropometric and food variables. Results. The mean age was 12 years and 57% were female. 64% of respondents reported no health problems, 37% had a family history of diabetes mellitus and 29% of students were overweight (17% overweight and 12% obese. A sedentary lifestyle was prevalent in the study group (70%. The dietary guidelines for consumption of fruits, vegetables, legumes, and complex carbohydrates are not properly fulfilled. Fast foods or 'junk' food was consumed by 43.5% of students. Conclusion. Most of the identified risk factors were related to unhealthy lifestyles that can lead to diabesity and other chronic non-communicable diseases. Identifying these factors allows planning nursing interventions for students, teachers and families.

  20. Cost-effectiveness of primary offer of IVF vs. primary offer of IUI followed by IVF (for IUI failures) in couples with unexplained or mild male factor subfertility.

    Science.gov (United States)

    Pashayan, Nora; Lyratzopoulos, Georgios; Mathur, Raj

    2006-06-23

    In unexplained and mild male factor subfertility, both intrauterine insemination (IUI) and in-vitro fertilisation (IVF) are indicated as first line treatments. Because the success rate of IUI is low, many couples failing IUI subsequently require IVF treatment. In practice, it is therefore important to examine the comparative outcomes (live birth-producing pregnancy), costs, and cost-effectiveness of primary offer of IVF, compared with primary offer of IUI followed by IVF for couples failing IUI. Mathematical modelling was used to estimate comparative clinical and cost effectiveness of either primary offer of one full IVF cycle (including frozen cycles when applicable) or "IUI + IVF" (defined as primary IUI followed by IVF for IUI failures) to a hypothetical cohort of subfertile couples who are eligible for both treatment strategies. Data used in calculations were derived from the published peer-reviewed literature as well as activity data of local infertility units. Cost-effectiveness ratios for IVF, "unstimulated-IUI (U-IUI) + IVF", and "stimulated IUI (S-IUI) + IVF" were 12,600 pounds sterling, 13,100 pound sterling and 15,100 pound sterling per live birth-producing pregnancy respectively. For a hypothetical cohort of 100 couples with unexplained or mild male factor subfertility, compared with primary offer of IVF, 6 cycles of "U-IUI + IVF" or of "S-IUI + IVF" would cost an additional 174,200 pounds sterling and 438,000 pounds sterling, representing an opportunity cost of 54 and 136 additional IVF cycles and 14 to 35 live birth-producing pregnancies respectively. For couples with unexplained and mild male factor subfertility, primary offer of a full IVF cycle is less costly and more cost-effective than providing IUI (of any modality) followed by IVF.

  1. Cost-effectiveness of primary offer of IVF vs. primary offer of IUI followed by IVF (for IUI failures in couples with unexplained or mild male factor subfertility

    Directory of Open Access Journals (Sweden)

    Lyratzopoulos Georgios

    2006-06-01

    Full Text Available Abstract Background In unexplained and mild male factor subfertility, both intrauterine insemination (IUI and in-vitro fertilisation (IVF are indicated as first line treatments. Because the success rate of IUI is low, many couples failing IUI subsequently require IVF treatment. In practice, it is therefore important to examine the comparative outcomes (live birth-producing pregnancy, costs, and cost-effectiveness of primary offer of IVF, compared with primary offer of IUI followed by IVF for couples failing IUI. Methods Mathematical modelling was used to estimate comparative clinical and cost effectiveness of either primary offer of one full IVF cycle (including frozen cycles when applicable or "IUI + IVF" (defined as primary IUI followed by IVF for IUI failures to a hypothetical cohort of subfertile couples who are eligible for both treatment strategies. Data used in calculations were derived from the published peer-reviewed literature as well as activity data of local infertility units. Results Cost-effectiveness ratios for IVF, "unstimulated-IUI (U-IUI + IVF", and "stimulated IUI (S-IUI + IVF" were £12,600, £13,100 and £15,100 per live birth-producing pregnancy respectively. For a hypothetical cohort of 100 couples with unexplained or mild male factor subfertility, compared with primary offer of IVF, 6 cycles of "U-IUI + IVF" or of "S-IUI + IVF" would cost an additional £174,200 and £438,000, representing an opportunity cost of 54 and 136 additional IVF cycles and 14 to 35 live birth-producing pregnancies respectively. Conclusion For couples with unexplained and mild male factor subfertility, primary offer of a full IVF cycle is less costly and more cost-effective than providing IUI (of any modality followed by IVF.

  2. Dementia and driving.

    Science.gov (United States)

    O'Neill, D; Neubauer, K; Boyle, M; Gerrard, J; Surmon, D; Wilcock, G K

    1992-04-01

    Many European countries test cars, but not their drivers, as they age. There is evidence to suggest that human factors are more important than vehicular factors as causes of motor crashes. The elderly also are involved in more accidents per distance travelled than middle-aged drivers. As the UK relies on self-certification of health by drivers over the age of 70 years, we examined the driving practices of patients with dementia attending a Memory Clinic. Nearly one-fifth of 329 patients with documented dementia continued to drive after the onset of dementia, and impaired driving ability was noted in two-thirds of these. Their families experienced great difficulty in persuading patients to stop driving, and had to invoke outside help in many cases. Neuropsychological tests did not help to identify those who drove badly while activity of daily living scores were related to driving ability. These findings suggest that many patients with dementia drive in an unsafe fashion after the onset of the illness. The present system of self-certification of health by the elderly for driver-licensing purposes needs to be reassessed.

  3. What should primary health care practitioners know about factors influencing young people’s food choices?

    Directory of Open Access Journals (Sweden)

    Louise Holmberg

    2010-04-01

    Full Text Available BackgroundTo identify factors that determine the nature and extent ofyoung consumers trust in food; sources of information whichinfluence young consumer food choices; and how trustimpacts on young people’s food choices.MethodIn-depth qualitative research interviews were conducted withyoung women and men, who are the primary food purchasersin their household (n=8ResultsFood choices of young adults were generally determined bycost and convenience. The overall perception was thatAustralian food regulation was effective and therefore, foodsafety need not be questioned. Health including long termhealth, although considered, was not central in food choicebehaviour. Trustworthy nutrition information sourcesincluded family and friends. While food labels were used theywere considered scientific and complex. The media and thefood industry were deemed to be untrustworthy informationsources.ConclusionCost and convenience were major determinants of foodchoice in this group of young people who generally lacked areflexive capacity with regards to food safety and health. Afailure to prioritise health raises questions regarding theengagement of young people in public health initiatives, andshould be of interest to primary health care practitioners.These data suggest that general practitioners should beaware that cost and convenience may take priority overhealth issues for young people. Further research isrequired to confirm the findings of this small study, withfuture studies aiming to include young people fromvarying socio-demographic backgrounds in order to gain amore comprehensive view of young people’s trust infood.

  4. Cognitive impairment and driving safety.

    Science.gov (United States)

    Eby, David W; Molnar, Lisa J

    2012-11-01

    As the populations of many countries continue to age, cognitive impairment will likely become more common. Individuals with cognitive impairment pose special challenges for families, health professionals, driving safety professionals, and the larger community, particularly if these older adults depend on driving as their primary means of community mobility. It is vital that we continue to extend our knowledge about the driving behavior of individuals' with cognitive impairment, as well as try to develop effective means of screening and assessing these individuals for fitness to drive and help facilitate their transition to non-driving when appropriate. This special issue is intended to provide researchers and practitioners an opportunity to present the most recent research findings on driving-related issues among older adults with cognitive impairment. The issue contains 11 original contributions from seven countries. The topics covered by these papers are: crash risks; screening, assessment, and fitness to drive; driving performance using a driving simulator; and driving behaviors and driving-related decisions of people with cognitive impairments. Copyright © 2012. Published by Elsevier Ltd.

