WorldWideScience

Sample records for primary factor limiting

  1. 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

  2. Primary system temperature limits and transient mitigation

    Energy Technology Data Exchange (ETDEWEB)

    Drucker, G.S.; Bost, D.S.

    1978-10-03

    Results of a study to determine the limiting temperature conditions in a large reactor system are presented. The study considers a sodium-cooled breeder reactor system having a loop-type primary system configuration. A temperature range of 930 to 1050/sup 0/F in reactor outlet temperature is covered. Significant findings were that the use of the materials for the 930/sup 0/F reference design, i.e., a core material of 20% cold-worked 316 stainless steel, a primary piping material of 316SS, and a steam generator material of unstabilized 2-1/4 Cr - 1 Mo resulted in limiting conditions in component performance at the higher temperatures. Means to circumvent these limits through the use of alternate materials, mitigation of thermal transients, and/or design changes are presented. The economic incentive to make some materials changes is also presented.

  3. Landscape genetics and limiting factors

    Science.gov (United States)

    Samuel A. Cushman; Andrew J. Shirk; Erin L. Landguth

    2013-01-01

    Population connectivity is mediated by the movement of organisms or propagules through landscapes. However, little is known about how variation in the pattern of landscape mosaics affects the detectability of landscape genetic relationships. The goal of this paper is to explore the impacts of limiting factors on landscape genetic processes using simulation...

  4. Preliminary disposal limits, plume interaction factors, and final disposal limits

    Energy Technology Data Exchange (ETDEWEB)

    Flach, G. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL)

    2018-01-11

    In the 2008 E-Area Performance Assessment (PA), each final disposal limit was constructed as the product of a preliminary disposal limit and a plume interaction factor. The following mathematical development demonstrates that performance objectives are generally expected to be satisfied with high confidence under practical PA scenarios using this method. However, radionuclides that experience significant decay between a disposal unit and the 100-meter boundary, such as H-3 and Sr-90, can challenge performance objectives, depending on the disposed-of waste composition, facility geometry, and the significance of the plume interaction factor. Pros and cons of analyzing single disposal units or multiple disposal units as a group in the preliminary disposal limits analysis are also identified.

  5. Limiting factors in caribou population ecology

    Directory of Open Access Journals (Sweden)

    David R. Klein

    1991-10-01

    Full Text Available Caribou and wild reindeer populations fluctuate over time. On this fact there is general agreement. Factors responsible for population limitation and subsequent declines have been examined within the framework of animal population theory. There is, however, little agreement when factors limiting specific populations are generalized to Rangifer populations over broad geographic regions. Comparative examinations of wild Rangifer populations worldwide discloses that factors that have regulated those populations are highly variable between populations, apparently as a reflection of the differences in environmental variables unique to each population. Examples exist of populations where major regulating factors have been climatic extremes, predation, hunting mortality, food limitation, insects, parasites, disease, interspecific competition, and human developmental impacts or combinations of these factors. This diversity of limiting factors affecting caribou and wild reindeer populations is a reflection of the ecologial complexity of the species, a concept that has often been ignored in past efforts to reach management decisions by extrapolation from the limited localized knowledge available on the species.

  6. 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.

  7. Factors limiting device efficiency in organic photovoltaics

    NARCIS (Netherlands)

    Janssen, R.A.J.; Nelson, J.

    2013-01-01

    The power conversion efficiency of the most efficient organic photovoltaic (OPV) cells has recently increased to over 10%. To enable further increases, the factors limiting the device efficiency in OPV must be identified. In this review, the operational mechanism of OPV cells is explained and the

  8. Neural Anatomy of Primary Visual Cortex Limits Visual Working Memory.

    Science.gov (United States)

    Bergmann, Johanna; Genç, Erhan; Kohler, Axel; Singer, Wolf; Pearson, Joel

    2016-01-01

    Despite the immense processing power of the human brain, working memory storage is severely limited, and the neuroanatomical basis of these limitations has remained elusive. Here, we show that the stable storage limits of visual working memory for over 9 s are bound by the precise gray matter volume of primary visual cortex (V1), defined by fMRI retinotopic mapping. Individuals with a bigger V1 tended to have greater visual working memory storage. This relationship was present independently for both surface size and thickness of V1 but absent in V2, V3 and for non-visual working memory measures. Additional whole-brain analyses confirmed the specificity of the relationship to V1. Our findings indicate that the size of primary visual cortex plays a critical role in limiting what we can hold in mind, acting like a gatekeeper in constraining the richness of working mental function. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  9. Limiting Factors for External Reactor Vessel Cooling

    International Nuclear Information System (INIS)

    Cheung, F.B.

    2005-01-01

    The method of external reactor vessel cooling (ERVC) that involves flooding of the reactor cavity during a severe accident has been considered a viable means for in-vessel retention (IVR). For high-power reactors, however, there are some limiting factors that might adversely affect the feasibility of using ERVC as a means for IVR. In this paper, the key limiting factors for ERVC have been identified and critically discussed. These factors include the choking limit for steam venting (CLSV) through the bottleneck of the vessel/insulation structure, the critical heat flux (CHF) for downward-facing boiling on the vessel outer surface, and the two-phase flow instabilities in the natural circulation loop within the flooded cavity. To enhance ERVC, it is necessary to eliminate or relax these limiting factors. Accordingly, methods to enhance ERVC and thus improve margins for IVR have been proposed and demonstrated, using the APR1400 as an example. The strategy is based on using two distinctly different methods to enhance ERVC. One involves the use of an enhanced vessel/insulation design to facilitate steam venting through the bottleneck of the annular channel. The other involves the use of an appropriate vessel coating to promote downward-facing boiling. It is found that the use of an enhanced vessel/insulation design with bottleneck enlargement could greatly facilitate the process of steam venting through the bottleneck region as well as streamline the resulting two-phase motions in the annular channel. By selecting a suitable enhanced vessel/insulation design, not only the CLSV but also the CHF limits could be significantly increased. In addition, the problem associated with two-phase flow instabilities and flow-induced mechanical vibration could be minimized. It is also found that the use of vessel coatings made of microporous metallic layers could greatly facilitate downward-facing boiling on the vessel outer surface. With vessel coatings, the local CHF limits at

  10. Nucleon form factors. Probing the chiral limit

    Energy Technology Data Exchange (ETDEWEB)

    Goeckeler, M. [Regensburg Univ. (Germany). Inst. fuer Theoretische Physik; Haegler, P. [Technische Univ. Muenchen, Garching (Germany). Physik-Dept.; Horsley, R. [Edinburgh Univ. (GB). School of Physics] (and others)

    2006-10-15

    The electromagnetic form factors provide important hints for the internal structure of the nucleon and continue to be of major interest for experimentalists. For an intermediate range of momentum transfers the form factors can be calculated on the lattice. However, reliability of the results is limited by systematic errors due to the required extrapolation to physical quark masses. Chiral effective field theories predict a rather strong quark mass dependence in a range which was yet unaccessible for lattice simulations. We give an update on recent results from the QCDSF collaboration using gauge configurations with Nf=2, non-perturbatively O(a)-improved Wilson fermions at very small quark masses down to 340 MeV pion mass, where we start to probe the relevant quark mass region. (orig.)

  11. Nucleon form factors. Probing the chiral limit

    International Nuclear Information System (INIS)

    Goeckeler, M.; Haegler, P.; Horsley, R.

    2006-10-01

    The electromagnetic form factors provide important hints for the internal structure of the nucleon and continue to be of major interest for experimentalists. For an intermediate range of momentum transfers the form factors can be calculated on the lattice. However, reliability of the results is limited by systematic errors due to the required extrapolation to physical quark masses. Chiral effective field theories predict a rather strong quark mass dependence in a range which was yet unaccessible for lattice simulations. We give an update on recent results from the QCDSF collaboration using gauge configurations with Nf=2, non-perturbatively O(a)-improved Wilson fermions at very small quark masses down to 340 MeV pion mass, where we start to probe the relevant quark mass region. (orig.)

  12. Captopril suppression: limitations for confirmation of primary aldosteronism.

    Science.gov (United States)

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

    2011-09-01

    The aldosterone/renin ratio (ARR) is the first line screening test for primary aldosteronism (PA). However, in hypertensive patients with an increased ARR, PA needs to be confirmed by other means. A 25 mg oral captopril test was performed in 16 healthy subjects to obtain reference values for aldosterone and ARR at 120 minutes after the test. Subsequently these data were applied to 46 hypertensive patients screened for PA with an increased ARR. At 120 minutes after the captopril test ARR decreased in healthy subjects within a narrow range, but remained high in patients with PA and in patients with primary hypertension, especially for those with low renin characteristics. At 120 minutes after captopril, the range of ARR in primary hypertensive patients overlapped in 88% of the cases with the range of the ARR in the PA patients. Sensitivity and specificity of basal ARR and ARR after the captopril test to diagnose PA, calculated as receiver operator characteristics, showed an area under the curve of 0.595 for basal ARR and 0.664 for ARR at 120 minutes after the test. The ARR at 120 minutes after the captopril test is only marginally better than basal ARR in diagnosing PA in hypertensive patients screened with an increased ARR. Owing to an overall limited capacity to clearly discriminate PA from primary hypertension, the test could not therefore be recommended for the confirmatory diagnosis of PA.

  13. 14 CFR 27.337 - Limit maneuvering load factor.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Limit maneuvering load factor. 27.337... Limit maneuvering load factor. The rotorcraft must be designed for— (a) A limit maneuvering load factor... load factor not less than 2.0 and any negative limit maneuvering load factor of not less than −0.5 for...

  14. 14 CFR 29.337 - Limit maneuvering load factor.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Limit maneuvering load factor. 29.337... Limit maneuvering load factor. The rotorcraft must be designed for— (a) A limit maneuvering load factor... load factor not less than 2.0 and any negative limit maneuvering load factor of not less than −0.5 for...

  15. 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.

  16. Uranium, a factor limiting nuclear energy?

    International Nuclear Information System (INIS)

    Ohnemus, J.

    2006-01-01

    Nuclear power has been back as a topic of public debate since early this year. A special subject under discussion is the extension of nuclear power plant life. Hardly had it been on the agenda, when interested parties announced that this step was impossible because uranium reserves were no longer sufficient. A variety of terms are being used in this discussion without their meaning being taken into account: stocks, resources, and reserves. To clarify the situation, this article outlines important aspects of short and long term uranium supplies, and analyzes their meaning. Here are some of the most important issues under consideration: - For what period of time is there really enough uranium? - Is uranium becoming the limiting factor in the use of nuclear power? - Is uranium really a 'sustainable' energy resource? - Will higher prices extend the range? - What is the influence of the price of uranium on the cost of electricity generation? Among other results, it is found that comprehensive sources of low-price uranium and nuclear fuels are, or can be made, available worldwide. Consequently, the 'range' is beyond the time frames currently mentioned, also as a function of technological factors, i.e. reaching several hundred years. It is also important to note that nuclear power - ensures greater independence of volatile imported sources, - guarantees reliably low electricity prices, - has a huge potential of environmental protection, and - is a clean source of energy. (orig.)

  17. Uranium, a factor limiting nuclear energy?

    International Nuclear Information System (INIS)

    2006-01-01

    Nuclear power has been back as a topic of public debate since early this year. A special subject under discussion is the extension of nuclear power plant life. Hardly had it been on the agenda, when interested parties announced that this step was impossible because uranium reserves were no longer sufficient. A variety of terms are being used in this discussion without their meaning being taken into account: stocks, resources, and reserves. To clarify the situation, this article outlines important aspects of short and long term uranium supplies, and analyzes their meaning. Here are some of the most important issues under consideration: - For what period of time is there really enough uranium? - Is uranium becoming the limiting factor in the use of nuclear power? - Is uranium really a 'sustainable' energy resource? - Will higher prices extend the range? - What is the influence of the price of uranium on the cost of electricity generation? Among other results, it is found that comprehensive sources of low-price uranium and nuclear fuels are, or can be made, available worldwide. Consequently, the 'range' is beyond the time frames currently mentioned, also as a function of technological factors, i.e. reaching several hundred years. It is also important to note that nuclear power - ensures greater independence of volatile imported sources, - guarantees reliably low electricity prices, - has a huge potential of environmental protection, and - is a clean source of energy. (orig./GL)

  18. Uranium - a factor limiting nuclear energy?

    International Nuclear Information System (INIS)

    Ohnemus, J.

    2006-01-01

    Nuclear power has been back as a topic of public debate since early this year. A special subject under discussion is the extension of nuclear power plant life. Hardly had it been on the agenda, when interested parties announced that this st ep was impossible because uranium reserves were no longer sufficient. A variety of terms are being used in this discussion without their meaning being taken int o account: stocks, resources, and reserves. To clarify the situation, this artic le outlines important aspects of short and long term uranium supplies, and analy zes their meaning. Here are some of the most important issues under consideration: - For what period of time is there really enough uranium? - Is uranium becoming the limiting factor in the use of nuclear power? - Is uranium really a 'sustainable' energy resource? - Will higher prices extend the range? - What is the in fluence of the price of uranium on the cost of electricity generation? Among oth er results, it is found that comprehensive sources of low-price uranium and nucl ear fuels are, or can be made, available worldwide. Consequently, the 'range' is beyond the time frames currently mentioned, also as a function of technological factors, i.e. reaching several hundred years. It is also important to note that nuclear power - ensures greater independence of volatile imported sources, - guarantees reliably low electricity prices, - has a huge potential of environmental protection, and - is a clean source of energy. (orig.)

  19. 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

  20. 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.

  1. Effects of internal limiting membrane peeling during vitrectomy for macula-off primary rhegmatogenous retinal detachment.

    Science.gov (United States)

    Blanco-Teijeiro, María José; Bande Rodriguez, Manuel; Mansilla Cuñarro, Raquel; Paniagua Fernández, Laura; Ruiz-Oliva Ruiz, Francisco; Piñeiro Ces, Antonio

    2018-03-01

    To determine the effectiveness of internal limiting membrane peeling during vitrectomy for macula-off primary rhegmatogenous retinal detachment in the prevention of postoperative epiretinal membrane formation and achievement of good visual outcomes and to identify preoperative and intraoperative risk factors for epiretinal membrane formation. We retrospectively analyzed data from 62 eyes of 62 consecutive patients with macula-off primary rhegmatogenous retinal detachment who underwent vitrectomy with (n = 30) or without (n = 32) internal limiting membrane peeling between January 2014 and March 2016 and were followed up for at least 12 months. The effects of internal limiting membrane peeling on visual outcomes and postoperative recovery of the macular structure were determined. We subsequently divided patients into an epiretinal membrane group and a non-epiretinal membrane group and assessed the effects of various preoperative and intraoperative factors on postoperative epiretinal membrane formation. Postoperative epiretinal membrane developed in 10 patients in the no internal limiting membrane peeling group and three patients in the internal limiting membrane peeling group. Postoperative visual acuity significantly improved in both groups. Epiretinal membrane formation was found to be correlated with a higher number of retinal breaks. Our results suggest that internal limiting membrane peeling during macula-off primary rhegmatogenous retinal detachment surgery can reduce the occurrence of postoperative epiretinal membrane, is safe, and results in favorable visual outcomes.

  2. Perceived factors limiting rice production in Pategi Local ...

    African Journals Online (AJOL)

    user

    perceived limiting factors in rice production include lack of rice processing ... This production increase has not been enough to meet the consumption demand of ... of Kwara State, Nigeria seeks to determine some of the factors limiting rice ...

  3. Genetic transformation of barley: limiting factors

    Czech Academy of Sciences Publication Activity Database

    Vyroubalová, Š.; Šmehilová, M.; Galuszka, P.; Ohnoutková, Ludmila

    2011-01-01

    Roč. 55, č. 2 (2011), s. 213-224 ISSN 0006-3134 R&D Projects: GA ČR GD522/08/H003; GA MŠk 1M06030 Institutional research plan: CEZ:AV0Z50380511 Keywords : Agrobacterium * albinism * Hordeum Subject RIV: EB - Genetics ; Molecular Biology Impact factor: 1.974, year: 2011

  4. Radiation risk factors and dose limits

    International Nuclear Information System (INIS)

    Barendsen, G.W.

    1979-01-01

    The contents of the ICRP publications 9 (1965) and 26 (1977) are outlined and the research conducted during these years considered. Expressions are derived for the frequency for induction of cancer from the most common irradiations - X rays, gamma rays and electrons. The dose limits advised by the ICRP are discussed and the first two fundamental principles are presented - that no one should be subjected to radiation without useful cause and that in those cases where irradiation is thought necessary, the medical, scientific, social and economic advantages need to be carefully considered with respect to the possible disadvantages. (C.F.)

  5. Metabolic factors limiting performance in marathon runners.

    Science.gov (United States)

    Rapoport, Benjamin I

    2010-10-21

    Each year in the past three decades has seen hundreds of thousands of runners register to run a major marathon. Of those who attempt to race over the marathon distance of 26 miles and 385 yards (42.195 kilometers), more than two-fifths experience severe and performance-limiting depletion of physiologic carbohydrate reserves (a phenomenon known as 'hitting the wall'), and thousands drop out before reaching the finish lines (approximately 1-2% of those who start). Analyses of endurance physiology have often either used coarse approximations to suggest that human glycogen reserves are insufficient to fuel a marathon (making 'hitting the wall' seem inevitable), or implied that maximal glycogen loading is required in order to complete a marathon without 'hitting the wall.' The present computational study demonstrates that the energetic constraints on endurance runners are more subtle, and depend on several physiologic variables including the muscle mass distribution, liver and muscle glycogen densities, and running speed (exercise intensity as a fraction of aerobic capacity) of individual runners, in personalized but nevertheless quantifiable and predictable ways. The analytic approach presented here is used to estimate the distance at which runners will exhaust their glycogen stores as a function of running intensity. In so doing it also provides a basis for guidelines ensuring the safety and optimizing the performance of endurance runners, both by setting personally appropriate paces and by prescribing midrace fueling requirements for avoiding 'the wall.' The present analysis also sheds physiologically principled light on important standards in marathon running that until now have remained empirically defined: The qualifying times for the Boston Marathon.

  6. Metabolic factors limiting performance in marathon runners.

    Directory of Open Access Journals (Sweden)

    Benjamin I Rapoport

    2010-10-01

    Full Text Available Each year in the past three decades has seen hundreds of thousands of runners register to run a major marathon. Of those who attempt to race over the marathon distance of 26 miles and 385 yards (42.195 kilometers, more than two-fifths experience severe and performance-limiting depletion of physiologic carbohydrate reserves (a phenomenon known as 'hitting the wall', and thousands drop out before reaching the finish lines (approximately 1-2% of those who start. Analyses of endurance physiology have often either used coarse approximations to suggest that human glycogen reserves are insufficient to fuel a marathon (making 'hitting the wall' seem inevitable, or implied that maximal glycogen loading is required in order to complete a marathon without 'hitting the wall.' The present computational study demonstrates that the energetic constraints on endurance runners are more subtle, and depend on several physiologic variables including the muscle mass distribution, liver and muscle glycogen densities, and running speed (exercise intensity as a fraction of aerobic capacity of individual runners, in personalized but nevertheless quantifiable and predictable ways. The analytic approach presented here is used to estimate the distance at which runners will exhaust their glycogen stores as a function of running intensity. In so doing it also provides a basis for guidelines ensuring the safety and optimizing the performance of endurance runners, both by setting personally appropriate paces and by prescribing midrace fueling requirements for avoiding 'the wall.' The present analysis also sheds physiologically principled light on important standards in marathon running that until now have remained empirically defined: The qualifying times for the Boston Marathon.

  7. Factors associated with persistent airflow limitation in severe asthma

    NARCIS (Netherlands)

    ten Brinke, A.; Zwinderman, A. H.; Sterk, P. J.; Rabe, K. F.; Bel, E. H.

    2001-01-01

    Persistent airflow limitation can develop in nonsmoking patients with asthma. However, the prevalence and risk factors for airways obstruction with incomplete reversibility in asthma are unknown. We assessed the prevalence of persistent airflow limitation (defined as postbronchodilator FEV(1) or

  8. Quantifying environmental limiting factors on tree cover using geospatial data.

    Science.gov (United States)

    Greenberg, Jonathan A; Santos, Maria J; Dobrowski, Solomon Z; Vanderbilt, Vern C; Ustin, Susan L

    2015-01-01

    Environmental limiting factors (ELFs) are the thresholds that determine the maximum or minimum biological response for a given suite of environmental conditions. We asked the following questions: 1) Can we detect ELFs on percent tree cover across the eastern slopes of the Lake Tahoe Basin, NV? 2) How are the ELFs distributed spatially? 3) To what extent are unmeasured environmental factors limiting tree cover? ELFs are difficult to quantify as they require significant sample sizes. We addressed this by using geospatial data over a relatively large spatial extent, where the wall-to-wall sampling ensures the inclusion of rare data points which define the minimum or maximum response to environmental factors. We tested mean temperature, minimum temperature, potential evapotranspiration (PET) and PET minus precipitation (PET-P) as potential limiting factors on percent tree cover. We found that the study area showed system-wide limitations on tree cover, and each of the factors showed evidence of being limiting on tree cover. However, only 1.2% of the total area appeared to be limited by the four (4) environmental factors, suggesting other unmeasured factors are limiting much of the tree cover in the study area. Where sites were near their theoretical maximum, non-forest sites (tree cover demand, and closed-canopy forests were not limited by any particular environmental factor. The detection of ELFs is necessary in order to fully understand the width of limitations that species experience within their geographic range.

  9. Variable Eddington factors and flux-limiting diffusion coefficients

    International Nuclear Information System (INIS)

    Whalen, P.P.

    1982-01-01

    Variable Eddington factors and flux limiting diffusion coefficients arise in two common techniques of closing the moment equations of transport. The first two moment equations of the full transport equation are still frequently used to solve many problems of radiative or particle transport. An approximate analysis, developed by Levermore, exhibits the relation between the coefficients of the two different techniques. This analysis is described and then used to test the validity of several commonly used flux limiters and Eddington factors. All of the ad-hoc flux limiters have limited validity. All of the variable Eddington factors derived from some underlying description of the angular distribution function are generally valid. The use of coefficients from Minerbo's elegant maximum entropy Eddington factor analysis is suggested for use in either flux limited diffusion or variable Eddington factor equations

  10. Quantifying environmental limiting factors on tree cover using geospatial data.

    Directory of Open Access Journals (Sweden)

    Jonathan A Greenberg

    Full Text Available Environmental limiting factors (ELFs are the thresholds that determine the maximum or minimum biological response for a given suite of environmental conditions. We asked the following questions: 1 Can we detect ELFs on percent tree cover across the eastern slopes of the Lake Tahoe Basin, NV? 2 How are the ELFs distributed spatially? 3 To what extent are unmeasured environmental factors limiting tree cover? ELFs are difficult to quantify as they require significant sample sizes. We addressed this by using geospatial data over a relatively large spatial extent, where the wall-to-wall sampling ensures the inclusion of rare data points which define the minimum or maximum response to environmental factors. We tested mean temperature, minimum temperature, potential evapotranspiration (PET and PET minus precipitation (PET-P as potential limiting factors on percent tree cover. We found that the study area showed system-wide limitations on tree cover, and each of the factors showed evidence of being limiting on tree cover. However, only 1.2% of the total area appeared to be limited by the four (4 environmental factors, suggesting other unmeasured factors are limiting much of the tree cover in the study area. Where sites were near their theoretical maximum, non-forest sites (tree cover < 25% were primarily limited by cold mean temperatures, open-canopy forest sites (tree cover between 25% and 60% were primarily limited by evaporative demand, and closed-canopy forests were not limited by any particular environmental factor. The detection of ELFs is necessary in order to fully understand the width of limitations that species experience within their geographic range.

  11. 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.

  12. Classical limit of diagonal form factors and HHL correlators

    Energy Technology Data Exchange (ETDEWEB)

    Bajnok, Zoltan [MTA Lendület Holographic QFT Group, Wigner Research Centre,H-1525 Budapest 114, P.O.B. 49 (Hungary); Janik, Romuald A. [Institute of Physics, Jagiellonian University,ul. Łojasiewicza 11, 30-348 Kraków (Poland)

    2017-01-16

    We propose an expression for the classical limit of diagonal form factors in which we integrate the corresponding observable over the moduli space of classical solutions. In infinite volume the integral has to be regularized by proper subtractions and we present the one, which corresponds to the classical limit of the connected diagonal form factors. In finite volume the integral is finite and can be expressed in terms of the classical infinite volume diagonal form factors and subvolumes of the moduli space. We analyze carefully the periodicity properties of the finite volume moduli space and found a classical analogue of the Bethe-Yang equations. By applying the results to the heavy-heavy-light three point functions we can express their strong coupling limit in terms of the classical limit of the sine-Gordon diagonal form factors.

  13. Critical Success Factors for Limited Service Hotels in Malaysia

    OpenAIRE

    Wong, Chee Keng

    2015-01-01

    Critical success factors were used originally in Information technology areas when it was first introduced but has since been applied generically in other industries. This study explores the critical success factors for limited service hotels in Malaysia from both customer and hotel operator/ business owners’ perspective. The literature presents information from tourism in general and in Malaysia, definition of limited service hotels and its relevance to the hospitality industry in Malaysia, ...

  14. 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.

  15. 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 ...

  16. 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

  17. Thermoelectric Power Factor Limit of a 1D Nanowire

    Science.gov (United States)

    Chen, I.-Ju; Burke, Adam; Svilans, Artis; Linke, Heiner; Thelander, Claes

    2018-04-01

    In the past decade, there has been significant interest in the potentially advantageous thermoelectric properties of one-dimensional (1D) nanowires, but it has been challenging to find high thermoelectric power factors based on 1D effects in practice. Here we point out that there is an upper limit to the thermoelectric power factor of nonballistic 1D nanowires, as a consequence of the recently established quantum bound of thermoelectric power output. We experimentally test this limit in quasiballistic InAs nanowires by extracting the maximum power factor of the first 1D subband through I -V characterization, finding that the measured maximum power factors conform to the theoretical limit. The established limit allows the prediction of the achievable power factor of a specific nanowire material system with 1D electronic transport based on the nanowire dimension and mean free path. The power factor of state-of-the-art semiconductor nanowires with small cross section and high crystal quality can be expected to be highly competitive (on the order of mW /m K2 ) at low temperatures. However, they have no clear advantage over bulk materials at, or above, room temperature.

  18. 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 ...

  19. 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

  20. Local melanoma recurrences in the scar after limited surgery for primary tumor

    DEFF Research Database (Denmark)

    Drzewiecki, K T; Andersson, A P

    1995-01-01

    The clinical and histologic records of 46 consecutive patients were reviewed who during the period 1980-1993 had recurrence from melanoma in the scar after limited surgery for a skin tumor. They constituted about 50% of all patients admitted with local recurrence from melanoma during this period....... At reexamination of the primary tumors, 16 were found to be malignant melanomas and 9 were nevi (four atypical and five benign). Twenty-one were missing, 11 of which had never been set for histologic examination. The median thickness of nine measurable melanomas was 0.66 mm. The recurrences in scar consisted of 34...... recurrences in the form of a new primary in a scar following limited surgery supports the theory of limited field change around a primary melanoma. Furthermore, limited procedures for primary melanoma, if followed by a recurrence in the scar, worsen the prognosis....

  1. 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 ...

  2. Quantifying Environmental Limiting Factors on Tree Cover Using Geospatial Data

    NARCIS (Netherlands)

    Greenberg, Jonathan; Ferreira Dos Santos, Maria Joao; Dobrowski, Solomon; Vanderbilt, Vern; Ustin, Susan

    2015-01-01

    Environmental limiting factors (ELFs) are the thresholds that determine the maximum or minimum biological response for a given suite of environmental conditions. We asked the following questions: 1) Can we detect ELFs on percent tree cover across the eastern slopes of the Lake Tahoe Basin, NV? 2)

  3. 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.

  4. Host Cell Restriction Factors that Limit Influenza A Infection

    Directory of Open Access Journals (Sweden)

    Fernando Villalón-Letelier

    2017-12-01

    Full Text Available Viral infection of different cell types induces a unique spectrum of host defence genes, including interferon-stimulated genes (ISGs and genes encoding other proteins with antiviral potential. Although hundreds of ISGs have been described, the vast majority have not been functionally characterised. Cellular proteins with putative antiviral activity (hereafter referred to as “restriction factors” can target various steps in the virus life-cycle. In the context of influenza virus infection, restriction factors have been described that target virus entry, genomic replication, translation and virus release. Genome wide analyses, in combination with ectopic overexpression and/or gene silencing studies, have accelerated the identification of restriction factors that are active against influenza and other viruses, as well as providing important insights regarding mechanisms of antiviral activity. Herein, we review current knowledge regarding restriction factors that mediate anti-influenza virus activity and consider the viral countermeasures that are known to limit their impact. Moreover, we consider the strengths and limitations of experimental approaches to study restriction factors, discrepancies between in vitro and in vivo studies, and the potential to exploit restriction factors to limit disease caused by influenza and other respiratory viruses.

  5. Factors limiting heterotrophic bacterial production in the southern Pacific Ocean

    Directory of Open Access Journals (Sweden)

    F. Van Wambeke

    2008-05-01

    Full Text Available The role of potential factors limiting bacterial growth was investigated along vertical and longitudinal gradients across the South Eastern Pacific Gyre. The effects of glucose, nitrate, ammonium and phosphate additions on heterotrophic bacterial production (using leucine technique were studied in parallel in unfiltered seawater samples incubated under natural daily irradiance. The enrichments realized on the subsurface showed three types of responses. From 141° W (Marquesas plateau to approx 125° W, bacteria were not bottom-up controlled, as confirmed by the huge potential of growth in non-enriched seawater (median of enhancement factor×39 in 24 h. Within the Gyre (125° W–95° W, nitrogen alone stimulated leucine incorporation rates (median×4.2, but rapidly labile carbon (glucose became a second limiting factor (median×37 when the two elements were added. Finally from the border of the gyre to the Chilean upwelling (95° W–73° W, labile carbon was the only factor stimulating heterotrophic bacterial production. Interaction between phytoplankton and heterotrophic bacterial communities and the direct versus indirect effect of iron and macronutrients on bacterial production were also investigated in four selected sites: two sites on the vicinity of the Marquesas plateau, the centre of the gyre and the Eastern border of the gyre. Both phytoplankton and heterotrophic bacteria were limited by availability of nitrogen within the gyre, but not by iron. Iron limited phytoplankton at Marquesas plateau and at the eastern border of the gyre. However 48 h enrichment experiments were not sufficient to show any clear limitation of heterotrophic bacteria within Marquesas plateau and showed a limitation of these organisms by labile carbon in the eastern border of the Gyre.

  6. The Limitation of Primary Signals Entering DVB-T On-Channel-Repeater Working in SFN Network

    Directory of Open Access Journals (Sweden)

    Marek Dvorsky

    2013-01-01

    Full Text Available This paper considers an issue of signal coverage in uncovered places using a broadcasting device called a Gap Filler. The main focus is placed on the analysis of potential negative effects while signals from two and more primary transmitters simultaneously enter to the Gap Filler. In particular, in the measurements the impact of reception cross delayed signals received by the Gap Filler from two adjacent primary transmitters operating in the Single Frequency Network was analysed. The influence of different receive signal levels from two adjacent primary transmitters was also examined. In the conclusion, based on the experiments, the limiting factors useful for individual transmitters in the Single Frequency Network were determined. The analysis and finding the limit parameters can help bradcasters in further setting and debugging of the Gap Filler network. Finally, the described laboratory experiment was also verified under the real SFN network condition in border region Vsetinsko to verify the laboratory findings.

  7. Limited interface between physiotherapy primary care and people with severe mental illness: a qualitative study.

    Science.gov (United States)

    Lee, Samantha; Waters, Flavie; Briffa, Kathy; Fary, Robyn E

    2017-07-01

    How do mental health professionals perceive the role of physiotherapists in the care of people with severe and persistent mental illness, and what factors do they perceive as influencing access to physiotherapy services? How do people with severe and persistent mental illness understand the potential role of physiotherapy in their healthcare, and what factors do they perceive as influencing access to physiotherapy services? Qualitative study. Twenty-four mental health professionals and 35 people with severe and persistent mental illness. Interview schedules were developed to explore participants' understanding of physiotherapy, as well as barriers and enablers to service access. Focus groups and interviews were conducted for each group of participants. Transcripts were analysed using an inductive approach to derive key themes. Both the mental health professionals and the people with severe and persistent mental illness expressed a limited understanding of the role and relevance of physiotherapy for physical health in mental healthcare. Common barriers to service access were cost, transport and lack of motivation. Likewise, enablers of reduced cost, provision of transport and education about physiotherapy to improve their understanding were identified. The health system structure and perceived lack of mental health knowledge by physiotherapists influenced referrals from mental health professionals. Consequently, education in mental health for physiotherapists and integration of the service within mental health were identified as potential enablers to physiotherapy access. Limited understanding about physiotherapy and its relevance to physical health in mental healthcare among mental health professionals and people with severe and persistent mental illness was found to be a key factor influencing service access. Limited physiotherapy presence and advocacy within mental health were also highlighted. There is a need for greater understanding about physiotherapy among

  8. Statistical Hot Channel Factors and Safety Limit CHFR/OFIR

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Byeonghee; Park, Suki [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

    2016-10-15

    The fuel integrity of research reactors are usually judged by comparing the critical heat flux ratio (CHFR) and the maximum fuel temperature (MFT) with the safety limits. Onset of flow instability ratio (OFIR) can also be used for the examination with CHFR. Hot channel factors (HCFs) are incorporated when calculating the CHFR/OFIR and MFT, to consider the uncertainties of fuel properties and thermo-hydraulic variables affecting them. The HCFs and safety limit CHFR is sometimes estimated to include too much conservatism, deteriorating the design flexibilities and operating margins. In this paper, a statistical estimation of HCFs and the safety limit CHFR/OFIR is presented by a random sampling of uncertainty parameters. A 15MW pool type research reactor is selected as the sample reactor for the estimation. The HCFs and the safety limit CHFR/OFIR of a 15MW pool type research reactor are evaluated statistically. The parameters affecting the HCF and the safety limit CHFR/OFIR are listed and their uncertainties are estimated. The relevant parameter uncertainties are sampled randomly and the HCFs and the safety limits are evaluated from them. The HCFs and the safety limit CHFR/OFIR with 95% probability are smaller than those estimated deterministically because the statistical evaluation convolute the correlation uncertainties and the other uncertainties in probabilistic way, whereas the deterministic evaluation simply multiply them.

  9. Massive three-loop form factor in the planar limit

    Energy Technology Data Exchange (ETDEWEB)

    Henn, Johannes [PRISMA Cluster of Excellence, Johannes Gutenberg University,Staudingerweg 9, 55099 Mainz (Germany); Smirnov, Alexander V. [Research Computing Center, Moscow State University,119991 Moscow (Russian Federation); Smirnov, Vladimir A. [Skobeltsyn Institute of Nuclear Physics of Moscow State University,119991 Moscow (Russian Federation); Institut für Theoretische Teilchenphysik, Karlsruhe Institute of Technology (KIT),Wolfgang-Gaede Straße 1, 76128 Karlsruhe (Germany); Steinhauser, Matthias [Institut für Theoretische Teilchenphysik, Karlsruhe Institute of Technology (KIT),Wolfgang-Gaede Straße 1, 76128 Karlsruhe (Germany)

    2017-01-17

    We compute the three-loop QCD corrections to the massive quark-anti-quark-photon form factors F{sub 1} and F{sub 2} in the large-N{sub c} limit. The analytic results are expressed in terms of Goncharov polylogarithms. This allows for a straightforward numerical evaluation. We also derive series expansions, including power suppressed terms, for three kinematic regions corresponding to small and large invariant masses of the photon momentum, and small velocities of the heavy quarks.

  10. 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.

  11. 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.

  12. 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

  13. [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.

  14. 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

  15. LIMITING FACTORS FOR THE DEVELOPMENT OF THE SERBIAN HOSPITALITY INDUSTRY

    Directory of Open Access Journals (Sweden)

    Nikolina Kosar

    2016-12-01

    Full Text Available Heterogeneity and complexity determine multidisciplinary approach to the hospitality research. Identification and analysis of limited hospitality development factors imply very complex scientific approach. Case study methodology is applied on Republic of Serbia, which is transition country and candidate for EU accession. Research results identified key factors which had impact on lag, stagnation and contemporary level of hospitality development. Firstly, way of executed privatization process of hospitality companies in Serbia i.e. only ownership transformation, as part of business transformation, was done (organizational, management, technological, financial and human resources parts of business transformation didn’t implement. Secondly, non-acceptable terms and conditions of credit lines for financing privatization and future business of privatized hospitality companies. Furthermore, buyers of privatized hospitality companies didn’t prepared adequate projections of cash flow and sources of financing (owned and borrowed. Finally, technological development and human resources were result of the first mentioned limited factor. In order to improve business in hospitality industry in transition economies, all stakeholders should be involved. State should improve business environment. Educational institutions should create applicable programs on market. Investors should be ready to invest in technological and human resource development. Banks should implement the best financing practice from headquarters in EU.

  16. Limiting factors in the production of deep microstructures

    Science.gov (United States)

    Tolfree, David W. L.; O'Neill, William; Tunna, Leslie; Sutcliffe, Christopher

    1999-10-01

    Microsystems increasingly require precision deep microstructures that can be cost-effectively designed and manufactured. New products must be able to meet the demands of the rapidly growing markets for microfluidic, micro- optical and micromechanical devices in industrial sectors which include chemicals, pharmaceuticals, biosciences, medicine and food. The realization of such products, first requires an effective process to design and manufacture prototypes. Two process methods used for the fabrication of high aspect-ratio microstructures are based on X-ray beam lithography with electroforming processes and direct micromachining with a frequency multiplied Nd:YAG laser using nanosecond pulse widths. Factors which limit the efficiency and precision obtainable using such processes are important parameters when deciding on the best fabrication method to use. A basic microstructure with narrow channels suitable for a microfluidic mixer have been fabricated using both these techniques and comparisons made of the limitations and suitability of the processes in respect of fast prototyping and manufacture or working devices.

  17. 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.

  18. Possibilities And Limitations In The Implementation Of The Policy For Men's Health In Primary Care

    Directory of Open Access Journals (Sweden)

    Flávio William Brito de Azevedo Ramalho

    2017-05-01

    Full Text Available Objective: Investigate the possibilities and limitations to implement the National Policy for Integrated Healthcare in Human Primary João Pessoa - Paraíba. Method: An exploratory study with a qualitative approach using semi-structured interviews. Data were collected from September 2010 to February 2011. The study subjects were 12 nurses who engage in Integrated Health Units in João Pessoa-Paraíba. Results: In the treatment of the results we used the Content Analysis of Bardin. All respondents were female, aged 28-43 years, operating time of 7-12 years and most have expertise. The research affirms the occurrence of major deficits in the perception of health professionals regarding the implementation of the policy. Conclusion: The limits revealed require actions by users, professionals and management, so that policy becomes a reality in everyday primary care. Descriptors: Primary Health Care; Health Policy; Men's Health. Nursing.

  19. Nitrogen and carbon limitation of planktonic primary production and phytoplankton–bacterioplankton coupling in ponds on the McMurdo Ice Shelf, Antarctica

    International Nuclear Information System (INIS)

    Sorrell, Brian K; Safi, Karl; Hawes, Ian

    2013-01-01

    We compared planktonic primary and secondary production across twenty meltwater ponds on the surface of the McMurdo Ice Shelf in January 2007, including some ponds with basal brines created by meromictic stratification. Primary production ranged from 1.07 to 65.72 mgC m −3 h −1 in surface waters. In stratified ponds primary production was always more than ten times higher in basal brines than in the corresponding mixolimnion. Regression tree analysis (r 2 = 0.80) identified inorganic nitrogen (as NH 4 + ) as the main factor limiting planktonic primary production. However, there was also evidence of inorganic carbon co-limitation of photosynthesis in some of the more oligotrophic waters. Neither C nor N limited carbon fixation at [NH 4 –N] > 50 mg m −3 , with photoinhibition the factor most likely limiting photosynthesis under such conditions. Primary production was the only factor significantly correlated to bacterial production and the relationship (r 2 = 0.56) was non-linear. Nitrogen limitation and tight coupling of planktonic primary and bacterial production is surprising in these ponds, as all have large pools of dissolved organic carbon (1.2–260 g m −3 ) and organic nitrogen (all >130 mg m −3 ). The dissolved pools of organic carbon and nitrogen appear to be recalcitrant and bacterial production to be constrained by limited release of labile organics from phytoplankton. (letter)

  20. Factors Limiting Complete Tumor Ablation by Radiofrequency Ablation

    International Nuclear Information System (INIS)

    Paulet, Erwan; Aube, Christophe; Pessaux, Patrick; Lebigot, Jerome; Lhermitte, Emilie; Oberti, Frederic; Ponthieux, Anne; Cales, Paul; Ridereau-Zins, Catherine; Pereira, Philippe L.

