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  1. Medical treatment of primary, secondary, and tertiary hyperparathyroidism.

    Science.gov (United States)

    Vestergaard, Peter; Thomsen, Susanna vid Strym

    2011-04-01

    Hyperparathyroidism is a condition with elevated parathyroid hormone (PTH). The increase may be due to a) primary hyperparathyroidism which is caused by adenoma of one or more parathyroid glands or hyperplasia of all four glands, b) secondary hyperparathyroidism, which may be caused by deficiency in vitamin D or uremia, and 3) tertiary hyperparathyroidism, which most often is the result of a long-standing, severe secondary hyperparathyroidism, which has turned autonomous once the cause of the secondary hyperparathyroidism has been removed. Many new treatment options have been introduced in recent years. Cinacalcet is calcium sensing receptor agonist, which by stimulating the receptor decreases PTH and calcium levels. It may be used in primary hyperparathyroidism, secondary hyperparathyroidism caused by uremia, which may not be controlled with calcium and activated vitamin D. It may also be used in tertiary hyperparathyroidism. Newer analogues of vitamin D such as paricalcitol have also been introduced, which may have an advantage over traditional compounds such as alphacalcidol and calcitriol.

  2. Corot 310266512: A Light Curve With Primary, Secondary And Tertiary Eclipses

    Directory of Open Access Journals (Sweden)

    Fernández Fernández Javier

    2015-01-01

    Full Text Available We present the photometric study of an interesting target in the CoRoT exoplanet database: CoRoT 310266512. Its light curve shows primary, secondary and tertiary eclipses that suggests the presence of at least three celestial bodies. The primary and secondary eclipses have the same orbital period, 7.42 days, and the tertiary eclipse has an orbital period of 3.27 days. Two of the tertiary eclipses fall within a primary eclipse and a secondary eclipse. The properties of the light curve indicate the presence of two physically separated systems. The primary and secondary eclipses corresponds to a binary system (System I. The tertiary eclipses correspond to a star-planet system or a star-dwarf system (System II. Some parameters of these two systems are obtained from JKTEBOP [1] program.

  3. The use of tribromoisocyanuric acid to distinguish among primary, secondary and tertiary alcohols

    Energy Technology Data Exchange (ETDEWEB)

    Crespo, Livia T.C., E-mail: livia.vilela@ifrj.edu.br [Universidade Federal do Rio de Janeiro (UFRJ), RJ (Brazil). Instituto de Quimica. Departamento de Quimica Organica; Instituto Federal de Educacao, Ciencia e Tecnologia do Rio de Janeiro (IF-RJ), Duque de Caxias, RJ (Brazil); Mattos, Marcio C.S. de; Esteves, Pierre M. [Universidade Federal do Rio de Janeiro (UFRJ), RJ (Brazil). Instituto de Quimica. Departamento de Quimica Organica

    2013-09-01

    Primary, secondary and tertiary alcohols can be easily distinguished due to their reactivity towards tribromoisocyanuric acid (TBCA). The test is performed by adding TBCA to the alcohol in a test tube heated in a boiling water bath. Orange color develops in the tube containing the primary alcohol, light yellow is observed in the tube containing the secondary alcohol while the tertiary alcohol results in a colorless mixture. (author)

  4. The use of tribromoisocyanuric acid to distinguish among primary, secondary and tertiary alcohols

    International Nuclear Information System (INIS)

    Crespo, Livia T.C.; Mattos, Marcio C.S. de; Esteves, Pierre M.

    2013-01-01

    Primary, secondary and tertiary alcohols can be easily distinguished due to their reactivity towards tribromoisocyanuric acid (TBCA). The test is performed by adding TBCA to the alcohol in a test tube heated in a boiling water bath. Orange color develops in the tube containing the primary alcohol, light yellow is observed in the tube containing the secondary alcohol while the tertiary alcohol results in a colorless mixture. (author)

  5. The use of tribromoisocyanuric acid to distinguish among primary, secondary and tertiary alcohols

    Directory of Open Access Journals (Sweden)

    Lívia T. C. Crespo

    2013-01-01

    Full Text Available Primary, secondary and tertiary alcohols can be easily distinguished due to their reactivity towards tribromoisocyanuric acid (TBCA. The test is performed by adding TBCA to the alcohol in a test tube heated in a boiling water bath. Orange color develops in the tube containing the primary alcohol, light yellow is observed in the tube containing the secondary alcohol while the tertiary alcohol results in a colorless mixture.

  6. Medical treatment of primary, secondary, and tertiary hyperparathyroidism

    DEFF Research Database (Denmark)

    Vestergaard, Peter; við Streym, Susanna

    2011-01-01

    years. Cinacalcet is calcium sensing receptor agonist, which by stimulating the receptor decreases PTH and calcium levels. It may be used in primary hyperparathyroidism, secondary hyperparathyroidism caused by uremia, which may not be controlled with calcium and activated vitamin D. It may also be used...

  7. Effects of Primary, Secondary and Tertiary Education on Conflict Intensity in Africa

    Directory of Open Access Journals (Sweden)

    Julius A. Agbor

    2015-10-01

    Full Text Available This study investigates the impact of different schooling dimensions (primary, secondary and tertiary on the intensity of intra-state conflicts in 25 African states during the period 1989–2008. It uses fixed-effects and Generalized Methods of Moments (GMM estimators in an annualized panel data framework. Parameter estimates suggest the following (1 primary schooling broadly mitigates conflicts in Africa. However, in environments with high natural resource rents, it could ignite conflicts; (2 there is evidence, although not overwhelming, that secondary schooling potentially drives conflicts in Africa. There is also evidence that urbanization potentially drives conflicts in Africa. However, although secondary schooling and urbanization potentially drives conflicts, in environments where secondary schooling (urbanization is high, urbanization (secondary schooling mitigates conflicts; (3 there is no evidence of a strong direct positive impact of tertiary education on conflicts and conditioning on tertiary schooling, income inequality potentially drives conflicts in African states. However, in contexts where income inequality (tertiary schooling is high, tertiary schooling (inequality mitigates conflict. Two important policy implications follow from this study. First, in contexts where income inequality is high (for instance, in South Africa, governments should strive to foster tertiary education in order to reduce conflict. Second, where urbanization rates are high, they should foster both secondary and tertiary education. This study contributes to existing knowledge by clearly demonstrating the utility of distinguishing between different educational dimensions and the contexts wherein they matter for conflict mitigation in Africa.

  8. Peracetic acid (PAA) disinfection of primary, secondary and tertiary treated municipal wastewaters.

    Science.gov (United States)

    Koivunen, J; Heinonen-Tanski, H

    2005-11-01

    The efficiency of peracetic acid (PAA) disinfection against enteric bacteria and viruses in municipal wastewaters was studied in pilot-scale. Disinfection pilot-plant was fed with the primary or secondary effluent of Kuopio municipal wastewater treatment plant or tertiary effluent from the pilot-scale dissolved air flotation (DAF) unit. Disinfectant doses ranged from 2 to 7 mg/l PAA in the secondary and tertiary effluents, and from 5 to 15 mg/l PAA in the primary effluents. Disinfection contact times were 4-27 min. Disinfection of secondary and tertiary effluents with 2-7 mg/l PAA and 27 min contact time achieved around 3 log reductions of total coliforms (TC) and enterococci (EC). PAA disinfection also significantly improved the hygienic quality of the primary effluents: 10-15 mg/l PAA achieved 3-4 log reductions of TC and EC, 5 mg/l PAA resulting in below 2 log reductions. F-RNA coliphages were more resistant against the PAA disinfection and around 1 log reductions of these enteric viruses were typically achieved in the disinfection treatments of the primary, secondary and tertiary effluents. Most of the microbial reductions occurred during the first 4-18 min of contact time, depending on the PAA dose and microorganism. The PAA disinfection efficiency remained relatively constant in the secondary and tertiary effluents, despite of small changes of wastewater quality (COD, SS, turbidity, 253.7 nm transmittance) or temperature. The disinfection efficiency clearly decreased in the primary effluents with substantially higher microbial, organic matter and suspended solids concentrations. The results demonstrated that PAA could be a good alternative disinfection method for elimination of enteric microbes from different wastewaters.

  9. Variant selection of primary, secondary and tertiary twins in a deformed Mg alloy

    International Nuclear Information System (INIS)

    Mu, Sijia; Jonas, John J.; Gottstein, Günter

    2012-01-01

    Samples of magnesium alloy AZ31 were deformed in plane strain compression in a channel die at 100 °C and a strain rate of 5 × 10 −3 s −1 . The initial texture was favorably oriented for extension twinning. At a true strain of ε = −0.11, many primary extension twins were observed to consume their parent grains completely. Furthermore, numerous secondary contraction twins formed within the primary extension twins and some tertiary extension twins grew within the secondary contraction twins. The orientations of the parent grains and all three generations of twins were measured. The twin variants selected during each of the three stages of twinning were determined by electron backscatter diffraction techniques and the absent potential twin variants were also identified. The way in which the selected primary extension twins grow so as to consume the parent grains and contact all the neighboring grains is explained in terms of the accommodation strains imposed on the neighboring grains. The analysis shows that the primary twin selected is not necessarily the variant with the highest Schmid factor but the one that requires the least accommodation work in most of the neighboring grains. The same principle was found to hold for the secondary and tertiary twins. By contrast, potential high Schmid factor twins that required the consumption of appreciable accommodation energy did not form. A Taylor simulation produced similar results and indicates that the accommodation strain concept is consistent with the principle of the minimization of plastic work.

  10. Primary versus secondary hypertension in children followed up at an outpatient tertiary unit.

    Science.gov (United States)

    Gomes, Romina S; Quirino, Isabel G; Pereira, Regina M; Vitor, Breno M; Leite, Alysson F; Oliveira, Eduardo A; Simões e Silva, Ana Cristina

    2011-03-01

    Childhood hypertension has classically been recognized as a secondary disease. However, primary hypertension also occurs in children. The aim of this study was to compare clinical features of pediatric patients with elevated blood pressure, which were referred to an outpatient tertiary unit, and to detect variables associated with the identification of primary hypertension. The records of 220 patients with hypertension followed between 1996 and 2006 were analyzed. The variable of interest was primary hypertension. Logistic regression analysis was applied to identify clinical variables that were independently associated with primary hypertension. Of 220 patients, 33 (15%) had primary hypertension, and 187 (85%) exhibited secondary hypertension. No statistically significant differences were detected in gender, race, age at diagnosis, and systolic/diastolic blood pressure levels between both groups. After adjustment, four variables at baseline remained independently associated with primary hypertension: absence of signs/symptoms (OR 18.87, 95% CI 6.32-56.29), normal serum creatinine (OR 0.02, 95% CI 0.00-0.27), family history of hypertension (OR 3.03, 95% CI 1.04-8.79), and elevated body weight (OR 1.06, 95% CI 1.02-1.10). The absence of signs/symptoms, normal serum creatinine, family history of hypertension, and overweight/obesity at admission are clues to diagnose primary hypertension in childhood.

  11. Challenges and opportunities for primary, secondary, and tertiary prevention of Chagas' disease.

    Science.gov (United States)

    Rassi, A; Dias, J C P; Marin-Neto, J A; Rassi, A

    2009-04-01

    A century after its discovery, Chagas' disease still represents a major public health challenge in Latin America. Moreover, because of growing population movements, an increasing number of cases of imported Chagas' disease have now been detected in non-endemic areas, such as North America and some European countries. This parasitic zoonosis, caused by Trypanosoma cruzi, is transmitted to humans by infected Triatominae insects, or occasionally by non-vectorial mechanisms, such as blood transfusion, mother to fetus, or oral ingestion of materials contaminated with parasites. Following the acute phase of the infection, untreated individuals enter a chronic phase that is initially asymptomatic or clinically unapparent. Usually, a few decades later, 40-50% of patients develop progressive cardiomyopathy and/or motility disturbances of the oesophagus and colon. In the last decades several interventions targeting primary, secondary and tertiary prevention of Chagas' disease have been attempted. While control of both vectorial and blood transfusion transmission of T cruzi (primary prevention) has been successful in many regions of Latin America, early detection and aetiological treatment of asymptomatic subjects with Chagas' disease (secondary prevention) have been largely underutilised. At the same time, in patients with established chronic disease, several pharmacological and non-pharmacological interventions are currently available and have been increasingly used with the intention of preventing or delaying complications of the disease (tertiary prevention). In this review we discuss in detail each of these issues.

  12. Treatment of Type 2 Diabetes Mellitus in a Primary Care Setting in Taiwan: Comparison with Secondary/Tertiary Care

    Directory of Open Access Journals (Sweden)

    Tong-Yuan Tai

    2006-01-01

    Conclusion: Diabetes control was poorer in primary care than in secondary/tertiary care patients, but control of blood pressure was better in primary care patients. The shorter duration of diabetes and better control of blood pressure in primary care patients and in patients aged < 65 years compared with their elderly counterparts might be related to a lower prevalence of complications.

  13. Secondary and tertiary hyperparathyroidism.

    Science.gov (United States)

    Jamal, Sophie A; Miller, Paul D

    2013-01-01

    We reviewed the etiology and management of secondary and tertiary hyperparathyroidism. Secondary hyperparathyroidism is characterized by an increase in parathyroid hormone (PTH) that is appropriate and in response to a stimulus, most commonly low serum calcium. In secondary hyperparathyroidism, the serum calcium is normal and the PTH level is elevated. Tertiary hyperparathyroidism is characterized by excessive secretion of PTH after longstanding secondary hyperparathyroidism, in which hypercalcemia has ensued. Tertiary hyperparathyroidism typically occurs in men and women with chronic kidney disease usually after kidney transplant. The etiology and treatment of secondary hyperparathyroidism is relatively straightforward whereas data on the management of tertiary hyperparathyroidism is limited to a few small trials with short follow-up. Copyright © 2013 The International Society for Clinical Densitometry. Published by Elsevier Inc. All rights reserved.

  14. Equilibrium and Transport Properties of Primary, Secondary and Tertiary Amines by Molecular Simulation

    International Nuclear Information System (INIS)

    Orozco, Gustavo A.; Nieto-Draghi, Carlos; Lachet, Veronique; Mackie, Allan D.

    2014-01-01

    Using molecular simulation techniques such as Monte Carlo (MC) and molecular dynamics (MD), we present several simulation results of thermodynamic and transport properties for primary, secondary and tertiary amines. These calculations are based on a recently proposed force field for amines that follows the Anisotropic United Atom approach (AUA). Different amine molecules have been studied, including n-Butylamine, di-n-Butylamine, tri-n-Butylamine and 1,4-Butanediamine for primary, secondary, tertiary and multi-functional amines respectively. For the transport properties, we have calculated the viscosity coefficients as a function of temperature using the isothermal-isobaric (NPT) ensemble. In the case of the pure components, we have investigated different thermodynamic properties using NVT Gibbs ensemble simulations such as liquid-vapor phase equilibrium diagrams, vaporization enthalpies, vapor pressures, normal boiling points, critical temperatures and critical densities. We have also calculated the excess enthalpies for water-n-Butylamine and n-heptane-n-Butylamine mixtures using Monte Carlo simulations in the NPT ensemble. In addition, we present the calculation of liquid-vapor surface tensions of n-Butylamine using a two-phase NVT simulation as well as the radial distribution functions. Finally, we have investigated the physical Henry constants of nitrous oxide (N 2 O) and nitrogen (N 2 ) in an aqueous solutions of n-Butylamine. In general, we found a good agreement between the available experimental information and our simulation results for all the studied properties, ratifying the predictive capability of the AUA force field for amines. (authors)

  15. Human norovirus in untreated sewage and effluents from primary, secondary and tertiary treatment processes.

    Science.gov (United States)

    Campos, Carlos J A; Avant, Justin; Lowther, James; Till, Dale; Lees, David N

    2016-10-15

    Wastewater treatments are considered important means to control the environmental transmission of human norovirus (NoV). Information about NoV concentrations in untreated and treated effluents, their seasonality and typical removal rates achieved by different treatment processes is required to assess the effectiveness of sewage treatment processes in reducing human exposure to NoV. This paper reports on a characterisation of concentrations of NoV (genogroups I and II) in untreated sewage (screened influent) and treated effluents from five full scale wastewater treatment works (WwTW) in England. Results are shown for effluent samples characteristic of primary- (primary settlement, storm tank overflows), secondary- (activated sludge, trickling filters, humus tanks) and tertiary (UV disinfection) treatments. NoV occurrence in untreated sewage varied between years. This variation was consistent with the annual variation of the virus in the community as indicated by outbreak laboratory reports. Significant differences were found between mean NoV concentrations in effluents subject to different levels of treatment. Primary settlement achieved approximately 1 log10 removal for both genogroups. Concentrations of NoV and Escherichia coli in untreated sewage were of the same order of magnitude of those in storm tank overflows. Of the secondary treatments studied, activated sludge was the most effective in removing NoV with mean log10 removals of 3.11 and 2.34 for GI and GII, respectively. The results of this study provide evidence that monitoring of NoV in raw sewage or treated effluents could provide early warning of an elevated risk for NoV and potentially help prevent outbreaks through environmental exposure. They also provide evidence that elimination of stormwater discharges and improvement of the efficiency of activated sludge for NoV removal would be effective for reducing the risk of environmental transmission. Crown Copyright © 2016. Published by Elsevier Ltd. All

  16. Comparison of scintigraphy and ultrasound imaging in patients with primary, secondary and tertiary hyperparathyroidism – own experience

    Directory of Open Access Journals (Sweden)

    Małgorzata Kobylecka

    2017-03-01

    Full Text Available Background: The imaging techniques most commonly used in the diagnosis of hyperparathyroidisms are ultrasound and scintigraphy. The diagnostic algorithms vary, depending mainly on the population, and experience of physicians. Aim: Aim of the present research was to determine the usefulness of parathyroid scintigraphy and ultrasonography in patients diagnosed for hyperparathyroidism in own material. Material and method: In the present research, 96 operated patients with documented primary, secondary and tertiary hyperparathyroidism were retrospectively analyzed. All patients underwent a 99mTc hexakis- 2-methoxyisobutylisonitrile scintigraphy of the neck with the use of subtraction and twophase examinations. Ultrasonography of the neck was performed in all the patients in B mode 2D presentation. A total number of 172 parathyroid glands were analyzed. Results: The sensitivity and specificity of scintigraphy was 68% and 60%, respectively. The sensitivity of ultrasound was 49% and specificity 85%. Both techniques allowed visualization of 76 parathyroid glands. Ultrasound revealed 19 glands that were not visible in scintigraphy. Scintigraphy showed 76 parathyroid glands that were not visualized on ultrasound. Having combined the results of scintigraphy and ultrasound, the sensitivity of 76% and specificity of 50% were obtained. Considering the ability to locate the parathyroid glands in both techniques as a positive result, the sensitivity decreased to 37% and specificity rose to 95%. Conclusions: Scintigraphy showed greater sensitivity than ultrasound in the localization of enlarged parathyroid glands. Ultrasound, in turn, was characterized by a higher specificity. The combined use of scintigraphy and ultrasonography allowed to obtain the specificity of 95%. In the light of obtained results, scintigraphy and ultrasonography are complementary and should be used together.

  17. Bladder and bowel dysfunctions in 1748 children referred to pelvic physiotherapy: clinical characteristics and locomotor problems in primary, secondary, and tertiary healthcare settings.

    Science.gov (United States)

    van Engelenburg-van Lonkhuyzen, Marieke L; Bols, Esther M J; Benninga, Marc A; Verwijs, Wim A; de Bie, Rob A

    2017-02-01

    The aims of this study are to evaluate in a pragmatic cross-sectional study, the clinical characteristics of childhood bladder and/or bowel dysfunctions (CBBD) and locomotor problems in the primary through tertiary health care setting. It was hypothesized that problems would increase, going from primary to tertiary healthcare. Data were retrieved from patient-records of children (1-16 years) presenting with CBBD and visiting pelvic physiotherapists. Prevalence's of dysfunctions were compared between healthcare settings and gender using ANOVA and chi-square test. Agreement between physicians' diagnoses and parent-reported symptoms was evaluated (Cohen's Kappa). One thousand seventy hundred forty-eight children (mean age 7.7 years [SD 2.9], 48.9% boys) were included. Daytime urinary incontinence (P = 0.039) and enuresis (P physiotherapy are comparable in primary, secondary, and tertiary healthcare settings. • Concomitant CBBD appeared to be more prevalent than earlier reported. • Discrepancies exist between referring physicians' diagnoses and parent-reported symptoms.

  18. Highly Chemoselective Reduction of Amides (Primary, Secondary, Tertiary) to Alcohols using SmI2/Amine/H2O under Mild Conditions

    Science.gov (United States)

    2014-01-01

    Highly chemoselective direct reduction of primary, secondary, and tertiary amides to alcohols using SmI2/amine/H2O is reported. The reaction proceeds with C–N bond cleavage in the carbinolamine intermediate, shows excellent functional group tolerance, and delivers the alcohol products in very high yields. The expected C–O cleavage products are not formed under the reaction conditions. The observed reactivity is opposite to the electrophilicity of polar carbonyl groups resulting from the nX → π*C=O (X = O, N) conjugation. Mechanistic studies suggest that coordination of Sm to the carbonyl and then to Lewis basic nitrogen in the tetrahedral intermediate facilitate electron transfer and control the selectivity of the C–N/C–O cleavage. Notably, the method provides direct access to acyl-type radicals from unactivated amides under mild electron transfer conditions. PMID:24460078

  19. Promoting School Success for Lesbian, Gay, Bisexual, Transgendered, and Questioning Students: Primary, Secondary, and Tertiary Prevention and Intervention Strategies

    Science.gov (United States)

    Fisher, Emily S.; Komosa-Hawkins, Karen; Saldana, Enrique; Thomas, Genevieve M.; Hsiao, Cyndi; Rauld, Michelle; Miller, Dorian

    2008-01-01

    Lesbian, gay, bisexual, transgendered, and questioning (LGBTQ) students are likely to be in every classroom in every secondary school in the United States; yet, their needs are often overlooked. LGBTQ students are at risk for developing academic, social, and emotional problems due to harassment and bullying experienced at school. Although schools…

  20. Increased oil recovery: secondary and tertiary. Application and future prospect

    Energy Technology Data Exchange (ETDEWEB)

    Whiting, R L

    1978-01-01

    Oil is initially produced using the nature reservoir pressure present, in a process called primary oil recovery. Secondary recovery uses artificial means to increase the natural reservoir pressure; tertiary, or enhanced oil recovery, uses a number of methods to enhance the flow characteristics of the oil. The scope for such techniques to increase the yield from oil fields in the US is estimated; the practicality of their application is shown to be particularly dependent upon pricing, taxation, and other existing policies. 16 references.

  1. [Primary and secondary encopresis].

    Science.gov (United States)

    Lang-Langer, Ellen

    2007-01-01

    While the difficulty of the child to part with its faeces in primary encopresis is linked to the incapability to experience the object as separated and independent from himself, secondary encopresis is a progressed psychical state of development. In this case we have to deal with regression caused by conflict. Two case-studies show clearly the differences.

  2. Utility of an intraoperabive gamma probe in the surgical management of secondary or tertiary hyperparathyroidism

    NARCIS (Netherlands)

    Jorna, Francisca H.; Jager, Pieter L.; Lemstra, Clara; Wiggers, Theo; Stegeman, Coen A.; Plukker, John T. M.

    BACKGROUND: In primary hyperparathyroidism the gamma probe is effective, but its role in secondary hyperparathyroidism is unclear. We investigated the utility of the probe in the surgical management of secondary and tertiary hyperparathyroidism. METHODS: The value of the probe in guiding resection

  3. Interactions to the fifth trophic level: secondary and tertiary parasitoid wasps show extraordinary efficiency in utilizing host resources

    NARCIS (Netherlands)

    Harvey, J.A.; Wagenaar, R.; Bezemer, T.M.

    2009-01-01

    1. Parasitoid wasps are highly efficient organisms at utilizing and assimilating limited resources from their hosts. This study explores interactions over three trophic levels, from the third (primary parasitoid) to the fourth (secondary parasitoid) and terminating in the fifth (tertiary

  4. Secondary and Tertiary Hyperparathyroidism, State of the Art Surgical Management

    Science.gov (United States)

    Pitt, Susan C.; Sippel, Rebecca S.

    2010-01-01

    Synopsis This article reviews the current surgical management of patients with secondary and tertiary hyperparathyroidism. The focus is on innovative surgical strategies that have improved the care of these patients over the past 10 to 15 years. Modalities such as intraoperative parathyroid hormone monitoring and radioguided probe utilization are discussed. PMID:19836494

  5. Chemoselective organocatalytic aerobic oxidation of primary amines to secondary imines.

    Science.gov (United States)

    Wendlandt, Alison E; Stahl, Shannon S

    2012-06-01

    Biomimetic aerobic oxidation of primary benzylic amines has been achieved by using a quinone catalyst. Excellent selectivity is observed for primary, unbranched benzylic amines relative to secondary/tertiary amines, branched benzylic amines, and aliphatic amines. The exquisite selectivity for benzylic amines enables oxidative self-sorting within dynamic mixtures of amines and imines to afford high yields of cross-coupled imine products.

  6. Summarizing primary and secondary effects

    DEFF Research Database (Denmark)

    Karlson, Kristian Bernt

    2013-01-01

    Current methods for decomposing class differentials in educational decisions into primary and secondary effects produce many parameters, rendering them ill-equipped for parsimonious comparisons across countries or birth cohorts. This paper develops a parametric method that provides an optimal...... summary of primary and secondary effects across discrete class origins. Under the testable assumption that the pattern of effects of class origins on academic ability is proportional to the pattern of effects of class origins on educational choice net of academic ability, the method returns a single...

  7. Primary versus secondary achalasia: New signs on barium esophagogram

    Science.gov (United States)

    Gupta, Pankaj; Debi, Uma; Sinha, Saroj Kant; Prasad, Kaushal Kishor

    2015-01-01

    Aim: To investigate new signs on barium swallow that can differentiate primary from secondary achalasia. Materials and Methods: Records of 30 patients with primary achalasia and 17 patients with secondary achalasia were reviewed. Clinical, endoscopic, and manometric data was recorded. Barium esophagograms were evaluated for peristalsis and morphology of distal esophageal segment (length, symmetry, nodularity, shouldering, filling defects, and “tram-track sign”). Results: Mean age at presentation was 39 years in primary achalasia and 49 years in secondary achalasia. The mean duration of symptoms was 3.5 years in primary achalasia and 3 months in secondary achalasia. False-negative endoscopic results were noted in the first instance in five patients. In the secondary achalasia group, five patients had distal esophageal segment morphology indistinguishable from that of primary achalasia. None of the patients with primary achalasia and 35% patients with secondary achalasia had a length of the distal segment approaching combined height of two vertebral bodies. None of the patients with secondary achalasia and 34% patients with primary achalasia had maximum caliber of esophagus approaching combined height of two vertebral bodies. Tertiary contractions were noted in 90% patients with primary achalasia and 24% patients with secondary achalasia. Tram-track sign was found in 55% patients with primary achalasia. Filling defects in the distal esophageal segment were noted in 94% patients with secondary achalasia. Conclusion: Length of distal esophageal segment, tertiary contractions, tram-track sign, and filling defects in distal esophageal segment are useful esophagographic features distinguishing primary from secondary achalasia. PMID:26288525

  8. Secondary and tertiary hyperparathyroidism in chronic kidney disease

    Directory of Open Access Journals (Sweden)

    Lilit V. Egshatyan

    2017-12-01

    Full Text Available In the treatment of secondary hyperparathyroidism of end-stage chronic kidney disease, vitamin D receptor activation and allosteric modulators of the calcium-sensing receptor – inhibit glandular hyperplasia, reduce parathyroid hormone levels, impact on bone turnover and mineral density. But the use of calcimimetic and vitamin D analogs or mimetics did not reduce the need for parathyroidectomy for refractory hyperparathyroidism. The enlarged parathyroid gland and gland nodular transformation became refractory to medical therapy and patient need for parathyroidectomy. Tertiary hyperparathyroidism is a state of excessive secretion of parathyroid hormone after a long period of secondary hyperparathyroidism and renal transplantation. In this article, we present the case of a Caucasian male with chronic kidney disease (end-stage on chronic hemodialysis and after kidney transplantation and different forms of hyperparathyroidism (secondary and tertiary. Our case study shows that only a multi-interventional strategy is likely to be more effective treatment in cases of severe and refractory to medical therapy hyperparathyroidism.

  9. Cryptosporidium and Giardia removal by secondary and tertiary wastewater treatment.

    Science.gov (United States)

    Taran-Benshoshan, Marina; Ofer, Naomi; Dalit, Vaizel-Ohayon; Aharoni, Avi; Revhun, Menahem; Nitzan, Yeshayahu; Nasser, Abidelfatah M

    2015-01-01

    Wastewater disposal may be a source of environmental contamination by Cryptosporidium and Giardia. This study was conducted to evaluate the prevalence of Cryptosporidium oocysts and Giardia cysts in raw and treated wastewater effluents. A prevalence of 100% was demonstrated for Giardia cysts in raw wastewater, at a concentration range of 10 to 12,225 cysts L(-1), whereas the concentration of Cryptosporidium oocysts in raw wastewater was 4 to 125 oocysts L(-1). The removal of Giardia cysts by secondary and tertiary treatment processes was greater than those observed for Cryptosporidium oocysts and turbidity. Cryptosporidium and Giardia were present in 68.5% and 76% of the tertiary effluent samples, respectively, at an average concentration of 0.93 cysts L(-1) and 9.94 oocysts L(-1). A higher detection limit of Cryptosporidium oocysts in wastewater was observed for nested PCR as compared to immune fluorescent assay (IFA). C. hominis was found to be the dominant genotype in wastewater effluents followed by C. parvum and C. andersoni or C. muris. Giardia was more prevalent than Cryptosporidium in the studied community and treatment processes were more efficient for the removal of Giardia than Cryptosporidium. Zoonotic genotypes of Cryptosporidium were also present in the human community. To assess the public health significance of Cryptosporidium oocysts present in tertiary effluent, viability (infectivity) needs to be assessed.

  10. Horizontal transfer of bait in the German cockroach: indoxacarb causes secondary and tertiary mortality.

    Science.gov (United States)

    Buczkowski, Grzegorz; Scherer, Clay W; Bennett, Gary W

    2008-06-01

    Horizontal transfer of indoxacarb in the German cockroach, Blattella germanica (L.), was examined under laboratory conditions. Results show that a single bait-fed adult cockroach (i.e., the donor) transferred indoxacarb to numerous primary recipients (secondary mortality),which then became secondary donors. These recipients subsequently became donors to other cockroaches and caused significant mortality in other members of the aggregation, resulting in tertiary kill. Indoxacarb was effectively transferred among adult cockroaches and resulted in significant secondary mortality. When adult males served as donors and vectored the insecticide to adult males, the donor:recipient ratio affected the mortality of the recipients and the rate of secondary mortality increased with increasing the ratio of donors to recipients. Furthermore, secondary mortality in the untreated cockroaches was significantly affected by the freshness of excretions from the donors, the presence of alternative food, and the duration of contact between the donors and the recipients. Ingested indoxacarb was most effectively translocated when the recipients interacted with freshly symptomatic donors in the absence of alternative food. The transfer of indoxacarb continued beyond secondary mortality and resulted in significant tertiary mortality. Excretions from a single bait-fed adult killed 38/50 (76%) nymphs within 72 h. The dead nymphs then vectored indoxacarb to 20 adult males and killed 16/20 (81%) recipients within 72 h. Behavioral mechanisms involved in the horizontal transfer of indoxacarb may include: contact with excretions, necrophagy, emetophagy, and ingestion of other excretions that originate from the donors.

  11. Epilepsy in Ireland: towards the primary-tertiary care continuum.

    Science.gov (United States)

    Varley, Jarlath; Delanty, Norman; Normand, Charles; Coyne, Imelda; McQuaid, Louise; Collins, Claire; Boland, Michael; Grimson, Jane; Fitzsimons, Mary

    2010-01-01

    Epilepsy is a chronic neurological disease affecting people of every age, gender, race and socio-economic background. The diagnosis and optimal management relies on contribution from a number of healthcare disciplines in a variety of healthcare settings. To explore the interface between primary care and specialist epilepsy services in Ireland. Using appreciative inquiry, focus groups were held with healthcare professionals (n=33) from both primary and tertiary epilepsy specialist services in Ireland. There are significant challenges to delivering a consistent high standard of epilepsy care in Ireland. The barriers that were identified are: the stigma of epilepsy, unequal access to care services, insufficient human resources, unclear communication between primary-tertiary services and lack of knowledge. Improving the management of people with epilepsy requires reconfiguration of the primary-tertiary interface and establishing clearly defined roles and formalised clinical pathways. Such initiatives require resources in the form of further education and training and increased usage of information communication technology (ICT). Epilepsy services across the primary-tertiary interface can be significantly enhanced through the implementation of a shared model of care underpinned by an electronic patient record (EPR) system and information communication technology (ICT). Better chronic disease management has the potential to halt the progression of epilepsy with ensuing benefits for patients and the healthcare system. Copyright 2009 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  12. Selective N-alkylation of amines using nitriles under hydrogenation conditions: facile synthesis of secondary and tertiary amines.

    Science.gov (United States)

    Ikawa, Takashi; Fujita, Yuki; Mizusaki, Tomoteru; Betsuin, Sae; Takamatsu, Haruki; Maegawa, Tomohiro; Monguchi, Yasunari; Sajiki, Hironao

    2012-01-14

    Nitriles were found to be highly effective alkylating reagents for the selective N-alkylation of amines under catalytic hydrogenation conditions. For the aromatic primary amines, the corresponding secondary amines were selectively obtained under Pd/C-catalyzed hydrogenation conditions. Although the use of electron poor aromatic amines or bulky nitriles showed a lower reactivity toward the reductive alkylation, the addition of NH(4)OAc enhanced the reactivity to give secondary aromatic amines in good to excellent yields. Under the same reaction conditions, aromatic nitro compounds instead of the aromatic primary amines could be directly transformed into secondary amines via a domino reaction involving the one-pot hydrogenation of the nitro group and the reductive alkylation of the amines. While aliphatic amines were effectively converted to the corresponding tertiary amines under Pd/C-catalyzed conditions, Rh/C was a highly effective catalyst for the N-monoalkylation of aliphatic primary amines without over-alkylation to the tertiary amines. Furthermore, the combination of the Rh/C-catalyzed N-monoalkylation of the aliphatic primary amines and additional Pd/C-catalyzed alkylation of the resulting secondary aliphatic amines could selectively prepare aliphatic tertiary amines possessing three different alkyl groups. According to the mechanistic studies, it seems reasonable to conclude that nitriles were reduced to aldimines before the nucleophilic attack of the amine during the first step of the reaction.

  13. A Comparison of Teacher and Lecturer Perspectives on the Transition from Secondary to Tertiary Mathematics Education

    Science.gov (United States)

    Hong, Ye Yoon; Kerr, Suzanne; Klymchuk, Sergiy; McHardy, Johanna; Murphy, Priscilla; Spencer, Sue; Thomas, Michael O. J.; Watson, Peter

    2009-01-01

    The transition from school to tertiary study of mathematics comes under increasing scrutiny in research. This article reports on some findings from a project analysing the transition from secondary to tertiary education in mathematics. One key variable in this transition is the teacher or lecturer. This article deals with a small part of the data…

  14. The medical and surgical treatment in secondary and tertiary hyperparathyroidism. Review.

    Science.gov (United States)

    Cocchiara, G; Fazzotta, S; Palumbo, V D; Damiano, G; Cajozzo, M; Maione, C; Buscemi, S; Spinelli, G; Ficarella, S; Maffongelli, A; Caternicchia, F; Ignazio Lo Monte, A; Buscemi, G

    2017-01-01

    Hyperparathyroidism is an alteration of the pathophysiological parathyroid hormone (PTH) secretion due or an independent and abnormal release (primary or tertiary hyperparathyroidism) by the parathyroid or an alteration of calcium homeostasis that stimulates the excessive production of parathyroid hormone (secondary hyperparathyroidism). There is not a standard, clinical or surgical, treatment for hyperparathyroidism. We review current diagnostic and therapeutic methods. In secondary hyperparathyroidism (2HPT) there is a progressive hyperplasia of the parathyroid glands and an increased production of parathyroid hormone. Several causes are proposed: chronic renal insufficiency, vitamin D deficiency, malabsorption syndrome. The tertiary hyperparathyroidism (3HPT) is considered a state of excessive autonomous secretion of PTH due to long-standing 2HPT and it's usually the result of a lack of suppression in the production of PTH. The pathophysiological implications are both skeletal and extraskeletal: it damages the cardiovascular system, nervous system, immune, hematopoietic and endocrine system. The introduction of new drugs has improved the survival of these patients, allowing the inhibition of the synthesis of PTH. Indication for surgical treatment is unresponsive medical therapy. There are no large prospective studies that comparing the medical and surgical treatment. The choice is not unique and we have to consider the singolar case and the clinical condition of the patient.

  15. Primary expectations of secondary metabolites

    Science.gov (United States)

    My program examines the plant secondary metabolites (i.e. phenolics) important for human health, and which impart the organoleptic properties that are quality indicators for fresh and processed foods. Consumer expectations such as appearance, taste, or texture influence their purchasing decisions; a...

  16. Induction of secondary and tertiary lymphoid structures in the skin.

    NARCIS (Netherlands)

    Cupedo, T.; Jansen, W.; Kraal, G.; Mebius, R.E.

    2004-01-01

    During embryogenesis a developmental program leading to the formation of lymph nodes and Peyer's patches is initiated. We now show that lymph node-like structures as well as tertiary lymphoid structures can ectopically be induced by intradermal injection of newborn lymph node-derived cells.

  17. Modes of failures: primary and secondary stresses

    International Nuclear Information System (INIS)

    Roche, R.L.

    1987-07-01

    The paper begins with a reminder that the purpose of stress classification is to ensure suitable margins with respect to failure modes. The distinction between primary stresses and secondary stresses is then examined and a method is given for assessing the degree of elastic follow up in the elastic plastic field. The importance of elastic follow up is then highlighted by an examination of the effect of primary and secondary stresses on crack behavior

  18. Secondary emission electron gun using external primaries

    Science.gov (United States)

    Srinivasan-Rao, Triveni [Shoreham, NY; Ben-Zvi, Ilan [Setauket, NY

    2009-10-13

    An electron gun for generating an electron beam is provided, which includes a secondary emitter. The secondary emitter includes a non-contaminating negative-electron-affinity (NEA) material and emitting surface. The gun includes an accelerating region which accelerates the secondaries from the emitting surface. The secondaries are emitted in response to a primary beam generated external to the accelerating region. The accelerating region may include a superconducting radio frequency (RF) cavity, and the gun may be operated in a continuous wave (CW) mode. The secondary emitter includes hydrogenated diamond. A uniform electrically conductive layer is superposed on the emitter to replenish the extracted current, preventing charging of the emitter. An encapsulated secondary emission enhanced cathode device, useful in a superconducting RF cavity, includes a housing for maintaining vacuum, a cathode, e.g., a photocathode, and the non-contaminating NEA secondary emitter with the uniform electrically conductive layer superposed thereon.