  5. Preoperative diagnosis of N-factor by MR in primary lung cancer

    International Nuclear Information System (INIS)

    Akata, Soichi; Amino, Saburo; Abe, Kimihiko

    1993-01-01

    We compared the accuracies of preoperative diagnosis of N-factor by CT and MR in 71 cases of primary lung cancer. Lymph nodes larger than 10 mm in diameter were defined as positive. As a result, CT and MR both achieved an accuracy of more than 80%. MR was inefficient in detecting calcification and showed lower spatial resolution than CT; however, MR was useful in detecting hilar lymph nodes because of the signal loss of blood vessels. MR should be used to detect the contralateral hilar lymph nodes swelling because the sensitivity in the hilus is 20% higher in MR than in CT and the information about the contralateral hilar lymph nodes is more important than ipsilateral hilar lymph nodes for operation. (author)

  6. Evaluation of pN factors in patients with primary lung cancer by using perfusion, inhalation and ventilation studies

    International Nuclear Information System (INIS)

    Tamai, Toyosato; Tanabe, Masatada; Satoh, Katashi

    1987-01-01

    The interpretation of scintigraphic patterns and the role of pathophysiological mechanisms in patients with primary lung cancer were investigated. To determine the relative roles of perfusion, inhalation and ventilation scintigraphy, the relationship between the count ratio of the affected side to the healthy side and the post-surgical histological lymph nodes factors were observed in this study. These scintigraphic count ratio's in patients with primary lung cancer did not reflect the pN factors except in the perfusion study in patients with hilar primary lung cancer. (author)

  7. Work stress, fatigue and risk behaviors at the wheel: Data to assess the association between psychosocial work factors and risky driving on Bus Rapid Transit drivers

    Directory of Open Access Journals (Sweden)

    Sergio Useche

    2017-12-01

    Full Text Available This Data in Brief (DiB article presents a hierarchical multiple linear regression model that examine the associations between psychosocial work factors and risk behaviors at the wheel in Bus Rapid Transit (BRT drivers (n=524. The data were collected using a structured self-administrable questionnaire made of measurements of wok stress (job strain and effort- reward imbalance, fatigue (need for recovery and chronic fatigue, psychological distress and demographics (professional driving experience, hours driven per day and days working per week. The data contains 4 parts: descriptive statistics, bivariate correlations between the study variables and a regression model predicting risk behaviors at the wheel and the entire study dataset. For further information, it is convenient to read the full article entitled “Stress-related Psychosocial Factors at Work, Fatigue, and Risky Driving Behavior in Bus Rapid Transport (BRT Drivers”, published in Accident Analysis & Prevention. Keywords: Professional drivers, Work stress, Fatigue, Psychological distress, Risk behaviors, Bus Rapid Transport, BRT

  8. Driving things

    DEFF Research Database (Denmark)

    Nevile, Maurice Richard

    2015-01-01

    I explore how participants organise involvement with objects brought into the car, relative to the demands of driving and social activity. Objects in cars commonly include phones or other technologies, food, body care products, texts, clothing, bags and carry items, toys, and even animals...... 2004, Haddington et al. 2012). I focus here especially on how the practical and interactional work of locating, seeing, placing, handling, hearing, and relinquishing, is ordered and accomplished relative to the emerging and contingent demands of both driving and social participation......, such that involvement with objects is constituted as secondary to driving in a multiactivity setting (e.g. Haddington et al. 2014). We see how events with, for, of, and even by objects can occur as predictable, planned and even designed for (e.g. changing glasses, applying body lotion), or might be unexpected...

  9. Key factors determining success of primary eye care through vision centres in rural India: Patients′ perspectives

    Directory of Open Access Journals (Sweden)

    Vilas Kovai

    2012-01-01

    Full Text Available Aim : This paper intends to discuss the patients′ perspective on the determinants of primary eye care services from vision centers (VC in rural India. Materials and Methods : A retrospective study design and interview method was used on 127 randomly selected patients who accessed the 4 VCs in 2007. Factor analyses and linear regression models were used to predict the associations with patient satisfaction. Results : The three factors derived from factor analyses were: (1-vision technician (VT, (2-location of VC, and (3-access to VC; explaining 60% of the variance in total patients′ satisfaction with VC. The first model (R2 : 0.61; F 1,124=144.36, P <0.001, indicated that respondents who had ′difficulty to travel to the place of VC′ and those who can afford to pay had less satisfaction with VT services. The second model (R2 =0.18; F 1,124=29.5, P <0.001 explained that respondents′ difficulty to identify the building of VC had decreased patients′ satisfaction and the third model (R2 =0.36; F 1,124=45.6, P <0.001 indicated that those who had to travel<5 km to the VC and had 0.38 units of increased satisfaction level with the services of VC. Conclusion : A good VT can enhance patient satisfaction. However, patient expectations are not only confined to the provider but also other factors such as ability to pay and convenient transportation that helps patients reach the location of the VC with ease.

  10. Risk Factors for Primary Open-Angle Glaucoma in Western Turkey

    Directory of Open Access Journals (Sweden)

    Güliz Fatma Yavaş

    2013-04-01

    Full Text Available Pur po se: To evaluate the prevalence of primary open-angle glaucoma (POAG in subjects aged over 40 years in Western Turkey and to quantify its association with several systemic risk factors. Ma te ri al and Met hod: The research was conducted in Afyonkarahisar, a middle Anatolian city, between November 2005 and February 2006. A total of 1533 subjects aged 40 years or more were included in the study. Diabetes mellitus, hypertension, atherosclerotic cardiac disease, obesity, smoking, alcohol consumption, and dietary habitus (meat, chicken, and fish consumption were asked. Level of blood glucose, serum total cholesterol, triglyceride, high-density lipoprotein, low-density lipoprotein, very-low-density lipoprotein, Vitamin B12, and thyroid-stimulating-hormone were determined. Ophthalmic examination was performed, and intraocular pressure was measured by tonopen. Subjects with an IOP of 21 mmHg or more and/or with a cupping/disc ratio of 0.3 or more were told to come to the clinic for visual field analysis and gonioscopy. Subjects with a typical glaucomatous visual field defect and an open angle were recorded as POAG. Risk factors for POAG were determined by chi-square test. Re sults: Prevalence of POAG was found to be 2% (30 subjects and the only associated risk factor was age (p=0.05. Dietary habitus was also not associated with glaucoma (p>0.05. Dis cus si on: This study provides a population-based data about the prevalence and risk factors of POAG in Turkey. (Turk J Ophthalmol 2013; 43: 87-90

  11. Activated platelet-derived growth factor autocrine pathway drives the transformed phenotype of a human glioblastoma cell line.

    Science.gov (United States)

    Vassbotn, F S; Ostman, A; Langeland, N; Holmsen, H; Westermark, B; Heldin, C H; Nistér, M

    1994-02-01

    Human glioblastoma cells (A172) were found to concomitantly express PDGF-BB and PDGF beta-receptors. The receptors were constitutively autophosphorylated in the absence of exogenous ligand, suggesting the presence of an autocrine PDGF pathway. Neutralizing PDGF antibodies as well as suramin inhibited the autonomous PDGF receptor tyrosine kinase activity and resulted in up-regulation of receptor protein. The interruption of the autocrine loop by the PDGF antibodies reversed the transformed phenotype of the glioblastoma cell, as determined by (1) diminished DNA synthesis, (2) inhibition of tumor colony growth, and (3) reversion of the transformed morphology of the tumor cells. The PDGF antibodies showed no effect on the DNA synthesis of another glioblastoma cells line (U-343MGa 31L) or on Ki-ras-transformed fibroblasts. The present study demonstrates an endogenously activated PDGF pathway in a spontaneous human glioblastoma cell line. Furthermore, we provide evidence that the autocrine PDGF pathway drives the transformed phenotype of the tumor cells, a process that can be blocked by extracellular antagonists.

  12. Evaluation of aldehyde dehydrogenase 1 and transcription factors in both primary breast cancer and axillary lymph node metastases as a prognostic factor.