    2008-01-01

    The purpose of this study was to determine radiological or physical factors to predict the risk of residual mass or local recurrence of primary and secondary hepatic tumors treated by radiofrequency ablation (RFA). Eighty-two patients, with 146 lesions (80 hepatocellular carcinomas, 66 metastases), were treated by RFA. Morphological parameters of the lesions included size, location, number, ultrasound echogenicity, computed tomography density, and magnetic resonance signal intensity were obtained before and after treatment. Parameters of the generator were recorded during radiofrequency application. The recurrence-free group was statistically compared to the recurrence and residual mass groups on all these parameters. Twenty residual masses were detected. Twenty-nine lesions recurred after a mean follow-up of 18 months. Size was a predictive parameter. Patients' sex and age and the echogenicity and density of lesions were significantly different for the recurrence and residual mass groups compared to the recurrence-free group (p < 0.05). The presence of an enhanced ring on the magnetic resonance control was more frequent in the recurrence and residual mass groups. In the group of patients with residual lesions, analysis of physical parameters showed a significant increase (p < 0.05) in the time necessary for the temperature to rise. In conclusion, this study confirms risk factors of recurrence such as the size of the tumor and emphasizes other factors such as a posttreatment enhanced ring and an increase in the time necessary for the rise in temperature. These factors should be taken into consideration when performing RFA and during follow-up

  1. Radiation pressure acceleration: The factors limiting maximum attainable ion energy

    Energy Technology Data Exchange (ETDEWEB)

    Bulanov, S. S.; Esarey, E.; Schroeder, C. B. [Lawrence Berkeley National Laboratory, Berkeley, California 94720 (United States); Bulanov, S. V. [KPSI, National Institutes for Quantum and Radiological Science and Technology, Kizugawa, Kyoto 619-0215 (Japan); A. M. Prokhorov Institute of General Physics RAS, Moscow 119991 (Russian Federation); Esirkepov, T. Zh.; Kando, M. [KPSI, National Institutes for Quantum and Radiological Science and Technology, Kizugawa, Kyoto 619-0215 (Japan); Pegoraro, F. [Physics Department, University of Pisa and Istituto Nazionale di Ottica, CNR, Pisa 56127 (Italy); Leemans, W. P. [Lawrence Berkeley National Laboratory, Berkeley, California 94720 (United States); Physics Department, University of California, Berkeley, California 94720 (United States)

    2016-05-15

    Radiation pressure acceleration (RPA) is a highly efficient mechanism of laser-driven ion acceleration, with near complete transfer of the laser energy to the ions in the relativistic regime. However, there is a fundamental limit on the maximum attainable ion energy, which is determined by the group velocity of the laser. The tightly focused laser pulses have group velocities smaller than the vacuum light speed, and, since they offer the high intensity needed for the RPA regime, it is plausible that group velocity effects would manifest themselves in the experiments involving tightly focused pulses and thin foils. However, in this case, finite spot size effects are important, and another limiting factor, the transverse expansion of the target, may dominate over the group velocity effect. As the laser pulse diffracts after passing the focus, the target expands accordingly due to the transverse intensity profile of the laser. Due to this expansion, the areal density of the target decreases, making it transparent for radiation and effectively terminating the acceleration. The off-normal incidence of the laser on the target, due either to the experimental setup, or to the deformation of the target, will also lead to establishing a limit on maximum ion energy.

  2. 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.

  3. Do limiting factors at Alaskan treelines shift with climatic regimes?

    International Nuclear Information System (INIS)

    Ohse, B; Jansen, F; Wilmking, M

    2012-01-01

    Trees at Alaskan treelines are assumed to be limited by temperature and to expand upslope and/or to higher latitudes with global warming. However, recent studies describe negative temperature responses and drought stress of Alaskan treeline trees in recent decades. In this study, we have analyzed the responses of treeline white spruce to temperature and precipitation according to different climatic regimes in Alaska, described as negative (cool) and positive (warm) phases of the Pacific Decadal Oscillation (PDO). We found that in three consecutive phases (positive from 1925–46, negative from 1947–76, and positive again from 1977–98), the growth responses to temperature and precipitation differed markedly. Before 1947, in a phase of warm winters and with summer temperatures being close to the century mean, the trees at most sites responded positively to summer temperature, as one would expect from treeline trees at northern high latitudes. Between 1947 and 1976, a phase of cold winters and average summers, the trees showed similar responses, but a new pattern of negative responses to the summer temperature of the year prior to growth coupled with positive responses to the precipitation in the same year emerged at some sites. As the precipitation was relatively low at those sites, we assume that drought stress might have played a role. However, the climate responses were not uniform but were modified by regional gradients (trees at northern sites responded more often to temperature than trees at southern sites) and local site conditions (forest trees responded more often to precipitation than treeline trees), possibly reflecting differences in energy and water balance across regions and sites, respectively. However, since the shift in the PDO in 1976 from a negative to a positive phase, the trees’ climate–growth responses are much less pronounced and climate seems to have lost its importance as a limiting factor for the growth of treeline white spruce. If

  4. 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.

  5. 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.

  6. 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.

  7. Limiting factors in single particle cryo electron tomography

    Directory of Open Access Journals (Sweden)

    Mikhail Kudryashev

    2012-07-01

    Full Text Available Modern methods of cryo electron microscopy and tomography allow visualization of protein nanomachines in their native state at the nanometer scale. Image processing methods including sub-volume averaging applied to repeating macromolecular elements within tomograms allow exploring their structures within the native context of the cell, avoiding the need for protein isolation and purification. Today, many different data acquisition protocols and software solutions are available to researchers to determine average structures of macromolecular complexes and potentially to classify structural intermediates. Here, we list the density maps reported in the literature, and analyze each structure for the chosen instrumental settings, sample conditions, main processing steps, and obtained resolution. We present conclusions that identify factors currently limiting the resolution gained by this approach.

  8. Factors associated with worker slipping in limited-service restaurants.

    Science.gov (United States)

    Courtney, Theodore K; Verma, Santosh K; Huang, Yueng-Hsiang; Chang, Wen-Ruey; Li, Kai Way; Filiaggi, Alfred J

    2010-02-01

    Slips, trips and falls (STF) are responsible for a substantial injury burden in the global workplace. Restaurant environments are challenged by STF. This study assessed individual and work environment factors related to slipping in US limited-service restaurant workers. Workers in 10 limited-service restaurants in Massachusetts were recruited to participate. Workers' occupational slip and/or fall history within the past 4 weeks was collected by multilingual written questionnaires. Age, gender, job tenure, work hours per week and work shift were also collected. Shoe type, condition and gross shoe contamination were visually assessed. Floor friction was measured and each restaurant's overall mean coefficient of friction (COF) was calculated. The logistic generalised estimating equations model was used to compute adjusted odds ratios (OR). Of 125 workers, 42 reported one or more slips in the past 4 weeks with two reporting a resultant fall. Results from multivariable regression showed that higher restaurant mean COF was significantly associated with a decreased risk of self-reported slipping (OR 0.59, 95% CI 0.42 to 0.82). From the highest to the lowest COF restaurant, the odds of a positive slip history increased by a factor of more than seven. Younger age, male gender, lower weekly work hours and the presence of gross contamination on worker's shoe sole were also associated with increased odds of slip history. Published findings of an association between friction and slipping and falling in actual work environments are rare. The findings suggest that effective intervention strategies to reduce the risk of slips and falls in restaurant workers could include increasing COF and improving housekeeping practices.

  9. 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.

  10. 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

  11. 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.

  12. [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.

  13. 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)

  14. Skidders, Trucking, and Fellers limiting Factors in WV Logging Industry

    Science.gov (United States)

    William G. Luppold; Curt C. Hassler; Shawn Grushecky; Shawn Grushecky

    1998-01-01

    Like many states in the Central Appalachian region West Virginia has experienced a continual expansion in primary hardwood processing capacity during the 1990s. In the early part of the decade, hardwood sawmill capacity increased by nearly 40 percent to more than 700 million board feet per year. In the mid and late 1990s, several other primary processing facilities...

  15. Is iron a limiting factor of Nodularia spumigena blooms?

    Directory of Open Access Journals (Sweden)

    Lidia Paczuska

    2003-12-01

    Full Text Available It is well known that a deficiency of iron, a trace element essential to every living organism, limits the growth of algae and cyanobacteria. Nodularia spumigena Mertens is a blue-green algae species inhabiting the Baltic region that often forms toxic blooms.     The aim of the study was to assess the growth of the toxic cyanobacteria with respect to iron bioavailability. The measured growth parameters were the numbers of cells (optical density, chlorophyll a and pheopigment a concentrations. The iron concentrations used ranged from 10-7 to 10-4 mol dm-3. Under iron stress conditions (<5 × 10-7 mol dm-3, growth inhibition, gradual pigment decay and cell mortality were observed. However, enriching the medium with complexing factors like citric acid and EDTA significantly stimulated the growth rate and chlorophyll a production. The citric acid - EDTA - Fe (5 × 10-7 mol dm-3 complex was demonstrably effective in stimulating the rate of cell division. Starting with 10-6 mol dm-3, the higher the iron(III concentration used in the media, the more intensive the growth of the cyanobacteria populations. This was most rapid in the presence of high iron concentrations (10-4 mol dm-3, regardless of the presence of complexing agents.     It appears that the growth of toxic cyanobacteria N. spumigena, and thus also its ability to form blooms, may well depend on iron availability in the environment.

  16. Factors which could limit the nuclear fuel cycle development

    International Nuclear Information System (INIS)

    Pecqueur, M.; Barre, B.

    1977-01-01

    The nuclear fuel cycle is a most important industry for the energy future of the world. It has also a leading part as regards the physical continuity of energy supply of the countries engaged in the nuclear field. The development of this industry is subject to the economic or political constraints involved by the availability of raw materials, technologies or production means. The various limiting factors which could affect the different stages of the fuel cycle are linked with the technical, economic and financial aspects, with the impact on the environment, nuclear safety, risks of non-pacific uses and proliferation of arms. Interesting to note is also the correlation between the fuel cycle development and the problems of energy independence and security of nuclear programs. As a conclusion, the nuclear fuel cycle industry is confronted to difficulties due to its extremely rapid growth (doubling time 5 years) which only few heavy industries have encountered for long periods. It is more over submitted to the political and safety constraints always linked with nuclear matters. The task is therefore a difficult one. But the objective is worth-while since it is a condition to the development of nuclear industry [fr

  17. 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.

  18. Resolution-limiting factors in 2-deoxyglucose autoradiography. I. Factors other than diffusion

    Energy Technology Data Exchange (ETDEWEB)

    Gallistel, C.R.; Nichols, S. (Pennsylvania Univ., Philadelphia, PA (USA). Dept. of Psychology)

    1983-05-16

    The authors measured the extent to which factors other than the diffusion of the radioactive label during tissue preparation limits the spatial resolving power of 2-deoxyglucose (2-DG) autoradiography. Radioactive swept frequency gratings were created using microcircuit lithography. The gratings consisted of alternating equal width radioactive and non-radioactive bars in groups of narrowing bar width (effective range 500-20 ..mu..m). The vertical thickness of the gratings ranged from 2.25 to 20 ..mu..m. The isotope in the radioactive bars was either /sup 14/C or /sup 3/H. A variety of X-ray films were exposed to these gratings and the resulting images scanned with microdensitometers or video digitizers to determine the fall off in image contrast (dark-bar values minus light-bar values) as a function of the number of dark bars (lines) per millimeter. The power of the isotope was the resolution limiting factor. Grating thickness and type of film made little difference. The limit of resolution with /sup 14/C was 10 lines/mm: with /sup 3/H it was 25 lines/mm. The microdensitometer itself is apt to be a resolution limiting factor; the resolving power of those commonly used in autoradiography is unlikely to exceed 10 lines/mm. From measurements of the steepness of gray-matter to white-matter transitions in the image from a tissue section, they conclude that the resolution in the image was no worse than 1.6-3.2 lines/mm. Either the isotope or diffusion of the 2-DG during tissue preparation must be the factor that limits resolution.

  19. Influence of gas mixture and primary ionization on the performance of limit streamer mode tubes

    International Nuclear Information System (INIS)

    An Jigang; Anderson, K.J.; Merritt, F.S.; Oreglia, M.; Pilcher, J.E.; Possoz, A.; Schappert, W.; Chicago Univ., IL

    1988-01-01

    We report a study of the dependence of limited streamer mode operation on gas composition. Results are given for the plateau onset voltage, plateau length, charge versus voltage, charge spectra and pulse width for various fractions of (Ar, CO 2 , pentane) and (Ar, isobutane). In addition, a series of argon-free strong quenching gas mixtures has been studied which have very attractive characteristics. Chamber lifetime tests for these are also reported. As part of a study of the nature of the limited streamer mode mechanism, the response to X-rays and minimum ionizing particles are compared and differences noted. The character of the primary ionization is found to have a clear effect on the chamber response even in the streamer region. (orig.)

  20. [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.

  1. Influenza Virus Induces Inflammatory Response in Mouse Primary Cortical Neurons with Limited Viral Replication

    Directory of Open Access Journals (Sweden)

    Gefei Wang

    2016-01-01

    Full Text Available Unlike stereotypical neurotropic viruses, influenza A viruses have been detected in the brain tissues of human and animal models. To investigate the interaction between neurons and influenza A viruses, mouse cortical neurons were isolated, infected with human H1N1 influenza virus, and then examined for the production of various inflammatory molecules involved in immune response. We found that replication of the influenza virus in neurons was limited, although early viral transcription was not affected. Virus-induced neuron viability decreased at 6 h postinfection (p.i. but increased at 24 h p.i. depending upon the viral strain. Virus-induced apoptosis and cytopathy in primary cortical neurons were not apparent at 24 h p.i. The mRNA levels of inflammatory cytokines, chemokines, and type I interferons were upregulated at 6 h and 24 h p.i. These results indicate that the influenza virus induces inflammatory response in mouse primary cortical neurons with limited viral replication. The cytokines released in viral infection-induced neuroinflammation might play critical roles in influenza encephalopathy, rather than in viral replication-induced cytopathy.

  2. 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)

  3. 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.

  4. 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.

  5. Factors Limiting Vocational Agriculture Student Participation in Supervised Occupational Experience Programs in Nebraska.

    Science.gov (United States)

    Foster, Richard M.

    1986-01-01

    In this study, economic factors were consistently rated as important considerations in limited student participation in supervised farm practice in Nebraska high schools. It was indicated that administrative support was the least limiting factor for student participation. (CT)

  6. Links between primary occupation and functional limitations among older adults in Mexico

    Directory of Open Access Journals (Sweden)

    Hiram Beltrán-Sánchez

    2017-12-01

    Full Text Available Social inequalities in health and disability are often attributed to differences in childhood adversity, access to care, health behavior, residential environments, stress, and the psychosocial aspects of work environments. Yet, disadvantaged people are also more likely to hold jobs requiring heavy physical labor, repetitive movement, ergonomic strain, and safety hazards. We investigate the role of physical work conditions in contributing to social inequality in mobility among older adults in Mexico, using data from the Mexican Health and Aging Survey (MHAS and an innovative statistical modeling approach. We use data on categories of primary adult occupation to serve as proxies for jobs with more or less demanding physical work requirements. Our results show that more physically demanding jobs are associated with mobility limitations at older ages, even when we control for age and sex. Inclusion of job categories attenuates the effects of education and wealth on mobility limitations, suggesting that physical work conditions account for at least part of the socioeconomic differentials in mobility limitations in Mexico.

  7. Nutrient limitation of primary productivity in the Southeast Pacific (BIOSOPE cruise

    Directory of Open Access Journals (Sweden)

    S. Bonnet

    2008-02-01

    Full Text Available Iron is an essential nutrient involved in a variety of biological processes in the ocean, including photosynthesis, respiration and dinitrogen fixation. Atmospheric deposition of aerosols is recognized as the main source of iron for the surface ocean. In high nutrient, low chlorophyll areas, it is now clearly established that iron limits phytoplankton productivity but its biogeochemical role in low nutrient, low chlorophyll environments has been poorly studied. We investigated this question in the unexplored southeast Pacific, arguably the most oligotrophic area of the global ocean. Situated far from any continental aerosol source, the atmospheric iron flux to this province is amongst the lowest of the world ocean. Here we report that, despite low dissolved iron concentrations (~0.1 nmol l−1 across the whole gyre (3 stations located in the center and at the western and the eastern edges, primary productivity are only limited by iron availability at the border of the gyre, but not in the center. The seasonal stability of the gyre has apparently allowed for the development of populations acclimated to these extreme oligotrophic conditions. Moreover, despite clear evidence of nitrogen limitation in the central gyre, we were unable to measure dinitrogen fixation in our experiments, even after iron and/or phosphate additions, and cyanobacterial nif H gene abundances were extremely low compared to the North Pacific Gyre. The South Pacific gyre is therefore unique with respect to the physiological status of its phytoplankton populations.

  8. Factors Limiting Adoption of Technologies by Farmers in Catabola Municipality, Angola

    Directory of Open Access Journals (Sweden)

    Rušarová K.

    2016-06-01

    Full Text Available The objective of the paper is to define the factors influencing the adoption of animal traction and/or mechanical-power technology in the conditions of Catabola municipality where hand-tool technology is being used on 99.7% of the area cultivated by small farmers. Primary data collection was conducted in the period July–August 2011; semi-structured questionnaires and focus group discussions were the most frequent methods used. In total, 151 small-scale farmers from 9 villages participated in the survey. Ten factors influencing the dependent variable – level of technology used by farmers in combination with hiring of labour – were defined. The factors were statistically analyzed by ANOVA. The area of cultivated land and the educational level of both parents and children were found to be the factors limiting the process of animal traction or mechanical power adoption by small farmers in the Catabola municipality. In addition, a relatively high rate of child labour was observed. With the exclusion of childless families, 62.7% of small farmer families regularly use children aged 0–14 years for field operations. The results confirm that the factor of hiring extra labour is irrelevant in determining the development in technology use by small farmers in the Catabola municipality.

  9. Diagnosis of primary ciliary dyskinesia: potential options for resource-limited countries

    Directory of Open Access Journals (Sweden)

    Nisreen Rumman

    2017-01-01

    Full Text Available Primary ciliary dyskinesia is a genetic disease of ciliary function leading to chronic upper and lower respiratory tract symptoms. The diagnosis is frequently overlooked because the symptoms are nonspecific and the knowledge about the disease in the primary care setting is poor. Additionally, none of the available tests is accurate enough to be used in isolation. These tests are expensive, and need sophisticated equipment and expertise to analyse and interpret results; diagnosis is therefore only available at highly specialised centres. The diagnosis is particularly challenging in countries with limited resources due to the lack of such costly equipment and expertise. In this review, we discuss the importance of early and accurate diagnosis especially for countries where the disease is clinically prevalent but diagnostic tests are lacking. We review the diagnostic tests available in specialised centres (nasal nitric oxide, high-speed video microscopy, transmission electron microscopy, immunofluorescence and genetics. We then consider modifications that might be considered in less well-resourced countries whilst maintaining acceptable accuracy.

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

    Science.gov (United States)

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

    2016-07-01

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

  11. 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

  12. 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

  13. 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

  14. 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.

  15. THE INFLUENCE OF LIMITING FACTORS ON ELECTRIC MACHINES ELECTROMAGNETIC POWER

    Directory of Open Access Journals (Sweden)

    Mr. Konstantin K. Kim

    2016-06-01

    Full Text Available The increase of electromechanical transducers single capacity is one of the main ways of their efficiency upgrading. The article discusses the impact of the main electromagnetic and me-chanical factors on the power, transmitted through the air gap of DC electric machines.

  16. Activity limitations and factors influencing functional outcome of ...

    African Journals Online (AJOL)

    EB

    2013-09-03

    Sep 3, 2013 ... life and satisfaction with life1,22. A recent study conducted among community dwelling stroke survivors found functional ability and independence to be the strongest predictor of, and were responsible for the greatest variance on participation22. For determining the factors influencing outcome with the use ...

  17. 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

    commonly originated from primary gastrointestinal tract. The prognosis of ovarian metastasis is dismal and the benefit of ovarian metastatectomy is limited. Combined metastasis outside ovaries, locally invasion and massive intraoperative ascites were independent factors for predicting unfavorable overall survival. The identification of the primary tumor is required to plan for adequate treatment for this group of patients

  18. Six Sigma: Problems, Limitations, Critical Success Factors and Future Prospects

    Directory of Open Access Journals (Sweden)

    Paulo Mazieiro Pohlmann

    2015-12-01

    Full Text Available Six Sigma is a business strategy based on objective decision making and problem solving in order to achieve, maintain and maximize business success through understanding and meeting the needs of customers. The visualization of this methodology as a powerful tool in reducing variability and improving quality led to the interest in performing this bibliographical study, whose purpose was to assess the critical success factors and future prospects of this managerial system. A survey was conducted in order to discover the main critical success factors of the implementation of the methodology in organizations, among which stood out the proper selection of projects, connecting the project with the business strategy, customer focus, financial, human and infrastructure resources, the involvement of senior management, professional training, and cultural change.

  19. Latent Factors Limiting the Performance of sEMG-Interfaces

    Directory of Open Access Journals (Sweden)

    Sergey Lobov

    2018-04-01

    Full Text Available Recent advances in recording and real-time analysis of surface electromyographic signals (sEMG have fostered the use of sEMG human–machine interfaces for controlling personal computers, prostheses of upper limbs, and exoskeletons among others. Despite a relatively high mean performance, sEMG-interfaces still exhibit strong variance in the fidelity of gesture recognition among different users. Here, we systematically study the latent factors determining the performance of sEMG-interfaces in synthetic tests and in an arcade game. We show that the degree of muscle cooperation and the amount of the body fatty tissue are the decisive factors in synthetic tests. Our data suggest that these factors can only be adjusted by long-term training, which promotes fine-tuning of low-level neural circuits driving the muscles. Short-term training has no effect on synthetic tests, but significantly increases the game scoring. This implies that it works at a higher decision-making level, not relevant for synthetic gestures. We propose a procedure that enables quantification of the gestures’ fidelity in a dynamic gaming environment. For each individual subject, the approach allows identifying “problematic” gestures that decrease gaming performance. This information can be used for optimizing the training strategy and for adapting the signal processing algorithms to individual users, which could be a way for a qualitative leap in the development of future sEMG-interfaces.

  20. 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.

  1. 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 ...

  2. Normal limits of the electrocardiogram derived from a large database of Brazilian primary care patients.

    Science.gov (United States)

    Palhares, Daniel M F; Marcolino, Milena S; Santos, Thales M M; da Silva, José L P; Gomes, Paulo R; Ribeiro, Leonardo B; Macfarlane, Peter W; Ribeiro, Antonio L P

    2017-06-13

    Knowledge of the normal limits of the electrocardiogram (ECG) is mandatory for establishing which patients have abnormal ECGs. No studies have assessed the reference standards for a Latin American population. Our aim was to establish the normal ranges of the ECG for pediatric and adult Brazilian primary care patients. This retrospective observational study assessed all the consecutive 12-lead digital electrocardiograms of primary care patients at least 1 year old in Minas Gerais state, Brazil, recorded between 2010 and 2015. ECGs were excluded if there were technical problems, selected abnormalities were present or patients with selected self-declared comorbidities or on drug therapy. Only the first ECG from patients with multiple ECGs was accepted. The University of Glasgow ECG analysis program was used to automatically interpret the ECGs. For each variable, the 1st, 2nd, 50th, 98th and 99th percentiles were determined and results were compared to selected studies. A total of 1,493,905 ECGs were recorded. 1,007,891 were excluded and 486.014 were analyzed. This large study provided normal values for heart rate, P, QRS and T frontal axis, P and QRS overall duration, PR and QT overall intervals and QTc corrected by Hodges, Bazett, Fridericia and Framingham formulae. Overall, the results were similar to those from other studies performed in different populations but there were differences in extreme ages and specific measurements. This study has provided reference values for Latinos of both sexes older than 1 year. Our results are comparable to studies performed in different populations.

  3. Is oxygen availability a limiting factor for in vitro folliculogenesis?

    Directory of Open Access Journals (Sweden)

    Riccardo Talevi

    Full Text Available Transplantation of ovarian tissue for the preservation of fertility in oncological patients is becoming an accepted clinical practice. However, the risk of re-introducing tumour cells at transplantation has stirred an increased interest for complete in vitro folliculogenesis. This has not yet been achieved in humans possibly for the lack of knowledge on the environmental milieu that orchestrates folliculogenesis in vivo. The main aim of this study was to investigate the effect of oxygen availability on follicle health and growth during in vitro culture of ovarian tissue strips. To this end, a model was developed to predict the dissolved oxygen concentration in tissue under varying culture conditions. Ovarian cortical strips of bovine, adopted as an animal model, and human tissue were cultured in conventional (CD and gas permeable (PD dishes under different media column heights and gaseous oxygen tensions for 3, 6 and 9 days. Follicle quality, activation of primordial follicles to the primary stage, and progression to the secondary stage were analysed through histology. Follicle viability was assessed through a live-dead assay at the confocal scanning laser microscope. Findings showed a higher follicle quality and viability after culture of bovine ovarian strips in PD in adequate medium height and oxygen tensions. The best culture conditions found in the bovine were adopted for human ovarian strip culture and promoted a higher follicle quality, viability and progression. Overall, data demonstrated that modulation of oxygen availability in tissue plays a key role in maintaining follicles' health and their ability to survive and progress to the secondary stage during ovarian tissue in vitro culture. Such culture conditions could increase the yield of healthy secondary follicles for subsequent dissection and individual culture to obtain competent oocytes.

  4. Explanatory factors of female entrepreneurship and limiting elements

    Directory of Open Access Journals (Sweden)

    Carmina Pérez-Pérez

    2016-06-01

    Full Text Available Researches on entrepreneurship from a gender perspective reveal significant differences not only between the levels of participation of men and women in business, but also between the orientations, motives and business opportunities for both. Based on this fact, the following investigation is performed, whose objective is twofold: firstly, to know what are the aspects that influence the entrepreneurship of women and secondly, to identify what factors determine and/or difficult the creation and development of business that they undertake. To achieve both, it is reviewed, first, the literature on this subject and, second, are exposed the main results of the qualitative analysis with Atlas.ti from interviews with a group of Spanish entrepreneurs.

  5. Application of beryllium as first wall armour for ITER primary, baffle and limiter modules

    International Nuclear Information System (INIS)

    Cardella, A.; Barabash, V.; Ioki, K.; Yamada, M.; Mazul, I.; Merola, M.; Strebkov, Y.

    2000-01-01

    During the engineering design activities of the ITER project, beryllium has been selected as the armour material for the first wall of the primary, baffle and limiter blanket modules. These components have different requirements according to their function, so the armour design and its joining technology has been developed in order to withstand different operating and loading conditions. Extensive R and D has been performed to develop, select and characterise the beryllium material and the joining techniques. In parallel, beryllium plasma spray coating has been developed, mainly as a possible in situ repair method for locally damaged areas. For the reduced technical objectives / reduced cost (RTO/RC) ITER project, it is proposed to maintain Be as the reference armour material and to optimise the manufacturing technologies in order to minimise costs. The paper presents the rationale of the design choices for the application of beryllium to the blanket first wall and gives an overview of the R and D performed and the results achieved. (orig.)

  6. Efficiency limit factor analysis for the Francis-99 hydraulic turbine

    Science.gov (United States)

    Zeng, Y.; Zhang, L. X.; Guo, J. P.; Guo, Y. K.; Pan, Q. L.; Qian, J.

    2017-01-01

    The energy loss in hydraulic turbine is the most direct factor that affects the efficiency of the hydraulic turbine. Based on the analysis theory of inner energy loss of hydraulic turbine, combining the measurement data of the Francis-99, this paper calculates characteristic parameters of inner energy loss of the hydraulic turbine, and establishes the calculation model of the hydraulic turbine power. Taken the start-up test conditions given by Francis-99 as case, characteristics of the inner energy of the hydraulic turbine in transient and transformation law are researched. Further, analyzing mechanical friction in hydraulic turbine, we think that main ingredients of mechanical friction loss is the rotation friction loss between rotating runner and water body, and defined as the inner mechanical friction loss. The calculation method of the inner mechanical friction loss is given roughly. Our purpose is that explore and research the method and way increasing transformation efficiency of water flow by means of analysis energy losses in hydraulic turbine.

  7. Children's selective trust decisions: rational competence and limiting performance factors.

    Science.gov (United States)

    Hermes, Jonas; Behne, Tanya; Bich, Anna Elisa; Thielert, Christa; Rakoczy, Hannes

    2018-03-01

    Recent research has amply documented that even preschoolers learn selectively from others, preferring, for example, reliable over unreliable and competent over incompetent models. It remains unclear, however, what the cognitive foundations of such selective learning are, in particular, whether it builds on rational inferences or on less sophisticated processes. The current study, therefore, was designed to test directly the possibility that children are in principle capable of selective learning based on rational inference, yet revert to simpler strategies such as global impression formation under certain circumstances. Preschoolers (N = 75) were shown pairs of models that either differed in their degree of competence within one domain (strong vs. weak or knowledgeable vs. ignorant) or were both highly competent, but in different domains (e.g., strong vs. knowledgeable model). In the test trials, children chose between the models for strength- or knowledge-related tasks. The results suggest that, in fact, children are capable of rational inference-based selective trust: when both models were highly competent, children preferred the model with the competence most predictive and relevant for a given task. However, when choosing between two models that differed in competence on one dimension, children reverted to halo-style wide generalizations and preferred the competent models for both relevant and irrelevant tasks. These findings suggest that the rational strategies for selective learning, that children master in principle, can get masked by various performance factors. © 2017 John Wiley & Sons Ltd.

  8. Factors limiting the recovery of boreal toads (Bufo b. boreas)

    Science.gov (United States)

    Carey, C.; Corn, P.S.; Jones, M.S.; Livo, L.J.; Muths, E.; Loeffler, C.W.; Lannoo, M.

    2005-01-01

    early 1990s, however, indicated that the toads were still present in only one of 377 historical sites in parts of western Colorado (Hammerson, 1992) and in about 17% of previously known sites in the Colorado Front Range (Corn et al., 1989). Once common in Rocky Mountain National Park, boreal toads are now found at only seven localities, with just two or three of these populations likely to be reproducing successfully each year (Corn et al., 1997). Intensive surveys by the Boreal Toad Recovery Team since 1995 have found about 50 breeding sites comprising 25 distinct populations within Colorado (Loeffler, unpublished data). Of these populations, most are small (fewer than five egg clutches laid per year) and may not survive over the long term. Efforts to restore population sizes and expand the geographical distribution of boreal toads in the southern Rocky Mountains have involved considerable person-hours and financial commitments. Special care has been taken to protect habitats and, when feasible, to improve sites where breeding populations currently exist. However, initial attempts to repatriate these toads in historic habitats in which boreal toads were present before 1975 have generally proven unsuccessful (Carey, unpublished data; Muths et al., 2003). It is too early to determine if recent repatriations will establish breeding populations (Scherff-Norris, 1999), but these efforts will likely continue. Despite the best human intentions and efforts, the recovery of former population sizes and the historical distribution of boreal toads will greatly depend on its own life history characteristics. However, as we will review in this paper, environmental factors affect many life history attributes in a manner that poses serious obstacles for recovery.

  9. [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.

  10. 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.

  11. Developing the Botswana Primary Care Guideline: an integrated, symptom-based primary care guideline for the adult patient in a resource-limited setting

    Directory of Open Access Journals (Sweden)

    Tsima BM

    2016-08-01

    Full Text Available Billy M Tsima,1 Vincent Setlhare,1 Oathokwa Nkomazana2 1Department of Family Medicine and Public Health, 2Department of Surgery, Faculty of Medicine, University of Botswana, Gaborone, Botswana Background: Botswana’s health care system is based on a primary care model. Various national guidelines exist for specific diseases. However, most of the guidelines address management at a tertiary level and often appear nonapplicable for the limited resources in primary care facilities. An integrated symptom-based guideline was developed so as to translate the Botswana national guidelines to those applicable in primary care. The Botswana Primary Care Guideline (BPCG integrates the care of communicable diseases, including HIV/AIDS and noncommunicable diseases, by frontline primary health care workers.Methods: The Department of Family Medicine, Faculty of Medicine, University of Botswana, together with guideline developers from the Knowledge Translation Unit (University of Cape Town collaborated with the Ministry of Health to develop the guideline. Stakeholder groups were set up to review specific content of the guideline to ensure compliance with Botswana government policy and the essential drug list.Results: Participants included clinicians, academics, patient advocacy groups, and policymakers from different disciplines, both private and public. Drug-related issues were identified as necessary for implementing recommendations of the guideline. There was consensus by working groups for updating the essential drug list for primary care and expansion of prescribing rights of trained nurse prescribers in primary care within their scope of practice. An integrated guideline incorporating common symptoms of diseases seen in the Botswana primary care setting was developed.Conclusion: The development of the BPCG took a broad consultative approach with buy in from relevant stakeholders. It is anticipated that implementation of the BPCG will translate into better

  12. 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...

  13. [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.

  14. Age-dependent dose factors and dose limits of annual radioactivity uptake with unsealed radioactive substances by occupationally exposed persons

    International Nuclear Information System (INIS)

    Kaul, A.; Nosske, D; Elsasser, U; Roedler, H.D.; Henrichs, K.

    1986-01-01

    The dose factors have been calculated on the basis of the ICRP models for dosimetric and metabolistic assessment, and are laid open in accordance with Annex XI ( to sec. 45 sub-section (2)) of the amended version of the Radiation Protection Ordinance. The contribution in hand explains the scientific fundamentals and results of the calculations of dose factors relating to inhalation and ingestion of unsealed radioactive substances by adult reference man, and age-dependent factors calculated for children and adolescents. Further, annual limits of uptake by occupationally exposed persons, as calculated on the basis of primary dose limits pursunant to the draft amendment presented by the Federal Interior Minister, are compared with relevant data given by the ICRP and EC institutions. (orig./DG) [de

  15. 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...

  16. 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 ...

  17. 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 ...

  18. 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

  19. 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.

  20. 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...

  1. 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.

  2. 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)

  3. 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.

  4. Risk factors for mobility limitation in community-dwelling older adults: a social ecological perspective.

    Science.gov (United States)

    Yeom, Hye A; Fleury, Julie; Keller, Colleen

    2008-01-01

    Although a variety of risk factors for mobility limitation in older adults have been examined, a collective review of relevant literature has not been reported. The purposes of this review are to report the intrapersonal, interpersonal, environmental, and organizational risk factors related to mobility limitation using a social ecological perspective and to discuss the direction of future clinical practice consistent with current literature on mobility limitation of community-dwelling older adults. Intrapersonal risk factors related to mobility limitation include advanced age, female gender, low socioeconomic status, comorbidity, lack of motivation (i.e., dependent personality, decreased self-efficacy), lifestyle factors (i.e., sedentary lifestyle, smoking, obesity), and physiological factors (i.e., vitamin D deficiency, inflammation, poor nutritional status). Interpersonal risk factors related to mobility limitation include weak social networks and limited social activities. Geriatric clients may also experience a decline in mobility when they encounter environmental challenges such as an inconvenient home environment and lack of availability of services in their community, as well as lack of organizational resources stemming from social policy. Potential intervention strategies focused on modifiable risk factors may include lifestyle modifications, social networking programs, and enhancing awareness of environmental and organizational resources in the community for older adults at risk for mobility limitation.

  5. 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

  6. Transport and homeostasis of potassium and phosphate: limiting factors for sustainable crop production.

    Science.gov (United States)

    Luan, Mingda; Tang, Ren-Jie; Tang, Yumei; Tian, Wang; Hou, Congong; Zhao, Fugeng; Lan, Wenzhi; Luan, Sheng

    2017-06-01

    Potassium (K) and phosphate (Pi) are both macronutrients essential for plant growth and crop production, but the unrenewable resources of phosphorus rock and potash have become limiting factors for food security. One critical measure to help solve this problem is to improve nutrient use efficiency (NUE) in plants by understanding and engineering genetic networks for ion uptake, translocation, and storage. Plants have evolved multiple systems to adapt to various nutrient conditions for growth and production. Within the NUE networks, transport proteins and their regulators are the primary players for maintaining nutrient homeostasis and could be utilized to engineer high NUE traits in crop plants. A large number of publications have detailed K+ and Pi transport proteins in plants over the past three decades. Meanwhile, the discovery and validation of their regulatory mechanisms are fast-track topics for research. Here, we provide an overview of K+ and Pi transport proteins and their regulatory mechanisms, which participate in the uptake, translocation, storage, and recycling of these nutrients in plants. © The Author 2016. Published by Oxford University Press on behalf of the Society for Experimental Biology. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  7. Limitations of Tc99m-MIBI-SPECT imaging scans in persistent primary hyperparathyroidism

    NARCIS (Netherlands)

    Witteveen, Janneke E.; Kievit, Job; Stokkel, Marcel P. M.; Morreau, Hans; Romijn, Johannes A.; Hamdy, Neveen A. T.

    2011-01-01

    In primary hyperparathyroidism (PHPT) the predictive value of technetium 99m sestamibi single emission computed tomography (Tc99m-MIBI-SPECT) for localizing pathological parathyroid glands before a first parathyroidectomy (PTx) is 83-100%. Data are scarce in patients undergoing reoperative

  8. Exogenous Classic Phytohormones Have Limited Regulatory Effects on Fructan and Primary Carbohydrate Metabolism in Perennial Ryegrass (Lolium perenne L.)

    Czech Academy of Sciences Publication Activity Database

    Gasperl, A.; Morvan-Bertrand, A.; Prud'homme, M. P.; van der Graaff, E.; Roitsch, Thomas

    2016-01-01

    Roč. 6, jan (2016), s. 1251 ISSN 1664-462X R&D Projects: GA MŠk(CZ) LO1415 Institutional support: RVO:67179843 Keywords : enzymatic activity * fructan exohydrolase * fructan metabolism * fructosyltransferase * perennial ryegrass * phytohormones * primary carbohydrate metabolism Subject RIV: ED - Physiology Impact factor: 4.298, year: 2016

  9. 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

  10. 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

  11. 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

  12. 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

  13. 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...

  14. Limitations of Tc99m-MIBI-SPECT imaging scans in persistent primary hyperparathyroidism.

    Science.gov (United States)

    Witteveen, Janneke E; Kievit, Job; Stokkel, Marcel P M; Morreau, Hans; Romijn, Johannes A; Hamdy, Neveen A T

    2011-01-01

    In primary hyperparathyroidism (PHPT) the predictive value of technetium 99m sestamibi single emission computed tomography (Tc99m-MIBI-SPECT) for localizing pathological parathyroid glands before a first parathyroidectomy (PTx) is 83-100%. Data are scarce in patients undergoing reoperative parathyroidectomy for persistent hyperparathyroidism. The aim of the present study was to determine the value of Tc99m-MIBI-SPECT in localizing residual hyperactive parathyroid tissue in patients with persistent primary hyperparathyroidism (PHPT) after initial excision of one or more pathological glands. We retrospectively evaluated the localizing accuracy of Tc99m-MIBI-SPECT scans in 19 consecutive patients with persistent PHPT who had a scan before reoperative parathyroidectomy. We used as controls 23 patients with sporadic PHPT who had a scan before initial surgery. In patients with persistent PHPT, Tc99m-MIBI-SPECT accurately localized a pathological parathyroid gland in 33% of cases before reoperative parathyroidectomy, compared to 61% before first PTx for sporadic PHPT. The Tc99m-MIBI-SPECT scan accurately localized intra-thyroidal glands in 2 of 7 cases and a mediastinal gland in 1 of 3 cases either before initial or reoperative parathyroidectomy. Our data suggest that the accuracy of Tc99m-MIBI-SPECT in localizing residual hyperactive glands is significantly lower before reoperative parathyroidectomy for persistent PHPT than before initial surgery for sporadic PHPT. These findings should be taken in consideration in the preoperative workup of patients with persistent primary hyperparathyroidism.

  15. N-P Co-Limitation of Primary Production and Response of Arthropods to N and P in Early Primary Succession on Mount St. Helens Volcano

    Science.gov (United States)

    Bishop, John G.; O'Hara, Niamh B.; Titus, Jonathan H.; Apple, Jennifer L.; Gill, Richard A.; Wynn, Louise

    2010-01-01

    Background The effect of low nutrient availability on plant-consumer interactions during early succession is poorly understood. The low productivity and complexity of primary successional communities are expected to limit diversity and abundance of arthropods, but few studies have examined arthropod responses to enhanced nutrient supply in this context. We investigated the effects of nitrogen (N) and phosphorus (P) addition on plant productivity and arthropod abundance on 24-yr-old soils at Mount St. Helens volcano. Methodology/Principal Findings We measured the relative abundance of eight arthropod orders and five families in plots that received N, P, or no nutrients for 3–5 years. We also measured plant % cover, leaf %N, and plant diversity. Vegetation responded rapidly to N addition but showed a lagged response to P that, combined with evidence of increased N fixation, suggested P-limitation to N availability. After 3 yrs of fertilization, orthopterans (primarily Anabrus simplex (Tettigoniidae) and Melanoplus spp (Acrididae)) showed a striking attraction to P addition plots, while no other taxa responded to fertilization. After 5 yrs of fertilization, orthopteran density in the same plots increased 80%–130% with P addition and 40% with N. Using structural equation modeling, we show that in year 3 orthopteran abundance was associated with a P-mediated increase in plant cover (or correlated increases in resource quality), whereas in year 5 orthopteran density was not related to cover, diversity or plant %N, but rather to unmeasured effects of P, such as its influence on other aspects of resource quality. Conclusions/Significance The marked surprising response to P by orthopterans, combined with a previous observation of P-limitation in lepidopteran herbivores at these sites, suggests that P-mediated effects of food quantity or quality are critical to insect herbivores in this N-P co-limited primary successional system. Our results also support a previous

  16. 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.