  19. Distinguishing between tertiary and secondary facilities: a case study of cardiac diagnostic-related groups (DRGs).

    Science.gov (United States)

    Rouse, Paul; Arulambalam, Ajit; Correa, Ralph; Ullman, Cornelia

    2010-05-14

    To develop a classification of tertiary cardiac DRGs in order to investigate differences in tertiary/secondary product mix across New Zealand district health boards (DHBs). 67 DRGs from 85,442 cardiac cases were analysed using cost weights and patient comorbidity complexity levels, which were used as a proxy for complexity. The research found high variability of severity within some DRGs. 5 DHBs are the main providers of 27 DRGs which are high cost and identified as tertiary by several ADHB clinicians; the same 5 DHBs have on average higher severity by DRG than the other DHBs. NZ tertiary hospitals have a product mix of DRGs with higher complexity than secondary hospitals. Funding based on case weights needs to recognise the additional resource requirements for this higher complexity.

  20. Ascertainment bias in dementias: a secondary to tertiary centre analysis in Central Italy and conceptual review.

    Science.gov (United States)

    Bonanni, L; Bontempo, G; Borrelli, I; Bifolchetti, S; Buongarzone, M P; Carlesi, N; Carolei, A; Ciccocioppo, F; Colangelo, U; Colonna, G; Desiderio, M; Ferretti, S; Fiorelli, L; D'Alessio, O; D'Amico, A; D'Amico, M C; De Lucia, R; Del Re, L; Di Blasio, F; Di Giacomo, R; Di Iorio, A; Di Santo, E; Di Giuseppe, M; Felice, N; Litterio, P; Gabriele, A; Mancino, E; Manzoli, L; Maruotti, V; Mearelli, S; Molino, G; Monaco, D; Nuccetelli, F; Onofrj, M; Perfetti, B; Sacchet, C; Sensi, F; Sensi, S; Sucapane, P; Taylor, J P; Thomas, A; Viola, P; Viola, S; Zito, M; Zhuzhuni, H

    2013-06-01

    Ascertainment bias (AB) indicates a bias of an evaluation centre in estimating the prevalence/incidence of a disease due to the specific expertise of the centre. The aim of our study was to evaluate classification of different types of dementia in new cases appearing in secondary and tertiary centres, in order to evidence possible occurrence of AB in the various (secondary to tertiary) dementia centres. To assess the mechanism of AB, the rates of new cases of the different forms of dementia reported by different centres were compared. The centres involved in the study were 11 hospital-based centres including a tertiary centre, located in the University Department of Clinical Neurology. The tertiary centre is endowed with state-of-the-art diagnostic facilities and its scientific production is prominently focused on dementia with Lewy bodies (DLB) thus suggesting the possible occurrence of a bias. Four main categories of dementia were identified: Alzheimer's disease (AD), DLB, fronto-temporal dementia (FTD), vascular dementia (VaD), with other forms in a category apart. The classification rate of new cases of dementia in the tertiary centre was compared with rates reported by secondary centres and rates of recoding were calculated during a follow-up of 2 years. The study classified 2,042 newly diagnosed cases of dementia in a population of 1,370,000 inhabitants of which 315,000 were older than 65. AD was categorized in 48-52 % of cases, DLB in 25-28 %, FTD in 2-4 % and VaD in 17-28 %. During the 2-year follow-up the diagnosis was re-classified in 40 patients (3 %). The rate of recoding was 5 % in the tertiary centre, 2-8 % in referrals from secondary to tertiary centre, 2-10 % in recodings performed in secondary centres and addressed to tertiary centre. Recoding or percentages of new cases of AD or DLB were not different in the comparison between secondary or between secondary and tertiary centres. FTD and VaD were instead significantly recoded. The results

  1. Evaluation of alternate secondary (and tertiary) coolants for the molten-salt breeder reactor

    International Nuclear Information System (INIS)

    Kelmers, A.D.; Baes, C.F.; Bettis, E.S.; Brynestad, J.; Cantor, S.; Engel, J.R.; Grimes, W.R.; McCoy, H.E.; Meyer, A.S.

    1976-04-01

    The three most promising coolant selections for an MSBR have been identified and evaluated in detail from the many coolants considered for application either as a secondary coolant in 1000-MW(e) MSBR configurations using only one coolant, or as secondary and tertiary coolants in an MSBR dual coolant configuration employing two different coolants. These are, as single secondary coolants: (1) a ternary sodium--lithium--beryllium fluoride melt; (2) the sodium fluoroborate--sodium fluoride eutectic melt, the present reference design secondary coolant. In the case of the dual coolant configuration, the preferred system is molten lithium--beryllium fluoride (Li 2 BeF 4 ) as the secondary coolant and helium gas as the tertiary coolant

  2. A Comparison of Mathematics Teachers' and Professors' Views on Secondary Preparation for Tertiary Calculus

    Science.gov (United States)

    Wade, Carol; Sonnert, Gerhard; Sadler, Philip M.; Hazari, Zahra; Watson, Charity

    2016-01-01

    This article compares the views of teachers and professors about the transition from secondary mathematics to tertiary calculus. Quantitative analysis revealed five categories where teachers and professors differed significantly in the relative frequency of addressing them. Using the rite of passage theory, the separation and incorporation phases…

  3. Impact of the Introduction of Calcimimetics on Timing of Parathyroidectomy in Secondary and Tertiary Hyperparathyroidism

    NARCIS (Netherlands)

    van der Plas, Willemijn Y.; Engelsman, Anton F.; Ozyilmaz, Akin; van der Horst-Schrivers, Anouk N.; Meijer, Kornelis; van Dam, Gooitzen M.; Pol, Robert A.; de Borst, Martin H.; Kruijff, Schelto

    Hyperparathyroidism (HPT), both secondary and tertiary, is common in patients with end-stage renal disease, and is associated with severe bone disorders, cardiovascular complications, and increased mortality. Since the introduction of calcimimetics in 2004, treatment of HPT has shifted from surgery

  4. Utility of Amyloid and FDG-PET in Clinical Practice: Differences Between Secondary and Tertiary Care Memory Units.

    Science.gov (United States)

    Lage, Carmen; Suarez, Andrea Gonzalez; Pozueta, Ana; Riancho, Javier; Kazimierczak, Martha; Bravo, Maria; Jimenez Bonilla, Julio; de Arcocha Torres, Marıa; Quirce, Remedios; Banzo, Ignacio; Vazquez-Higuera, Jose Luis; Rabinovici, Gil D; Rodriguez-Rodriguez, Eloy; Sánchez-Juan, Pascual

    2018-04-27

    The clinical utility of amyloid positron emission tomography (PET) has not been fully established. Our aim was to evaluate the effect of amyloid imaging on clinical decision making in a secondary care unit and compare our results with a previous study in a tertiary center following the same methods. We reviewed retrospectively 151 cognitively impaired patients who underwent amyloid (Pittsburgh compound B [PiB]) PET and were evaluated clinically before and after the scan in a secondary care unit. One hundred and fifty concurrently underwent fluorodeoxyglucose (FDG)-PET. We assessed changes between the pre- and post-PET clinical diagnosis and Alzheimer's disease treatment plan. The association between PiB/FDG results and changes in management was evaluated using χ2 and multivariate logistic regression. Concordance between classification based on scan readings and baseline diagnosis was 66% for PiB and 47% for FDG. The primary diagnosis changed after PET in 17.2% of cases. When examined independently, discordant PiB and discordant FDG were both associated with diagnostic change (p PET due to a higher likelihood of diagnostic change. We found that changes in diagnosis after PET in our secondary center almost doubled those of our previous analysis of a tertiary unit (9% versus 17.2%). Our results offer some clues about the rational use of amyloid PET in a secondary care memory unit stressing its utility in mild cognitive impairment patients.

  5. Teaching Design in Adolescent Environments: Twinning Secondary and Tertiary Learning Experiences

    Directory of Open Access Journals (Sweden)

    David Jones

    2004-06-01

    Full Text Available Increasingly our landscape architecture teaching and educational pedagogies are facing an internationalisation in approach and expectation. We are positioned within a tertiary learning layer in a tripartite educational system for which each layer assumes certain expectations and outcomes. But their vertical linkages are unclear, and we incorrectly assume continuity of knowledge and skill learning strategies. It is a horizontally stratified teaching setting that we have to work within and while we can think of internationalisation as occurring within our level we need to appreciate that internationalisation is also occurring at the secondary level. This paper discusses the educational environment within which globalisation is occurring, and reviews a project model that builds bridges vertically between secondary and tertiary learning environments. The project displays possibilities in both secondary and tertiary educational sectors, but especially in enhancing and improving the design fluency of our annual incoming cohorts who often possess a naive understanding of built environmental design. Commencing in 1998 as an experimental project, it has been recognised at the South Australian state level as a forward-thinking initiative that has radically transformed secondary school Design teacher's perspectives as to educational possibilities, and substantially matured attitudes to landscape design by both suites of participants. As a consequence, it is an educational project that has experienced requests from numerous secondary schools around the State to participate.

  6. Primary and secondary hyperparathyroidism among vitamin D deficient Hashimoto's thyroiditis patients and the need for a parathyroid scan.

    Science.gov (United States)

    Mazokopakis, Elias; Papadomanolaki, Maria; Skarakis, Spyridon-Nikitas N; Tsekouras, Konstantinos

    2017-01-01

    The patients with Hashimoto thyroiditis must be investigated mainly for secondary hyperparathyroidism due to vitamin D deficiency/insufficiency. Parathyroid scintigraphy has no place in the diagnosis of primary, secondary or tertiary hyperparathyroidism or in the decision for surgical treatment. Parathyroid scintigraphy is a useful preoperative technique for the localization of the pathological parathyroid glands.

  7. Patient satisfaction in outpatient healthcare services at secondary level vs. tertiary level

    Directory of Open Access Journals (Sweden)

    Velikj-Stefanovska Vesna

    2014-01-01

    Full Text Available Introduction. Patients satisfaction is a very important part of any clinical practice both for evaluation and improvement of healthcare services. Objective. The aim of this study was to determine patient satisfaction with public outpatient healthcare services at secondary and tertiary level and to assess possible differences between the two levels. Methods. In a quantitative cross-sectional study, a convenient sample of 646 patients who experienced public outpatient healthcare services at the secondary and tertiary level during the last two months were interviewed. Patient satisfaction questionnaires, with statements regarding various aspects of satisfaction, were completed during face-to-face interviews (response rate 84.6%. The research instrument was tested for internal consistency using the Cronbach’s coefficient alpha estimate. Results. The patients were significantly more satisfied in tertiary than in secondary outpatient healthcare facilities in almost all aspects of assessment related to general settings, nurse/administrative staff performance and physician performance (p<0.001. The patients in the secondary healthcare services (SHCS were more satisfied than in the tertiary healthcare services (THCS but only regarding the information on location (83.9% vs.78.3% and possibilities to enter and move inside the department (88.8% vs. 83.3%. Analysis of data for SHCS and THCS showed that there was no significant difference between the mean overall satisfaction scores with regard to patients’ gender, age, marital status, educational level, employment and number of visits. Conclusion. There is a need to improve the current level of patient-provider relationship and communication, as well as that of hospital environment, while special efforts should be made to address the problem of patient waiting time and hospital bureaucracy.

  8. Distribution of Independent Boutique Hotels on Secondary and Tertiary Markets in Germany

    OpenAIRE

    Dambach, Marie-Theres

    2016-01-01

    Boutique hotels are a recent trend in the hospitality industry. As they are receiving more and more attention independent operators on secondary and tertiary markets need to find ways to reach and sell to their customer in order to stay competitive. Therefore, the question is raised whether the way independent German boutique hoteliers distribute their products matches the way their guests prefer or would prefer to buy them. Moreover, it was evaluated if soft brands are an efficient tool to s...

  9. Concise Redox Deracemization of Secondary and Tertiary Amines with a Tetrahydroisoquinoline Core via a Nonenzymatic Process.

    Science.gov (United States)

    Ji, Yue; Shi, Lei; Chen, Mu-Wang; Feng, Guang-Shou; Zhou, Yong-Gui

    2015-08-26

    A concise deracemization of racemic secondary and tertiary amines with a tetrahydroisoquinoline core has been successfully realized by orchestrating a redox process consisted of N-bromosuccinimide oxidation and iridum-catalyzed asymmetric hydrogenation. This compatible redox combination enables one-pot, single-operation deracemization to generate chiral 1-substituted 1,2,3,4-tetrahydroisoquinolines with up to 98% ee in 93% yield, offering a simple and scalable synthetic technique for chiral amines directly from racemic starting materials.

  10. Primary and secondary prevention of breast cancer.

    Science.gov (United States)

    Kolak, Agnieszka; Kamińska, Marzena; Sygit, Katarzyna; Budny, Agnieszka; Surdyka, Dariusz; Kukiełka-Budny, Bożena; Burdan, Franciszek

    2017-12-23

    Breast cancer is the most common cancer among women and is the second cancer frequently occurring worldwide of newly-diagnosed cancers. There is much evidence showing the influence of life style and environmental factors on the development of mammary gland cancer (high-fat diet, alcohol consumption, lack of physical exercise), the elimination of which (primary prevention) may contribute to a decrease in morbidity and mortality. Secondary prevention, comprising diagnostic tests (e.g. mammography, ultrasonography, magnetic resonance imaging, breast self-examination, as well as modern and more precise imaging methods) help the early detection of tumours or lesions predisposing to tumours. The aim of this study paper is to review current knowledge and reports regarding primary and secondary prevention of breast cancer. It is estimated that nearly 70% of malign tumours are caused by environmental factors, whereas in breast cancer this percentage reaches 90-95%. There are national programmes established in many countries to fight cancer, where both types of prevention are stressed as serving to decrease morbidity and mortality due to cancers. Cancer prevention is currently playing a key role in the fight against the disease. Behaviour modification, as well as greater awareness among women regarding breast cancer, may significantly contribute towards reducing the incidence of this cancer. Another important aspect is the number of women undergoing diagnostic tests, which still remains at an unsatisfactory level.

  11. Outcome of total parathyroidectomy and autotransplantation as treatment of secondary and tertiary hyperparathyroidism in children and adults.

    NARCIS (Netherlands)

    Kievit, A.J.; Tinnemans, J.G.; Idu, M.M.; Groothoff, J.W.; Surachno, S.; Aronson, D.C.

    2010-01-01

    BACKGROUND: Treatment safety and effectiveness of total parathyroidectomy and autotransplantation for secondary and tertiary hyperparathyroidism have been extensively proven in adults; the evidence for children, however, is scarce. Children and adolescents cannot simply be seen as young adults in

  12. Examination of factors predicting secondary students' interest in tertiary STEM education

    Science.gov (United States)

    Chachashvili-Bolotin, Svetlana; Milner-Bolotin, Marina; Lissitsa, Sabina

    2016-02-01

    Based on the Social Cognitive Career Theory (SCCT), the study aims to investigate factors that predict students' interest in pursuing science, technology, engineering, and mathematics (STEM) fields in tertiary education both in general and in relation to their gender and socio-economic background. The results of the analysis of survey responses of 2458 secondary public school students in the fifth-largest Israeli city indicate that STEM learning experience positively associates with students' interest in pursuing STEM fields in tertiary education as opposed to non-STEM fields. Moreover, studying advanced science courses at the secondary school level decreases (but does not eliminate) the gender gap and eliminates the effect of family background on students' interest in pursuing STEM fields in the future. Findings regarding outcome expectations and self-efficacy beliefs only partially support the SCCT model. Outcome expectations and self-efficacy beliefs positively correlate with students' entering tertiary education but did not differentiate between their interests in the fields of study.

  13. Primary and Secondary Prevention of Colorectal Cancer

    Directory of Open Access Journals (Sweden)

    Pedro J. Tárraga López

    2014-07-01

    Full Text Available Introduction Cancer is a worldwide problem as it will affect one in three men and one in four women during their lifetime. Colorectal cancer (CRC is the third most frequent cancer in men, after lung and prostate cancer, and is the second most frequent cancer in women after breast cancer. It is also the third cause of death in men and women separately, and is the second most frequent cause of death by cancer if both genders are considered together. CRC represents approximately 10% of deaths by cancer. Modifiable risk factors of CRC include smoking, physical inactivity, being overweight and obesity, eating processed meat, and drinking alcohol excessively. CRC screening programs are possible only in economically developed countries. However, attention should be paid in the future to geographical areas with ageing populations and a western lifestyle. 19 , 20 Sigmoidoscopy screening done with people aged 55-64 years has been demonstrated to reduce the incidence of CRC by 33% and mortality by CRC by 43%. Objective To assess the effect on the incidence and mortality of CRC diet and lifestyle and to determine the effect of secondary prevention through early diagnosis of CRC. Methodology A comprehensive search of Medline and Pubmed articles related to primary and secondary prevention of CRC and subsequently, a meta-analysis of the same blocks are performed. Results 225 articles related to primary or secondary prevention of CRC were retrieved. Of these 145 were considered valid on meta-analysis: 12 on epidemiology, 56 on diet and lifestyle, and over 77 different screenings for early detection of CRC. Cancer is a worldwide problem as it will affect one in three men and one in four women during their lifetime. There is no doubt whatsoever which environmental factors, probably diet, may account for these cancer rates. Excessive alcohol consumption and cholesterol-rich diet are associated with a high risk of colon cancer. A diet poor in folic acid and vitamin

  14. Internet use among primary care patients attending a tertiary health ...

    African Journals Online (AJOL)

    Background: Global attention is being drawn to the use of internet resource because of its overwhelming benefits. Individuals, families, social groups, patients as well as research teams spend quality time on a daily basis exploring the internet. Objective: We carried out a study to determine internet use among primary care ...

  15. Azobisisobutyronitrile initiated aerobic oxidative transformation of amines: coupling of primary amines and cyanation of tertiary amines.

    Science.gov (United States)

    Liu, Lianghui; Wang, Zikuan; Fu, Xuefeng; Yan, Chun-Hua

    2012-11-16

    In the presence of a catalytic amount of radical initiator AIBN, primary amines are oxidatively coupled to imines and tertiary amines are cyanated to α-aminonitriles. These "metal-free" aerobic oxidative coupling reactions may find applications in a wide range of "green" oxidation chemistry.

  16. Fast force actuators for LSST primary/tertiary mirror

    Science.gov (United States)

    Hileman, Edward; Warner, Michael; Wiecha, Oliver

    2010-07-01

    The very short slew times and resulting high inertial loads imposed upon the Large Synoptic Survey Telescope (LSST) create new challenges to the primary mirror support actuators. Traditionally large borosilicate mirrors are supported by pneumatic systems, which is also the case for the LSST. These force based actuators bear the weight of the mirror and provide active figure correction, but do not define the mirror position. A set of six locating actuators (hardpoints) arranged in a hexapod fashion serve to locate the mirror. The stringent dynamic requirements demand that the force actuators must be able to counteract in real time for dynamic forces on the hardpoints during slewing to prevent excessive hardpoint loads. The support actuators must also maintain the prescribed forces accurately during tracking to maintain acceptable mirror figure. To meet these requirements, candidate pneumatic cylinders incorporating force feedback control and high speed servo valves are being tested using custom instrumentation with automatic data recording. Comparative charts are produced showing details of friction, hysteresis cycles, operating bandwidth, and temperature dependency. Extremely low power actuator controllers are being developed to avoid heat dissipation in critical portions of the mirror and also to allow for increased control capabilities at the actuator level, thus improving safety, performance, and the flexibility of the support system.

  17. Role model and prototype matching: Upper-secondary school students’ meetings with tertiary STEM students

    Directory of Open Access Journals (Sweden)

    Eva Lykkegaard

    2016-04-01

    Full Text Available Previous research has found that young people’s prototypes of science students and scientists affect their inclination to choose tertiary STEM programs (Science, Technology, Engineering and Mathematics. Consequently, many recruitment initiatives include role models to challenge these prototypes. The present study followed 15 STEM-oriented upper-secondary school students from university-distant backgrounds during and after their participation in an 18-months long university-based recruitment and outreach project involving tertiary STEM students as role models. The analysis focusses on how the students’ meetings with the role models affected their thoughts concerning STEM students and attending university. The regular self-to-prototype matching process was shown in real-life role-models meetings to be extended to a more complex three-way matching process between students’ self-perceptions, prototype images and situation-specific conceptions of role models. Furthermore, the study underlined the positive effect of prolonged role-model contact, the importance of using several role models and that traditional school subjects catered more resistant prototype images than unfamiliar ones did.

  18. Chemoselective reductive nucleophilic addition to tertiary amides, secondary amides, and N-methoxyamides.

    Science.gov (United States)

    Nakajima, Minami; Oda, Yukiko; Wada, Takamasa; Minamikawa, Ryo; Shirokane, Kenji; Sato, Takaaki; Chida, Noritaka

    2014-12-22

    As the complexity of targeted molecules increases in modern organic synthesis, chemoselectivity is recognized as an important factor in the development of new methodologies. Chemoselective nucleophilic addition to amide carbonyl centers is a challenge because classical methods require harsh reaction conditions to overcome the poor electrophilicity of the amide carbonyl group. We have successfully developed a reductive nucleophilic addition of mild nucleophiles to tertiary amides, secondary amides, and N-methoxyamides that uses the Schwartz reagent [Cp2 ZrHCl]. The reaction took place in a highly chemoselective fashion in the presence of a variety of sensitive functional groups, such as methyl esters, which conventionally require protection prior to nucleophilic addition. The reaction will be applicable to the concise synthesis of complex natural alkaloids from readily available amide groups. © 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  19. [Changes in the secondary and tertiary structure of serum albumin in interactions with ligands of various structures].

    Science.gov (United States)

    Trinus, F P; Braver-Chernobul'skaia, B S; Luĭk, A I; Boldeskul, A E; Velichko, A N

    1984-01-01

    High affinity interactions between blood serum albumin and five substances of various chemical structure, exhibiting distinct physiological activity, were accompanied by alterations in the protein tertiary structure, while the albumin secondary structure was involved in conformational transformation after less effective affinity binding.

  20. Outcome of Total Parathyroidectomy and Autotransplantation as Treatment of Secondary and Tertiary Hyperparathyroidism in Children and Adults

    NARCIS (Netherlands)

    Kievit, A. J.; Tinnemans, J. G. M.; Idu, M. M.; Groothoff, J. W.; Surachno, S.; Aronson, D. C.

    2010-01-01

    Treatment safety and effectiveness of total parathyroidectomy and autotransplantation for secondary and tertiary hyperparathyroidism have been extensively proven in adults; the evidence for children, however, is scarce. Children and adolescents cannot simply be seen as young adults in the case of

  1. New developments in seismic analysis of primary and secondary systems

    International Nuclear Information System (INIS)

    Gupta, A.K.

    1984-01-01

    Primary and secondary systems often must be analyzed using decoupled models. This paper presents recent advances made at NCSU in the seismic analysis of these systems. Algorithms are presented by which coupled mode shapes and frequencies can be evaluated without performing a new eigenvalue solution, given the mode shapes and frequencies of the decoupled models. Simple and accurate equations are presented to predict changes in frequencies and responses. With the coupled mode shapes and frequencies, one can obtain any primary or secondary response directly from the input spectrum. Alternatively, one can develop instructure spectra at various locations in the primary system accounting for the primary-secondary system interaction. Correlation between the support motions is also generated. Equations are presented for evaluating complex mode shapes and frequencies of coupled systems when due to unequal damping values of primary and secondary systems, the coupled system becomes nonproportionally damped. Recent progress, in case of tuned systems is also reported

  2. Nature and pattern of primary teeth extractions in a tertiary care hospital setting in South India

    Directory of Open Access Journals (Sweden)

    Shini Susan Samuel

    2018-01-01

    Full Text Available Background: Many studies have been carried out on the prevalence of dental diseases in children although not much information is available regarding its outcome among Indian children. Aim: The aim of the present study was to analyze the type of primary tooth extracted and the reasons for the extraction among children attending a tertiary care hospital in the Southern part of India. Materials and Methods: The dental records of pediatric patients who had visited the dental clinic of a tertiary care hospital located in Tamil Nadu, South India from December 2013 to November 2016 were reviewed. Patients who underwent extraction of at least one primary tooth under local or general anesthesia were included in the study. Results: A total of 943 primary teeth were extracted from 447 patients over 3 years. The most commonly extracted tooth type was the first primary molar followed by the primary central incisor. Grouping by age, the most frequently extracted tooth type between 2 and 5 years was the primary central incisor, the first primary molar among the 6–9-year-old and the second primary molar among 10–15-year-old. The majority of primary teeth extractions were performed in the age group of 6–9 years. No significant gender differences were noted. The most common reason for extraction of primary teeth in children was dental caries. Conclusions: This study demonstrates a high prevalence of untimely primary teeth extractions in young children and dental caries continues to be the leading cause. It clearly reflects on the lack of infant oral health care, the inadequacy of awareness and underutilization of oral health services among children in India.

  3. Feline hyperparathyroidism: pathophysiology, diagnosis and treatment of primary and secondary disease.

    Science.gov (United States)

    Parker, Valerie J; Gilor, Chen; Chew, Dennis J

    2015-05-01

    Hyperparathyroidism exists in primary and secondary forms. Primary hyperparathyroidism has typically been considered a disease that uncommonly affects cats, but this condition is more prevalent than previous diagnoses would suggest. Secondary hyperparathyroidism may be caused by either nutritional influences (ie, nutritional secondary hyperparathyroidism) or chronic kidney disease (ie, renal secondary hyperparathyroidism). Tertiary hyperparathyroidism has yet to be documented in veterinary medicine, but it is possible that this condition occurs in some cats following longstanding renal secondary hyperparathyroidism. Diagnosis of this group of calcium metabolic disorders presents a number of challenges for the clinician. For example, clinical signs can be non-specific and, especially in the case of primary hyperparathyroidism, there is often a low index of suspicion for the disease; careful sample handling is required for testing of parathyroid hormone (PTH) and ionized calcium levels; and there is currently no feline-specific assay for PTH, which has implications for test sensitivity and interpretation of results. This article briefly outlines PTH and calcium physiology by way of introduction to a review of PTH measurement and interpretation. Various forms of feline hyperparathyroidism are then described, encompassing diagnosis and treatment options. © ISFM and AAFP 2015.

  4. Hypophysiary hyperplasia secondary to primary hypothyroidism

    International Nuclear Information System (INIS)

    Garcia, Jorge; Polania, Diana Ligia; Builes, Carlos Alfonso

    2005-01-01

    This is a 43 years old woman, complaining of galactorhea, headache and hyperprolactinaemia. A large macro adenoma of the pituitary with extensive suprasellar extension and displacement of the optic chiasm was detected on MRI and primary hypothyroidism was found. After treatment with levothyroxine for four months, her TSH and prolactin levels returned to normal, her symptoms improved and a marked shrinkage of the selar lesion was observed. The visual fields returned to normal. This is a case of pituitary hyperplasia due to primary hypothyroidism

  5. Secondary and tertiary gas injection in fractured carbonate rock: Experimental study

    Energy Technology Data Exchange (ETDEWEB)

    Karimaie, H.; Torsaeter, O. [SPE, NTNU (Norway); Darvish, G.R. [SPE, STATOIL (Norway); Lindeberg, E. [SPE, SINTEF (Norway)

    2008-09-15

    The use of CO{sub 2} has received considerable interest as a method of EOR but a major drawback is its availability and increasing cost. Therefore, as the number of CO{sub 2} injection projects increase, an alternative must be considered to meet the economic considerations. For this reason attention has been directed to nitrogen injection which may be a good substitute for CO{sub 2}. The purpose of the experiments described in this paper was to investigate the efficiency of oil recovery by CO{sub 2} and N{sub 2} in fractured carbonate rock. The combined effects of gravity drainage and component exchange between gas in fracture and oil in matrix on oil recovery in fractured reservoirs subjected to CO{sub 2} or nitrogen gas injection are experimentally studied. Laboratory experiments have been carried out on a low permeable outcrop chalk, as an analogue to a North Sea reservoir rock. This was surrounded by a fracture, established with a novel experimental set-up. The experiments aimed to investigate the potential of oil recovery by secondary and tertiary CO{sub 2} and nitrogen gas injection at high pressure high temperature condition. The matrix block was saturated using recombined binary mixture live oil (C{sub 1}-C{sub 7}), while the fracture was filled with a sealing material to obtain a homogeneous saturation. The sealing material was then removed by increasing the temperature which in turn creates the fracture surrounding the core. Gas was injected into the fracture at pressures above the bubble point of the oil. Oil recovery as a function of time was monitored during the experiments. Results from secondary gas injection experiments indicate that CO{sub 2} injection at elevated pressure and temperature is more efficient than N{sub 2} injection. Results from tertiary gas injection experiments also show that injection of CO{sub 2} could significantly recover the oil, even after waterflooding, compared to N{sub 2} injection. (author)

  6. Changes in grouping practices over primary and secondary school

    OpenAIRE

    Baines, Ed; Blatchford, Peter; Kutnick, P.

    2003-01-01

    The research detailed in this paper provides a systematic description and analysis of grouping practices in primary and secondary schools in England. Practices are compared to main findings in developmental and educational literature with regard to effective contexts for learning and recent ideas about pedagogy. The research is based on an analysis of 4924 groupings from 672 Reception, Year 2 and Year 5 classes in 331 primary schools and 248 Year 7 and Year 10 classes in 47 secondary schools....

  7. Temporomandibular disorder is more prevalent among patients with primary headaches in a tertiary outpatient clinic

    Directory of Open Access Journals (Sweden)

    James Felipe Tomaz-Morais

    2015-11-01

    Full Text Available Objective The aim of this study was to estimate the prevalence of signs and symptoms of temporomandibular disorders (TMD in patients with primary headaches attended in a tertiary neurology ambulatory.Method Authorized by the Ethics Committee, the present cross-sectional study was conducted with a random sample of patients screened for orofacial pain and primary headaches at a tertiary hospital in Northeast of Brazil.Results The sample consisted in 42 patients with primary headache, 59.5% male. The prevalence of > 6 TMD signs and symptoms was 54.8%. In those patients with migraine TMD was present in 71.4% and in tension-type headache in 38.1% (p = 0.030; OR = 4.1. TMD was related to the clinical status of headache associated or attributed to medication overuse (p = 0.001.Conclusion TMD has a high prevalence in patients with primary headaches (54.8%. Special attention must be given to patients with migraine and headache associated or attributed to medication overuse.

  8. PREVALENCE OF DEVASTATING OCULAR TRAUMA, IT’S EMERGENCY AND SECONDARY MANAGEMENT AND OUTCOME IN A TERTIARY CARE CENTRE

    Directory of Open Access Journals (Sweden)

    Jagadish Prasad Rou

    2017-10-01

    Full Text Available BACKGROUND Usually, young adults are the common victims of ocular trauma in their productive age. Severe ocular trauma most often leads to poor vision, at times total loss of vision, which is not only burden to their family, but also to the entire nation. Proper evaluation of severity of ocular trauma at the time of initial examination may help in planning for skillful management and help in prevention of severe visual morbidity. The aim of the study is to study the prevalence of ocular trauma and the visual outcome after one year of its emergency management and secondary management in selected cases in a tertiary care center. MATERIALS AND METHODS 89 cases of ocular trauma who presented to our tertiary care center of different age groups were studied prospectively from July 2016 to July 2017. Evaluation of all ocular trauma case was done primarily by slit-lamp examination, indirect ophthalmoscopy and 90D biomicroscopy, x-ray orbit, B-scan and CT scan orbit. All patients who required immediate admission and emergency management were included in the study and old cases of ocular trauma or underwent previous ocular surgical procedure and had ocular infections or any ocular pathology were excluded. All the subjects were managed either conservatively or surgically as and when required. Primary management like repair of lacerated lid injuries, corneal laceration and penetrating injury with or without iris prolapse, corneoscleral tear suturing, scleral tear suturing and removal of IOFB were done on emergency basis. Secondarily, patients were taken up for surgery for traumatic cataract extraction, posttraumatic glaucoma surgery, vitreoretinal surgery for vitreous haemorrhage, retinal haemorrhage and retinal detachment. RESULTS Out of 89 cases, 69 were males and 20 were females. Agricultural injury was the leading cause of ocular trauma in which injury from vegetative matter were the most common causative aetiology followed by objects like knife and

  9. Interaction Of Calcium Phosphate Nanoparticles With Human Chorionic Gonadotropin Modifies Secondary And Tertiary Protein Structure

    Directory of Open Access Journals (Sweden)

    Al-Hakeim Hussein K

    2015-12-01

    Full Text Available Calcium phosphate nanoparticles (CaPNP have good biocompatibility and bioactivity inside human body. In this study, the interaction between CaPNP and human chorionic gonadotropin (hCG was analyzed to determine the changes in the protein structure in the presence of CaPNP and the quantity of protein adsorbed on the CaPNP surface. The results showed a significant adsorption of hCG on the CaPNP nanoparticle surface. The optimal fit was achieved using the Sips isotherm equation with a maximum adsorption capacity of 68.23 µg/mg. The thermodynamic parameters, including ∆H° and ∆G°, of the adsorption process are positive, whereas ∆S° is negative. The circular dichroism results of the adsorption of hCG on CaPNP showed the changes in its secondary structure; such changes include the decomposition of α-helix strand and the increase in β-pleated sheet and random coil percentages. Fluorescence study indicated minimal changes in the tertiary structure near the microenvironment of the aromatic amino acids such as tyrosine and phenyl alanine caused by the interaction forces between the CaPNP and hCG protein. The desorption process showed that the quantity of the hCG desorbed significantly increases as temperature increases, which indicates the weak forces between hCG and the surface.

  10. Prediction of primary vs secondary hypertension in children.

    Science.gov (United States)

    Baracco, Rossana; Kapur, Gaurav; Mattoo, Tej; Jain, Amrish; Valentini, Rudolph; Ahmed, Maheen; Thomas, Ronald

    2012-05-01

    Despite current guidelines, variability exists in the workup of hypertensive children due to physician preferences. The study evaluates primary vs secondary hypertension diagnosis from investigations routinely performed in hypertensive children. This retrospective study included children 5 to 19 years with primary and secondary hypertension. The proportions of abnormal laboratory and imaging tests were compared between primary and secondary hypertension groups. Risk factors for primary vs secondary hypertension were evaluated by logistic regression and likelihood function analysis. Patients with secondary hypertension were younger (5-12 years) and had a higher proportion of abnormal creatinine, renal ultrasound, and echocardiogram findings. There was no significant difference in abnormal results of thyroid function, urine catecholamines, plasma renin, and aldosterone. Abnormal renal ultrasound findings and age were predictors of secondary hypertension by regression and likelihood function analysis. Children aged 5 to 12 years with abnormal renal ultrasound findings and high diastolic blood pressures are at higher risk for secondary hypertension that requires detailed evaluation. © 2012 Wiley Periodicals, Inc.

  11. Effectiveness of secondary and tertiary prevention for violence against women in low and low-middle income countries: a systematic review.

    Science.gov (United States)

    Kirk, Lucy; Terry, Samantha; Lokuge, Kamalini; Watterson, Jessica L

    2017-07-04

    Violence against women (VAW) is a major problem worldwide, with one in three women experiencing violence in their lifetime. While interventions to prevent violence (primary prevention) are extremely important, they can take many years. This review focuses on secondary and tertiary prevention interventions that address the needs of survivors of violence and aim to prevent recurrence. This review also focuses on studies taking place in low and low-middle income countries, where rates of VAW are highest. Searches of peer-reviewed and grey literature took place from March-June 2016 through databases (Embase, CINAHL, WHO Global Index Medicus, Medline, PsychINFO, Web of Science, Cochrane Library, Applied Social Sciences Index and Abstracts and Sociological Abstracts) and by consulting experts in the field. Only primary research was eligible for inclusion and studies had to focus on secondary or tertiary prevention for survivors of VAW in low or low-middle income countries. All study designs were eligible, as long as the study examined client-related outcome measures (e.g., incidence of violence, health outcomes or client satisfaction). Data were extracted and quality of the studies was assessed using the Effective Public Health Practice Project Quality Assessment Tool for Quantitative Studies and a qualitative quality assessment tool developed by Mays and Pope. Due to the low number of results and heterogeneity of the study populations and outcomes, a narrative synthesis was conducted and evidence was summarized. One thousand two hundred fifteen studies were identified through the search strategy and 22 of these met the eligibility criteria. Overall, the evidence for interventions is weak and study limitations prevent definitive conclusions on what works. There is some evidence that interventions targeting alcohol use, both among perpetrators and survivors, may be effective at reducing VAW through secondary prevention, and that psychotherapy might be effective for

  12. Salience of Primary and Secondary Colours in Infancy

    Science.gov (United States)

    Franklin, Anna; Pitchford, Nicola; Hart, Lynsey; Davies, Ian R. L.; Clausse, Samantha; Jennings, Siobhan

    2008-01-01

    Primary colour terms ("black", "white", "red", "green", "yellow", and "blue") are more fundamental in colour language than secondary colour terms ("pink", "purple", "orange", "brown", and "grey"). Here, we assess whether this distinction exists in the absence of language, by investigating whether primary colours attract and sustain preverbal…

  13. Primary and Secondary Labor Markets: Implications for Vocational Rehabilitation.

    Science.gov (United States)

    Hagner, David

    2000-01-01

    Reviews theoretical and empirical work in labor economics and the sociology of work relating to the segmentation of the labor market into a primary and a secondary sector and examines the implications for vocational rehabilitation. Transition into primary sector employment is explored as an important aspect of career development for individuals…

  14. Blood pressure variability in children with primary vs secondary hypertension.

    Science.gov (United States)

    Leisman, Daniel; Meyers, Melissa; Schnall, Jeremy; Chorny, Nataliya; Frank, Rachel; Infante, Lulette; Sethna, Christine B

    2014-06-01

    Increased blood pressure variability (BPV) is correlated with adverse cardiovascular (CV) events in adults. However, there has been limited research on its effect in the pediatric population. Additionally, BPV differences between primary and secondary hypertension (HTN) are not known. Children with primary and secondary HTN underwent 24-hour ambulatory blood pressure monitoring and echocardiography studies. BPV measures of standard deviation (SD), average real variability (ARV), and range were calculated for the 24-hour, daytime, and nighttime periods. Seventy-four patients (median age, 13.5 years; 74% boys) were examined, 40 of whom had primary HTN. Body mass index z score and age were independent predictors of systolic ARV (R(2) =0.14) and SD (R(2) =0.39). There were no statistically significant differences in overall or wake period BPV measures between secondary or primary HTN groups, but sleep period diastolic SD was significantly greater in the secondary HTN group (9.26±3.8 vs 7.1±2.8, P=.039). On multiple regression analysis, secondary HTN was associated with increased sleep period diastolic SD (P=.025). No metrics of BPV in the overall, wake, and sleep periods were found to be significantly associated with left ventricular hypertrophy (LVH). The results of this study do not show a strong relationship between overall or wake BPV with primary vs secondary HTN, but the association of secondary HTN with sleep period diastolic BPV deserves further exploration. Contrary to expectation, the findings of this study failed to indicate a relationship between BPV and LVH for all patients as well for primary hypertensive and secondary hypertensive patients. ©2014 Wiley Periodicals, Inc.

  15. [Colonization of Porphyromonas endodontalis in primary and secondary endodontic infections].