    Science.gov (United States)

    Ito, Maiko; Shien, Tadahiko; Omori, Masako; Mizoo, Taeko; Iwamoto, Takayuki; Nogami, Tomohiro; Motoki, Takayuki; Taira, Naruto; Doihara, Hiroyoshi; Miyoshi, Shinichiro

    2016-05-01

    Aldehyde dehydrogenase 1 (ALDH1) is a marker of breast cancer stem cells, and the expression of ALDH1 may be a prognostic factor of poor clinical outcome. The epithelial-mesenchymal transition may produce cells with stem-cell-like properties promoted by transcription factors. We investigated the expression of ALDH1 and transcription factors in both primary and metastatic lesions, and prognostic value of them in breast cancer patients with axillary lymph node metastasis (ALNM). Forty-seven breast cancer patients with ALNM who underwent surgery at Okayama University Hospital from 2002 to 2008 were enrolled. We retrospectively evaluated the levels of ALDH1 and transcription factors, such as Snail, Slug and Twist, in both primary and metastatic lesions by immunohistochemistry. In primary lesions, the positive rate of ALDH1, Snail, Slug and Twist was 19, 49, 40 and 26%, respectively. In lymph nodes, that of ALDH1, Snail, Slug and Twist was 21, 32, 13 and 23%, respectively. The expression of ALDH1 or transcription factors alone was not significantly associated with a poor prognosis. However, co-expression of ALDH1 and Slug in primary lesions was associated with a shorter DFS (P = 0.009). The evaluation of the co-expression of ALDH1 and transcription factors in primary lesions may be useful in prognosis of node-positive breast cancers.

  13. Primary Otomycosis in the Indian Subcontinent: Predisposing Factors, Microbiology, and Classification

    Directory of Open Access Journals (Sweden)

    Sampath Chandra Prasad

    2014-01-01

    Full Text Available Objective. To define otomycosis and determine the predisposing factors and microbiology in primary otomycosis. Study Design. Prospective study of two years and review of the literature. Setting. Academic Department of Otolaryngology in a coastal city in India. Patients. 150 immunocompetent individuals of whom 100 consecutive patients with a clinical diagnosis of otomycosis are considered as the study group and 50 consecutive patients with no otomycosis are considered as the control group. Results and Observations. Instillation of coconut oil (42%, use of topical antibiotic eardrops (20%, and compulsive cleaning of external ear with hard objects (32% appeared to be the main predisposing factors in otomycosis. Aspergilli were the most common isolates (80% followed by Penicillium (8%, Candida albicans (4%, Rhizopus (1%, and Chrysosporium (1%, the last being reported for the first time in otomycosis. Among aspergilli, A. niger complex (38% was the most common followed by A. fumigatus complex (27% and A. flavus complex (15%. Bacterial isolates associated with fungi in otomycosis were S. aureus, P. aeruginosa, and Proteus spp. In 42% of healthy external ears fungi were isolated. Conclusion. Aspergillus spp. were the most common fungi isolated, followed by Penicillium. Otomycotic ears are often associated with bacterial isolates when compared to normal ears. Fungi are also present in a significant number of healthy external auditory canals and their profiles match those in cases of otomycosis. The use of terms “primary” and “secondary” otomycosis is important to standardize reporting.

  14. Incidence, Mortality, and Predictive Factors of Hepatocellular Carcinoma in Primary Biliary Cirrhosis

    Directory of Open Access Journals (Sweden)

    Kenichi Hosonuma

    2013-01-01

    Full Text Available Background. The study aims to analyze in detail the incidence, mortality using the standardized incidence ratio (SIR, and standardized mortality ratio (SMR of hepatocellular carcinoma (HCC in primary biliary cirrhosis (PBC, because no large case studies have focused on the detailed statistical analysis of them in Asia. Methods. The study cohorts were consecutively diagnosed at Gunma University and its affiliated hospitals. Age- or sex-specific annual cancer incidence and deaths were obtained from Japanese Cancer Registry and Death Registry as a reference for the comparison of SIR or SMR of HCC. Moreover, univariate analyses and multivariate analyses were performed to clarify predictive factors for the incidence of HCC. Results. The overall 179 patients were followed up for a median of 97 months. HCC had developed in 13 cases. SIR for HCC was 11.6 (95% confidence interval (CI, 6.2–19.8 and SMR for HCC was 11.2 (95% CI, 5.4–20.6 in overall patients. The serum albumin levels were a predictive factor for the incidence of HCC in overall patients. Conclusions. The incidence and mortality of HCC in PBC patients were significantly higher than those in Japanese general population. PBC patients with low serum albumin levels were populations at high risk for HCC.

  15. Prevalence and risk factors for allergic rhinitis in primary schoolchildren in Budapest.

    Science.gov (United States)

    Sultész, Monika; Katona, Gábor; Hirschberg, Andor; Gálffy, Gabriella

    2010-05-01

    There is growing evidence that the prevalence of allergic diseases is increasing, especially among children. The aim of this study was to evaluate the incidence and risk factors of allergic rhinitis in 6-12-year-old schoolchildren in Budapest. A total of 6335 children aged between 6 and 12 years attending 21 randomly selected primary schools in Budapest were surveyed in September 2007 by using a questionnaire consisting in part of questions compiled by the International Study of Asthma and Allergies in Childhood and in part of questions based on our own experience. 3933 of the questionnaires (1976 M/1957 F) were appropriately completed by the parents. The prevalence of current allergic rhinitis was 14.9% (n=530), that of physician-diagnosed allergic rhinitis was 11.6% (n=413), and that of cumulative allergic rhinitis was 26.5% (n=943). Male gender (pBudapest was 14.9%, which is higher than reported from other European countries. Our findings differ from those on other cohorts in that exposure to ragweed and to indoor environmental factors in concrete housing estates in Budapest may be of particular importance as concerns allergic sensitization. Copyright (c) 2010 Elsevier Ireland Ltd. All rights reserved.

  16. Factors associated with developing a fear of falling in subjects with primary open-angle glaucoma.

    Science.gov (United States)

    Adachi, Sayaka; Yuki, Kenya; Awano-Tanabe, Sachiko; Ono, Takeshi; Shiba, Daisuke; Murata, Hiroshi; Asaoka, Ryo; Tsubota, Kazuo

    2018-02-13

    To investigate the relationship between clinical risk factors, including visual field (VF) defects and visual acuity, and a fear of falling, among patients with primary open-angle glaucoma (POAG). All participants answered the following question at a baseline ophthalmic examination: Are you afraid of falling? The same question was then answered every 12 months for 3 years. A binocular integrated visual field was calculated by merging a patient's monocular Humphrey field analyzer VFs, using the 'best sensitivity' method. The means of total deviation values in the whole, superior peripheral, superior central, inferior central, and inferior peripheral VFs were calculated. The relationship between these mean VF measurements, and various clinical factors, against patients' baseline fear of falling and future fear of falling was analyzed using multiple logistic regression. Among 392 POAG subjects, 342 patients (87.2%) responded to the fear of falling question at least twice in the 3 years study period. The optimal regression model for patients' baseline fear of falling included age, gender, mean of total deviation values in the inferior peripheral VF and number of previous falls. The optimal regression equation for future fear of falling included age, gender, mean of total deviation values in the inferior peripheral VF and number of previous falls. Defects in the inferior peripheral VF area are significantly related to the development of a fear of falling.

  17. Factors influencing survival and recurrence-free intervals after treatment of primary breast cancer

    International Nuclear Information System (INIS)

    O'Higgins, N.; Brady, H.R.; Clark, C.G.

    1984-01-01

    A retrospective analysis of 739 patients with breast cancer is presented. Factors influencing overall survival, recurrence-free interval and survival after first recurrence are analysed and discussed. None of the factors was affected by age or menopausal status at the time of presentation. Overall survival and recurrence-free intervals varied significantly with tumour size, extent of nodal spread and tumour site. Medially situated tumours, large tumours and extensive nodal spread were associated with earlier first recurrence and poor prognosis. No difference in survival or recurrence-free interval was observed between different surgical operations. Although overall survival was longer in patients who received post-operative radiotherapy, no significant differences in survival or disease-free intervals were noted when patients were standardised for operation or tumour stage. Survival after local recurrence was longer than survival after distant metastases, although the time of onset of local and distant disease followed an identical pattern. These results suggest that the tumour characteristics of size, site and nodal spread are important determinants of survival and recurrence-free interval in primary breast cancer. Local recurrence should be regarded as a manifestation of systemic disease. (author)

  18. [Nutritional factors associated with dyslipidemia in users of service in primary health care].