  17. Risk factors for persistent airflow limitation: Analysis of 306 patients with asthma

    OpenAIRE

    Wang, Lingcheng; Gao, Shuncui; Zhu, Wei; Su, Jun

    2014-01-01

    Objectives : To determine the risk factors associated with persistent airflow limitation in patients with asthma. Method s: This study was designed and carried out in the department of respiratory medicine, fourth People?s Hospital of Jinan City, Shandong province, China between Jan 2012 and Dec 2012. Three hundred and six asthma patients participating in the study were divided into persistent airflow limitation group (PAFL) and no persistent airflow limitation group (NPAFL). The patients par...

  18. Factors associated with dental caries in the primary dentition of children with cerebral palsy

    Directory of Open Access Journals (Sweden)

    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.

  19. Limiting Factors for Agricultural Production and Differentiation of Soil Management in Romania

    Science.gov (United States)

    Ioana Moraru, Paula; Rusu, Teodor; Bogdan, Ileana; Ioan Pop, Adrian; Pop, Horia

    2017-04-01

    deficit of rainfall, and poor to very poor supply of humus, phosphorus, and potassium. In Forest-Steppe zone limiting factors of the area include: drought, erosion, temporary excessive moisture, soil compaction, slope, exposition, groundwater depth, occurrence of white frost period, and early/late frosts; climate is also highly variable from one sub-area to another. Irrigation and water conservation measures in the soil have a very important role in the forest steppe. Most lands in the forest steppe are situated on slopes so the tillage system must include anti-erosion agrotechnics. Furthermore, finding the optimal timing of tillage is very important for avoiding secondary compaction of the soil. In Forest area limiting factors of the area include mixed relief, reduced field surface, excess surface moisture, lower soil fertility compared to previously studied areas, soil erosion, landslides, primary and secondary soil compaction, soil acidity, pronounced diverse spectrum of weeds and vegetative development opportunities compared to previous areas. Harnessing the sustainable arable lands on slopes and their conservation implies that the organization of the territory and differentiated soil management will achieve the following: i) cultivation of an assortment of plants suitable for the purposes and conditions offered by the slopes and design of crop rotations with an anti-erosion role; ii) use of anti-erosion culture systems on slopes, level curve direction in strips, grassed strips and arable terraces; iii) application of differentiated soil management elements, respecting regional planning projects; iv) execution of soil tillage on the general direction of level curves; v) adaptation of agro-components such as: fertilization, integrated control of weeds (especially herbicide application), and the maintenance, mechanization, and harvesting of the specific land. Acknowledgments This work was supported by a grant of the Romanian National Authority for Scientific Research

  20. Limited knowledge of chronic kidney disease among primary care patients – a cross-sectional survey

    Directory of Open Access Journals (Sweden)

    Chow Wai

    2012-07-01

    Full Text Available Abstract Background Kidney disease is the 9th leading cause of death in Singapore. While preventive effects have focused on early detection and education, little is known about the knowledge level of chronic kidney disease (CKD locally. We seek to evaluate the knowledge of CKD among primary care patients. Methods We conducted a cross-sectional survey of a convenience sample of 1520 patients from 3 primary care centers. Those with existing CKD or on dialysis were excluded. Knowledge was assessed based on 7 questions on CKD in the self-administered questionnaire. One point was given for each correct answer with a maximum of 7 points. Results 1435 completed all 7 questions on CKD. Mean age was 48.9 ±15.0 (SD years. 50.9% were male. 62.3% had a secondary and below education and 52.4% had a monthly household income of ≤ $2000. 43.7% had chronic diseases. Mean score was 3.44 ± 1.53 (out of a maximum of 7. Median score was 4. In multivariate logistic regression, being older {>60 years [Odds Ratio (OR 0.50, 95% Confidence Interval (CI 0.32-0.79]; 40–60 years (OR 0.62, 95% CI 0.43,0.89}, less educated [up to primary education (OR 0.33, 95% CI 0.22-0.49], having a lower monthly household income [ Conclusion This suggests that CKD education should be targeted at older patients with lower education and lower socioeconomic status.

  1. Role of electromagnetic filter in limitating radioactivity in the primary circuits of light water reactors

    International Nuclear Information System (INIS)

    Dolle, L.

    1978-01-01

    High temperature electromagnetic filtration of particulate corrosion products can be carried out with discharges up to 5% of the cooling flow rate. It allows efficient extraction of particulate matter which rate constants required for considerable reduction of activable crud deposition in the core. The paper holds a review of the preventing operation in the primary circuit of a PWR, and reports experimental results of efficiency measurments with an electromagnetic filter set in out-of-pile and in-pile pressurized water loops. The notable efficiencies towards radioactive fine grain and colloidal matter justify more extensive reactor scale application experiments. (author)

  2. Role of electromagnetic filter in limitating radioactivity in the primary circuits of light water reactors

    International Nuclear Information System (INIS)

    Dolle, L.

    1978-01-01

    High temperature electromagnetic filtration of particulate corrosion products can be carried out with discharges up to 5% of the cooling flow rate. It allows efficient extraction of particulate matter with rate constants required for considerable reduction of activable crud deposition in the core. The paper holds a review of the preventing operation in the primary circuit of a PWR, and reports experimental results of efficiency measurements with an electromagnetic filter set in out-of-pile and in-pile pressurized water loops. The notable efficiencies towards radioactive fine grain and colloidal matter justify more extensive reactor scale application experiments

  3. Supporting the Language Development of Limited English Proficient Students through Arts Integration in the Primary Grades

    Science.gov (United States)

    Brouillette, Liane

    2012-01-01

    This article looks at how arts integration can boost the language development of limited English proficient students in kindergarten through second grade. I first review existing research on how young children learn and describe the special challenges faced by children who must learn in an unfamiliar language. I then identify arts-based mechanisms…

  4. 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.

  5. 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

  6. Nutrient limitation of primary prodductivity in the Southeast Pacific (BIOSOPE cruise)

    Czech Academy of Sciences Publication Activity Database

    Bonnet, S.; Guieu, C.; Bruyant, F.; Prášil, Ondřej; Van Wambeke, F.; Raimbault, P.; Moutin, T.; Grob, C.; Gorbunov, M. Y.; Zehr, J. P.; Masquelier, S. M.

    2008-01-01

    Roč. 5, č. 1 (2008), s. 215-225 ISSN 1726-4170 Institutional research plan: CEZ:AV0Z50200510 Keywords : southeast pacific * phytoplankton * iron Subject RIV: EE - Microbiology, Virology Impact factor: 3.445, year: 2008

  7. 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…

  8. CD11c controls herpes simplex virus 1 responses to limit virus replication during primary infection.

    Science.gov (United States)

    Allen, Sariah J; Mott, Kevin R; Chentoufi, Aziz A; BenMohamed, Lbachir; Wechsler, Steven L; Ballantyne, Christie M; Ghiasi, Homayon

    2011-10-01

    CD11c is expressed on the surface of dendritic cells (DCs) and is one of the main markers for identification of DCs. DCs are the effectors of central innate immune responses, but they also affect acquired immune responses to infection. However, how DCs influence the efficacy of adaptive immunity is poorly understood. Here, we show that CD11c(+) DCs negatively orchestrate both adaptive and innate immunity against herpes simplex virus type 1 (HSV-1) ocular infection. The effectiveness and quantity of virus-specific CD8(+) T cell responses are increased in CD11c-deficient animals. In addition, the levels of CD83, CD11b, alpha interferon (IFN-α), and IFN-β, but not IFN-γ, were significantly increased in CD11c-deficient animals. Higher levels of IFN-α, IFN-β, and CD8(+) T cells in the CD11c-deficient mice may have contributed to lower virus replication in the eye and trigeminal ganglia (TG) during the early period of infection than in wild-type mice. However, the absence of CD11c did not influence survival, severity of eye disease, or latency. Our studies provide for the first time evidence that CD11c expression may abrogate the ability to reduce primary virus replication in the eye and TG via higher activities of type 1 interferon and CD8(+) T cell responses.

  9. 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

  10. Limiting factor analysis of high availability nuclear plants (boiling water reactors). Final report

    International Nuclear Information System (INIS)

    Frederick, L.G.; Brady, R.M.; Shor, S.W.W.; McCusker, J.T.; Alden, W.M.; Kovacs, S.

    1979-08-01

    The pertinent results are presented of a 16-month study conducted for Electric Power Research Institute by General Electric Company, Bechtel Power Corporation, and Philadelphia Electric Company. The study centered around the Peach Bottom 2 Atomic Power Station, but also included limited study of operations at 20 additional operating boiling water reactors. The purpose of the study was to identify and evaluate key factors limiting plant availability, and to identify potential improvements for eliminating or alleviating those limitations. The key limiting factors were found to be refueling activities; activities related to the reactor fuel; reactor scrams; activities related to 20 operating systems or major components; delays due to radiation, turbid water during refueling operations, facilities/working conditions, and dirt/foreign material; and general maintenance/repair of valves and piping. Existing programs to reduce the effect on plant unavailability are identified, and suggestions for further action are made

  11. Simplified method to predict mutual interactions of human transcription factors based on their primary structure

    KAUST Repository

    Schmeier, Sebastian

    2011-07-05

    Background: Physical interactions between transcription factors (TFs) are necessary for forming regulatory protein complexes and thus play a crucial role in gene regulation. Currently, knowledge about the mechanisms of these TF interactions is incomplete and the number of known TF interactions is limited. Computational prediction of such interactions can help identify potential new TF interactions as well as contribute to better understanding the complex machinery involved in gene regulation. Methodology: We propose here such a method for the prediction of TF interactions. The method uses only the primary sequence information of the interacting TFs, resulting in a much greater simplicity of the prediction algorithm. Through an advanced feature selection process, we determined a subset of 97 model features that constitute the optimized model in the subset we considered. The model, based on quadratic discriminant analysis, achieves a prediction accuracy of 85.39% on a blind set of interactions. This result is achieved despite the selection for the negative data set of only those TF from the same type of proteins, i.e. TFs that function in the same cellular compartment (nucleus) and in the same type of molecular process (transcription initiation). Such selection poses significant challenges for developing models with high specificity, but at the same time better reflects real-world problems. Conclusions: The performance of our predictor compares well to those of much more complex approaches for predicting TF and general protein-protein interactions, particularly when taking the reduced complexity of model utilisation into account. © 2011 Schmeier et al.

  12. Simplified method to predict mutual interactions of human transcription factors based on their primary structure.

    Directory of Open Access Journals (Sweden)

    Sebastian Schmeier

    Full Text Available BACKGROUND: Physical interactions between transcription factors (TFs are necessary for forming regulatory protein complexes and thus play a crucial role in gene regulation. Currently, knowledge about the mechanisms of these TF interactions is incomplete and the number of known TF interactions is limited. Computational prediction of such interactions can help identify potential new TF interactions as well as contribute to better understanding the complex machinery involved in gene regulation. METHODOLOGY: We propose here such a method for the prediction of TF interactions. The method uses only the primary sequence information of the interacting TFs, resulting in a much greater simplicity of the prediction algorithm. Through an advanced feature selection process, we determined a subset of 97 model features that constitute the optimized model in the subset we considered. The model, based on quadratic discriminant analysis, achieves a prediction accuracy of 85.39% on a blind set of interactions. This result is achieved despite the selection for the negative data set of only those TF from the same type of proteins, i.e. TFs that function in the same cellular compartment (nucleus and in the same type of molecular process (transcription initiation. Such selection poses significant challenges for developing models with high specificity, but at the same time better reflects real-world problems. CONCLUSIONS: The performance of our predictor compares well to those of much more complex approaches for predicting TF and general protein-protein interactions, particularly when taking the reduced complexity of model utilisation into account.

  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. Soil types and limiting factors in agricultural production in the San Fernando district, Tamaulipas, Mexico

    International Nuclear Information System (INIS)

    Espinosa Ramirez, M.; Garza Cedillo, R.; Andrade limas, E.; Belmonte Serrato, F.

    2009-01-01

    The limiting factors in agricultural production, defined as those properties and characteristics of the geographical environment that influence the development of crops, can be diverse and are grouped with the physical environment of soil. They are the result of soil characteristics and soil degradation processes by anthropogenic influence. Due to the above, the objective of this study was to identify and surveying the limitative factors to agricultural production, as well as to define its ability land use capacity in San Fernando district, Tamaulipas. (Author) 7 refs.

  16. Thermal-maturity limit for primary thermogenic-gas generation from humic coals as determined by hydrous pyrolysis

    Science.gov (United States)

    Lewan, Michael; Kotarba, M.J.

    2014-01-01

    Hydrous-pyrolysis experiments at 360°C (680°F) for 72 h were conducted on 53 humic coals representing ranks from lignite through anthracite to determine the upper maturity limit for hydrocarbon-gas generation from their kerogen and associated bitumen (i.e., primary gas generation). These experimental conditions are below those needed for oil cracking to ensure that generated gas was not derived from the decomposition of expelled oil generated from some of the coals (i.e., secondary gas generation). Experimental results showed that generation of hydrocarbon gas ends before a vitrinite reflectance of 2.0%. This reflectance is equivalent to Rock-Eval maximum-yield temperature and hydrogen indices (HIs) of 555°C (1031°F) and 35 mg/g total organic carbon (TOC), respectively. At these maturity levels, essentially no soluble bitumen is present in the coals before or after hydrous pyrolysis. The equivalent kerogen atomic H/C ratio is 0.50 at the primary gas-generation limit and indicates that no alkyl moieties are remaining to source hydrocarbon gases. The convergence of atomic H/C ratios of type-II and -I kerogen to this same value at a reflectance of indicates that the primary gas-generation limits for humic coal and type-III kerogen also apply to oil-prone kerogen. Although gas generation from source rocks does not exceed vitrinite reflectance values greater than , trapped hydrocarbon gases can remain stable at higher reflectance values. Distinguishing trapped gas from generated gas in hydrous-pyrolysis experiments is readily determined by of the hydrocarbon gases when a -depleted water is used in the experiments. Water serves as a source of hydrogen in hydrous pyrolysis and, as a result, the use of -depleted water is reflected in the generated gases but not pre-existing trapped gases.

  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. A survey of infectious agents as risk factors for primary sclerosing cholangitis: are Chlamydia species involved?

    NARCIS (Netherlands)

    Ponsioen, Cyriel Y.; Defoer, Jacqueline; ten Kate, Fiebo J. W.; Weverling, Gerrit J.; Tytgat, Guido N. J.; Pannekoek, Yvonne; Wertheim-Dillen, Pauline M. E.

    2002-01-01

    Objectives The aetiology of primary sclerosing cholangitis (PSC) is unknown, and the role of micro-organisms has been studied only to a limited extent. We tested the hypothesis that past or persisting infection with common viruses or atypical bacteria might play a role in genetically susceptible

  19. JOB BEHAVIORAL FACTORS AND TURNOVER INTENTION: EVIDENCE FROM SIME DARBY PROPERTY LIMITED

    OpenAIRE

    Amran Awang; Abdul Razak Amir; Wirda Osman

    2013-01-01

    Some job behavioral factors are utilized to examine their relationship with turnover intention among 201 employees in Sime Darby Property (Malaysia) Limited. Job satisfaction, job stress, organizational commitment, job enrichment and person-organization fit are the job behavioral factors selected for the study. The variables used in the study justify the reliability scores consistent with indicators in previous studies. Research methodology justifies the quantitative requirements ...

  20. The influence of the key limiting factors on the limitations of heat transfer in heat pipes with various working fluids

    Directory of Open Access Journals (Sweden)

    Melnyk R. S.

    2017-04-01

    Full Text Available Aluminium and copper heat pipes with grooved and metal fibrous capillary structure are high effective heat transfer devices. They are used in different cooling systems of electronic equipment like a LED modules, microprocessors, receive-transmit modules and so on. However thus heat pipes have heat transfer limitations. There are few types of this limitations: hydraulic limitation, boiling limitation, liquid entrainment by vapor flow and sonic limitation. There is necessity to know which one of these limitations is determinant for heat pipe due to design process. At a present article calculations of maximum heat transfer ability represented. All these calculations were made for LED cooling by using heat pipes with grooved and metal fibrous capillary structures. Pentane, acetone, isobutane and water were used as a coolants. It was shown that the main operation limit for axial grooved heat pipe, which determinate maximum heat transfer ability due to inclination angle for location of cooling zone higher than evaporation zone case, is entrainment limit for pentane and acetone coolants. Nevertheless, for isobutane coolant the main limitation is a boiling limit. However, for heat pipes with metal fibrous capillary structure the main limitation is a capillary limit. This limitation was a determinant for all calculated coolants: water, pentane and acetone. For high porosity range of capillary structure, capillary limit transfer to sonic limit for heat pipes with water, that means that the vapor velocity increases to sonic velocity and can't grow any more. Due to this, coolant cant in a needed quantity infill condensation zone and the last one drained. For heat pipes with acetone and pentane, capillary limit transfer to boiling limit. All calculations were made for vapor temperature equal to 50°C, and for porosity range from 30% to 90%.

  1. 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.

  2. 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.

  3. 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.

  4. Exploration of factors limiting biomass estimation by polarimetric radar in tropical forests

    NARCIS (Netherlands)

    Quiñones Fernández, M.J.; Hoekman, D.H.

    2004-01-01

    Direct inversion of radar return signals for forest biomass estimation is limited by signal saturation at medium biomass levels (roughly 150 ton/ha for P-band). Disturbing factors such as forest structural differences-and, notably, at low biomass levels, terrain roughness, and soil moisture

  5. Lifestyle Factors and Incident Mobility Limitation in Obese and Non-obese Older Adults.

    NARCIS (Netherlands)

    Koster, A.; Penninx, B.W.J.H.; Newman, A.B.; Visser, M.; van Gool, C.H.; Harris, T.B.; van Eijk, J.T.; Kempen, G.I.; Brach, J.S.; Simonsick, E.M.; Houston, D.K.; Tylavsky, F.A.; Rubin, S.M.; Kritchevsky, S.B.

    2007-01-01

    Objective: This study examines the association between incident mobility limitation and 4 lifestyle factors: smoking, alcohol intake, physical activity, and diet in well-functioning obese (n = 667) and non-obese (n = 2027) older adults. Research Methods and Procedures: Data were from men and women,

  6. What is the most prominent factor limiting photosynthesis in different layers of a greenhouse cucumber canopy?

    NARCIS (Netherlands)

    Chen, T.W.; Henke, M.; Visser, de P.H.B.; Buck-Sorlin, G.H.; Wiechers, D.; Kahlen, K.; Stützel, H.

    2014-01-01

    Background and Aims Maximizing photosynthesis at the canopy level is important for enhancing crop yield, and this requires insights into the limiting factors of photosynthesis. Using greenhouse cucumber (Cucumis sativus) as an example, this study provides a novel approach to quantify different

  7. Scientific Study of Malnutrition as a Limiting Factor in the Development of Education.

    Science.gov (United States)

    Picasso de Oyague, Alfredo

    This study on malnutrition as a limiting factor in the development of education (and, hence, in socioeconomic development generally) was presented to the UNESCO Seminar on Education, Nutrition, Agriculture and Man. The paper reports on recent research showing that the development of the central nervous system in very young children (including the…

  8. Enhanced production of recombinant nattokinase in Bacillus subtilis by the elimination of limiting factors.

    Science.gov (United States)

    Chen, Po Ting; Chao, Yun-Peng

    2006-10-01

    By systematic investigation, glutamate and a mixture of metal ions were identified as factors limiting the production of nattokinase in Bacillus subtilis. Consequently, in medium supplemented with these materials, the recombinant strain secreted 4 times more nattokinase (260 mg l(-1)) than when grown in the unsupplemented medium.

  9. Evaluation of prognostic factors in liver-limited metastatic colorectal cancer: a preplanned analysis of the FIRE-1 trial

    Science.gov (United States)

    Giessen, C; Fischer von Weikersthal, L; Laubender, R P; Stintzing, S; Modest, D P; Schalhorn, A; Schulz, C; Heinemann, V

    2013-01-01

    Background: Liver-limited disease (LLD) denotes a specific subgroup of metastatic colorectal cancer (mCRC) patients. Patients and Methods: A total of 479 patients with unresectable mCRC from an irinotecan-based randomised phase III trial were evaluated. Patients with LLD and non-LLD and hepatic resection were differentiated. Based on baseline patient characteristic, prognostic factors for hepatic resection were evaluated. Furthermore, prognostic factors for median overall survival (OS) were estimated via Cox regression in LLD patients. Results: Secondary liver resection was performed in 38 out of 479 patients (resection rate: 7.9%). Prognostic factors for hepatic resection were LLD, lactate dehydrogenase (LDH), node-negative primary, alkaline phosphatase (AP) and Karnofsky performance status (PS). Median OS was significantly increased after hepatic resection (48 months), whereas OS in LLD (17 months) and non-LLD (19 months) was comparable in non-resected patients. With the inapplicability of Koehne's risk classification in LLD patients, a new score based on only the independent prognostic factors LDH and white blood cell (WBC) provided markedly improved information on the outcome. Conclusion: Patients undergoing hepatic resection showed favourable long-term survival, whereas non-resected LLD patients and non-LLD patients did not differ with regard to progression-free survival and OS. The LDH levels and WBC count were confirmed as prognostic factors and provide a useful and simple score for OS-related risk stratification also in LLD. PMID:23963138

  10. [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.

  11. The Nutraceutical Bioavailability Classification Scheme: Classifying Nutraceuticals According to Factors Limiting their Oral Bioavailability.

    Science.gov (United States)

    McClements, David Julian; Li, Fang; Xiao, Hang

    2015-01-01

    The oral bioavailability of a health-promoting dietary component (nutraceutical) may be limited by various physicochemical and physiological phenomena: liberation from food matrices, solubility in gastrointestinal fluids, interaction with gastrointestinal components, chemical degradation or metabolism, and epithelium cell permeability. Nutraceutical bioavailability can therefore be improved by designing food matrices that control their bioaccessibility (B*), absorption (A*), and transformation (T*) within the gastrointestinal tract (GIT). This article reviews the major factors influencing the gastrointestinal fate of nutraceuticals, and then uses this information to develop a new scheme to classify the major factors limiting nutraceutical bioavailability: the nutraceutical bioavailability classification scheme (NuBACS). This new scheme is analogous to the biopharmaceutical classification scheme (BCS) used by the pharmaceutical industry to classify drug bioavailability, but it contains additional factors important for understanding nutraceutical bioavailability in foods. The article also highlights potential strategies for increasing the oral bioavailability of nutraceuticals based on their NuBACS designation (B*A*T*).

  12. 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

  13. 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…

  14. 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…

  15. 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

  16. 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

  17. 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

  18. 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

  19. 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

  20. 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.

  1. 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…

  2. 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…

  3. 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

  4. 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…

  5. 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.

  6. Psychosocial factors at work and the development of mobility limitations among adults in Denmark

    DEFF Research Database (Denmark)

    Hansen, Åse Marie; Darsø, Lilie; Manty, Minna

    2014-01-01

    Aim: Psychosocial factors in the working environment have been shown to be associated with mobility limitations, but this has not yet been confirmed in a Danish population. We aimed to examine how psychosocial factors at work are related to developing mobility limitations in Denmark. Methods......: This study is based on data from 2952 middle-aged men and women without mobility limitations in 2000. Results: We found increased risk of incident mobility limitations during 6-year follow up among men who often perceived high work pace (OR 5.45, 95% CI 1.21-24.52) vs. never, who only sometimes or....../never perceived the work to be meaningful (OR 6.54, 95% CI 1.55-27.55) vs. always, and who sometimes perceived high emotional demands at work (OR 7.85, 95% CI 1.78-34.65) vs. never. Among women, lower risk of incident mobility limitations was observed among those who in 2000 perceived high work pace sometimes (OR...

  7. Fuel channel life limiting factors that dictate fuel channel maintenance requirements

    International Nuclear Information System (INIS)

    Richinson, P.J.; Wong, H.W.; Ellis, P.J.

    1995-01-01

    CANDU reactors have been operating for 33 years. The Nuclear Power Demonstration (NPD) Unit started up in 1962 and the prototype of CANDU, Douglas Point, started in 1967. The first commercial reactors, Pickering Units 1 and 2 both went into service in 1971 closely followed by Units 3 and 4 in 1972 and 1973 respectively. Operating commercial reactor experience represents over 10,000 pressure tubes, not including the replaced channels in all the Pickering A Units, and nearly 130,000 pressure tube operating years. No pressure tube has yet operated for its 30 year design lifetime of 210 KEFPH at 80% capacity factor. The longest operating time for pressure tubes to-date is about 120 KEFPH in Pickering Unit 4. Many lessons have been learned regarding pressure tube life limiting factors from the early CANDU units and these, together with the information obtained from an extensive pressure tube R and D program, have resulted in many design changes and improvements in material properties, mainly from manufacturing route changes. Reactors built recently are expected to achieve their 30 year design life. The development of Periodic and In-service Inspection programs and equipment, assessment methodologies and acceptance criteria, and the development of maintenance tooling and procedures are enabling the life limiting factors to be addressed in the currently operating units. The life limiting factors in currently operating Units are reviewed in relation to the experience gained from the early units, the R and D programs and the inspection and maintenance performed to date. (author)

  8. Breastfeeding in the first hour of life and modern technology: prevalence and limiting factors

    Directory of Open Access Journals (Sweden)

    Maria Cristina Pillegi

    2008-12-01

    Full Text Available Objective: To identify the prevalence and limiting factors ofbreastfeeding in the first hour of life at the Maternity Center of HospitalIsraelita Albert Einstein, where the predominant model of childbirthcare is largely based on the use of modern technology. Methods: Aretrospective study with quantitative analysis in a middle and upperclass population of different cultural backgrounds. Data were obtainedfrom the delivery record book in a total of 12,350 births from January2004 to December 2007. Results: Of 12,350 births, 3,277 (26.9%were excluded because of contraindications to breastfeeding in thefirst hour of life such as: prematurity, respiratory distress, adverseeffects of anesthesia, obstetric conditions, congenital malformation,and others. Other 180 cases were excluded due to missing data.Of the remaining 8,893 cases, 2,279 (18.7% were not breastfedbecause of limiting factors that require improvement actions: highdelivery turnover, patient refusal, medical refusal, tiredness due toprolonged labor, loss of data recording. Cesarean delivery and the useof anesthesia did neither prevent breastfeeding in the first hour of lifenor skin-to-skin contact. The prevalence was 74.3%. Conclusions:The use of technology and the hospital practices interfere inbreastfeeding, but are not factors that prevent it. The identificationof the prevalence and limiting factors contributes to the evaluationof the care provided and elaboration of nursing interventions forcontinuous improvement of the care practice. Improvement actionsshould include prenatal care and delivery itself.

  9. 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.

  10. 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.

  11. Factors associated with anemia among Sri Lankan primary school children in rural North Central Province.

    Science.gov (United States)

    Amarasinghe, Gayani Shashikala; Naottunna, Naotunna Palliya Guruge Chamidri Randika; Agampodi, Thilini Chanchala; Agampodi, Suneth Buddhika

    2017-03-27

    Despite interventions, childhood anemia is still a major public health problem in low and middle income countries. Purpose of the present study is to determine factors associated with anemia among rural primary school children in Sri Lanka, a country undergoing rapid socioeconomic changes. Multi stage cluster sampling was used to select 100 rural schools in NCP and a maximum of 50 children aged 60-131 months were enrolled from each school. Self-administered questionnaires were sent to parents. Anthropometric measurements and blood samples were obtained by trained investigators. Blood reports were analyzed in a commercial laboratory with external quality control measures. Total of 4412 children were included in the analysis. A Multiple regression was performed for hemoglobin. Only 4.2% of the change in hemoglobin could be explained by the model. District (p > 0.001), age (p > 0.001), timing of warm treatment(p = 0.026) and BMI for age (p = 0.002) uniquely contributed 1.12%, 1.19%, 0.13% and 0.26% to change in hemoglobin level respectively whereas, sex, monthly family income and frequency of meat and green leaf consumption didn't contribute significantly. Peripheral blood film analyses were available for 146 anemic children. Blood film was reported as normal in 19.9% while evidence of iron deficiency (18.5%), early iron deficiency (32.5%) and thalassemia trait with iron deficiency (29.5%) were reported in the rest. Serum ferritin level was available for 417 children with hemoglobin less than 12 g/dl. Mean ferritin level was 63.7 microgram/l. Only 0.5% had depleted iron stores. A multiple regression was performed for serum ferritin and R 2 was 0.123 (p nutrition of younger children in Sri Lanka, studying weather behaviors are related to anemia in primary school children is important. Possible etiologies including but not limited to nutritional deficiencies need to be studied further.

  12. 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

  13. Limited english proficiency, primary language at home, and disparities in children's health care: how language barriers are measured matters.

    Science.gov (United States)

    Flores, Glenn; Abreu, Milagros; Tomany-Korman, Sandra C

    2005-01-01

    Approximately 3.5 million U.S. schoolchildren are limited in English proficiency (LEP). Disparities in children's health and health care are associated with both LEP and speaking a language other than English at home, but prior research has not examined which of these two measures of language barriers is most useful in examining health care disparities. Our objectives were to compare primary language spoken at home vs. parental LEP and their associations with health status, access to care, and use of health services in children. We surveyed parents at urban community sites in Boston, asking 74 questions on children's health status, access to health care, and use of health services. Some 98% of the 1,100 participating children and families were of non-white race/ethnicity, 72% of parents were LEP, and 13 different primary languages were spoken at home. "Dose-response" relationships were observed between parental English proficiency and several child and parental sociodemographic features, including children's insurance coverage, parental educational attainment, citizenship and employment, and family income. Similar "dose-response" relationships were noted between the primary language spoken at home and many but not all of the same sociodemographic features. In multivariate analyses, LEP parents were associated with triple the odds of a child having fair/poor health status, double the odds of the child spending at least one day in bed for illness in the past year, and significantly greater odds of children not being brought in for needed medical care for six of nine access barriers to care. None of these findings were observed in analyses of the primary language spoken at home. Individual parental LEP categories were associated with different risks of adverse health status and outcomes. Parental LEP is superior to the primary language spoken at home as a measure of the impact of language barriers on children's health and health care. Individual parental LEP

  14. 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.

  15. 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

  16. 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.

  17. 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.

  18. 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).

  19. 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...

  20. 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

  1. 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.

  2. Breastfeeding in the first hour of life and modern technology: prevalence and limiting factors

    OpenAIRE

    Maria Cristina Pillegi; Adriana Policastro; Sulim Abramovici; Eduardo Cordioli; Alice D’Agostini Deutsch

    2008-01-01

    Objective: To identify the prevalence and limiting factors ofbreastfeeding in the first hour of life at the Maternity Center of HospitalIsraelita Albert Einstein, where the predominant model of childbirthcare is largely based on the use of modern technology. Methods: Aretrospective study with quantitative analysis in a middle and upperclass population of different cultural backgrounds. Data were obtainedfrom the delivery record book in a total of 12,350 births from January2004 to December 200...

  3. Preliminary identification of the bioremediation limiting factors of a clay bearing soil contaminated with crude oil

    OpenAIRE

    Rizzo, Andréa C. L.; Cunha, Claudia D. da; Santos, Ronaldo L. C.; Santos, Renata M.; Magalhães, Hugo M.; Leite, Selma G. F.; Soriano, Adriana U.

    2008-01-01

    Bioremediation is an attractive alternative to treat soils contaminated with petroleum hydrocarbons. However, the effectiveness of biodegradation process can be limited by both contaminant characteristics and its bioavailability in soil. This work aims at establishing a preliminary procedure to identify the main factor (hydrocarbon recalcitrance or its bioavailability) that impairs the biodegradation, possibly resulting in low remediation efficiencies. Tests in soil microcosms were carried ou...

  4. Tokamak βaB/I limit and its dependence on the safety factor

    International Nuclear Information System (INIS)

    Ramos, J.J.

    1990-01-01

    It is shown that, for a given tokamak cross-sectional shape and arbitrary values of the magnetic axis safety factor q 0 , the first stability condition against pressure-driven magnetohydrodynamic modes has the form 40πβaB 0 /I≤C R (q 0 )/q 0 . Moreover, in the limit of large q 0 , C R (q 0 ) becomes independent of q 0 and independent of the toroidal mode number

  5. Biodiversities and limiting factors of Lashgardar Protected Area (LPA), Hamadan Province, Iran

    OpenAIRE

    MAHDI REYAHI KHORAM; VAHID NORISHARIKABAD

    2010-01-01

    Reyahi-Khoram M, Norisharikabad V (2011) Biodiversities and limiting factors of Lashgardar Protected Area (LPA), Hamadan Province, Iran. Biodiversitas 12: 216-221. Lashgardar Protected Area (LPA) located in Hamadan Province in Iran, it is a mountainous and plain area and proximal to Malayer Township. In 1991, the region was known as a protected area for increasing wild animals' population. This research has been conducted during 2001 through 2009. Plant and animal species of the region were i...

  6. Impact of selected risk factors on expected lifetime without long-standing, limiting illness in Denmark

    DEFF Research Database (Denmark)

    Brønnum-Hansen, Henrik; Juel, Knud; Davidsen, Michael

    2007-01-01

    long-standing, limiting illness was 8-10 years shorter among sedentary than physically active people. Obesity shortened lifetime without illness by 5 years for men and ten years for women. CONCLUSION: The results of this study could be used in health policy-making, as the potential gains in public......OBJECTIVE: To estimate the impacts of tobacco smoking, high alcohol consumption, physical inactivity and overweight on expected lifetime with and without long-standing, limiting illness. METHODS: Life tables for each level of exposure to the risk factors were constructed, mainly on the basis......-olds was 9-10 years shorter for heavy smokers than for those who never smoke, and all the lifetime lost would have been without long-standing, limiting illness. Similarly, all 5 years of expected lifetime lost by men with high alcohol consumption would have been without illness. The expected lifetime without...

  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. 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

  11. 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.

  12. What is the most prominent factor limiting photosynthesis in different layers of a greenhouse cucumber canopy?

    Science.gov (United States)

    Chen, Tsu-Wei; Henke, Michael; de Visser, Pieter H B; Buck-Sorlin, Gerhard; Wiechers, Dirk; Kahlen, Katrin; Stützel, Hartmut

    2014-09-01

    Maximizing photosynthesis at the canopy level is important for enhancing crop yield, and this requires insights into the limiting factors of photosynthesis. Using greenhouse cucumber (Cucumis sativus) as an example, this study provides a novel approach to quantify different components of photosynthetic limitations at the leaf level and to upscale these limitations to different canopy layers and the whole plant. A static virtual three-dimensional canopy structure was constructed using digitized plant data in GroIMP. Light interception of the leaves was simulated by a ray-tracer and used to compute leaf photosynthesis. Different components of photosynthetic limitations, namely stomatal (S(L)), mesophyll (M(L)), biochemical (B(L)) and light (L(L)) limitations, were calculated by a quantitative limitation analysis of photosynthesis under different light regimes. In the virtual cucumber canopy, B(L) and L(L) were the most prominent factors limiting whole-plant photosynthesis. Diffusional limitations (S(L) + M(L)) contributed Photosynthesis in the lower canopy was more limited by the biochemical capacity, and the upper canopy was more sensitive to light than other canopy parts. Although leaves in the upper canopy received more light, their photosynthesis was more light restricted than in the leaves of the lower canopy, especially when the light condition above the canopy was poor. An increase in whole-plant photosynthesis under diffuse light did not result from an improvement of light use efficiency but from an increase in light interception. Diffuse light increased the photosynthesis of leaves that were directly shaded by other leaves in the canopy by up to 55%. Based on the results, maintaining biochemical capacity of the middle-lower canopy and increasing the leaf area of the upper canopy would be promising strategies to improve canopy photosynthesis in a high-wire cucumber cropping system. Further analyses using the approach described in this study can be expected to

  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. [Limiting factors in the class III camouflage treatment: a potential protocol].

    Science.gov (United States)

    Chaques Asensi, José

    2016-06-01

    The Class III skeletal malocclusion has been traditionally treated with a combined approach of orthodontics and orthognathic surgery or with a strategy of orthodontic camouflage. Some severe cases can be identified as ideal candidates for a surgical treatment whereas some others can be handled with orthodontics alone, with a reasonable expectation of an acceptable result. However, the problem remains for the borderline patient. In fact, limited information is available in the literature regarding the identification of the factors that can help in establishing the limits for one treatment modality or the other. Furthermore, the quantification of some of these factors, for practical purposes, is practically missing or very seldom suggested. Therefore, the decision making process remains a subjective reflection based on the "good clinical sense" of the orthodontist or just reduced to an "educated guess". In order to add some information, hopefully useful in deciding the most suitable treatment option for the individual patient, we propose a clinical protocol based on four different factors. Namely: the skeletal discrepancy, the occlusal discrepancy, the periodontal condition and facial aesthetics. For each one of these factors several parameters will be evaluated and, for some of them, an attempt to provide some reference numerical values will be made. Finally, clinical examples will be presented to illustrate the concepts discussed and the treatment alternatives, final treatment plan and treatment outcome will be analyzed for each one of them. © EDP Sciences, SFODF, 2016.

  15. Thermodynamic limit of particle-hole form factors in the massless XXZ Heisenberg chain

    Energy Technology Data Exchange (ETDEWEB)

    Kitanine, N. [Univ. de Bourgogne (France). IMB, UMR 5584 du CNRS; Kozlowski, K.K. [Deutsches Elektronen-Synchrotron (DESY), Hamburg (Germany); Maillet, J.M.; Terras, V. [ENS Lyon (France). UMR 5672 du CNRS, Lab. de Physique; Slavnov, N.A. [Steklov Mathematical Inst., Moscow (Russian Federation)

    2011-03-15

    We study the thermodynamic limit of the particle-hole form factors of the XXZ Heisenberg chain in the massless regime. We show that, in this limit, such form factors decrease as an explicitly computed power-law in the system size. Moreover, the corresponding amplitudes can be obtained as a product of a ''smooth'' and a ''discrete'' part: the former depends continuously on the rapidities of the particles and holes, whereas the latter has an additional explicit dependence on the set of integer numbers that label each excited state in the associated logarithmic Bethe equations. We also show that special form factors corresponding to zero-energy excitations lying on the Fermi surface decrease as a power-law in the system size with the same critical exponents as in the longdistance asymptotic behavior of the related two-point correlation functions. The methods we develop in this article are rather general and can be applied to other massless integrable models associated to the six-vertex R-matrix and having determinant representations for their form factors. (orig.)

  16. Registration factors that limit international mobility of people holding physiotherapy qualifications: A systematic review.

    Science.gov (United States)

    Foo, Jonathan S; Storr, Michael; Maloney, Stephen

    2016-06-01

    There is no enforced international standardisation of the physiotherapy profession. Thus, registration is used in many countries to maintain standards of care and to protect the public. However, registration may also limit international workforce mobility. What is known about the professional registration factors that may limit the international mobility of people holding physiotherapy qualifications? Systematic review using an electronic database search and hand searching of the World Confederation for Physical Therapy and International Network of Physiotherapy Regulatory Authorities websites. Analysis was conducted using thematic analysis. 10 articles and eight websites were included from the search strategy. Data is representative of high-income English speaking countries. Four themes emerged regarding limitations to professional mobility: practice context, qualification recognition, verification of fitness to practice, and incidental limitations arising from the registration process. Professional mobility is limited by differences in physiotherapy education programmes, resulting in varying standards of competency. Thus, it is often necessary to verify clinical competencies through assessments, as well as determining professional attributes and ability to apply competencies in a different practice context, as part of the registration process. There has been little evaluation of registration practices, and at present, there is a need to re-evaluate current registration processes to ensure they are efficient and effective, thereby enhancing workforce mobility. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  17. Comparing the demographic factors of patient with limited and diffuse type of alopecia areata

    Directory of Open Access Journals (Sweden)

    Mina Daliri

    2010-09-01

    Full Text Available Background: Alopecia areata is a chronic inflammatory disease that involves the hair follicle. Clinically, patients with alopecia areata may have patchy or confluent hair loss on the scalp or body so we conduct a study to compare the demographic aspects of patient with limited and diffuse type of alopecia areata.Materials and Method: We conducted a descriptive-analyzing study in which 306 patient were chosen. The patients were divided into two groups of diffuse and limited Alopecia. Demographic factors including age, gender, disease onset were compared in two groups. Results: Out of 306 patients, 58.8 % were male and 41.2 % were female. 247 patients (80.7% suffered from limited type and 59 patients (19.2% suffered from diffuse type. The mean age of the onset of involvement in limited group was 21.9±12 yr and 15.8±12 yr in diffuse group. The mean duration of involvement in limited group was 18.7 months and 71 months in diffuse group. Conclusion: Diffuse type alopecia areata starts at lower age and has longer duration. Our study results were similar to the others. Like other studies, thyroid disorders and atopic dermatitis are positively correlative to the severity of disease

  18. 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.