    Science.gov (United States)

    Hong, Li; Hai, Ji; Yan-Yan, He; Shenghui, Yang; Benxiang, Hou

    2015-02-01

    This study aims to assess and compare the prevalence of Porphyromonas endodontalis (P. endodontalis) in root canals associated with primary and secondary endodontic infections by using 16s rDNA PCR and real-time fluorescence quantitative polymerase chain reaction (RTFQ-PCR). A total of 120 adult patients with one radiographically documented periapical lesion were included. Sixty teeth presented with primary endodontic infections and 60 with secondary endodontic infections requiring retreatment. P. endodontalis was identified by using 16s rDNA PCR techniques. The positive DNA expression of P. endodontalis in two types of infected root canals were quantitatively compared by using SYBR GREEN I RTFQ-PCR. The prevalence of P. endodontalis in the root canals with primary endodontic infections was significantly higher than that in root canals with secondary endodontic infections (P = 0.001). However, RTFQ-PCR results showed no significant difference in DNA expression quantities between the primary and secondary endodontic infections root canals (P = 0.303). P. endodontalis is more highly associated with root canals having primary endodontic infections, although P. endodontalis colonize in both root canals with primary and secondary chronic apical periodontitis.

  16. 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.

  17. Clinical presentation and treatment of primary and secondary paranasal mucoceles

    Directory of Open Access Journals (Sweden)

    Jih-Chin Lee

    2014-01-01

    Full Text Available Background: This retrospective study was conducted to describe and compare the clinical characteristics of primary mucoceles occurring in patients without a previous history of sinus surgery, the cause of mucoceles and secondary mucoceles resulting as a complication following endoscopic sinus surgery, and the Caldwell-Luc operation. Materials and Methods: This study reviewed 18 cases of primary mucoceles and 21 cases of secondary mucoceles, who were diagnosed and had received surgical intervention between 1995 and 2012. Results: The most common presenting symptoms in primary mucoceles were: Visual disturbance (18.6%, nasal obstruction (12.5%, and headache (12.5%. In secondary mucoceles, the most common symptoms were: Nasal obstruction (27.5%, rhinorrhea (15%, and postnasal drip (12.5%. The most common sites of origin for primary mucoceles were the ethmoid sinus (31.5% and sphenoid sinus (31.5%. In secondary mucoceles, the maxillary sinus was the most common site of origin (40.7%, followed by the ethmoid sinus (29.6%. All patients with secondary mucoceles had a history of sinus surgery. Conclusions: Mucoceles are benign lesions of the paranasal sinus. Cases of secondary mucoceles that occur following sinus endoscopic surgery develop more frequently in the ethmoid sinus compared to those following the Caldwell-Luc procedure. Endoscopic intranasal surgery of mucoceles is a reliable therapeutic measure with a favorable long-term outcome.

  18. Analysis of haloforms in wastewater. Removal of haloforms during secondary and tertiary treatment and formation during disinfection

    Energy Technology Data Exchange (ETDEWEB)

    de Leer, E W.B.

    1980-01-01

    The removal of haloforms during secondary and tertiary treatment and formation during disinfection was determined with a pentane extraction method followed by gas chromatographic separation with quantification by electron capture detection, which showed good results. High chloroform and trichloroethane levels in domestic sewage were reduced in activated-sludge tanks to 0 to 2 ..mu..g/l, one order of magnitude lower than Rotterdam drinking water.

  19. Usefulness of ultrasonographic evaluation in primary and secondary hyperparathyroidism

    International Nuclear Information System (INIS)

    Jeon, Tae Joo; Kim, Eun Kyung; Lee, Jong Doo; Park, Jung Soo; Lee, Jong Tae; Yoo, Hyung Sik

    1999-01-01

    To evaluate the accuracy and ultrasonographic findings of primary and secondary hyperparathyroidism (HPT) and correlate them with pathologic results. We reviewed 31 cases of surgically confirmed primary (n=22) and secondary (n=9) hyperparathyroidism. We used 10 or 7.5 MHz linear transducer and reviewed the location, contour, size and echogenicity of lesions. Then we evaluated the detection rate of parathyroid lesions based on surgical result and compared the result of 99m Tc-sestamibi scan (15 cases). Location of primary HPT was left lower in 9, left upper in 5, right lower in 4, right upper in 3, left midportion in 1 and superior mediastinum in 1. Lesions showed variable echogenicity-mild low echo (2), moderate low echo (10), severe low echo (2), isoecho (4) and heterogeneous echo pattern (1). All the lesions except 5 were well defined and 3 lesions had echogenic rim. Posterior enhancement and lateral shadowing were noted in 3 and 4 lesions, respectively. Nineteen of 23 primary lesions were detected by ultrasonography (82.6%) and well correlated with sestamibi scan. In case of secondary HPT, most were well defined low echoic nodular lesions, and we could detect 6 of 9 patients (67%) and 15 of 36 lesions (41.7%). Only 6 of 24 secondary lesion were detected by sestamibi scan (25%). The detection rate of ultrasonography in primary HPT was fairly good and well correlated with the result of the 99m Tc-sestamibi scan, but both diagnostic modalities were not promising in secondary HPT.

  20. The utility of neck ultrasound and sestamibi scans in patients with secondary and tertiary hyperparathyroidism.

    Science.gov (United States)

    Alkhalili, Eyas; Tasci, Yunus; Aksoy, Erol; Aliyev, Shamil; Soundararajan, Saranya; Taskin, Eren; Siperstein, Allan; Berber, Eren

    2015-03-01

    Secondary hyperparathyroidism (SHPT) and tertiary hyperparathyroidism (THPT) are disease entities in patients with chronic kidney disease that are caused by parathyroid hyperplasia. The role of preoperative localization studies in patients undergoing parathyroidectomy for these conditions remains poorly defined. To evaluate the utility of surgeon-performed neck ultrasound (US) as well as sestamibi scans in the localization of parathyroid glands in patients with SHPT/THPT. A retrospective analysis of patients with SHPT/THPT who underwent parathyroidectomy at a single institution. Results of preoperative localization studies were compared to intraoperative findings. One hundred and three patients underwent parathyroidectomy for SHPT/THPT. All patients underwent surgeon-performed neck US, while 92 (89%) underwent sestamibi scans. US failed to localize any of the parathyroids in 4 patients (3.8%), while sestamibi was negative in 11 (12%). Forty-seven ectopic glands were identified in 38 patients in whom sestamibi was performed. In five patients (13%), ectopic glands were identified by both modalities, by US only in 6 (16%), by sestamibi only in 8 (21%), and by neither study in 19 patients (50%). US showed new thyroid nodules in 19 patients (18.4 %), leading to lobectomy or thyroidectomy at the time of parathyroidectomy in 16 patients (15.5%). Pathology showed malignancy in 7 patients (6.8%). US and MIBI offer little benefit in localizing ectopic glands and rarely change the conduct of a standard four-gland exploration. Although there was a benefit of US in the assessment of thyroid nodules, in only 8.7% of patients was sestamibi of benefit in identifying ectopic glands.

  1. Evaluation of Parathyroidectomy for Secondary and Tertiary Hyperparathyroidism by the Parathyroid Surgeons' Society of Japan.

    Science.gov (United States)

    Tominaga, Yoshihiro; Kakuta, Takatoshi; Yasunaga, Chikao; Nakamura, Michio; Kadokura, Yoshiyuki; Tahara, Hideki

    2016-02-01

    Secondary hyperparathyroidism (SHPT) remains a serious complication in patients with chronic kidney disease, and some patients require parathyroidectomy. The Parathyroid Surgeons' Society of Japan (PSSJ) evaluated parathyroidectomy for SHPT and tertiary hyperparathyroidism (THPT) in Japan. The annual numbers of parathyroidectomies between 2004 and 2013 were evaluated using questionnaires. Since 2010, the PSSJ has registered the patients. In total, 826 patients from 42 institutions were registered. The annual number of parathyroidectomies for SHPT and THPT in Japan increased from 2004 to 2007 and then decreased markedly after 2007, with 296 operations performed in 2013. The number of women and men was almost equal (397/427). Median (interquartile range) age of these patients was 59.0 (24-87) years, the duration of hemodialysis before parathyroidectomy was 10.83 (0.0-38.7) years, and diabetic nephropathy was 87/826 (10.5%). Of these patients 59.6% were treated with cinacalcet at undergoing parathyroidectomy. In 75.3% of patients, a total parathyroidectomy with forearm autograft was performed. In 77.7% of patients, four or more parathyroid glands were removed during the initial operation. The incidences of husky voice and wound hemorrhage were 2.9% and 1.1%, respectively. The number of parathyroidectomies for SHPT in Japan decreased markedly after the introduction of cinacalcet. Based on the evaluation of registered patients, parathyroidectomies have been successfully performed at the institutions participating in the PSSJ. © 2016 The Authors. Therapeutic Apheresis and Dialysis published by John Wiley & Sons Australia, Ltd on behalf of International Society for Apheresis, Japanese Society for Apheresis, and Japanese Society for Dialysis Therapy.

  2. Input, Process, and Learning in primary and lower secondary schools

    DEFF Research Database (Denmark)

    Larsen, Michael Søgaard; Nordenbo, Sven Erik; Holm, Anders

    What do we want to know? What empirical research has been carried out to examine the relationship between factors in primary and lower secondary schools (inputs and processes) and the learning achieved by primary and lower secondary school pupils (outputs and outcomes)? What are the results...... with weight of evidence of this empirical research? Who wants to know and why? The project was commissioned by the Danish Evaluation Institute (Danmarks Evalueringsinstitut) and was performed on behalf of the Nordic Indicator Workgroup (DNI). DNI is a workgroup nominated by the Nordic Evaluation Network...... and development etc. within the primary and lower secondary school sector. What did we find? From 1990 to 2008, 109 studies were published on malleable school factors within school effectiveness research. Of these studies, 71 are of high or medium weight of evidence. Synthesising these studies establishes that 11...

  3. [Diagnostics and treatment of primary and secondary hyperparathyroidism].

    Science.gov (United States)

    Zarivchatskiĭ, M F; Denisov, S A; Blinov, S A; Kolevatov, A P; Teplykh, N S

    2013-01-01

    The experience of treatment of 41 patients (aged 32-67 years) was presented in the article. The duration of disease was 2-5 years. Primary hyperparathyroidism was diagnosed in 16 patients and secondary--in 25. Diagnostics of the disease included clinical methods of treatment; studying levels of general and ionized calcium, phosphorus, parathormone; an ultrasound of thyroid and parathyroid glands, the substratum scintigraphy. All patients were undergone the operation. Adenomas of parathyroid glands were removed in the case of primary hyperparathyroidism including mini-access. Hyperplastic parathyroid glands (31/2) were disposed in the case of secondary hyperparathyroidism. Good immediate and long-term results were obtained.

  4. Cosmic ray antimatter: Is it primary or secondary?

    Science.gov (United States)

    Stecker, F. W.; Protheroe, R. J.; Kazanas, D.

    1981-01-01

    The relative merits and difficulties of the primary and secondary origin hypotheses for the observed cosmic ray antiprotons, including the low energy measurement of Buffington, were examined. It is concluded that the cosmic ray antiproton data may be strong evidence for antimatter galaxies and baryon symmetric cosmology. The present antiproton data are consistent with a primary extragalactic component having antiproton/proton approximately equal to .0032 + or - 0.7.

  5. Physical Activity and Nutrition in Primary and Tertiary Prevention of Colorectal Cancer.

    Science.gov (United States)

    Schoenberg, Michael H

    2016-06-01

    Lifestyle factors play a pivotal role in the primary and tertiary prevention of colorectal cancer. The purpose of this review article is to summarize data concerning the effect of the lifestyle factors physical activity (PA) and nutrition in primary and, more importantly, tertiary prevention of colorectal cancer (CRC). Focusing on the influence of lifestyle factors on prognosis und quality of life (QOL), a comprehensive literature search of clinical studies published mainly in the years 2000 until 2015 was performed and the current knowledge based on these clinical studies reviewed. Besides avoiding risk factors (such as smoking and overindulgence in alcohol), healthy weight, regular and moderate PA as well as a diet which contains fruit, vegetables, poultry, and fish (so-called 'Mediterranean' diet) may reduce the risk of the disease significantly. Patients already diagnosed with CRC can also actively improve the prognosis of CRC and QOL by changing their lifestyle. Patients commencing moderate exercise and modifying their eating habits in terms of a 'Mediterranean' diet can reduce cancer-specific and overall mortality by up to 40% and significantly increase their quality of life already during chemotherapy. Therefore, moderate physical exercise, calorie restriction, and a Mediterranean dietary pattern for patients with CRC should be recommended by physicians treating these patients. In fact, the World Cancer Research Fund/American Institute for Cancer Research (AICR/WCRF) systematic literature review from 2007 shows that the lifestyle changes recommended after diagnosis are the same for primary prevention of this disease. Lifestyle changes such as moderate PA and a Mediterranean diet significantly improve the QOL as well as the prognosis of patients suffering from colorectal disease. However, the effect of lifestyle changes is mostly based on observational studies, while only few studies are prospective and none are randomized. Therefore, these observational

  6. Frequency of causes of primary postpartum haemorrhage in a tertiary care hospital

    International Nuclear Information System (INIS)

    Munir, S.I.

    2015-01-01

    Objective: To study the frequency of causes of primary postpartum hemorrhage (PPH) in women managed in a tertiary care Hospital. material and Methods: The study was conducted in the department of Obstetrics and Gynecology, Unit - 1, Lady Willingdon Hospital King Edward Medical University, Lahore from July 2013 to December 2013. All the women having postpartum haemorrhage after vaginal delivery in the labour room or referred with primary postpartum haemorrhage were included in the study and were evaluated to see the frequency of postpartum haemorrhage as well as the causes of PPH in women being treated in a tertiary care unit. Results: During the study period 1344 women delivered in unit I and 250 patients developed postpartum haemorrhage giving frequency of primary postpartum haemorrhage 18.60%. Majority of the women 29.6% (n = 74) were between 26 - 30 years of age, mean and SD was 28.43 ± 4.76 years. The gestation of 55.2% (n = 138) patients was between 37 - 40 weeks. The frequency of postpartum haemorrhage in booked women during antenatal period was recorded as 25.2% (n = 63) while 74.8% (n = 187) were not booked in any health facility. Among patients who developed PPH, uterine atony was the most common cause 57.6% (n = 144), followed by genital tract teats which was 29.2% (n = 73). The rest of the causes of PPH were retained placenta in 10% (n = 25), uterine rupture in 3.6% (n = 9) and uterine inversion in 1.6% (n = 4). Conclusions: Postpartum haemorrhage is still a leading but preventable cause of maternal morbidity and mortality in our country due to under utilization of health facilities, the major cause is uterine atony followed by perineal tears. (author)

  7. Problems of discipline in primary and secondary school: Teachers' opinions

    Directory of Open Access Journals (Sweden)

    Savović Branka B.

    2002-01-01

    Full Text Available Investigations carried out in late 2001 in primary and secondary schools of Belgrade, Novi Sad and Niš comprised students, teachers and associates. The aim of investigations was to get insight into the state-of-the-arts problems and needs of our primary and secondary schools. The paper is a part of investigations, related to the results obtained for students' opinions of their interrelations with teachers as well as opinions of teachers themselves. The sample comprised 727 students of 4th grade of secondary vocational and high schools, 562 students of 8th grade of primary schools 168 secondary school and 107 primary school teachers. We investigated their interrelationships and within this framework the level of potential or current aggressive behavior. The majority of teachers (51% estimated student-teacher relationships mediocre - neither good nor bad. The most frequent problem in students' behavior is, according to the teachers instruction disturbance. One-quarter of teachers find that students offend them, ridicule them, or mock at them in front of others, and 5 per cent complain of physical injury intimidation on the part of students. When a problem comes up, 18 per cent of teachers talk with a student, and nearly 10 per cent of teachers give lower grades in their subject, so as to punish a student for undisciplined behaviors. In teachers' opinion, society, school the least, is to be blamed for the situation.

  8. Celebrating the Ministry of Primary and Secondary Education ...

    African Journals Online (AJOL)

    Celebrating the Ministry of Primary and Secondary Education Curriculum ... Accordingly the thesis defended in this paper is that; contrary to public opinion, it is a ... from documentary analysis with special focus on Plato's Theory of Forms and ... By Country · List All Titles · Free To Read Titles This Journal is Open Access.

  9. Characterization of primary and secondary metabolites of leaf and ...

    African Journals Online (AJOL)

    This study evaluates the primary and secondary metabolite profiles of Eurycoma longifolia Jack (EL) stems and leaves to determine whether it can be utilized for therapeutic purposes as the roots. A total of six types of extracts were tested. The extracts showed high content of glycosaponins, polysaccharides, proteins and ...

  10. Primary and Secondary Selection Tools in an Optometry Admission Process.

    Science.gov (United States)

    Spafford, Marlee M.

    2000-01-01

    A five-year evaluation of the admissions decision process at the University of Waterloo (Ontario) School of Optometry found that when primary tools (i.e., university grades, Optometry Admission Test scores) did not differentiate candidates, there was an increased emphasis on secondary tools (i.e., interview, autobiographic sketch, prerequisite…

  11. Short Communication Further refutation of the primary-secondary ...

    African Journals Online (AJOL)

    The primary-secondary settlement hypothesis, that mussels first settle in algae and then move to mussel beds, was rejected as the only mode of recruitment for the brown mussel Perna perna in a previous study at one location over one year on the south coast of South Africa. We investigated recruitment of P. perna into ...

  12. Average Distance Travelled To School by Primary and Secondary ...

    African Journals Online (AJOL)

    This study investigated average distance travelled to school by students in primary and secondary schools in Anambra, Enugu, and Ebonyi States and effect on attendance. These are among the top ten densely populated and educationally advantaged States in Nigeria. Research evidences report high dropout rates in ...

  13. Instructional Leadership in Primary and Secondary Schools in Western Australia.

    Science.gov (United States)

    Wildy, Helen; Dimmock, Clive

    1993-01-01

    Investigates teachers' and principals' perceptions of instructional leadership in a sample of Western Australian government primary and secondary schools, using the Instructional Leadership Questionnaire. Instructional leadership was viewed as a shared responsibility; teachers felt principals were less involved than principals felt they were.…

  14. Computer attitudes of primary and secondary students in South Africa.

    NARCIS (Netherlands)

    Bovee, Chantal; Voogt, Joke; Meelissen, Martina R.M.

    2007-01-01

    This study investigated computer attitudes of 240 students from eight primary and secondary schools in South Africa. The student population of six of the eight schools that participated in the study can be characterised as middle or upper class. Two schools were from South African townships. All

  15. Crossing the Primary and Secondary School Divide in Teacher Preparation

    Science.gov (United States)

    Knipe, Sally

    2012-01-01

    Teacher education courses at universities qualify graduates to teach in age-related contexts of primary/early childhood/secondary that reflect the organisational structure of schools. In terms of teacher employment, for some considerable time, these longstanding organisational divisions have been by-passed whereby a shortage of teachers in…

  16. Teaching Japanese Language in Tertiary and Secondary Education: State and Private Institutions in Romania

    Directory of Open Access Journals (Sweden)

    Angela DRAGAN

    2018-01-01

    Full Text Available In Romania, Japanese language, literature and culture are taught at university level in two private universities and two state universities. Japanese departments are part of either a Faculty of Letters or a Faculty of Languages and Literatures. Students have to choose another language to study, in addition to Japanese. This gives them a dual major / dual specialization. A large number of graduates decide on pursuing a teaching career in one of their specializations. My paper looks at the way in which university provides an educational background for teachers at lower and upper education. It also looks into the way it shapes secondary education through its curriculum. This refers to compulsory education in an integrated national system of education. But, in the last ten years, this perspective has broadened. Language schools, which are not part of this integrated system, have appeared. Some of them teach exclusively Japanese language and Japanese culture classes. In the beginning, the students were mainly adults, age 18+ but in the last several years, more children have started to be interested in attending classes in these language schools. My paper also discusses this new perspective. A questionnaire and its results will also be presented on this topic. It will show not only the increasing number of young learners but also, their very young age, which goes as far as primary school. This tendency, in studying Japanese as a foreign language, could provide a preview into its development at the secondary level.

  17. Phenomenon of primary and secondary extinction in textured material

    International Nuclear Information System (INIS)

    Kryshtab, T.G.; Palacios G, J.; Mazin, M.O.

    2002-01-01

    A new X-ray diffraction method is proposed for a more exact calculation of pole figures to determine the crystallite orientation distribution function (CODF) in textured materials, by the introduction of a correction of the integrated intensity of the diffracted beam due to the phenomenon of extinction. Besides, for the case of a symmetrical Bragg reflection from an ''infinitely thick'' flat parallel plate textured sample a simple solution is developed for the problem of separation and determination of primary and secondary extinction parameters, which can be present simultaneously. The determination of these parameters gives additional information about crystallite structure and allows us to evaluate the average subgrains size and their disorientation, respectively. In this work according to the dynamic diffraction theory, it is shown that the extinction length, which is directly connected with the phenomenon of primary extinction, in the Bragg geometry for σ polarization (perpendicular) is independent on the wavelength used for a given reflection. On the other hand, the additional contribution from secondary extinction depends on X-ray wavelength due to the change of effective absorption coefficient. Considering this fact, the calculations of pole density and the parameters of primary and secondary extinction are performed using the same strong reflection for two different wavelengths and, for one of these wavelengths, a second order of reflection. For confirmation of the proposed method a partially cold rolled aluminium sample and an aluminium powder standard sample were measured. The corrected pole densities, the values of primary and secondary extinction and the average sizes of perfect coherent areas and average angle of disorientation of subgrains in the selected directions were obtained. The obtained results show that the precise X-ray diffraction characterization of textured materials requires the consideration, in general, of primary as well as secondary

  18. Start App: a coding experience between primary and secondary school

    Directory of Open Access Journals (Sweden)

    Filippo Bruni

    2016-04-01

    Full Text Available The paper presents a coding experience in primary school (“Colozza” in Campobasso. Within the theoretical framework offered by computational thinking, using App Inventor, it was created a calculator for smartphone in the Android environment. High school students (from a technical secondary school guided the pupils in primary school, making an interesting form of cooperation between primary and secondary schools. Start App: una esperienza di coding tra scuola primaria e scuola secondariaIl contributo presenta una esperienza di coding nella scuola primaria dell’Istituto Comprensivo statale “Colozza” di Campobasso. All’interno della cornice teorica offerta dal pensiero computazionale, utilizzando App Inventor, è stata realizzata una calcolatrice per smartphone in ambiente Android. A guidare gli allievi della primaria sono stati gli studenti dell’Istituto Tecnico Industriale “Marconi” di Campobasso realizzando una interessante forma di collaborazione tra istituti scolastici di ordine diverso.

  19. Lung Parenchymal Assessment in Primary and Secondary Pneumothorax.

    Science.gov (United States)

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

    2016-03-01

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

  20. Enhanced primary and secondary performance through cognitive relaying and leveraging primary feedback

    KAUST Repository

    Hamza, Doha R.

    2014-06-01

    We consider a spectrum-sharing system, where the primary terminal operates in a time-slotted fashion and is active only when it has a packet to send. The secondary terminal uses spectrum sensing results and the primary automatic repeat request (ARQ) feedback to access the channel probabilistically. To enhance the primary\\'s system performance, the secondary user (SU) acts as a relay for the primary user (PU) in the event of transmission failure on the direct link of the latter. Closed-form expressions for the primary and secondary throughputs are obtained for the described scheme. The optimal medium access probabilities are then obtained by maximizing the secondary throughput subject to constraints that guarantee the stability of the considered queues, a minimum primary throughput, and a maximum primary queueing delay. The results clearly indicate the benefits of cognitive relaying in enhancing the throughput performance for both the PU and SU. Furthermore, by guaranteeing minimum rate and maximum delay requirements, our scheme is shown to provide a definitive notion of protection for the licensed users of the network. © 2013 IEEE.

  1. Enhanced primary and secondary performance through cognitive relaying and leveraging primary feedback

    KAUST Repository

    Hamza, Doha R.; Aï ssa, Sonia

    2014-01-01

    We consider a spectrum-sharing system, where the primary terminal operates in a time-slotted fashion and is active only when it has a packet to send. The secondary terminal uses spectrum sensing results and the primary automatic repeat request (ARQ) feedback to access the channel probabilistically. To enhance the primary's system performance, the secondary user (SU) acts as a relay for the primary user (PU) in the event of transmission failure on the direct link of the latter. Closed-form expressions for the primary and secondary throughputs are obtained for the described scheme. The optimal medium access probabilities are then obtained by maximizing the secondary throughput subject to constraints that guarantee the stability of the considered queues, a minimum primary throughput, and a maximum primary queueing delay. The results clearly indicate the benefits of cognitive relaying in enhancing the throughput performance for both the PU and SU. Furthermore, by guaranteeing minimum rate and maximum delay requirements, our scheme is shown to provide a definitive notion of protection for the licensed users of the network. © 2013 IEEE.

  2. Primary and secondary fragmentation of crystal-bearing intermediate magma

    Science.gov (United States)

    Jones, Thomas J.; McNamara, Keri; Eychenne, Julia; Rust, Alison C.; Cashman, Katharine V.; Scheu, Bettina; Edwards, Robyn

    2016-11-01

    Crystal-rich intermediate magmas are subjected to both primary and secondary fragmentation processes, each of which may produce texturally distinct tephra. Of particular interest for volcanic hazards is the extent to which each process contributes ash to volcanic plumes. One way to address this question is by fragmenting pyroclasts under controlled conditions. We fragmented pumice samples from Soufriere Hills Volcano (SHV), Montserrat, by three methods: rapid decompression in a shock tube-like apparatus, impact by a falling piston, and milling in a ball mill. Grain size distributions of the products reveal that all three mechanisms produce fractal breakage patterns, and that the fractal dimension increases from a minimum of 2.1 for decompression fragmentation (primary fragmentation) to a maximum of 2.7 by repeated impact (secondary fragmentation). To assess the details of the fragmentation process, we quantified the shape, texture and components of constituent ash particles. Ash shape analysis shows that the axial ratio increases during milling and that particle convexity increases with repeated impacts. We also quantify the extent to which the matrix is separated from the crystals, which shows that secondary processes efficiently remove adhering matrix from crystals, particularly during milling (abrasion). Furthermore, measurements of crystal size distributions before (using x-ray computed tomography) and after (by componentry of individual grain size classes) decompression-driven fragmentation show not only that crystals influence particular size fractions across the total grain size distribution, but also that free crystals are smaller in the fragmented material than in the original pumice clast. Taken together, our results confirm previous work showing both the control of initial texture on the primary fragmentation process and the contributions of secondary processes to ash formation. Critically, however, our extension of previous analyses to characterisation

  3. Psychological functioning in primary progressive versus secondary progressive multiple sclerosis

    DEFF Research Database (Denmark)

    Vleugels, L; Pfennings, L E; Pouwer, F

    1998-01-01

    Psychological functioning in two types of multiple sclerosis (MS) patients is assessed: primary progressive (PP) and secondary progressive (SP) patients. On the basis of differences in clinical course and underlying pathology we hypothesized that primary progressive patients and secondary...... progressive patients might have different psychological functioning. Seventy patients treated in an MS centre were examined cross-sectionally. Forty had an SP course of MS and 30 a PP course. The 33 male and 37 female patients had a mean age of 48.4 years (SD 11.2) and mean age of onset of MS of 30.7 years...... (SD 11.1). Patients completed questionnaires measuring among others the following aspects of psychological functioning: depression (BDI, SCL-90), anxiety (STAI, SCL-90), agoraphobia (SCL-90), somatic complaints (SCL-90), hostility (SCL-90) and attitude towards handicap (GHAS). Patients with a PP...

  4. Small bowel volvulus with jejunal diverticulum: Primary or secondary?

    Science.gov (United States)

    Shen, Xiao-Fei; Guan, Wen-Xian; Cao, Ke; Wang, Hao; Du, Jun-Feng

    2015-09-28

    Small bowel volvulus, which is torsion of the small bowel and its mesentery, is a medical emergency, and is categorized as primary or secondary type. Primary type often occurs without any apparent intrinsic anatomical anomalies, while the secondary type is common clinically and could be caused by numerous factors including postoperative adhesions, intestinal diverticulum, and/or tumors. Here, we report a rare case of a 60-year-old man diagnosed with small bowel volvulus using multidetector computed tomography (MDCT) angiography. Further discovery by laparotomy showed one jejunal diverticulum, longer corresponding mesentery with a narrower insertion, and a lack of mesenteric fat. This case report includes several etiological factors of small bowel volvulus, and we discuss the possible cause of small bowel volvulus in this patient. We also highlight the importance of MDCT angiography in the diagnosis of volvulus and share our experience in treating this disease.

  5. Evaluation of a tertiary teledermatology service between peripheral and academic dermatologists in the Netherlands

    NARCIS (Netherlands)

    van der Heijden, Job P.; de Keizer, Nicolette F.; Witkamp, Leonard; Spuls, Phyllis I.

    2014-01-01

    Tertiary teledermatology (TTD)-secondary-care to tertiary-care teleconsultation-is applied rarely compared with the frequently applied secondary teledermatology (primary to secondary care). The objective of this study was to determine the effect of TTD on referrals from peripheral dermatologists to

  6. Dabigatran experience in primary and secondary prevention of cardioembolic stroke

    Directory of Open Access Journals (Sweden)

    Maksim Alekseyevich Domashenko

    2013-01-01

    Full Text Available The review of novel oral anticoagulants (dabigatran, rivaroxaban and apixaban in stroke prevention and also own data of administration of dabigatran in primary and secondary prevention of ischemic stroke in 45 patients with cerebrovascular diseases are presented. Most patients received dabigatran 14 days after the first stroke associated with nonvalvular atrial fibrillation. In other cases dabigatran was used for primary prevention of stroke in patients with chronic forms of cerebrovascular diseases and nonvalvular atrial fibrillation. Dabigatran shows good tolerability and efficacy. Recurrent strokes were diagnosed in 2 patients. The reasons for these events were arterial hypertension in one case and symptomatic atherosclerotic plaque in the other case.

  7. Nuclear fuel assembly incorporating primary and secondary structural support members

    International Nuclear Information System (INIS)

    Carlson, W.R.; Gjertsen, R.K.; Miller, J.V.

    1987-01-01

    A nuclear fuel assembly, comprising: (a) an upper end structure; (b) a lower end structure; (c) elongated primary structural members extending longitudinally between and rigidly interconnecting the upper and lower end structures, the upper and lower end structures and primary structural members together forming a rigid structural skeleton of the fuel assembly; (d) transverse grids supported on the primary structural members at axially spaced locations therealong between the upper and lower end structures; (e) fuel rods extending through and supported by the grids between the upper and lower end structures so as to extend in generally side-by-side spaced relation to one another and to the primary structural members; and (f) elongated secondary structural members extending longitudinally between but unconnected with the upper and lower end structures, the secondary structural members extending through and rigidly interconnected with the grids to extend in generally side-by-side spaced relation to one another, to the fuel rods and to the primary structural members so as to bolster the stiffness of the structural skeleton of the fuel assembly

  8. Internet evolved : from secondary to primary competitive intelligence data

    OpenAIRE

    Dabrowska, Dominika

    2011-01-01

    Primary data is an important source ofinformation for Competitive Intelligence. Traditionally, it has been collected from interviews with stakeholders, talks at conferences and other means of direct interpersonal communication. The role of the Internet in the data collection – if it was used at all – was that of a provider of supplementary secondary data. Here, this approach is challenged and, using three examples of Social Media, it is shown that the Internet can and does provide valuable pr...

  9. How Secondary and Tertiary Amide Moieties are Molecular Stations for Dibenzo-24-crown-8 in [2]Rotaxane Molecular Shuttles?

    Science.gov (United States)

    Riss-Yaw, Benjamin; Morin, Justine; Clavel, Caroline; Coutrot, Frédéric

    2017-11-21

    Interlocked molecular machines like [2]rotaxanes are intriguing aesthetic molecules. The control of the localization of the macrocycle, which surrounds a molecular axle, along the thread leads to translational isomers of very different properties. Although many moieties have been used as sites of interactions for crown ethers, the very straightforwardly obtained amide motif has more rarely been envisaged as molecular station. In this article, we report the use of secondary and tertiary amide moieties as efficient secondary molecular station in pH-sensitive molecular shuttles. Depending on the N -substitution of the amide station, and on deprotonation or deprotonation-carbamoylation, the actuation of the molecular machinery differs accordingly to very distinct interactions between the axle and the DB24C8.

  10. [Management of adult secondary insomnia in primary health care].

    Science.gov (United States)

    Cavadas, Luís Filipe; Ribeiro, Lúcia

    2011-01-01

    Insomnia is the most common sleep disorder in adults, with secondary insomnia being the most prevalent. This sleep disorder is associated with important medical and social consequences. The General Practitioner (GP) plays a key role in the diagnosis of insomnia, which may affect about 69% of their patients in the PHC (Primary Health Care). Recognize the differential diagnosis of secondary insomnia in adults, evaluate and manage these patients in the PHC, appropriately use the treatments available and meet the criteria for referral. Bibliographic search in MEDLINE databases, and evidence based review databases, using the MeSH terms: Primary Health Care, Sleep Disorders, Insomnia, for articles published since January 2000 until July 2009, in English, Portuguese, French and Spanish. Index de Revistas Médicas Portuguesas and scientific societies dedicated to sleep disorders were searched. Mood and anxiety disorders are the main co-morbidities associated with secondary insomnia, being present in 30% to 50% of patients with insomnia. The medical pathology and substance abuse are present respectively in 10% of patients. It is essential a proper clinical history, with a history of sleep, sleep diary and the partner information. There is evidence that the combination of specific pharmacological treatments (benzodiazepines and the benzodiazepine receptor agonists) with the nonpharmacological (cognitive-behavioral therapy) may be useful in secondary insomnia, as co-adjuvant treatment of the underlying disease. There are several treatment options with their indications and adverse effects. The criteria for referral should be defined according to the availability of human resources. Due to the high prevalence and the serious consequences of secondary insomnia in adults, it must be systematically managed by the GP. It is important to know and to use non-pharmacological therapy in GP consultation, because this therapy was shown to be important in treating this type of insomnia

  11. Astronomy in Primary and Secondary Education in Slovenia

    Science.gov (United States)

    Gomboc, Andreja

    2015-08-01

    I will present the status of astronomy in educational system in Slovenia. In primary schools astronomy is offered as an optional course in the last 3 grades (12-15 yrs old), while in secondary schools a few astronomical topics are present only as part of other subjects (e.g. physics, geography). I will describe a pilot project of an astronomy course in secondary schools, which was carried out in the school year 2013/14. The main focus of my presentation will be the experience gained with organisation of the Slovenian National Astronomy Competition. It is organised by the Slovenian Society of Mathematicians, Physicists and Astronomers since 2009, building on an extensive network of over 200 primary and secondary school teachers who participated in IYA2009 activities, and who now represent majority of mentors for the competition. In 2013, only 5 years after the start of competition, our pupils attended the International Olympiad on Astronomy and Astrophysics for the first time and with great success. Supporting activities include the Slovenian version of the Portal to the Universe (www.portalvvesolje.si) and translation of Space Scoop astronomy news for children.

  12. Etiology and management of primary amenorrhoea: A study of 102 cases at tertiary centre.

    Science.gov (United States)

    Kriplani, Alka; Goyal, Manu; Kachhawa, Garima; Mahey, Reeta; Kulshrestha, Vidushi

    2017-12-01

    To determine the prevalence of etiologic causes of primary amenorrhea in Indian population. A retrospective study was performed using 102 complete medical records of women with primary amenorrhea who attended the Gynaecologic Endocrinology Clinic, Department of Obstetrics and Gynaecology, AIIMS, New Delhi from September 2012 to September 2015. Cases were analysed according to clinical profile, development of secondary sexual characteristics, physical examination, pelvic and rectal examination, X-ray of chest and lumbo-sacral spine, hormone profile, pelvic USG, MRI, and cytogenetic study including karyotype. The three most common causes of primary amenorrhea were Mullerian anomalies (47%), gonadal dysgenesis (20.5%), and hypogonadotropic hypogonadism (14.7%) in the present study. There were 3 cases of Turner syndrome (45,XO), 5 cases of Swyer's syndrome (46,XY) and 2 cases of Androgen insensitivity syndrome (46,XY). One case had pituitary macroadenoma and eight cases (7.8%) were of genital tuberculosis. The present study has currently been the largest case series of primary amenorrhea from North India. Mullerian anomaly is the most prevalent etiological factor leading to amenorrhoea followed by gonadal dysgenesis in our study. Racial, genetic and environmental factors could play role in the cause of primary amenorrhea. Copyright © 2017. Published by Elsevier B.V.

  13. Seasonality of primary and secondary production in an Arctic river

    Science.gov (United States)

    Kendrick, M.; Huryn, A.; Deegan, L.

    2011-12-01

    Rivers and streams that freeze solid for 8-9 months each year provide excellent examples of the extreme seasonality of arctic habitats. The communities of organisms inhabiting these rivers must complete growth and development during summer, resulting in a rapid ramp-up and down of production over the short ice-free period. The effects of recent shifts in the timing of the spring thaw and autumn freeze-up on the duration and pattern of the period of active production are poorly understood. We are currently investigating: 1) the response of the biotic community of the Kuparuk River (Arctic Alaska) to shifts in the seasonality of the ice-free period, and 2) the community response to increases in phosphorous (P) supply anticipated as the volume of the permafrost active-layer increases in response to climate warming. Here algal production supports a 2-tier web of consumers. We tracked primary and secondary production from the spring thaw through mid-August in a reference reach and one receiving low-level P fertilization. Gross primary production/community respiration (GPP/R) ratios for both reaches were increasing through mid-July, with higher GPP/R in response to the P addition. Understanding the degree of synchrony between primary and secondary production in this Arctic river system will enhance further understanding of how shifts in seasonality affect trophic dynamics.