    Science.gov (United States)

    Ferreira, Nathália Luíza; Rodrigues, Maria Tereza; Abreu, Mery Natali; Lopes, Aline Cristine

    2011-12-01

    Dyslipidemias are relevant to public health because are one of the major risk factors for Non-Communicable Diseases and Disorders, especially cardiovascular diseases. Identify factors associated with dyslipidemias on users of Primary Health Care Center. Users were assessed through the nutritional anamnesis (demographic data, consumption of foods and nutrients and morbidity) and anthropometry. Was performed descriptive analysis, t-Student, Chi-Square and Mann Whitney tests (ppercentage of adequacy monounsaturated fatty acids (MUFA) (p=0.007). In contrast, had higher proportion of adequacy of lipid (p=0.017), lower mean weight (p=0.044) and lower inadequate intake of fatty meat (p=0.005). Multivariate analysis showed that insufficient consumption of MUFA (p=0.005) and inadequate intake of lard (p=0.021) were the main variables which influenced the presence of dyslipidemia. The results show that important dietary changes for the prevention and control of dyslipidemia have not been implemented, demonstrating the importance of nutritional interventions aimed at to clarify new dietary strategies, such as reduce consumption of sugar and to maintain an adequate consumption of lipid fractions.

  19. Factors affecting 18 F FDOPA standardized uptake value in patients with primary brain tumors after treatment

    International Nuclear Information System (INIS)

    Chiaravalloti, Agostino; Fiorentini, Alessandro; Villani, Veronica; Carapella, Carmine; Pace, Andrea; Di Pietro, Barbara; Di Russo, Carmen; Palumbo, Barbara; Floris, Roberto; Schillaci, Orazio

    2015-01-01

    Aim: To investigate the factors affecting 18 F FDOPA uptake in patients with primary brain tumors (PBT) after treatment. Materials and methods: 97 patients with PBT (6 were grade I, 40 were grade II, 29 were grade III and 22 were grade IV) underwent 18 F FDOPA positron emission tomography/computed tomography (PET/CT) after treatment. Intervals from surgery, chemotherapy (CHT) and radiotherapy (RT) were 41.48 (± 42.27), 16.04 (± 29.08) and 28.62 (± 34.49) months respectively. Results: 18 F FDOPA uptake in the site of recurrence was not related to the interval from surgery and CHT while a significant relationship has been found with the interval from RT and tumor grade. Conclusions: The results of our study show that the interval from RT and the grade of PBT should be considered carefully when evaluating brain PET/CT scans since these factors could directly affect 18 F FDOPA uptake

  20. Factors associated with dental caries in the primary dentition of children with cerebral palsy

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    Luana Leal Roberto

    2012-10-01

    Full Text Available The aim of this study was to investigate factors associated with caries experience in the primary dentition of one- to five-year-old children with cerebral palsy. A total of 266 dental records were examined, and caries experience was measured by dmft. The following variables were also analyzed: gender, oral hygiene, history of gastroesophageal reflux, use of medications for gastroesophageal reflux, gingival status, sugar intake and reports of polyuria, excessive thirst and xerostomia. For analysis purposes, the individuals were categorized as those with and without caries experience and subcategorized into the following age groups: one year; two to three years; and four to five years. After bivariate analysis, variables with a p-value < 0.25 were selected for incorporation into the Poisson regression models. Considering the limitations of the protocol, the level of oral hygiene perceived on the first appointment was the only factor associated with caries experience among two-to-fiveyear-old children with cerebral palsy.

  1. Identification of risk factors for postoperative dysphagia after primary anti-reflux surgery.

    Science.gov (United States)

    Tsuboi, Kazuto; Lee, Tommy H; Legner, András; Yano, Fumiaki; Dworak, Thomas; Mittal, Sumeet K

    2011-03-01

    Transient postoperative dysphagia is not uncommon after antireflux surgery and usually runs a self-limiting course. However, a subset of patients report long-term dysphagia. The purpose of this study was to determine the risk factors for persistent postoperative dysphagia at 1 year after surgery. All patients who underwent antireflux surgery were entered into a prospectively maintained database. After obtaining institutional review board approval, the database was queried to identify patients who underwent primary antireflux surgery and were at least 1 year from surgery. Postoperative severity of dysphagia was evaluated using a standardized questionnaire (scale 0-3). Patients with scores of 2 or 3 were defined as having significant dysphagia. A total of 316 consecutive patients underwent primary antireflux surgery by a single surgeon. Of these, 219 patients had 1 year postoperative symptom data. Significant postoperative dysphagia at 1 year was reported by 19 (9.1%) patients. Thirty-eight patients (18.3%) required postoperative dilation for dysphagia. Multivariate logistic regression analysis identified preoperative dysphagia (odds ratio (OR), 4.4; 95% confidence interval (CI), 1.2-15.5; p = 0.023) and preoperative delayed esophageal transit by barium swallow (OR, 8.2; 95% CI, 1.6-42.2; p = 0.012) as risk factors for postoperative dysphagia. Female gender was a risk factor for requiring dilation during the early postoperative period (OR, 3.6; 95% CI, 1.3-10.2; p = 0.016). No correlations were found with preoperative manometry. There also was no correlation between a need for early dilation and persistent dysphagia at 1 year of follow-up (p = 0.109). Patients with preoperative dysphagia and delayed esophageal transit on preoperative contrast study were significantly more likely to report moderate to severe postoperative dysphagia 1 year after antireflux surgery. This study confirms that the manometric criteria used to define esophageal dysmotility are not reliable

  2. Study of Factors Preventing Children from Enrolment in Primary School in the Republic of Honduras: Analysis Using Structural Equation Modelling

    Science.gov (United States)

    Ashida, Akemi

    2015-01-01

    Studies have investigated factors that impede enrolment in Honduras. However, they have not analysed individual factors as a whole or identified the relationships among them. This study used longitudinal data for 1971 children who entered primary schools from 1986 to 2000, and employed structural equation modelling to examine the factors…

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

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    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

  4. Factors driving the development of healthcare waste management in the United Kingdom over the past 60 years.

    Science.gov (United States)

    Townend, William K; Cheeseman, Christopher; Edgar, Jen; Tudor, Terry

    2009-06-01

    Since the creation of the National Health Service (NHS) in the United Kingdom in 1948 there have been significant changes in the way waste materials produced by healthcare facilities have been managed due to a number of environmental, legal and social drivers. This paper reviews the key changes in legislation and healthcare waste management that have occurred in the UK between 1948 and the present time. It investigates reasons for the changes and how the problems associated with healthcare wastes have been addressed. The reaction of the public to offensive disposal practices taking place locally required political action by the UK government and subsequently by the European legislature. The relatively new UK industry of hazardous healthcare waste management has developed rapidly over the past 25 years in response to significant changes in healthcare practices. The growth in knowledge and appreciation of environmental issues has also been fundamental to the development of this industry. Legislation emanating from Europe is now responsible for driving change to UK healthcare waste management. This paper examines the drivers that have caused the healthcare waste management to move forward in the 60 years since the NHS was formed. It demonstrates that the situation has moved from a position where there was no overall strategy to the current situation where there is a strong regulatory framework but still no national strategy. The reasons for this situation are examined and based upon the experience gained; suggestions are made for the benefit of countries with systems for healthcare waste management still in the early stages of development or without any provisions at all.