  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

    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.

  20. 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.

  1. 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.

  2. 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

  3. 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.

  4. Implications of incorporating N cycling and N limitations on primary production in an individual-based dynamic vegetation model

    Science.gov (United States)

    Smith, B.; Wårlind, D.; Arneth, A.; Hickler, T.; Leadley, P.; Siltberg, J.; Zaehle, S.

    2014-04-01

    The LPJ-GUESS dynamic vegetation model uniquely combines an individual- and patch-based representation of vegetation dynamics with ecosystem biogeochemical cycling from regional to global scales. We present an updated version that includes plant and soil N dynamics, analysing the implications of accounting for C-N interactions on predictions and performance of the model. Stand structural dynamics and allometric scaling of tree growth suggested by global databases of forest stand structure and development were well reproduced by the model in comparison to an earlier multi-model study. Accounting for N cycle dynamics improved the goodness of fit for broadleaved forests. N limitation associated with low N-mineralisation rates reduces productivity of cold-climate and dry-climate ecosystems relative to mesic temperate and tropical ecosystems. In a model experiment emulating free-air CO2 enrichment (FACE) treatment for forests globally, N limitation associated with low N-mineralisation rates of colder soils reduces CO2 enhancement of net primary production (NPP) for boreal forests, while some temperate and tropical forests exhibit increased NPP enhancement. Under a business-as-usual future climate and emissions scenario, ecosystem C storage globally was projected to increase by ca. 10%; additional N requirements to match this increasing ecosystem C were within the high N supply limit estimated on stoichiometric grounds in an earlier study. Our results highlight the importance of accounting for C-N interactions in studies of global terrestrial N cycling, and as a basis for understanding mechanisms on local scales and in different regional contexts.

  5. 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...

  6. 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.

  7. 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

  8. 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)

  9. 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.

  10. 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

  11. Interleukin-17 limits hypoxia-inducible factor 1α and development of hypoxic granulomas during tuberculosis.

    Science.gov (United States)

    Domingo-Gonzalez, Racquel; Das, Shibali; Griffiths, Kristin L; Ahmed, Mushtaq; Bambouskova, Monika; Gopal, Radha; Gondi, Suhas; Muñoz-Torrico, Marcela; Salazar-Lezama, Miguel A; Cruz-Lagunas, Alfredo; Jiménez-Álvarez, Luis; Ramirez-Martinez, Gustavo; Espinosa-Soto, Ramón; Sultana, Tamanna; Lyons-Weiler, James; Reinhart, Todd A; Arcos, Jesus; de la Luz Garcia-Hernandez, Maria; Mastrangelo, Michael A; Al-Hammadi, Noor; Townsend, Reid; Balada-Llasat, Joan-Miquel; Torrelles, Jordi B; Kaplan, Gilla; Horne, William; Kolls, Jay K; Artyomov, Maxim N; Rangel-Moreno, Javier; Zúñiga, Joaquín; Khader, Shabaana A

    2017-10-05

    Mycobacterium tuberculosis (Mtb) is a global health threat, compounded by the emergence of drug-resistant strains. A hallmark of pulmonary tuberculosis (TB) is the formation of hypoxic necrotic granulomas, which upon disintegration, release infectious Mtb. Furthermore, hypoxic necrotic granulomas are associated with increased disease severity and provide a niche for drug-resistant Mtb. However, the host immune responses that promote the development of hypoxic TB granulomas are not well described. Using a necrotic Mtb mouse model, we show that loss of Mtb virulence factors, such as phenolic glycolipids, decreases the production of the proinflammatory cytokine IL-17 (also referred to as IL-17A). IL-17 production negatively regulates the development of hypoxic TB granulomas by limiting the expression of the transcription factor hypoxia-inducible factor 1α (HIF1α). In human TB patients, HIF1α mRNA expression is increased. Through genotyping and association analyses in human samples, we identified a link between the single nucleotide polymorphism rs2275913 in the IL-17 promoter (-197G/G), which is associated with decreased IL-17 production upon stimulation with Mtb cell wall. Together, our data highlight a potentially novel role for IL-17 in limiting the development of hypoxic necrotic granulomas and reducing disease severity in TB.

  12. Effects of Common Factors on Dynamics of Stocks Traded by Investors with Limited Information Capacity

    Directory of Open Access Journals (Sweden)

    Songtao Wu

    2017-01-01

    Full Text Available An artificial stock market with agent-based model is built to investigate effects of different information characteristics of common factors on the dynamics stock returns. Investors with limited information capacity update their beliefs based on the information they have obtained and processed and optimize portfolios based on beliefs. We find that with changing of concerned information characteristics the uncertainty of stock price returns rises and is higher than the uncertainty of intrinsic value returns. However, this increase is constrained by the limited information capacity of investors. At the same time, we also find that dependence between returns of stock prices also increased with the changing information environment. The uncertainty and dependency pertaining to prices show a positive relationship. However, the positive relationship is weakened when taking into account the features of intrinsic values, based on which prices are generated.

  13. 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.

  14. 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.

  15. 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.

  16. Unlocking Ft: Modeling thermodynamic controls and isotope fractionation factors in nutrient limited environments

    Science.gov (United States)

    Druhan, J. L.; Giannetta, M.; Sanford, R. A.

    2017-12-01

    In recent years, reactive transport principles have expanded from early applications, largely based in contaminant hydrology, to a wide range of biologically mediated redox environments including marine sedimentary diagenesis, terrestrial metal ore deposits, soils, and critical zone weathering profiles. A common observation across this diversity of systems is that they often function under energetically limited conditions in comparison to those typical of contaminated aquifers subject to engineered remediation techniques. As a result, the kinetic rate expressions traditionally employed within reactive transport frameworks to simulate microbially mediated redox transformations have required modification. This was recognized in a series of seminal papers by Jin and Bethke (2005, 2007) in which the authors expanded upon a Monod rate law to include a thermodynamic potential factor `Ft' which exerts a limitation on the overall rate based on the thermodynamic driving force of the electron transfer reaction. This new rate expression is now commonly implemented within many of the major reactive transport software packages, though appropriate application has yet to be thoroughly demonstrated. Notably, the characteristically large partitioning of stable isotopes during microbially mediated reactions, which is extensively utilized to identify and quantify these redox transformations, has yet to be simulated under conditions in which the Ft term may be expected to exert a significant mass dependent influence. Here, we develop a series of simplified simulations for the microbially mediated reduction of sulfate based on the datasets reported by Jin and Bethke, and apply appropriate mass-bias within the Ft term to consider the extent to which the resulting isotopic fractionation is consistent with that observed in energetically limited systems. We show that the Ft term can exert a significant influence on the observed fractionation factor under common environmental conditions

  17. 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.

  18. 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.

  19. Density as a factor limiting the workability of P/M materials

    International Nuclear Information System (INIS)

    Libura, W.; Zasadzinski, J.

    1993-01-01

    In this study a general scheme expressing the factors which affect a workability of powder materials is presented. It was found from laboratory experiments that workability of powder metal materials is limited by their density. Aluminium based materials with additions of Cu, Ni and Sn were used in the experiments. Workability determined in compression tests depends strongly on a sintered density, independently of the chemical composition of material. A linear dependence between workability and sintered density was found. The results are related to relatively high density values, taken from the range of 0.85-0.96 of theoretical density. (orig.)

  20. Sensory shelf-life limiting factor of high hydrostatic pressure processed avocado paste.

    Science.gov (United States)

    Jacobo-Velázquez, D A; Hernández-Brenes, C

    2011-08-01

    High hydrostatic pressure (HHP) processing pasteurizes avocado paste without a significant impact on flavor. Although HHP-treated avocado paste stored under refrigeration is safe for human consumption for months, sensory changes taking place during storage cause the rejection of the product by consumers within days. Although it is known that the shelf life of the product ends before its microbial counts are high, its sensory shelf life limiting factor remains unknown. The present study focused on the use of a trained panel and a consumer panel to determine the sensory shelf life limiting factor of HHP-treated avocado paste. The trained panel identified sour and rancid flavors as the main sensory descriptors (critical descriptors) that differentiated stored from freshly processed samples. Further data obtained from consumers identified sour flavor as the main cause for a significant decrease in the acceptability (shelf life limiting factor) of refrigerated HHP-treated avocado paste. The study allowed the elucidation of a proposed deterioration mechanism for HHP-treated avocado paste during its refrigerated shelf life. The information through this work enhances scientific knowledge of the product and proposes the sour flavor development during storage as a relevant sensory attribute that needs to be improved in order to enhance the product shelf life. At present, HHP is the most effective commercial nonthermal technology to process avocado paste when compared to thermal and chemical alternatives. HHP-treated avocado paste is a microbiologically stable food for a period of at least 45 d stored under refrigeration. However, previous published work indicated that consumers rejected the product after approximately 19 d of storage due to sensory changes. This manuscript presents a sensory study that permitted the identification of the critical sensory descriptor that is acting as the sensory shelf life limiting factor of the product. The data presented herein along with

  1. Determining the 95% limit of detection for waterborne pathogen analyses from primary concentration to qPCR

    Science.gov (United States)

    Stokdyk, Joel P.; Firnstahl, Aaron; Spencer, Susan K.; Burch, Tucker R; Borchardt, Mark A.

    2016-01-01

    The limit of detection (LOD) for qPCR-based analyses is not consistently defined or determined in studies on waterborne pathogens. Moreover, the LODs reported often reflect the qPCR assay alone rather than the entire sample process. Our objective was to develop an approach to determine the 95% LOD (lowest concentration at which 95% of positive samples are detected) for the entire process of waterborne pathogen detection. We began by spiking the lowest concentration that was consistently positive at the qPCR step (based on its standard curve) into each procedural step working backwards (i.e., extraction, secondary concentration, primary concentration), which established a concentration that was detectable following losses of the pathogen from processing. Using the fraction of positive replicates (n = 10) at this concentration, we selected and analyzed a second, and then third, concentration. If the fraction of positive replicates equaled 1 or 0 for two concentrations, we selected another. We calculated the LOD using probit analysis. To demonstrate our approach we determined the 95% LOD for Salmonella enterica serovar Typhimurium, adenovirus 41, and vaccine-derived poliovirus Sabin 3, which were 11, 12, and 6 genomic copies (gc) per reaction (rxn), respectively (equivalent to 1.3, 1.5, and 4.0 gc L−1 assuming the 1500 L tap-water sample volume prescribed in EPA Method 1615). This approach limited the number of analyses required and was amenable to testing multiple genetic targets simultaneously (i.e., spiking a single sample with multiple microorganisms). An LOD determined this way can facilitate study design, guide the number of required technical replicates, aid method evaluation, and inform data interpretation.

  2. Nitrogen and carbon limitation of planktonic primary production and phytoplankton-bacterioplankton coupling in ponds on the McMurdo Ice Shelf, Antarctica

    DEFF Research Database (Denmark)

    Sorrell, B.K.; Hawes, I.; Safi, K.

    2013-01-01

    The nature of nutrient limitation and coupling of planktonic primary and secondary production were investigated in meltwater ponds of the Ross Ice Shelf, Antarctica, using regression tree analysis and multiple regression. Phytoplankton were primaril N-limited but inorganic carbon apparently co...

  3. Limiting factors for vegetation development during the early late glacial in Denmark

    DEFF Research Database (Denmark)

    Mortensen, Morten Fischer; Odgaard, Bent Vad; Jessen, Cathrine

    Slotseng, a small basin in southern Jutland, is the first Danish site with a bio- and chronostratigraphy that unambiguously reflects the environment of the earliest late glacial, the Bølling period. Results of pollen and macrofossil analyses show that the vegetation of the Bølling and Older Dryas...... periods at Slotseng was dominated by Betula nana and Dryas octopetala and associated with many herbs of open habitats. Late-glacial pollen records are frequently interpreted only in the context of climate change. However, the forcing mechanisms of vegetational change may shift over time between e...... to climate change suggests that other factors limited vegetational development. These factors included soil instability, aridity and low soil nitrogen.. This study highlights the multitude of climatic, physical, chemical and biological interactions important for the formation of pollen records of late...

  4. 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.

  5. [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.

  6. 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.

  7. 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.

  8. 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.

  9. 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.

  10. 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.

  11. 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.

  12. PWSCC Growth Assessment Model Considering Stress Triaxiality Factor for Primary Alloy 600 Components

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    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.

  13. Factors of Innate and Adaptive Local Immunity in Children with Primary Deficiencies of Antibody Formation

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    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.

  14. 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.

  15. 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.

  16. Frequency and interrelations of risk factors for chronic low back pain in a primary care setting.

    Directory of Open Access Journals (Sweden)

    Marie-Martine Lefevre-Colau

    Full Text Available INTRODUCTION: Many risk factors have been identified for chronic low back pain (cLBP, but only one study evaluated their interrelations. We aimed to investigate the frequency of cLBP risk factors and their interrelations in patients consulting their general practitioners (GPs for cLBP. METHODS: A cross-sectional, descriptive, national survey was performed. 3000 GPs randomly selected were asked to include at least one patient consulting for cLBP. Demographic, clinical characteristics and the presence of cLBP risk factors were recorded. The frequency of each cLBP risk factor was calculated and multiple correspondence analysis (MCA was performed to study their interrelations. RESULTS: A total of 2068 GPs (68.9% included at least 1 patient, for 4522 questionnaires analyzed. In the whole sample of patients, the 2 risk factors most commonly observed were history of recurrent LBP (72.1% and initial limitation of activities of daily living (66.4%. For working patients, common professional risk factors were beliefs, that LBP was due to maintaining a specific posture at work (79.0% and frequent heavy lifting at work (65.5%. On MCA, we identified 3 risk-factor dimensions (axes for working and nonworking patients. The main dimension for working patients involved professional risk factors and among these factors, patients' job satisfaction and job recognition largely contribute to this dimension. DISCUSSION: Our results shed in light for the first time the interrelation and the respective contribution of several previously identified cLBP risk factors. They suggest that risk factors representing a "work-related" dimension are the most important cLBP risk factors in the working population.

  17. 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)

  18. 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

  19. Factors limiting deceased organ donation: focus groups' perspective from culturally diverse community.

    Science.gov (United States)

    Wong, L P

    2010-06-01

    In-depth understanding of cultural and religious factors limiting organ donation of three ethnic populations (Malay, Chinese, and Indian) in Southeast Asia is lacking. Identification of factors limiting organ donation among these three ethnic groups will provide insights into culturally appropriate strategies to promote acceptance of organ donation in a multiethnic Asian community. A total of 17 focus group discussions (105 participants) were conducted between September and December 2008. Participants were members of the general public aged 18 to 60 years, recruited through convenient sampling around the Klang Valley area of Malaysia. Although the majority had favorable attitudes toward deceased organ donation and transplantation, a diversity of myths and misinformation were unearthed from the discussions across the ethnic groups. These include perceived religious prohibition, cultural myths and misperceptions, fear of disfigurement, fear of surgery, distrust of the medical system, and family disapproval. Culture and religious beliefs played important prohibitive roles among those opposed to organ donations. There were distinctive ethnic differences in cultural and religious concerns regarding organ donation. Less-educated and rural groups appeared to have more misconceptions than the well-educated and the urban groups. Our findings may assist organ donation and transplantation organizations to reach diverse sociodemographic and ethnic communities with culture-specific information about organ donation. The involvement of community and religious leaders is critical in organ donation requests.

  20. Farmer perceptions on factors influencing water scarcity for goats in resource-limited communal farming environments.

    Science.gov (United States)

    Mdletshe, Zwelethu Mfanafuthi; Ndlela, Sithembile Zenith; Nsahlai, Ignatius Verla; Chimonyo, Michael

    2018-05-09

    The objective of the study was to compare factors influencing water scarcity for goats in areas where there are seasonal and perennial rivers under resource-limited communal farming environments. Data were collected using a structured questionnaire (n = 285) administered randomly to smallholder goat farmers from areas with seasonal and perennial rivers. Ceremonies was ranked as the major reason for keeping goats. Water scarcity was ranked the major constraint to goat production in areas with seasonal rivers when compared to areas with perennial rivers (P goat drinking in areas with seasonal and perennial river systems during cool dry and rainy seasons. Rivers were ranked as an important water source for goat drinking where there are seasonal and perennial river systems during the cool dry season. Households located close (≤ 3 km) to the nearest water source reported drinking water for goats a scarce resource. These results show that river systems, season and distance to the nearest water source from a household were factors perceived by farmers to influence water scarcity for goats in resource-limited communal farming environments. Farmers should explore water-saving strategies such as recycling wastewater from kitchens and bathrooms as an alternative water source. The government may assist farmers through sinking boreholes to supply water for both humans and livestock.

  1. 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

  2. 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.

  3. [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.

  4. 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.

  5. 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%.

  6. 23 CFR 636.302 - Are there any limitations on the selection and use of proposal evaluation factors?

    Science.gov (United States)

    2010-04-01

    ... Are there any limitations on the selection and use of proposal evaluation factors? (a) The selection... 23 Highways 1 2010-04-01 2010-04-01 false Are there any limitations on the selection and use of proposal evaluation factors? 636.302 Section 636.302 Highways FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF...

  7. [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.

  8. Trait Mindfulness as a Limiting Factor for Residual Depressive Symptoms: An Explorative Study Using Quantile Regression

    Science.gov (United States)

    Radford, Sholto; Eames, Catrin; Brennan, Kate; Lambert, Gwladys; Crane, Catherine; Williams, J. Mark G.; Duggan, Danielle S.; Barnhofer, Thorsten

    2014-01-01

    Mindfulness has been suggested to be an important protective factor for emotional health. However, this effect might vary with regard to context. This study applied a novel statistical approach, quantile regression, in order to investigate the relation between trait mindfulness and residual depressive symptoms in individuals with a history of recurrent depression, while taking into account symptom severity and number of episodes as contextual factors. Rather than fitting to a single indicator of central tendency, quantile regression allows exploration of relations across the entire range of the response variable. Analysis of self-report data from 274 participants with a history of three or more previous episodes of depression showed that relatively higher levels of mindfulness were associated with relatively lower levels of residual depressive symptoms. This relationship was most pronounced near the upper end of the response distribution and moderated by the number of previous episodes of depression at the higher quantiles. The findings suggest that with lower levels of mindfulness, residual symptoms are less constrained and more likely to be influenced by other factors. Further, the limiting effect of mindfulness on residual symptoms is most salient in those with higher numbers of episodes. PMID:24988072

  9. Prognostic factors for patients with inoperable non-small cell lung cancer, limited disease

    International Nuclear Information System (INIS)

    Kaasa, S.; Mastekaasa, A.; Lund, E.

    1989-01-01

    In a prospective controlled clinical trial, 102 patients with inoperable non-small lung cancer (NSCLC), limited disease, stage II and III were treated with combination chemotherapy, cisplatin 70 mg/m 2 i.v. on day one and etoposide 100 mg/m 2 i.v. on day one, and etoposide 200 mg/m 2 orally on days 2 and 3, or radiotherapy given in 15 fractions of 2.8 Gy with two anterior/posterior fields during a period of three weeks. The patients completed a validated self-administered questionnaire before the start of treatment that assessed their psychosocial well-being, disease-related symptoms, personal functioning, and every day activity. These subjective varibles were evaluated together with treatment modality, WHO performance status, weight loss, and stage of disease, with regard to their value in predicting survival. Univariate survival analyses were undertaken for each individual factor, median survival was calculated according to life-table analyses. A step-wise multiple regression analysis was used to measure the prognostic value of the various factors. In the univariate analysis, general symptons (p=0.0006) psychosocial well-being (p=0.0002) and stage of disease (p=0.007) were the best predictive factors. In the multiple regression analyses the subjective variables, general symptons (p<0.01) and psychosocial well-being (p<0.05) were shown to have the best predictive value for the patients' survival. (author). 20 refs.; 4 figs.; 3 tabs

  10. Factors Contributing to the Subjective Career Success among Islamic Educators in Primary Schools

    OpenAIRE

    Mesnan Supa`ad; Nor Wahiza Abd Wahat; Fathiyah Mohd Fakhruddin; Turiman Suandi

    2013-01-01

    A very limited research has been done in the field of career development among Islamic education teachers. Most of the previous researches showed an improvement in terms of grades, positions, and responsibilities of their previous routines as an indicator of their career advancement. However, this conceptual (concept paper) discusses how personality factors, career planning, and career strategy can provide significant contribution to the success of Islamic education teachers’ career. Based on...

  11. 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.

  12. 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.

  13. 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.

  14. 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

  15. 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

  16. 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

  17. 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

  18. 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

  19. [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.

  20. 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.

  1. 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

  2. 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

  3. 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.

  4. 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

  5. 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.

  6. Searching out the hydrogen absorption/desorption limiting reaction factors: Strategies allowing to increase kinetics

    Energy Technology Data Exchange (ETDEWEB)

    Zeaiter, Ali, E-mail: ali.zeaiter@femto-st.fr; Chapelle, David; Nardin, Philippe

    2015-10-05

    Highlights: • A macro scale thermodynamic model that simulates the response of a FeTi-X hydride tank is performed, and validated experimentally. • A sensibility study to identify the most influent input variables that can changes very largely the reaction rate. - Abstract: Hydrogen gas has become one of the most promising energy carriers. Main breakthrough concerns hydrogen solid storage, specially based on intermetallic material use. Regarding the raw material abundance and cost, the AB type alloy FeTi is an auspicious candidate to store hydrogen. Its absorption/desorption kinetics is a basic hindrance to common use, compared with more usual hydrides. First, discussions based on literature help us identifying the successive steps leading to metal hydriding, and allow to introduce the physical parameters which drive or limit the reaction. This analysis leads us to suggest strategies in order to increase absorption/desorption kinetics. Attention is then paid to a thermofluidodynamic model, allowing to describe a macroscopic solid storage reactor. Thus, we can achieve a simulation which describes the overall reaction inside the hydrogen reactor and, by varying the sub-mentioned parameters (thermal conductivity, the powder granularity, environment heat exchange…), we attempt to hierarchy the reaction limiting factors. These simulations are correlated to absorption/desorption experiments for which pressure, temperature and hydrogen flow are recorded.

  7. Factors Contributing to the Subjective Career Success among Islamic Educators in Primary Schools

    Directory of Open Access Journals (Sweden)

    Mesnan Supa`ad

    2013-07-01

    Full Text Available A very limited research has been done in the field of career development among Islamic education teachers. Most of the previous researches showed an improvement in terms of grades, positions, and responsibilities of their previous routines as an indicator of their career advancement. However, this conceptual (concept paper discusses how personality factors, career planning, and career strategy can provide significant contribution to the success of Islamic education teachers’ career. Based on the Five Factor Model, Gould Planning Model, and the support of previous researches, this paper discusses how these three factors can contribute to the success of Islamic education teachers’ career. This paper also discusses its impact towards Islamic education teachers in Malaysia, schools management, District Education Office, Ministry of Education, and teachers education institutions.

  8. Factors Associated With Access to HIV Testing and Primary Care Among Migrants Living in Europe: Cross-Sectional Survey.

    Science.gov (United States)

    Fakoya, Ibidun; Álvarez-Del Arco, Débora; Copas, Andrew J; Teixeira, Bryan; Block, Koen; Gennotte, Anne-Francoise; Volny-Anne, Alain; Bil, Janneke P; Touloumi, Giota; Del Amo, Julia; Burns, Fiona M

    2017-11-06

    There is a heavy and disproportionate burden of human immunodeficiency virus (HIV) infection among migrant communities living in Europe. Despite this, the published evidence related to HIV testing, prevention, and treatment needs for migrants is sparse. The aim of this study was to identify the factors associated with access to primary care and HIV testing among migrant groups living in Europe. A Web-based survey (available in 14 languages) was open to all people aged 18 years and older, living outside their country of birth in the World Health Organization (WHO) European area. Community organizations in 9 countries promoted the survey to migrant groups, focusing on those at a higher risk of HIV (sub-Saharan Africans, Latin Americans, gay or bisexual men, and people who inject drugs). Multivariable analysis examined factors associated with access to primary care and previous history of an HIV test. In total, 559 women, 395 heterosexual men, and 674 gay or bisexual men were included in the analysis, and 68.1% (359/527) of women, 59.5% (220/371) of heterosexual men, and 89.6% (596/664) of gay or bisexual men had tested for HIV. Low perceived risk was the reason given for not testing by 62.3% (43/69) of gay or bisexual men and 83.3% (140/168) of women and heterosexual men who reported never having tested for HIV. Access to primary care was >60% in all groups. Access to primary care was strongly positively associated with living in Northern Europe compared with Southern Europe (women: adjusted odds ratio, aOR 34.56 [95% CI 11.58-101]; heterosexual men: aOR 6.93 [95% CI 2.49-19.35], and gay or bisexual men: aOR 2.53 [95% CI 1.23-5.19]), whereas those with temporary residency permits were less likely to have access to primary care (women: aOR 0.41 [95% CI 0.21-0.80] and heterosexual men: aOR 0.24 [95% CI 0.10-0.54] only). Women who had experience of forced sex (aOR 3.53 [95% CI 1.39-9.00]) or postmigration antenatal care (aOR 3.07 [95% CI 1.55-6.07]) were more likely to

  9. 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.

  10. 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.

  11. 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.

  12. 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.

  13. [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.

  14. From patient care to research: a validation study examining the factors contributing to data quality in a primary care electronic medical record database.

    Science.gov (United States)

    Coleman, Nathan; Halas, Gayle; Peeler, William; Casaclang, Natalie; Williamson, Tyler; Katz, Alan

    2015-02-05

    Electronic Medical Records (EMRs) are increasingly used in the provision of primary care and have been compiled into databases which can be utilized for surveillance, research and informing practice. The primary purpose of these records is for the provision of individual patient care; validation and examination of underlying limitations is crucial for use for research and data quality improvement. This study examines and describes the validity of chronic disease case definition algorithms and factors affecting data quality in a primary care EMR database. A retrospective chart audit of an age stratified random sample was used to validate and examine diagnostic algorithms applied to EMR data from the Manitoba Primary Care Research Network (MaPCReN), part of the Canadian Primary Care Sentinel Surveillance Network (CPCSSN). The presence of diabetes, hypertension, depression, osteoarthritis and chronic obstructive pulmonary disease (COPD) was determined by review of the medical record and compared to algorithm identified cases to identify discrepancies and describe the underlying contributing factors. The algorithm for diabetes had high sensitivity, specificity and positive predictive value (PPV) with all scores being over 90%. Specificities of the algorithms were greater than 90% for all conditions except for hypertension at 79.2%. The largest deficits in algorithm performance included poor PPV for COPD at 36.7% and limited sensitivity for COPD, depression and osteoarthritis at 72.0%, 73.3% and 63.2% respectively. Main sources of discrepancy included missing coding, alternative coding, inappropriate diagnosis detection based on medications used for alternate indications, inappropriate exclusion due to comorbidity and loss of data. Comparison to medical chart review shows that at MaPCReN the CPCSSN case finding algorithms are valid with a few limitations. This study provides the basis for the validated data to be utilized for research and informs users of its

  15. 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.

  16. Evaluation of Limiting Climatic Factors and Simulation of a Climatically Suitable Habitat for Chinese Sea Buckthorn.

    Directory of Open Access Journals (Sweden)

    Guoqing Li

    Full Text Available Chinese sea buckthorn (Hippophae rhamnoides subsp. sinensis has considerable economic potential and plays an important role in reclamation and soil and water conservation. For scientific cultivation of this species across China, we identified the key climatic factors and explored climatically suitable habitat in order to maximize survival of Chinese sea buckthorn using MaxEnt and GIS tools, based on 98 occurrence records from herbarium and publications and 13 climatic factors from Bioclim, Holdridge life zone and Kria' index variables. Our simulation showed that the MaxEnt model performance was significantly better than random, with an average test AUC value of 0.93 with 10-fold cross validation. A jackknife test and the regularized gain change, which were applied to the training algorithm, showed that precipitation of the driest month (PDM, annual precipitation (AP, coldness index (CI and annual range of temperature (ART were the most influential climatic factors in limiting the distribution of Chinese sea buckthorn, which explained 70.1% of the variation. The predicted map showed that the core of climatically suitable habitat was distributed from the southwest to northwest of Gansu, Ningxia, Shaanxi and Shanxi provinces, where the most influential climate variables were PDM of 1.0-7.0 mm, AP of 344.0-1089.0 mm, CI of -47.7-0.0°C, and ART of 26.1-45.0°C. We conclude that the distribution patterns of Chinese sea buckthorn are related to the northwest winter monsoon, the southwest summer monsoon and the southeast summer monsoon systems in China.

  17. 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.

  18. [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.

  19. 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.

  20. 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…

  1. 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...

  2. 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

  3. [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

  4. 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.

  5. 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

  6. 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.

  7. Incidence of short-term complications and associated factors after primary trabeculectomy in Chiang Mai University Hospital.

    Science.gov (United States)

    Leeungurasatien, Thidarat; Khunsongkiet, Preeyanuch; Pathanapitoon, Kassara; Wiwatwongwana, Damrong

    2016-10-01

    To determine the incidence of early postoperative complications and associated factors after primary trabeculectomy in Thai glaucoma patients. This was a retrospective observational study performed in Chiang Mai University Hospital. One hundred and eighteen glaucoma patients participated in the study. All glaucoma patients underwent primary trabeculectomy with mitomycin C (MMC) using fornix-based conjunctival flap technique between December 2011 and May 2013. Surgical complications during the first 3 months of follow-up were recorded, and associated risk factors were analyzed. The incidence of posttrabeculectomy complications was the main outcome measure. One hundred and eighteen eyes of 118 patients were included. Early postoperative complications developed in 55 eyes (56.7%). Complications included hypotony (25 eyes, 27.2%), serous choroidal detachment (CD) (14 eyes, 15.6%), subconjunctival hemorrhage (12 eyes, 13.0%), hyphema (11 eyes, 12.4%), bleb leak (8 eyes, 8.8%), encapsulated bleb (2 eyes, 2.2%), aqueous misdirection (1 eyes, 1.1%), corneal epithelial defect (1 eyes, 1.1%), and overfiltration (1 eyes, 1.1%). There were no reported cases of endophthalmitis or blebitis. Hypotony was associated with serous CD (P = 0.006), and hyphema was associated with neovascular glaucoma (NVG) patients (P = 0.009). NVG was not associated with the increased rate of surgical failure (P = 0.083). The incidence of early complications after first-time trabeculectomy with MMC was high (56.7%) in this Thai clinic setting, but most were transient and self-limited conditions. The correlations between hypotony and CD as well as hyphema and NVG were compatible with the previous studies.

  8. Primary dysmenorrhea magnitude, associated risk factors, and its effect on academic performance: evidence from female university students in Ethiopia.

    Science.gov (United States)

    Hailemeskel, Solomon; Demissie, Asrate; Assefa, Nigussie

    2016-01-01

    Primary dysmenorrhea (PD) is the most common gynecologic compliant among adolescent females. There is a wide variation in the estimate of PD, which ranges from 50% to 90%, and the disorder is the most common cause of work and school absenteeism in adolescent females. To assess the prevalence and associated risk factors of PD among female university students and understand its effects on students' academic performance. A cross-sectional study was employed in 440 research participants. A multistage stratified sampling technique was employed to select the study units. Structured and pretested self-administered questionnaires were used and weight and height measurements were conducted. The severity of dysmenorrheal pain was assessed by using a verbal multidimensional scoring system and visual analog scale. The data were double entered in Epi Info version 3.1 and analyzed using SPSS version 17. Descriptive statistics, chi-square test, and logistic regression analysis were performed. A total of 440 students participated in this study. The prevalence of PD was 368 (85.4%). Of these, 123 (28.5%) had mild, 164 (38.1%) moderate, and 81 (18.8%) severe primary dysmenorrheal pain. Among students with PD, 88.3% reported that PD had a negative effect on their academic performance. Of these, 80% reported school absence, 66.8% reported loss of class concentration, 56.3% reported class absence, 47.4% reported loss of class participation, 37.8% reported limited sport participation, 31.7% reported limitation in going out with friends, and 21% reported inability to do homework. Based on the multivariate logistic regression, PD was statistically significant with those who had lower monthly stipends, a history of attempt to lose weight, a history of depression or anxiety, disruption of social network of family, friends or people they love, who consumed more than four glasses of tea per day, who drunk one or more Coca-Cola or Pepsi per day, in nullipara, and students with a family history

  9. Age is not a limiting factor for radical radiotherapy in pelvic malignancies

    International Nuclear Information System (INIS)

    Pignon, T.; Horiot, J.C.; Bolla, M.; Poppel, H. van; Bartelink, H.; Roelofsen, F.; Pene, F.; Gerard, A.; Einhorn, N.; Nguyen, T.D.; Vanglabbeke, M.; Scalliet, P.

    1997-01-01

    Background and purpose: Pelvic radiotherapy (RT) toxicity in the elderly is poorly documented. We developed a study aiming to evaluate whether or not a limit of age could be identified beyond which toxicities in patients receiving pelvic RT were more frequent or more severe. Material and methods: 1619 patients with pelvic cancers enrolled in nine EORTC trials, RT arms, were retrospectively studied. Patients were split into six age ranges from 50 years to 70 years and over. Survivals and late toxicity occurrence were calculated with the Kaplan-Meier method and comparison between age groups with the logrank test. A trend test was done to examine if chronological age had an impact on acute toxicity occurrence. Results: Survival was comparable in each age group for prostate (P=0.18), uterus (0.41), anal canal cancer (P=0.6) and slightly better for the younger group of rectum cancer (P=0.04). A total of 1722 acute and 514 late grade ≥1 were recorded. Acute nausea/vomiting, skin complications and performance status deterioration were significantly more frequent in younger patients. There was no trend toward more aged patients to experience diarrhea (P=0.149) and after adjustment on RT dose, acute urinary complications were observed equally in each age range (P=0.32). Eighty percent of patients were free of late complication at 5 years in each age range (P=0.79). For the grade >2 late side-effects, a plateau was observed after 1 year at near 9% without any difference (P=0.06) nor trend (P=0.13) between age-groups. Conclusion: Age per se is not a limiting factor for radical radiotherapy in pelvic malignancies

  10. 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.

  11. 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.

  12. 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.

  13. Mycoplasma hyorhinis-Contaminated Cell Lines Activate Primary Innate Immune Cells via a Protease-Sensitive Factor.

    Directory of Open Access Journals (Sweden)

    Simon Heidegger

    Full Text Available Mycoplasma are a frequent and occult contaminant of cell cultures, whereby these prokaryotic organisms can modify many aspects of cell physiology, rendering experiments that are conducted with such contaminated cells problematic. Chronic Mycoplasma contamination in human monocytic cells lines has been associated with suppressed Toll-like receptor (TLR function. In contrast, we show here that components derived from a Mycoplasma hyorhinis-infected cell line can activate innate immunity in non-infected primary immune cells. Release of pro-inflammatory cytokines such as IL-6 by dendritic cells in response to Mycoplasma hyorhinis-infected cell components was critically dependent on the adapter protein MyD88 but only partially on TLR2. Unlike canonical TLR2 signaling that is triggered in response to the detection of Mycoplasma infection, innate immune activation by components of Mycoplasma-infected cells was inhibited by chloroquine treatment and sensitive to protease treatment. We further show that in plasmacytoid dendritic cells, soluble factors from Mycoplasma hyorhinis-infected cells induce the production of large amounts of IFN-α. We conclude that Mycoplasma hyorhinis-infected cell lines release protein factors that can potently activate co-cultured innate immune cells via a previously unrecognized mechanism, thus limiting the validity of such co-culture experiments.

  14. 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)

  15. 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)

  16. Factors responsible for the emergence of arboviruses; strategies, challenges and limitations for their control.

    Science.gov (United States)

    Liang, Guodong; Gao, Xiaoyan; Gould, Ernest A

    2015-03-01

    Slave trading of Africans to the Americas, during the 16th to the 19th century was responsible for the first recorded emergence in the New World of two arthropod-borne viruses (arboviruses), yellow fever virus and dengue virus. Many other arboviruses have since emerged from their sylvatic reservoirs and dispersed globally due to evolving factors that include anthropological behaviour, commercial transportation and land-remediation. Here, we outline some characteristics of these highly divergent arboviruses, including the variety of life cycles they have developed and the mechanisms by which they have adapted to evolving changes in habitat and host availability. We cite recent examples of virus emergence that exemplify how arboviruses have exploited the consequences of the modern human lifestyle. Using our current understanding of these viruses, we also attempt to demonstrate some of the limitations encountered in developing control strategies to reduce the impact of future emerging arbovirus diseases. Finally, we present recommendations for development by an international panel of experts reporting directly to World Health Organization, with the intention of providing internationally acceptable guidelines for improving emerging arbovirus disease control strategies. Success in these aims should alleviate the suffering and costs encountered during recent decades when arboviruses have emerged from their sylvatic environment.

  17. Biodiversities and limiting factors of Lashgardar Protected Area (LPA, Hamadan Province, Iran

    Directory of Open Access Journals (Sweden)

    MAHDI REYAHI KHORAM

    2010-10-01

    Full Text Available Reyahi-Khoram M, Norisharikabad V (2011 Biodiversities and limiting factors of Lashgardar Protected Area (LPA, Hamadan Province, Iran. Biodiversitas 12: 216-221. Lashgardar Protected Area (LPA located in Hamadan Province in Iran, it is a mountainous and plain area and proximal to Malayer Township. In 1991, the region was known as a protected area for increasing wild animals' population. This research has been conducted during 2001 through 2009. Plant and animal species of the region were identified and statistics of the population of animal flagship species were gathered. In this research, valid academic resources were used for identification of animal and plant species. Geographic Information System (GIS has been used to evaluate the land as main tool. The software used was Arc View (version 3.2a scale was 1/50,000. Due to cold mountainous climate, the region is covered by a wide diversity of trees, shrubs, grasses and herbs. There were 18 species of mammals as well as 75 bird species in LPA. Most abundant mammalian population belongs to wild sheep (558 animals and the second abundance was related to wild goat (515 animals. Also, the most abundant bird species belong to ortolans. Result of the present study showed that construction of connection roads in vicinity the region, establishment of factories inside and around the region, military garrison, unauthorized grazing, unlawful hunting, and Ahangaran mine and rail road have all exposed put LPA to serious threat and danger.

  18. [Limiting factors of waste land revegetation in indigenous zinc smelting areas of western Guizhou].

    Science.gov (United States)

    Lin, Wen-Jie; Xiao, Tang-Fu; Ao, Zi-Qiang; Xing, Jun; Ma, Huan-Cheng; Hu, Ting-Xing

    2007-03-01

    With indigenous zinc smelting waste residue, contaminated soil and background soil as test substrates, a pot experiment was conducted to study the growth characteristics of Lolium perenne and Trifolium pretense on these substrates. The results showed that the major limiting factors of waste land revegetation in indigenous zinc smelting areas of western Guizhou were the salt-alkali stress and the lower contents of organic matter, total N, available N and total K. The heavy metals in waste residue had a high concentration, but their available forms only occupied a small proportion, with low toxicity to plant but having potential harmful risk. Contaminated soil had lower concentrations of heavy metals than waste residue, but its contained heavy metals were more in available form. The constraints of revegetation on contaminated soil were the toxicity of heavy metals and the low contents of available P and K. Mixing contaminated soil with zinc smelting waste residue could be one of the effective approaches for the substrate amendment in indigenous zinc smelting areas.

  19. Theory of factors limiting high gradient operation of warm accelerating structures

    Energy Technology Data Exchange (ETDEWEB)

    Nusinovich, Gregory S. [University of Maryland; Antonsen, Thomas M. [University of Maryland; Kishek, Rami [University of Maryland

    2014-07-25

    This final report summarizes the research performed during the time period from 8/1/2010 to 7/31/2013. It consists of two parts describing our studies in two directions: (a) analysis of factors limiting operation of dielectric-loaded accelerating (DLA) structures where the main problem is the occurrence of multipactor on dielectric surfaces, and (b) studies of effects associated with either RF magnetic or RF electric fields which may cause the RF breakdown in high-gradient metallic accelerating structures. In the studies of DLA structures, at least, two accomplishments should be mentioned: the development of a 3D non-stationary, self-consistent code describing the multipactor phenomena and yielding very good agreement with some experimental data obtained in joint ANL/NRL experiments. In the metallic structures, such phenomena as the heating and melting of micro-particles (metallic dust) by RF electric and magnetic fields in single-shot and rep-rate regimes is analyzed. Also, such processes in micro-protrusions on the structure surfaces as heating and melting due to the field emitted current and the Nottingham effect are thoroughly investigated with the account for space charge of emitted current on the field emission from the tip.

  20. An analysis of factors affecting participation behavior of limited resource farmers in agricultural cost-share programs in Alabama

    Science.gov (United States)

    Okwudili Onianwa; Gerald Wheelock; Buddhi Gyawali; Jianbang Gan; Mark Dubois; John Schelhas

    2004-01-01

    This study examines factors that affect the participation behavior of limited resource farmers in agricultural cost-share programs in Alabama. The data were generated from a survey administered to a sample of limited resource farm operators. A binary logit model was employed to analyze the data. Results indicate that college education, age, gross sales, ratio of owned...

  1. Key factors determining success of primary eye care through vision centres in rural India: Patients′ perspectives

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    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.