  14. Primary and secondary organic aerosols in summer 2016 in Beijing

    Science.gov (United States)

    Tang, Rongzhi; Wu, Zepeng; Li, Xiao; Wang, Yujue; Shang, Dongjie; Xiao, Yao; Li, Mengren; Zeng, Limin; Wu, Zhijun; Hallquist, Mattias; Hu, Min; Guo, Song

    2018-03-01

    To improve air quality, the Beijing government has employed several air pollution control measures since the 2008 Olympics. In order to investigate organic aerosol sources after the implementation of these measures, ambient fine particulate matter was collected at a regional site in Changping (CP) and an urban site at the Peking University Atmosphere Environment Monitoring Station (PKUERS) during the Photochemical Smog in China field campaign in summer 2016. Chemical mass balance (CMB) modeling and the tracer yield method were used to apportion primary and secondary organic sources. Our results showed that the particle concentration decreased significantly during the last few years. The apportioned primary and secondary sources explained 62.8 ± 18.3 and 80.9 ± 27.2 % of the measured OC at CP and PKUERS, respectively. Vehicular emissions served as the dominant source. Except for gasoline engine emissions, the contributions of all the other primary sources decreased. In addition, the anthropogenic SOC, i.e., toluene SOC, also decreased, implying that deducting primary emissions can reduce anthropogenic SOA. In contrast to the SOA from other regions in the world where biogenic SOA was dominant, anthropogenic SOA was the major contributor to SOA, implying that deducting anthropogenic VOC emissions is an efficient way to reduce SOA in Beijing. Back-trajectory cluster analysis results showed that high mass concentrations of OC were observed when the air mass was from the south. However, the contributions of different primary organic sources were similar, suggesting regional particle pollution. The ozone concentration and temperature correlated well with the SOA concentration. Different correlations between day and night samples suggested different SOA formation pathways. Significant enhancement of SOA with increasing particle water content and acidity was observed in our study, suggesting that aqueous-phase acid-catalyzed reactions may be the important SOA formation

  15. Primary and secondary organic aerosols in summer 2016 in Beijing

    Directory of Open Access Journals (Sweden)

    R. Tang

    2018-03-01

    Full Text Available To improve air quality, the Beijing government has employed several air pollution control measures since the 2008 Olympics. In order to investigate organic aerosol sources after the implementation of these measures, ambient fine particulate matter was collected at a regional site in Changping (CP and an urban site at the Peking University Atmosphere Environment Monitoring Station (PKUERS during the Photochemical Smog in China field campaign in summer 2016. Chemical mass balance (CMB modeling and the tracer yield method were used to apportion primary and secondary organic sources. Our results showed that the particle concentration decreased significantly during the last few years. The apportioned primary and secondary sources explained 62.8 ± 18.3 and 80.9 ± 27.2 % of the measured OC at CP and PKUERS, respectively. Vehicular emissions served as the dominant source. Except for gasoline engine emissions, the contributions of all the other primary sources decreased. In addition, the anthropogenic SOC, i.e., toluene SOC, also decreased, implying that deducting primary emissions can reduce anthropogenic SOA. In contrast to the SOA from other regions in the world where biogenic SOA was dominant, anthropogenic SOA was the major contributor to SOA, implying that deducting anthropogenic VOC emissions is an efficient way to reduce SOA in Beijing. Back-trajectory cluster analysis results showed that high mass concentrations of OC were observed when the air mass was from the south. However, the contributions of different primary organic sources were similar, suggesting regional particle pollution. The ozone concentration and temperature correlated well with the SOA concentration. Different correlations between day and night samples suggested different SOA formation pathways. Significant enhancement of SOA with increasing particle water content and acidity was observed in our study, suggesting that aqueous-phase acid-catalyzed reactions may be

  16. Difference between Japanese Secondary and Tertiary Medical Facilities Regarding Changes in the Hospitalization of Children for Pneumonia after the Introduction of the Pneumococcal Conjugate Vaccine.

    Science.gov (United States)

    Haro, Kaoru; Ogawa, Masato; Hoshina, Takayuki; Kojiro, Masumi; Kusuhara, Koichi

    2017-05-24

    This study aimed to compare hospitalization of children for pneumonia between secondary and tertiary medical facilities, which hospitalize many children without and with underlying diseases, respectively, after the introduction of the pneumococcal conjugate vaccine (PCV). Our retrospective study included children admitted to the Department of Pediatrics at Kitakyushu General Hospital, a secondary medical facility, and the Hospital of the University of Occupational and Environment Health, Japan, a tertiary medical facility, from 2009 to 2013 for pneumonia. We compared the change in the rate of hospitalization for pneumonia after the introduction of the 7-valent PCV between the secondary and tertiary medical facilities. Hospitalization of patients with pneumonia declined by 28.8% in our secondary medical facility. In particular, hospitalization for pneumonia other than confirmed mycoplasmal or viral pneumonia was significantly reduced by 49.2%. In contrast, hospitalization of patients with pneumonia did not decline in our tertiary medical facility. After the introduction of PCV, hospitalization of children for pneumonia was not reduced at the tertiary medical facility. Various other pathogens besides pneumococcus may be associated with the development of pneumonia in children with underlying diseases.

  17. Appendectomy in primary and secondary staging operations for ovarian malignancy.

    Science.gov (United States)

    Rose, P G; Reale, F R; Fisher, A; Hunter, R E

    1991-01-01

    Appendectomy was performed at primary or secondary staging operations in 100 patients with ovarian malignancies. Of 80 patients who underwent appendectomy at the time of their primary surgery, 25 (31.2%) had appendiceal metastases. Among 47 patients who were believed to have disease limited to the pelvis at the time of surgery--stage I (N = 34), II (N = 7), IIIA (N = 5), and those designated stage IIIC solely on the basis of microscopic para-aortic nodal metastasis (N = 1)--the appendix was involved with disease in only two patients (4.3%). However, among 33 patients with advanced disease--stage IIIB (N = 6), IIIC except those designated IIIC solely on the basis of microscopic paraaortic nodal metastasis (N = 19), and IV (N = 8)--the appendix was involved with disease in 23 patients (69.7%) (P less than .001). Poorly differentiated tumors and serous histologic cell types more frequently metastasized to the appendix (64, 15, 6, and 8% for grades 3, 2, and 1 and borderline histology, respectively; P less than .001; and 48, 13, and 8% for serous, endometrioid, and mucinous; P less than .001). Of 20 patients who underwent appendectomy at their secondary staging procedure, two had metastases. Metastatic disease in the appendix was microscopic in nine of 27 patients. Because the frequency of appendiceal metastasis is similar to that of other metastatic sites in stages I and II ovarian cancer, it should be removed at primary staging procedures. Appendectomy should also be performed in patients with advanced ovarian malignancies if it contributes to cytoreduction or at the time of secondary staging procedures.

  18. Modified Valsalva test differentiates primary from secondary cough headache.

    Science.gov (United States)

    Lane, Russell J M; Davies, Paul T G

    2013-03-28

    The current definition of cough headache includes provocation of the symptom by Valsalva manoeuvre, and it is generally believed that all cough headache results from a sudden increase in intracranial pressure. We sought to question that presumption and to determine whether the Valsalva test might distinguish primary from secondary cough headache. We examined 16 consecutive cough headache patients using a modified Valsalva test (exhalation into the connecting tube of a standard anaeroid sphygmomanometer to 60 mm Hg for 10 seconds). A positive response was recorded if the manoeuvre provoked headache. All patients subsequently underwent brain MRI. None of the patients had neurological signs. Eleven had positive modified Valsalva tests. Ten were found subsequently to have posterior fossa pathologies (secondary cough headache: 8 Chiari Type 1 malformations, 2 posterior fossa meningiomas). The cough headache was relieved following surgery in all cases. One patient with a positive Valsalva test had an apparently normal brain MRI but measurements of hindbrain and posterior fossa dimensions were consistent with 'posterior fossa crowdedness'. The remaining 5 patients had negative (4 patients) or equivocal (1 patient) Valsalva tests and normal MRI scans (primary cough headache). These findings suggest that secondary cough headache results from a transient increase in intracranial CSF pressure during exertion in the presence of obstruction to normal cerebrospinal fluid dynamics. The modified Valsalva test can also determine whether tonsillar herniation found on brain MRI is symptomatic. Primary cough headache appears to be caused by a different mechanism, possibly through congestion of the orbital venous plexus in the presence of jugular venous incompetence and a reduced threshold for trigeminal sensory activation.

  19. Lithium-Catalyzed Thiol Alkylation with Tertiary and Secondary Alcohols: Synthesis of 3-Sulfanyl-Oxetanes as Bioisosteres.

    Science.gov (United States)

    Croft, Rosemary A; Mousseau, James J; Choi, Chulho; Bull, James A

    2018-01-19

    3-Sulfanyl-oxetanes are presented as promising novel bioisosteric replacements for thioesters or benzyl sulfides. From oxetan-3-ols, a mild and inexpensive Li catalyst enables chemoselective C-OH activation and thiol alkylation. Oxetane sulfides are formed from various thiols providing novel motifs in new chemical space and specifically as bioisosteres for thioesters due to their similar shape and electronic properties. Under the same conditions, various π-activated secondary and tertiary alcohols are also successful. Derivatization of the oxetane sulfide linker provides further novel oxetane classes and building blocks. Comparisons of key physicochemical properties of the oxetane compounds to selected carbonyl and methylene analogues indicate that these motifs are suitable for incorporation into drug discovery efforts. © 2018 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

  20. Envisioning DIY learning in primary and secondary schools

    Directory of Open Access Journals (Sweden)

    Juana Maria Sancho-Gil

    2015-11-01

    Full Text Available The DIYLab project (Do it yourself in Education: expanding digital competence to foster student agency and collaborative learning. European Commission seeks to explore the changes (and its educational effects occurring in the last decade regarding digital competencies, especially in relation to the emergence of a culture of collaboration, that connects youth learning, technology and DIY (Kafai & Peppler, 2011. To achieve the project's objective, we are following a methodology based on the principles of collaborative action research (CAR. This paper focuses on the first step of the CAR process and shows the main challenges identified by teachers, students and parents in order to implement the project’s learning philosophy in the current curricula and schools organisation. We carried out a series of focus groups with teachers, students and parents from primary and secondary schools and the university to discuss what DIY learning looks like in the participants’ educational contexts. Based on these discussions we have begun to analyse how each context imagines DIY learning and how it relates to the notion of virtual space. This paper focuses in the Spanish primary and secondary school participating in the project.

  1. Media literacy between primary and secondary students in Andalusia (Spain

    Directory of Open Access Journals (Sweden)

    Ignacio Aguaded

    2015-03-01

    Full Text Available The media consumption by children and young people in our society is a fact. Since 2010 there has been an R&D project that aims to assess media literacy in compulsory education in Andalusia. The content was defined in terms of six dimensions developed to assess the skill levels of citizenship. This article analyzes the degree of media literacy in primary and secondary school population in Andalusia. It is an important challenge for the information society to prepare media literate students. The study reports the comparative results of two surveys conducted in a varied sample of Andalusian schools. Both tools are designed to be implemented online with real-time tracking of the platform, to identify needs and gaps and plan for future strategies at school. The study defines media literacy and analysis of its dimensions and various categories of the quantitative study. This research concludes that the population of primary and secondary media literacy lacks the dimensions analyzed. It is, therefore, necessary to develop a course in media education in the school curriculum.

  2. COMMUNITY MEDICINE & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    Journal of Community Medicine and Primary Health Care. ... Ladoke Akintola University of Technology, PMB 4400, Osogbo, Osun State. ... weak management and poor adherence to the basic infrastructure e.g. primary, secondary and tertiary.

  3. A Study on Primary and Secondary School Students' Misconceptions about Greenhouse Effect (Erzurum Sampling)

    Science.gov (United States)

    Gul, Seyda; Yesilyurt, Selami

    2011-01-01

    The aim of this study is to determine what level of primary and secondary school students' misconceptions related to greenhouse effect is. Study group consists of totally 280 students attended to totally 8 primary and secondary schools (4 primary school, 4 secondary school) which were determined with convenient sampling method from center of…

  4. Corrosion of alloy 800 in PHWR primary and secondary conditions

    International Nuclear Information System (INIS)

    Maroto, A.J.G.; Blesa, M.A.; Villegas, M.; Olmedo, A.M.; Bordoni, R.; Alvarez, M.G.; Sainz, R.

    1998-01-01

    A hot leg section of a steam generator tubing was removed for destructive examination from one of the steam generators (SG) of the Embalse Nuclear Power Plant. The tube material is Alloy 800 and carbon steel is the tube support plate material. Samples of the deposits were taken at the first tube support plate and at the top, mid-height and bottom of the sludge pile. Transverse sections were taken at several locations along the tube length measuring the oxide thicknesses and studying the morphology of the oxide layer by scanning electron microscopy on the primary and secondary side at each location. Deposit layers on the outer tube surface revealed iron as major component and the presence of calcium, phosphorous, zinc and manganese. The oxide scale thickness at the secondary side in the open area was around 22 to 30 μm. The oxide thickness grown under isothermal conditions on the corrosion test samples installed in the autoclaves facilities of the primary circuit of the plant was measured and compared with that found on the inner surface of the examined tube section. The oxide thickness of the test samples was around 1-2 μm showing the influence of the deposition of corrosion products from the coolant. Deposition and precipitation of oxide was also found in the actual tube, where the common feature was the irregularity of the oxide layer on the primary side and thicknesses values in the range 4 to 10 μm were measured. The autoclave tests and SG tubing examination permit to compare the influence of materials and of operating (flow rate, isothermal vs non-isothermal) conditions on corrosion and deposition. (author)

  5. Primary Trabeculectomy Outcomes by Glaucoma Fellows in a Tertiary Hospital in Brazil.

    Science.gov (United States)

    Abe, Ricardo Y; Shigueoka, Leonardo S; Vasconcellos, José P C; Costa, Vital P

    2017-11-01

    To examine outcomes of trabeculectomy with mitomycin C for uncontrolled glaucoma when performed by glaucoma trainee surgeons. Retrospective case series of patients who underwent trabeculectomy with mitomycin C. Primary outcome was to assess the rate of failure, which was defined as intraocular pressure in 2 consecutive visits >18 or glaucoma surgery, or loss of light perception. The secondary outcome was to investigate risk factors for failure and surgical complications. One hundred forty-three eyes from 126 glaucoma patients underwent primary trabeculectomy between 2013 and 2014 at University of Campinas. Mean follow-up time was 1.47±0.96 years. Kaplan-Meier analysis showed cumulative survival rates of 70.1%, 62.5%, and 57.8%, after 1, 2, and 3 years, respectively. Multivariate analysis with generalized estimating equations revealed that neovascular glaucoma [odd ratios (OR): 5.05, P=0.043], suture lysis (OR: 8.89, P=0.011), and early bleb leak (OR: 4.63, P=0.011) were risk factors for failure. A success rate of approximately 60% was obtained 3 years after primary trabeculectomy performed by trainees. Patients with neovascular glaucoma, who underwent suture lysis and who presented an early bleb leak had an increased risk for failure during follow-up.

  6. [Primary intestinal lymphangiectasia: twenty years of experience at a Mexican tertiary care hospital].

    Science.gov (United States)

    Valdovinos-Oregón, D; Ramírez-Mayans, J; Cervantes-Bustamante, R; Toro-Monjaraz, E; Cázares-Méndez, M; Cadena-León, J; Zárate-Mondragón, F; Montijo-Barrios, E

    2014-01-01

    Primary intestinal lymphangiectasia is a rare congenital disease described by Waldmann in 1961 that is a consequence of obstruction of the lymphatic drainage of the small bowel with secondary lymph vessel dilation. This distorts the architecture of the villi and causes a leakage of lymph into the intestinal lumen, resulting in protein-losing enteropathy and malabsorption. To describe the clinical, biochemical, radiologic, endoscopic, and histologic characteristics in children with primary intestinal lymphangiectasia. A retrospective observational, descriptive, cross-sectional study was conducted that reviewed the case records of children diagnosed with primary intestinal lymphangiectasia that were seen at the Department of Gastroenterology and Nutrition of the Instituto Nacional de Pediatría within the time frame of January 1, 1992 to September 30, 2012. Four patients were found that presented with primary intestinal lymphangiectasia. Three of them had been diagnosed before 3 years of age. All the patients presented with chronic diarrhea, edema, lymphopenia, hypocalcemia, and hypogammaglobulinemia, and 3 patients presented with hypocholesterolemia. Bowel transit time, endoscopy, and intestinal biopsies were characteristic of this pathology. Intestinal lymphangiectasia should be suspected when there is a clinical picture of chronic diarrhea and protein-losing enteropathy accompanied with edema at any level, as well as hypoalbuminemia, hypocalcemia, lymphopenia, hypogammaglobulinemia, and hypocholesterolemia, which are the main biochemical findings of this pathology. All children presenting with intestinal lymphangiectasia should undergo an upper gastrointestinal series with bowel transit time and endoscopy with biopsies taken at the level of the duodenum. Treatment includes diet and the periodic administration of albumin and gamma globulin. Copyright © 2013 Asociación Mexicana de Gastroenterología. Published by Masson Doyma México S.A. All rights reserved.

  7. Health promotion in primary and secondary schools in Denmark

    DEFF Research Database (Denmark)

    Nabe-Nielsen, Kirsten; Krølner, Rikke; Mortensen, Laust Hvas

    2015-01-01

    BACKGROUND: Schools are important arenas for interventions among children as health promoting initiatives in childhood is expected to have substantial influence on health and well-being in adulthood. In countries with compulsory school attention, all children could potentially benefit from health...... promotion at the school level regardless of socioeconomic status or other background factors. The first aim was to elucidate time trends in the number and types of school health promoting activities by describing the number and type of health promoting activities in primary and secondary schools in Denmark....... The second aim was to investigate which characteristics of schools and students that are associated with participation in many (≥3) versus few (0-2) health promoting activities during the preceding 2-3 years. METHODS: We used cross-sectional data from the 2006- and 2010-survey of the Health Behaviour...

  8. Cerebral hydatid disease: Is it primary or secondary?

    Directory of Open Access Journals (Sweden)

    Onteddu Joji Reddy

    2014-01-01

    Full Text Available Hydatid disease is a serious medical problem in Mediterranean and particularly among sheep farming countries, caused by larval stages of dog tapeworms belonging to the genus Echinococcus. Hydatid cysts may affect every organ in the human body; however, multiple organ involvement (spleen, adrenal gland, heart, pericardium, intravascular growth of hydatids and brain without affecting the two major filters in the body liver and the lung was very rare. In this case, myocardial hydatid cyst is considered as primary and involvement of other organs such as brain, spleen, adrenal glands, and vascular involvement are considered as secondary involvement due to the rupture of hydatid in heart. Rarity of this atypical presentation of hydatid disease leads to this case report.

  9. Development and function of secondary and tertiary lymphoid organs in the small intestine and the colon

    Directory of Open Access Journals (Sweden)

    Manuela Buettner

    2016-09-01

    Full Text Available The immune system of the gut has evolved a number of specific lymphoid structures that contribute to homeostasis in the face of microbial colonization and food-derived antigenic challenge. These lymphoid organs encompass Peyer’s patches (PP in the small intestine and their colonic counterparts that develop in a programmed fashion before birth. In addition, the gut harbors a network of lymphoid tissues that is commonly designated as solitary intestinal lymphoid tissues (SILT. In contrast to PP, SILT develop strictly after birth and consist of a dynamic continuum of structures ranging from small cryptopatches (CP to large, mature isolated lymphoid follicles (ILF. Although the development of PP and SILT follow similar principles, such as an early clustering of lymphoid tissue inducer (LTi cells and the requirement for lymphotoxin beta (LTβ receptor-mediated signaling, the formation of CP and their further maturation into ILF is associated with additional intrinsic and environmental signals. Moreover, recent data also indicate that specific differences exist in the regulation of ILF formation between the small intestine and the colon. Importantly, intestinal inflammation in both mice and humans is associated with a strong expansion of the lymphoid network in the gut. Recent experiments in mice suggest that these structures, although they resemble large, mature ILF in appearance, may represent de novo-induced tertiary lymphoid organs (TLO. While so far it is not clear whether intestinal TLO contribute to the exacerbation of inflammatory pathology, it has been shown that ILF provide the critical microenvironment necessary for the induction of an effective host response upon infection with enteric bacterial pathogens. Regarding the importance of ILF for intestinal immunity, interfering with the development and maturation of these lymphoid tissues may offer novel means for manipulating the immune response during intestinal infection or inflammation.

  10. Development and Function of Secondary and Tertiary Lymphoid Organs in the Small Intestine and the Colon

    Science.gov (United States)

    Buettner, Manuela; Lochner, Matthias

    2016-01-01

    The immune system of the gut has evolved a number of specific lymphoid structures that contribute to homeostasis in the face of microbial colonization and food-derived antigenic challenge. These lymphoid organs encompass Peyer’s patches (PP) in the small intestine and their colonic counterparts that develop in a programed fashion before birth. In addition, the gut harbors a network of lymphoid tissues that is commonly designated as solitary intestinal lymphoid tissues (SILT). In contrast to PP, SILT develop strictly after birth and consist of a dynamic continuum of structures ranging from small cryptopatches (CP) to large, mature isolated lymphoid follicles (ILF). Although the development of PP and SILT follow similar principles, such as an early clustering of lymphoid tissue inducer (LTi) cells and the requirement for lymphotoxin beta (LTβ) receptor-mediated signaling, the formation of CP and their further maturation into ILF is associated with additional intrinsic and environmental signals. Moreover, recent data also indicate that specific differences exist in the regulation of ILF formation between the small intestine and the colon. Importantly, intestinal inflammation in both mice and humans is associated with a strong expansion of the lymphoid network in the gut. Recent experiments in mice suggest that these structures, although they resemble large, mature ILF in appearance, may represent de novo-induced tertiary lymphoid organs (TLO). While, so far, it is not clear whether intestinal TLO contribute to the exacerbation of inflammatory pathology, it has been shown that ILF provide the critical microenvironment necessary for the induction of an effective host response upon infection with enteric bacterial pathogens. Regarding the importance of ILF for intestinal immunity, interfering with the development and maturation of these lymphoid tissues may offer novel means for manipulating the immune response during intestinal infection or inflammation. PMID

  11. Development and Function of Secondary and Tertiary Lymphoid Organs in the Small Intestine and the Colon.

    Science.gov (United States)

    Buettner, Manuela; Lochner, Matthias

    2016-01-01

    The immune system of the gut has evolved a number of specific lymphoid structures that contribute to homeostasis in the face of microbial colonization and food-derived antigenic challenge. These lymphoid organs encompass Peyer's patches (PP) in the small intestine and their colonic counterparts that develop in a programed fashion before birth. In addition, the gut harbors a network of lymphoid tissues that is commonly designated as solitary intestinal lymphoid tissues (SILT). In contrast to PP, SILT develop strictly after birth and consist of a dynamic continuum of structures ranging from small cryptopatches (CP) to large, mature isolated lymphoid follicles (ILF). Although the development of PP and SILT follow similar principles, such as an early clustering of lymphoid tissue inducer (LTi) cells and the requirement for lymphotoxin beta (LTβ) receptor-mediated signaling, the formation of CP and their further maturation into ILF is associated with additional intrinsic and environmental signals. Moreover, recent data also indicate that specific differences exist in the regulation of ILF formation between the small intestine and the colon. Importantly, intestinal inflammation in both mice and humans is associated with a strong expansion of the lymphoid network in the gut. Recent experiments in mice suggest that these structures, although they resemble large, mature ILF in appearance, may represent de novo-induced tertiary lymphoid organs (TLO). While, so far, it is not clear whether intestinal TLO contribute to the exacerbation of inflammatory pathology, it has been shown that ILF provide the critical microenvironment necessary for the induction of an effective host response upon infection with enteric bacterial pathogens. Regarding the importance of ILF for intestinal immunity, interfering with the development and maturation of these lymphoid tissues may offer novel means for manipulating the immune response during intestinal infection or inflammation.

  12. Electron beam irradiation process applied to primary and secondary recycled high density polyethylene

    Energy Technology Data Exchange (ETDEWEB)

    Cardoso, Jéssica R.; Moura, Eduardo de; Geraldo, Áurea B.C., E-mail: ageraldo@ipen.br [Instituto de Pesquisas Energéticas e Nucleares (IPEN/CNEN-SP), São Paulo, SP (Brazil)

    2017-07-01

    Plastic bags, packaging and furniture items are examples of plastic utilities always present in life. However, the end-of-life of plastics impacts the environment because of this ubiquity and also often their high degradation time. Recycling processes are important in this scenario because they offer many solutions to this problem. Basically, four ways are known for plastic recycling: primary recycling, which consists in re-extrusion of clean plastic scraps from a production plant; secondary recycling, that uses end-of-life products that generally are reduced in size by extrusion to obtain a more desirable shape for reprocessing (pellets and powder); tertiary recover which is related to thermo-chemical methods to produce fuels and petrochemical feedstock; and quaternary route, that is related to energy recovery and it is done in appropriate reactors. In this work, high density polyethylene (HDPE) was recovered to simulate empirically the primary and secondary recycling ways using materials which ranged from pristine to 20-fold re-extrused materials. The final 20-fold recycled thermoplastic was irradiated in an electron beam accelerator under a dose rate of 22.4 kGy/s and absorbed doses of 50 kGy and 100 kGy. The characterization of HDPE in distinct levels of recovering was performed by infrared spectroscopy (FTIR) and thermogravimetric degradation. In the HDPE recycling, degradation and crosslinking are consecutive processes; degradation is very noticeable in the 20-fold recycled product. Despite this, the 20-fold recycled product presents crosslinking after irradiation process and the post-irradiation product presents similarities in spectroscopic and thermal degradation characteristics of pristine, irradiated HDPE. These results are discussed. (author)

  13. Electron beam irradiation process applied to primary and secondary recycled high density polyethylene

    International Nuclear Information System (INIS)

    Cardoso, Jéssica R.; Moura, Eduardo de; Geraldo, Áurea B.C.

    2017-01-01

    Plastic bags, packaging and furniture items are examples of plastic utilities always present in life. However, the end-of-life of plastics impacts the environment because of this ubiquity and also often their high degradation time. Recycling processes are important in this scenario because they offer many solutions to this problem. Basically, four ways are known for plastic recycling: primary recycling, which consists in re-extrusion of clean plastic scraps from a production plant; secondary recycling, that uses end-of-life products that generally are reduced in size by extrusion to obtain a more desirable shape for reprocessing (pellets and powder); tertiary recover which is related to thermo-chemical methods to produce fuels and petrochemical feedstock; and quaternary route, that is related to energy recovery and it is done in appropriate reactors. In this work, high density polyethylene (HDPE) was recovered to simulate empirically the primary and secondary recycling ways using materials which ranged from pristine to 20-fold re-extrused materials. The final 20-fold recycled thermoplastic was irradiated in an electron beam accelerator under a dose rate of 22.4 kGy/s and absorbed doses of 50 kGy and 100 kGy. The characterization of HDPE in distinct levels of recovering was performed by infrared spectroscopy (FTIR) and thermogravimetric degradation. In the HDPE recycling, degradation and crosslinking are consecutive processes; degradation is very noticeable in the 20-fold recycled product. Despite this, the 20-fold recycled product presents crosslinking after irradiation process and the post-irradiation product presents similarities in spectroscopic and thermal degradation characteristics of pristine, irradiated HDPE. These results are discussed. (author)

  14. Characterization of secondary treated effluents for tertiary membrane filtration and water recycling

    KAUST Repository

    Ayache, C.; Pidou, Marc; Gernjak, Wolfgang; Poussade, Yvan; Croue, Jean-Philippe; Tazi-Pain, Annie; Keller, Jurg R.

    2012-01-01

    This study evaluates the impacts of water quality from three different secondary effluents on low pressure membrane fouling. Effluent organic matter (EfOM) has been reported by previous studies as responsible for membrane fouling. However, the contribution of the different components of EfOM to membrane fouling is still not well understood. In order to improve and optimize treatment processes, characterization and quantification of the organic matter are important. The characterization methods used in this study are liquid chromatography coupled with an organic detector (LC-OCD) and excitation emission matrix fluorescence spectroscopy (EEM). A bench-scale hollow fibre membrane system was used to identify the type of fouling depending on the feed water quality. Results showed no measurable dissolved organic carbon removal by the membranes for the three secondary effluents. Biopolymers and humic-like substances found in different proportions in the three effluents were partially retained by the membranes and were identified to contribute significantly to the flux decline of the low pressure membranes. The observed fouling was determined to be reversible by hydraulic backwashing for two effluents and only by chemical cleaning for the third effluent. © IWA Publishing 2012.

  15. Characterization of secondary treated effluents for tertiary membrane filtration and water recycling

    KAUST Repository

    Ayache, C.

    2012-06-01

    This study evaluates the impacts of water quality from three different secondary effluents on low pressure membrane fouling. Effluent organic matter (EfOM) has been reported by previous studies as responsible for membrane fouling. However, the contribution of the different components of EfOM to membrane fouling is still not well understood. In order to improve and optimize treatment processes, characterization and quantification of the organic matter are important. The characterization methods used in this study are liquid chromatography coupled with an organic detector (LC-OCD) and excitation emission matrix fluorescence spectroscopy (EEM). A bench-scale hollow fibre membrane system was used to identify the type of fouling depending on the feed water quality. Results showed no measurable dissolved organic carbon removal by the membranes for the three secondary effluents. Biopolymers and humic-like substances found in different proportions in the three effluents were partially retained by the membranes and were identified to contribute significantly to the flux decline of the low pressure membranes. The observed fouling was determined to be reversible by hydraulic backwashing for two effluents and only by chemical cleaning for the third effluent. © IWA Publishing 2012.

  16. MRI features of primary, secondary and metastatic medulloblastoma

    International Nuclear Information System (INIS)

    Buehring, U.; Strayle-Batra, M.; Kueker, W.; Freudenstein, D.; Scheel-Walter, H.-G.

    2002-01-01

    Medulloblastoma is the most frequent paediatric malignant brain tumour. The purpose of this study was to define imaging characteristics and contrast uptake patterns of primary and recurrent medulloblastoma using MRI. The MRI examinations of 17 histologically proven cases of medulloblastoma diagnosed in our institution (13 males and 4 females; mean age 13 years, 7 months) were reviewed in retrospect. Only patients with pre-treatment and follow-up examinations including T2-weighted images (fluid-attenuated inversion recovery or turbo spin echo) and T1-weighted images after contrast injection (0.1 mmol/kg Gd-DTPA) were included in this study. Whereas 6 of 7 tumours (n=17) were hyperintense on T2-weighted images, contrast enhancement was detected in 13 patients. Fifteen tumours occurred in the cerebellar vermis, two were located in the cerebellar hemispheres. Mean size at the time of presentation was 30.1 mm. All patients presented with some extent of an occlusive hydrocephalus. Local recurrent tumour or metastases were seen in 6 patients (3 months to 7 years, mean age 2.5 years). Whereas the T2 signal intensity of recurrent tumour or subarachnoidal metastases resembled the primary neoplasms, the contrast uptake tended to be less pronounced (n=3) or was completely absent (n=2); thus, suggestive signs of primary medulloblastoma are location in the vermis, hyperintensity on T2-weighted images and hydrocephalus. The amount of contrast enhancement is variable and nonspecific. Secondary medulloblastoma manifestation is characterized by T2 hyperintensity but not by contrast uptake. (orig.)

  17. A General Catalyst for Site-Selective C(sp(3))-H Bond Amination of Activated Secondary over Tertiary Alkyl C(sp(3))-H Bonds.

    Science.gov (United States)

    Scamp, Ryan J; Jirak, James G; Dolan, Nicholas S; Guzei, Ilia A; Schomaker, Jennifer M

    2016-06-17

    The discovery of transition metal complexes capable of promoting general, catalyst-controlled and selective carbon-hydrogen (C-H) bond amination of activated secondary C-H bonds over tertiary alkyl C(sp(3))-H bonds is challenging, as substrate control often dominates when reactive nitrene intermediates are involved. In this letter, we report the design of a new silver complex, [(Py5Me2)AgOTf]2, that displays general and good-to-excellent selectivity for nitrene insertion into propargylic, benzylic, and allylic C-H bonds over tertiary alkyl C(sp(3))-H bonds.

  18. A survey on evaluation function for contaminations and doses in the primary and the secondary radiation emergency hospitals

    International Nuclear Information System (INIS)

    Yamada, Yuji; Akashi, Makoto; Shiraishi, Kunio; Suzuki, Toshikazu; Ishigure, Nobuhito; Endo, Akira; Sanada, Tetsuya; Nakayama, Kazushige; Shizuma, Kiyoshi; Takada, Chie; Momose, Takumaro; Hoshi, Masaharu; Yamaguchi, Takenori

    2009-01-01

    The questionnaire on evaluation function for contaminations and doses was sent to the primary and the secondary radiation emergency hospitals in Japan by the network council for physical dosimetry in National Institute of Radiological Sciences (NIRS) designated as the tertiary hospital. The recovery percentage from the 88 hospitals was 70%. It turned out that six primary hospitals in 37 hospitals did not have even the basic instruments on radiation measurement such as GM counter and personal dosimeter. 64% of the secondary hospitals have the whole body counter, but its operation frequency including exercise was considerably low. It is thought that the main cause originates in a chronic manpower shortage and the budget shortfall seen by all the primary and the secondary hospitals. And also peculiar difficulty of correspondence to the radiation emergency medical treatment and the few experience might promote the problem. Thus the anxiety of the site staff had been appeared to the result of the questionnaire survey in shape like the opinion and the demand, etc. It will be necessary to advance the enhancement of training and to make the manual for the contaminations and the doses evaluation in the hospitals. (author)

  19. Antecedents of primary and secondary acute social withdrawal

    Directory of Open Access Journals (Sweden)

    Iryna Frankova

    2017-11-01

    Full Text Available Background. The phenomenon of acute social withdrawal (ASW is becoming more common and widespread nowadays and can be characterized by complete solitude/alienation from society for 6 months or longer. Previous studies of the ASW included patients with mental disorders and were focused on the psychopathological features of secondary ASW caused by depression, social phobia, or bulimia. Aim. To increase the effectiveness of acute social withdrawal differential diagnostics by determining the etiopathogenetic factors of its development and psychopathological features to improve further management of this condition. Materials and methods. At the Department of Psychosomatic Medicine and Psychotherapy of Bogomolets National Medical University 70 patients with ASW were examined: the first experimental group (EG1 - patients with mental disorders and ASW (n = 42, and the second (EG2 - a mentally healthy contingent with primary ASW (n = 28. Healthy people without ASW (n=56, control group, CG as well were examined. The following methods were used: Buss Durkee Hostility Inventory, Victim Behavior Questionnaire, Toronto Alexithymia Scale (TAS-26, Leongard-Schmishek Accentuated Personality Trait Questionnaire, Life Event Questionnaire (LEQ, Chaban Quality of Life Scale. Results. Comparing EG and CG regarding significance, there were determined several differences. The level of alexithymia in the EG was significantly higher than in the CG (p<0.005. The quality of life in the EG was significantly lower than in the CG (p<0.005.  According to the Leongard-Schmishek test in EG accentuated personality traits such cyclothymia, hyperthymia, dysthymia, anxiety (p<0.005, pedantic (p<0.05, demonstrativeness (p <0.1 were significantly higher than in the CG. According to the Buss-Durkee Hostility Inventory, such indicators as resentment (p<0.005, irritability (p<0.05, suspicion (p<0.05 and, as a consequence, an index of aggression (IA, (p<0.05 were significantly higher

  20. Attitudes toward epilepsy among the primary and secondary school teachers in Malaysia, using the public attitudes toward epilepsy (PATE) scale.

    Science.gov (United States)

    Lim, Kheng Seang; Hills, Michael D; Choo, Wan Yuen; Wong, Mee Hoo; Wu, Cathie; Tan, Chong Tin

    2013-10-01

    There is a lack of study comparing the attitudes toward epilepsy between the teachers and general population, teachers and students, using a similar quantitative scale. This study was performed in one primary and one secondary school in Kuala Lumpur, Malaysia, using the Public Attitudes Toward Epilepsy (PATE) scale. A total of 186 teachers aged 39.6±10.4 years completed the questionnaire. The mean scores in both personal and general domains of PATE scale were significantly better in the teachers, comparing to the scores in the secondary and college students reported in previous study (Lim et al., 2013; pjob, rather than tertiary education generally. Subanalysis showed that the attitudes of teachers were significantly better than the general population and the students related to employment and social life, but were equally negative on issues directly related to education, such as placing children with epilepsy in regular classes. Teachers had more positive attitudes toward epilepsy as compared with the general population with tertiary education. Attitude to epilepsy may differ specific to types of work. Copyright © 2013 Elsevier B.V. All rights reserved.

  1. Experiences with surgically treated primary or secondary hepatic sarcoma.

    Science.gov (United States)

    Fahrner, René; Dennler, Sandra G C; Dondorf, Felix; Ardelt, Michael; Rauchfuss, Falk; Settmacher, Utz

    2017-06-01

    Liver resection in hepatic sarcoma is rare, but other alternative treatment options are scarce. Surgery offers the only aggressive approach to achieve a tumour-free state. The aim of this investigation was to evaluate the outcome and survival of these patients at a single hepato-biliary university hospital. Between January 2004 and July 2013, 896 anatomical liver resections were performed. Eleven liver resections (1.2%) were performed due to primary hepatic sarcoma or hepatic sarcoma metastases. The demographic and clinical parameters were collected from the institutional patients' records. In eight patients (83%), liver resection was performed due to hepatic sarcoma metastases. The surgical procedures were as follows: two patients (18%) had segmentectomy, six patients (55%) had hemihepatectomy or extended hemihepatectomy and three patients (27%) had multivisceral resections. In nine patients (82%), the resection margins were tumour free. In 55% (n = 6) of the patients, the maximal tumour diameter was greater than 10 cm. The postoperative morbidity was low with a Clavien-Dindo score of 2 (range 0-5). One patient died on postoperative day 2 after multivisceral resection. During the follow-up of 932 days (range 2-2.220 days) the 1-, 2- and 3-year survival rates were 91, 63 and 45%, respectively. Tumour recurrence was detected in seven patients (63%). Liver resections in patients with primary or secondary hepatic sarcoma are rare. The main goal in these patients is to achieve complete tumour resection because chemotherapy offers no suitable alternative, but the long-term survival rates are limited because of high a recurrence rate even after aggressive surgical approaches.

  2. Removal of organic contaminants from secondary effluent by anodic oxidation with a boron-doped diamond anode as tertiary treatment

    Energy Technology Data Exchange (ETDEWEB)

    Garcia-Segura, Sergi, E-mail: sergigarcia@ub.edu [Advanced Water Management Centre, The University of Queensland, Level 4, Gehrmann Bld. (60), St Lucia, QLD 072 (Australia); Laboratori d’Electroquímica dels Materials i del Medi Ambient, Departament de Química Física, Facultat de Química, Universitat de Barcelona, Martí i Franquès 1-11, 08028 Barcelona (Spain); Keller, Jürg [Advanced Water Management Centre, The University of Queensland, Level 4, Gehrmann Bld. (60), St Lucia, QLD 072 (Australia); Brillas, Enric [Laboratori d’Electroquímica dels Materials i del Medi Ambient, Departament de Química Física, Facultat de Química, Universitat de Barcelona, Martí i Franquès 1-11, 08028 Barcelona (Spain); Radjenovic, Jelena, E-mail: j.radjenovic@awmc.uq.edu.au [Advanced Water Management Centre, The University of Queensland, Level 4, Gehrmann Bld. (60), St Lucia, QLD 072 (Australia)

    2015-02-11

    Graphical abstract: - Highlights: • Mineralization of secondary effluent by anodic oxidation with BDD anode. • Complete removal of 29 pharmaceuticals and pesticides at trace level concentrations. • Organochlorine and organobromine byproducts were formed at low μM concentrations. • Chlorine species evolution assessed to evaluate the anodic oxidation applicability. - Abstract: Electrochemical advanced oxidation processes (EAOPs) have been widely investigated as promising technologies to remove trace organic contaminants from water, but have rarely been used for the treatment of real waste streams. Anodic oxidation with a boron-doped diamond (BDD) anode was applied for the treatment of secondary effluent from a municipal sewage treatment plant containing 29 target pharmaceuticals and pesticides. The effectiveness of the treatment was assessed from the contaminants decay, dissolved organic carbon and chemical oxygen demand removal. The effect of applied current and pH was evaluated. Almost complete mineralization of effluent organic matter and trace contaminants can be obtained by this EAOP primarily due to the action of hydroxyl radicals formed at the BDD surface. The oxidation of Cl{sup −} ions present in the wastewater at the BDD anode gave rise to active chlorine species (Cl{sub 2}/HClO/ClO{sup −}), which are competitive oxidizing agents yielding chloramines and organohalogen byproducts, quantified as adsorbable organic halogen. However, further anodic oxidation of HClO/ClO{sup −} species led to the production of ClO{sub 3}{sup −} and ClO{sub 4}{sup −} ions. The formation of these species hampers the application as a single-stage tertiary treatment, but posterior cathodic reduction of chlorate and perchlorate species may reduce the risks associated to their presence in the environment.