  5. Toxoplasma gondii infection: seroprevalence and associated risk factors among primary schoolchildren in Lagos City, Southern Nigeria

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    Vincent Pam Gyang

    2015-02-01

    Full Text Available INTRODUCTION: Toxoplasma gondii infection has been described as the most widespread zoonotic infection of humans and other animals. Information concerning T. gondii infection among schoolchildren is unavailable in Lagos City, Nigeria. METHODS: This cross-sectional study investigated the seroprevalence and risk factors associated with T. gondii infection among primary schoolchildren (PSC from a community located in the center of Lagos, southern Nigeria, from November 2013 to March 2014. A total of 382 PSC were screened for the presence of sera anti-T. gondii antibodies using a latex agglutination test (TOXO Test-MT, Tokyo, Japan. A cutoff titer of ≥ 1:32 was considered positive, while titers ≥ 1:1,024 indicated high responders. Questionnaires were also used to obtain data on possible risk factors from parents/guardians. RESULTS: The overall seroprevalence was 24% (91/382, and 83.5% (76/91 of seropositive PSC were classified as high responders. Among the risk factors tested, including contact with cats and soil, consumption of raw meat and vegetables, and drinking unboiled water, none showed statistical significance after multivariate adjustment. No associations were observed among age, gender, body mass index (BMI, and parents' occupation/educational level. CONCLUSIONS: The findings in this study show evidence of active infection, and hence, there is need for urgent preventive measures in this city. Further investigation is required to clarify the transmission routes. Policy makers also need to initiate prevention and control programs to protect pregnant women and immunocompromised patients in particular because they are more severely affected by T. gondii infection.

  6. Primary dysmenorrhea: prevalence in adolescent population of Tbilisi, Georgia and risk factors

    Science.gov (United States)

    Gagua, Tinatin; Tkeshelashvili, Besarion; Gagua, David

    2012-01-01

    Objective The study aimed to determine the prevalence of dysmenorrhea in female adolescents living in Tbilisi, Georgia; find possible risk factors and establish an association, if any, with nutrition and sleep hygiene. Material and Methods A cross-sectional study was used. A retrospective case control study was used to identify risk factors. Participants: A total of 2561 women consented to participate in the research. 431 participants were included in the case-control study. Interventions: Detailed questionnaire included: reproductive history, demographic features, menstrual pattern, severity of dysmenorrhea and associated symptoms; information about nutrition and sleep hygiene. Results The prevalence of dysmenorrhea was 52.07%. Due to pain, 69.78% reported frequent school absenteeism. The risk of dysmenorrhea in students who had a family history of dysmenorrhea was approximately 6 times higher than in students with no prior history. The prevalence of dysmenorrhea was significantly higher among smokers compared with non-smokers 3.99% vs. 0.68% (p=.0.05 OR:6.102). Those women reporting an increased intake of sugar reported a marked increase of dysmenorrhea compared to women reporting no daily sugar intake (55.61% vs. 44.39%, p=.0023 LR:0.0002). However, alcohol, family atmosphere and nationality showed no correlation with dysmenorrhea. Our study revealed two most important risk factors of dysmenorrhea: meal skipping 59.78% vs. 27.03%, p=.00000 LR: 0.00000 OR:4.014 and sleep hygiene-receiving less sleep 38.77% vs. 19.59%, p=0.000055 LR: 0.000036 OR:2.598. Conclusion Primary dysmenorrhea is a common problem in the adolescent population of Tbilisi Geogia. It adversely affects their educational performance. Meal skipping and sleep quantity are associated with dysmenorrhea and may cause other reproductive dysfunctions. PMID:24592031

  7. Factors leading to poor water sanitation hygiene among primary school going children in Chitungwiza

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    Blessing Dube

    2012-03-01

    Full Text Available Although the world has progressed in the area of water and sanitation, more than 2.3 billion people still live without access to sanitation facilities and some are unable to practice basic hygiene. Access to water and basic sanitation has deteriorated in Chitungwiza and children are at risk of developing illness and missing school due to the deterioration. We sought to investigate the predisposing, enabling and reinforcing factors that are causally related to water- and sanitation- related hygiene practices among school going children. A random sample of 400 primary school children (196 males, 204 females in four schools in Chitungwiza town, Zimbabwe was interviewed. Behavioural factors were assessed through cross examination of the PROCEED PRECEDE Model. The respondents had been stratified through the random sampling where strata were classes. A structured observation checklist was also administered to assess hygiene enabling facilities for each school. Children’s knowledge and perceptions were inconsistent with hygienic behaviour. The family institution seemed to play a more important role in life skills training and positive reinforcement compared to the school (50% vs 27.3%. There was no association between a child’s sex, age and parents’ occupation with any of the factors assessed (P=0.646. Schools did not provide a hygiene enabling environment as there were no learning materials, policy and resources on hygiene and health. The challenges lay in the provision of hygiene enabling facilities, particularly, the lack of access to sanitation for the maturing girl child and a school curriculum that provides positive reinforcement and practical life skills training approach.

  8. Parental perception and factors associated with treatment strategies for primary nocturnal enuresis.

    Science.gov (United States)

    Tai, Thomson T; Tai, Brent T; Chang, Yu-Jun; Huang, Kuo-Hsuan

    2017-06-01

    The aim was to investigate the factors influencing parents seeking reasonable managements for their child and their overall outlook toward primary nocturnal enuresis (PNE). We recruited 93 children with PNE from enuresis clinics and requested their parents to complete questionnaires regarding their child's medical history and behavior, their methods for coping with PNE, and their perception of enuresis. Logistic regression models were applied to investigate factors influencing the parents to adopt a positive approach toward enuresis and to subsequently seek a medical consultation. One-third of the parents had an encouraging attitude toward children with PNE, whereas slightly less than half reacted with anger. The more educated the father or the younger the child with NE, the larger the possibility of the parents utilizing a positive approach, such as encouragement, for coping with NE. Factors that influenced parents to seek medical consultation for NE were socioeconomic status, maternal educational level, and the age and birth order of their child. From our results, angry and frustrated parents (43.0%) were significantly more likely to punish their child for bedwetting than were parents who approached NE positively (comfort and encouragement; 33.3%). A lack of encouragement may negatively affect the self-esteem of children with NE. Moreover, an individual's self-esteem or confidence, both of which can help them eliminate NE, determines the person's behavioral response to bedwetting. In our study, approximately 50% of the parents who approached NE positively (comfort and encouragement) or inconsistently (ambivalence) reported that they comforted their child after bedwetting. Nearly half the parents reacted angrily to children with NE, and some parents even punished their child. The parents' socioeconomic background, education, and the age and birth order of the child were the factors associated with their seeking active treatment for NE. A father's education and

  9. Prevalence of suicidal behaviour & associated factors among tuberculosis patients in public primary care in South Africa.

    Science.gov (United States)

    Peltzer, Karl; Louw, Julia

    2013-01-01

    In spite of the high prevalence of tuberculosis worldwide, there are only a few studies on its psychiatric complications such as suicidal behaviour. We undertook this study to assess the prevalence of suicidal behaviour and its associated factors among tuberculosis patients in public primary care in South Africa. In a cross-sectional survey conducted in three provinces of South Africa new TB and new re-treatment patients were assessed within one month of anti-tuberculosis treatment. The sample included 4900 (54.5% men and women 45.5%) consecutively selected tuberculosis patients from 42 public primary care clinics in three districts in South Africa. A total of 322 patients (9.0%) reported suicidal ideation and 131 (3.1%) had a history of a suicide attempt. In multivariate analysis female gender [Odds Ratio (OR)= 0.56, Confidence Interval (CI)= 0.43-0.74], psychological distress (OR=2.36, CI=1.04-2.29), post-traumatic stress disorders (PTSD) (OR=4.98, CI=3.76-6.59), harmful alcohol use (OR=1.97, CI=1.25-3.09) and being a TB re-treatment patient (OR=1.76, CI=1.32-2.34) were associated with suicidal ideation, and psychological distress (OR=3.27, CI=1.51-7.10), PTSD symptoms (OR=4.48, CI=3.04-6.61) and harmful alcohol use (OR=3.01, CI=1.83-4.95) were associated with a suicide attempt. Our findings suggest that co-morbid illnesses of psychological distress, PTSD and harmful alcohol use and HIV infection should be assessed in TB patients under TB control programmes to prevent suicidal behaviour. Clinicians should be aware about suicidality in tuberculosis patients to reduce mortality.