  2. 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

  3. Interministerial decree of 10 February 1988 fixing the derived limits of the air concentration and the annual intake limit and the values of the quality factor and the neutron fluence rate

    International Nuclear Information System (INIS)

    1988-01-01

    This decree establishes the derived concentration limits in the air and annual inhalation limits for the radioisotopes and the values of the quality factors and the conversion factors fluence/dose equivalent for neutrons and protons

  4. [Functional and Anatomic Outcomes of Primary and Secondary Internal Limiting Membrane Transplantation in Large and Persistent Macular Holes].

    Science.gov (United States)

    Hess, Jelka A; Michels, Stephan; Becker, Matthias D

    2017-11-20

    Background The gold standard therapy for full-thickness macular holes (FTMH) is vitrectomy (PPV) with peeling of the internal limiting membrane (ILM), gas tamponade of the vitreous cavity and postoperative face-down positioning. Nevertheless, eyes with large macular holes (> 400 µm) and surgical failures remain difficult to manage. Recently, ILM transplantation (ILM-TX) techniques were developed with acceptable results, advocating different mechanisms of hole closure: in such a setting, the ILM could serve as a scaffold for neuronal tissue in the pedicle ILM flap technique or the ILM could induce a contraction of the FTMH rims through shrinking of a folded ILM plug. Patients/Material and Methods This retrospective study evaluates the functional and anatomic outcomes following ILM-TX for large FTMH and failed FMTH surgery. Large holes (group 1) were treated by the pedicle flap and the plug technique. Persistent holes following vitrectomy and ILM peeling (group 2) were treated with the plug technique. All ILM-TX were performed under perfluorocarbon liquid (PFCL) with a subsequent silicone oil tamponade. Results In group 1 (6 eyes), three eyes had a free ILM graft and three eyes underwent a pedunculated ILM-TX. The mean best corrected visual acuity (BCVA, LogMar) before primary ILM-TX was 1.18 ± 0.54 with a mean initial hole size of 681 ± 106 µm and a photoreceptor defect (PRD) of 1829 ± 474 µm. Five of six eyes showed a postoperative anatomical macular hole closure (83%). The mean BCVA after a mean follow-up of 9.3 ± 5.1 months was 0.83 ± 0.31 after a free ILM graft and 0.95 ± 0.79 after a pedunculated ILM flap. The PRD reduced to 1781 ± 713 µm after a free ILM graft and 1148 ± 378 µm after a pedunculated ILM flap. In group 2 (7 eyes), all patients had failed initial macular hole surgery closure. Prior to free ILM-TX BCVA was 1.05 ± 0.41, the hole size was 433 ± 183 µm and PRD was 2012 ± 718

  5. The limits of market-based reforms in the NHS: the case of alternative providers in primary care.

    Science.gov (United States)

    Coleman, Anna; Checkland, Kath; McDermott, Imelda; Harrison, Stephen

    2013-01-01

    Historically, primary medical care in the UK has been delivered by general practitioners who are independent contractors, operating under a contract, which until 2004 was subject to little performance management. In keeping with the wider political impetus to introduce markets and competition into the NHS, reforms were introduced to allow new providers to bid for contracts to provide primary care services in England. These contracts known as 'Alternative Provider Medical Services', were encouraged by two centrally-driven rounds of procurement (2007/8 and 2008/9). This research investigated the commissioning and operation of such Alternative Providers of Primary Care (APPCs). Two qualitative case studies were undertaken in purposively sampled English Primary Care Trusts (PCTs) and their associated APPCs over 14 months (2009-10). We observed 65 hours of meetings, conducted 23 interviews with PCT and practice staff, and gathered relevant associated documentation. We found that the procurement and contracting process was costly and time-consuming. Extensive local consultation was undertaken, and there was considerable opposition in some areas. Many APPCs struggled to build up their patient list sizes, whilst over-performing on walk-in contracts. Contracting for APPCs was 'transactional', in marked contrast to the 'relational' contracting usually found in the NHS, with APPCs subject to tight performance management. These complicated and costly processes contrast to those experienced by traditionally owned GP partnerships. However, managers reported that the perception of competition had led existing practices to improve their services. The Coalition Government elected in 2010 is committed to 'Any Qualified Provider' of secondary care, and some commentators argue that this should also be applied to primary care. Our research suggests that, if this is to happen, a debate is needed about the operation of a market in primary care provision, including the trade-offs between

  6. The limits of market-based reforms in the NHS: the case of alternative providers in primary care

    Science.gov (United States)

    2013-01-01

    Background Historically, primary medical care in the UK has been delivered by general practitioners who are independent contractors, operating under a contract, which until 2004 was subject to little performance management. In keeping with the wider political impetus to introduce markets and competition into the NHS, reforms were introduced to allow new providers to bid for contracts to provide primary care services in England. These contracts known as ‘Alternative Provider Medical Services’, were encouraged by two centrally-driven rounds of procurement (2007/8 and 2008/9). This research investigated the commissioning and operation of such Alternative Providers of Primary Care (APPCs). Methods Two qualitative case studies were undertaken in purposively sampled English Primary Care Trusts (PCTs) and their associated APPCs over 14 months (2009-10). We observed 65 hours of meetings, conducted 23 interviews with PCT and practice staff, and gathered relevant associated documentation. Results and conclusions We found that the procurement and contracting process was costly and time-consuming. Extensive local consultation was undertaken, and there was considerable opposition in some areas. Many APPCs struggled to build up their patient list sizes, whilst over-performing on walk-in contracts. Contracting for APPCs was ‘transactional’, in marked contrast to the ‘relational’ contracting usually found in the NHS, with APPCs subject to tight performance management. These complicated and costly processes contrast to those experienced by traditionally owned GP partnerships. However, managers reported that the perception of competition had led existing practices to improve their services. The Coalition Government elected in 2010 is committed to ‘Any Qualified Provider’ of secondary care, and some commentators argue that this should also be applied to primary care. Our research suggests that, if this is to happen, a debate is needed about the operation of a market

  7. 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.

  8. [Frequency of self-reported vocal problems and associated occupational factors in primary schoolteachers in Londrina, Paraná State, Brazil].

    Science.gov (United States)

    Fillis, Michelle Moreira Abujamra; Andrade, Selma Maffei de; González, Alberto Durán; Melanda, Francine Nesello; Mesas, Arthur Eumann

    2016-01-01

    This study aimed to estimate the prevalence of self-reported vocal problems among primary schoolteachers and to identify associated occupational factors, using a cross-sectional design and face-to-face interviews with 967 teachers in 20 public schools in Londrina, Paraná State, Brazil. Prevalence of self-reported vocal problems was 25.7%. Adjusted analyses showed associations with characteristics of the employment relationship (workweek ≥ 40 hours and poor perception of salaries and health benefits), characteristics of the work environment (number of students per class and exposure to chalk dust and microorganisms), psychological factors (low job satisfaction, limited opportunities to express opinions, worse relationship with superiors, and poor balance between professional and personal life), and violence (insults and bullying). Vocal disorders affected one in four primary schoolteachers and were associated with various characteristics of the teaching profession (both structural and work-related).

  9. 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.

  10. 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.

  11. 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.

  12. 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.

  13. 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)

  14. [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.

  15. 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

  16. 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…

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

    Directory of Open Access Journals (Sweden)

    Liena Sofiana

    2018-01-01

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

  18. Updating Environmental Media Concentration Limits and Uncertainty factors in the ERICA Tool

    Energy Technology Data Exchange (ETDEWEB)

    Brown, J.E.; Hosseini, A. [Norwegian Radiation Protection Authority, P.O. Box 55, N-1332 Oesteraas (Norway); Alfonso, B.; Avila, R. [Facilia AB, S-167 51 Bromma (Sweden); Beresford, N.A. [Centre for Ecology and Hydrology, CEH-Lancaster, Lancaster Environment Centre, Library Avenue, Bailrigg, Lancaster LA 1 4AP (United Kingdom); Copplestone, D. [Dept. Biological and Environmental Sciences, University of Stirling, Stirling, FK9 4LA (United Kingdom)

    2014-07-01

    Tiered approaches have become a standard means of structuring information in the process of conducting environmental risk assessments. For cases involving the assessment of impacts on wildlife from ionising radiation, the ERICA integrated approach and its supporting software (The ERICA Tool) provides such a structure, splitting the system into two generic screening tiers and a third site-specific tier. The first Tier is very simple, based around Environmental Media Concentration Limits, EMCLs, and requires minimal input from the assessor. The second Tier, although still a screening tier, calculates dose rates and requires more detailed input from the assessor allowing for scrutiny and editing of default parameters in the process. A key element of Tier 2 involves the application of Uncertainty Factors, UFs. Such factors reflect our knowledge concerning probability distribution functions and provide a way of incorporating conservatism into the assessment by considering high percentile values in underlying parameters. Following its launch in 2007, there have been significant developments regarding certain components of the ERICA integrated approach. Most notably, an extended international collation of concentration ratio data has precipitated the need to update parameter values in the Tools databases. In addition, more considered guidance has been developed with regards to filling knowledge gaps in the absence of transfer data. Furthermore, the efficacy of the methods used in assigning probability distribution functions has been questioned leading to an acknowledgement from the developers that the methods were not described in enough detail nor were the justifications for applying the selected approach provided in a convincing way. This has implications for the EMCL values which are derived probabilistically using parameters including concentration ratios. Furthermore, there are implications for UF derivation that relies upon a robust consideration of underlying

  19. 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.

  20. 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

  1. Factors leading to poor water sanitation hygiene among primary school going children in Chitungwiza

    Directory of Open Access Journals (Sweden)

    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.

  2. Factors associated with use of slip-resistant shoes in US limited-service restaurant workers.

    Science.gov (United States)

    Verma, Santosh K; Courtney, Theodore K; Corns, Helen L; Huang, Yueng-Hsiang; Lombardi, David A; Chang, Wen-Ruey; Brennan, Melanye J; Perry, Melissa J

    2012-06-01

    Slips and falls are a leading cause of injury at work. Several studies have indicated that slip-resistant shoes can reduce the risk of occupational slips and falls. Few studies, however, have examined the determinants of slip-resistant shoe use. This study examined the individual and workplace factors associated with slip-resistant shoe use. 475 workers from 36 limited-service restaurants in the USA participated in a study of workplace slipping. Demographic and job characteristic information about each participant was collected. Restaurant managers provided information on whether slip-resistant shoes were provided and paid for by the employer and whether any guidance was given regarding slip-resistant shoe use when they were not provided. Kitchen floor coefficient of friction was measured. Slip-resistant status of the shoes was determined by noting the presence of a 'slip-resistant' marking on the sole. Poisson regression with robust SE was used to calculate prevalence ratios. 320 participants wore slip-resistant shoes (67%). In the multivariate analysis, the prevalence of slip-resistant shoe use was lowest in 15-19-year age group. Women were more likely to wear slip-resistant shoes (prevalence ratio 1.18, 95% CI 1.07 to 1.31). The prevalence of slip-resistant shoe use was lower when no guidance regarding slip-resistant shoes was given as compared to when they were provided by the employer (prevalence ratio 0.66, 95% CI 0.55 to 0.79). Education level, job tenure and the mean coefficient of friction had no significant effects on the use of slip-resistant shoes. Provision of slip-resistant shoes was the strongest predictor of their use. Given their effectiveness and low cost, employers should consider providing slip-resistant shoes at work.

  3. Weathering as the limiting factor of denudation in the Western escarpment of the Andes

    Science.gov (United States)

    Abbühl, L. M.; Schlunegger, F.; Kracht, O.; Ramseyer, K.; Rieke-Zapp, D.; Aldahan, A.; von Blanckenburg, F.

    2009-04-01

    additional river profile knickzone in the transition zone between the easterlies and the westerlies. Analysis of 10Be in quartz of river-born sand and of bedrock reveals that denudation correlates positively with the present-day rainfall pattern related to the easterlies. Denudation rates in the headwaters range from 0.14 mm/year in Northern Peru down to 0.05 mm/yr in Northern Chile (Kober et al., 2007). In addition, 10Be-based denudation rates reveal a decreasing trend from the Cordillera to the Pacific coast that positively correlates with the decreasing precipitation rate, irrespective of the nature of the bedrock. Interestingly, the 10Be analysis conducted in the Piura system reveals no influence of the episodic precipitation in relation to El Niño on the sediment production rates. In summary, the pattern of denudation rates together with morphometric observations and quantitative denudation rate estimates strongly hints at weathering being the driving but also limiting factor of denudation. Accordingly, in the western Peruvian Andes, sediment production and export are most probably controlled by the pattern and rate of precipitation. Kober, F., Ivy-Ochs, S., Schlunegger, F., Baur, H., Kubik, P. W., and Wieler, R. (2007). Denudation rates and a topography-driven rainfall threshold in northern Chile: Multiple cosmogenic nuclide data and sediment yield budgets. Geomorphology 83, 97-120.

  4. 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

  5. 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.

  6. Prevalence of suicidal behaviour & associated factors among tuberculosis patients in public primary care in South Africa

    Directory of Open Access Journals (Sweden)

    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.

  7. [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.

  8. 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.

  9. Prediction factors for failure to seek treatment following traumatic dental injuries to primary teeth

    Directory of Open Access Journals (Sweden)

    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.

  10. 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.

  11. 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

  12. 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

  13. 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

  14. Limiting values of radionuclide intake and air concentration and dose conversion factors for inhalation, submersion, and ingestion: Federal guidance report No. 11

    International Nuclear Information System (INIS)

    Eckerman, K.F.; Wolbarst, A.B.; Richardson, A.C.B.

    1988-09-01

    Radiation protection programs for workers are based, in the United States, on a hierarchy of limitations stemming from Federal guidance approved by the President. This guidance, which consists of principles, policies, and numerical primary guides, is used by Federal agencies as the basis for developing and implementing their own regulatory standards. The primary guides are usually expressed in terms of limiting doses to workers. The protection of workers against taking radioactive materials into the body, however, is accomplished largely through the use of regulations based on derived guides expressed in terms of quantities or concentrations of radionuclides. The values of these derived guides are chosen so as to assure that workers in work environments that conform to them are unlikely to receive radiation doses that exceed the primary guides. The purpose of the present report is to set forth derived guides that are consistent with current Federal radiation protection guidance. They are intended to serve as the basis for regulations setting upper bounds on the inhalation and ingestion of, and submersion in, radioactive materials in the workplace. The report also includes tables of exposure-to-dose conversion factors, for general use in assessing average individual committed doses in any population that is adequately characterized by Reference Man. 38 refs

  15. Limiting values of radionuclide intake and air concentration and dose conversion factors for inhalation, submersion, and ingestion: Federal guidance report No. 11

    Energy Technology Data Exchange (ETDEWEB)

    Eckerman, K.F.; Wolbarst, A.B.; Richardson, A.C.B.

    1988-09-01

    Radiation protection programs for workers are based, in the United States, on a hierarchy of limitations stemming from Federal guidance approved by the President. This guidance, which consists of principles, policies, and numerical primary guides, is used by Federal agencies as the basis for developing and implementing their own regulatory standards. The primary guides are usually expressed in terms of limiting doses to workers. The protection of workers against taking radioactive materials into the body, however, is accomplished largely through the use of regulations based on derived guides expressed in terms of quantities or concentrations of radionuclides. The values of these derived guides are chosen so as to assure that workers in work environments that conform to them are unlikely to receive radiation doses that exceed the primary guides. The purpose of the present report is to set forth derived guides that are consistent with current Federal radiation protection guidance. They are intended to serve as the basis for regulations setting upper bounds on the inhalation and ingestion of, and submersion in, radioactive materials in the workplace. The report also includes tables of exposure-to-dose conversion factors, for general use in assessing average individual committed doses in any population that is adequately characterized by Reference Man. 38 refs.

  16. Risk factors for acute exacerbations of COPD in a primary care population: a retrospective observational cohort study

    Science.gov (United States)

    Müllerová, Hana; Shukla, Amit; Hawkins, Adam; Quint, Jennifer

    2014-01-01

    Objectives To evaluate risk factors associated with exacerbation frequency in primary care. Information on exacerbations of chronic obstructive pulmonary disease (COPD) has mainly been generated by secondary care-based clinical cohorts. Design Retrospective observational cohort study. Setting Electronic medical records database (England and Wales). Participants 58 589 patients with COPD aged ≥40 years with COPD diagnosis recorded between 1 April 2009 and 30 September 2012, and with at least 365 days of follow-up before and after the COPD diagnosis, were identified in the Clinical Practice Research Datalink. Mean age: 69 years; 47% female; mean forced expiratory volume in 1s 60% predicted. Outcome measures Data on moderate or severe exacerbation episodes defined by diagnosis and/or medication codes 12 months following cohort entry were retrieved, together with demographic and clinical characteristics. Associations between patient characteristics and odds of having none versus one, none versus frequent (≥2) and one versus frequent exacerbations over 12 months follow-up were evaluated using multivariate logistic regression models. Results During follow-up, 23% of patients had evidence of frequent moderate-to-severe COPD exacerbations (24% one; 53% none). Independent predictors of increased odds of having exacerbations during the follow-up, either frequent episodes or one episode, included prior exacerbations, increasing dyspnoea score, increasing grade of airflow limitation, females and prior or current history of several comorbidities (eg, asthma, depression, anxiety, heart failure and cancer). Conclusions Primary care-managed patients with COPD at the highest risk of exacerbations can be identified by exploring medical history for the presence of prior exacerbations, greater COPD disease severity and co-occurrence of other medical conditions. PMID:25524545

  17. Exploring the interaction of activity limitations with context, systems, community and personal factors in accessing public health care services: A presentation of South African case studies.

    Science.gov (United States)

    Mji, Gubela; Braathen, Stine H; Vergunst, Richard; Scheffler, Elsje; Kritzinger, Janis; Mannan, Hasheem; Schneider, Marguerite; Swartz, Leslie; Visagie, Surona

    2017-02-08

    There are many factors that influence access to public health services, such as the context people live in, the existing health services, and personal, cultural and community factors. People with disabilities (activity limitations), through their experience of health services, may offer a particular understanding of the performance of the health services, thus exposing health system limitations more clearly than perhaps any other health service user. This article explores how activity limitations interact with factors related to context, systems, community and personal factors in accessing public health care services in South Africa. We present four case studies of people with disabilities from four low-resource diverse contexts in South Africa (rural, semi-rural, farming community and peri-urban) to highlight challenges of access to health services experienced by people with activity limitations in a variety of contexts. One case study of a person with disabilities was chosen from each study setting to build evidence using an intensive qualitative case study methodology to elucidate individual and household experiences of challenges experienced by people with activity limitations when attempting to access public health services. In-depth interviews were used to collect data, using an interview guide. The analysis was conducted in the form of a thematic analysis using the interview topics as a starting point. First, these four case studies demonstrate that equitable access to health services for people with activity limitations is influenced by a complex interplay of a variety of factors for a single individual in a particular context. Secondly, that while problems with access to public health services are experienced by everyone, people with activity limitations are affected in particular ways making them particularly vulnerable in using public health services. The revitalisation of primary health care and the introduction of national health

  18. 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...

  19. 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...

  20. 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...

  1. 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.

  2. 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.

  3. Outcome and risk factors of recurrence after thoracoscopic bullectomy in young adults with primary spontaneous pneumothorax.

    Science.gov (United States)

    Nakayama, Takashi; Takahashi, Yusuke; Uehara, Hirofumi; Matsutani, Noriyuki; Kawamura, Masafumi

    2017-07-01

    To investigate the risk factors of recurrence of pneumothorax following thoracoscopic bullectomy in young adults. Between January, 2005 and September, 2015, 167 patients aged ≤40 years underwent initial thoracoscopic bullectomy for primary spontaneous pneumothorax (PSP) at our hospital. Recurrence-free probability was calculated from the date of surgery to recurrence or last follow-up, using the Kaplan-Meier method. Sixteen (9.6%) of the 167 patients suffered a recurrence (collective total, 16 recurrences). The recurrence-free intervals were 3-107 months (median 25.8 months), and the 5-year recurrence-free probability was 85.9%. Multivariate Cox analysis demonstrated that age ≤23 years (p = 0.029) and a history of ipsilateral pneumothorax before surgery (p = 0.029) were significantly associated with higher risk of recurrence. The 5-year recurrence-free probability was 72.3% for patients aged ≤23 years and a history of ipsilateral pneumothorax before surgery and 94.1% for those with neither of these factors (p = 0.001). Recurrence developed within 3 years after surgery in 14 of the 16 patients. Patients ≤23 years of age with a history of ipsilateral pneumothorax before surgery are at significantly high risk of its recurrence, frequently within 3 years; thus, the risk of postoperative recurrence of a pneumothorax must be kept in mind.

  4. Factors influencing referral of patients with voice disorders from primary care to otolaryngology.

    Science.gov (United States)

    Cohen, Seth M; Kim, Jaewhan; Roy, Nelson; Courey, Mark

    2014-01-01

    To evaluate the frequency, timing, and factors that influence referral of patients with laryngeal/voice disorders to otolaryngology following initial evaluation by a primary care physician (PCP). Retrospective analysis of a large, national administrative US claims database. Patients with a laryngeal disorder based on International Classification of Diseases, Ninth Revision, Clinical Modification codes from January 1, 2004 to December 31, 2008, seen by a PCP as an outpatient (with or without otolaryngology involvement), and continuously enrolled for 12 months were included. Patient age, gender, geographic region, last PCP laryngeal diagnosis, comorbid conditions, time from first PCP visit to first otolaryngology visit, number of PCP outpatient visits, and number of PCP laryngeal diagnoses were collected. Cox and generalized linear regressions were performed. A total of 149,653 unique patients saw a PCP as an outpatient for a laryngeal/voice disorder, with 136,152 (90.9%) only seeing a PCP, 6,013 (4.0%) referred by a PCP to an otolaryngologist, and 3,820 (2.6%) self-referred to an otolaryngologist. Acute laryngitis had a lower hazard ratio (HR) for otolaryngology referral than chronic laryngitis, nonspecific dysphonia, and laryngeal cancer. Having multiple comorbid conditions was associated with a greater HR for otolaryngology referral than having no comorbidities. Patient age, gender, and geographic region also affected otolaryngology referral. The time to otolaryngology evaluation ranged from 3 months. PCP-referred patients had less time to the otolaryngology evaluation than self-referred patients. Multiple factors affected otolaryngology referral for patients with laryngeal/voice disorders. Further education of PCPs regarding appropriate otolaryngology referral for laryngeal/voice disorders is needed. © 2013 The American Laryngological, Rhinological and Otological Society, Inc.

  5. Incidence of dental caries in primary dentition and risk factors: a longitudinal study.

    Science.gov (United States)

    Corrêa-Faria, Patrícia; Paixão-Gonçalves, Suzane; Paiva, Saul Martins; Pordeus, Isabela Almeida

    2016-05-20

    The objectives of this prospective, longitudinal, population-based study were to estimate the incidence of dental caries in the primary dentition, identify risk factors and determine the proportion of children receiving dental treatment, through a two-year follow up. The first dental exam was conducted with 381 children aged one to five years, at health centers during immunization campaigns; 184 of them had dental caries and 197 had no caries experience. The second exam was carried out two years later at a nursery or at home with the same individuals who participated in the first exam. The diagnosis of dental caries was performed using the dmft criteria. Parents were interviewed regarding socioeconomic indicators. Descriptive, bivariate and adjusted Poisson regression analyses were performed. Among the 381 children, 234 were reexamined after two years (non-exposed: 139; exposed: 95). The overall incidence of dental caries was 46.6%. The greatest incidence of dental caries was found in the group of children with previous caries experience (61.1%). Among the children without dental caries in the first exam, 36.7% exhibited caries in the second exam. The majority of children (72.6%) received no treatment for carious lesions in the two-year interval between examinations. Children with previous dental caries (RR: 1.52, 95%CI: 1.12-2.05) had a greater risk of developing new lesions, compared with the children without previous dental caries. The incidence of dental caries was high and most of children's caries were untreated. Previous caries experience is a risk factor for developing new carious lesions in children.

  6. Obesity as a risk factor for developing functional limitation among older adults: A conditional inference tree analysis.

    Science.gov (United States)

    Cheng, Feon W; Gao, Xiang; Bao, Le; Mitchell, Diane C; Wood, Craig; Sliwinski, Martin J; Smiciklas-Wright, Helen; Still, Christopher D; Rolston, David D K; Jensen, Gordon L

    2017-07-01

    To examine the risk factors of developing functional decline and make probabilistic predictions by using a tree-based method that allows higher order polynomials and interactions of the risk factors. The conditional inference tree analysis, a data mining approach, was used to construct a risk stratification algorithm for developing functional limitation based on BMI and other potential risk factors for disability in 1,951 older adults without functional limitations at baseline (baseline age 73.1 ± 4.2 y). We also analyzed the data with multivariate stepwise logistic regression and compared the two approaches (e.g., cross-validation). Over a mean of 9.2 ± 1.7 years of follow-up, 221 individuals developed functional limitation. Higher BMI, age, and comorbidity were consistently identified as significant risk factors for functional decline using both methods. Based on these factors, individuals were stratified into four risk groups via the conditional inference tree analysis. Compared to the low-risk group, all other groups had a significantly higher risk of developing functional limitation. The odds ratio comparing two extreme categories was 9.09 (95% confidence interval: 4.68, 17.6). Higher BMI, age, and comorbid disease were consistently identified as significant risk factors for functional decline among older individuals across all approaches and analyses. © 2017 The Obesity Society.

  7. Factors associated with patients' satisfaction in Brazilian dental primary health care.

    Science.gov (United States)

    Aldosari, Muath Abdullah; Tavares, Mary Angela; Matta-Machado, Antônio Thomaz Gonzaga; Abreu, Mauro Henrique Nogueira Guimarães

    2017-01-01

    To assess factors associated with patients' satisfaction with the treatment by dentists in primary health care (PHC) in Brazil. The dataset was part of a nationwide cross-sectional survey for evaluating PHC teams conducted by the Brazilian Ministry of Health. Patients from each of 16,202 oral health teams were interviewed. In addition to sociodemographic information, the questionnaire included information about patient experience domains: access and booking of dental appointments, bonding and accountability, welcoming of the patient, and their perception of dental facilities. The dependent variable was the answer to the question 'From 0 to 10, how would you grade your satisfaction with treatment received from the dentist?' Negative binomial regression models were used to estimate the unadjusted and adjusted rate ratios and corresponding 95% confidence interval. The mean patient satisfaction was 9.4 (±2.3). Higher patient satisfaction with PHC was associated with lower education and the patient's perception of the clinic conditions. Moreover, higher satisfaction was associated with positive reception and hospitality, enough time for treatment, and instructions that met patients' needs. Lower satisfaction with PHC was associated with patients who have jobs compared to those who do not work. Patient satisfaction is increased with friendly and understanding PHC staff. Moreover, meeting patient expectations by taking time to understand the needs and giving the right instructions is associated with higher satisfaction.

  8. Factors associated with patients’ satisfaction in Brazilian dental primary health care

    Science.gov (United States)

    Tavares, Mary Angela; Matta-Machado, Antônio Thomaz Gonzaga

    2017-01-01

    Objective To assess factors associated with patients’ satisfaction with the treatment by dentists in primary health care (PHC) in Brazil. Materials and methods The dataset was part of a nationwide cross-sectional survey for evaluating PHC teams conducted by the Brazilian Ministry of Health. Patients from each of 16,202 oral health teams were interviewed. In addition to sociodemographic information, the questionnaire included information about patient experience domains: access and booking of dental appointments, bonding and accountability, welcoming of the patient, and their perception of dental facilities. Statistical analysis The dependent variable was the answer to the question ‘From 0 to 10, how would you grade your satisfaction with treatment received from the dentist?’ Negative binomial regression models were used to estimate the unadjusted and adjusted rate ratios and corresponding 95% confidence interval. Results The mean patient satisfaction was 9.4 (±2.3). Higher patient satisfaction with PHC was associated with lower education and the patient’s perception of the clinic conditions. Moreover, higher satisfaction was associated with positive reception and hospitality, enough time for treatment, and instructions that met patients’ needs. Lower satisfaction with PHC was associated with patients who have jobs compared to those who do not work. Conclusion Patient satisfaction is increased with friendly and understanding PHC staff. Moreover, meeting patient expectations by taking time to understand the needs and giving the right instructions is associated with higher satisfaction. PMID:29145438

  9. Social factors associated with mental disorders with risk situations in the primary health care

    Directory of Open Access Journals (Sweden)

    Bruno Lopes da Costa Drummond

    2014-01-01

    Full Text Available OBJECTIVE: To evaluate patients with mental disorders, with or without risk situations, treated at primary health care (PHC units. METHOD: A cross-sectional study was performed in samples of 240 patients living in a region of high social vulnerability in Belo Horizonte. The response variable was mental disorders with risk situations (MD-WR. The explanatory variables were gender, age, marital status, literacy, education, employment, social benefits and per capita income. Instruments from Berkman and Syme (social network, Sherbourne and Stewart (social support, adapted for Brazil, were applied. Pearson's χ2 test and binary logistic regression were used for the adjusted analyzes. RESULTS: The factors associated with MD-WR were being male (OR = 3.62; 95%CI 1.84 - 7.09; having "up to one confident relative" only (OR = 2.53; 95%CI 1.18 - 5.42; being "not able to return home" when away from their living area (OR = 3.49; 95%CI 1.40 - 8.71. The reduction in the affective dimension of the Medical Outcomes Study (MOS scale increases the chance of MD-WR. Conclusion: The availability and access to social and support networks are lower for patients with MD-WR and need to be strengthened to promote autonomy and citizenship among its users. We conclude that there is the need of public policies to increase the availability of social networking equipment and social support projects, encouraging the participation of families.

  10. Vascular endothelial growth factor A-stimulated signaling from endosomes in primary endothelial cells.

    Science.gov (United States)

    Fearnley, Gareth W; Smith, Gina A; Odell, Adam F; Latham, Antony M; Wheatcroft, Stephen B; Harrison, Michael A; Tomlinson, Darren C; Ponnambalam, Sreenivasan

    2014-01-01

    The vascular endothelial growth factor A (VEGF-A) is a multifunctional cytokine that stimulates blood vessel sprouting, vascular repair, and regeneration. VEGF-A binds to VEGF receptor tyrosine kinases (VEGFRs) and stimulates intracellular signaling leading to changes in vascular physiology. An important aspect of this phenomenon is the spatiotemporal coordination of VEGFR trafficking and intracellular signaling to ensure that VEGFR residence in different organelles is linked to downstream cellular outputs. Here, we describe a series of assays to evaluate the effects of VEGF-A-stimulated intracellular signaling from intracellular compartments such as the endosome-lysosome system. These assays include the initial isolation and characterization of primary human endothelial cells, performing reverse genetics for analyzing protein function; methods used to study receptor trafficking, signaling, and proteolysis; and assays used to measure changes in cell migration, proliferation, and tubulogenesis. Each of these assays has been exemplified with studies performed in our laboratories. In conclusion, we describe necessary techniques for studying the role of VEGF-A in endothelial cell function. © 2014 Elsevier Inc. All rights reserved.

  11. Magnitude and risk factors for burnout among primary health care physicians in Asir Province, Saudi Arabia.

    Science.gov (United States)

    Al-Sareai, N S; Al-Khaldi, Y M; Mostafa, O A; Abdel-Fattah, M M

    2013-05-01

    Job-related burnout is an occupational hazard for health care professionals. This study aimed to determine the prevalence of burnout and its associated factors among physicians working at primary health care centres in Asir province, Saudi Arabia. In a cross-sectional survey applying the Maslach Burnout Inventory (MBI) with standard cutoffs, 29.5% of respondents reported high emotional exhaustion, 15.7% high depersonalization and 19.7% low personal accomplishment, with 6.3% scoring high in all 3 dimensions. High emotional exhaustion score was associated with younger age, Saudi nationality and salary 15,000-20,000 SR. Physicians who had more working days and those who had longer duration of annual vacation were less likely to report emotional exhaustion. High depersonalization score was associated with Saudi nationality, working for 5-15 years and salary > 20,000 SR. Low personal accomplishment score was associated with younger age, non-Saudi nationality, working for > or =5 years and more annual vacation.

  12. Factors Associated with Dental Caries in Primary Dentition in a Non-Fluoridated Rural Community of New South Wales, Australia

    Directory of Open Access Journals (Sweden)

    Amit Arora

    2017-11-01

    Full Text Available Dental caries persists as one of the most prevalent chronic diseases among children worldwide. This study aims to determine factors that influence dental caries in primary dentition among primary school children residing in the rural non-fluoridated community of Lithgow, New South Wales, Australia. A total of 495 children aged 5–10 years old from all the six primary schools in Lithgow were approached to participate in a cross-sectional survey prior to implementation of water fluoridation in 2014. Following parental consent, children were clinically examined for caries in their primary teeth, and parents were requested to complete a questionnaire on previous fluoride exposure, diet and relevant socio-demographic characteristics that influence oral health. Multiple logistic regression analysis was employed to examine the independent risk factors of primary dentition caries. Overall, 51 percent of children had dental caries in one or more teeth. In the multiple logistic regression analysis, child’s age (Adjusted Odd’s Ratio (AOR = 1.30, 95% CI: 1.14–1.49 and mother’s extraction history (AOR = 2.05, 95% CI: 1.40–3.00 were significantly associated with caries experience in the child’s primary teeth. In addition, each serve of chocolate consumption was associated with 52 percent higher odds (AOR = 1.52, 95% CI: 1.19–1.93 of primary dentition caries.

  13. Factors Associated with Dental Caries in Primary Dentition in a Non-Fluoridated Rural Community of New South Wales, Australia.

    Science.gov (United States)

    Arora, Amit; Manohar, Narendar; John, James Rufus

    2017-11-23

    Dental caries persists as one of the most prevalent chronic diseases among children worldwide. This study aims to determine factors that influence dental caries in primary dentition among primary school children residing in the rural non-fluoridated community of Lithgow, New South Wales, Australia. A total of 495 children aged 5-10 years old from all the six primary schools in Lithgow were approached to participate in a cross-sectional survey prior to implementation of water fluoridation in 2014. Following parental consent, children were clinically examined for caries in their primary teeth, and parents were requested to complete a questionnaire on previous fluoride exposure, diet and relevant socio-demographic characteristics that influence oral health. Multiple logistic regression analysis was employed to examine the independent risk factors of primary dentition caries. Overall, 51 percent of children had dental caries in one or more teeth. In the multiple logistic regression analysis, child's age (Adjusted Odd's Ratio (AOR) = 1.30, 95% CI: 1.14-1.49) and mother's extraction history (AOR = 2.05, 95% CI: 1.40-3.00) were significantly associated with caries experience in the child's primary teeth. In addition, each serve of chocolate consumption was associated with 52 percent higher odds (AOR = 1.52, 95% CI: 1.19-1.93) of primary dentition caries.

  14. How primary health care physicians make sick listing decisions: The impact of medical factors and functioning

    Directory of Open Access Journals (Sweden)

    Svärdsudd Kurt

    2008-01-01

    Full Text Available Abstract Background The decision to issue sickness certification in Sweden for a patient should be based on the physician's assessment of the reduction of the patient's work capacity due to a disease or injury, not on psychosocial factors, in spite of the fact that they are known as risk factors for sickness absence. The aim of this study was to investigate the influence of medical factors and functioning on sick listing probability. Methods Four hundred and seventy-four patient-physician consultations, where sick listing could be an option, in general practice in Örebro county, central Sweden, were documented using physician and patient questionnaires. Information sought was the physicians' assessments of causes and consequences of the patients' complaints, potential to recover, diagnoses and prescriptions on sick leave, and the patients' view of their family and work situation and functioning as well as data on the patients' former and present health situation. The outcome measure was whether or not a sickness certificate was issued. Multivariate analyses were performed. Results Complaints entirely or mainly somatic as assessed by the physician decreased the risk of sick listing, and complaints resulting in severe limitation of occupational work capacity, as assessed by the patient as well as the physician, increased the risk of sick listing, as did appointments for locomotor complaints. The results for patients with infectious diseases or musculoskeletal diseases were partly similar to those for all diseases. Conclusion The strongest predictors for sickness certification were patient's and GP's assessment of reduced work capacity, with a striking concordance between physician and patient on this assessment. When patient's complaints were judged to be non-somatic the risk of sickness certification was enhanced.

  15. [Prevalence of myopia and influencing factors among primary and middle school students in 6 provinces of China].

    Science.gov (United States)

    Zhou, Jia; Ma, Yinghua; Ma, Jun; Zou, Zhiyong; Meng, Xiangkun; Tao, Fangbiao; Luo, Chunyan; Jing, Jin; Pan, Dehong; Luo, Jiayou; Zhang, Xin; Wang, Hong; Zhao, Haiping

    2016-01-01

    To understand the prevalence of myopia in primary and middle school students in 6 provinces and the possible influencing factors. Primary and middle school students were selected through multistage cluster sampling in 60 primary and middle schools in 6 provinces in China. The questionnaire survey and eyesight test were conducted among all the students selected according to the national student's physique and health survey protocol. Pearson chi-square test and binary multivariate logistic regression analysis were done to identify the influencing factors for myopia in students. The prevalence of myopia among primary and middle school students surveyed was 55.7%, the gender specific difference was statistically significant (59.7% for girls, 51.9% for boys) (Psleep time, average outdoor activity time during last week, school sport activities in the afternoon, the size of television set at home, time spent on watching TV and playing computer were the influencing factors for myopia. The prevalence of myopia is till high in primary and middle school students. Myopia is associated with both genetic factors and individual eye health related behaviors.

  16. Primary dysmenorrhea magnitude, associated risk factors, and its effect on academic performance: evidence from female university students in Ethiopia

    Directory of Open Access Journals (Sweden)

    Hailemeskel S

    2016-09-01

    Full Text Available Solomon Hailemeskel,1 Asrate Demissie,2 Nigussie Assefa3 1Department of Midwifery, College of Health Science, Institute of Medicine and Health Science, Debre Berhan University, Debre Berhan, Ethiopia; 2Department of Nursing and Midwifery, School of Allied Health Science, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia; 3Department of Reproductive Health and Health Service Management, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia Background: Primary dysmenorrhea (PD is the most common gynecologic compliant among adolescent females. There is a wide variation in the estimate of PD, which ranges from 50% to 90%, and the disorder is the most common cause of work and school absenteeism in adolescent females.Objective: To assess the prevalence and associated risk factors of PD among female university students and understand its effects on students’ academic performance.Methods: A cross-sectional study was employed in 440 research participants. A multistage stratified sampling technique was employed to select the study units. Structured and pretested self-administered questionnaires were used and weight and height measurements were conducted. The severity of dysmenorrheal pain was assessed by using a verbal multidimensional scoring system and visual analog scale. The data were double entered in Epi Info version 3.1 and analyzed using SPSS version 17. Descriptive statistics, chi-square test, and logistic regression analysis were performed.Results: A total of 440 students participated in this study. The prevalence of PD was 368 (85.4%. Of these, 123 (28.5% had mild, 164 (38.1% moderate, and 81 (18.8% severe primary dysmenorrheal pain. Among students with PD, 88.3% reported that PD had a negative effect on their academic performance. Of these, 80% reported school absence, 66.8% reported loss of class concentration, 56.3% reported class absence, 47.4% reported loss of class

  17. Risky Sexual Behavior among Rural Female Adolescents in Malaysia: A Limited Role of Protective Factors

    OpenAIRE

    Ahmadian, Maryam; Hamsan, Hanina H.; Abdullah, Haslinda; Samah, Asnarulkhadi Abu; Noor, Amna Md

    2014-01-01

    Purpose: This paper presents the findings of a cross-sectional survey on the risk and protective factors of premarital sexual behavior among rural female adolescents in Peninsular Malaysia. Methods: We investigated data on 770 female respondents aged 13-17 years in rural areas to identify predictive factors for premarital sexual intercourse. Data were analyzed using bivariate and multivariate regression. Specific socio-demographic factors, psychological and family domains, peer delinquency, a...