  3. Coordination between primary and secondary healthcare in Denmark and Sweden

    Directory of Open Access Journals (Sweden)

    Sarah Wadmann

    2009-03-01

    Full Text Available Introduction: Insights into effective policy strategies for improved coordination of care is needed. In this study we describe and compare the policy strategies chosen in Denmark and Sweden, and discuss them in relation to interorganisational network theory. Policy practice: The policy initiatives to improve collaboration between primary and secondary healthcare in Denmark and Sweden include legislation and agreements aiming at clarifying areas of responsibility and defining requirements, creation of links across organisational boarders. In Denmark many initiatives have been centrally induced, while development of local solutions is more prominent in Sweden. Many Danish initiatives target the administrative level, while in Sweden initiatives are also directed at the operational level. In both countries economic incentives for collaboration are weak or lacking, and use of sanctions as a regulatory mean is limited. Discussion and conclusion: Despite a variety of policy initiatives, lacking or poorly developed structures to support implementation function as barriers for coordination. The two cases illustrate that even in two relatively coherent health systems, with regional management of both the hospital and general practice sector, there are issues to resolve in regard to administrative and operational coordination. The interorganisational network literature can provide useful tools and concepts for interpreting such issues.

  4. Primary Nonfunction of Renal Allograft Secondary to Acute Oxalate Nephropathy

    Directory of Open Access Journals (Sweden)

    Ravi Parasuraman

    2011-01-01

    Full Text Available Primary nonfunction (PNF accounts for 0.6 to 8% of renal allograft failure, and the focus on causes of PNF has changed from rejection to other causes. Calcium oxalate (CaOx deposition is common in early allograft biopsies, and it contributes in moderate intensity to higher incidence of acute tubular necrosis and poor graft survival. A-49-year old male with ESRD secondary to polycystic kidney disease underwent extended criteria donor kidney transplantation. Posttransplant, patient developed delayed graft function (DGF, and the biopsy showed moderately intense CaOx deposition that persisted on subsequent biopsies for 16 weeks, eventually resulting in PNF. The serum oxalate level was 3 times more than normal at 85 μmol/L (normal <27 μmol/L. Allograft nephrectomy showed massive aggregates of CaOx crystal deposition in renal collecting system. In conclusion, acute oxalate nephropathy should be considered in the differential diagnosis of DGF since optimal management could change the outcome of the allograft.

  5. An analysis model of the secondary tunnel lining considering ground-primary support-secondary lining interaction

    Energy Technology Data Exchange (ETDEWEB)

    Seo, Seong-Ho; Chang, Seok-Bue [Yooshin Engineering Corporation, Seoul(Korea); Lee, Sang-Duk [Ajou University, Suwon(Korea)

    2002-06-30

    It is the common practice to over design the reinforcement for the secondary tunnel lining due to the lack of rational insight into the ground loosening loads, and due to the conservative application of the empirical design methods. The main loads of the secondary lining are the ground loosening loads and the ground water pressure, and the ground load is critical in the reinforcement design of the secondary lining in the case of drained tunnel. If the external load is absent around a tunnel. the reasons of the load for secondary tunnel lining are the deterioration of the primary supports such as shotcrete, steel rib, and rock bolts. Accordingly, the analysis method considering the ground-primary supports-secondary lining interaction should be required for the rational design of the secondary tunnel lining. In this paper, the interaction was conceptually described by the simple mass-spring model and the load transfer from the ground and primary supports to the secondary lining is showed by the ground-primary supports-secondary lining reaction curves for the theoretical solution of a circular tunnel, And also, the application of this proposed model to numerical analysis is verified in order to check the potential for the tunnel with the complex analysis conditions. (author). 8 refs., 2 tabs., 7 figs.

  6. Outcomes of Primary Transsphenoidal Surgery in Cushing Disease: Experience of a Tertiary Center.

    Science.gov (United States)

    Keskin, Fatma Ela; Ozkaya, Hande Mefkure; Bolayirli, Murat; Erden, Secil; Kadioglu, Pınar; Tanriover, Necmettin; Gazioglu, Nurperi

    2017-10-01

    To report the initial and long-term remission rates and related factors, secondary treatments, and outcomes of a series of patients with Cushing disease (CD). We included 147 consecutive adult patients with CD who underwent primary transsphenoidal surgery (TSS) between 1998 and 2014 in this study. Eighty-two were followed up in the Cerrahpasa Medical Faculty Endocrinology and Metabolism outpatient clinic. Patients were requested to attend a long-term remission assessment; 55 could be contacted, and data for the remaining 27 patients' last visit to the outpatient clinics were reviewed for early and late remission. Six patients were excluded from the study. Magnetic resonance imaging (MRI) findings and pathologic results including mitosis, Ki-67 levels, and P53 in immunostaining of all patients were evaluated. Data of 82 patients with CD with an average age of 36 years [interquartile range: 29-47] were analyzed with a mean follow-up of 7.5 years [interquartile range: 5-10]. Overall initial remission rates were 72.3% after TSS. Among the 82 patients, 16 patients had Gamma Knife radiosurgery and 7 patients underwent adrenalectomy. After these additional treatments, the long-term remission rate was found as 69.7%. The highest remission rates were with microadenomas. Recurrence was most frequently seen in patients without tumor evidence on MRI. Patients with high Ki-67 levels had higher recurrence rates in long-term follow-up (P = 0.02). Life-long follow-up for patients with CD seems essential. Undetectable tumors on MRI before TSS and high Ki-67 immunopositivity were found as risk factors for tumor recurrence. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. Clozapine Patients at the Interface between Primary and Secondary Care.

    LENUS (Irish Health Repository)

    Barrett, Marita

    2018-02-26

    outcomes for patients included BMI, total cholesterol, and HbA1clevels, which were elevated in 75%, 54% and 17% respectively. Patients prescribed clozapine did not receive a seamless service, between primary and secondary care settings. Community pharmacists were not informed of clozapine, prescribed for their patients, in two thirds of cases. Patients in this study were exposed to clozapine-related drug-drug interactions and hence potential adverse effects. This study supports reports in the literature of substandard management of the physical health of this patient group. This study shows that there is an opportunity for pharmacists to develop active roles in the management of all clozapine-related effects, in addition to their traditional obligatory role in haematological monitoring. This study supports the need for a clinical pharmacist to review inpatients commencing on clozapine, monitor for drug-drug interactions and provide counselling.

  8. Clozapine Patients at the Interface between Primary and Secondary Care

    Directory of Open Access Journals (Sweden)

    Marita Barrett

    2018-02-01

    /patient. Secondary outcomes for patients included BMI, total cholesterol, and HbA1c levels, which were elevated in 75%, 54% and 17% respectively. Patients prescribed clozapine did not receive a seamless service, between primary and secondary care settings. Community pharmacists were not informed of clozapine, prescribed for their patients, in two thirds of cases. Patients in this study were exposed to clozapine-related drug-drug interactions and hence potential adverse effects. This study supports reports in the literature of substandard management of the physical health of this patient group. This study shows that there is an opportunity for pharmacists to develop active roles in the management of all clozapine-related effects, in addition to their traditional obligatory role in haematological monitoring. This study supports the need for a clinical pharmacist to review inpatients commencing on clozapine, monitor for drug-drug interactions and provide counselling.

  9. Different angiogenic phenotypes in primary and secondary glioblastomas.

    Science.gov (United States)

    Karcher, Sibylle; Steiner, Hans-Herbert; Ahmadi, Rezvan; Zoubaa, Saida; Vasvari, Gergely; Bauer, Harry; Unterberg, Andreas; Herold-Mende, Christel

    2006-05-01

    Primary and secondary glioblastomas (pGBM, sGBM) are supposed to evolve through different genetic pathways, including EGF receptor and PDGF and its receptor and thus genes that are involved in tumor-induced angiogenesis. However, whether other angiogenic cytokines are also differentially expressed in these glioblastoma subtypes is not known so far, but this knowledge might be important to optimize an antiangiogenic therapy. Therefore, we studied the expression of several angiogenic cytokines, including VEGF-A, HGF, bFGF, PDGF-AB, PDGF-BB, G-CSF and GM-CSF in pGBMs and sGBMs as well as in gliomas WHO III, the precursor lesions of sGBMs. In tumor tissues, expression of all cytokines was observed albeit with marked differences concerning intensity and distribution pattern. Quantification of the cytokines in the supernatant of 30 tissue-corresponding glioma cultures revealed a predominant expression of VEGF-A in pGBMs and significantly higher expression levels of PDGF-AB in sGBMs. HGF and bFGF were determined in nearly all tumor cultures but with no GBM subtype or malignancy-related differences. Interestingly, GM-CSF and especially G-CSF were produced less frequently by tumor cells. However, GM-CSF secretion occurred together with an increased number of simultaneously secreted cytokines and correlated with a worse patient prognosis and may thus represent a more aggressive angiogenic phenotype. Finally, we confirmed an independent contribution of each tumor-derived cytokine analyzed to tumor-induced vascularization. Our data indicate that an optimal antiangiogenic therapy may require targeting of multiple angiogenic pathways that seem to differ markedly in pGBMs and sGBMs. 2005 Wiley-Liss, Inc.

  10. Impact Of Secondary-Primary Pumps Operating Sequence On The Electrical Power Supply System

    International Nuclear Information System (INIS)

    Suwoto; Rusdiyanto; Kiswanto

    2001-01-01

    The operating procedure of the reactor cooling system has decided that the primary cooling pump should be operated before secondary cooling pump as known primary-secondary pumps operating sequence. This decision is based on consideration that starting current of the primary pump is higher than secondary pump. Therefore, the primary-secondary pumps operating sequence can avoid the power supply system failure. However, this operating procedure has to take a consequence that in case of primary pump failure, the shutdown time period of the reaktor to be longer caused to re operate the primary pump has required that the running secondary pump should be shutted off. To solve this problem, an impact analysis of the secondary-primary pumps operating sequence on the electric power supply system was carried out to identify the revision possibility of the cooling pump operating procedure. The analysis by discussion of the measuring results of the secondary and primary pump starting current related to another electrical loads has been measured. From discussion it can be concluded that secondary-primary pumps operating sequence has no impact to failure in electric power supply system

  11. Site-specific reaction rate constant measurements for various secondary and tertiary H-abstraction by OH radicals

    KAUST Repository

    Badra, Jihad

    2015-02-01

    Reaction rate constants for nine site-specific hydrogen atom (H) abstraction by hydroxyl radicals (OH) have been determined using experimental measurements of the rate constants of Alkane+OH→Products reactions. Seven secondary (S 20, S 21, S 22, S 30, S 31, S 32, and S 33) and two tertiary (T 100 and T 101) site-specific rate constants, where the subscripts refer to the number of carbon atoms (C) connected to the next-nearest-neighbor (N-N-N) C atom, were obtained for a wide temperature range (250-1450K). This was done by measuring the reaction rate constants for H abstraction by OH from a series of carefully selected large branched alkanes. The rate constant of OH with four different alkanes, namely 2,2-dimethyl-pentane, 2,4-dimethyl-pentane, 2,2,4-trimethyl-pentane (iso-octane), and 2,2,4,4-tetramethyl-pentane were measured at high temperatures (822-1367K) using a shock tube and OH absorption diagnostic. Hydroxyl radicals were detected using the narrow-line-width ring-dye laser absorption of the R1(5) transition of OH spectrum near 306.69nm.Previous low-temperature rate constant measurements are added to the current data to generate three-parameter rate expressions that successfully represent the available direct measurements over a wide temperature range (250-1450. K). Similarly, literature values of the low-temperature rate constants for the reaction of OH with seven normal and branched alkanes are combined with the recently measured high-temperature rate constants from our group [1]. Subsequent to that, site-specific rate constants for abstractions from various types of secondary and tertiary H atoms by OH radicals are derived and have the following modified Arrhenius expressions:. S20=8.49×10-17T1.52exp(73.4K/T)cm3molecule-1s-1(250-1450K) S21=1.07×10-15T1.07exp(208.3K/T)cm3molecule-1s-1(296-1440K) S22=2.88×10-13T0.41exp(-291.5K/T)cm3molecule-1s-1(272-1311K) S30=3.35×10-18T1.97exp(323.1K/T)cm3molecule-1s-1(250-1366K) S31=1.60×10-18T2.0exp(500.0K/T)cm3

  12. STUDENTS’ PERCEPTION ABOUT CLINICAL LEARNING ENVIRONMENT IN THE PRIMARY, SECONDARY AND TERTIARY MEDICAL FACILITIES

    OpenAIRE

    Dewi, Dian Puspita; Rahayu, Gandes Retno; Kristina, Tri Nur

    2018-01-01

    Background: Learning environment is an important factor in learning process and can affect students' competence and work-readiness. Learning environment is not only about physical facilities but also social and psychological condition. The complexity of clinical learning environments pose challenges and problems that may affect students learning process so it is necessary to monitoring and evaluating students learning environments. This study aims to assess students' perception of their learn...

  13. Characteristics and management of patients with inflammatory bowel disease between a secondary and tertiary hospitals: a propensity score analysis

    Directory of Open Access Journals (Sweden)

    Ki Hwan Song

    2018-04-01

    Full Text Available Background/Aims : This study aimed to compare the clinical characteristics and management patterns of inflammatory bowel disease (IBD patients in a secondary hospital (SH with those in tertiary referral centers (TRC. Methods : Data from IBD patients in SH and 2 TRCs were retrospectively reviewed. The cumulative thiopurine use rate was compared between hospitals after controlling for different baseline characteristics using propensity score matching. Results : Among the total of 447 patients with IBD, 178 Crohn's disease (CD and 269 ulcerative colitis (UC patients were included. Regarding initial CD symptoms, patients from SH were more likely to show perianal symptoms, such as anal pain or discharge (56.6% vs. 34.3%, P=0.003, whereas those from TRCs more often had luminal symptoms, such as abdominal pain (54.9% vs. 17.1%, P<0.001, diarrhea (44.1% vs. 18.4%, P<0.001, and body weight loss (9.8% vs. 1.3%, P=0.025. Complicating behaviors, such as stricturing and penetrating, were significantly higher in TRCs, while perianal disease was more common in SH. Ileal location was more frequently observed in TRCs. For UC, SH had a more limited extent of disease (proctitis 58.8% vs. 21.2%, P<0.001. The cumulative azathioprine use rate in SH was significantly lower than that in TRCs in both CD and UC patients after controlling for disease behavior, location, and perianal disease of CD and extent of UC. Conclusions : The clinical characteristics and management of the IBD patients in SH were substantially different from those in TRCs. Thiopurine treatment was less commonly used for SH patients.

  14. Bangladesh: Summary Report. Financing Primary and Secondary Education in Bangladesh. Asia-South Pacific Education Watch

    Science.gov (United States)

    Ahmad, Qazi Kholiquzzaman

    2007-01-01

    The main objective of the study is to gain an understanding on educational expenditure at primary and secondary levels in Bangladesh. In estimating educational expenditure by source, it has been sought to determine: (1) sources of financing of primary and secondary education; (2) rural-urban variation; (3) variation between boys and girls; (4)…

  15. How Do Primary and Lower Secondary Teachers Compare? Education Indicators in Focus. No. 58

    Science.gov (United States)

    OECD Publishing, 2018

    2018-01-01

    While policy debate is often focused on the whole teaching profession, primary and secondary teachers differ in more ways than one. While all countries require teachers to have at least a bachelor degree to enter the profession in primary or lower secondary education, the structure and content of the programmes vary and are less geared towards…

  16. Amino Acid Molecular Units: Building Primary and Secondary Protein Structures

    Directory of Open Access Journals (Sweden)

    Aparecido R. Silva

    2008-05-01

    Full Text Available In order to guarantee the learning quality and suitable knowledge  use  about structural biology, it is fundamental to  exist, since the beginning of  students’ formation, the possibility of clear visualization of biomolecule structures. Nevertheless, the didactic books can only bring  schematic  drawings; even more elaborated figures and graphic computation  do not permit the necessary interaction.  The representation of three-dimensional molecular structures with ludic models, built with representative units, have supplied to the students and teachers a successfully experience to  visualize such structures and correlate them to the real molecules.  The design and applicability of the representative units were discussed with researchers and teachers before mould implementation.  In this stage  it  will be presented the  developed  kit  containing the  representative  plastic parts of the main amino acids.  The kit can demonstrate the interaction among the amino acids  functional groups  (represented by colors, shapes,  sizes and  the peptidic bonds between them  facilitating the assembly and visuali zation of the primary and secondary protein structure.  The models were designed for  Ca,  amino,  carboxyl groups  and  hydrogen. The  lateral chains have  well defined models that represent their geometrical shape.  The completed kit set  will be presented in this meeting (patent requested.  In the last phase of the project will be realized  an effective evaluation  of the kit  as a facilitative didactic tool of the teaching/learning process in the Structural Molecular Biology area.

  17. Primary and secondary prophylaxis to the use of inhaled glucocorticoid in primary health care

    DEFF Research Database (Denmark)

    Nielsen, B.R.; Jorgensen, N.R.; Schwarz, P.

    2008-01-01

    into criteria for recommending prophylaxis with calcium and vitamin D for patients in actual IGC treatment, routine examinations for osteoporosis before starting asthma or chronic obstructive pulmonary disease (COPD) treatment with IGC, and criteria for starting anti-osteoporotic treatment (bisphosphonates...... + calcium + vitamin D) for patients in IGC treatment. A total of 535 questionnaires were eligible for evaluation and covered almost 25% of the Danish population. In general, the questionnaires documented that physicians do not use primary nor secondary prophylaxis in their patients treated with IGC...... with or without risk factors of osteoporosis. CONCLUSION: More studies are warranted to verify the effects of IGC treatment on bone health and the importance of prophylaxis to prevent osteoporosis in IGC-treated patients before outlining specific recommendations for the management of the disease Udgivelsesdato...

  18. The impact of BWR MK I primary containment failure dynamics on secondary containment integrity

    International Nuclear Information System (INIS)

    Greene, S.R.

    1987-01-01

    During the past four years, the ORNL BWRSAT Program has developed a series of increasingly sophisticated BWR secondary containment models. These models have been applied in a variety of studies to evaluate the severe accident mitigation capability of BWR secondary containments. This paper describes the results of a recent ORNL study of the impact of BWR MK I primary containment failure dynamics on secondary containment integrity. A 26-cell MELCOR Browns Ferry secondary containment model is described and the predicted thermodynamic response of the secondary containment to a variety of postulated primary containment failure modes is presented. The effects of primary containment failure location, timing, and ultimate hole size on secondary containment response is investigated, and the potential impact of hydrogen deflagrations on secondary containment integrity is explored

  19. [Skeletal manifestations of primary and secondary hyperparathyroiditis. Differential radiological diagnostic problems].

    Science.gov (United States)

    Melella, A; Basilico, L; Lupini, A; Renda, F

    1978-10-31

    Primary and secondary hyperparathyroidism are both marked by widespread skeletal demineralisation, subperiosteal erosion of the cortex, brown tumours, osteosclerosis, and extraosseous calcification. Differential diagnosis is guided by the different association of these findings. Brown tumours and more extensive erosion are marks of the primary form, whereas osteosclerosis and extra-osseous calcification are a prominent feature of secondary hyperparathyroidism. Radiologists, therefore, should direct their attention to features suggesting the presence of secondary forms in addition to looking for bone alterations associated with hyperparathyroidism.

  20. Primary and secondary cases in Escherichia coli O157 outbreaks: a statistical analysis.

    LENUS (Irish Health Repository)

    Snedeker, Kate G

    2009-01-01

    BACKGROUND: Within outbreaks of Escherichia coli O157 (E. coli O157), at least 10-15% of cases are thought to have been acquired by secondary transmission. However, there has been little systematic quantification or characterisation of secondary outbreak cases worldwide. The aim of this study was to characterise secondary outbreak cases, estimate the overall proportion of outbreak cases that were the result of secondary transmission and to analyse the relationships between primary and secondary outbreak cases by mode of transmission, country and median age. METHODS: Published data was obtained from 90 confirmed Escherichia coli O157 outbreaks in Great Britain, Ireland, Scandinavia, Canada, the United States and Japan, and the outbreaks were described in terms of modes of primary and secondary transmission, country, case numbers and median case age. Outbreaks were tested for statistically significant differences in the number of ill, confirmed, primary and secondary cases (analysis of variance and Kruskal-Wallis) and in the rate of secondary cases between these variables (Generalised Linear Models). RESULTS: The outbreaks had a median of 13.5 confirmed cases, and mean proportion of 0.195 secondary cases. There were statistically significant differences in the numbers of ill, confirmed, primary and secondary cases between modes of primary transmission (p < 0.021), and in primary and secondary cases between median age categories (p < 0.039) and modes of secondary transmission (p < 0.001).Secondary case rates differed statistically significantly between modes of secondary and primary transmission and median age categories (all p < 0.001), but not between countries (p = 0.23). Statistically significantly higher rates of secondary transmission were found in outbreaks with a median age <6 years and those with secondary transmission via person to person spread in nurseries. No statistically significant interactions were found between country, mode of transmission and age

  1. Thermodynamic study of (heptane + amine) mixtures. III: Excess and partial molar volumes in mixtures with secondary, tertiary, and cyclic amines at 298.15 K

    International Nuclear Information System (INIS)

    Lepori, Luciano; Gianni, Paolo; Spanedda, Andrea; Matteoli, Enrico

    2011-01-01

    Graphical abstract: Highlights: → Excess volumes of (sec., tert., or cyclic amines + heptane) mixtures. → Excess volumes are positive for small size amines and decrease as the size increases. → Group contributions to predict the partial molar volumes of amines in heptane. → The void volume is larger for sec. and tert. than for linear amines in heptane. → The void volume is much smaller for cyclic than for linear amines in heptane. - Abstract: Excess molar volumes V E at 298.15 K were determined by means of a vibrating tube densimeter for binary mixtures of {heptane + open chain secondary (diethyl to dibutyl) and tertiary (triethyl to tripentyl) amines} as well as for cyclic imines (C 2 , C 3 , C 4 , C 6 , and C 7 ) and primary cycloalkylamines (C 5 , C 6 , C 7 , and C 12 ). The V E values were found positive for mixtures involving small size amines, with V E decreasing as the size increases. Negative V E 's were found for tributyl- and tripentylamine, heptamethylenimine, and cyclododecylamine. Mixtures of heptane with cycloheptylamine showed an s-shaped curve. Partial molar volumes V 0 of amines at infinite dilution in heptane were obtained from V E and compared with V 0 of hydrocarbons and other classes of organic compounds taken from literature. An additivity scheme, based on the intrinsic volume approach, was applied to estimate group (CH 3 , CH 2 , CH, C, NH 2 , NH, N, OH, O, CO, and COO) contributions to V 0 . These contributions, the effect of cyclization on V 0 , and the limiting slope of the apparent excess molar volumes were discussed in terms of solute-solvent and solute-solute interactions.

  2. A tertiary care-primary care partnership model for medically complex and fragile children and youth with special health care needs.

    Science.gov (United States)

    Gordon, John B; Colby, Holly H; Bartelt, Tera; Jablonski, Debra; Krauthoefer, Mary L; Havens, Peter

    2007-10-01

    To evaluate the impact of a tertiary care center special needs program that partners with families and primary care physicians to ensure seamless inpatient and outpatient care and assist in providing medical homes. Up to 3 years of preenrollment and postenrollment data were compared for patients in the special needs program from July 1, 2002, through June 30, 2005. A tertiary care center pediatric hospital and medical school serving urban and rural patients. A total of 227 of 230 medically complex and fragile children and youth with special needs who had a wide range of chronic disorders and were enrolled in the special needs program. Care coordination provided by a special needs program pediatric nurse case manager with or without a special needs program physician. Preenrollment and postenrollment tertiary care center resource utilization, charges, and payments. A statistically significant decrease was found in the number of hospitalizations, number of hospital days, and tertiary care center charges and payments, and an increase was found in the use of outpatient services. Aggregate data revealed a decrease in hospital days from 7926 to 3831, an increase in clinic visits from 3150 to 5420, and a decrease in tertiary care center payments of $10.7 million. The special needs program budget for fiscal year 2005 had a deficit of $400,000. This tertiary care-primary care partnership model improved health care and reduced costs with relatively modest institutional support.

  3. A Multi-Antenna Framework for Spectrum Reuse Based on Primary-Secondary Cooperation

    KAUST Repository

    Bakr, Omar

    2008-10-01

    This paper proposes a new framework for spectrum reuse. Existing architectures have centered on secondary users (cognitive radios) that can reliably sense primary users and opportunistically transmit, without directly interacting with the primary system. We present a paradigm in which the primary and secondary systems cooperate, to minimize interference to primary users and provide predictable access for secondary users. Because this architecture gives the primary system full control over spectrum sharing, it could be more favorable in the current economic and political environment. We illustrate a concrete instance of our framework by showing how secondary radios can reuse the entire uplink channel of a cellular network, with only modest changes to the primary infrastructure. ©2008 IEEE.

  4. A Multi-Antenna Framework for Spectrum Reuse Based on Primary-Secondary Cooperation

    KAUST Repository

    Bakr, Omar; Johnson, Mark; Wild, Ben; Ramchandran, Kannan

    2008-01-01

    This paper proposes a new framework for spectrum reuse. Existing architectures have centered on secondary users (cognitive radios) that can reliably sense primary users and opportunistically transmit, without directly interacting with the primary system. We present a paradigm in which the primary and secondary systems cooperate, to minimize interference to primary users and provide predictable access for secondary users. Because this architecture gives the primary system full control over spectrum sharing, it could be more favorable in the current economic and political environment. We illustrate a concrete instance of our framework by showing how secondary radios can reuse the entire uplink channel of a cellular network, with only modest changes to the primary infrastructure. ©2008 IEEE.

  5. Primary care nurses: effects on secondary care referrals for diabetes?

    NARCIS (Netherlands)

    Dijk, C.E. van; Verheij, R.A.; Hansen, J.; Velden, L. van der; Nijpels, G.; Groenewegen, P.P.; Bakker, D.H. de

    2010-01-01

    BACKGROUND: Primary care nurses play an important role in diabetes care, and were introduced in GP-practice partly to shift care from hospital to primary care. The aim of this study was to assess whether the referral rate for hospital treatment for diabetes type II (T2DM) patients has changed with

  6. Physical Activity and Gastrointestinal Cancers: Primary and Tertiary Preventive Effects and Possible Biological Mechanisms

    Directory of Open Access Journals (Sweden)

    Karen Steindorf

    2015-07-01

    Full Text Available Gastrointestinal cancers account for 37% of all cancer deaths worldwide, underlining the need to further investigate modifiable factors for gastrointestinal cancer risk and prognosis. This review summarizes the corresponding evidence for physical activity (PA, including, briefly, possible biological mechanisms. Despite high public health relevance, there is still a scarcity of studies, especially for tertiary prevention. Besides the convincing evidence of beneficial effects of PA on colon cancer risk, clear risk reduction for gastroesophageal cancer was identified, as well as weak indications for pancreatic cancer. Inverse associations were observed for liver cancer, yet based on few studies. Only for rectal cancer, PA appeared to be not associated with cancer risk. With regard to cancer-specific mortality of the general population, published data were rare but indicated suggestive evidence of protective effects for colon and liver cancer, and to a lesser extent for rectal and gastroesophageal cancer. Studies in cancer patients on cancer-specific and total mortality were published for colorectal cancer only, providing good evidence of inverse associations with post-diagnosis PA. Overall, evidence of associations of PA with gastrointestinal cancer risk and progression is promising but still limited. However, the already available knowledge further underlines the importance of PA to combat cancer.

  7. Comparison of depression symptoms between primary depression and secondary-to-schizophrenia depression.

    Science.gov (United States)

    Rahim, Twana; Rashid, Roshe

    2017-11-01

    This study exclusively aimed to clinically assess which symptom pattern discriminates primary depression from depression-secondary to-schizophrenia. A total of 98 patients with primary depression and 71 patients with secondary-to-schizophrenia depression were assessed for identifying the clinical phenomena of depression. Diagnosis of schizophrenia was confirmed by Mini International Neuropsychiatric Interview. Each participant was, however, assessed by Patient Health Questionnaire-9 as well as Calgary Depression Scale for Schizophrenia (CDSS) for possible concurrent depressive symptoms. Depressed mood, loss of interest, reduced energy and pathological guilt were more common in primary depression, whereas sleep disturbance and guilty ideas of reference were more amounting towards the diagnosis of depression secondary-to-schizophrenia. It is clinically hard to differentiate primary from secondary-to-schizophrenia depression, especially in the absence of obvious psychotic symptoms. However, the classical symptoms of depression like subjective depressed mood, anhedonia, reduced energy and pathological guilt are more prominent in the primary depression.

  8. Long-Term Performance of Primary and Secondary Electroactive Biofilms Using Layered Corrugated Carbon Electrodes

    International Nuclear Information System (INIS)

    Baudler, André; Riedl, Sebastian; Schröder, Uwe

    2014-01-01

    The performance of primary and secondary electroactive biofilms grown on layered corrugated carbon (LCC) electrodes was studied over a period of several months. With an average projected current density of 6.7 mA cm −2 , the studied secondary electroactive biofilms outperformed the primary biofilms (3.0 mA cm −2 ) over the entire experimental period. At the same time, both, primary and secondary biofilms, exhibited a constant Coulomb efficiency of about 89%. The study further illustrates that three-dimensional electrodes such as LCC allow a sustained long-term performance without significant decrease in electrode performance.

  9. Long-Term Performance of Primary and Secondary Electroactive Biofilms Using Layered Corrugated Carbon Electrodes

    Energy Technology Data Exchange (ETDEWEB)

    Baudler, André; Riedl, Sebastian; Schröder, Uwe, E-mail: uwe.schroeder@tu-bs.de [Institute of Environmental and Sustainable Chemistry, Technische Universität Braunschweig, Braunschweig (Germany)

    2014-07-30

    The performance of primary and secondary electroactive biofilms grown on layered corrugated carbon (LCC) electrodes was studied over a period of several months. With an average projected current density of 6.7 mA cm{sup −2}, the studied secondary electroactive biofilms outperformed the primary biofilms (3.0 mA cm{sup −2}) over the entire experimental period. At the same time, both, primary and secondary biofilms, exhibited a constant Coulomb efficiency of about 89%. The study further illustrates that three-dimensional electrodes such as LCC allow a sustained long-term performance without significant decrease in electrode performance.

  10. Trans arterial embolization of primary and secondary tumors of the skeletal system

    International Nuclear Information System (INIS)

    Radeleff, B.; Eiers, M.; Lopez-Benitez, R.; Noeldge, G.; Hallscheidt, P.; Grenacher, L.; Libicher, M.; Zeifang, F.; Meeder, P.J.; Kauffmann, G.W.; Richter, G.M.

    2006-01-01

    Percutaneous transcatheter al embolization s of primary and secondary bone tumors are important minimal invasive angiographic interventions of the skeletal system. In most of the cases embolization is performed for preoperative devascularization or as a palliative measure to treat tumor-associated pain or other tumor bulk symptoms. The transarterial embolization of primary and secondary tumors of the skeletal system has been developed to a safe and very effective method. Indications, techniques, results and complications of this minimal invasive interventional therapy for treatment of primary and secondary bone tumors are described and discussed and compared with the newer literature and our own results

  11. Primary Molecular Disorders and Secondary Biological Adaptations in Bartter Syndrome

    Science.gov (United States)

    Deschênes, Georges; Fila, Marc

    2011-01-01

    Bartter syndrome is a hereditary disorder that has been characterized by the association of hypokalemia, alkalosis, and the hypertrophy of the juxtaglomerular complex with secondary hyperaldosteronism and normal blood pressure. By contrast, the genetic causes of Bartter syndrome primarily affect molecular structures directly involved in the sodium reabsorption at the level of the Henle loop. The ensuing urinary sodium wasting and chronic sodium depletion are responsible for the contraction of the extracellular volume, the activation of the renin-aldosterone axis, the secretion of prostaglandins, and the biological adaptations of downstream tubular segments, meaning the distal convoluted tubule and the collecting duct. These secondary biological adaptations lead to hypokalemia and alkalosis, illustrating a close integration of the solutes regulation in the tubular structures. PMID:21941653

  12. Primary Molecular Disorders and Secondary Biological Adaptations in Bartter Syndrome

    Directory of Open Access Journals (Sweden)

    Georges Deschênes

    2011-01-01

    Full Text Available Bartter syndrome is a hereditary disorder that has been characterized by the association of hypokalemia, alkalosis, and the hypertrophy of the juxtaglomerular complex with secondary hyperaldosteronism and normal blood pressure. By contrast, the genetic causes of Bartter syndrome primarily affect molecular structures directly involved in the sodium reabsorption at the level of the Henle loop. The ensuing urinary sodium wasting and chronic sodium depletion are responsible for the contraction of the extracellular volume, the activation of the renin-aldosterone axis, the secretion of prostaglandins, and the biological adaptations of downstream tubular segments, meaning the distal convoluted tubule and the collecting duct. These secondary biological adaptations lead to hypokalemia and alkalosis, illustrating a close integration of the solutes regulation in the tubular structures.

  13. Analysis of violence against primary and secondary schools students

    OpenAIRE

    Knafelc, Breda

    2013-01-01

    This master's thesis studies peer and domestic violence on elementary and secondary schools pupils from the theoretical and practical point of view. The first part of the theoretical part in detail studies the notion of violence. Forms of violence are presented with its specific forms, goals and consequences of individual forms of violence. In detail are presented forms of physical violence which represent one of the roughest forms of overpowering an individual, psychological violence as ...

  14. Primary vs. secondary antibody deficiency: clinical features and infection outcomes of immunoglobulin replacement.

    Directory of Open Access Journals (Sweden)

    Sai S Duraisingham

    Full Text Available Secondary antibody deficiency can occur as a result of haematological malignancies or certain medications, but not much is known about the clinical and immunological features of this group of patients as a whole. Here we describe a cohort of 167 patients with primary or secondary antibody deficiencies on immunoglobulin (Ig-replacement treatment. The demographics, causes of immunodeficiency, diagnostic delay, clinical and laboratory features, and infection frequency were analysed retrospectively. Chemotherapy for B cell lymphoma and the use of Rituximab, corticosteroids or immunosuppressive medications were the most common causes of secondary antibody deficiency in this cohort. There was no difference in diagnostic delay or bronchiectasis between primary and secondary antibody deficiency patients, and both groups experienced disorders associated with immune dysregulation. Secondary antibody deficiency patients had similar baseline levels of serum IgG, but higher IgM and IgA, and a higher frequency of switched memory B cells than primary antibody deficiency patients. Serious and non-serious infections before and after Ig-replacement were also compared in both groups. Although secondary antibody deficiency patients had more serious infections before initiation of Ig-replacement, treatment resulted in a significant reduction of serious and non-serious infections in both primary and secondary antibody deficiency patients. Patients with secondary antibody deficiency experience similar delays in diagnosis as primary antibody deficiency patients and can also benefit from immunoglobulin-replacement treatment.

  15. Primary vs. Secondary Antibody Deficiency: Clinical Features and Infection Outcomes of Immunoglobulin Replacement

    Science.gov (United States)

    Duraisingham, Sai S.; Buckland, Matthew; Dempster, John; Lorenzo, Lorena; Grigoriadou, Sofia; Longhurst, Hilary J.

    2014-01-01

    Secondary antibody deficiency can occur as a result of haematological malignancies or certain medications, but not much is known about the clinical and immunological features of this group of patients as a whole. Here we describe a cohort of 167 patients with primary or secondary antibody deficiencies on immunoglobulin (Ig)-replacement treatment. The demographics, causes of immunodeficiency, diagnostic delay, clinical and laboratory features, and infection frequency were analysed retrospectively. Chemotherapy for B cell lymphoma and the use of Rituximab, corticosteroids or immunosuppressive medications were the most common causes of secondary antibody deficiency in this cohort. There was no difference in diagnostic delay or bronchiectasis between primary and secondary antibody deficiency patients, and both groups experienced disorders associated with immune dysregulation. Secondary antibody deficiency patients had similar baseline levels of serum IgG, but higher IgM and IgA, and a higher frequency of switched memory B cells than primary antibody deficiency patients. Serious and non-serious infections before and after Ig-replacement were also compared in both groups. Although secondary antibody deficiency patients had more serious infections before initiation of Ig-replacement, treatment resulted in a significant reduction of serious and non-serious infections in both primary and secondary antibody deficiency patients. Patients with secondary antibody deficiency experience similar delays in diagnosis as primary antibody deficiency patients and can also benefit from immunoglobulin-replacement treatment. PMID:24971644

  16. Secondary access based on sensing and primary ARQ feedback in spectrum sharing systems

    KAUST Repository

    Hamza, Doha R.

    2012-04-01

    In the context of primary/secondary spectrum sharing, we propose a randomized secondary access strategy with access probabilities that are a function of both the primary automatic repeat request (ARQ) feedback and the spectrum sensing outcome. The primary terminal operates in a time slotted fashion and is active only when it has a packet to send. The primary receiver can send a positive acknowledgment (ACK) when the received packet is decoded correctly. Lack of ARQ feedback is interpreted as erroneous reception or inactivity. We call this the explicit ACK scheme. The primary receiver may also send a negative acknowledgment (NACK) when the packet is received in error. Lack of ARQ feedback is interpreted as an ACK or no-transmission. This is called the explicit NACK scheme. Under both schemes, when the primary feedback is interpreted as a NACK, the secondary user assumes that there will be retransmission in the next slot and accesses the channel with a certain probability. When the primary feedback is interpreted as an ACK, the secondary user accesses the channel with either one of two probabilities based on the sensing outcome. Under these settings, we find the three optimal access probabilities via maximizing the secondary throughput given a constraint on the primary throughput. We compare the performance of the explicit ACK and explicit NACK schemes and contrast them with schemes based on either sensing or primary ARQ feedback only. © 2012 IEEE.

  17. Scientific and Technological Skills Acquisition at the Primary School ...

    African Journals Online (AJOL)

    ... at the Primary School Level as a Strategy to Mitigating the Challenges of Vision 2020 ... Primary science is the foundation on which subsequent science teaching and learning at the secondary and tertiary levels of education is built. The low

  18. Costing of severe pneumonia in hospitalized infants and children aged 2-36 months, at a secondary and tertiary level hospital of a not-for-profit organization

    DEFF Research Database (Denmark)

    Madsen, Helle Ostergaard; Hanehøj, Malin; Das, Ashima Rani

    2009-01-01

    OBJECTIVES: To determine health care provider cost and household cost of the treatment of severe pneumonia in infants and young children admitted to secondary and tertiary level health care facilities. METHODS: The study was done in a private, not-for-profit medical college hospital, in Vellore...... comprised travel, accommodation and special food during the period of illness, and indirect costs of productivity loss for family members. Patient specific resource consumption and related charges were recorded from charts, nursing records, pharmacy lists and hospital bills, and the providers view point...