  10. Prevalence of suicidal behaviour & associated factors among tuberculosis patients in public primary care in South Africa

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    Karl Peltzer

    2013-01-01

    Full Text Available Background & objectives: In spite of the high prevalence of tuberculosis worldwide, there are only a few studies on its psychiatric complications such as suicidal behaviour. We undertook this study to assess the prevalence of suicidal behaviour and its associated factors among tuberculosis patients in public primary care in South Africa. Methods: In a cross-sectional survey conducted in three provinces of South Africa new TB and new re-treatment patients were assessed within one month of anti-tuberculosis treatment. The sample included 4900 (54.5% men and women 45.5% consecutively selected tuberculosis patients from 42 public primary care clinics in three districts in South Africa. Results: A total of 322 patients (9.0% reported suicidal ideation and 131 (3.1% had a history of a suicide attempt. In multivariate analysis female gender [Odds Ratio (OR= 0.56, Confidence Interval (CI= 0.43-0.74], psychological distress (OR=2.36, CI=1.04-2.29, post-traumatic stress disorders (PTSD (OR=4.98, CI=3.76-6.59, harmful alcohol use (OR=1.97, CI=1.25-3.09 and being a TB re-treatment patient (OR=1.76, CI=1.32-2.34 were associated with suicidal ideation, and psychological distress (OR=3.27, CI=1.51-7.10, PTSD symptoms (OR=4.48, CI=3.04-6.61 and harmful alcohol use (OR=3.01, CI=1.83-4.95 were associated with a suicide attempt. Interpretation & conclusions: Our findings suggest that co-morbid illnesses of psychological distress, PTSD and harmful alcohol use and HIV infection should be assessed in TB patients under TB control programmes to prevent suicidal behaviour. Clinicians should be aware about suicidality in tuberculosis patients to reduce mortality.

  11. [Overweight in primary school-age children. Prevalence and risk factors].

    Science.gov (United States)

    Funk, M B; Bausback-Schomakers, S; Hanschmann, K M; Gerhards, B; Kuhn, K; Krackhardt, B

    2015-10-01

    Various studies show that pre-school age is a sensitive period for the development of overweight and obesity. During a longitudinal study between 2010 and 2013, the municipal health authority (city of Frankfurt) in cooperation with the university children's hospital investigated the development of weight in children aged 5 to 8. The weight and height of a collective of 5720 children were measured (2010/11). In addition, nutritional and exercise habits, as well as media consumption was documented for 4758 children through a questionnaire during the school enrolment procedure. The weight and height of 3481 children were measured again in the second grade (2012/13). Over a period of 24 months, the percentage of overweight (not obese) children increased from 7.5 to 9.4 % and that of obese children from 4.5 to 5.0 %. 164 of 2818 children with a normal initial weight (5.8 %) changed to percentile class overweight or obese. 79 of 260 children who were initially overweight, not obese (30 %), changed to the group of normal weight, but only 4 out of 156 obese children (3 %). Increased TV consumption (> 1 h per day), availability of their own television, lack of physical activity, and consumption of high-calorie drinks were risk factors for the development of overweight during the primary school age. 72 % of parents of overweight children and 22 % of obese children falsely classified their children as normal weight. Targeted education about the risk of obesity in the primary school age and offers for early intervention should be established in the healthcare services concerned.

  12. Elevated blood pressure among primary school children in Dar es salaam, Tanzania: prevalence and risk factors.

    Science.gov (United States)

    Muhihi, Alfa J; Njelekela, Marina A; Mpembeni, Rose N M; Muhihi, Bikolimana G; Anaeli, Amani; Chillo, Omary; Kubhoja, Sulende; Lujani, Benjamin; Maghembe, Mwanamkuu; Ngarashi, Davis

    2018-02-13

    Whilst the burden of non-communicable diseases is increasing in developing countries, little data is available on blood pressure among Tanzanian children. This study aimed at determining the blood pressure profiles and risk factors associated with elevated blood pressure among primary school children in Dar es Salaam, Tanzania. We conducted a cross sectional survey among 446 children aged 6-17 years from 9 randomly selected primary schools in Dar es Salaam. We measured blood pressure using a standardized digital blood pressure measuring machine (Omron Digital HEM-907, Tokyo, Japan). We used an average of the three blood pressure readings for analysis. Elevated blood pressure was defined as average systolic or diastolic blood pressure ≥ 90th percentile for age, gender and height. The proportion of children with elevated blood pressure was 15.2% (pre-hypertension 4.4% and hypertension 10.8%). No significant gender differences were observed in the prevalence of elevated BP. Increasing age and overweight/obese children were significantly associated with elevated BP (p = 0.0029 and p < 0.0001) respectively. Similar associations were observed for age and overweight/obesity with hypertension. (p = 0.0506 and p < 0.0001) respectively. In multivariate analysis, age above 10 years (adjusted RR = 3.63, 95% CI = 1.03-7.82) was significantly and independently associated with elevated BP in this population of school age children. We observed a higher proportion of elevated BP in this population of school age children. Older age and overweight/obesity were associated with elevated BP. Assessment of BP and BMI should be incorporated in school health program in Tanzania to identify those at risk so that appropriate interventions can be instituted before development of associated complications.

  13. Prediction factors for failure to seek treatment following traumatic dental injuries to primary teeth

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    Ramon Targino Firmino

    2014-06-01

    Full Text Available The objective of this study was to evaluate prediction factors for failure to seek treatment following a traumatic dental injury (TDI to primary teeth among preschool children in the city of Campina Grande, Brazil. A cross-sectional study was carried out involving 277 children 3 to 5 years of age, with TDI, enrolled in public and private preschools. Parents filled out a form addressing demographic data and whether or not they had sought treatment. Clinical examinations were performed by three dentists who had undergone a calibration exercise (Kappa: 0.85 to 0.90 for the evaluation of TDI. Bivariate and multivariate Poisson regression models were constructed (α = 5%. Enamel fracture was the most prevalent type of TDI (48.7% and the upper central incisors were the most affected teeth (88.4%. The frequency of seeking dental treatment was low (9.7%. The following variables were associated with failure to seek treatment following TDI: a household income greater than one minimum wage (PR = 1.170; 95%CI 1.018-1.341, parents/caregivers’ perception of a child’s oral health as poor (PR = 1.100; 95%CI 1.026-1.176, and the non-perception of TDI by parents/caregivers (PR = 1.250; 95%CI 1.142-1.360. In the present study, the frequency of seeking treatment following TDI was low, and parents/caregivers with a higher income, a poor perception of their child’s oral health and a lack of awareness regarding the trauma were more likely to fail to seek treatment following TDI to primary teeth.

  14. Factors that affect television viewing time in preschool and primary schoolchildren.

    Science.gov (United States)

    Songül Yalçin, Siddika; Tugrul, Belma; Naçar, NazIre; Tuncer, Murat; Yurdakök, Kadriye

    2002-12-01

    Excessive viewing of television (TV) has been linked to aggressive behavior, violence and childhood obesity. A cross-sectional study was conducted among preschool children and primary schoolchildren in Ankara during March and April 1999 to detect the factors that affect TV viewing time and to evaluate their parents' knowledge, attitudes and practices with regard to TV. The parents were asked to fill out a questionnaire about TV habits of their family, the number and location of TVs in the household and the effect of TV on children. Of 400 questionnaires, 350 answered the questions appropriately for this study. Children were divided into two groups, preschool children and primary schoolchildren. Television viewing time was given daily, as a mean of weekday. The mean age for becoming a TV viewer was 2.7 +/- 1.6 years. Of all, 62% of children spent >/= 2h/day watching TV and 8.3% of children spent > 4 h. The TV viewing time of child was significantly and positively correlated with that of siblings, mother and father for both groups. Age and sleeping time of the child, age and the education level of mother, presence of TV in the child's room and the starting age watching TV did not affect the viewing time. One-half of parents reported that the TV programs watched included violence, and one-third thought TV depicts child abuse, especially emotional abuse. It was found that the TV watching habits of parents had an influence on those of their children. Therefore, pediatricians should take 'TV histories' of children and their parents and educate parents how to become good TV viewers.