  18. Recurrent rates and risk factors associated with recurrent painful bullous keratopathy after primary phototherapeutic keratectomy

    Directory of Open Access Journals (Sweden)

    Kasetsuwan N

    2015-09-01

    Full Text Available Ngamjit Kasetsuwan, Kanokorn Sakpisuttivanit, Usanee Reinprayoon, Vilavun Puangsricharern Department of Ophthalmology, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand Objective: To assess the recurrent rate, mean survival time, and risk factors associated with recurrent painful bullous keratopathy (BK after primary treatment with phototherapeutic keratectomy.Methods: Medical records from 72 patients (72 eyes who had phototherapeutic keratectomy for painful BK were evaluated. Data for sex, age, duration of BK, associated ocular and systemic diseases (hypertension, diabetes mellitus, ischemic heart disease, asthma, dyslipidemia, and rheumatoid arthritis, frequency and degree of pain (grade 1–3, visual acuity, corneal thickness, intraocular pressure, and laser setting were extracted and analyzed.Results: The mean age of the patients was 64.2±11.4 years. The mean preoperative duration of BK was 15.0±11.0 months. Most patients had pseudophakic BK (69.40%. Majority of the cases had grade 3 degree of pain (48.60%. Glaucoma and hypertension were markedly found among these patients (51.40% and 19.40%, respectively. Preoperative mean intraocular pressure and corneal thickness were 13.70±4.95 mmHg and 734.1±83.80 µm, respectively. The mean laser diameter and depth were 8.36±1.22 mm and 38.89±8.81 µm, respectively. Systemic disease was significantly associated with the risk for developing recurrent painful BK (P=0.022, hazard ratio [HR] 1.673, 95% confidence interval [CI] 1.08–2.58. The overall recurrent rate was 51%. The average duration time of recurrent painful BK was 17.3±12.9 months (range 1–50 months. The median survival time before recurrence was 29.0±6.6 months.Conclusion: Systemic disease was found to be the only risk factor significantly associated with the development of recurrent painful BK. Low recurrent rate and long mean survival time showed that phototherapeutic

  19. Evaluating factors affecting the implementation of evidence based medicine in primary healthcare centers in Dubai.

    Science.gov (United States)

    Albarrak, Ahmed I; Ali Abbdulrahim, Suhair Aqil; Mohammed, Rafiuddin

    2014-07-01

    To assess the current evidence based medicine (EBM) knowledge, attitude and perceptions of physicians at Dubai Primary Health Care Sector (PHCS). Further to evaluate barrier and facilitator factors toward implementing the EBM practice. A cross-sectional study, at Dubai PHCS, UAE between June and August 2010. The survey was composed of two phases. The first phase was a self administrated questionnaire employed for data collection and the second phase was qualitative method, which was in the form of individual interviews. Statistical Package for Social Sciences (SPSS) was used for data analysis. In total 48 participants responded to the survey questionnaire and 13 responded to individual interviews. The response rate was 70.0%. Mean age was 42.18 (SD 10.46). The majority were females (64.6%). The physicians who attended EBM courses reported 70.30% using EBM and showed statistical significance (p = 0.002) from those who did not attend the EBM courses. 65.0% believe that 50-75% of the patients are capable of participating in clinical decision while 71.8% disagreed that the concept of EBM is not applicable to their culture. In addition they showed significance (p = 0.03) between physician beliefs with regard to patient capacity to take decision. About 67.0% of the family physicians were knowledgeable and followed systematic review as the strongest evidence. They had no access to the EBM resources (37.0%) and had no time to practice the EBM (38.0%). Nearly 40.0% interviewees reported lack of encouragement to attend EBM courses. EBM activities (22.0%) and active audit (18.0%) were top rated facilitating factors. EBM is not fully utilized by indefinite physicians in the Dubai PHC sector. Factors associated with non-utilization of EBM in the PHCS are lack of encouragement to attend EBM courses, senior physicians resist adoption of EBM, lack of time and insufficient dissemination process for implementing the clinical guideline.

  20. Primary drug-resistant tuberculosis in Hanoi, Viet Nam: present status and risk factors.

    Directory of Open Access Journals (Sweden)

    Nguyen Thi Le Hang

    Full Text Available INTRODUCTION: Resistance of Mycobacterium tuberculosis (MTB to anti-tuberculosis (TB drugs presents a serious challenge to TB control worldwide. We investigated the status of drug resistance, including multidrug-resistant (MDR TB, and possible risk factors among newly diagnosed TB patients in Hanoi, the capital of Viet Nam. METHODS: Clinical and epidemiological information was collected from 506 newly diagnosed patients with sputum smear- and culture-positive TB, and 489 (96.6% MTB isolates were subjected to conventional drug susceptibility testing, spoligotyping, and 15-locus variable numbers of tandem repeats typing. Adjusted odds ratios (aORs were calculated to analyze the risk factors for primary drug resistance. RESULTS: Of 489 isolates, 298 (60.9% were sensitive to all drugs tested. Resistance to isoniazid, rifampicin, streptomycin, ethambutol, and MDR accounted for 28.2%, 4.9%, 28.2%, 2.9%, and 4.5%, respectively. Of 24 isolates with rifampicin resistance, 22 (91.7% were MDR and also resistant to streptomycin, except one case. Factors associated with isoniazid resistance included living in old urban areas, presence of the Beijing genotype, and clustered strains [aOR = 2.23, 95% confidence interval (CI 1.15-4.35; 1.91, 1.18-3.10; and 1.69, 1.06-2.69, respectively. The Beijing genotype was also associated with streptomycin resistance (aOR = 2.10, 95% CI 1.29-3.40. Human immunodeficiency virus (HIV coinfection was associated with rifampicin resistance and MDR (aOR = 5.42, 95% CI 2.07-14.14; 6.23, 2.34-16.58, respectively. CONCLUSION: Isoniazid and streptomycin resistance was observed in more than a quarter of TB patients without treatment history in Hanoi. Transmission of isoniazid-resistant TB among younger people should be carefully monitored in urban areas, where Beijing strains and HIV coinfection are prevalent. Choosing an optimal treatment regimen on the basis of the results of drug susceptibility tests and monitoring of treatment

  1. Correlation between dmft, Diet and Social Factors in Primary School Children of Tehran-Iran in 2009-2010

    OpenAIRE

    Mozhgan Faezi; Sareh Farhadi; Hossein NikKerdar

    2012-01-01

    Introduction: One of the factors that can affect dental caries is the type of diet. So, this study was designed to evaluate the correlation between diet, social factors and dmft in primary school children of Tehran in 2009 and 2010.Materials & Methods: Eight handred and twenty primary school children of 6-12 years old (boys and girls) in Tehran were randomly selected in this descriptive study and after filling out the forms, underwent dental examinations. The data were analyzed by chi-square ...

  2. Human Factors Assessment of the UH-60M Crew Station During the Limited User Test (LUT)

    National Research Council Canada - National Science Library

    Havir, Thomas J; Durbin, David B; Frederick, Lorraine J; Hicks, Jamison S

    2006-01-01

    The utility helicopter (UH)-60M Product Manager requested the U.S. Army Research Laboratory's Human Research and Engineering Directorate to participate in the Limited User Test for the UH-60M Black Hawk...

  3. Correlation of primary tumor FDG uptake with clinicopathologic prognostic factors in invasive ductal carcinoma of the breast

    International Nuclear Information System (INIS)

    Jo, I; Kim, Sung Hoon; Kim, Hae Won; Kang, Sung Hee; Zeon, Seok Kil; Kim, Su Jin

    2015-01-01

    The purpose of this study was to investigate the correlation of primary tumor FDG uptake to clinicopathological prognostic factors in invasive ductal carcinoma of the breast. We retrospectively reviewed 136 of 215 female patients with pathologically proven invasive ductal breast cancer from January 2008 to December 2011 who underwent F-18 FDG PET/CT for initial staging and follow-up after curative treatment with analysis of estrogen receptor (ER), progesterone receptor (PR) and human epithelial growth factor receptor 2 (HER2). The maximum standardized uptake value (SUV max ) of the primary breast tumor was measured and compared with hormonal receptor and HER2 overexpression status. The high SUV max of primary breast tumors is significantly correlated with the clinicopathological factors: tumor size, histologic grade, TNM stage, negativity of ER, negativity of PR, HER2 overexpression and triple negativity. The recurrent group with non-triple negative cancer had a higher SUV max compared with the non-recurrent group, though no significant difference in FDG uptake was noted between the recurrence and non-recurrent groups in subjects with triple-negative cancer. Lymph node involvement was the independent risk factor for cancer recurrence in the multivariate analysis. In conclusion, high FDG uptake in primary breast tumors is significantly correlated with clinicopathological factors, such as tumor size, histologic grade, TNM stage, negativity of the hormonal receptor, HER2 overexpression and triple negativity. Therefore, FDG PET/CT is a helpful prognostic tool to direct the further management of patients with breast cancer

  4. Phthalates Are Metabolised by Primary Thyroid Cell Cultures but Have Limited Influence on Selected Thyroid Cell Functions In Vitro

    DEFF Research Database (Denmark)

    Hansen, Juliana Frohnert; Brorson, Marianne Møller; Boas, Malene

    2016-01-01

    Phthalates are plasticisers added to a wide variety of products, resulting in measurable exposure of humans. They are suspected to disrupt the thyroid axis as epidemiological studies suggest an influence on the peripheral thyroid hormone concentration. The mechanism is still unknown as only few...... in vitro studies within this area exist. The aim of the present study was to investigate the influence of three phthalate diesters (di-ethyl phthalate, di-n-butyl phthalate (DnBP), di-(2-ethylhexyl) phthalate (DEHP)) and two monoesters (mono-n-butyl phthalate and mono-(2-ethylhexyl) phthalate (MEHP......)) on the differentiated function of primary human thyroid cell cultures. Also, the kinetics of phthalate metabolism were investigated. DEHP and its monoester, MEHP, both had an inhibitory influence on 3'-5'-cyclic adenosine monophosphate secretion from the cells, and MEHP also on thyroglobulin (Tg) secretion from...

  5. Chances and Limitations of Implementing Measures of Differentiation for Gifted Children in Primary Schools: The Teachers’ Part

    Directory of Open Access Journals (Sweden)

    Martina Endepohls-Ulpe

    2014-06-01

    Full Text Available The presented study analyzes German primary school teachers’ attitudes towards several measures of internal differentiation with re-spect to the anticipated benefit for gifted pupils and the anticipated work load for teachers. Be-sides, correlations of these attitudes with teach-ers’ statements on the frequency of adopting the measures in their own classes were inspected. One-hundred thirty-seven teachers and teacher students were interviewed with a questionnaire on the assessed consequences and the fre-quency of the usage of several methods of dif-ferentiation. Data analysis was done by anal-yses of variance and calculation of Pearson cor-relation coefficients. Results show that teachers, as well as teacher students, mostly assessed the listed measures of internal differentiation to be appropriate for the promotion of gifted pupils, but for teachers there were significant negative correlations between assessed work load and frequency of usage in their own classes.

  6. Factors influencing recording of drug misuse in primary care: a qualitative study of GPs in England.

    Science.gov (United States)

    Davies-Kershaw, Hilary; Petersen, Irene; Nazareth, Irwin; Stevenson, Fiona

    2018-04-01

    Drug misuse is a serious public health problem. Evidence from previous epidemiological studies show that GPs are recording drug misuse in electronic patient records (EPR). However, although the recording trends are similar to national surveys, recording rates are much lower. To explore the factors that influence GPs to record drug misuse in the EPR, and to gain a clearer understanding of the gap between the amount of drug misuse recorded in primary care and that in national surveys and other studies. A semi-structured qualitative interview study of GPs working in general practices across England. Purposive sampling was employed to recruit 12 GPs, both with and without a special interest in drug misuse, from across England. Semi-structured face-to-face interviews were conducted to consider whether and why GPs record drug misuse, which methods GPs use for recording, GPs' actions if a patient asks for the information not to be recorded, and GPs' actions if they think a patient misuses drugs but does not disclose the information. Resulting data were analysed using a combination of inductive and deductive thematic analysis. The complexity of asking about drug misuse preceded GPs' decision to record. They described how the context of the general practice protocols, interaction between GP and patient, and the questioning process affected whether, how, and in which circumstances they asked about drug use. This led to GPs making a clinical decision on whether, who, and how to record in the EPR. When making decisions about whether or not to record drug misuse, GPs face complex choices. Aside from their own views, they reported feelings of pressure from the general practice environment in which they worked and their clinical commissioning group, as well as government policies. © British Journal of General Practice 2018.

  7. Malnutrition and some related factors in primary school children, Semnan, Iran.

    Science.gov (United States)

    Karimi, Batool; Ghorbani, Raheb; Niaki, Mehri A

    2016-12-01

    Malnutrition places a direct and indirect burden on individuals, especially children and communities. Malnutrition or growth failure can occur because of various reasons. This study aimed to determine the prevalence of thinness, underweight, stunting, and their related factors in students aged 6-12 years in Semnan province, central Iran. Using multistage sampling, a total of 2195 primary students in Semnan province, between November 2012 and March 2013, were selected randomly and the prevalences of wasting, underweight, and stunting among the students were estimated. Students' weights were measured using a Burer digital scale (Germany), with an accuracy of 100 g. Students' heights were measured using a nonstretchable tape measure. The BMI was calculated. Using the CDC 2000 standards, values less than the fifth percentile of BMI, weight-for-age, and height-for-age were defined as thinness, underweight, and stunting, respectively. In the total sample, 12.5, 9.2, and 9.0% of the students, respectively, were affected by thinness, underweight, and stunting. Lack of access to a computer increased the odds ratio (OR) of thinness by 1.38 times [OR=1.38, 95% confidence interval (CI): 1.06-1.78, P=0.015). Other variables (including age) did not show a significant association with the prevalence of thinness. Similarly, of all the variables studied, only access to a computer showed a significant association with the prevalence of underweight (OR=1.37, 95% CI: 1.02-1.84, P=0.036). The prevalence of stunting was associated significantly with a history of parasitic infection (OR=2.32, 95% CI: 1.53-3.51, Pmalnutrition among students is high. Hence, families and stakeholders must pay special attention to various measures including healthcare services to improve the condition. Education, health, and support programs must be strengthened and continued.

  8. Primary localization and tumor thickness as prognostic factors of survival in patients with mucosal melanoma.

    Directory of Open Access Journals (Sweden)

    Tarun Mehra

    Full Text Available Data on survival with mucosal melanoma and on prognostic factors of are scarce. It is still unclear if the disease course allows for mucosal melanoma to be treated as primary cutaneous melanoma or if differences in overall survival patterns require adapted therapeutic approaches. Furthermore, this investigation is the first to present 10-year survival rates for mucosal melanomas of different anatomical localizations.116 cases from Sep 10 1984 until Feb 15 2011 retrieved from the Comprehensive Cancer Center and of the Central Register of the German Dermatologic Society databases in Tübingen were included in our analysis. We recorded anatomical location and tumor thickness, and estimated overall survival at 2, 5 and 10 years and the mean overall survival time. Survival times were analyzed with the Kaplan-Meier method. The log-rank test was used to compare survival times by localizations and by T-stages.We found a median overall survival time of 80.9 months, with an overall 2-year survival of 71.7%, 5-year survival of 55.8% and 10-year survival of 38.3%. The 10-year survival rates for patients with T1, T2, T3 or T4 stage tumors were 100.0%, 77.9%, 66.3% and 10.6% respectively. 10-year survival of patients with melanomas of the vulva was 64.5% in comparison to 22.3% of patients with non-vulva mucosal melanomas.Survival times differed significantly between patients with melanomas of the vulva compared to the rest (p = 0.0006. It also depends on T-stage at the time of diagnosis (p < 0.0001.

  9. Is Primary Hyperparathyroidism a Risk Factor for Papillary Thyroid Cancer? An Exemplar Study and Literature Review

    Directory of Open Access Journals (Sweden)

    Cinamon, Udi

    2014-12-01

    Full Text Available Introduction Primary hyperparathyroidism (PHPT is associated with several cancer types, including papillary thyroid carcinoma (PTC. Objective To explore further the relation between PHPT and PTC. Methods By considering patients with PHPT as extra-suspicious for PTC, we studied an exemplar group of patients with PHPT with a small (≤1 cm thyroid nodule, which was negative in preoperative cytologic examination. During parathyroidectomy, a frozen section biopsy of the thyroid nodule confirmed PTC, as did the final surgical specimen, revealing that the preoperative cytology was false-negative. Additionally, relevant reports retrieved from the English literature addressing thyroid cancer and hyperparathyroidism were reviewed and processed. Results Four patients with PHPT were studied. Three had a multifocal thyroid disease, and three had neck lymph node metastasis. Processing previous report data supported an association between PHPT and PTC. Although thyroid nodularity among patients with PHPT was similar to the general population, PTC incidence was higher. This was true also for patients with secondary hyperparathyroidism. Conclusions This study emphasized that PHPT should be considered as a noteworthy risk factor for PTC. Fine needle aspiration of a thyroid nodule is the most valuable diagnostic procedure for thyroid cancer. Yet, false-negative results were reported in up to 10% of cases, especially in small, subcentimeter nodules. In line with our data and the literature, patients with PHPT should have both a detailed ultrasound addressing the thyroid and cytology of any thyroid nodule, including small subcentimeter lesions. Moreover, surgical flexibility, allowing intraoperative thyroid nodule sampling, should be considered even for “innocent” nodules.

  10. Association of increased levels of plasma tumor necrosis factor alpha with primary open-angle glaucoma

    Directory of Open Access Journals (Sweden)

    Kondkar AA

    2018-04-01

    Full Text Available Altaf A Kondkar, Tahira Sultan, Faisal A Almobarak, Hatem Kalantan, Saleh A Al-Obeidan, Khaled K Abu-Amero Glaucoma Research Chair, Department of Ophthalmology, College of Medicine, King Saud University, Riyadh, Saudi Arabia Purpose: Retinal ganglion cell (RGC death is a key feature of glaucoma. Elevated levels of tumor necrosis factor alpha (TNF-α, a pro-inflammatory cytokine, can induce RGC apoptosis and play a critical role in glaucomatous neurodegeneration. Based on the possible role of inflammation and oxidative stress in the pathogenesis of primary open-angle glaucoma (POAG, we investigated the association between plasma levels of TNF-α and POAG or its clinical indices in comparison to non-glaucomatous controls. Patients and methods: In a case–control retrospective cohort of 51 POAG cases and 88 controls, plasma TNF-α levels were measured using an enzyme-linked immunosorbent assay (ELISA. The assay was performed in duplicates on an automated ELISA analyzer. Results: Mean TNF-α level was significantly elevated in POAG cases (1.88 ± 2.17 pg/mL than the controls (0.93 ± 1.49 pg/mL; p = 0.003. The overall dose–response trend was significant (Χ2 = 6.12, df = 2; p = 0.047. No statistical difference was seen in age, gender and systemic disease distribution. A modest negative and significant correlation was seen between TNF-α level and number of antiglaucoma medications, an important clinical index of POAG severity. Moreover, logistic regression analysis showed that the risk of POAG was most significantly affected by TNF-α level and not by age and sex. Conclusion: High systemic level of an inflammatory cytokine, TNF-α, is associated with POAG; however, its possible use as a biomarker for early glaucoma diagnosis and/or disease severity needs further investigation. Keywords: apoptosis, biomarker, cytokines, ELISA, inflammation, neurodegeneration, oxidative stress

  11. A primary care physician perspective survey on the limited use of handwriting and pen computing in the electronic medical record

    Directory of Open Access Journals (Sweden)

    Gary Arvary

    2002-09-01

    The use of handwriting in the EMR was broadly supported by this group of PCPs in private practice. Likewise, wireless pen computers were the overwhelming choice of computer for use during a consultation. In this group, older and lower volume physicians were less likely to desire a computer for use during a consultation. User acceptance of the EMR may be related to how closely it resembles the processes that are being automated. More surveys are required to determine the needs and expectations of physicians. The data also support other research studies that demonstrate the preference for handwriting and wireless computers, and the need for a limited, standardised and controlled vocabulary.

  12. Primary antiphospholipid syndrome: absence of premature atherosclerosis in patients without traditional coronary artery disease risk factors.

    Science.gov (United States)

    Andrade, D; Bortolotto, L; Bonfá, E; Borba, E

    2016-04-01

    To investigate if patients with Primary Antiphospholipid Syndrome (PAPS) with venous and/or arterial thrombosis without traditional coronary artery disease (CAD) risk factors develop early atherosclerotic vascular damage. 27 female patients with PAPS (Sidney criteria) and 27 age, body mass index (BMI), and sex matched controls were consecutively selected. Exclusion criteria were: black race, age ≥55 years, traditional cardiovascular risk factors, other thrombophilias or connective tissue diseases, corticosteroids use and pregnancy. All subjects underwent Pulse Wave Velocity (PWV) and Echo-Tracking (ET), both in carotidal bed, to analyse vascular functional properties. Age (p = 0.92) and BMI (p = 0.91) were comparable in both groups. PAPS patients and controls had similar PWV (9.07 ± 1.08 m/s vs 9.42 ± 1.47 m/s, p = 0.34) as well as echo tracking parameters such as intima-media thickness (683 ± 171 µm vs 636 ± 140 µm, p = 0.52), carotideal diameter (p = 0.26), distensibility (p = 0.92), compliance coefficients (p = 0.36) and elastic modulus (p = 0.78). Patients with exclusively venous thrombosis showed lower PWV than patients with arterial thrombosis (8.55 ± 0.70 m/s vs 9.56 ± 0.94 m/s, p = 0.01), but no difference regarding intima-media thickness (683 ± 171 µm vs 636 ± 140 µm, p = 0.52) was observed. Patients with PAPS do not seem to be at higher risk of developing premature atherosclerosis. Patients who suffered exclusively venous thrombosis seem to be at lower risk than those with exclusively arterial events. Other studies need to confirm our findings. © The Author(s) 2015.

  13. Prevalence of Primary Dysmenorrhea and Factors Associated with Its Intensity Among Undergraduate Students: A Cross-Sectional Study.

    Science.gov (United States)

    Habibi, Nahal; Huang, Mary Soo Lee; Gan, Wan Ying; Zulida, Rejali; Safavi, Sayyed Morteza

    2015-12-01

    Primary dysmenorrhea is a womanhood problem around the world and negatively affects quality of life. This study was designed to investigate the prevalence of primary dysmenorrhea and to determine the factors associated with its intensity. A cross-sectional study was carried out among 311 undergraduate female students aged 18 to 27 years in Isfahan University of Medical Sciences, Iran. Socio-demographic characteristics and menstrual factors were obtained through interviews with the help of a pretested questionnaire. The prevalence of primary dysmenorrhea was 89.1%. Residing at home, younger age, lower number of years of formal education for the mother, positive family history of dysmenorrhea, higher severity of bleeding, and shorter menstrual period intervals were significantly associated with the higher intensity of primary dysmenorrhea. Primary dysmenorrhea is a common health concern among young women. Being aware of the factors that are associated with its intensity makes it possible for health professionals to organize better focused programs to reduce the adverse effects of dysmenorrhea. Copyright © 2015 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    Made Ratna Dewi

    2013-10-01

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

  15. Apolipoprotein A-I Limits the Negative Effect of Tumor Necrosis Factor on Lymphangiogenesis

    NARCIS (Netherlands)

    Bisoendial, Radjesh; Tabet, Fatiha; Tak, Paul P.; Petrides, Francine; Cuesta Torres, Luisa F.; Hou, Liming; Cook, Adam; Barter, Philip J.; Weninger, Wolfgang; Rye, Kerry-Anne

    2015-01-01

    Lymphatic endothelial dysfunction underlies the pathogenesis of many chronic inflammatory disorders. The proinflammatory cytokine tumor necrosis factor (TNF) is known for its role in disrupting the function of the lymphatic vasculature. This study investigates the ability of apolipoprotein (apo)

  16. The persistence of gender inequality in Zimbabwe: factors that impede the advancement of women into leadership positions in primary schools

    OpenAIRE

    Chabaya, Owence; Rembe, Symphorosa; Wadesango, Newman

    2009-01-01

    We investigated and analysed the factors that women teachers consider as barriers to their advancement to headship positions in Zimbabwean primary schools. Specifically, we sought to identify the factors perceived by women school heads to be causes of persistent under-representation of women in school headship positions. Data were collected through structured face-to-face inter­views and focus group discussions with 13 experienced women school heads. The findings revealed that although the ma...

  17. [Limiting a Medline/PubMed query to the "best" articles using the JCR relative impact factor].

    Science.gov (United States)

    Avillach, P; Kerdelhué, G; Devos, P; Maisonneuve, H; Darmoni, S J

    2014-12-01

    Medline/PubMed is the most frequently used medical bibliographic research database. The aim of this study was to propose a new generic method to limit any Medline/PubMed query based on the relative impact factor and the A & B categories of the SIGAPS score. The entire PubMed corpus was used for the feasibility study, then ten frequent diseases in terms of PubMed indexing and the citations of four Nobel prize winners. The relative impact factor (RIF) was calculated by medical specialty defined in Journal Citation Reports. The two queries, which included all the journals in category A (or A OR B), were added to any Medline/PubMed query as a central point of the feasibility study. Limitation using the SIGAPS category A was larger than the when using the Core Clinical Journals (CCJ): 15.65% of PubMed corpus vs 8.64% for CCJ. The response time of this limit applied to the entire PubMed corpus was less than two seconds. For five diseases out of ten, limiting the citations with the RIF was more effective than with the CCJ. For the four Nobel prize winners, limiting the citations with the RIF was more effective than the CCJ. The feasibility study to apply a new filter based on the relative impact factor on any Medline/PubMed query was positive. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  18. Phthalates Are Metabolised by Primary Thyroid Cell Cultures but Have Limited Influence on Selected Thyroid Cell Functions In Vitro.

    Directory of Open Access Journals (Sweden)

    Juliana Frohnert Hansen

    Full Text Available Phthalates are plasticisers added to a wide variety of products, resulting in measurable exposure of humans. They are suspected to disrupt the thyroid axis as epidemiological studies suggest an influence on the peripheral thyroid hormone concentration. The mechanism is still unknown as only few in vitro studies within this area exist. The aim of the present study was to investigate the influence of three phthalate diesters (di-ethyl phthalate, di-n-butyl phthalate (DnBP, di-(2-ethylhexyl phthalate (DEHP and two monoesters (mono-n-butyl phthalate and mono-(2-ethylhexyl phthalate (MEHP on the differentiated function of primary human thyroid cell cultures. Also, the kinetics of phthalate metabolism were investigated. DEHP and its monoester, MEHP, both had an inhibitory influence on 3'-5'-cyclic adenosine monophosphate secretion from the cells, and MEHP also on thyroglobulin (Tg secretion from the cells. Results of the lactate dehydrogenase-measurements indicated that the MEHP-mediated influence was caused by cell death. No influence on gene expression of thyroid specific genes (Tg, thyroid peroxidase, sodium iodine symporter and thyroid stimulating hormone receptor by any of the investigated diesters could be demonstrated. All phthalate diesters were metabolised to the respective monoester, however with a fall in efficiency for high concentrations of the larger diesters DnBP and DEHP. In conclusion, human thyroid cells were able to metabolise phthalates but this phthalate-exposure did not appear to substantially influence selected functions of these cells.

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

    Science.gov (United States)

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

    2008-02-01

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

  20. Impact of Primary and Secondary Social Origin Factors on the Transition to University in the Czech Republic

    Czech Academy of Sciences Publication Activity Database

    Simonová, Natalie; Soukup, P.

    2015-01-01

    Roč. 36, č. 5 (2015), s. 707-728 ISSN 0142-5692 Institutional support: RVO:68378025 Keywords : educational inequality * social origin * primary and secondary effects Subject RIV: AO - Sociology, Demography Impact factor: 1.220, year: 2015 http://dx.doi.org/10.1080/01425692.2013.854690

  1. Childhood Anxiety in a Diverse Primary Care Population: Parent-Child Reports, Ethnicity and SCARED Factor Structure

    Science.gov (United States)

    Wren, Frances J.; Berg, Eric A.; Heiden, Lynda A.; Kinnamon, Carolyn J.; Ohlson, Lirio A.; Bridge, Jeffrey A.; Birmaher, Boris; Bernal, M. Pilar

    2007-01-01

    Objective: To explore in a multiethnic primary care population the impact of child gender and of race/ethnicity on parent and child reports of school-age anxiety and on the factor structure of the Screen for Childhood Anxiety and Related Emotional Disorders (SCARED). Method: A consecutive sample of 515 children (8 to less than 13 years) and their…

  2. Factors affecting the local control of stereotactic body radiotherapy for lung tumors including primary lung cancer and metastatic lung tumors

    International Nuclear Information System (INIS)

    Hamamoto, Yasushi; Kataoka, Masaaki; Yamashita, Motohiro

    2012-01-01

    The purpose of this study was to identify factors affecting local control of stereotactic body radiotherapy (SBRT) for lung tumors including primary lung cancer and metastatic lung tumors. Between June 2006 and June 2009, 159 lung tumors in 144 patients (primary lung cancer, 128; metastatic lung tumor, 31) were treated with SBRT with 48-60 Gy (mean 50.1 Gy) in 4-5 fractions. Higher doses were given to larger tumors and metastatic tumors in principle. Assessed factors were age, gender, tumor origin (primary vs. metastatic), histological subtype, tumor size, tumor appearance (solid vs. ground glass opacity), maximum standardized uptake value of positron emission tomography using 18 F-fluoro-2-deoxy-D-glucose, and SBRT doses. Follow-up time was 1-60 months (median 18 months). The 1-, 2-, and 3-year local failure-free rates of all lesions were 90, 80, and 77%, respectively. On univariate analysis, metastatic tumors (p<0.0001), solid tumors (p=0.0246), and higher SBRT doses (p=0.0334) were the statistically significant unfavorable factors for local control. On multivariate analysis, only tumor origin was statistically significant (p=0.0027). The 2-year local failure-free rates of primary lung cancer and metastatic lung tumors were 87 and 50%, respectively. A metastatic tumor was the only independently significant unfavorable factor for local control after SBRT. (author)

  3. Principals' Attitudes towards Risky Internet Use of Primary School Students: The Role of Occupational Factors

    Science.gov (United States)

    Touloupis, Thanos; Athanasiades, Christina

    2018-01-01

    The present study aimed to investigate primary school principals' attitudes towards risky internet use of school-aged students and how occupational factors, such as work self-efficacy, job satisfaction, and burnout, may affect these attitudes especially in a context of economic crisis, which has adversely affected working conditions and duties of…

  4. Risk factors for development of impaired renal function in Type 2 diabetes mellitus patients in primary care.

    NARCIS (Netherlands)

    Naushahi, M.J.; Grauw, W.J.C. de; Avery, A.J.; Gerwen, W.H.E.M. van; Lisdonk, E.H. van de; Weel, C. van

    2004-01-01

    AIMS: To evaluate risk factors for the development of an impaired renal function, defined as a glomerular filtration rate (GFR) by Cockcroft-Gault formula < 50.5 ml/min, in primary care patients with Type 2 diabetes mellitus. METHODS: A case-control study of Type 2 diabetes mellitus patients with

  5. Relationship between insulin-like growth factor-1 and radiographic disease in patients with primary osteoarthritis: a systematic review.

    NARCIS (Netherlands)

    Claessen, K.M.; Ramautar, S.R.; Pereira, A.M.; Smit, J.W.A.; Biermasz, N.R.; Kloppenburg, M.

    2012-01-01

    OBJECTIVE: To evaluate the association between radiographic osteoarthritis (OA) and either serum insulin-like growth factor-1 (IGF-1) levels or IGF-1 gene polymorphisms in patients with primary OA. METHODS: We conducted a systematic review of reported associations between circulating IGF-1 and/or

  6. Public and Private School Distinction, Regional Development Differences, and Other Factors Influencing the Success of Primary School Students in Turkey

    Science.gov (United States)

    Sulku, Seher Nur; Abdioglu, Zehra

    2015-01-01

    This study investigates the factors influencing the success of students in primary schools in Turkey. TIMSS 2011 data for Turkey, measuring the success of eighth-grade students in the field of mathematics, were used in an econometric analysis, performed using classical linear regression models. Two hundred thirty-nine schools participated in the…

  7. Characterization of connective tissue growth factor expression in primary cultures of human tubular epithelial cells: modulation by hypoxia

    NARCIS (Netherlands)

    Kroening, Sven; Neubauer, Emily; Wullich, Bernd; Aten, Jan; Goppelt-Struebe, Margarete

    2010-01-01

    Kroening S, Neubauer E, Wullich B, Aten J, Goppelt-Struebe M. Characterization of connective tissue growth factor expression in primary cultures of human tubular epithelial cells: modulation by hypoxia. Am J Physiol Renal Physiol 298:F796-F806, 2010. First published December 23, 2009;

  8. Primary cilia and coordination of receptor tyrosine kinase (RTK) and transforming growth factor β (TGF-β) signaling

    DEFF Research Database (Denmark)

    Christensen, Søren Tvorup; Morthorst, Stine Kjær; Mogensen, Johanne Bay

    2017-01-01

    are at the root of a pleiotropic group of diseases and syndromic disorders called ciliopathies. In this review, we present an overview of primary cilia-mediated regulation of receptor tyrosine kinase (RTK) and transforming growth factor β (TGF-β) signaling. Further, we discuss how defects in the coordination...

  9. Lake Roosevelt Fisheries Evaluation Program; Evaluation of Limiting Factors for Stocked Kokanee and Rainbow Trout in Lake Roosevelt, Washington, 1999 Annual Report.

    Energy Technology Data Exchange (ETDEWEB)

    Baldwin, Casey; Polacek, Matt

    2009-03-01

    Hatchery supplementation of kokanee Oncorhynchus nerka and rainbow trout O. mykiss has been the primary mitigation provided by Bonneville Power Administration for loss of anadromous fish to the waters above Grand Coulee Dam (GCD). The hatchery program for rainbow trout has consistently met management goals and provided a substantial contribution to the fishery; however, spawner returns and creel survey results for kokanee have been below management goals. Our objective was to identify factors that limit limnetic fish production in Lake Roosevelt by evaluating abiotic conditions, food limitations, piscivory, and entrainment. Dissolved oxygen concentration was adequate throughout most of the year; however, levels dropped to near 6 mg/L in late July. For kokanee, warm water temperatures during mid-late summer limited their nocturnal distribution to 80-100 m in the lower section of the reservoir. Kokanee spawner length was consistently several centimeters longer than in other Pacific Northwest systems, and the relative weights of rainbow trout and large kokanee were comparable to national averages. Large bodied daphnia (> 1.7 mm) were present in the zooplankton community during all seasons indicating that top down effects were not limiting secondary productivity. Walleye Stizostedion vitreum were the primary piscivore of salmonids in 1998 and 1999. Burbot Lota lota smallmouth bass Micropterus dolomieui, and northern pikeminnow Ptychocheilus oregonensis preyed on salmonids to a lesser degree. Age 3 and 4 walleye were responsible for the majority (65%) of the total walleye consumption of salmonids. Bioenergetics modeling indicated that reservoir wide consumption by walleye could account for a 31-39% loss of stocked kokanee but only 6-12% of rainbow trout. Size at release was the primary reason for differential mortality rates due to predation. Entrainment ranged from 2% to 16% of the monthly abundance estimates of limnetic fish, and could account for 30% of total

  10. Low skeletal muscle mass is a predictive factor for chemotherapy dose-limiting toxicity in patients with locally advanced head and neck cancer.

    Science.gov (United States)

    Wendrich, Anne W; Swartz, Justin E; Bril, Sandra I; Wegner, Inge; de Graeff, Alexander; Smid, Ernst J; de Bree, Remco; Pothen, Ajit J

    2017-08-01

    Low skeletal muscle mass (SMM) or sarcopenia is emerging as an adverse prognostic factor for chemotherapy dose-limiting toxicity (CLDT) and survival in cancer patients. Our aim was to determine the impact of low SMM on CDLT in patients with locally advanced head and neck squamous cell carcinoma (LA-HNSCC) treated with primary radiochemotherapy (RCT). Consecutive patients diagnosed with LA-HNSCC and treated with primary RCT between 2007 and 2011 in our center were included. Clinical variables were retrospectively retrieved and SMM was measured at the level of the third cervical vertebra using pre-treatment head and neck CT-scans. After determining a cut-off value for low SMM, multivariate analysis was performed to identify prognostic factors for CDLT. Of 112 patients included, 30.4% experienced CDLT. The optimal cut-off value for low SMM as a predictor of CDLT was ≤43.2cm 2 /m 2 . Using this cut-off, 54.5% patients had low SMM. Patients with low SMM experienced CDLT more frequently than patients with normal SMM (44.3% vs. 13.7%, pSMM, p=0.044). At multivariate analysis, low SMM was independently inversely associated with CDLT (OR 0.93, 95%CI: 0.88-0.98). Patients experiencing CDLT had a lower overall survival than patients who did not (mean 36.6vs. 54.2months, p=0.038). Low SMM is an independent risk factor for CDLT in LA-HNSCC patients treated with primary RCT. Pre-therapeutic estimation of SMM using routine CT-scans of the head and neck region may identify patients at risk of CDLT. Copyright © 2017 Elsevier Ltd. All rights reserved.

  11. Low supply or core labour like limit factor of the growth the factory

    Directory of Open Access Journals (Sweden)

    Jiří Luňáček

    2013-11-01

    Full Text Available All companies act under the impact of allocation of manufacturing factors. Despite noticeable modernisation and automation of manufacturing processes, human labour still remains an indispensable manufacturing factor. At present, some industries face a low labour supply. Theoretical economics sees several possibilities of eliminating such facts. They can be modelled on the choice of a suitable company that is affected by such facts. In order to eliminate these unfavourable facts, the company has a chance to focus on a change in its strategy. This consists in changes of wage rates.

  12. Prevalence and factors associated with urogenital schistosomiasis among primary school children in barrage, Magba sub-division of Cameroon

    Directory of Open Access Journals (Sweden)

    Anna Longdoh Njunda

    2017-07-01

    Full Text Available Abstract Background The purpose of this study was to determine the prevalence and intensity as well as the factors associated with urogenital schistosomiasis (US in Barrage, a rural community around the Mape΄ dam, in the West region of Cameroon not previously documented for transmission. Methods In this cross sectional parasitological survey, 382 children were enrolled from three primary schools in the study area between March and May 2016. A semi-structured questionnaire was used to collect information on demographics, clinical and predisposing factors. The syringe filtration technique was used to analyse urine samples. Samples with visible or gross haematuria were recorded prior to filtration. The Pearson chi-square, the student T-test and logistic regression were all performed as part of the statistical analyses. Results The overall prevalence of US was 41.1% (95% CI: 36.1–46.2. Infection was more common in children below 10 years (p = 0.009, in males (p = 0.029, and in children who frequently come into contact with water from the dam (p < 0.001. Furthermore, US was more common in children attending Ecole Public (EP Manbonko Bord (81.1%, p < 0.001 which is very close to the dam and in children from a fishing background (80.9%, p < 0.001. On the contrary, knowledge about schistosomiasis was not observed to be associated with prevalence. In this study, the intensity of infection was observed to be higher in children below 10 years (p < 0.001, in males (p = 0.001, and in children attending EP Manbonko Bord (p < 0.001. The intensity of infection was also highest in children presenting with haematuria (p < 0.001. Frequent contact with water from the dam and having parents whose occupation was fishing were identified as the associated factors for US. Conclusion A high prevalence of US was observed in school-aged children in the study area especially in those attending EP Manbonko Bord. Limiting contact with water from the dam

  13. Factors That May Tend to Limit the Religious Education of Recruits

    Science.gov (United States)

    1992-05-01

    chaplains also mentioned the following as tending to limit recruit religious education : (1) a lack of adequate chapel facilities , (2) not enough chaplains...inadequate chapel facilities at Recruit Training Command for recruit worship and religious education . This is a particular concern for the Catholic and... education . Procedures Data was gathered by distributing questionnaires to members of Division Six on October 22-23, 1991. Participation was voluntary

  14. Off-shell form factors in the soft photon limit for pion photoproduction

    International Nuclear Information System (INIS)

    Chumbalov, A.A.; Kamalov, S.S.

    1991-01-01

    The low energy theorems for the pion photoproduction are considered on the basis of the Adler-Dothan procedure. It is shown that the soft photon limit necessarily leads to the Born approximation for the π 0 -photoproduction amplitude at the threshold. All additional terms, according to the Adler-Dothan recipe, are to be neglected in the derivation of the LET. 5 refs.; 2 figs

  15. Physics of Limiting Phenomena in Superconducting Microwave Resonators: Vortex Dissipation, Ultimate Quench and Quality Factor Degradation Mechanisms

    Energy Technology Data Exchange (ETDEWEB)

    Checchin, Mattia [Illinois Inst. of Technology, Chicago, IL (United States)

    2016-12-01

    Superconducting niobium accelerating cavities are devices operating in radio-frequency and able to accelerate charged particles up to energy of tera-electron-volts. Such accelerating structures are though limited in terms of quality factor and accelerating gradient, that translates--in some cases--in higher capital costs of construction and operation of superconducting rf accelerators. Looking forward for a new generation of more affordable accelerators, the physical description of limiting mechanisms in superconducting microwave resonators is discussed. In particular, the physics behind the dissipation introduced by vortices in the superconductor, the ultimate quench limitations and the quality factor degradation mechanism after a quench are described in detail. One of the limiting factor of the quality factor is the dissipation introduced by trapped magnetic flux vortices. The radio-frequency complex response of trapped vortices in superconductors is derived by solving the motion equation for a magnetic flux line, assuming a bi-dimensional and mean free path-dependent Lorentzian-shaped pinning potential. The resulting surface resistance shows the bell-shaped trend as a function of the mean free path, in agreement with the experimental data observed. Such bell-shaped trend of the surface resistance is described in terms of the interplay of the two limiting regimes identified as pinning and flux flow regimes, for low and large mean free path values respectively. The model predicts that the dissipation regime--pinning- or flux-flow-dominated--can be tuned either by acting on the frequency or on the electron mean free path value. The effect of different configurations of pinning sites and strength on the vortex surface resistance are also discussed. Accelerating cavities are also limited by the quench of the superconductive state, which limits the maximum accelerating gradient achievable. The accelerating field limiting factor is usually associate d to the

  16. Physics of limiting phenomena in superconducting microwave resonators: Vortex dissipation, ultimate quench and quality factor degradation mechanisms

    Science.gov (United States)

    Checchin, Mattia

    Superconducting niobium accelerating cavities are devices operating in radiofrequency and able to accelerate charged particles up to energy of tera-electron-volts. Such accelerating structures are though limited in terms of quality factor and accelerating gradient, that translates--in some cases--in higher capital costs of construction and operation of superconducting rf accelerators. Looking forward for a new generation of more affordable accelerators, the physical description of limiting mechanisms in superconducting microwave resonators is discussed. In particular, the physics behind the dissipation introduced by vortices in the superconductor, the ultimate quench limitations and the quality factor degradation mechanism after a quench are described in detail. One of the limiting factor of the quality factor is the dissipation introduced by trapped magnetic flux vortices. The radio-frequency complex response of trapped vortices in superconductors is derived by solving the motion equation for a magnetic flux line, assuming a bi-dimensional and mean free path-dependent Lorentzian-shaped pinning potential. The resulting surface resistance shows the bell-shaped trend as a function of the mean free path, in agreement with the experimental data observed. Such bell-shaped trend of the surface resistance is described in terms of the interplay of the two limiting regimes identified as pinning and flux flow regimes, for low and large mean free path values respectively. The model predicts that the dissipation regime--pinning- or flux-flow-dominated--can be tuned either by acting on the frequency or on the electron mean free path value. The effect of different configurations of pinning sites and strength on the vortex surface resistance are also discussed. Accelerating cavities are also limited by the quench of the superconductive state, which limits the maximum accelerating gradient achievable. The accelerating field limiting factor is usually associated to the superheating

  17. The Road to Rural Primary Care: A Narrative Review of Factors That Help Develop, Recruit, and Retain Rural Primary Care Physicians.