  19. Fetal antigen 2 in primary and secondary brain tumors

    DEFF Research Database (Denmark)

    Rasmussen, H Boje; Teisner, B; Schrøder, H D

    1991-01-01

    Immunohistochemical deposition and distribution of fetal antigen 2 (FA2) was examined in normal brain tissue and in primary and metastatic tumors of the brain. In normal brain tissue FA2 was exclusively found linearly around the vessels, along pia and in arachnoidea. A similar localization was seen...

  20. Baseline survey of oral health of primary and secondary school ...

    African Journals Online (AJOL)

    Background: Among the issues that determine the performance of a child at school is health. In recognition of this, the Uganda government has embarked on a school health program for the success of universal primary education. Although dental health is an important component of school health there is little information on ...

  1. Primary versus secondary intraocular lens implantation in the management of congenital cataract

    Directory of Open Access Journals (Sweden)

    Thanaa H Mohamed

    2016-01-01

    Conclusion Primary IOL implantation was found to be safe and effective in the management of congenital cataract; it leads to lower incidence of complications and better visual outcomes compared with aphakia and secondary IOL implantation.

  2. An experimental investigation of the interaction of primary and secondary stresses in fuel plates

    International Nuclear Information System (INIS)

    Swinson, W.F.; Battiste, R.L.; Yahr, G.T.

    1996-01-01

    If the load is not relieved as a structure starts to yield, the induced stress is defined as primary stress. If the load relaxes, as a structure begins yield the induced stress is defined as secondary stress. In design it is not uncommon to give more weight to primary stresses than to secondary stresses. However, knowing when this is good design practice and when it is not good design practice represents a problem. In particular, the fuel plates in operating reactors contain both primary stresses and secondary stresses and to properly assess a design there is a need to assign design weights to the stresses. Tests were conducted on reactor fuel plates intended for the Advanced Neutron Source (ANS) to determine the potential of giving different design weights to the primary and secondary stresses. The results of these tests and the conclusion that the stresses should be weighted the same are given in this paper

  3. Effects of primary and secondary morphological family size in monolingual and bilingual word processing

    NARCIS (Netherlands)

    Mulder, K.; Dijkstra, A.F.J.; Schreuder, R.; Baayen, Harald

    2014-01-01

    This study investigated primary and secondary morphological family size effects in monolingual and bilingual processing, combining experimentation with computational modeling. Family size effects were investigated in an English lexical decision task for Dutch-English bilinguals and English

  4. Diagnostic Air Quality Model Evaluation of Source-Specific Primary and Secondary Fine Particulate Carbon

    Science.gov (United States)

    Ambient measurements of 78 source-specific tracers of primary and secondary carbonaceous fine particulate matter collected at four midwestern United States locations over a full year (March 2004–February 2005) provided an unprecedented opportunity to diagnostically evaluate...

  5. NNDSS - Table II. Spotted fever rickettsiosis to Syphilis, primary and secondary

    Data.gov (United States)

    U.S. Department of Health & Human Services — NNDSS - Table II. Spotted fever rickettsiosis to Syphilis, primary and secondary - 2018. In this Table, provisional cases of selected notifiable diseases (≥1,000...

  6. Obstacles to the Primary and Secondary Prevention of Breast Cancer in African-American Women

    National Research Council Canada - National Science Library

    Hargreaves, Margaret

    1997-01-01

    Study objectives are to develop a quantitative assessment tool to describe barriers to primary and secondary prevention of breast cancer, to use this tool to establish preliminary norms in an urban...

  7. Potato cv. Romano reaction to primary and secondary infection with potato necrotic strain Y virus (PVYNTN

    Directory of Open Access Journals (Sweden)

    Drago Milošević

    2015-01-01

    Full Text Available Primary and secondary infections with PVYNTN were investigated on forty plants of the potato cv. Romano inoculated in a greenhouse in Serbia in 2012 and 2013. PVY isolates were collected from the potato growing region of Čačak and identified by ELISA and RT-PCR methods. The sequence of the Serbian isolate 3D (Acc. No. KJ946936 showed 100% match with seven PVY isolates deposited in GenBank and described as NTN. A significant difference was detected between PVYNTN symptoms exibited on leaves of the cv. Romano under primary and secondary infections. The findings are significant because they are based on symptoms observed, so that it is clear that there are two distinct types of infection: primary and secondary. Symptoms of primary and secondary infection were the same on potato tubers and had the form of necrotic rings.

  8. An experimental investigation on the interaction of primary and secondary stresses in fuel plates

    International Nuclear Information System (INIS)

    Swinson, W.F.; Battiste, R.L.; Yahr, G.T.

    1997-01-01

    If the load is not relieved as a structure starts to yield, the induced stress is defined as primary stress. If the load relaxes, as a structure begins to yield the induced stress is defined as secondary stress. In design, it is not uncommon to give more weight to primary stresses than to secondary stresses. However, knowing when this is good design practice and when it is not good design practice represent a problem. In particular, the fuel plates in operating reactors contain both primary stresses and secondary stresses, and to properly assess a design there is a need to assign design weights to the stresses. Tests were conducted on reactor fuel plates intended for the advanced neutron source (ANS) to determine the potential of giving different design weights to the primary and secondary stresses. The results of these tests and the conclusion that the stresses should be weighted the same are given in this paper

  9. Primary and Secondary Variants of Psychopathy in a Volunteer Sample Are Associated With Different Neurocognitive Mechanisms.

    Science.gov (United States)

    Sethi, Arjun; McCrory, Eamon; Puetz, Vanessa; Hoffmann, Ferdinand; Knodt, Annchen R; Radtke, Spenser R; Brigidi, Bartholomew D; Hariri, Ahmad R; Viding, Essi

    2018-04-12

    Recent work has indicated that there at least two distinct subtypes of psychopathy. Primary psychopathy is characterized by low anxiety and thought to result from a genetic predisposition, whereas secondary psychopathy is characterized by high anxiety and thought to develop in response to environmental adversity. Primary psychopathy is robustly associated with reduced neural activation to others' emotions and, in particular, distress. However, it has been proposed that the secondary presentation has different neurocognitive correlates. Primary (n = 50), secondary (n = 100), and comparison (n = 82) groups were drawn from a large volunteer sample (N = 1444) using a quartile-split approach across psychopathic trait (affective-interpersonal) and anxiety measures. Participants performed a widely utilized emotional face processing task during functional magnetic resonance imaging. The primary group showed reduced amygdala and insula activity in response to fear. The secondary group did not differ from the comparison group in these regions. Instead, the secondary group showed reduced activity compared with the comparison group in other areas, including the superior temporal sulcus/inferior parietal lobe, thalamus, pallidum, and substantia nigra. Both psychopathy groups also showed reduced activity in response to fear in the anterior cingulate cortex. During anger processing, the secondary group exhibited reduced activity in the anterior cingulate cortex compared with the primary group. Distinct neural correlates of fear processing characterize individuals with primary and secondary psychopathy. The reduced neural response to fear that characterizes individuals with the primary variant of psychopathic traits is not observed in individuals with the secondary presentation. The neurocognitive mechanisms underpinning secondary psychopathy warrant further systematic investigation. Copyright © 2018 Society of Biological Psychiatry. Published by Elsevier Inc. All rights

  10. Tertiary center experience with primary endoscopic laryngoplasty in pediatric acquired subglottic stenosis and literature review

    Directory of Open Access Journals (Sweden)

    Jaber Alshammari

    2017-03-01

    Conclusion: Our study showed that primary endoscopic management was successful in 82.3% of cases of acquired subglottic stenosis including those with high grade stenosis and long segment of more than 12 mm in terms of the craniocaudal length. CO2 laser was an important tool to convert mature hard stenotic segment into a soft one. The latter yielded to the lateral pressure created by balloon dilatation better.

  11. Etiology of anemia in primary hypothyroid subjects in a tertiary care center in Eastern India

    Directory of Open Access Journals (Sweden)

    Chanchal Das

    2012-01-01

    Full Text Available Introduction: The association of anemia with primary hypothyroidism has been common knowledge for many years. However; its pathogenesis is far from clear in many cases. Often the causes of anemia are manifold. Aims and objectives: In this study, we evaluated the causes of anemia in patients with primary hypothyroidism. Materials and Methods : Sixty adult nonpregnant untreated primary hypothyroid patients with anemia without any obvious cause were included. All patients were subjected to full medical history, clinical examination, biochemical and imaging studies. Serum iron profile, vitamin B12, folic acid, anti parietal cell antibody, anti TPO antibody, bone marrow study, and stool for occult blood, Coomb′s test, HPLC for hemoglobinopathies and complete hemogram with reticulocyte count were done and analyzed. Results: Normocytic, normochromic anemia was present in 31 patients (51.6% followed by microcytic anemia in 26 patients (43.3%. Six patients (10% had megaloblastic anemia with vitamin B12 deficiency including 3 cases of pernicious anemia. Two patients had combined deficiency of iron and vitamin B12. Conclusion: Normocytic normochromic anemia with normal bone marrow was commonest type of anemia in this study, followed by iron deficiency anemia.

  12. Primary Germ Cell Tumors of the Mediastinum: 10 Years of Experience in a Tertiary Teaching Hospital

    Directory of Open Access Journals (Sweden)

    Chih-Jen Yang

    2005-09-01

    Full Text Available Germ cell tumors occur mostly in the gonad. Extragonadal germ cell tumors are rare, and most occur in the retroperitoneum and mediastinum. Primary mediastinal germ cell tumors are often found in the anterior portion of the mediastinum and include teratomas and non-teratomatous tumors. Non-teratomatous tumors include seminomas and malignant non-seminomatous germ cell tumors (MNSGCTs. MNSGCTs include yolk sac tumors, choriocarcinomas, embryonal carcinomas, and mixed type germ cell tumors. Teratomas are the most common germ cell tumors of the mediastinum, and seminomas are the most common non-teratomatous germ cell tumors of the mediastinum. Cases of primary mediastinal MNSGCT reported in the literature are rare. In this report, we review all primary mediastinal germ cell tumors from a 10-year period at the Chung-Ho Memorial Hospital of Kaohsiung Medical University. A total of 14 cases were reviewed, including 11 patients with mature teratomas, two with yolk sac tumors, and one with seminoma. We discuss the differences in clinical presentation, histopathologic characteristics, treatment, and prognosis.

  13. Modeling PWR systems for monitoring primary-to-secondary leakage using tritium tracer

    International Nuclear Information System (INIS)

    Peiffer, D.G.

    1992-01-01

    This paper discusses several techniques available for monitoring primary to secondary leakage, focusing on the advantages and disadvantages of each. A mathematical model of Millstone 2 describes the behavior of tritium activity in the secondary plant water when a leak exists. Real data from Millstone 2 illustrate the accuracy and reliability of the model and use of the model to measure the mass of water in the secondary system

  14. RETROSPECTIVE STUDY OF PRIMARY CAESAREAN SECTION AT A TERTIARY CARE CENTRE

    Directory of Open Access Journals (Sweden)

    S. Prasanna Lakshmi

    2016-12-01

    Full Text Available BACKGROUND The caesarean section epidemic is a reason for immediate concern and deserves serious National and International attention. Rates of caesarean section are of concern to both developed and developing countries. The indications for caesarean section have been undergoing a gradual change over the last few decades. Besides the obstetric causes, several other medical, social, ethical, economical and medicolegal factors play a role in the rising trend of caesarean section. The aim of the study was undertaken to determine the rate, indications, intraoperative and postoperative complications of primary caesarean section in primi and multipara and maternal and foetal morbidities in these patients. MATERIALS AND METHODS This is a retrospective study carried out on primary caesarean section in the Department of O and G at Mahatma Gandhi Memorial Government Hospital attached to K.A.P.Viswanatham Government Medical College, Trichy, during 1 year period from January 2015-December 2015. Inclusion Criteria- Patients (booked/unbooked attending the labour room undergoing primary caesarean section in the department. Their intraoperative and postoperative complications were noted and also maternal and foetal morbidities and complications. Exclusion Criteria- Gestational age <28 wks., previous LSCS, previous uterine surgery or hysterotomy, multiple gestation. RESULTS There has been a steady increase in total deliveries (increase by 5.2% in the last 2 yrs. at Mahathma Gandhi Memorial Government Hospital attached to K.A.P. Viswanatham Government Medical College, Trichy, and total caesarean section rate (increased by 19.3% and primary caesarean section rate (increased by 12.3% in the past 2 years with concomitant reduction in neonatal mortality rate by 28%. However, this doesn’t justify the increase in primary caesarean section rate. CONCLUSION Potentially modifiable factors such as patient preferences, practice variations among hospitals, systems and

  15. Animal models for the study of primary and secondary hypertension in humans

    OpenAIRE

    Lin, Hiu Yu; Lee, Yee Ting; Chan, Yin Wah; Tse, Gary

    2016-01-01

    Hypertension is a significant cause of morbidity and mortality worldwide. It is defined as systolic and diastolic blood pressures (SBP/DBP) >140 and 90 mmHg, respectively. Individuals with an SBP between 120 and 139, or DBP between 80 and 89 mmHg, are said to exhibit pre-hypertension. Hypertension can have primary or secondary causes. Primary or essential hypertension is a multifactorial disease caused by interacting environmental and polygenic factors. Secondary causes are renovascular hyper...

  16. BACKGROUND AND MOTIVATION OF STUDENT TEACHERS IN PRIMARY AND SECONDARY SCIENCE

    DEFF Research Database (Denmark)

    Hyllested, Trine

    The students attending teacher training at University College Capital in Copenhagen, Denmark fall into two groups with different subject profiles: One group prefers to teach at the primary level, the other prefers to teach at the secondary level. The students of primary level science combine...... with other subjects such as History, Danish or Physical Education. The students of secondary level science combine with subjects such as Mathematics and related science subjects: Biology, Geography, Physics and Chemistry....

  17. Iridium-Catalyzed Condensation of Primary Amines To Form Secondary Amines

    DEFF Research Database (Denmark)

    Lorentz-Petersen, Linda Luise Reeh; Jensen, Paw; Madsen, Robert

    2009-01-01

    Symmetric secondary amines are readily obtained by heating a neat primary amine with 0.5 mol% of bis(dichloro[eta(5)-pentamethylcyclopentadienyl]iridium). The products are isolated by direct distillation in good yields.......Symmetric secondary amines are readily obtained by heating a neat primary amine with 0.5 mol% of bis(dichloro[eta(5)-pentamethylcyclopentadienyl]iridium). The products are isolated by direct distillation in good yields....

  18. Quasi-resonant converter with divided resonant capacitor on primary and secondary side

    OpenAIRE

    Shiroyama, Hironobu; Matsuo, Hirofumi; Ishizuka, Yoichi

    2009-01-01

    This paper presents a quasi-resonant converter with divided resonant capacitor on primary and secondary side of the isolation transformer. A conventional quasi-resonant converter using flyback topology can realize soft switching with simple circuit. However, relatively large surge voltage is generated in the switching device. To suppress such surge voltage, resonant capacitor is divided on primary side and secondary side in the proposed converter. In case of prototype 95W converter, the volta...

  19. Challenges with Tertiary-Level Mechatronic Fluid Power

    DEFF Research Database (Denmark)

    Dransfield, Peter; Conrad, Finn

    1996-01-01

    As authors we take the view that mechatronics, as it relates to fluid power, has three levels which we designate as primary, secondary and tertiary. A brief review of the current status of fluid power, hydraulic and pneumatic, and of electronic control of it is presented and discussed. The focus...... is then on tertiary-level mechatronic fluid power and the challenges to it being applied successfully....

  20. Primary versus secondary closure of cutaneous abscesses in the emergency department: a randomized controlled trial.

    Science.gov (United States)

    Singer, Adam J; Taira, Breena R; Chale, Stuart; Bhat, Rahul; Kennedy, David; Schmitz, Gillian

    2013-01-01

    Cutaneous abscesses have traditionally been treated with incision and drainage (I&D) and left to heal by secondary closure. The objective was to compare the healing rates of cutaneous abscesses following I&D after primary or secondary closure. This was a randomized, controlled, trial, balanced by center, with blocked randomization created by a random-number generator. One urban and one suburban academic emergency department (ED) participated. Subjects were randomized to primary or secondary wound closure following I&D of the abscess. Main outcome measures were the percentage of healed wounds (wound was completely closed by visual inspection; a 40% difference in wound healing was sought) and overall failure rate (need for additional intervention including suture removal, additional drainage, antibiotics, or admission within 7 days after drainage). Fifty-six adult patients with simple localized cutaneous abscesses were included; 29 were randomized to primary closure, and 27 were randomized to secondary closure. Healing rates at 7 days were similar between the primary and secondary closure groups (69.6%, 95% confidence interval [CI] = 49.1% to 84.4% vs. 59.3%, 95% CI = 40.7% to 75.5%; difference 10.3%, 95% CI = -15.8% to 34.1%). Overall failure rates at 7 days were also similar between the primary and secondary closure groups (30.4%, 95% CI = 15.6% to 50.9% vs. 28.6%, 95% CI = 15.2% to 47.1%; difference 1.8%, 95% CI = -24.2% to 28.8%). The rates of wound healing and treatment failure following I&D of simple abscesses in the ED are similar after primary or secondary closure. The authors did not detect a difference of at least 40% in healing rates between primary and secondary closure. © 2013 by the Society for Academic Emergency Medicine.

  1. Fulminant Hepatic Failure Secondary to Primary Hepatic Angiosarcoma

    Directory of Open Access Journals (Sweden)

    Ayokunle T. Abegunde

    2015-01-01

    Full Text Available Background. Hepatic angiosarcoma is a rare and aggressive tumor that often presents at an advanced stage with nonspecific symptoms. Objective. To report a case of primary hepatic angiosarcoma in an otherwise healthy man with normal liver function tests two months prior to presenting with a short period of jaundice that progressed to fulminant hepatic failure. Methods. Case report and review of literature. Conclusion. This case illustrates the rapidity of progression to death after the onset of symptoms in a patient with hepatic angiosarcoma. Research on early diagnostic strategies and newer therapies are needed to improve prognosis in this rare and poorly understood malignancy with limited treatment options.

  2. Highly efficient and diastereoselective gold(I)-catalyzed synthesis of tertiary amines from secondary amines and alkynes: substrate scope and mechanistic insights.

    Science.gov (United States)

    Liu, Xin-Yuan; Guo, Zhen; Dong, Sijia S; Li, Xiao-Hua; Che, Chi-Ming

    2011-11-11

    An efficient method for the synthesis of tertiary amines through a gold(I)-catalyzed tandem reaction of alkynes with secondary amines has been developed. In the presence of ethyl Hantzsch ester and [{(tBu)(2)(o-biphenyl)P}AuCl]/AgBF(4) (2 mol %), a variety of secondary amines bearing electron-deficient and electron-rich substituents and a wide range of alkynes, including terminal and internal aryl alkynes, aliphatic alkynes, and electron-deficient alkynes, underwent a tandem reaction to afford the corresponding tertiary amines in up to 99 % yield. For indolines bearing a preexisting chiral center, their reactions with alkynes in the presence of ethyl Hantzsch ester catalyzed by [{(tBu)(2)(o-biphenyl)P}AuCl]/AgBF(4) (2 mol %) afforded tertiary amines in excellent yields and with good to excellent diastereoselectivity. All of these organic transformations can be conducted as a one-pot reaction from simple and readily available starting materials without the need of isolation of air/moisture-sensitive enamine intermediates, and under mild reaction conditions (mostly room temperature and mild reducing agents). Mechanistic studies by NMR spectroscopy, ESI-MS, isotope labeling studies, and DFT calculations on this gold(I)-catalyzed tandem reaction reveal that the first step involving a monomeric cationic gold(I)-alkyne intermediate is more likely than a gold(I)-amine intermediate, a three-coordinate gold(I) intermediate, or a dinuclear gold(I)-alkyne intermediate. These studies also support the proposed reaction pathway, which involves a gold(I)-coordinated enamine complex as a key intermediate for the subsequent transfer hydrogenation with a hydride source, and reveal the intrinsic stereospecific nature of these transformations observed in the experiments. Copyright © 2011 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  3. Medication adherence and blood pressure control amongst adults with primary hypertension attending a tertiary hospital primary care clinic in Eastern Nigeria

    Science.gov (United States)

    Ofoedu, John N.; Njoku, Patrick U.; Amadi, Agwu N.; Godswill-Uko, Ezinne U.

    2013-01-01

    Abstract Background As the case detection rates of hypertension increase in adult Nigerians, achieving target blood pressure (BP) control has become an important management challenge. Objectives To describe medication adherence and BP control amongst adult Nigerians with primary hypertension attending a primary care clinic of a tertiary hospital in a resource-poor environment in Eastern Nigeria. Methods A cross-sectional study was carried out in 140 adult patients with primary hypertension who have been on treatment for at least 6 months at the primary care clinic of Federal Medical Centre, Umuahia. A patient was said to have achieved goal BP control if the BP was < 140 per 90 mmHg. Adherence was assessed in the previous 30 days using a pretested researcher-administered questionnaire on 30 days of self-reported therapy. Adherence was graded using an ordinal scoring system of 0–4; an adherent patient was one who scored 4 points in the previous 30 days. Reasons for non-adherence were documented. Results Adherence to medication and BP control rates were 42.9% and 35.0% respectively. BP control was significantly associated with medication adherence (p = 0.03), antihypertensive medication duration ≥3 years (p = 0.042), and taking ≥ one form of antihypertensive medication (p = 0.04). BP at the recruitment visit was significantly higher than at the end of the study (p = 0.036). The most common reason for non-adherence was forgetfulness (p = 0.046). Conclusions The rate of BP control amongst the study population was low, which may be connected with low medication adherence. This study urges consideration of factors relating to adherence alongside other factors driving goal BP control.

  4. Medication adherence and blood pressure control amongst adults with primary hypertension attending a tertiary hospital primary care clinic in Eastern Nigeria

    Directory of Open Access Journals (Sweden)

    Gabriel UP. Iloh

    2013-02-01

    Full Text Available Background: As the case detection rates of hypertension increase in adult Nigerians, achieving target blood pressure (BP control has become an important management challenge.Objectives: To describe medication adherence and BP control amongst adult Nigerians with primary hypertension attending a primary care clinic of a tertiary hospital in a resource-poor environment in Eastern Nigeria.Methods: A cross-sectional study was carried out in 140 adult patients with primary hypertension who have been on treatment for at least 6 months at the primary care clinic of Federal Medical Centre, Umuahia. A patient was said to have achieved goal BP control if the BP was < 140 per 90 mmHg. Adherence was assessed in the previous 30 days using a pretested researcher-administered questionnaire on 30 days of self-reported therapy. Adherence was graded using an ordinal scoring system of 0–4; an adherent patient was one who scored 4 points in the previous 30 days. Reasons for non-adherence were documented.Results: Adherence to medication and BP control rates were 42.9% and 35.0% respectively. BP control was significantly associated with medication adherence (p = 0.03, antihypertensive medication duration ≥3 years (p = 0.042, and taking ≥ one form of antihypertensive medication (p = 0.04. BP at the recruitment visit was significantly higher than at the end of the study (p = 0.036. The most common reason for non-adherence was forgetfulness (p = 0.046. Conclusion: The rate of BP control amongst the study population was low, which may be connected with low medication adherence. This study urges consideration of factors relating to adherence alongside other factors driving goal BP control.

  5. Secondary visual workload capability with primary visual and kinesthetic-tactual displays

    Science.gov (United States)

    Gilson, R. D.; Burke, M. W.; Jagacinski, R. J.

    1978-01-01

    Subjects performed a cross-adaptive tracking task with a visual secondary display and either a visual or a quickened kinesthetic-tactual (K-T) primary display. The quickened K-T display resulted in superior secondary task performance. Comparisons of secondary workload capability with integrated and separated visual displays indicated that the superiority of the quickened K-T display was not simply due to the elimination of visual scanning. When subjects did not have to perform a secondary task, there was no significant difference between visual and quickened K-T displays in performing a critical tracking task.

  6. Global Warming Responses at the Primary Secondary Interface: 2. Potential Effectiveness of Education

    Science.gov (United States)

    Skamp, Keith; Boyes, Eddie; Stannistreet, Martin

    2009-01-01

    In an earlier paper (Skamp, Boyes, & Stanisstreet, 2009b), students' beliefs and willingness to act in relation to 16 specific actions related to global warming were compared across the primary secondary interface. More primary students believed in the effectiveness of most actions to reduce global warming and were willing to take those…

  7. Global Warming Responses at the Primary Secondary Interface: 1. Students' Beliefs and Willingness to Act

    Science.gov (United States)

    Skamp, Keith; Boyes, Eddie; Stannistreet, Martin

    2009-01-01

    Using survey methodology, students' beliefs, and willingness to act, about 16 specific actions related to global warming are compared across the primary secondary interface. More primary students believed in the effectiveness of most actions to reduce global warming and were willing to take those actions. In general there was a disparity between…

  8. Radionuclide imaging in primary and secondary disorders of the myocardium

    International Nuclear Information System (INIS)

    Follansbee, W.P.

    1987-01-01

    The list of all potential causes of myocardial disease or injury is an extensive one: a condensed version is presented. Conceptually these processes can be categorized into those which are, or appear to be, primary to the myocardium and those which secondarily involve it. Nuclear imaging procedures, particularly those used to assess ventricular function, are in a general sense potentially applicable to the clinical evaluation of any of these entities. In certain of these conditions, however, nuclear cardiac procedures have a demonstrated or potential additional and more specific role for the diagnosis and quantification of the entity. A number of these, including coronary artery disease, valvular heart disease, cor pulmonale, and myocardial trauma, are the topics of other chapters and, therefore, are not dealt with further here. The remainder of the myocardial disorders in which nuclear imaging procedures have a recognized or potential specific role are the focus of this discussion

  9. Relay-Assisted Primary and Secondary Transmissions in Cognitive Radio Networks

    KAUST Repository

    Shafie, Ahmed El

    2016-09-27

    We assume a set of cognitive relay nodes that assists both primary and secondary transmissions in a time-slotted cognitive radio networks. To regulate the channel access of the various nodes in the network, we propose an overlapped spectrum sensing strategy for channel sensing, where the secondary source node senses the channel from the beginning of the time slot and the cognitive relay nodes sense the channel for double the sensing time used by the secondary source node to detect the activities of both the primary and secondary source nodes. Hence, the secondary source node has an intrinsic priority over the relay nodes. The relay nodes help both the primary user and the secondary user to deliver their unsuccessfully decoded packets at their destinations. In a given time slot, the scheduled relay node for data transmission starts its transmission when both the primary and secondary users are sensed to be inactive (i.e. have no data to transmit). We propose two optimization-based formulations with quality-of-service (QoS) constraints involving average queueing delay and average service rate requirements. We investigate both cases of perfect and imperfect spectrum sensing. To further enhance the users\\' QoS requirements, we propose three packet decoding strategies at the relay nodes and compare their performance. We derive an upper bound on the secondary queue average service rate to determine which decoding strategy can achieve that bound. Our numerical results show the benefits of relaying and its ability to enhance the performance of both the primary and secondary users. Moreover, the performance of the proposed schemes is close to the derived upper bound.

  10. The Cretaceous-Tertiary boundary marine extinction and global primary productivity collapse

    Science.gov (United States)

    Zachos, J. C.; Arthus, M. A.; Dean, W. E.

    1988-01-01

    The extinction of marine phyto-and zoo-plankton across the K-T boundary has been well documented. Such an event may have resulted in decreased photosynthetic fixation of carbon in surface waters and a collapse of the food chain in the marine biosphere. Because the vertical and horizontal distribution of the carbon isotopic composition of total dissolved carton (TDC) in the modern ocean is controlled by the transfer of organic carbon from the surface to deep reservoirs, it follows that a major disruption of the marine biosphere would have had a major effect on the distribution of carbon isotopes in the ocean. Negative carbon isotope excursions have been identified at many marine K-T boundary sequences worldwide and are interpreted as a signal of decreased oceanic primary productivity. However, the magnitude, duration and consequences of this productivity crisis have been poorly constrained. On the basis of planktonic and benthic calcareous microfossil carbon isotope and other geochemical data from DSDP Site 577 located on the Shatsky Rise in the north-central Pacific, as well as other sites, researchers have been able to provide a reasonable estimate of the duration and magnitude of this event.

  11. Oxidation of the Primary Alcoholic Moiety Selectively in the Presence of the Secondary Alcoholic Moieties

    International Nuclear Information System (INIS)

    Tin Myint Htwe

    2011-12-01

    Both primary and secondary alcoholic moieties are very sensitive to oxidation reactions. But sometimes it is necessary to oxidized only the primary alcoholic moiety. Such cases are usually found in Food Industries. In this situation, TEMPO (1, 1, 6, 6-Tetramethyl-1-Piperidine Oxoammonium) was used as an oxidizing agent. In this paper, Alpha starch was successfully oxidized using TEMPO as the oxidizing agent in combination with sodium hypochlorite with and without sodium bromide. The oxidation of primary alcoholic moiety only and the remaining untouched secondary alcoholic moiety were proved by infrared spectroscopy method.

  12. Assessment of a primary and tertiary care integrated management model for chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Peiro Meritxell

    2009-02-01

    Full Text Available Abstract Background The diagnosis and treatment of patients with chronic obstructive pulmonary disease (COPD in Spain continues to present challenges, and problems are exacerbated when there is a lack of coordinated follow-up between levels of care. This paper sets out the protocol for assessing the impact of an integrated management model for the care of patients with COPD. The new model will be evaluated in terms of 1 improvement in the rational utilization of health-care services and 2 benefits reflected in improved health status and quality of life for patients. Methods/Design A quasi-experimental study of the effectiveness of a COPD management model called COPD PROCESS. The patients in the study cohorts will be residents of neighborhoods served by two referral hospitals in Barcelona, Spain. One area comprises the intervention group (n = 32,248 patients and the other the control group (n = 32,114 patients. The study will include pre- and post-intervention assessment 18 months after the program goes into effect. Analyses will be on two datasets: clinical and administrative data available for all patients, and clinical assessment information for a cohort of 440 patients sampled randomly from the intervention and control areas. The main endpoints will be the hospitalization rates in the two health-care areas and quality-of-life measures in the two cohorts. Discussion The COPD PROCESS model foresees the integrated multidisciplinary management of interventions at different levels of the health-care system through coordinated routine clinical practice. It will put into practice diagnostic and treatment procedures that are based on current evidence, multidisciplinary consensus, and efficient use of available resources. Care pathways in this model are defined in terms of patient characteristics, level of disease severity and the presence or absence of exacerbation. The protocol covers the full range of care from primary prevention to treatment of

  13. Trabectome surgery for primary and secondary open angle glaucomas.

    Science.gov (United States)

    Jordan, Jens F; Wecker, Thomas; van Oterendorp, Christian; Anton, Alexandra; Reinhard, Thomas; Boehringer, Daniel; Neuburger, Matthias

    2013-12-01

    In most forms of open angle glaucoma, the trabecular meshwork is the main barrier for aqueous humor outflow, causing elevated intraocular pressure (IOP). The Trabectome is a minimal invasive device for the surgical treatment of open angle glaucoma, particularly eliminating the juxtacanalicular meshwork. This study was conducted to compare the effectiveness and complication profile among different glaucoma subgroups. Single center prospective observational study. There were 557 consecutive eyes of 487 patients included in this study. Trabectome surgery was performed either alone or in combination with cataract surgery. Intraoperative and postoperative complications were documented systematically. Main outcome measures were IOP reduction over time and the preoperative and postoperative number of IOP-lowering medications. Due to subgroup sizes, only data from eyes with primary open angle glaucoma and pseudoexfoliation glaucoma were processed for statistical analysis. For the 261 eyes classified as primary open angle glaucoma, preoperative IOP was 24 ± 5.5 mmHg (mean ± SD) under 2.1 ± 1.3 IOP-lowering medications. After a mean follow-up of 204 ± 238 days, IOP was reduced to 18 ± 6.1 mmHg, and medication was reduced to 1.2 ± 1.1. For the 173 eyes classified as pseudoexfoliation glaucoma, after a mean follow-up of 200 ± 278 days, IOP was reduced from 25 ± 5.9 mmHg to 18 ± 8.2 mmHg, and medication was reduced from 2.0 ± 1.2 to 1.1 ± 1.1. A Cox proportional hazards model hinted forward superiority of the combined surgery cases (Trabectome + Phaco + intraocular lens) in comparison to Trabectome surgery only in phakic or pseudophakic eyes. No serious complications were observed. Minimal invasive glaucoma surgery with the Trabectome seems to be safe and effective. The subgroup analysis of different kinds of open angle glaucomas presented in this study may help in first-line patient selection. The lack of ocular surface alterations makes it a valuable addition to

  14. Hyponatraemia secondary to nivolumab-induced primary adrenal failure

    Directory of Open Access Journals (Sweden)

    Harris Trainer

    2016-11-01

    Full Text Available Checkpoint inhibitors, such as ipilimumab and pembrolizumab, have transformed the prognosis for patients with advanced malignant melanoma and squamous non-small-cell lung cancer, and their use will only expand as experience is gained in a variety of other malignancies, for instance, renal and lymphoma. As the use of checkpoint inhibitors increases, so too will the incidence of their unique side effects, termed immune-related adverse events (irAEs, which can affect dermatological, gastrointestinal, hepatic, endocrine and other systems. Nivolumab is a monoclonal antibody that blocks the human programmed death receptor-1 ligand (PD-L1 found on many cancer cells and is licensed for the treatment of advanced malignant melanoma. We describe the first case of nivolumab-induced adrenalitis resulting in primary adrenal failure presenting with hyponatraemia in a 43-year-old man with malignant melanoma. The case highlights the potentially life-threatening complications of checkpoint inhibitors and the need for patient education and awareness of irAEs among the wider clinical community because such side effects require prompt recognition and treatment.

  15. The role of university research in primary and secondary education

    Science.gov (United States)

    Redondo, A.; Llopart, M.; Ramos, L.; Roger, T.; Rafols, R.; Redondo, J. M.

    2009-04-01

    One of the most important roles of educators at all levels(transversally and inter-generationally between adult education, university and the primary schools, specially in sciences is to estimulate the quest for new knowledge and to help to provide the basic thinking tools of the proper scientific method. An innovative plan has been set up though the Campus Universitari de la Mediterrania that integrates the UPC, the local Education authorities and the local governement in Vilanova i la Geltru, Barcelona. To coordinate university professors invited to lecture in summer courses, so their research and lecturing materials may be used as school level material (as a CD collection) and to help younger students to iniciate their own research proyects. During 2006-2008 a series of Environmental science seminars, group proyects decided by the students or proposed jointly by the CUM were started. Examples of these works, such as Cetacean comunication (with the help of the Laboratory of Bioacustic Applications of the UPC), Shapes and patterns in the environment (Cosmocaixa Science Museum), the Rainbow, Waves and Tides, Turbulence, The growth of snails and the Fibonacci sequence, etc... will be presented, showing the importance of comunicating scientific interest to the younger generations.

  16. The transition from primary to secondary school in mainstream education for children with autism spectrum disorder.

    Science.gov (United States)

    Mandy, William; Murin, Marianna; Baykaner, Ozlem; Staunton, Sara; Hellriegel, Josselyn; Anderson, Seonaid; Skuse, David

    2016-01-01

    The transition from primary to secondary education (hereafter 'school transition') is a major ecological shift that poses considerable social, emotional, academic and organisational challenges. It is commonly assumed that this school transition is especially difficult for children with autism spectrum disorder, but that idea is mainly based on anecdotal evidence and requires systematic investigation. We describe change and continuity for children with autism spectrum disorder (N = 28, mean age = 11.29 years, mean full-scale IQ = 87.86) transitioning in mainstream education from primary to secondary school. Levels of psychopathology, adaptive functioning and peer victimisation were measured by parent, self and teacher report in the last year of primary school, and again after one term of secondary school. At follow-up, all participants were still in their secondary school, and there was no evidence for a marked escalation of difficulties during the transition. Instead, we observed high levels of psychopathology and maladaption at baseline which persisted across the transition and were in some cases under-recognised. By parent report, levels of bullying fell from primary to secondary school. Future research should investigate factors, such as school characteristics, that influence the move to secondary education in autism spectrum disorder, to inform the development of interventions to promote successful school transition. © The Author(s) 2015.

  17. Transitional woes: On the impact of L2 input continuity from primary to secondary school

    Directory of Open Access Journals (Sweden)

    Simone E. Pfenninger

    2017-09-01

    Full Text Available In this paper, we discuss the problem of articulation between levels in the educational system, as the transition from a rather more communicative, contentbased and holistic approach to English as a foreign language (EFL teaching at primary level to more formal and explicit ways of foreign language (FL teaching at secondary is often experienced as problematic by students and teachers alike (see, e.g., Muñoz, Tragant, & Camuñas, 2015. The results of a mixed methods analysis are presented, in which we analyzed, through a questionnaire and language experience essays, perceived continuity between input received in primary school and secondary school, as well as learners’ beliefs, attitudes and self-efficacy before and after they transitioned to secondary school. Twelve primary schools and six secondary schools in Switzerland participated in the study, with a total of 280 early learners of EFL (biological age 12-13 years, age of onset 8 years. We will argue that one of the main reasons why early FL instruction seems not to bear fruit later in secondary school is that, on the one hand, coherence in curriculum design and practice vary in a few—but crucial—aspects within and between primary schools. On the other hand, the fact that secondary education becomes a meeting point for mixed ability classes also seems to mitigate the potential advantages of an earlier start.

  18. Psychologic and sexual dysfunction in primary and secondary infertile male patients

    Directory of Open Access Journals (Sweden)

    Aytac Sahin

    2017-06-01

    Full Text Available Objective: The aim of this study was to compare depression and sexual dysfunctions observed in primary and secondary infertile patients. Material and method: The study was performed in 39 primary and 31 secondary infertile male patients. Male sexual health was evaluated using the International Index of Erectile Function (IIEF score and depression with Beck Depression Inventory (BDI. Results: Mean age of the participants and their partners were 31.54 ± 5.37 (range, 24-48 yrs, and 28.16 ± 5.58 (range, 20- 46 yrs years, respectively. Mean duration of their marriage ranged between 1 and 17 years (mean, 5.06 ± 4.15 yrs. A statistically significant intergroup difference was detected between groups as for BDI scores (p = 0.015; p < 0. 05. BDI scores of the primary group were significantly lower than those of the secondary group. A statistically and extremely significant difference was detected between IIEF scores of the groups (p = 0.006; p < 0.01. IIEF scores of the primary infertile group were higher than those of the secondary group. Conclusion: Our study, frequency of the depression and erectile dysfunction seen in the patients with secondary infertility was seen significantly higher than the patients with primary infertility.