  15. Contribution of immunological and virological factors to extremely severe primary HIV-1 infection

    Science.gov (United States)

    Dalmau, Judith; Puertas, Maria Carmen; Azuara, Marta; Mariño, Ana; Frahm, Nicole; Mothe, Beatriz; Izquierdo-Useros, Nuria; Buzón, Maria José; Paredes, Roger; Matas, Lourdes; Allen, Todd M.; Brander, Christian; Rodrigo, Carlos; Clotet, Bonaventura; Martinez-Picado, Javier

    2009-01-01

    Background During acute HIV infection, high viral loads and the induction of host immune responses typically coincide with the onset of clinical symptoms. However, clinically severe presentations during acute HIV-1 infection, including AIDS-defining symptoms, are unusual. Methods Virus isolates were tested for clade, drug susceptibility, coreceptor usage, and growth rate for two cases of clinically severe sexual transmission. HLA genotype was determined, and HIV-1-specific CTL responses to an overlapping peptide set spanning the entire HIV clade A and clade B proteome were assayed. Results The virus isolated from the two unrelated cases of severe primary HIV-1 infection showed R5/X4 dual/mixed tropism, belonged to clade B and CRF02-AG, and were highly replicative in peripheral blood mononuclear cell culture. Impaired humoral responses were paralleled by a profound absence of HIV-1-specific CTL responses to the entire viral proteome in the two study cases. One case for which the virus source was available, showed a remarkable HLA similarity between the transmission pair as all 4 HLA-A and -B alleles were HLA supertype-matched between the subjects involved in the transmission case. Conclusions The data suggest that concurrence of viral and host factors contribute to the clinical severity of primary HIV-1 infection and that subjects infected with highly replicative dual tropic viruses are more prone to develop AIDS-defining symptoms during acute infection if they are unable to mount humoral and cellular HIV-1-specific immune responses. Concordant HLA supertypes might facilitate the preferential transmission of HLA-adapted viral variants, further accelerating disease progression. PMID:19093810

  16. 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

  17. 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

  18. Radon in indoor air of primary schools: determinant factors, their variability and effective dose.

    Science.gov (United States)

    Madureira, Joana; Paciência, Inês; Rufo, João; Moreira, André; de Oliveira Fernandes, Eduardo; Pereira, Alcides

    2016-04-01

    Radon is a radioactive gas, abundant in granitic areas, such as in the city of Porto at the north-east of Portugal. This gas is a recognized carcinogenic agent, being appointed by the World Health Organization as the leading cause of lung cancer after smoking. The aim of this preliminary survey was to determine indoor radon concentrations in public primary schools, to analyse the main factors influencing their indoor concentration levels and to estimate the effective dose in students and teachers in primary schools. Radon concentrations were measured in 45 classrooms from 13 public primary schools located in Porto, using CR-39 passive radon detectors for about 2-month period. In all schools, radon concentrations ranged from 56 to 889 Bq/m(3) (mean = 197 Bq/m(3)). The results showed that the limit of 100 Bq/m(3) established by WHO IAQ guidelines was exceeded in 92 % of the measurements, as well as 8 % of the measurements exceeded the limit of 400 Bq/m(3) established by the national legislation. Moreover, the mean annual effective dose was calculated as 1.25 mSv/y (ranging between 0.58 and 3.07 mSv/y), which is below the action level (3-10 mSv). The considerable variability of radon concentration observed between and within floors indicates a need to monitor concentrations in several rooms for each floor. A single radon detector for each room can be used, provided that the measurement error is considerably lower than variability of radon concentration between rooms. The results of the present survey will provide useful baseline data for adopting safety measures and dealing effectively with radiation emergencies. In particular, radon remediation techniques should be used in buildings located in the highest radon risk areas of Portugal. The results obtained in the current study concerning radon levels and their variations will be useful to optimize the design of future research surveys.

  19. Factors that drive insulin-dosing decisions of diabetes care providers: a vignette-based study in the Netherlands

    NARCIS (Netherlands)

    Simon, A. C. R.; Schopman, J. E.; Hoekstra, J. B. L.; Abu-Hanna, A.; Gerdes, V. E. A.; Peek, N.; Holleman, F.

    2015-01-01

    To test how certain patient factors would influence the decision of Dutch care providers regarding insulin dose adjustments. We hypothesize that some of these decisions would diverge from recent evidence and consensus statements. We developed narrative vignettes describing clinical scenarios of

  20. Dimensions of driving anger and their relationships with aberrant driving.

    Science.gov (United States)

    Zhang, Tingru; Chan, Alan H S; Zhang, Wei

    2015-08-01

    The purpose of this study was to investigate the relationship between driving anger and aberrant driving behaviours. An internet-based questionnaire survey was administered to a sample of Chinese drivers, with driving anger measured by a 14-item short Driving Anger Scale (DAS) and the aberrant driving behaviours measured by a 23-item Driver Behaviour Questionnaire (DBQ). The results of Confirmatory Factor Analysis demonstrated that the three-factor model (hostile gesture, arrival-blocking and safety-blocking) of the DAS fitted the driving anger data well. The Exploratory Factor Analysis on DBQ data differentiated four types of aberrant driving, viz. emotional violation, error, deliberate violation and maintaining progress violation. For the anger-aberration relation, it was found that only "arrival-blocking" anger was a significant positive predictor for all four types of aberrant driving behaviours. The "safety-blocking" anger revealed a negative impact on deliberate violations, a finding different from previously established positive anger-aberration relation. These results suggest that drivers with different patterns of driving anger would show different behavioural tendencies and as a result intervention strategies may be differentially effective for drivers of different profiles. Copyright © 2015 Elsevier Ltd. All rights reserved.

  1. Use of the Theoretical Domains Framework to evaluate factors driving successful implementation of the Accelerated Chest pain Risk Evaluation (ACRE) project.

    Science.gov (United States)

    Skoien, Wade; Page, Katie; Parsonage, William; Ashover, Sarah; Milburn, Tanya; Cullen, Louise

    2016-10-12

    The translation of healthcare research into practice is typically challenging and limited in effectiveness. The Theoretical Domains Framework (TDF) identifies 12 domains of behaviour determinants which can be used to understand the principles of behavioural change, a key factor influencing implementation. The Accelerated Chest pain Risk Evaluation (ACRE) project has successfully translated research into practice, by implementing an intervention to improve the assessment of low to intermediate risk patients presenting to emergency departments (EDs) with chest pain. The aims of this paper are to describe use of the TDF to determine which factors successfully influenced implementation and to describe use of the TDF as a tool to evaluate implementation efforts and which domains are most relevant to successful implementation. A 30-item questionnaire targeting clinicians was developed using the TDF as a guide. Questions encompassed ten of the domains of the TDF: Knowledge; Skills; Social/professional role and identity; Beliefs about capabilities; Optimism; Beliefs about consequences; Intentions; Memory, attention and decision processes; Environmental context and resources; and Social influences. Sixty-three of 176 stakeholders (36 %) responded to the questionnaire. Responses for all scales showed that respondents were highly favourable to all aspects of the implementation. Scales with the highest mean responses were Intentions, Knowledge, and Optimism, suggesting that initial education and awareness strategies around the ACRE project were effective. Scales with the lowest mean responses were Environmental context and resources, and Social influences, perhaps highlighting that implementation planning could have benefitted from further consideration of the factors underlying these scales. The ACRE project was successful, and therefore, a perfect case study for understanding factors which drive implementation success. The overwhelmingly positive response suggests that it

  2. Towards GMO-free landscapes? Identifying driving factors for the establishment of cooperative GMO-free zones in Germany

    OpenAIRE

    Consmuller, Nicola; Beckmann, Volker; Petrick, Martin

    2011-01-01

    Since the end of the quasi-moratorium on genetically modified organisms (GMO) in the European Union in 2004, the establishment of GMO-free zones has become an EU wide phenomenon. In contrast to other European countries, Germany follows the concept of cooperative GMO-free zones where neighbouring farmers contractually refrain from GMO cultivation. In this article, we address the question which underlying factors could account for the establishment of cooperative GMO-free zones in Germany. Draw...

  3. 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...

  4. Prevalence and factors associated with breast milk donation in banks that receive human milk in primary health care units,

    OpenAIRE

    Meneses, Tatiana Mota Xavier de; Oliveira, Maria Inês Couto de; Boccolini, Cristiano Siqueira

    2017-01-01

    Abstract Objective: To estimate the prevalence and to analyze factors associated with breast milk donation at primary health care units in order to increase the human milk bank reserves. Methods: Cross-sectional study carried out in 2013 in Rio de Janeiro, Brazil. A representative sample of 695 mothers of children younger than 1 year attended to at the nine primary health care units with human milk donation services were interviewed. A hierarchical approach was used to obtain adjusted preva...