    Science.gov (United States)

    Parlier, Anna Beth; Galvin, Shelley L; Thach, Sarah; Kruidenier, David; Fagan, Ernest Blake

    2018-01-01

    To examine the literature documenting successes in recruiting and retaining rural primary care physicians. The authors conducted a narrative review of literature on individual, educational, and professional characteristics and experiences that lead to recruitment and retention of rural primary care physicians. In May 2016, they searched MEDLINE, PubMed, CINAHL, ERIC, Web of Science, Google Scholar, the Grey Literature Report, and reference lists of included studies for literature published in or after 1990 in the United States, Canada, or Australia. The authors identified 83 articles meeting inclusion criteria. They synthesized results and developed a theoretical model that proposes how the findings interact and influence rural recruitment and retention. The authors' proposed theoretical model suggests factors interact across multiple dimensions to facilitate the development of a rural physician identity. Rural upbringing, personal attributes, positive rural exposure, preparation for rural life and medicine, partner receptivity to rural living, financial incentives, integration into rural communities, and good work-life balance influence recruitment and retention. However, attending medical schools and/or residencies with a rural emphasis and participating in rural training may reflect, rather than produce, intention for rural practice. Many factors enhance rural physician identity development and influence whether physicians enter, remain in, and thrive in rural practice. To help trainees and young physicians develop the professional identity of a rural physician, multifactorial medical training approaches aimed at encouraging long-term rural practice should focus on rural-specific clinical and nonclinical competencies while providing trainees with positive rural experiences.

  18. Factor structure of the Wechsler Intelligence Scale for Children-Fifth Edition: Exploratory factor analyses with the 16 primary and secondary subtests.

    Science.gov (United States)

    Canivez, Gary L; Watkins, Marley W; Dombrowski, Stefan C

    2016-08-01

    The factor structure of the 16 Primary and Secondary subtests of the Wechsler Intelligence Scale for Children-Fifth Edition (WISC-V; Wechsler, 2014a) standardization sample was examined with exploratory factor analytic methods (EFA) not included in the WISC-V Technical and Interpretive Manual (Wechsler, 2014b). Factor extraction criteria suggested 1 to 4 factors and results favored 4 first-order factors. When this structure was transformed with the Schmid and Leiman (1957) orthogonalization procedure, the hierarchical g-factor accounted for large portions of total and common variance while the 4 first-order factors accounted for small portions of total and common variance; rendering interpretation at the factor index level less appropriate. Although the publisher favored a 5-factor model where the Perceptual Reasoning factor was split into separate Visual Spatial and Fluid Reasoning dimensions, no evidence for 5 factors was found. It was concluded that the WISC-V provides strong measurement of general intelligence and clinical interpretation should be primarily, if not exclusively, at that level. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  19. Anatomy of a bottleneck: diagnosing factors limiting population growth in the Puerto Rican Parrot

    Science.gov (United States)

    S.R. Beissinger; Jr Wunderle; J.M. Meyers; B.E. Saether; S. Engen

    2008-01-01

    The relative importance of genetic, demographic, environmental, and catastrophic processes that maintain population bottlenecks has received little consideration. We evaluate the role of these factors in maintaining the Puerto Rican Parrot (Amazona vittata) in a prolonged bottleneck from 1973 through 2000 despite intensive conservation efforts. We first conduct a risk...

  20. Pushing the limits of excited-state g-factor measurements

    Science.gov (United States)

    Stuchbery, Andrew E.; McCormick, Brendan P.; Gray, Timothy J.; Coombes, Ben J.

    2018-05-01

    Current developments in excited-state g-factor measurements are discussed with an emphasis on cases where the experimental methodology is being extended into new regimes. The transient-field technique, the recoil in vacuum method, and moment measurements with LaBr3 detectors are discussed.

  1. Internal limiting membrane flap transposition for surgical repair of macular holes in primary surgery and in persistent macular holes.

    Science.gov (United States)

    Leisser, Christoph; Hirnschall, Nino; Döller, Birgit; Varsits, Ralph; Ullrich, Marlies; Kefer, Katharina; Findl, Oliver

    2018-03-01

    Classical or temporal internal limiting membrane (ILM) flap transposition with air or gas tamponade are current trends with the potential to improve surgical results, especially in cases with large macular holes. A prospective case series included patients with idiopathic macular holes or persistent macular holes after 23-G pars plana vitrectomy (PPV) and ILM peeling with gas tamponade. In all patients, 23-G PPV and ILM peeling with ILM flap transposition with gas tamponade and postoperative face-down position was performed. In 7 of 9 eyes, temporal ILM flap transposition combined with pedicle ILM flap could be successfully performed and macular holes were closed in all eyes after surgery. The remaining 2 eyes were converted to pedicle ILM flap transposition with macular hole closure after surgery. Three eyes were scheduled as pedicle ILM flap transposition due to previous ILM peeling. In 2 of these eyes, the macular hole could be closed with pedicle ILM flap transposition. In 3 eyes, free ILM flap transposition was performed and in 2 of these eyes macular hole could be closed after surgery, whereas in 1 eye a second surgery, performed as pedicle ILM flap transposition, was performed and led to successful macular hole closure. Use of ILM flaps in surgical repair of macular hole surgery is a new option of treatment with excellent results independent of the diameter of macular holes. For patients with persistent macular holes, pedicle ILM flap transposition or free ILM flap transposition are surgical options.

  2. Late presentation for HIV care in central Haiti: factors limiting access to care.

    Science.gov (United States)

    Louis, C; Ivers, L C; Smith Fawzi, M C; Freedberg, K A; Castro, A

    2007-04-01

    Many patients with HIV infection present for care late in the course of their disease, a factor which is associated with poor prognosis. Our objective was to identify factors associated with late presentation for HIV care among patients in central Haiti. Thirty-one HIV-positive adults, approximately 10% of the HIV-infected population followed at a central Haiti hospital, participated in this research study. A two-part research tool that included a structured questionnaire and an ethnographic life history interview was used to collect quantitative as well as qualitative data about demographic factors related to presentation for HIV care. Sixty-five percent of the patients in this study presented late for HIV care, as defined by CD4 cell count below 350 cells/mm3. Factors associated with late presentation included male sex, older age, patient belief that symptoms are not caused by a medical condition, greater distance from the medical clinic, lack of prior access to effective medical care, previous requirement to pay for medical care, and prior negative experience at local hospitals. Harsh poverty was a striking theme among all patients interviewed. Delays in presentation for HIV care in rural Haiti are linked to demographic, socioeconomic and structural factors, many of which are rooted in poverty. These data suggest that a multifaceted approach is needed to overcome barriers to early presentation for care. This approach might include poverty alleviation strategies; provision of effective, reliable and free medical care; patient outreach through community health workers and collaboration with traditional healers.

  3. Risky sexual behavior among rural female adolescents in Malaysia: a limited role of protective factors.

    Science.gov (United States)

    Ahmadian, Maryam; Hamsan, Hanina H; Abdullah, Haslinda; Samah, Asnarulkhadi Abu; Noor, Amna Md

    2014-03-23

    This paper presents the findings of a cross-sectional survey on the risk and protective factors of premarital sexual behavior among rural female adolescents in Peninsular Malaysia. We investigated data on 770 female respondents aged 13-17 years in rural areas to identify predictive factors for premarital sexual intercourse. Data were analyzed using bivariate and multivariate regression. Specific socio-demographic factors, psychological and family domains, peer delinquency, and knowledge and attitudes about sexuality were considered in risky sexual behaviors in rural Malay girls. The effects of other covariates for premarital sexual intercourse were controlled by logistic regression model. Of the 770 rural female students, about 3.2% of respondents reported experience of sexual intercourse in the past three months. Out of those sexually active girls, 36% were 17 years old and 20% stated having sexual intercourse with more than one partner, and 72% did not use contraception during the most recent sexual intercourse. Midnight activities, peer-sexual disorder, self-evaluation, and attitude toward sexual health were significant predictors of sexual intercourse in rural girls in Malaysia. The finding highlights the impact of psychological factors and peer group influences on the challenges of premarital sexual behavior among rural girls and the notion of school-based sexual health education for adolescents. This study triggers other researchers take into account a comprehensive view of protective factors operating in adolescents' risky sexual behaviors in Asian culture seeing that family domain variables, unexpectedly, exerted no predicting influence on sexually active female teens in rural areas in Malaysia.

  4. Risky Sexual Behavior among Rural Female Adolescents in Malaysia: A Limited Role of Protective Factors

    Science.gov (United States)

    Ahmadian, Maryam; Hamsan, Hanina H.; Abdullah, Haslinda; Samah, Asnarulkhadi Abu; Noor, Amna Md

    2014-01-01

    Purpose: This paper presents the findings of a cross-sectional survey on the risk and protective factors of premarital sexual behavior among rural female adolescents in Peninsular Malaysia. Methods: We investigated data on 770 female respondents aged 13-17 years in rural areas to identify predictive factors for premarital sexual intercourse. Data were analyzed using bivariate and multivariate regression. Specific socio-demographic factors, psychological and family domains, peer delinquency, and knowledge and attitudes about sexuality were considered in risky sexual behaviors in rural Malay girls. The effects of other covariates for premarital sexual intercourse were controlled by logistic regression model. Results: Of the 770 rural female students, about 3.2% of respondents reported experience of sexual intercourse in the past three months. Out of those sexually active girls, 36% were 17 years old and 20% stated having sexual intercourse with more than one partner, and 72% did not use contraception during the most recent sexual intercourse. Midnight activities, peer-sexual disorder, self-evaluation, and attitude toward sexual health were significant predictors of sexual intercourse in rural girls in Malaysia. Conclusion: The finding highlights the impact of psychological factors and peer group influences on the challenges of premarital sexual behavior among rural girls and the notion of school-based sexual health education for adolescents. This study triggers other researchers take into account a comprehensive view of protective factors operating in adolescents’ risky sexual behaviors in Asian culture seeing that family domain variables, unexpectedly, exerted no predicting influence on sexually active female teens in rural areas in Malaysia. PMID:24762359

  5. [Factors associated with primary care professionals' readiness to respond to intimate partner violence in Spain].

    Science.gov (United States)

    Murillo, Pilar; Sebastián, Miguel San; Vives-Cases, Carmen; Goicolea, Isabel

    2017-05-22

    To analyse the Spanish primary care professionals' readiness to respond to intimate partner violence (IPV) in primary care and identify possible determinants that could facilitate a better response. A cross-sectional study with a non-probabilistic sampling by convenience was performed among healthcare professionals working in 15 primary care centres in Spain. The Physician Readiness to Manage Intimate Partner Violence Survey (PREMIS), the version validated and translated into Spanish, was the instrument used to collect information about knowledge, opinions and practices regarding intimate partner violence. Descriptive analysis and, simple and multiple linear regression analysis were performed. A total of 265 completed questionnaires were received, with a response rate of 80.3%. An exposure-response effect was observed, where at higher hours of training a higher score was obtained on the questionnaire sections (p <0.05). Age, type of profession, years of experience in primary care, hours of IPV training and reading the protocol showed positive association with knowledge (perceived preparation, perceived knowledge, actual knowledge), opinions (staff preparation, legal requirements, self-efficacy, workplace issues, constraints, understanding of the victim) and practice of healthcare professionals. Reading the regional/national protocol for action and receiving training in IPV were the most important interventions associated to a better primary care professionals' readiness to respond to IPV in Spanish primary care settings. Copyright © 2017 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

  6. Psychological risk and protective factors for disability in chronic low back pain - a longitudinal analysis in primary care.

    Science.gov (United States)

    Jegan, Nikita Roman A; Brugger, Markus; Viniol, Annika; Strauch, Konstantin; Barth, Jürgen; Baum, Erika; Leonhardt, Corinna; Becker, Annette

    2017-03-20

    Utilizing psychological resources when dealing with chronic low back pain might aid the prevention of disability. The observational study at hand examined the longitudinal impact of resilience and coping resources on disability in addition to established risk factors. Four hundred eighty four patients with chronic low back pain (>3 months) were recruited in primary care practices and followed up for one year. Resilience, coping, depression, somatization, pain and demographic variables were measured at baseline. At follow-up (participation rate 89%), data on disability was collected. We first calculated bivariate correlations of all the predictors with each other and with follow-up disability. We then used a multiple regression to evaluate the impact of all the predictors on disability together. More than half of the followed up sample showed a high degree of disability at baseline (53.7%) and had suffered for more than 10 years from pain (50.4%). Besides gender all of the predictors were bivariately associated with follow-up disability. However in the main analysis (multiple regression), disability at follow up was only predicted by baseline disability, age and somatization. There was no relationship between resilience and disability, nor between coping resources and disability. Although it is known that there are cross-sectional relationships between resilience/coping resources and disability we were not able to replicate it in the multiple regression. This can have several reasons: a) the majority of patients in our sample were much more disabled and suffered for a longer time than in other studies. Therefore our results might be limited to this specific population and resilience and coping resources might still have a protective influence in acute or subacute populations. b) We used a rather broad operationalization of resilience. There is emerging evidence that focusing on more concrete sub facets like (pain) self-efficacy and acceptance might be more

  7. Factors that contribute to physician variability in decisions to limit life support in the ICU: a qualitative study.

    Science.gov (United States)

    Wilson, Michael E; Rhudy, Lori M; Ballinger, Beth A; Tescher, Ann N; Pickering, Brian W; Gajic, Ognjen

    2013-06-01

    Our aim was to explore reasons for physician variability in decisions to limit life support in the intensive care unit (ICU) utilizing qualitative methodology. Single center study consisting of semi-structured interviews with experienced physicians and nurses. Seventeen intensivists from medical (n = 7), surgical (n = 5), and anesthesia (n = 5) critical care backgrounds, and ten nurses from medical (n = 5) and surgical (n = 5) ICU backgrounds were interviewed. Principles of grounded theory were used to analyze the interview transcripts. Eleven factors within four categories were identified that influenced physician variability in decisions to limit life support: (1) physician work environment-workload and competing priorities, shift changes and handoffs, and incorporation of nursing input; (2) physician experiences-of unexpected patient survival, and of limiting life support in physician's family; (3) physician attitudes-investment in a good surgical outcome, specialty perspective, values and beliefs; and (4) physician relationship with patient and family-hearing the patient's wishes firsthand, engagement in family communication, and family negotiation. We identified several factors which physicians and nurses perceived were important sources of physician variability in decisions to limit life support. Ways to raise awareness and ameliorate the potentially adverse effects of factors such as workload, competing priorities, shift changes, and handoffs should be explored. Exposing intensivists to long term patient outcomes, formalizing nursing input, providing additional training, and emphasizing firsthand knowledge of patient wishes may improve decision making.

  8. Utilization of cervical cancer screening services and its associated factors among primary school teachers in Ilala Municipality, Dar es Salaam, Tanzania.

    Science.gov (United States)

    Kileo, Neema Minja; Michael, Denna; Neke, Nyasule Majura; Moshiro, Candida

    2015-12-15

    Worldwide cervical cancer is one of the more common forms of carcinoma among women, causing high morbidity and high mortality. Despite being a major health problem in Tanzania, screening services for cervical cancer are very limited, and uptake of those services is low. We therefore conducted a study to investigate utilization of cancer screening services, and its associated factors among female primary school teachers in Ilala Municipality, Dar es Salaam. We conducted a cross-sectional study between May - August 2011 which involved 110 primary schools in Ilala Municipality in Dar es Salaam. Five hundred and twelve female primary school teachers were sampled using a two-stage cluster sampling procedure. Data on utilization of cervical cancer and risk factors were collected using a self-administered questionnaire. Proportional utilization of cervical cancer screening services was identified through a self report. Risk factors for services utilization were assessed using logistic regression analyses. Out of 512 female primary school teachers, only 108 (21 %) reported to ever been screened for cervical cancer. Utilization of cervical cancer screening services was 28 % among those aged 20-29, 22 % among married and 24 % among those with higher level of education. Women were more likely to utilize the cancer-screening service if they were multiparous (age-adjusted OR = 3.05, 95 % CI 1.15-8.06, P value 0.025), or reported more than one lifetime sexual partner (age-adjusted OR 2.17, 95 % CI 1.04-4.54, P value 0.038), or did not involve their spouse in making health decisions (adjusted OR 3.56, 95 % CI 2.05-6.18, P value service among female primary school teachers in Ilala munipality. Female primary school teachers with more than one previous pregnancy and those with more than one life-time sex partners were more likely to report utilization of the service. Spouse or partners support was an important factor in the utilization of cervical cancer screening

  9. Factors limiting the implementation of mechanical harvesting of sugarcane in Campos dos Goytacazes, RJ, Brazil

    Directory of Open Access Journals (Sweden)

    Cristóbal Soto Solano

    Full Text Available ABSTRACT The objective of this research was to identify and characterize the main technical factors that affect the deployment of the mechanized harvesting of sugarcane in Campos dos Goytacazes, Rio de Janeiro, Brazil. In general, it can be stated there were restrictive factors related to machinery, administrative management, and technical planning. We identified significant technical restrictions in the planting system, particularly in relation to the size and shape of the plots, length of the rows, row spacing, and inadequate varieties. For efficient use of mechanized harvesting, a technical planning is necessary with changes in the cropping system, adopting wider and more uniform plots regarding to its format, with rows over 500 m length and row spacing of 1.50 m and upright, productive, and deep-rooted varieties.

  10. Theory of factors limiting high gradient operation of warm accelerating structures

    Energy Technology Data Exchange (ETDEWEB)

    Nusinovich, Gregory S. [Univ. of Maryland, College Park, MD (United States)

    2014-07-22

    This report consists of two parts. In the first part we describe a study of the heating of microprotrusions on surfaces of accelerating structures. This ;process is believed to lead to breakdown in these structures. Our study revealed that for current accelerator parameters melting should not occur due to space charge limitations of the current emitted by a protrusion. The second part describes a novel concept to develop THz range sources based on harmonic cyclotron masers for driving future colliders. This work was stimulated by a recent request of SLAC to develop high power, high-efficiency sources of sub-THz radiation for future high-gradient accelerators.

  11. HSL MI28: An Efficient and Robust Limited-Memory Incomplete Cholesky Factorization Code

    Czech Academy of Sciences Publication Activity Database

    Scott, J.; Tůma, Miroslav

    2014-01-01

    Roč. 40, č. 4 (2014), Article number 24 ISSN 0098-3500 R&D Projects: GA ČR GA13-06684S Grant - others:EPSRC(GB) EP/I013067/1 Institutional support: RVO:67985807 Keywords : preconditioning * sparse linear systems * incomplete decompositions * preconditioned iterative methods Subject RIV: IN - Informatics, Computer Science Impact factor: 1.863, year: 2014

  12. HSL MI28: An Efficient and Robust Limited-Memory Incomplete Cholesky Factorization Code

    Czech Academy of Sciences Publication Activity Database

    Scott, J.; Tůma, Miroslav

    2014-01-01

    Roč. 40, č. 4 (2014), Art icle number 24 ISSN 0098-3500 R&D Projects: GA ČR GA13-06684S Grant - others:EPSRC(GB) EP/I013067/1 Institutional support: RVO:67985807 Keywords : preconditioning * sparse linear systems * incomplete decompositions * preconditioned iterative methods Subject RIV: IN - Informatics, Computer Science Impact factor: 1.863, year: 2014

  13. Hepatocyte growth factor limits autoimmune neuroinflammation via glucocorticoid-induced leucine zipper expression in dendritic cells.

    Science.gov (United States)

    Benkhoucha, Mahdia; Molnarfi, Nicolas; Dunand-Sauthier, Isabelle; Merkler, Doron; Schneiter, Gregory; Bruscoli, Stefano; Riccardi, Carlo; Tabata, Yasuhiko; Funakoshi, Hiroshi; Nakamura, Toshikazu; Reith, Walter; Santiago-Raber, Marie-Laure; Lalive, Patrice H

    2014-09-15

    Autoimmune neuroinflammation, including multiple sclerosis and its animal model, experimental autoimmune encephalomyelitis (EAE), a prototype for T cell-mediated autoimmunity, is believed to result from immune tolerance dysfunction leading to demyelination and substantial neurodegeneration. We previously showed that CNS-restricted expression of hepatocyte growth factor (HGF), a potent neuroprotective factor, reduced CNS inflammation and clinical deficits associated with EAE. In this study, we demonstrate that systemic HGF treatment ameliorates EAE through the development of tolerogenic dendritic cells (DCs) with high expression levels of glucocorticoid-induced leucine zipper (GILZ), a transcriptional repressor of gene expression and a key endogenous regulator of the inflammatory response. RNA interference-directed neutralization of GILZ expression by DCs suppressed the induction of tolerance caused by HGF. Finally, adoptive transfer of HGF-treated DCs from wild-type but not GILZ gene-deficient mice potently mediated functional recovery in recipient mice with established EAE through effective modulation of autoaggressive T cell responses. Altogether, these results show that by inducing GILZ in DCs, HGF reproduces the mechanism of immune regulation induced by potent immunomodulatory factors such as IL-10, TGF-β1, and glucocorticoids and therefore that HGF therapy may have potential in the treatment of autoimmune dysfunctions. Copyright © 2014 by The American Association of Immunologists, Inc.

  14. Barriers to primary care responsiveness to poverty as a risk factor for health.

    Science.gov (United States)

    Bloch, Gary; Rozmovits, Linda; Giambrone, Broden

    2011-06-29

    Poverty is widely recognized as a major determinant of poor health, and this link has been extensively studied and verified. Despite the strong evidentiary link, little work has been done to determine what primary care health providers can do to address their patients' income as a risk to their health. This qualitative study explores the barriers to primary care responsiveness to poverty as a health issue in a well-resourced jurisdiction with near-universal health care insurance coverage. One to one interviews were conducted with twelve experts on poverty and health in primary care in Ontario, Canada. Participants included family physicians, specialist physicians, nurse practitioners, community workers, advocates, policy experts and researchers. The interviews were analysed for anticipated and emergent themes. This study reveals provider- and patient-centred structural, attitudinal, and knowledge-based barriers to addressing poverty as a risk to health. While many of its findings reinforce previous work in this area, this study's findings point to a number of areas front line primary care providers could target to address their patients' poverty. These include a lack of provider understanding of the lived reality of poverty, leading to a failure to collect adequate data about patients' social circumstances, and to the development of inappropriate care plans. Participants also pointed to prejudicial attitudes among providers, a failure of primary care disciplines to incorporate approaches to poverty as a standard of care, and a lack of knowledge of concrete steps providers can take to address patients' poverty. While this study reinforces, in a well-resourced jurisdiction such as Ontario, the previously reported existence of significant barriers to addressing income as a health issue within primary care, the findings point to the possibility of front line primary care providers taking direct steps to address the health risks posed by poverty. The consistent

  15. Cerebral Damage May Be the Primary Risk Factor for Visual Impairment in Preschool Children Born Extremely Premature

    DEFF Research Database (Denmark)

    Slidsborg, Carina; Bangsgaard, Regitze; Fledelius, Hans Callø

    2012-01-01

    OBJECTIVES To investigate the importance of cerebral damage and retinopathy of prematurity (ROP) for visual impairment in preschool children born extremely premature and to determine the primary risk factor of the two. METHODS A clinical follow-up study of a Danish national cohort of children born......, 3.0-25.2; P visual impairment in children born extremely premature, and cerebral damage may be the primary risk...... participants were identified through the National Birth Register and invited to participate in a clinical examination. The children were evaluated with regard to visual acuity, foveal sequelae, and maximum ROP stage and the presence of global developmental deficits (an indicator for cerebral damage...

  16. Factors predicting the duration of adrenal insufficiency in patients successfully treated for Cushing disease and nonmalignant primary adrenal Cushing syndrome.

    Science.gov (United States)

    Prete, Alessandro; Paragliola, Rosa Maria; Bottiglieri, Filomena; Rota, Carlo Antonio; Pontecorvi, Alfredo; Salvatori, Roberto; Corsello, Salvatore Maria

    2017-03-01

    Successful treatment of Cushing syndrome causes transient or permanent adrenal insufficiency deriving from endogenous hypercortisolism-induced hypothalamus-pituitary-adrenal-axis suppression. We analyzed pre-treatment factors potentially affecting the duration of adrenal insufficiency. We conducted a retrospective analysis on patients successfully treated for Cushing disease (15 patients) who underwent transsphenoidal surgery, and nonmalignant primary adrenal Cushing syndrome (31 patients) who underwent unilateral adrenalectomy, divided into patients with overt primary adrenal Cushing syndrome (14 patients) and subclinical primary adrenal Cushing syndrome (17 patients). Epidemiological data, medical history, and hormonal parameters depending on the etiology of hypercortisolism were collected and compared to the duration of adrenal insufficiency. The median duration of follow-up after surgery for Cushing disease and primary adrenal Cushing syndrome was 70 and 48 months, respectively. In the Cushing disease group, the median duration of adrenal insufficiency after transsphenoidal surgery was 15 months: younger age at diagnosis and longer duration of signs and symptoms of hypercortisolism before diagnosis and surgery were associated with longer duration of adrenal insufficiency. The median duration of adrenal insufficiency was 6 months for subclinical primary adrenal Cushing syndrome and 18.5 months for overt primary adrenal Cushing syndrome. The biochemical severity of hypercortisolism, the grade of hypothalamus-pituitary-adrenal-axis suppression, and treatment with ketoconazole before surgery accounted for longer duration of adrenal insufficiency. In patients with Cushing disease, younger age and delayed diagnosis and treatment predict longer need for glucocorticoid replacement therapy after successful transsphenoidal surgery. In patients with primary adrenal Cushing syndrome, the severity of hypercortisolism plays a primary role in influencing the duration of

  17. Confirmatory factor analysis of the Malay version comprehensive feeding practices questionnaire tested among mothers of primary school children in Malaysia.

    Science.gov (United States)

    Shohaimi, Shamarina; Wei, Wong Yoke; Shariff, Zalilah Mohd

    2014-01-01

    Comprehensive feeding practices questionnaire (CFPQ) is an instrument specifically developed to evaluate parental feeding practices. It has been confirmed among children in America and applied to populations in France, Norway, and New Zealand. In order to extend the application of CFPQ, we conducted a factor structure validation of the translated version of CFPQ (CFPQ-M) using confirmatory factor analysis among mothers of primary school children (N = 397) in Malaysia. Several items were modified for cultural adaptation. Of 49 items, 39 items with loading factors >0.40 were retained in the final model. The confirmatory factor analysis revealed that the final model (twelve-factor model with 39 items and 2 error covariances) displayed the best fit for our sample (Chi-square = 1147; df = 634; P Malaysia. The present study extends the usability of the CFPQ and enables researchers and parents to better understand the relationships between parental feeding practices and related problems such as childhood obesity.

  18. Factors limiting the domestic density of Triatoma infestans in north-west Argentina: a longitudinal study.

    Science.gov (United States)

    Cecere, M C; Gürtler, R E; Chuit, R; Cohen, J E

    1998-01-01

    Reported are the environmental and demographic risk factors associated with the domestic infestation and density of Triatoma infestans in three heavily infested rural villages in Santiago del Estero Province, Argentina. In a one-factor unadjusted analysis, the number of T. infestans captured per person-hour was associated significantly and negatively with the use of domestic insecticides by householders, type of thatch used in the roofs and the age of the house; and positively with the following: degree of cracking of the indoor walls and presence of hens nesting indoors. In one model, using multiple linear regression and a backward stepwise elimination procedure, most of the variation in the overall abundance of T. infestans was explained by insecticide use and the presence of hens nesting indoors; in another model using the same procedure it was explained by insecticide use, bug density in 1988 and previous spraying with deltamethrin in 1985. Variations in bug density per capture stratum (household goods, beds, walls and roof) were explained by the bug density in other strata and by one or two of the following risk factors: hens nesting indoors, type of roof, presence of cracks in the walls and number of people living in the house. Bug density might be locally controlled by the availability of refuges in the roofs and walls, by the presence of hens nesting indoors and by the use of domestic insecticides. Certain local materials, such as a grass known as simbol, could be successfully used in rural housing improvement programmes aimed at reducing the availability of refuges for insects in the roof.

  19. The Factor Structure of ADHD in a General Population of Primary School Children

    Science.gov (United States)

    Ullebo, Anne Karin; Breivik, Kyrre; Gillberg, Christopher; Lundervold, Astri J.; Posserud, Maj-Britt

    2012-01-01

    Objective: To examine whether a bifactor model with a general ADHD factor and domain specific factors of inattention, hyperactivity and impulsivity was supported in a large general population sample of children. We also explored the utility of forming subscales based on the domain-specific factors. Methods: Child mental health questionnaires were…

  20. Investigation on the Quality Factor Limit of the (111 Silicon Based Disk Resonator

    Directory of Open Access Journals (Sweden)

    Xin Zhou

    2018-01-01

    Full Text Available Quality factor is one of the most important parameters for a MEMS resonator. Most MEMS resonators are dominated by thermoelastic dissipation (TED. This paper demonstrates that the TED in a disk resonator that is made of (111 single-crystal silicon is surpassed by clamping loss. The stiffness-mass decoupling design method, combined with reducing the beam width, was used to engineer high QTED. Experiments show that Q of the (111 disk resonator have an upper boundary that is determined by the clamping loss caused by the unbalanced out-of-plane displacement. The origin of the out-of-plane displacement is explained by theory and simulation.

  1. The primary extinction and static Debye-Waller factor in the characterization of textured nickel by X-ray diffraction

    International Nuclear Information System (INIS)

    Kryshtab, T.; Palacios G, J.; Cadena A, A.; Kryvko, A.

    2015-01-01

    The texture analysis using X-ray diffraction (XRD) implies measurement of pole figures (Pf) from the diffracted intensities considering the model of kinematical dispersion. The extinction phenomenon results in a decrease of diffracted intensity and that in turn in a decrease of pole densities (Pds). The phenomenon appears in the kinematical theory of XRD as the primary extinction and the secondary extinction to characterize the loss of intensity of kinematical dispersion. In turn, the static Debye-Waller factor is an integral characteristic of defects in crystals that is introduced in the kinematical theory of XRD and also is used in dynamical theory of XRD. In this work the correlation between the primary extinction coefficient and the static Debye-Waller factor in the case of textured nickel was determined. The value of static Debye-Waller factor was determined from the value of the calculated primary extinction coefficient. For the evaluation there were used Pds in the maxima of Pf obtained for 111 and 200 reflections with Mo Kα radiation, and the Pds in the maxima of Pf obtained for the first and second orders of these reflections with Cu Kα and Co Kα radiations. There were calculated the dislocation densities in grains using values of static Debye-Waller factor and the extinction coefficients. The dislocation densities calculated from these two characteristics are practically equal. (Author)

  2. Factors limiting vocal-tract length discrimination in cochlear implant simulations.

    Science.gov (United States)

    Gaudrain, Etienne; Başkent, Deniz

    2015-03-01

    Perception of voice characteristics allows normal hearing listeners to identify the gender of a speaker, and to better segregate speakers from each other in cocktail party situations. This benefit is largely driven by the perception of two vocal characteristics of the speaker: The fundamental frequency (F0) and the vocal-tract length (VTL). Previous studies have suggested that cochlear implant (CI) users have difficulties in perceiving these cues. The aim of the present study was to investigate possible causes for limited sensitivity to VTL differences in CI users. Different acoustic simulations of CI stimulation were implemented to characterize the role of spectral resolution on VTL, both in terms of number of channels and amount of channel interaction. The results indicate that with 12 channels, channel interaction caused by current spread is likely to prevent CI users from perceiving VTL differences typically found between male and female speakers.

  3. Continuum limit of the leading order HQET form factor in B{sub s}→Klν decays

    Energy Technology Data Exchange (ETDEWEB)

    Bahr, Felix; Banerjee, Debasish; Koren, Mateusz; Simma, Hubert; Sommer, Rainer [Deutsches Elektronen-Synchrotron (DESY), Zeuthen (Germany). John von Neumann-Inst. fuer Computing NIC; Bernardoni, Fabio [Deutsches Elektronen-Synchrotron (DESY), Zeuthen (Germany). John von Neumann-Inst. fuer Computing NIC; Technische Univ. Dresden (Germany). Medizinische Fakultaet ' ' Carl Gustav Carus' ' ; Joseph, Anosh [Cambridge Univ. (United Kingdom). Dept. of Applied Mathematics and Theoretical Physics (DAMTP); Collaboration: ALPHA Collaboration

    2016-01-15

    We discuss the computation of form factors for semi-leptonic decays of B-, B{sub s}- mesons in lattice QCD. Considering in particular the example of the static B{sub s} form factors we demonstrate that after non-perturbative renormalization the continuum limit can be taken with confidence. The resulting precision is of interest for extractions of V{sub ub}. The size of the corrections of order 1/m{sub b} is just estimated at present but it is expected that their inclusion does not pose significant difficulties.

  4. The Transcription Factor STAT6 Mediates Direct Repression of Inflammatory Enhancers and Limits Activation of Alternatively Polarized Macrophages

    OpenAIRE

    Czimmerer, Zsolt; Daniel, Bence; Horvath, Attila; Rückerl, Dominik; Nagy, Gergely; Kiss, Mate; Peloquin, Matthew; Budai, Marietta M.; Cuaranta-Monroy, Ixchelt; Simandi, Zoltan; Steiner, Laszlo; Nagy, Bela; Poliska, Szilard; Banko, Csaba; Bacso, Zsolt

    2018-01-01

    Summary The molecular basis of signal-dependent transcriptional activation has been extensively studied in macrophage polarization, but our understanding remains limited regarding the molecular determinants of repression. Here we show that IL-4-activated STAT6 transcription factor is required for the direct transcriptional repression of a large number of genes during in vitro and in vivo alternative macrophage polarization. Repression results in decreased lineage-determining transcription fac...

  5. [Factors limiting distribution of the rare lichen species Lobaria pulmonaria (in forests of the Kologriv Forest Nature Reserve)].

    Science.gov (United States)

    Ivanova, N V

    2015-01-01

    The distribution patterns and coenotic confines ofthe epiphytic lichen Lobaria pulmonaria have been studied. The factors limiting the habitat of this rare lichen species in the Kologriv Forest Nature Reserve (southern taiga subzone) have been revealed. It has been shown that L. pulmonaria is attracted to forest areas, which are less affected by humans and characterized by better light conditions than other communities. It has been found that L. pulmonaria is able to colonize trees at various ontogenetic states, beginning from virginal ones.

  6. Limited clinical efficacy of azacitidine in transfusion-dependent, growth factor-resistant, low- and Int-1-risk MDS

    DEFF Research Database (Denmark)

    Holm, Mette; Dybedahl, I; Holm, Mette

    2014-01-01

    This prospective phase II study evaluated the efficacy of azacitidine (Aza)+erythropoietin (Epo) in transfusion-dependent patients with lower-risk myelodysplastic syndrome (MDS). Patients ineligible for or refractory to full-dose Epo+granulocyte colony stimulation factors for >8 weeks and a trans...... patients, but efficacy is limited, toxicity substantial and most responses of short duration. This treatment cannot be generally recommended in lower-risk MDS. Mutational screening revealed a high frequency of mutations....

  7. Effect of internal limiting membrane peeling on the development of epiretinal membrane after pars plana vitrectomy for primary rhegmatogenous retinal detachment.

    Science.gov (United States)

    Nam, Ki Yup; Kim, Jung Yeul

    2015-05-01

    To investigate the difference in the occurrence of postoperative epiretinal membranes (ERMs) in vitrectomy for rhegmatogenous retinal detachment with and without peeling of the internal limiting membrane (ILM). The medical records of the 135 patients, who underwent vitrectomy for primary rhegmatogenous retinal detachment from November 2007 to August 2011, were analyzed retrospectively. Of the subjects, 70 patients underwent ILM peeling during the surgery and 65 did not. The best-corrected visual acuity, fundus photograph, and optical coherence tomography were collected 3, 6, and 12 months postoperatively. The relationship between ILM peeling and the preoperative findings of rhegmatogenous retinal detachment and development of a postoperative ERM was analyzed. No ERM occurred in the ILM peeling group, whereas an ERM occurred in 14 of 65 patients who underwent vitrectomy without ILM peeling (21.5%). This difference was significant (P peeling group and was significantly higher 12 months postoperatively (P = 0.03). Internal limiting membrane peeling seems to prevent the occurrence of a postoperative ERM in patients with primary rhegmatogenous retinal detachment.