  19. Comparison of endotoxin levels found in primary and secondary endodontic infections.

    Science.gov (United States)

    Gomes, Brenda P F A; Endo, Marcos S; Martinho, Frederico C

    2012-08-01

    This clinical study was conducted to compare the levels of endotoxins (lipopolysaccharides [LPSs]) found in primary and secondary endodontic infections with apical periodontitis by correlating LPS contents with clinical/radiographic findings. In addition, the presence of target gram-negative anaerobic bacteria was also investigated. Samples were taken from 15 root canals with primary infections and 15 with secondary infections by using paper points. The limulus amebocyte lysate assay was used to quantify endotoxins, and the polymerase chain reaction technique (16S rDNA) was used for bacterial investigation. Endotoxins were detected in 100% of the root canal samples collected from primary (15/15) and secondary (15/15) infections with median values of 7.49 EU/mL and 3.96 EU/mL, respectively (P asymptomatic teeth with primary infections (P 3 mm) (P < .05). Prevotella nigrescens (10/15, 4/15), Fusobacterium nucleatum (5/15, 1/15), Treponema denticola (3/15, 1/15), and Treponema socranskii (5/15, 1/15) were detected in teeth with primary and secondary infections, respectively. P. endodontalis was present only in teeth with primary infections (5/15). Teeth with primary endodontic infections had higher contents of endotoxins and a more complex gram-negative bacterial community than teeth with secondary infections. Moreover, the levels of endotoxins were related to the severity of bone destruction in periapical tissues as well as the development of clinical features in teeth with primary infections. Copyright © 2012 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  20. 40 CFR Appendix P to Part 50 - Interpretation of the Primary and Secondary National Ambient Air Quality Standards for Ozone

    Science.gov (United States)

    2010-07-01

    ... the data handling procedures for the reported data). 2.3Comparisons with the Primary and Secondary... Secondary National Ambient Air Quality Standards for Ozone P Appendix P to Part 50 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS NATIONAL PRIMARY AND SECONDARY AMBIENT AIR QUALITY...

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

    Science.gov (United States)

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

    2009-03-01

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

  2. Investigation of the conservatism associated with different combinations between primary and secondary piping responses

    International Nuclear Information System (INIS)

    Wang, Y.K.; Subudhi, M.; Bezler, P.

    1983-01-01

    This report includes the findings of an investigation of the conservatism associated with different combinations between the primary and secondary stress components for piping systems under dynamic loading, such as in an earthquake event. The primary stresses are induced by piping response to its mass inertia effects. The secondary stresses are induced by relative displacements of piping supports. The study involves an independnent time history analysis of several typical piping models to predict a best estimate of the actual dynamic and pseudo-static pipe responses to an earthquake. These piping systems are also analyzed using the response spectrum method to obtain the maximum primary stress components. Secondary stresses are next calculated by performing a set of static analyses which provide the worst stress condition. The two components are then combined by both SRSS and absolute sum methods as the results are compared with time history solutions. It is found that the SRSS combination of the primary and secondary stress components yield acceptable results provided the secondary stress component is calculated in the most unfavorable phasing relationship among displacements of piping supports

  3. Parametric study of the primary and secondary systems of the CAREM-25 reactor on steady state

    International Nuclear Information System (INIS)

    Halpert, Silvia; Vazquez, Luis

    2000-01-01

    In the CAREM-25 reactor the primary coolant flows by natural convection that's why the flow is established when the balance between the buoyancy force and friction pressure drop through circuit is obtained. This paper presents a parametric study on primary and secondary systems of the reactor on steady state, for different values of some thermohydraulics parameters: safety factor on friction loss pressure calculations (f), steam generator heat transfer area (A T ) and primary pressure (P P ). The ESCAREM 2.08 thermohydraulic code, which calculates the primary system behavior for steady state conditions, was used for this study. The conclusions of this study are: -) There was a variation of the 15% on the primary coolant flow when the safety factor was changed a 50 %; -) The primary and secondary systems conditions do not change when the power is less than 100 MW; -) Between 100 and 110 MW the decrease of the heat transfer area produces an important change on the secondary systems conditions: the outlet steam generator temperature decrease and there is an important rice in the flow; -) The primary pressure could decrease up to 11.4 MPa without violating turbine requirements. (author)

  4. Magnetic resonance imaging appearances in primary and secondary angiosarcoma of the breast.

    LENUS (Irish Health Repository)

    O'Neill, Ailbhe C

    2014-04-01

    Angiosarcomas are malignant tumours of endovascular origin. They are rare tumours accounting for 0.04-1% of all breast malignancies. Two different forms are described: primary, occurring in young women, and secondary angiosarcoma, which occurs in older women with a history of breast-conserving surgery and radiation therapy. Imaging findings on mammography and ultrasound are non-specific, but magnetic resonance imaging with dynamic contrast enhancement is more informative. We present two cases - one of primary and one of secondary angiosarcoma - and review the imaging findings.

  5. What Do Primary and Secondary School Teachers Know About ADHD in Children?

    DEFF Research Database (Denmark)

    Mohr-Jensen, Christina; Steen-Jensen, T.; Bang-Schnack, Maria

    2017-01-01

    OBJECTIVE: To identify what primary and secondary school teachers know about ADHD in children and, furthermore, to identify which factors predict their knowledge. METHOD: A 29-item questionnaire about ADHD was distributed to a random, nationwide, and representative sample of Danish primary...... and secondary school teachers. Data were analyzed descriptively and by hierarchical regression analysis. RESULTS: A total of 528 teachers were included. Most teachers identified the symptoms of ADHD (79%-96%) and effective classroom intervention strategies (75%-98%). However, knowledge about other...... knowledge about ADHD to successfully include and manage children with ADHD and, additionally, to ensure positive working environments for teachers and support constructive school-home working collaborations....

  6. Mechanism of the N-Hydroxylation of Primary and Secondary Amines by Cytochrome P450

    DEFF Research Database (Denmark)

    Seger, Signe T.; Rydberg, Patrik; Olsen, Lars

    2015-01-01

    Cytochrome P450 enzymes (CYPs) metabolize alkyl- and arylamines, generating several different products. For the primary and secondary amines, some of these reactions result in hydroxylated amines, which may be toxic. Thus, when designing new drugs containing amine groups, it is important to be able...... to predict if a given compound will be a substrate for CYPs, in order to avoid toxic metabolites, and hence to understand the mechanism that is utilized by CYPs. Two possible mechanisms, for the N-hydroxylation of primary and secondary amines mediated by CYPs, are studied by density functional theory (DFT...

  7. Parental education, children's performance and the transition to higher secondary education: trends in primary and secondary effects over five Dutch school cohorts (1965-99).

    Science.gov (United States)

    Kloosterman, Rianne; Ruiter, Stijn; de Graaf, Paul M; Kraaykamp, Gerbert

    2009-06-01

    According to Boudon, social background affects educational transitions as a result of differences in children's academic performance (primary effects) and differences in transition probabilities given children's level of academic performance (secondary effects). This study addresses historical changes in both primary and secondary effects on the educational transition from primary school to higher secondary education in The Netherlands. In addition, it considers changes over time in the relative importance of these effects. The study compares five cohorts of Dutch pupils, specifically those enrolling in secondary education in 1965, 1977, 1989, 1993 and 1999, and it employs counterfactual analyses. The main findings are that secondary effects have been stable and primary effects have fluctuated to some extent. As a result, the proportion of the total effect of social background accounted for by primary effects has increased somewhat, from 53 per cent to 58 per cent.

  8. Investigating Power System Primary and Secondary Reserve Interaction under High Wind Power Penetration

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Yingchen [National Renewable Energy Lab. (NREL), Golden, CO (United States); Tan, Jin [National Renewable Energy Lab. (NREL), Golden, CO (United States); Krad, Ibrahim [National Renewable Energy Lab. (NREL), Golden, CO (United States); Yang, Rui [National Renewable Energy Lab. (NREL), Golden, CO (United States); Gevorgian, Vahan [National Renewable Energy Lab. (NREL), Golden, CO (United States); Ela, Erik [Electric Power Research Inst. (EPRI), Knoxville, TN (United States)

    2016-12-01

    Power system frequency needs to be maintained close to its nominal value at all times to successfully balance load and generation and maintain system reliability. Adequate primary frequency response and secondary frequency response are the primary forces to correct an energy imbalance at the second-to-minute level. As wind energy becomes a larger portion of the world's energy portfolio, there is an increased need for wind to provide frequency response. This paper addresses one of the major concerns about using wind for frequency regulation: the unknown factor of the interaction between primary and secondary reserves. The lack of a commercially available tool to model this has limited the energy industry's understanding of when the depletion of primary reserves will impact the performance of secondary response or vice versa. This paper investigates the issue by developing a multi-area frequency response integration tool with combined primary and secondary capabilities. The simulation is conducted in close coordination with economical energy scheduling scenarios to ensure credible simulation results.

  9. Pyrosequencing Analysis of Cryogenically Ground Samples from Primary and Secondary/Persistent Endodontic Infections.

    Science.gov (United States)

    Keskin, Cangül; Demiryürek, Ebru Özsezer; Onuk, Ertan Emek

    2017-08-01

    This study aimed to characterize the microbial communities of primary and secondary/persistent endodontic infections using high-throughput pyrosequencing from the pulverized samples. The roots of 20 extracted human teeth with primary endodontic infection and 20 teeth with secondary/persistent endodontic infection were collected. The outer surfaces of the roots were disinfected, and whole roots were cryopulverized. 16S amplicon pyrosequencing data from the DNA extracted from the pulverized root powders were obtained, and microorganism abundance and diversity were calculated. Data were analyzed using statistical and bioinformatic methods. Pyrosequencing analysis resulted a total of 2,606,128 sequences from 40 samples. A total of 15 phyla, 160 genera, and 368 species were detected. No significant difference between primary and secondary/persistent endodontic infections was found regarding the diversity and richness of operational taxonomic units at the phyla, genera, and species levels (P > .005). The present study revealed that the microbial diversity of secondary/persistent endodontic infections did not differ than those of primary endodontic infections. A new archaeal species, Candidatus Nitrosoarchaeum limnia, was detected in root canals of 1 patient with primary endodontic infection for the first time. Copyright © 2017 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  10. Mild Conditions for Deuteration of Primary and Secondary Arylamines for the Synthesis of Deuterated Optoelectronic Organic Molecules

    Directory of Open Access Journals (Sweden)

    Anwen M. Krause-Heuer

    2014-11-01

    Full Text Available Deuterated arylamines demonstrate great potential for use in optoelectronic devices, but their widespread utility requires a method for large-scale synthesis. The incorporation of these deuterated materials into optoelectronic devices also provides the opportunity for studies of the functioning device using neutron reflectometry based on the difference in the scattering length density between protonated and deuterated compounds. Here we report mild deuteration conditions utilising standard laboratory glassware for the deuteration of: diphenylamine, N-phenylnaphthylamine, N-phenyl-o-phenylenediamine and 1-naphthylamine (via H/D exchange in D2O at 80 °C, catalysed by Pt/C and Pd/C. These conditions were not successful in the deuteration of triphenylamine or N,N-dimethylaniline, suggesting that these mild conditions are not suitable for the deuteration of tertiary arylamines, but are likely to be applicable for the deuteration of other primary and secondary arylamines. The deuterated arylamines can then be used for synthesis of larger organic molecules or polymers with optoelectronic applications.

  11. Continuous-flow oxidative cyanation of primary and secondary amines using singlet oxygen.

    Science.gov (United States)

    Ushakov, Dmitry B; Gilmore, Kerry; Kopetzki, Daniel; McQuade, D Tyler; Seeberger, Peter H

    2014-01-07

    Primary and secondary amines can be rapidly and quantitatively oxidized to the corresponding imines by singlet oxygen. This reactive form of oxygen was produced using a variable-temperature continuous-flow LED-photoreactor with a catalytic amount of tetraphenylporphyrin as the sensitizer. α-Aminonitriles were obtained in good to excellent yields when trimethylsilyl cyanide served as an in situ imine trap. At 25°C, primary amines were found to undergo oxidative coupling prior to cyanide addition and yielded secondary α-aminonitriles. Primary α-aminonitriles were synthesized from the corresponding primary amines for the first time, by an oxidative Strecker reaction at -50 °C. This atom-economic and protecting-group-free pathway provides a route to racemic amino acids, which was exemplified by the synthesis of tert-leucine hydrochloride from neopentylamine. Copyright © 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  12. Using Misoprostol for Primary versus Secondary Prevention of Postpartum Haemorrhage - Do Costs Matter?

    Science.gov (United States)

    Chatterjee, Susmita; Sarkar, Anupam; Rao, Krishna D

    2016-01-01

    Postpartum heammorrhage (PPH), defined as blood loss greater than or equal to 500 ml within 24 hours after birth, is the leading cause of maternal deaths globally and in India. Misoprostol is an important option for PPH management in setting where oxytocin (the gold standard for PPH prevention and treatment) in not available or not feasible to use. For the substantial number of deliveries which take place at home or at lower level heatlh facilities in India, misoprostol pills can be adminstered to prevent PPH. The standard approach using misoprostol is to administer it prophylactically as primary prevention (600 mcg). An alternative strategy could be to administer misoprostol only to those who are at high risk of having PPH i.e. as secondary prevention. This study reports on the relative cost per person of a strategy involving primary versus secondary prevention of PPH using misoprostol. It is based on a randomized cluster trial that was conducted in Bijapur district in Karnataka, India between December 2011 and March 2014 among pregnant women to compare two community-level strategies for the prevention of PPH: primary and secondary. The analysis was conducted from the government perspective using an ingredient approach. The cluster trial showed that there were no significant differences in clinical outcomes between the two study arms. However, the results of the cost analysis show that there is a difference of INR 6 (US$ 0.1) per birth for implementing the strategies primary versus secondary prevention. In India where 14.9 million births take place at sub-centres and at home, this additional cost of INR 6 per birth translates to an additional cost of INR 94 (US$ 1.6) million to the government to implement the primary prevention compared to the secondary prevention strategy. As clinical outcomes did not differ significantly between the two arms in the trial, taking into account the difference in costs and potential issues with sustainability, secondary prevention

  13. Management of primary-to-secondary leaks at Loviisa nuclear power plant

    Energy Technology Data Exchange (ETDEWEB)

    Mohnsen, B.; Jaenkaelae, K. [IVO International Ltd, Vantaa (Finland)

    1995-12-31

    The Loviisa Nuclear power plant consisting of two VVER-440 type press water reactor units has been in commercial operation since the late 1970`s. Specific features for VVER-440 reactors are six primary loops with horizontal steam generators and main gate valves. The structure of the horizontal steam generators construction may cause a large primary to secondary leak in case of a break in the cover of the primary collector. An accident where two primary collector covers opened totally and two covers opened partly took place in Rovno, Ukraine January 1982. Primary to secondary leaks are one of the main contributors to the core melt frequency in VVER reactors according to the Loviisa 1 Probabilistic Safety Assessment. The high core damage contribution has set requirements for the development of effective means to cope with all sizes of primary to secondary leaks in the steam generator. A concept for all leak sizes has been developed for Loviisa 1 and 2. The solution includes four main areas which are a new steam generator leakage monitoring system based on nitrogen-16 measurement, an upgraded pressurizer spray system, an increased emergency cooling water reserve and an automated isolation of the defected steam generator.

  14. Management of primary-to-secondary leaks at Loviisa nuclear power plant

    Energy Technology Data Exchange (ETDEWEB)

    Mohnsen, B; Jaenkaelae, K [IVO International Ltd, Vantaa (Finland)

    1996-12-31

    The Loviisa Nuclear power plant consisting of two VVER-440 type press water reactor units has been in commercial operation since the late 1970`s. Specific features for VVER-440 reactors are six primary loops with horizontal steam generators and main gate valves. The structure of the horizontal steam generators construction may cause a large primary to secondary leak in case of a break in the cover of the primary collector. An accident where two primary collector covers opened totally and two covers opened partly took place in Rovno, Ukraine January 1982. Primary to secondary leaks are one of the main contributors to the core melt frequency in VVER reactors according to the Loviisa 1 Probabilistic Safety Assessment. The high core damage contribution has set requirements for the development of effective means to cope with all sizes of primary to secondary leaks in the steam generator. A concept for all leak sizes has been developed for Loviisa 1 and 2. The solution includes four main areas which are a new steam generator leakage monitoring system based on nitrogen-16 measurement, an upgraded pressurizer spray system, an increased emergency cooling water reserve and an automated isolation of the defected steam generator.

  15. In vivo and ex vivo proton MR spectroscopy of primary and secondary melanoma

    Energy Technology Data Exchange (ETDEWEB)

    Bourne, Roger M.; Stanwell, Peter; Stretch, Jonathan R.; Scolyer, Richard A.; Thompson, John F.; Mountford, Carolyn E.; Lean, Cynthia L

    2005-03-01

    In vivo magnetic resonance (MR) spectroscopy at 1.5T was performed on a large polypoid cutaneous melanoma, and two enlarged lymph nodes containing metastatic melanoma, from three patients. Spectra were acquired in vivo from voxels wholly within the primary tumour or secondary lymph node and were thus uncontaminated by signals from adjacent tissue. Tissue biopsies taken after resection of primary tumours and secondary lymph nodes were examined by 8.5T magnetic resonance spectroscopy (MRS) and the results compared with the in vivo spectra, and with spectra from normal skin and a benign skin lesion. There was good agreement between the dominant features of 1.5T spectra acquired in vivo and 8.5T spectra acquired from resected tissue. However, less intense resonances observed at 8.5T in malignant biopsy tissue were not consistently observed at 1.5T in vivo. In vivo spectra from primary and metastatic melanoma showed high levels of choline metabolites. An intense lactate resonance was also present in the in vivo spectrum of primary melanoma. All 8.5T spectra of biopsies from primary and secondary melanoma showed high levels of choline metabolites and lactate, and additional resonances consistent with elevated levels of taurine, alanine, lysine, and glutamate/glutamine relative to normal and benign tissue. Elevated levels of choline, lactate, taurine, and amino acids appear to be clinically useful markers for identifying the pathology of primary and metastatic melanoma.

  16. Management of primary-to-secondary leaks at Loviisa nuclear power plant

    International Nuclear Information System (INIS)

    Mohnsen, B.; Jaenkaelae, K.

    1995-01-01

    The Loviisa Nuclear power plant consisting of two VVER-440 type press water reactor units has been in commercial operation since the late 1970's. Specific features for VVER-440 reactors are six primary loops with horizontal steam generators and main gate valves. The structure of the horizontal steam generators construction may cause a large primary to secondary leak in case of a break in the cover of the primary collector. An accident where two primary collector covers opened totally and two covers opened partly took place in Rovno, Ukraine January 1982. Primary to secondary leaks are one of the main contributors to the core melt frequency in VVER reactors according to the Loviisa 1 Probabilistic Safety Assessment. The high core damage contribution has set requirements for the development of effective means to cope with all sizes of primary to secondary leaks in the steam generator. A concept for all leak sizes has been developed for Loviisa 1 and 2. The solution includes four main areas which are a new steam generator leakage monitoring system based on nitrogen-16 measurement, an upgraded pressurizer spray system, an increased emergency cooling water reserve and an automated isolation of the defected steam generator

  17. Secondary pigmentary glaucoma in patients with underlying primary pigment dispersion syndrome

    Directory of Open Access Journals (Sweden)

    Sivaraman KR

    2013-03-01

    Full Text Available Kavitha R Sivaraman, Chirag G Patel, Thasarat S Vajaranant, Ahmad A ArefDepartment of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, University of Illinois at Chicago School of Medicine, Chicago, IL, USAAbstract: Primary pigment dispersion syndrome (PPDS is a bilateral condition that occurs in anatomically predisposed individuals. PPDS may evolve into pigmentary glaucoma, but it is difficult to predict which patients will progress. Secondary pigment dispersion is more often unilateral and acquired as a result of surgery, trauma, or intraocular tumor, but can likewise lead to pigmentary glaucoma. We report two cases of patients with bilateral PPDS who developed secondary pigment dispersion and pigmentary glaucoma in one eye. Patients with PPDS who acquire a secondary mechanism of pigment dispersion may be at an increased risk of progression to pigmentary glaucoma, presumably due to an increased burden of liberated pigment. In addition to regular surveillance for progression to glaucoma from PPDS, secondary causes of pigmentary dispersion in these eyes should be considered when patients present with grossly asymmetric findings. When secondary pigment dispersion is identified in eyes with PPDS, we recommend prompt intervention to alleviate the cause of secondary pigment dispersion and/or aggressive control of intraocular pressure to limit glaucomatous damage.Keywords: primary pigment dispersion syndrome, pigmentary glaucoma

  18. Secondary Chemistry School Teachers Working in Tertiary Education Chemistry Departments; Critical Reflections on the Positives and Negatives

    Science.gov (United States)

    Glover, S. R.; Harrison, T. G.; Shallcross, D. E.

    2016-01-01

    Several UK University Chemistry Departments have former secondary school chemistry teachers employed as School Teacher Fellows (STF) who are heavily involved in outreach work and a range of teaching responsibilities. This study looks at the outreach role from the point of view of several of the STFs; the benefits, and the barriers and how this…

  19. Evolutionary Rate Heterogeneity of Primary and Secondary Metabolic Pathway Genes in Arabidopsis thaliana.

    Science.gov (United States)

    Mukherjee, Dola; Mukherjee, Ashutosh; Ghosh, Tapash Chandra

    2015-11-10

    Primary metabolism is essential to plants for growth and development, and secondary metabolism helps plants to interact with the environment. Many plant metabolites are industrially important. These metabolites are produced by plants through complex metabolic pathways. Lack of knowledge about these pathways is hindering the successful breeding practices for these metabolites. For a better knowledge of the metabolism in plants as a whole, evolutionary rate variation of primary and secondary metabolic pathway genes is a prerequisite. In this study, evolutionary rate variation of primary and secondary metabolic pathway genes has been analyzed in the model plant Arabidopsis thaliana. Primary metabolic pathway genes were found to be more conserved than secondary metabolic pathway genes. Several factors such as gene structure, expression level, tissue specificity, multifunctionality, and domain number are the key factors behind this evolutionary rate variation. This study will help to better understand the evolutionary dynamics of plant metabolism. © The Author(s) 2015. Published by Oxford University Press on behalf of the Society for Molecular Biology and Evolution.

  20. Multimodal Robots As Educational Tools In Primary And Lower Secondary Education

    DEFF Research Database (Denmark)

    Majgaard, Gunver

    2015-01-01

    Multimodal humanoid robots have been used as educational tools in primary and lower secondary schools. The pupils involved were between 11 and 16 years old. The learning goals included: programming, language learning, ethics, technology and mathematics, e.g. practised by 7th grade pupils who...

  1. Impact of E-Learning and Digitalization in Primary and Secondary Schools

    Science.gov (United States)

    Tunmibi, Sunday; Aregbesola, Ayooluwa; Adejobi, Pascal; Ibrahim, Olaniyi

    2015-01-01

    This study examines into the impact of e-learning and digitalization in primary and secondary schools, using Greensprings School in Lagos State, Nigeria as a case study. Questionnaire was used as a data collection instrument, and descriptive statistical method was adopted for analysis. Responses from students and teachers reveal that application…

  2. Prevention Rather than Cure? Primary or Secondary Intervention for Dealing with Media Exposure to Terrorism

    Science.gov (United States)

    Slone, Michelle; Shoshani, Anat

    2010-01-01

    The authors examined the efficacy of primary versus secondary intervention in moderating state anxiety and state anger from media-based exposure to terrorism. Two hundred participants, allocated to a terrorism or nonterrorism media exposure and to antecedent or subsequent therapeutic or control intervention, were assessed for state anxiety and…

  3. Development of Questionnaire on Emotional Labor among Primary and Secondary School Teachers

    Science.gov (United States)

    Liu, Yanling; Zhang, Dajun

    2015-01-01

    In this study, based on the analysis of existing definitions of emotional labor, operational definition of teachers' emotional labor is given and questionnaire on emotional labor among primary and secondary school teachers is developed. Research results: exploratory factor analysis shows that teacher's emotional labor involves three dimensions…

  4. Old Anticipations, New Anxieties? A Contemporary Perspective on Primary to Secondary Transfer

    Science.gov (United States)

    Mellor, David; Delamont, Sara

    2011-01-01

    The transfer from primary to secondary school in England and Wales is a status passage, from child to teenager. Research on the anxieties and anticipations surrounding that transfer over a 30-year period shows continuities and discontinuities. As well as the contrast of sociological approaches, the perceptions of children in 1977-1978 and…

  5. [Appraisal of occupational stress and strain in primary and secondary school teachers].

    Science.gov (United States)

    Wang, Z; Lan, Y; Li, J; Wang, M

    2001-09-01

    This study was conducted to assess occupational stress and strain in primary and secondary school teachers. A test of occupational stress and strain was carried out by using Occupational Stress Inventory Revised Edition (OSI-R) in 1460 primary and secondary school teachers (teacher group) and 319 mental workers in non-educational area (non-teacher group as control). The results showed the level of occupational stress in role overload and physical environment in the teacher group was significantly higher than that in the non-teacher group (P < 0.05). In teacher group the level of occupational stress and strain increased with age; the occupational stress and strain in male teachers were significantly higher than those in female teachers (P < 0.01); the occupational stress and strain in secondary school teachers were significantly higher than those in primary school teachers. These results indicate: to protect and promote primary and secondary school teacher's health, particularly male teachers' health, to mitigate their work pressure and to raise the quality of education are important tasks in the area of occupational health.

  6. Transitional Woes: On the Impact of L2 Input Continuity from Primary to Secondary School

    Science.gov (United States)

    Pfenninger, Simone E.; Lendl, Johanna

    2017-01-01

    In this paper, we discuss the problem of articulation between levels in the educational system, as the transition from a rather more communicative, content-based and holistic approach to English as a foreign language (EFL) teaching at primary level to more formal and explicit ways of foreign language (FL) teaching at secondary is often experienced…

  7. Perspective Changing in Primary and Secondary Learning: A Gender Difference Study

    Science.gov (United States)

    Piccardi, L.; Risetti, M.; Nori, R.; Tanzilli, A.; Bernardi, L.; Guariglia, C.

    2011-01-01

    In the present study, we investigated the ability of 106 (55 males, 51 females) college students to recall an 8-step path from different viewpoints (0 degrees; 90 degrees; 180 degrees and 270 degrees) after primary and secondary learning without a time limit. For each participant, we computed the time and number of repetitions necessary to learn…

  8. 5. International seminar on primary and secondary side water chemistry of nuclear power plants

    International Nuclear Information System (INIS)

    2001-01-01

    The major subjects of the meetings are: water chemistry of primary and secondary coolant circuits of PWR type reactors (mainly WWER types), corrosion of steam generators, decontamination processes, treatment of radioactive waste waters and related subjects. All the 29 papers were individually indexed and abstracted for the INIS database. (R.P.)

  9. 5. International seminar on primary and secondary side water chemistry of nuclear power plants

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2001-07-01

    The major subjects of the meetings are: water chemistry of primary and secondary coolant circuits of PWR type reactors (mainly WWER types), corrosion of steam generators, decontamination processes, treatment of radioactive waste waters and related subjects. All the 29 papers were individually indexed and abstracted for the INIS database. (R.P.)

  10. Which features of primary care affect unscheduled secondary care use? A systematic review.

    Science.gov (United States)

    Huntley, Alyson; Lasserson, Daniel; Wye, Lesley; Morris, Richard; Checkland, Kath; England, Helen; Salisbury, Chris; Purdy, Sarah

    2014-05-23

    To conduct a systematic review to identify studies that describe factors and interventions at primary care practice level that impact on levels of utilisation of unscheduled secondary care. Observational studies at primary care practice level. Studies included people of any age of either sex living in Organisation for Economic Co-operation and Development (OECD) countries with any health condition. The primary outcome measure was unscheduled secondary care as measured by emergency department attendance and emergency hospital admissions. 48 papers were identified describing potential influencing features on emergency department visits (n=24 studies) and emergency admissions (n=22 studies). Patient factors associated with both outcomes were increased age, reduced socioeconomic status, lower educational attainment, chronic disease and multimorbidity. Features of primary care affecting unscheduled secondary care were more complex. Being able to see the same healthcare professional reduced unscheduled secondary care. Generally, better access was associated with reduced unscheduled care in the USA. Proximity to healthcare provision influenced patterns of use. Evidence relating to quality of care was limited and mixed. The majority of research was from different healthcare systems and limited in the extent to which it can inform policy. However, there is evidence that continuity of care is associated with reduced emergency department attendance and emergency hospital admissions. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  11. Validity of the rey visual design test in primary and secondary school children

    NARCIS (Netherlands)

    Wilhelm, P.; van Klink, M.; van Klink, M.

    2007-01-01

    The Rey Visual Design Learning Test (Rey, 1964, cited in Spreen & Strauss, 1991, Wilhelm, 2004) assesses immediate memory span, new learning, delayed recall and recognition for nonverbal material. Two studies are presented that focused on the construct validity of the RVDLT in primary and secondary

  12. Brazilian Primary and Secondary School Pupils' Perception of Science and Scientists

    Science.gov (United States)

    Bartoszeck, Amauri Betini; Bartoszeck, Flavio Kulevicz

    2017-01-01

    The purpose of this study is to understand in an exploratory way pupils' perception of science and the image of scientists at primary and secondary school levels. Data was collected by means of a survey questionnaire and a drawing representing pupils' depiction what scientists do during their working hours. A questionnaire anchored on a Likert…

  13. Interactions Between a Belowground Herbivore and Primary and Secondary Root Metabolites in Wild Cabbage

    NARCIS (Netherlands)

    Van Geem, Moniek; Harvey, J.A.; Cortesero, A.M.; Raaijmakers, C.E.; Gols, R.

    2015-01-01

    Plants are attacked by both above- and belowground herbivores. Toxic secondary compounds are part of the chemical defense arsenal of plants against a range of antagonists, and are subject to genetic variation. Plants also produce primary metabolites (amino acids, nutrients, sugars) that function as

  14. English Vocabulary Acquisition of Bilingual Learners at the Primary and Secondary Levels

    Science.gov (United States)

    Pholsward, Ruja; Boonprasitt, Donrutai

    2015-01-01

    This paper reports research findings of English vocabulary acquisition of bilingual learners at the levels of Primary 6 and Secondary 3 at Satit Bilingual School of Rangsit University. The purpose was to find out the extent to which learners at these levels have acquired English vocabulary to communicate their ideas about themselves and their…

  15. Assertive Skills and Academic Performance in Primary and Secondary Education, Giftedness, and Conflictive Students

    Science.gov (United States)

    Marugan de Miguelsanz, Montserrat; Carbonero Martin, Miguel Angel; Palazuelo Martinez, Ma Marcela

    2012-01-01

    Introduction: This study explores the level of assertiveness in various samples of students from Primary and Secondary Education. With the data obtained, on the one hand, we analyzed the relation between assertiveness and academic performance and, on the other, we verified whether students who are excluded from the norm, either because of their…

  16. The Impact of ISO Quality Management Systems on Primary and Secondary Schools in Spain

    Science.gov (United States)

    Arribas Díaz, Jorge Antonio; Martínez-Mediano, Catalina

    2018-01-01

    Purpose: The purpose of this study is to evaluate the application of quality management systems (QMS) based on international standards of quality in education (ISO 9001:2008) and ascertain the influence of this quality model on primary and secondary schools in Spain. Design/methodology/approach: The study was conducted in 26 publicly funded,…

  17. A Bridge Too Far: The Decline in Shared Science Activities during Primary-Secondary Transition

    Science.gov (United States)

    Galton, Maurice

    2016-01-01

    This article reviews the use of "bridging units" in science to improve curriculum continuity during transition from primary to secondary school. Based on research evidence collected over several decades, it suggests that the use of these units rose to a peak around the time of the millennium, but that in recent years few schools have…

  18. Reading Performance Profile of Children with Dyslexia in Primary and Secondary School Students

    Science.gov (United States)

    Balci, Emine; Çayir, Aybala

    2018-01-01

    The purpose of the present research was to provide information to the community about the reading subskill profiles of children with dyslexia in primary and secondary school students. 175 children (aged 7-15 yrs) were examined on a varied set of phonological coding, spelling and fluent reading tasks. For this purpose, students' fluent reading were…

  19. Inequality in the Transition from Primary to Secondary School: School Choices and Educational Disparities in Germany

    Science.gov (United States)

    Pietsch, Marcus; Stubbe, Tobias C.

    2007-01-01

    This article explores the mechanisms of educational pathway decision making at the transition from primary to secondary school in the German education system by analysing data from the Progress in International Reading Literacy Study (PIRLS). The highly reliable data of the German sample of the 2001 PIRLS make it possible to take into…

  20. Emergent Communities of Practice: Secondary Schools' Interaction with Primary School Foreign Language Teaching and Learning

    Science.gov (United States)

    Evans, Michael; Fisher, Linda

    2012-01-01

    The aim of this paper is to give an account of the response of secondary schools to the primary school foreign language teaching initiative recently introduced by the UK government. The paper also explores defining features of the process of cross-phase interaction and the role that knowledge and collaborative practice plays in generating change…

  1. Classroom-Based Assessment and the Issue of Continuity between Primary and Secondary School Languages Programs

    Science.gov (United States)

    Hill, Kathryn

    2010-01-01

    This article presents selected findings from an ethnographic study of classroom-based assessment practices in languages classrooms (Indonesian) in the final year of primary (Year 6) and the first year of secondary (Year 7), respectively. In particular, the paper focuses on differences between the respective year levels in how learning was assessed…

  2. Primary Versus Secondary Contributions to Particle Number Concentrations in the European Boundary Layer

    Czech Academy of Sciences Publication Activity Database

    Reddington, C.L.; Carslaw, K.S.; Spracklen, D.V.; Frontoso, M.G.; Collins, L.; Merikanto, J.; Minikin, A.; Hamburger, T.; Coe, H.; Kulmala, M.; Aalto, P.; Flentje, H.; Plass-Dülmer, C.; Birmili, W.; Wiedensohler, A.; Wehner, B.; Tuch, T.; Sonntag, A.; O'Dowd, C.D.; Jennings, S.G.; Dupuy, R.; Baltensperger, U.; Weingartner, A.; Hansson, H.-C.; Tunved, P.; Laj, P.; Sellegri, K.; Boulon, J.; Putaund, J.-P.; Gruening, C.; Swietlicki, E.; Roldin, P.; Henzing, J.S.; Moerman, M.; Mihalopoulos, N.; Kouvarakis, G.; Ždímal, Vladimír; Zíková, Naděžda; Marinoni, A.; Bonasoni, P.; Duchi, R.

    2011-01-01

    Roč. 11, č. 23 (2011), s. 12007-12036 ISSN 1680-7316 Grant - others:EUCAARI(XE) 036833-2; GFME(DE) FE370343200 Institutional research plan: CEZ:AV0Z40720504 Keywords : primary aerosol * secondary aerosol * boundary layer Subject RIV: CF - Physical ; Theoretical Chemistry Impact factor: 5.520, year: 2011

  3. Relay-Assisted Primary and Secondary Transmissions in Cognitive Radio Networks

    KAUST Repository

    Shafie, Ahmed El; Khattab, Tamer; Salem, Ahmed Sultan

    2016-01-01

    We assume a set of cognitive relay nodes that assists both primary and secondary transmissions in a time-slotted cognitive radio networks. To regulate the channel access of the various nodes in the network, we propose an overlapped spectrum sensing

  4. Evaluation of primary and secondary stability of titanium implants using different surgical techniques

    NARCIS (Netherlands)

    Tabassum, A.; Meijer, G.J.; Walboomers, X.F.; Jansen, J.A.

    2014-01-01

    OBJECTIVE: To investigate the influence of different surgical techniques on the primary and secondary implant stability using trabecular bone of goats as an implantation model. MATERIAL AND METHODS: In the iliac crest of eight goats, 48 cylindrical-screw-type implants with a diameter of 4.2 mm

  5. The Development of Local Private Primary and Secondary Schooling in Hong Kong, 1841-2012

    Science.gov (United States)

    Cheung, Alan C. K.; Randall, E. Vance; Tam, Man Kwan

    2016-01-01

    Purpose: This paper is a historical review of the development of private primary and secondary education in Hong Kong from 1841-2012. The purpose of this paper is to examine the evolving relationship between the state and private schools in Hong Kong. Design/methodology/approach: This paper utilizes sources from published official documents,…

  6. Primary and Secondary Education in Morocco: From Access to School into Generalization to Dropout

    Science.gov (United States)

    Mansouri, Zoulal; Moumine, Mohamed El Amine

    2017-01-01

    This article provides an overview of school wastage, namely repetition and dropout in primary and secondary schools in Morocco. It describes how this phenomenon has progressed since school was implemented in the 1960s. It shows that the fundamental principles of the education system established in the aftermath of Morocco?s independence in 1956…

  7. Cost-effectiveness of increasing statin adherence for primary and secondary prevention in community pharmacies

    NARCIS (Netherlands)

    Vegter, S.; Oosterhof, P.; Van Boven, J.F.; Stuurman-Bieze, A.G.G.; Hiddink, E.G.; Postma, M.J.

    2013-01-01

    Objectives: Therapy persistence is important to achieve optimal clinical benefits of statin therapy. The aim of this study was to determine the cost-effectiveness of pharmaceutical care in community pharmacies, aimed to increase persistence with statin therapy for both primary and secondary

  8. Primary and secondary prevention in cardiovascular disease : an old-fashioned concept?

    NARCIS (Netherlands)

    van Venrooij, FV; Stolk, RP; Banga, JD; Erkelens, DW; Grobbee, DE

    Objective. Is the concept of primary and secondary cardiovascular prevention an old-fashioned concept that needs to be re-defined? Design. Discussion paper. Results. Cardiovascular prevention means reduction of absolute risk for cardiovascular disease (CVD), irrespective of clinical stage.

  9. The value of arteriography in the differential diagnosis of primary and secondary Raynaud's syndrome

    International Nuclear Information System (INIS)

    Wagner, H.H.; Alexander, K.

    1985-01-01

    Arteriograms of the hands were carried out in 348 patients. Functional and organic changes were analysed in an attempt to differentiate primary from secondary Raynaud's syndrome. The value and limitations of this technique are illustrated by a number of examples. (orig.) [de

  10. Constructing Assessment Model of Primary and Secondary Educational Quality with Talent Quality as the Core Standard

    Science.gov (United States)

    Chen, Benyou

    2014-01-01

    Quality is the core of education and it is important to standardization construction of primary and secondary education in urban (U) and rural (R) areas. The ultimate goal of the integration of urban and rural education is to pursuit quality urban and rural education. Based on analysing the related policy basis and the existing assessment models…

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

    Science.gov (United States)

    Sampson, Rod; Barbour, Rosaline; Wilson, Philip

    2016-07-01

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

  12. The Transition from Primary to Secondary School in Mainstream Education for Children with Autism Spectrum Disorder

    Science.gov (United States)

    Mandy, William; Murin, Marianna; Baykaner, Ozlem; Staunton, Sara; Hellriegel, Josselyn; Anderson, Seonaid; Skuse, David

    2016-01-01

    The transition from primary to secondary education (hereafter "school transition") is a major ecological shift that poses considerable social, emotional, academic and organisational challenges. It is commonly assumed that this school transition is especially difficult for children with autism spectrum disorder, but that idea is mainly…

  13. Support Required for Primary and Secondary Students with Communication Disorders and/or Other Learning Needs

    Science.gov (United States)

    McLeod, Sharynne; McKinnon, David H.