  5. Prevalence and factors associated with breast milk donation in banks that receive human milk in primary health care units

    OpenAIRE

    Tatiana Mota Xavier de Meneses; Maria Inês Couto de Oliveira; Cristiano Siqueira Boccolini

    2017-01-01

    Abstract Objective: To estimate the prevalence and to analyze factors associated with breast milk donation at primary health care units in order to increase the human milk bank reserves. Methods: Cross-sectional study carried out in 2013 in Rio de Janeiro, Brazil. A representative sample of 695 mothers of children younger than 1 year attended to at the nine primary health care units with human milk donation services were interviewed. A hierarchical approach was used to obtain adjusted preva...

  6. Changes in chromatin state reveal ARNT2 at a node of a tumorigenic transcription factor signature driving glioblastoma cell aggressiveness.

    Science.gov (United States)

    Bogeas, Alexandra; Morvan-Dubois, Ghislaine; El-Habr, Elias A; Lejeune, François-Xavier; Defrance, Matthieu; Narayanan, Ashwin; Kuranda, Klaudia; Burel-Vandenbos, Fanny; Sayd, Salwa; Delaunay, Virgile; Dubois, Luiz G; Parrinello, Hugues; Rialle, Stéphanie; Fabrega, Sylvie; Idbaih, Ahmed; Haiech, Jacques; Bièche, Ivan; Virolle, Thierry; Goodhardt, Michele; Chneiweiss, Hervé; Junier, Marie-Pierre

    2018-02-01

    Although a growing body of evidence indicates that phenotypic plasticity exhibited by glioblastoma cells plays a central role in tumor development and post-therapy recurrence, the master drivers of their aggressiveness remain elusive. Here we mapped the changes in active (H3K4me3) and repressive (H3K27me3) histone modifications accompanying the repression of glioblastoma stem-like cells tumorigenicity. Genes with changing histone marks delineated a network of transcription factors related to cancerous behavior, stem state, and neural development, highlighting a previously unsuspected association between repression of ARNT2 and loss of cell tumorigenicity. Immunohistochemistry confirmed ARNT2 expression in cell sub-populations within proliferative zones of patients' glioblastoma. Decreased ARNT2 expression was consistently observed in non-tumorigenic glioblastoma cells, compared to tumorigenic cells. Moreover, ARNT2 expression correlated with a tumorigenic molecular signature at both the tissue level within the tumor core and at the single cell level in the patients' tumors. We found that ARNT2 knockdown decreased the expression of SOX9, POU3F2 and OLIG2, transcription factors implicated in glioblastoma cell tumorigenicity, and repressed glioblastoma stem-like cell tumorigenic properties in vivo. Our results reveal ARNT2 as a pivotal component of the glioblastoma cell tumorigenic signature, located at a node of a transcription factor network controlling glioblastoma cell aggressiveness.

  7. Regional factors rather than forest type drive the community structure of soil living oribatid mites (Acari, Oribatida).

    Science.gov (United States)

    Erdmann, Georgia; Scheu, Stefan; Maraun, Mark

    2012-06-01

    Most European forests are managed by humans. However, the manner and intensity of management vary. While the effect of forest management on above-ground communities has been investigated in detail, effects on the below-ground fauna remain poorly understood. Oribatid mites are abundant microarthropods in forest soil and important decomposers in terrestrial ecosystems. Here, we investigated the effect of four forest types (i.e., managed coniferous forests; 30 and 70 years old managed beech forests; natural beech forests) on the density, diversity and community structure of oribatid mites (Acari). The study was replicated at three regions in Germany: the Swabian Alb, the Hainich and the Schorfheide. To relate changes in oribatid mite community structure to environmental factors, litter mass, pH, C and N content of litter, fine roots and C content of soil were measured. Density of oribatid mites was highest in the coniferous forests and decreased in the order 30 years old, 70 years old, and natural beech forests. Mass of the litter layer and density of oribatid mites were strongly correlated indicating that the litter layer is an important factor regulating oribatid mite densities. Diversity of oribatid mites was little affected by forest type indicating that they harbor similar numbers of niches. Species composition differed between the forest types, suggesting different types of niches. The community structure of oribatid mites differed more strongly between the three regions than between the forest types indicating that regional factors are more important than effects associated with forest type.

  8. Factors Associated With Medication-Overuse Headache in Patients Seeking Treatment for Primary Headache.

    Science.gov (United States)

    Peck, Kelly R; Roland, Malcolm M; Smitherman, Todd A

    2018-03-09

    Although risk factors for medication-overuse headache have been identified within the general population, most studies have neglected clinical samples. The present study examined the relative and combined associations of these factors with medication-overuse headache in a sample of US adults seeking treatment for primary headache disorders. Treatment-seeking headache patients provided data on demographics, headache variables, psychiatric variables, use of headache medications, and use of other prescription medications and substances. A classification tree selection strategy was utilized within this cross-sectional study to differentiate between those with and without medication-overuse headache, and a final multivariable model assessed their combined utility. Forty-three of 164 participants (26.2%) met diagnostic criteria for medication-overuse headache. Relative to non-medication-overuse headache participants, participants with medication-overuse headache reported greater headache-related disability (odds ratio = 1.09, 95% confidence interval = 1.01-1.18), escape and avoidance responses indicative of fear of pain (odds ratio = 1.07, 95% confidence interval = 1.00-1.15), and use of combination medications for headache (odds ratio = 3.10, 95% confidence interval = 1.51-6.36). The final multivariable model differentiated well between the 2 groups (area under the receiver operating characteristic curve = .78; 95% confidence interval = .71-.86). Items that assess headache-related disability, use of combination medications, and fear of pain help identify patients who are currently overusing acute headache medications and may serve as indicators of treatment progress. Future studies should apply similar analytic approaches longitudinally to identify headache sufferers at risk for medication-overuse headache prior to headache progression. © 2018 American Headache Society.

  9. Surveillance of primary sclerosing cholangitis with ERC and brush cytology: risk factors for cholangiocarcinoma.

    Science.gov (United States)

    Boyd, Sonja; Mustonen, Harri; Tenca, Andrea; Jokelainen, Kalle; Arola, Johanna; Färkkilä, Martti A

    2017-02-01

    Primary sclerosing cholangitis (PSC) is a chronic cholestatic liver disease leading to bile duct strictures and fibrosis, and predisposing to cholangiocarcinoma (CCA). Biliary dysplasia is a known precursor of CCA. In our unit, PSC patients undergo regular surveillance with ERC and brush cytology (BC), and liver transplantation is an option in case with biliary dysplasia. We evaluated the risk factors for biliary dysplasia and CCA based on ERC imaging, BC and liver function tests. Seven hundred and eighty-eight ERCs were performed with BC for 447 PSC patients. ERC images were evaluated using the modified Amsterdam score, neutrophilic inflammation was assessed in BC, and liver function tests were collected. Ploidy analysis with DNA flow cytometry was performed in cases with advanced PSC or previous suspicious BC/aneuploidy. The endpoint was either a benign disease course (follow-up for ≥2.4 years after the latest ERC), benign histology, biliary dysplasia or CCA. Benign disease course was seen in 424/447 (including 23 cases with biliary dysplasia), and CCA in 17 (3.8%) patients. Gallbladder carcinoma/carcinoma in situ was diagnosed in three patients. Advanced ERC findings, male gender, suspicious BC, aneuploidy in flow cytometry, inflammation, and elevation of ALP, bilirubin, ALT, AST, GGT, CEA and CA19-9 represented significant risk factors for CCA in univariate analysis. PSC patients with advanced bile duct disease and elevated liver enzymes, CEA or CA19-9, inflammation or suspicious BC are most likely to develop CCA. These patients may benefit from surveillance with BC if early liver transplantation is possible.

  10. Outcome and risk factors of recurrence after thoracoscopic bullectomy in young adults with primary spontaneous pneumothorax.