  8. Clinical outcome and prognostic factors of primary gastric mucosa-associated lymphoid tissue lymphoma: a retrospective analysis of 77 cases

    International Nuclear Information System (INIS)

    Wang Shulian; Song Yongwen; Jin Jing; Wang Weihu; Liu Yueping; Liu Xinfan; Yu Zihao; Li Yexiong; Xue Liyan; Lv Ning

    2009-01-01

    Objective: To analyze the clinical results and prognostic factors of patients with early-stage primary gastric mucosa-associated lymphoid tissue (MALT) lymphoma. Methods: Seventy-seven patients with primary gastric MALT lymphoma treated from 1985 to 2006 were retrospectively analyzed. All patients were pathologically confirmed as MALT lymphoma in stage I, II and II E (by modified Blackedge staging system). Thirty-seven patients had stage I disease, 23 stage II and 17 stage II E . Sixty patients underwent surgical resection and 17 received non-surgical treatment. Survival rates were calculated by the Kaplan-Meier analysis with the Logrank test. Results: With a median follow up of 57 months for the surviving patients (ranging from 1 to 198 months for all patients), the 5-year overall survival rate, disease-free survival rate, loco-regional control rate and distant metastasis free survival rate were 74%, 70%, 76% and 87%, respectively. In univariate analysis, clinical stage was significantly associated with overall survival. Patients with stage I or II disease had a better overall survival than those with stage II E (P=0.01). Tumor size and surgical resection were significantly associated with disease-free survival. Patients with primary tumor 8 cm or less in diameter had better disease-free survival than those with primary tumor more than 8 cm in diameter (P =0.03). Patients who underwent complete resection had better disease-free survival than those who underwent incomplete resection or no surgery (P=0.02). Clinical stage, tumor size and surgical resection were significantly associated with loco-regional control. Patients with stage I or II disease had better loco-regional control than those with stage II E (P=0.03). Patients with primary tumor 8 cm or less in diameter had better loco-regional control than those with primary tumor more than 8 cm in diameter (P=0.01). Patients who underwent complete resection had better loco-regional control than those who underwent

  9. A measurement of the QCD colour factors and a limit on the light gluino

    CERN Document Server

    Barate, R; Décamp, D; Ghez, P; Goy, C; Lees, J P; Lucotte, A; Minard, M N; Nief, J Y; Odier, P; Pietrzyk, B; Casado, M P; Chmeissani, M; Comas, P; Crespo, J M; Delfino, M C; Fernández, E; Fernández-Bosman, M; Garrido, L; Juste, A; Martínez, M; Miquel, R; Mir, L M; Orteu, S; Padilla, C; Park, I C; Pascual, A; Perlas, J A; Riu, I; Sánchez, F; Teubert, F; Colaleo, A; Creanza, D; De Palma, M; Gelao, G; Iaselli, Giuseppe; Maggi, G; Maggi, M; Marinelli, N; Nuzzo, S; Ranieri, A; Raso, G; Ruggieri, F; Selvaggi, G; Silvestris, L; Tempesta, P; Tricomi, A; Zito, G; Huang, X; Lin, J; Ouyang, Q; Wang, T; Xie, Y; Xu, R; Xue, S; Zhang, J; Zhang, L; Zhao, W; Abbaneo, D; Alemany, R; Bazarko, A O; Bright-Thomas, P G; Cattaneo, M; Cerutti, F; Drevermann, H; Forty, Roger W; Frank, M; Hagelberg, R; Harvey, J; Janot, P; Jost, B; Kneringer, E; Knobloch, J; Lehraus, Ivan; Lutters, G; Mato, P; Minten, Adolf G; Moneta, L; Pacheco, A; Pusztaszeri, J F; Ranjard, F; Rensing, P E; Rizzo, G; Rolandi, Luigi; Schlatter, W D; Schmelling, M; Schmitt, M; Schneider, O; Tejessy, W; Tomalin, I R; Wachsmuth, H W; Wagner, A; Ajaltouni, Ziad J; Barrès, A; Boyer, C; Falvard, A; Ferdi, C; Gay, P; Guicheney, C; Henrard, P; Jousset, J; Michel, B; Monteil, S; Montret, J C; Pallin, D; Perret, P; Podlyski, F; Proriol, J; Rosnet, P; Rossignol, J M; Fearnley, Tom; Hansen, J B; Hansen, J D; Hansen, J R; Hansen, P H; Nilsson, B S; Rensch, B; Wäänänen, A; Daskalakis, G; Kyriakis, A; Markou, C; Simopoulou, Errietta; Siotis, I; Vayaki, Anna; Zachariadou, K; Blondel, A; Bonneaud, G R; Brient, J C; Bourdon, P; Rougé, A; Rumpf, M; Valassi, Andrea; Verderi, M; Videau, H L; Candlin, D J; Parsons, M I; Focardi, E; Parrini, G; Corden, M; Georgiopoulos, C H; Jaffe, D E; Antonelli, A; Bencivenni, G; Bologna, G; Bossi, F; Campana, P; Capon, G; Casper, David William; Chiarella, V; Felici, G; Laurelli, P; Mannocchi, G; Murtas, F; Murtas, G P; Passalacqua, L; Pepé-Altarelli, M; Curtis, L; Dorris, S J; Halley, A W; Knowles, I G; Lynch, J G; O'Shea, V; Raine, C; Scarr, J M; Smith, K; Teixeira-Dias, P; Thompson, A S; Thomson, E; Thomson, F; Turnbull, R M; Becker, U; Geweniger, C; Graefe, G; Hanke, P; Hansper, G; Hepp, V; Kluge, E E; Putzer, A; Schmidt, M; Sommer, J; Tittel, K; Werner, S; Wunsch, M; Beuselinck, R; Binnie, David M; Cameron, W; Dornan, Peter J; Girone, M; Goodsir, S M; Martin, E B; Moutoussi, A; Nash, J; Sedgbeer, J K; Stacey, A M; Williams, M D; Dissertori, G; Girtler, P; Kuhn, D; Rudolph, G; Betteridge, A P; Bowdery, C K; Colrain, P; Crawford, G; Finch, A J; Foster, F; Hughes, G; Sloan, Terence; Williams, M I; Galla, A; Giehl, I; Greene, A M; Hoffmann, C; Jakobs, K; Kleinknecht, K; Quast, G; Renk, B; Rohne, E; Sander, H G; Van Gemmeren, P; Zeitnitz, C; Aubert, Jean-Jacques; Benchouk, C; Bonissent, A; Bujosa, G; Calvet, D; Carr, J; Coyle, P; Diaconu, C A; Etienne, F; Konstantinidis, N P; Leroy, O; Payre, P; Rousseau, D; Talby, M; Sadouki, A; Thulasidas, M; Trabelsi, K; Aleppo, M; Ragusa, F; Berlich, R; Blum, Walter; Büscher, V; Dietl, H; Dydak, Friedrich; Ganis, G; Gotzhein, C; Kroha, H; Lütjens, G; Lutz, Gerhard; Männer, W; Moser, H G; Richter, R H; Rosado-Schlosser, A; Schael, S; Settles, Ronald; Seywerd, H C J; Saint-Denis, R; Stenzel, H; Wiedenmann, W; Wolf, G; Boucrot, J; Callot, O; Chen, S; Choi, Y; Cordier, A; Davier, M; Duflot, L; Grivaz, J F; Heusse, A; Höcker, A; Jacholkowska, A; Jacquet, M; Kim, D W; Le Diberder, F R; Lefrançois, J; Lutz, A M; Nikolic, I A; Park, H J; Schune, M H; Simion, S; Veillet, J J; Videau, I; Zerwas, D; Azzurri, P; Bagliesi, G; Batignani, G; Bettarini, S; Bozzi, C; Calderini, G; Carpinelli, M; Ciocci, M A; Ciulli, V; Dell'Orso, R; Fantechi, R; Ferrante, I; Foà, L; Forti, F; Giassi, A; Giorgi, M A; Gregorio, A; Ligabue, F; Lusiani, A; Marrocchesi, P S; Messineo, A; Palla, Fabrizio; Sanguinetti, G; Sciabà, A; Spagnolo, P; Steinberger, Jack; Tenchini, Roberto; Tonelli, G; Vannini, C; Venturi, A; Verdini, P G; Blair, G A; Bryant, L M; Chambers, J T; Gao, Y; Green, M G; Medcalf, T; Perrodo, P; Strong, J A; Von Wimmersperg-Töller, J H; Botterill, David R; Clifft, R W; Edgecock, T R; Haywood, S; Maley, P; Norton, P R; Thompson, J C; Wright, A E; Bloch-Devaux, B; Colas, P; Emery, S; Kozanecki, Witold; Lançon, E; Lemaire, M C; Locci, E; Pérez, P; Rander, J; Renardy, J F; Roussarie, A; Schuller, J P; Schwindling, J; Trabelsi, A; Vallage, B; Black, S N; Dann, J H; Johnson, R P; Kim, H Y; Litke, A M; McNeil, M A; Taylor, G; Booth, C N; Boswell, R; Brew, C A J; Cartwright, S L; Combley, F; Kelly, M S; Lehto, M H; Newton, W M; Reeve, J; Thompson, L F; Böhrer, A; Brandt, S; Cowan, G D; Grupen, Claus; Saraiva, P; Smolik, L; Stephan, F; Apollonio, M; Bosisio, L; Della Marina, R; Giannini, G; Gobbo, B; Musolino, G; Rothberg, J E; Wasserbaech, S R; Armstrong, S R; Elmer, P; Feng, Z; Ferguson, D P S; Gao, Y S; González, S; Grahl, J; Greening, T C; Hayes, O J; Hu, H; McNamara, P A; Nachtman, J M; Orejudos, W; Pan, Y B; Saadi, Y; Scott, I J; Walsh, J; Wu Sau Lan; Wu, X; Yamartino, J M; Zheng, M; Zobernig, G

    1997-01-01

    Using data collected from 1992 to 1995 with the ALEPH detector at LEP, a measurement of the colour factor ratios CA/CF and TF/CF and the strong coupling constant $\\overline{\\alpha}_s = CF \\alpha_s(Mz)/ (2\\pi)$ has been performed by fitting theoretical predictions simultaneously to the measured differential two-jet rate and angular distributions in four-jet events. The result is found to be in excellent agreement with QCD, CA/CF = 2.20 +- 0.09 (stat) +- 0.13 (syst) , TF/CF = 0.29 +- 0.05 (stat) +- 0.06 (syst) . Fixing CA/CF$ and TF/CF to the QCD values permits a determination of $\\alpha_s(Mz)$ and nf, the number of active flavours. With this measurement the existence of a gluino with mass below 6.3 GeV/c^2 is excluded at 95% confidence level.

  10. Cdc6 is a rate-limiting factor for proliferative capacity during HL60 cell differentiation

    International Nuclear Information System (INIS)

    Barkley, Laura R.; Hong, Hye Kyung; Kingsbury, Sarah R.; James, Michelle; Stoeber, Kai; Williams, Gareth H.

    2007-01-01

    The DNA replication (or origin) licensing pathway represents a critical step in cell proliferation control downstream of growth signalling pathways. Repression of origin licensing through down-regulation of the MCM licensing factors (Mcm2-7) is emerging as a ubiquitous route for lowering proliferative capacity as metazoan cells exit the cell division cycle into quiescent, terminally differentiated and senescent 'out-of-cycle' states. Using the HL60 monocyte/macrophage differentiation model system and a cell-free DNA replication assay, we have undertaken direct biochemical investigations of the coupling of origin licensing to the differentiation process. Our data show that down-regulation of the MCM loading factor Cdc6 acts as a molecular switch that triggers loss of proliferative capacity during early engagement of the somatic differentiation programme. Consequently, addition of recombinant Cdc6 protein to in vitro replication reactions restores DNA replication competence in nuclei prepared from differentiating cells. Differentiating HL60 cells over-expressing either wild-type Cdc6 or a CDK phosphorylation-resistant Cdc6 mutant protein (Cdc6A4) exhibit an extended period of cell proliferation compared to mock-infected cells. Notably, differentiating HL60 cells over-expressing the Cdc6A4 mutant fail to down-regulate Cdc6 protein levels, suggesting that CDK phosphorylation of Cdc6 is linked to its down-regulation during differentiation and the concomitant decrease in cell proliferation. In this experimental model, Cdc6 therefore plays a key role in the sequential molecular events leading to repression of origin licensing and loss of proliferative capacity during execution of the differentiation programme

  11. Flavin as an Indicator of the Rate-Limiting Factor for Microbial Current Production in Shewanella oneidensis MR-1

    International Nuclear Information System (INIS)

    Saito, Junki; Hashimoto, Kazuhito; Okamoto, Akihiro

    2016-01-01

    Microbial electrode catalysis such as microbial fuel cells or electrosynthesis involves electron exchange with the electrodes located at the cell exterior; i.e., extracellular electron transport (EET). Despite the vast amount of research on the kinetics of EET to optimize the catalysis rate, the relevance of other factors, including upstream metabolic reactions, has scarcely been investigated. Herein, we report an in vivo electrochemical assay to confirm whether EET limits anodic current production (j) for the lactate oxidation of Shewanella oneidensis MR-1. Addition of riboflavin, which specifically enhances the EET rate, increased j only in the early phase before j saturation. In contrast, when we removed a trace metal ion necessary for upstream reactions from the electrolyte, a significant decrease in j and the lactate consumption rate was observed only after j saturation. These data suggest that the limiting factor for j shifted from EET to upstream reactions, highlighting the general importance of enhancing, for example, microbial metabolism, especially for long-standing practical applications. Our concept to specifically control the rate of EET could be applicable to other bioelectrode catalysis systems as a strategy to monitor their rate-limiting factors.

  12. [Prevalence of dyslipidemia and its influential factors in 2 028 students from primary and middle schools in Changsha].

    Science.gov (United States)

    Li, Yamei; Luo, Jiayou; Ma, Jun; Zou, Zhiyong; Liu, Xiaoqun; Li, Huixia

    2017-06-28

    To determine the prevalence of dyslipidemia in students from the primary and middle schools and the influential factors, and to provide evidence for the prevention and control of dyslipidemia and relevant chronic diseases in primary and middle schools. 
 Methods: A total of 2 028 students aged 7 to 17 from the primary and middle schools in Changsha were selected by stratified random cluster sampling. The contents of the study included questionnaire survey, physical measurement and blood tests for fasting blood triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) levels. Non-high-density lipoprotein cholesterol (non-HDL-C) level was calculated by TC level minus HDL-C level. Chi-square test and non-conditional logistic regression model were used to analyze the factors that contributed to dyslipidemia.
 Results: The dyslipidemia rate was 18.6%, and the abnormal rates of TG, TC, LDL-C, non-HDL-C and HDL-C were 6.8%, 5.6%, 2.3%, 4.2% and 8.6%, respectively. By chi-square test, the dyslipidemia rate in students with different ages, home locations, BMI groups, central obesity, time on watching TV or playing computer per day, and daily sleep time was statistically significant. Non-conditional logistic regression analysis showed that home location for the city (OR=1.332), overweight (OR=1.548), obesity (OR=2.201), central obesity (OR=1.695), watching TV or playing computer for more than 2 hours per day (OR=1.357), daily sleep time longer than 11 hours (OR=2.518) were the risk factors for dyslipidemia in students from the primary and middle schools. 
 Conclusion: Nearly 1/5 primary and middle school students show dyslipidemia, which is associated with obesity and other bad behaviors.

  13. Seasonal shift in climatic limiting factors on tree transpiration: evidence from sap flow observations at alpine treelines in southeast Tibet

    Directory of Open Access Journals (Sweden)

    Liu Xinsheng

    2016-07-01

    Full Text Available Alpine and northern treelines are primarily controlled by low temperatures. However, little is known about the impact of low soil temperature on tree transpiration at treelines. We aim to test the hypothesis that in cold-limited forests, the main limiting factors for tree transpiration switch from low soil temperature before summer solstice to atmospheric evaporative demand after summer solstice, which generally results in low transpiration in the early growing season. Sap flow, meteorological factors and predawn needle water potential were continuously monitored throughout one growing season across Smith fir (Abies georgei var. smithii and juniper (Juniperus saltuaria treelines in southeast Tibet. Sap flow started in early May and corresponded to a threshold mean air-temperature of 0 oC. Across tree species, transpiration was mainly limited by low soil temperature prior to the summer solstice but by vapor pressure deficit and solar radiation post-summer solstice, which was further confirmed on a daily scale. As a result, tree transpiration for both tree species was significantly reduced in the pre-summer solstice period as compared to post-summer solstice, resulting in a lower predawn needle water potential for Smith fir trees in the early growing season. Our data supported the hypothesis, suggesting that tree transpiration mainly responds to soil temperature variations in the early growing season. The results are important for understanding the hydrological response of cold-limited forest ecosystems to climate change.

  14. Teacher Absence as a Factor in Gender Inequalities in Access to Primary Schooling in Rural Pakistan

    Science.gov (United States)

    Ghuman, Sharon; Lloyd, Cynthia

    2010-01-01

    The presence of a teacher in the classroom is central to the provision of schooling, with accumulating evidence showing that teacher absence compromises student learning. Teacher absence is common in schools in low- and middle-income countries. With much of the developing world making rapid progress in achieving universal primary school enrollment…

  15. Factor Structure of the 10 WISC-V Primary Subtests across Four Standardization Age Groups

    Science.gov (United States)

    Dombrowski, Stefan C.; Canivez, Gary L.; Watkins, Marley W.

    2018-01-01

    The Wechsler Intelligence Scale for Children-Fifth Edition (WISC-V; Wechsler 2014a) "Technical and Interpretation Manual" (Wechsler 2014b) dedicated only a single page to discussing the 10-subtest WISC-V primary battery across the entire 6 to 16 age range. Users are left to extrapolate the structure of the 10-subtest battery from the…

  16. Factors influencing primary health care professionals' physical activity promotion behaviors: A systematic review

    NARCIS (Netherlands)

    Huijg, J.M.; Gebhardt, W.A.; Verheijden, M.W.; Zouwe, N. van der; Vries, J.D. de; Middelkoop, B.J.C.; Crone, M.R.

    2015-01-01

    Background: 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. Purpose: To help understand why efficacious PHC-based

  17. Effect of surgery on cardiovascular risk factors in mild primary hyperparathyroidism

    DEFF Research Database (Denmark)

    Bollerslev, Jens; Rosen, Thord; Mollerup, Charlotte

    2009-01-01

    CONTEXT: Mild primary hyperparathyroidism (pHPT) seems to have a good prognosis, and indications for active treatment (surgery) are widely discussed. The extraskeletal effects of PTH, such as insulin resistance, arterial hypertension, and cardiovascular (CV) risk, may however be reversible...

  18. Attitude of Healthcare Professionals: A Major Limiting Factor in Organ Donation from Brain-Dead Donors

    Directory of Open Access Journals (Sweden)

    Maciej Kosieradzki

    2014-01-01

    Full Text Available Public attitude toward deceased donor organ recovery in Poland is quite positive, with only 15% opposing to donation of their own organs, yet actual donation rate is only 16/pmp. Moreover, donation rate varies greatly (from 5 to 28 pmp in different regions of the country. To identify the barriers of organ donation, we surveyed 587 physicians involved in brain death diagnosis from regions with low (LDR and high donation rates (HDR. Physicians from LDR were twice more reluctant to start diagnostic procedure when clinical signs of brain death were present (14% versus 5.5% physicians from HDR who would not diagnose death, resp.. Twenty-five percent of LDR physicians (as opposed to 12% of physicians from HDR would either continue with intensive therapy or confirm brain death and limit to the so-called minimal therapy. Only 32% of LDR physicians would proceed with brain death diagnosis regardless of organ donation, compared to 67% in HDR. When donation was not an option, mechanical ventilation would be continued more often in LDR regions (43% versus 26.7%; P<0.01. In conclusion, low donation activity seems to be mostly due to medical staff attitude.

  19. Exercise hyperthermia as a factor limiting physical performance - Temperature effect on muscle metabolism

    Science.gov (United States)

    Kozlowski, S.; Brzezinska, Z.; Kruk, B.; Kaciuba-Uscilko, H.; Greenleaf, J. E.

    1985-01-01

    The effect of trunk cooling on the muscle contents of ATP, ADP, AMP, creatine phosphate (CrP), and creatine, as well as of glycogen, some glycolytic intermediates, pyruvate, and lactate were assessed in 11 fasted dogs exercised at 20 C on treadmill to exhaustion. Without cooling, dogs were able to run 57 min, and their rectal (Tre) and muscle (Tm) temperatures increased to 41.8 and 43.0 C, respectively. Cooling with ice packs prolonged the ability to run by 45 percent, and resulted in lower Tre (by 1.1 C) and Tm (by 1.2 C). Depletion of muscle content of total high-energy phosphates (ATP + CrP) and glycogen, and increases in contents of AMP, pyruvate, and lactate were lower in cooled dogs than in non-cooled dogs. The muscle content of lactiate correlated positively with TM. These results indicate that hypothermia accelerates glycolysis, and shifts the equilibrium between high- and low-energy phosphates in favor of the latter. The adverse effect of hypothermia on muscle metabolism may be relevant to the limitation of endurance.

  20. Job Accommodations Availability and Utilization Among People With Lupus: An Examination of Workplace Activity Limitations and Work Context Factors.

    Science.gov (United States)

    Al Dhanhani, Ali M; Gignac, Monique A M; Beaton, Dorcas E; Su, Jiandong; Fortin, Paul R

    2015-11-01

    The aim of this study was to examine the availability of diverse job accommodations (or flexible working arrangements) and to describe their use among people with systemic lupus erythematosus (lupus), as well as to examine factors associated with the use of job accommodations. A mail survey was sent to adult lupus patients receiving care from a lupus clinic based in Toronto, Canada. The survey assessed demographic information, self-reported disease activity, work history, workplace activity limitations, job strain, and the availability and use of job accommodations. Standard multivariable linear regression analysis was used to examine factors associated with the use of job accommodations. We received 362 responses of 604 mailed surveys (60% response rate). Participants who were employed within the last 5 years, but who were not currently working, were less likely than currently employed participants to report having had job accommodations available to them at their last place of employment. The use of job accommodations was reported by 70% of currently employed respondents and by 72% of those not currently employed. The most common job accommodation used was sick leave days. Factors positively associated with the use of job accommodations among those who were employed included higher levels of education, being diagnosed with fibromyalgia, at least 1 episode of short-term work disability, not belonging to a union, greater workplace activity limitations, and greater job strain. The use of job accommodations among people with lupus is common. Work context factors, such as workplace activity limitations and job strain, are the main factors associated with the use of job accommodations. © 2015, American College of Rheumatology.

  1. Association of Vascular Endothelial Growth Factor Expression with Tumor Angiogenesis and with Early Relapse in Primary Breast Cancer

    Science.gov (United States)

    Hoshina, Seigo; Takayanagi, Toshiaki; Tominaga, Takeshi

    1994-01-01

    Angiogenesis is an independent prognostic indicator in breast cancer. In this report, the relationship between expression of vascular endothclial growth factor (VEGF; a selective mitogen for endothelial cells) and the microvessel density was examined in 103 primary breast cancers. The expression of VEGF was evaluated by immunocytochemical staining using anti‐VEGF antibody. The microvessel density, which was determined by immunostaining for factor VIII antigen, in VEGF‐rich tumors was clearly higher than that in VEGF‐poor tumors (P<0.01). There was a good correlation between VEGF expression and the increment of microvessel density. Furthermore, postoperative survey demonstrated that the relapse‐free survival rate of VEGF‐rich tumors was significantly worse than that of VEGF‐poor tumors. It was suggested that the expression of VEGF is closely associated with the promotion of angiogenesis and with early relapse in primary breast cancer. PMID:7525523

  2. Effects on coagulation factor production following primary hepatomitogen-induced direct hyperplasia.

    Science.gov (United States)

    Tatsumi, Kohei; Ohashi, Kazuo; Taminishi, Sanae; Takagi, Soichi; Utoh, Rie; Yoshioka, Akira; Shima, Midori; Okano, Teruo

    2009-11-14

    To investigate the molecular mechanisms involved in coagulation factor expression and/or function during direct hyperplasia (DH)-mediated liver regeneration. Direct hyperplasia-mediated liver regeneration was induced in female C57BL/6 mice by administering 1,4-bis[2-(3,5-dichloropyridyloxy)] benzene (TCPOBOP), a representative hepatomitogen. Mice were weighed and sacrificed at various time points [Day 0 (D0: prior to injection), 3 h, D1, D2, D3, and D10] after TCPOBOP administration to obtain liver and blood samples. Using the RNA samples extracted from the liver, a comprehensive analysis was performed on the hepatic gene expression profiling of coagulation-related factors by real-time RT-PCR (fibrinogen, prothrombin, factors V, VII, VIII, IX, X, XI, XII, XIIIbeta, plasminogen, antithrombin, protein C, protein S, ADAMTS13, and VWF). The corresponding plasma levels of coagulation factors (fibrinogen, prothrombin, factors V, VII, VIII, IX, X, XI, XII, XIII, and VWF) were also analyzed and compared with their mRNA levels. Gavage administration of TCPOBOP (3 mg/kg body weight) resulted in a marked and gradual increase in the weight of the mouse livers relative to the total body weight to 220% by D10 relative to the D0 (control) ratios. At the peak of liver regeneration (D1 and D2), the gene expression levels for most of the coagulation-related factors (fibrinogen, prothrombin, factors V, VII, VIII, IX, XI, XII, XIIIbeta, plasminogen, antithrombin, protein C, ADAMTS13, VWF) were found to be down-regulated in a time-dependent manner, and gradually recovered by D10 to the basal levels. Only mRNA levels of factor X and protein S failed to show any decrease during the regenerative phase. As for the plasma levels, 5 clotting factors (prothrombin, factors VIII, IX, XI, and XII) demonstrated a significant decrease (Pfactors, factor IX and factor XI showed the most dramatic decline in their activities by about 50% at D2 compared to the basal levels, and these reductions in

  3. 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

  4. Study of DNA Origami Dimerization and Dimer Dissociation Dynamics and of the Factors that Limit Dimerization.

    Science.gov (United States)

    Liber, Miran; Tomov, Toma E; Tsukanov, Roman; Berger, Yaron; Popov, Mary; Khara, Dinesh C; Nir, Eyal

    2018-06-01

    Organizing DNA origami building blocks into higher order structures is essential for fabrication of large structurally and functionally diverse devices and molecular machines. Unfortunately, the yields of origami building block attachment reactions are typically not sufficient to allow programed assembly of DNA devices made from more than a few origami building blocks. To investigate possible reasons for these low yields, a detailed single-molecule fluorescence study of the dynamics of rectangular origami dimerization and origami dimer dissociation reactions is conducted. Reactions kinetics and yields are investigated at different origami and ion concentrations, for different ion types, for different lengths of bridging strands, and for the "sticky end" and "weaving welding" attachment techniques. Dimerization yields are never higher than 86%, which is typical for such systems. Analysis of the dynamic data shows that the low yield cannot be explained by thermodynamic instability or structural imperfections of the origami constructs. Atomic force microscopy and gel electrophoresis evidence reveal self-dimerization of the origami monomers, likely via blunt-end interactions made possible by the presence of bridging strands. It is suggested that this mechanism is the major factor that inhibits correct dimerization and means to overcome it are discussed. © 2018 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  5. Apolipoprotein A-I Limits the Negative Effect of Tumor Necrosis Factor on Lymphangiogenesis.

    Science.gov (United States)

    Bisoendial, Radjesh; Tabet, Fatiha; Tak, Paul P; Petrides, Francine; Cuesta Torres, Luisa F; Hou, Liming; Cook, Adam; Barter, Philip J; Weninger, Wolfgang; Rye, Kerry-Anne

    2015-11-01

    Lymphatic endothelial dysfunction underlies the pathogenesis of many chronic inflammatory disorders. The proinflammatory cytokine tumor necrosis factor (TNF) is known for its role in disrupting the function of the lymphatic vasculature. This study investigates the ability of apolipoprotein (apo) A-I, the principal apolipoprotein of high-density lipoproteins, to preserve the normal function of lymphatic endothelial cells treated with TNF. TNF decreased the ability of lymphatic endothelial cells to form tube-like structures. Preincubation of lymphatic endothelial cells with apoA-I attenuated the TNF-mediated inhibition of tube formation in a concentration-dependent manner. In addition, apoA-I reversed the TNF-mediated suppression of lymphatic endothelial cell migration and lymphatic outgrowth in thoracic duct rings. ApoA-I also abrogated the negative effect of TNF on lymphatic neovascularization in an ATP-binding cassette transporter A1-dependent manner. At the molecular level, this involved downregulation of TNF receptor-1 and the conservation of prospero-related homeobox gene-1 expression, a master regulator of lymphangiogenesis. ApoA-I also re-established the normal phenotype of the lymphatic network in the diaphragms of human TNF transgenic mice. ApoA-I restores the neovascularization capacity of the lymphatic system during TNF-mediated inflammation. This study provides a proof-of-concept that high-density lipoprotein-based therapeutic strategies may attenuate chronic inflammation via its action on lymphatic vasculature. © 2015 American Heart Association, Inc.

  6. Limitations of the toxic equivalency factor (TEF) approach for risk assessment of halogenated aromatic hydrocarbons

    Energy Technology Data Exchange (ETDEWEB)

    Safe, S. [Texas A and M Univ., College Station, TX (United States). Dept. of Veterinary Physiology and Pharmacology

    1995-12-31

    2,3,7,8-Tetrachlorodibenzo-p-dioxin (TCDD) and related halogenated aromatic hydrocarbons (HAHs) are present as complex mixtures of polychlorinated dibenzo-p-dioxins (PCDDs), dibenzofurans (PCDFs) and biphenyls (PCBs) in most environmental matrices. Risk management of these mixtures utilize the toxic equivalency factor (TEF) approach in which the TCDD (dioxin) or toxic equivalents of a mixture is a summation of the congener concentration (Ci) times TEF{sub i} (potency relative to TCDD) where. TEQ{sub mixture} = {Sigma}[Cil] {times} TEF{sub i}. TEQs are determined only for those HAHs which are aryl hydrocarbon (Ah) receptor agonists and this approach assumes that the toxic or biochemical effects of individual compounds in a mixture are additive. Several in vivo and in vitro laboratory and field studies with different HAH mixtures have been utilized to validate the TEF approach. For some responses, the calculated toxicities of PCDD/PCDF and PCB mixtures predict the observed toxic potencies. However, for fetal cleft palate and immunotoxicity in mice, nonadditive (antagonistic) responses are observed using complex PCB mixtures or binary mixtures containing an Ah receptor agonist with 2,2{prime},4,4{prime},5,5{prime}-hexachlorobiphenyl (PCB153). The potential interactive effects of PCBs and other dietary Ah receptor antagonist suggest that the TEF approach for risk management of HAHs requires further refinement and should be used selectively.

  7. Photosynthetic Limitation as a Factor Influencing Yield in Highbush Blueberries (Vaccinium Corymbosum) Grown in a Northern European Environment.

    Science.gov (United States)

    Petridis, Antonios; van der Kaay, Jeroen; Chrysanthou, Elina; McCallum, Susan; Graham, Julie; Hancock, Robert D

    2018-03-24

    Published evidence indicates that nearly 60% of blueberry-producing countries experience yield instability. Yield is a complex trait determined by genetic and environmental factors. Here, using physiological and biochemical approaches, we tested the hypothesis that yield instability results from year-to-year environmental variation that limits carbon assimilation, storage and partitioning. Data indicate that fruit development depends primarily on the daily production of non-structural carbohydrates by leaves and there is no accumulation of a starch buffer to allow continuous ripening under conditions limiting for photosynthesis. Photosynthesis was saturated at moderate light irradiance and this was mainly due to stomatal and biochemical limitations. In a dynamic light environment photosynthesis was furher limited by slow stomatal response to increasing light. Finally, labelling with13CO2 at specific stages of fruit development revealed a relatively even distribution of newly assimilated carbon between stems, roots and fruits, suggesting that the fruit is not a strong sink. We conclude that a significant component of yield variability results from limitations in photosynthetic efficiency that is compounded by an inability to accumulate starch reserves in blueberry storage tissues under a typical northern European environment. This work informs techniques for improving agronomic management and indicates key traits required for yield stability in such environments.

  8. Risk factors for refractive errors in primary school children (6-12 years old) in Nakhon Pathom Province.

    Science.gov (United States)

    Yingyong, Penpimol

    2010-11-01

    Refractive error is one of the leading causes of visual impairment in children. An analysis of risk factors for refractive error is required to reduce and prevent this common eye disease. To identify the risk factors associated with refractive errors in primary school children (6-12 year old) in Nakhon Pathom province. A population-based cross-sectional analytic study was conducted between October 2008 and September 2009 in Nakhon Pathom. Refractive error, parental refractive status, and hours per week of near activities (studying, reading books, watching television, playing with video games, or working on the computer) were assessed in 377 children who participated in this study. The most common type of refractive error in primary school children was myopia. Myopic children were more likely to have parents with myopia. Children with myopia spend more time at near activities. The multivariate odds ratio (95% confidence interval)for two myopic parents was 6.37 (2.26-17.78) and for each diopter-hour per week of near work was 1.019 (1.005-1.033). Multivariate logistic regression models show no confounding effects between parental myopia and near work suggesting that each factor has an independent association with myopia. Statistical analysis by logistic regression revealed that family history of refractive error and hours of near-work were significantly associated with refractive error in primary school children.

  9. Characterization of coagulation factor synthesis in nine human primary cell types

    NARCIS (Netherlands)

    Dashty, Monireh; Akbarkhanzadeh, Vishtaseb; Zeebregts, Clark J.; Spek, C. Arnold; Sijbrands, Eric J.; Peppelenbosch, Maikel P.; Rezaee, Farhad

    2012-01-01

    The coagulation/fibrinolysis system is essential for wound healing after vascular injury. According to the standard paradigm, the synthesis of most coagulation factors is restricted to liver, platelets and endothelium. We challenged this interpretation by measuring coagulation factors in nine human

  10. Study on primary coolant system depressurization effect factor in pressurized water reactor

    International Nuclear Information System (INIS)

    Ji Duan; Cao Xuewu

    2006-01-01

    The progression of high-pressure core melting severe accident induced by very small break loss of coolant accident plus the loss of main feed water and auxiliary feed water failure is studied, and the entry condition and modes of primary cooling system depressurization during the severe accident are also estimated. The results show that the temperature below 650 degree C is preferable depressurization input temperature allowing recovery of core cooling, and the available and effective way to depressurize reactor cooling system and to arrest very small break loss of coolant accident sequences is activating pressurizer relief valves initially, then restoring the auxiliary feedwater and opening the steam generator relief valves. It can adequately reduce the primary pressure and keep the capacity loop of long-term core cooling. (authors)

  11. Psychological risk factors of micro- and macrovascular outcomes in primary care patients with type 2 diabetes

    DEFF Research Database (Denmark)

    Nefs, Giesje; Pouwer, François; Denollet, Johan

    2010-01-01

    tests and physical examinations, and pharmacy medication records. The DiaDDZoB Study uses data that have been collected during the original baseline assessment in 2005 (M0; N = 2,460) and the 2007 (M1; N = 2,225) and 2008 (M2; N = 2,032) follow-up assessments. DISCUSSION: The DiaDDZoB Study is expected......BACKGROUND: Depression is a common psychiatric complication of diabetes, but little is known about the natural course and the consequences of depressive symptoms in primary care patients with type 2 diabetes. While depression has been related to poor glycemic control and increased risk....... METHODS/DESIGN: This prospective cohort study will examine: (1) the course of depressive symptoms in primary care patients with type 2 diabetes; (2) whether depressive symptoms and Type D personality are associated with the development of microvascular and/or macrovascular complications and with the risk...

  12. Factors limiting microbial growth and activity at a proposed high-level nuclear repository, Yucca Mountain, Nevada

    International Nuclear Information System (INIS)

    Kieft, T.L.; Kovacik, W.P. Jr.; Ringelberg, D.B.; White, D.C.; Haldeman, D.L.; Amy, P.S.; Hersman, L.E.

    1997-01-01

    As part of the characterization of Yucca Mountain, Nev., as a potential repository for high-level nuclear waste, volcanic tuff was analyzed for microbial abundance and activity. Tuff was collected aseptically from nine sites along a tunnel in Yucca Mountain. Microbial abundance was generally low: direct microscopic cell counts were near detection limits at all sites (3.2 X 10(1) to 2.0 X 10(5) cells g-1 [dry weight]); plate counts of aerobic heterotrophs ranged from 1.0 X 10(1) to 3.2 X 10(3) CFU g-1 (dry weight). Phospholipid fatty acid concentrations (0.1 to 3.7 pmol g-1) also indicated low microbial biomasses: diglyceride fatty acid concentrations, indicative of dead cells, were in a similar range (0.2 to 2.3 pmol g-1). Potential microbial activity was quantified as 14CO2 production in microcosms containing radiolabeled substrates (glucose, acetate, and glutamic acid); amendments with water and nutrient solutions (N and P) were used to test factors potentially limiting this activity. Similarly, the potential for microbial growth and the factors limiting growth were determined by performing plate counts before and after incubating volcanic tuff samples for 24 h under various conditions: ambient moisture, water-amended, and amended with various nutrient solutions (N, P, and organic C). A high potential for microbial activity was demonstrated by high rates of substrate mineralization (as much as 70% of added organic C in 3 weeks). Water was the major limiting factor to growth and microbial activity, while amendments with N and P resulted in little further stimulation. Organic C amendments stimulated growth more than water alone

  13. Burnout and its Influencing Factors among Primary Health Care Providers in the North East of Iran.

    Science.gov (United States)

    Amiri, Mohammad; Khosravi, Ahmad; Eghtesadi, Ahmad Reza; Sadeghi, Zakieh; Abedi, Ghasem; Ranjbar, Mansour; Mehrabian, Fardin

    2016-01-01

    Burnout is a popular research topics in service providing jobs, including the health care field. This study aimed at assessing the level of job burnout and to consider the important antecedents which might be related to job burnout among primary health care providers in Iran. The participants in this applied cross-sectional study which was conducted in 2013 were 548 primary health care providers who were randomly selected from among those working in Shahroud, Sabzevar, Neishabour, Bojnord (provinces located in the north east of Iran). Maslach Burnout Inventory (MBI) was administered to the participants and the collected data were analyzed using SPSS through chi-square test and ordinal logistic regression model. The burnout mean score among the participants was 54.1 ± 27.2 and the mean scores of burnout components i.e., emotional exhaustion, depersonalization and personal accomplishment were 15.5 ± 13.6, 3.7 ± 5.4 and 35.5 ± 13.5 respectively. In terms of levels of burnout, 64.2% of the participants showed low levels (n = 352), 18.4% average levels (n = 101) and 17.3% high levels (n = 95). A significant relationship was observed between burnout, job resources and interest in job (p ≤ 0.05). However, no significant relationship was observed between burnout and the place (university) of working, age, satisfaction with income, experience, gender, level of education, marital status, housing status, having a second job and place of residence (p ≥0.05). Lack of personal accomplishment was highly prevalent among the participating primary health care providers. Lack of career advancement and job transfer opportunities may play a role in the burnout of primary health care providers. Therefore, paying attention to this aspect may help to reduce burnout and even increase job engagement.

  14. Burnout and its Influencing Factors among Primary Health Care Providers in the North East of Iran.

    Directory of Open Access Journals (Sweden)

    Mohammad Amiri

    Full Text Available Burnout is a popular research topics in service providing jobs, including the health care field. This study aimed at assessing the level of job burnout and to consider the important antecedents which might be related to job burnout among primary health care providers in Iran.The participants in this applied cross-sectional study which was conducted in 2013 were 548 primary health care providers who were randomly selected from among those working in Shahroud, Sabzevar, Neishabour, Bojnord (provinces located in the north east of Iran. Maslach Burnout Inventory (MBI was administered to the participants and the collected data were analyzed using SPSS through chi-square test and ordinal logistic regression model.The burnout mean score among the participants was 54.1 ± 27.2 and the mean scores of burnout components i.e., emotional exhaustion, depersonalization and personal accomplishment were 15.5 ± 13.6, 3.7 ± 5.4 and 35.5 ± 13.5 respectively. In terms of levels of burnout, 64.2% of the participants showed low levels (n = 352, 18.4% average levels (n = 101 and 17.3% high levels (n = 95. A significant relationship was observed between burnout, job resources and interest in job (p ≤ 0.05. However, no significant relationship was observed between burnout and the place (university of working, age, satisfaction with income, experience, gender, level of education, marital status, housing status, having a second job and place of residence (p ≥0.05.Lack of personal accomplishment was highly prevalent among the participating primary health care providers. Lack of career advancement and job transfer opportunities may play a role in the burnout of primary health care providers. Therefore, paying attention to this aspect may help to reduce burnout and even increase job engagement.

  15. Lack of awareness of risk factors for primary toxoplasmosis in pregnancy.

    LENUS (Irish Health Repository)

    Ferguson, W

    2011-12-01

    The overall seroprevalence of toxoplasma antibodies in women of childbearing age in Ireland is 25% [1]. Hence, 75% of women remain susceptible to primary toxoplasma infection during pregnancy, which if transmitted to the foetus can cause ocular, neurological and other sequelae. Toxoplasma exposure during pregnancy can be avoided if there is an awareness of the potential sources of infection, mainly contaminated food, water, soil and cat faeces.

  16. Prevalence of Behavioral Disorders and Its Associated Factors in Hamadan Primary School Students

    Directory of Open Access Journals (Sweden)

    F. Jalilian

    2013-01-01

    Full Text Available Introduction & Objective: Studies have shown the high prevalence rate of behavioral disorders in primary school students, which may underlie many complications and problems for the students and their families. The aim of this study was to determine the prevalence of behav-ioral disorders among primary school students. Materials & Methods: This is a cross sectional-descriptive study which have been done on 352 primary school students in Hamadan. Samples have been selected based on a multistage ran-dom sampling and Rutter behavioral disorder questionnaire (teacher form was used for data collection. The data were analyzed by SPSS version 20 using chi-square. Results: Our result showed that 16.1% of the participants suffered from behavioral disorders. The prevalence was more among the boys. Father's education and occupation, history of mental illness, parental divorce, and death of parents had significant relationships with the prevalence of behavioral disorders in these students. Conclusion: According to the results, designing and implementing educational programs for the prevention and treatment of student's behavioral disorders appear to be essential.(Sci J Hamadan Univ Med Sci 2013; 19 (4:62-68

  17. Primary particles and their agglomerate formation as modifying risk factors of nonfibrous nanosized dust.

    Science.gov (United States)

    Schneider, J; Walter, D; Brückel, B; Rödelsperger, K

    2013-01-01

    The incidence of certain cancers correlates with the number of dust particles in the air. Nanosized particles differ from coarser particles by their increasing tendency to form agglomerates. The dissociation of biodurable agglomerates after deposition in the alveolar region resulted in a higher toxic potential. Biodurable dusts in the urban and workplace environment were analyzed to determine an effect-relevant exposure parameter. The characterization of the dusts relating to their number of primary particles (P(p)) and agglomerates and aggregates (A + A) was performed by electron microscopy. Diesel soot, toner material, and seven further dust samples in the workplace environment are composed of high numbers of nanosized primary particles (agglomerates. Primary particles of rock, kaoline, and seven further dusts sampled in the workplace are not nanosized. In a multivariate analysis that predicted lung tumor risk, the mass, volume, and numbers of A + A and P(p) per milligram dust were shown to be relevant parameters. Dose-response relationships revealed an increased tumor risk in rats with higher numbers of P(p) in nanosized dust, which occurs unintentionally in the environment.

  18. Physical Activity on Prescription (PAP), in patients with metabolic risk factors. A 6-month follow-up study in primary health care.

    Science.gov (United States)

    Lundqvist, Stefan; Börjesson, Mats; Larsson, Maria E H; Hagberg, Lars; Cider, Åsa

    2017-01-01

    There is strong evidence that inadequate physical activity (PA) leads to an increased risk of lifestyle-related diseases and premature mortality. Physical activity on prescription (PAP) is a method to increase the level of PA of patients in primary care, but needs further evaluation. The aim of this observational study was to explore the association between PAP-treatment and the PA level of patients with metabolic risk factors and the relationship between changes in the PA level and health outcomes at the 6 month follow-up. This study included 444 patients in primary care, aged 27-85 years (56% females), who were physically inactive with at least one component of metabolic syndrome. The PAP-treatment model included: individualized di