    2010-01-01

    Prioritization of school students with additional learning needs is a reality due to a finite resource base. Limited evidence exists regarding teachers' prioritization of primary and secondary school students with additional learning needs. The aim of the present article was to differentiate teachers' perceptions of the level of support required…

  14. A Case Study on Primary, Secondary and University Students' Environmentally Responsible Behaviors in Turkey

    Science.gov (United States)

    Kahyaoglu, Mustafa

    2013-01-01

    The purpose of the study is to prove the environmentally responsible behaviors of primary, secondary and university students in Turkey. The students', who attended the study as participants, environmentally political behaviors, consumer/economical behaviors, direct behaviors toward protecting the environment and individual and public persuasion…

  15. Primary School Text Comprehension Predicts Mathematical Word Problem-Solving Skills in Secondary School

    Science.gov (United States)

    Björn, Piia Maria; Aunola, Kaisa; Nurmi, Jari-Erik

    2016-01-01

    This longitudinal study aimed to investigate the extent to which primary school text comprehension predicts mathematical word problem-solving skills in secondary school among Finnish students. The participants were 224 fourth graders (9-10 years old at the baseline). The children's text-reading fluency, text comprehension and basic calculation…

  16. Students' perceptions about science: The impact of transition from primary to secondary school

    Science.gov (United States)

    Speering, Wendy; Rennie, Léonie

    1996-09-01

    As students move through school, attitudes to school in general, and science in particular, become less positive. This paper reports on a longitudinal study which mapped, from the students' point of view, the transition between primary and secondary school in Western Australia. The study focused on the subject of science, and used both quantitative and qualitative methods. During the transition, there is a considerable change in the organisation of the school, the curriculum and the teacherstudent relationship. Students in this study, especially the girls, were generally disenchanted with the teaching strategies used in their secondary science classrooms, and regretted the loss of the close teacher-student relationship of their primary school years. Their perceptions were that science in secondary school was not what they had expected, and this experience may have long term implications for their subject and career choices.

  17. Ruthenium-catalyzed self-coupling of primary and secondary alcohols with the liberation of dihydrogen

    DEFF Research Database (Denmark)

    Makarov, Ilya; Madsen, Robert

    2013-01-01

    The dehydrogenative self-condensation of primary and secondary alcohols has been studied in the presence of RuCl2(IiPr)(p-cymene). The conversion of primary alcohols into esters has been further optimized by using magnesium nitride as an additive, which allows the reaction to take place...... at a temperature and catalyst loading lower than those described previously. Secondary alcohols were dimerized into racemic ketones by a dehydrogenative Guerbet reaction with potassium hydroxide as the additive. The transformation gave good yields of the ketone dimers with a range of alkan-2-ols, whereas more...... substituted secondary alcohols were unreactive. The reaction proceeds by dehydrogenation to the ketone, followed by an aldol reaction and hydrogenation of the resulting enone. © 2013 American Chemical Society....

  18. Dengue virus activates polyreactive, natural IgG B cells after primary and secondary infection.

    Directory of Open Access Journals (Sweden)

    Thavamalar Balakrishnan

    Full Text Available BACKGROUND: Dengue virus is transmitted by mosquitoes and has four serotypes. Cross-protection to other serotypes lasting for a few months is observed following infection with one serotype. There is evidence that low-affinity T and/or B cells from primary infections contribute to the severe syndromes often associated with secondary dengue infections. such pronounced immune-mediated enhancement suggests a dengue-specific pattern of immune cell activation. This study investigates the acute and early convalescent B cell response leading to the generation of cross-reactive and neutralizing antibodies following dengue infection. METHODOLOGY/PRINCIPAL FINDINGS: We assayed blood samples taken from dengue patients with primary or secondary infection during acute disease and convalescence and compared them to samples from patients presenting with non-dengue related fever. Dengue induced massive early plasmablast formation, which correlated with the appearance of polyclonal, cross-reactive IgG for both primary and secondary infection. Surprisingly, the contribution of IgG to the neutralizing titer 4-7 days after fever onset was more than 50% even after primary infection. CONCLUSIONS/SIGNIFICANCE: Poly-reactive and virus serotype cross-reactive IgG are an important component of the innate response in humans during both primary and secondary dengue infection, and "innate specificities" seem to constitute part of the adaptive response in dengue. While of potential importance for protection during secondary infection, cross-reactive B cells will also compete with highly neutralizing B cells and possibly interfere with their development.

  19. Electrocardiogram interpretation and arrhythmia management: a primary and secondary care survey.

    Science.gov (United States)

    Begg, Gordon; Willan, Kathryn; Tyndall, Keith; Pepper, Chris; Tayebjee, Muzahir

    2016-05-01

    There is increasing desire among service commissioners to treat arrhythmia in primary care. Accurate interpretation of the electrocardiogram (ECG) is fundamental to this. ECG interpretation has previously been shown to vary widely but there is little recent data. To examine the interpretation of ECGs in primary and secondary care. A cross-sectional survey of participants' interpretation of six ECGs and hypothetical management of patients based on those ECGs, at primary care educational events, and a cardiology department in Leeds. A total of 262 primary care clinicians and 20 cardiology clinicians were surveyed via questionnaire. Answers were compared with expert electrophysiologist opinion. In primary care, abnormal ECGs were interpreted as normal by 23% of responders. ST elevation and prolonged QT were incorrectly interpreted as normal by 1% and 22%, respectively. In cardiology, abnormal ECGs were interpreted as normal by 3%. ECG provision and interpretation remains inconsistent in both primary and secondary care. Primary care practitioners are less experienced and less confident with ECG interpretation than cardiologists, and require support in this area. © British Journal of General Practice 2016.

  20. Primary and secondary exercise dependence in a community-based sample of road race runners.

    Science.gov (United States)

    Cook, Brian; Karr, Trisha M; Zunker, Christie; Mitchell, James E; Thompson, Ron; Sherman, Roberta; Crosby, Ross D; Cao, Li; Erickson, Ann; Wonderlich, Stephen A

    2013-10-01

    The purpose of our study was to examine exercise dependence (EXD) in a large community-based sample of runners. The secondary purpose of this study was to examine differences in EXD symptoms between primary and secondary EXD. Our sample included 2660 runners recruited from a local road race (M age = 38.78 years, SD = 10.80; 66.39% women; 91.62% Caucasian) who completed all study measures online within 3 weeks of the race. In this study, EXD prevalence was lower than most previously reported rates (gamma = .248, p < .001) and individuals in the at-risk for EXD category participated in longer distance races, F(8,1) = 14.13, p = .01, partial eta squared = .05. Group differences were found for gender, F(1,1921) 8.08, p = .01, partial eta squared = .004, and primary or secondary group status, F(1,1921) 159.53, p = .01, partial eta squared = .077. Implications of primary and secondary EXD differences and future research are discussed.

  1. Implantable Cardioverter-defibrillator Therapy for Hypertrophic Cardiomyopathy: Usefulness in Primary and Secondary Prevention.

    Science.gov (United States)

    Sarrias, Axel; Galve, Enrique; Sabaté, Xavier; Moya, Àngel; Anguera, Ignacio; Núñez, Elaine; Villuendas, Roger; Alcalde, Óscar; García-Dorado, David

    2015-06-01

    Hypertrophic cardiomyopathy is a frequent cause of sudden death. Clinical practice guidelines indicate defibrillator implantation for primary prevention in patients with 1 or more risk factors and for secondary prevention in patients with a history of aborted sudden death or sustained ventricular arrhythmias. The aim of the present study was to analyze the follow-up of patients who received an implantable defibrillator following the current guidelines in nonreferral centers for this disease. This retrospective observational study included all patients who underwent defibrillator implantation between January 1996 and December 2012 in 3 centers in the province of Barcelona. The study included 69 patients (mean age [standard deviation], 44.8 [17] years; 79.3% men), 48 in primary prevention and 21 in secondary prevention. The mean number of risk factors per patient was 1.8 in the primary prevention group and 0.5 in the secondary prevention group (P=.029). The median follow-up duration was 40.5 months. The appropriate therapy rate was 32.7/100 patient-years in secondary prevention and 1.7/100 patient-years in primary prevention (P<.001). Overall mortality was 10.1%. Implant-related complications were experienced by 8.7% of patients, and 13% had inappropriate defibrillator discharges. In patients with a defibrillator for primary prevention, the appropriate therapy rate is extremely low, indicating the low predictive power of the current risk stratification criteria. Copyright © 2014 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

  2. CATHARE-2 prediction of large primary to secondary leakage (PRISE) at PSB-VVER experimental facility

    Energy Technology Data Exchange (ETDEWEB)

    Sabotinov, L.; Chevrier, P. [Institut de Radioprotection et de Surete Nucleaire, 92 - Fontenay aux Roses (France)

    2007-07-01

    The large primary to secondary leakage (PRISE) is a specific loss-of-coolant accident in VVER reactors, related to the break of the steam generator collector cover, leading to loss of primary mass inventory and possible direct radioactive release to atmosphere. The best estimate thermal-hydraulic computer code CATHARE-2 Version 2.5-1 was used for post-test analysis of a PRISE experiment, conducted at the large scale test facility PSB-VVER in Russia. The PSB rig is 1:300 scaled model of VVER-1000 NPP. The accident is calculated with a 1.4% break size, which corresponds to 100 mm leak from primary to secondary side in the real NPP. A computer model has been developed for CATHARE-2 V2.5-1, taking into account all important components of the PSB facility: reactor model (lower plenum, core, bypass, upper plenum, downcomer), 4 separate loops, pressurizer, horizontal multi-tube steam generators, break section. The secondary side is presented by recirculation model. A large number of sensitivity calculations has been performed regarding break modeling, reactor pressure vessel modeling, counter current flow modeling, hydraulic losses, heat losses, steam generator level regulation. Comparison between calculated and experimental results shows good prediction of the basic thermal-hydraulic phenomena and parameters such as primary and secondary pressures, temperatures, loop flows, etc. Some discrepancies were observed in the calculations of primary mass inventory and loop seal clearance. Nevertheless the final core heat up, which is one of the most important safety criteria, was correctly predicted. (authors)

  3. Secondary pigmentary glaucoma in patients with underlying primary pigment dispersion syndrome.

    Science.gov (United States)

    Sivaraman, Kavitha R; Patel, Chirag G; Vajaranant, Thasarat S; Aref, Ahmad A

    2013-01-01

    Primary pigment dispersion syndrome (PPDS) is a bilateral condition that occurs in anatomically predisposed individuals. PPDS may evolve into pigmentary glaucoma, but it is difficult to predict which patients will progress. Secondary pigment dispersion is more often unilateral and acquired as a result of surgery, trauma, or intraocular tumor, but can likewise lead to pigmentary glaucoma. We report two cases of patients with bilateral PPDS who developed secondary pigment dispersion and pigmentary glaucoma in one eye. Patients with PPDS who acquire a secondary mechanism of pigment dispersion may be at an increased risk of progression to pigmentary glaucoma, presumably due to an increased burden of liberated pigment. In addition to regular surveillance for progression to glaucoma from PPDS, secondary causes of pigmentary dispersion in these eyes should be considered when patients present with grossly asymmetric findings. When secondary pigment dispersion is identified in eyes with PPDS, we recommend prompt intervention to alleviate the cause of secondary pigment dispersion and/or aggressive control of intraocular pressure to limit glaucomatous damage.

  4. Differentiation to improve the articulation between levels : In the teaching of English in primary and secondary education in the Netherlands

    NARCIS (Netherlands)

    A.P. de Kraay

    2016-01-01

    In 1986, English became a compulsory subject in primary education in The Netherlands1. While secondary schools have, by law, been required to offer English since 1863 (Wilhelm, 2005) the articulation between Dutch primary and secondary education levels of English language teaching has always been

  5. Variability in the primary emissions and secondary gas and particle formation from vehicles using bioethanol mixtures.

    Science.gov (United States)

    Gramsch, E; Papapostolou, V; Reyes, F; Vásquez, Y; Castillo, M; Oyola, P; López, G; Cádiz, A; Ferguson, S; Wolfson, M; Lawrence, J; Koutrakis, P

    2018-04-01

    Bioethanol for use in vehicles is becoming a substantial part of global energy infrastructure because it is renewable and some emissions are reduced. Carbon monoxide (CO) emissions and total hydrocarbons (THC) are reduced, but there is still controversy regarding emissions of nitrogen oxides (NO x ), aldehydes, and ethanol; this may be a concern because all these compounds are precursors of ozone and secondary organic aerosol (SOA). The amount of emissions depends on the ethanol content, but it also may depend on the engine quality and ethanol origin. Thus, a photochemical chamber was used to study secondary gas and aerosol formation from two flex-fueled vehicles using different ethanol blends in gasoline. One vehicle and the fuel used were made in the United States, and the others were made in Brazil. Primary emissions of THC, CO, carbon dioxide (CO 2 ), and nonmethane hydrocarbons (NMHC) from both vehicles decreased as the amount of ethanol in gasoline increased. NO x emissions in the U.S. and Brazilian cars decreased with ethanol content. However, emissions of THC, CO, and NO x from the Brazilian car were markedly higher than those from the U.S. car, showing high variability between vehicle technologies. In the Brazilian car, formation of secondary nitrogen dioxide (NO 2 ) and ozone (O 3 ) was lower for higher ethanol content in the fuel. In the U.S. car, NO 2 and O 3 had a small increase. Secondary particle (particulate matter [PM]) formation in the chamber decreased for both vehicles as the fraction of ethanol in fuel increased, consistent with previous studies. Secondary to primary PM ratios for pure gasoline is 11, also consistent with previous studies. In addition, the time required to form secondary PM is longer for higher ethanol blends. These results indicate that using higher ethanol blends may have a positive impact on air quality. The use of bioethanol can significantly reduce petroleum use and greenhouse gas emissions worldwide. Given the extent of

  6. Using Misoprostol for Primary versus Secondary Prevention of Postpartum Haemorrhage - Do Costs Matter?

    Directory of Open Access Journals (Sweden)

    Susmita Chatterjee

    Full Text Available Postpartum heammorrhage (PPH, defined as blood loss greater than or equal to 500 ml within 24 hours after birth, is the leading cause of maternal deaths globally and in India. Misoprostol is an important option for PPH management in setting where oxytocin (the gold standard for PPH prevention and treatment in not available or not feasible to use. For the substantial number of deliveries which take place at home or at lower level heatlh facilities in India, misoprostol pills can be adminstered to prevent PPH. The standard approach using misoprostol is to administer it prophylactically as primary prevention (600 mcg. An alternative strategy could be to administer misoprostol only to those who are at high risk of having PPH i.e. as secondary prevention.This study reports on the relative cost per person of a strategy involving primary versus secondary prevention of PPH using misoprostol. It is based on a randomized cluster trial that was conducted in Bijapur district in Karnataka, India between December 2011 and March 2014 among pregnant women to compare two community-level strategies for the prevention of PPH: primary and secondary. The analysis was conducted from the government perspective using an ingredient approach.The cluster trial showed that there were no significant differences in clinical outcomes between the two study arms. However, the results of the cost analysis show that there is a difference of INR 6 (US$ 0.1 per birth for implementing the strategies primary versus secondary prevention. In India where 14.9 million births take place at sub-centres and at home, this additional cost of INR 6 per birth translates to an additional cost of INR 94 (US$ 1.6 million to the government to implement the primary prevention compared to the secondary prevention strategy.As clinical outcomes did not differ significantly between the two arms in the trial, taking into account the difference in costs and potential issues with sustainability, secondary

  7. Primary and secondary esophageal contractions in patients with gastroesophageal reflux disease

    Directory of Open Access Journals (Sweden)

    C.G. Aben-Athar

    2006-08-01

    Full Text Available We studied the primary and secondary esophageal peristalsis in 36 patients with heartburn and acid regurgitation and in 14 asymptomatic volunteers. Primary peristalsis was elicited by ten swallows of a 5-mL bolus of water and secondary peristalsis was elicited by intra-esophageal infusion of 5, 10, and 15 mL water, 0.1 N hydrochloric acid and air. Esophageal contractions were measured by an 8-lumen manometric catheter assembly incorporating a 6-cm sleeve device. Contractions were registered at 3, 9, and 15 cm from the upper margin of the sleeve and the infusion was done through a side hole located at 12 cm. Twenty patients had normal endoscopic esophageal examination, 10 with normal (group I and 10 with abnormal pH-metric examination (group II, and 16 had esophagitis (group III. The amplitude of contractions after swallows was lower (97.8 ± 10.0 mmHg in the distal esophagus of group III patients than in controls (142.3 ± 14.0 mmHg. Patients of group III had fewer secondary contractions (water: 25% of infusion than patients of the other groups and controls (67% of infusion. Patients of group III also had a lower amplitude of secondary peristalsis in the distal esophagus (water: 70.1 ± 9.6 mmHg than controls (129.2 ± 18.2 mmHg. We conclude that patients with esophagitis have an impairment of primary and secondary peristalsis in the distal esophagus.

  8. Understanding radiation and risk: the importance of primary and secondary education

    International Nuclear Information System (INIS)

    Tada, Junichiro

    1999-01-01

    In Japan's primary and secondary schools, radiation and radioactivity are taught as part of the curriculum dealing with social science subjects. Students learn much about the hazardous features of radiation, but lack the scientific understanding necessary to build a more balanced picture. Although the same point applies to education covering the harmful effects of volcanic eruptions, earthquakes, electrical storms and so on, public understanding of these events is relatively high and students are generally able to make informed judgments about the risks involved. By contrast, their limited understanding of radiation often contributes to fears that it is evil or even supernatural. To correct this distortion, it is important that primary and secondary education includes a scientific explanation of radiation. Like heat and light, radiation is fundamental to the history of the universe; and scientific education programs should give appropriate emphasis to this important subject. Students would then be able to make more objective judgments about the useful and hazardous aspects of radiation. (author)

  9. Future time orientation and temperament: exploration of their relationship to primary and secondary psychopathy.

    Science.gov (United States)

    Bjørnebekk, Gunnar; Gjesme, Torgrim

    2009-08-01

    The present study combines Lykken's theory about the role of reward sensitivity and punishment insensitivity in the development of antisocial behavior with Gjesme's theory of future time orientation. 158 adolescents comprised a target group of 79 adolescents who had defined behavioral problems and a matched referential group of 79 adolescents who did not have notable behavioral problems. The results suggest that attributes related to primary psychopathy are associated with a relatively weak or hyporeactive behavioral inhibition system, behavioral approach reactivity, and low future time orientation. Moreover, attributes related to secondary psychopathy are related to an overly sensitive (hyper-reactive) behavioral approach system and low future time orientation. Robust positive associations for behavioral approach reactivity and low future time orientation with primary and secondary psychopathy suggest that high behavioral approach/low future time orientation may represent a core feature common to the two factors of psychopathy.

  10. Representation of Migration Issues in Geography Textbooks for Primary and Secondary Schools

    Directory of Open Access Journals (Sweden)

    Ivana Đorđević

    2017-11-01

    Full Text Available The growth of the population, migratory movements and the consequences of these developments contribute to the formation of all-round development of personality of students and their scientific view of the world. A migration issue through varied and always current content encourages thinking and independent reasoning. It is therefore necessary to examine in detail the phenomenon of migration. In this way children develop critical thinking towards important socio-geographical and globalization processes. Consequently, they get acquainted with the ways of dealing with migration flows, which represent a global challenge today. The aim is to analyze the migration point to their representation in the geography textbooks for primary and secondary school. Bearing in mind that the socio-geographical theme interdisciplinary comparison is conducted geography curricula in Serbia, as well as selected European countrie. The results show the specificity and their underrepresentation in geography textbooks for primary and secondary school.

  11. Techniques for Primary-to-Secondary Leak Monitoring in PWR Plants

    International Nuclear Information System (INIS)

    Sohn, Wook; Chi, Jun Hwa; Kang, Duck Won; Tae, Jeong Woo

    2006-01-01

    Historically, corrosion and mechanical damage have made steam generator tubes in PWR plants see various types of degradation from both the primary and secondary sides of the tubes. Since the tube degradation can lead to through-wall failure, the plant personnel should make efforts to prevent the failure. One of such preventive efforts is to monitor primary-to-secondary leakage (PSL) that usually precedes the tube rupture. Thus the objective of PSL monitoring is to make operators to determine when to shutdown the plant in order to minimize the likelihood of propagation of leaks to tube rupture under normal and faulted conditions This paper addresses briefly the status of techniques for PSL monitoring used in PWR plants

  12. A Proposed Evaluation Technique for Computer Science Studies in Primary and Secondary Schools

    Directory of Open Access Journals (Sweden)

    Abraham OCHOCHE

    2008-06-01

    Full Text Available Education in Nigeria is an instrument for effecting the development of its citizens in particular, and the nation in general. Operators of education at the primary and secondary levels need to constantly engage in such a process that systematically and objectively determine the relevance, effectiveness and impact of activities at these levels in the light of the stated objectives. The teaching process is not complete without one form of evaluation or the order, as it helps the teacher and other stakeholders in determining the effectiveness of their teaching-learning process. The paper proposes a revolutionary approach to the evaluation of students at both primary and secondary schools. The procedure being proposed takes on more the characteristics of a survey designed to assess not just the achievements of students, the course and the programme, but also the effectiveness of the teachers who form a major part of the whole education machinery.

  13. ACCURATE MASSES FOR THE PRIMARY AND SECONDARY IN THE ECLIPSING WHITE DWARF BINARY NLTT 11748

    International Nuclear Information System (INIS)

    Kilic, Mukremin; Brown, Warren R.; Kenyon, S. J.; Allende Prieto, Carlos; Agueeros, M. A.; Camilo, Fernando

    2010-01-01

    We measure the radial velocity curve of the eclipsing detached white dwarf binary NLTT 11748. The primary exhibits velocity variations with a semi-amplitude of 273 km s -1 and an orbital period of 5.641 hr. We do not detect any spectral features from the secondary star or any spectral changes during the secondary eclipse. We use our composite spectrum to constrain the temperature and surface gravity of the primary to be T eff = 8690 ± 140 K and log g = 6.54 ± 0.05, which correspond to a mass of 0.18 M sun . For an inclination angle of 89. 0 9 derived from the eclipse modeling, the mass function requires a 0.76 M sun companion. The merger time for the system is 7.2 Gyr. However, due to the extreme mass ratio of 0.24, the binary will most likely create an AM CVn system instead of a merger.

  14. Experimental tests on ratchet of structural elements diagrams for primary tension and secondary twist

    International Nuclear Information System (INIS)

    Lebey, J.; Roche, R.L.; Cousseran, P.

    1980-05-01

    Design by analysis of pressure vessels is not complete without an appraisal of failure by progressive distortion or stress ratchet. Ratchet tests under constant axial stress associated with cyclic torsion deformation have been carried out on 304 L and 316 L thin tubular specimens, at room temperature. Results are given in the form of iso-deformation curves ranging from 0.1% to 2.5%, in the field definite by the primary and secondary stress intensities (Bree's diagram type). The use of an effective primary stress is proposed, as a practical way, to assess the elongation due to the ratchet effect

  15. [Primary and secondary prevention procedures of temporo-mandibular joint disease in the evolutive age].

    Science.gov (United States)

    Ciavarella, D; Mastrovincenzo, M; Sabatucci, A; Campisi, G; Di Cosola, M; Suriano, M; Lo Muzio, L

    2009-02-01

    In the last years prevention of temporomandiboular joint (TMJ) disease had acquired great importance. According to the neuro-occlusal rehabilitation (RNO) it is possible to say that TMJ disease starts since first years of life. So it is important both for dentist and for pediatric know what are the conditions and the atypical functions which predispose to this pathology. The aim of this work was to show how it is possible to intercept since primary teeth and the correct norms of primary and secondary prevention.

  16. VGB primary and secondary side water chemistry guidelines for PWR plants

    International Nuclear Information System (INIS)

    Neder, H.; Wolter, D.; Staudt, U.

    2007-01-01

    The recent revision of the VGB Water Chemistry Guidelines was issued in 2005 and published in the second half of 2006. These guidelines are based on the primary and secondary side operating chemistry experience with all Siemens designed pressurized water reactors gained since the beginning of the 1980s. These guidelines cover For the primary side chemistry Modified lithium boron chemistry, Zinc chemistry for dose rate reduction, Enriched boric acid (EBA) chemistry for high duty core design For the secondary side chemistry High all-volatile treatment (AVT) chemistry (high pH operation) Oxygen injection in the secondary side Especially for the secondary side chemistry, compared with the water chemistry guidelines of other organizations worldwide, these Guidelines are less stringent, providing more operational flexibility to the plant operation, and can be applied for all new designs of steam generators with egg-crates or broached hole tube supports and with I 690TT or I 800 tubing materials. This paper gives an overview of the 2006 revision of the VGB Water Chemistry Guidelines for PWR plants and describes the fundamental goals of water chemistry operation strategies. In addition, the reasons for the selected control parameters and action levels, to achieve an adequate plant performance, are presented based on the operating experience. (orig.)

  17. Structure and reactivity of boron-ate complexes derived from primary and secondary boronic esters.

    Science.gov (United States)

    Feeney, Kathryn; Berionni, Guillaume; Mayr, Herbert; Aggarwal, Varinder K

    2015-06-05

    Boron-ate complexes derived from primary and secondary boronic esters and aryllithiums have been isolated, and the kinetics of their reactions with carbenium ions studied. The second-order rate constants have been used to derive nucleophilicity parameters for the boron-ate complexes, revealing that nucleophilicity increased with (i) electron-donating aromatics on boron, (ii) neopentyl glycol over pinacol boronic esters, and (iii) 12-crown-4 ether.

  18. Hospital burden of road traffic injury: major concern in primary and secondary level hospitals in Bangladesh.

    Science.gov (United States)

    Mashreky, S R; Rahman, A; Khan, T F; Faruque, M; Svanström, L; Rahman, F

    2010-04-01

    To assess the burden of road traffic injury (RTI) in primary and secondary level hospitals in Bangladesh, and its economic impact on affected families. Cross-sectional study. The study was carried out in February and March 2001. To estimate the burden of RTI patients and the length of stay in hospital, the discharge records of primary and secondary level hospitals were used as data sources. Records from 16 district hospitals and 45 Upazila health complexes (subdistrict level hospitals), selected at random, were included in this study. A direct interview method was adopted to estimate the patient costs of RTI; this involved interviewing patients or their attendants. In this study, patient costs included money spent by the patient for medicine, transport, food and lodging (including attendants). Approximately 33% of the beds in primary and secondary level hospitals in Bangladesh were occupied by injury-related patients, and more than 19% of the injury patients had been injured in a road traffic accident. People aged 18-45 years were the major victims of RTI, and constituted 70% of the total RTI-related admissions in primary and secondary level hospitals. More than two-thirds of RTI patients were male. The average duration of hospital stay was 5.7 days, and the average patient cost for each RTI patient was US$86 (5834 BDT). RTI is a major cause of hospital admission in Bangladesh, and represents an economic and social burden for the family and the nation. A national strategy and road safety programme need to be developed to reduce the hospital burden and minimize the economic and social impact. 2010 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  19. Relationship between Primary and Secondary Dental Care in Public Health Services in Brazil.

    Science.gov (United States)

    Martins, Renata Castro; Reis, Clarice Magalhães Rodrigues Dos; Matta Machado, Antonio Thomaz Gonzaga da; Amaral, João Henrique Lara do; Werneck, Marcos Azeredo Furquim; Abreu, Mauro Henrique Nogueira Guimarães de

    2016-01-01

    This cross-sectional study evaluated the relationship between primary and secondary oral health care in Brazil. For this purpose, data from the National Program for Improving Access and Quality of Primary Care were used. Dentists from 12,403 oral health teams (OHTs) answered a structured questionnaire in 2012. The data were analyzed descriptively and by cluster analysis. Of the 12,387 (99.9%) OHTs that answered all the questions, 62.2% reported the existence of Dental Specialties Centers (DSCs) to which they could refer patients. The specialties with the highest frequencies were endodontics (68.4%), minor oral surgery (65.8%), periodontics (63.0%), radiology (46.8%), oral medicine (40.2%), orthodontics (20.5%) and implantology (6.2%). In all percentiles, the shortest wait time for secondary care was for radiology, followed by oral medicine and the other specialties. In the 50th percentile, the wait for endodontics, periodontics, minor oral surgery and orthodontics was 30 days, while for implantology, the wait was 60 days. Finally, in the 75th percentile, the wait for endodontics, orthodontics and implantology was 90 days or more. Two clusters, with different frequencies of OHT access to specialties, were identified. Cluster 1 (n = 7,913) included the OHTs with lower frequencies in all specialties except orthodontics and implantology compared with Cluster 2 (n = 4,474). Of the Brazilian regions, the South and Southeast regions had the highest frequencies for Cluster 2, with better rates for the relationship between primary and secondary care. This study suggests certain difficulties in the relationship between primary and secondary care in specific specialties in oral health, with a great number of OHTs with limited access to DSCs, in addition to different performance in terms of OHT access to DSCs across Brazilian regions.

  20. Improving the submicro determination of vanadium in natural water using primary-secondary wavelength spectrophotometry

    International Nuclear Information System (INIS)

    Khongven Gao

    1999-01-01

    In acidic solution and in the presence of ammonium persulfate, the conventional reaction of vanadium(5) with gallic acid to form an orange complex has been used for the improvement of the determination of trace amounts of vanadium in water by the updated method named primary-secondary wavelength spectrophotometry. The results show that the analytical precision and accuracy were improved and gave higher determination sensitivity than ordinary spectrophotometry. The relative standard deviations were less than 5.6 % [ru

  1. Physical activity and inactivity in primary and secondary school boys' and girls' daily program

    OpenAIRE

    Romana Hubáčková; Dorota Groffik; Lukasz Skrzypnik; Karel Frömel

    2016-01-01

    Background: Children's and youth education is becoming more and more demanding. In conjunction with development of information technology, this fact negatively affects lifestyle of children and youth. Apart from families, schools should play a crucial role in healthy lifestyle promotion in children and youth. Objective: The present study aimed to assess differences in physical activity (PA) and physical inactivity (PI) among primary and secondary school boys and girls in specific segments of ...

  2. Radiological contribution in the treatment of primary and secondary liver tumors

    International Nuclear Information System (INIS)

    Mathias, K.; Hoffmann, G.; Loeffler, T.; Hausamen, T.

    1986-01-01

    The prognosis of patients with primary and secondary liver tumors has been improved recently by more aggressive operative, chemotherapeutic and embolization treatment. In a personal series of 40 patients with liver metastases colorectal cancer, regional intraarterial chemotherapy was superior to systematic intravenous treatment, with a tumor remission rate in 66% in comparison to 48% of the cases. But the benefit of intraarterial chemotherapy is still questionable considering the higher complication rate and the absence of prognostic data of the procedure. (orig.) [de

  3. Sedentary behaviour across the primary-secondary school transition: A systematic review.

    Science.gov (United States)

    Pearson, Natalie; Haycraft, Emma; P Johnston, Julie; Atkin, Andrew J

    2017-01-01

    The transition from primary/middle school to secondary/high school is likely to be a key period in children's development, characterised by significant changes in their social and physical environment. However, little is known about the changes in sedentary behaviour that accompany this transition. This review aimed to identify, critically appraise and summarise the evidence on changes in sedentary behaviour across the primary - secondary school transition. Published English language studies were located from computerised and manual searches in 2015. Inclusion criteria specified a longitudinal design, baseline assessment when children were in primary/middle school with at least one follow-up during secondary/high school and a measure of sedentary behaviour at both (or all) points of assessment. Based on data from 11 articles (19 independent samples), tracking coefficients were typically in the range of 0.3 to 0.5 and relatively consistent across the different sedentary behaviours examined and durations of follow-up. Both screen-based sedentary behaviour and overall sedentary time increased during the school transition. Overall there was an increase of approximately 10-20min per day per year in accelerometer-assessed sedentary time. Consistent with the broader age-related changes in behaviour observed during this period, sedentary behaviour increases during the transition from primary/middle to secondary/high school. Investigating features of the social and physical environment that might exacerbate or attenuate this trend would be a valuable next step. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

  4. Secondary pigmentary glaucoma in patients with underlying primary pigment dispersion syndrome

    OpenAIRE

    Sivaraman, Kavitha R; Patel, Chirag G; Vajaranant, Thasarat S; Aref, Ahmad A

    2013-01-01

    Kavitha R Sivaraman, Chirag G Patel, Thasarat S Vajaranant, Ahmad A ArefDepartment of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, University of Illinois at Chicago School of Medicine, Chicago, IL, USAAbstract: Primary pigment dispersion syndrome (PPDS) is a bilateral condition that occurs in anatomically predisposed individuals. PPDS may evolve into pigmentary glaucoma, but it is difficult to predict which patients will progress. Secondary pigment dispersion is more oft...

  5. The Centers for Disease Control program to prevent primary and secondary disabilities in the United States.

    OpenAIRE

    Houk, V N; Thacker, S B

    1989-01-01

    The Disabilities Prevention Program builds on traditional Centers for Disease Control (CDC) strengths in public health surveillance, epidemiology, and technology transfer to State and local governments in translating the findings of research into prevention programs. The objectives of the CDC program are to provide a national focus for the prevention of primary and secondary disabilities, build capacity at the State and community levels to maintain programs to prevent disabilities, and increa...

  6. Primary and secondary metabolites production in signal grass around the year under nitrogen fertilizer

    OpenAIRE

    Syeda Maryam Hussain

    2016-01-01

    Plants produce a number of substances and products and primary and secondary metabolites (SM) are amongst them with many benefits but limitation as well. Usually, the fodder are not considered toxic to animals or as a source having higher SM. The Brachiaria decumbens has a considerable nutritional value, but it is considered as a toxic grass for causing photosensitization in animals, if the grass is not harvested for more than 30 days or solely. The absence of detailed information in the lite...

  7. Stereoinversion of tertiary alcohols to tertiary-alkyl isonitriles and amines.

    Science.gov (United States)

    Pronin, Sergey V; Reiher, Christopher A; Shenvi, Ryan A

    2013-09-12

    The SN2 reaction (bimolecular nucleophilic substitution) is a well-known chemical transformation that can be used to join two smaller molecules together into a larger molecule or to exchange one functional group for another. The SN2 reaction proceeds in a very predictable manner: substitution occurs with inversion of stereochemistry, resulting from the 'backside attack' of the electrophilic carbon by the nucleophile. A significant limitation of the SN2 reaction is its intolerance for tertiary carbon atoms: whereas primary and secondary alcohols are viable precursor substrates, tertiary alcohols and their derivatives usually either fail to react or produce stereochemical mixtures of products. Here we report the stereochemical inversion of chiral tertiary alcohols with a nitrogenous nucleophile facilitated by a Lewis-acid-catalysed solvolysis. The method is chemoselective against secondary and primary alcohols, thereby complementing the selectivity of the SN2 reaction. Furthermore, this method for carbon-nitrogen bond formation mimics a putative biosynthetic step in the synthesis of marine terpenoids and enables their preparation from the corresponding terrestrial terpenes. We expect that the general attributes of the methodology will allow chiral tertiary alcohols to be considered viable substrates for stereoinversion reactions.

  8. Socialization and organizational citizenship behavior among Turkish primary and secondary school teachers.

    Science.gov (United States)

    Çavuş, Mustafa Fedai

    2012-01-01

    The aim of the present study is to investigate the effects of organizational socialization levels of employees on organizational citizenship behavior (OCB). A total of 185 (70 female, 115 male) teachers were sampled at 27 primary and secondary schools. Their ages ranged from 23 to 55 years, with a mean (SD) of 36 (5.1). In this sample, 100 (54.1%) worked in primary schools, and 85 (45.9%) worked in secondary schools. A three-part questionnaire was designed for the study. The research scales were self-report measures of organizational socialization, OCB, and demographic variables. The hypothesized model was tested using Pearson correlation analyses and multiple regression analyses. The teachers demonstrated high level socialization (Mean 4.2, SD 0.7) and OCB (Mean 4.0, SD 0.54). Understanding, coworker support, and performance proficiency explained significant variance in organizational citizenship behavior; however, there was no relationship (p=0.286) between the organizational goals and values and OCB. The findings contribute to our understanding of the relationship between the level of organizational socialization and organizational citizenship behavior in educational settings. These findings suggest that high level organizational socialization supports organizational citizenship behavior in primary and secondary school teachers.

  9. [Effects of mental workload on work ability in primary and secondary school teachers].

    Science.gov (United States)

    Xiao, Yuanmei; Li, Weijuan; Ren, Qingfeng; Ren, Xiaohui; Wang, Zhiming; Wang, Mianzhen; Lan, Yajia

    2015-02-01

    To investigate the change pattern of primary and secondary school teachers' work ability with the changes in their mental workload. A total of 901 primary and secondary school teachers were selected by random cluster sampling, and then their mental workload and work ability were assessed by National Aeronautics and Space Administration-Task Load Index (NASA-TLX) and Work Ability Index (WAI) questionnaires, whose reliability and validity had been tested. The effects of their mental workload on the work ability were analyzed. Primary and secondary school teachers' work ability reached the highest level at a certain level of mental workload (55.73work ability had a positive correlation with the mental workload. Their work ability increased or maintained stable with the increasing mental workload. Moreover, the percentage of teachers with good work ability increased, while that of teachers with moderate work ability decreased. But when their mental workload was higher than the level, their work ability had a negative correlation with the mental workload. Their work ability significantly decreased with the increasing mental workload (P work ability decreased, while that of teachers with moderate work ability increased (P work ability. Moderate mental workload (55.73∼64.10) will benefit the maintaining and stabilization of their work ability.

  10. IEA-R1 primary and secondary coolant piping systems coupled stress analysis

    International Nuclear Information System (INIS)

    Fainer, Gerson; Faloppa, Altair A.; Oliveira, Carlos A.; Mattar Neto, Miguel

    2013-01-01

    The aim of this work is to perform the stress analysis of a coupled primary and secondary piping system of the IEA-R1 based on tridimensional model, taking into account the as built conditions. The nuclear research reactor IEA-R1 is a pool type reactor projected by Babcox-Willcox, which is operated by IPEN since 1957. The operation to 5 MW power limit was only possible after the conduction of life management and modernization programs in the last two decades. In these programs the components of the coolant systems, which are responsible for the water circulation into the reactor core to remove the heat generated inside it, were almost totally refurbished. The changes in the primary and secondary systems, mainly the replacement of pump and heat-exchanger, implied in piping layout modifications, and, therefore, the stress condition of the piping systems had to be reanalyzed. In this paper the structural stress assessment of the coupled primary and secondary piping systems is presented and the final results are discussed. (author)

  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. Executive Functions as Predictors of School Performance and Social Relationships: Primary and Secondary School Students.

    Science.gov (United States)

    Zorza, Juan Pablo; Marino, Julián; Acosta Mesas, Alberto

    2016-05-12

    This study examined the relationship between executive functions (EFs) and school performance in primary and secondary school students aged 8 to 13 years (N = 146, M = 10.4, 45.8% girls). EFs were evaluated using the Trail Making Test (TMT), Verbal Fluency (VF), and the Stroop Test. Students' GPAs and teachers' assessment of academic skills were used to measure school performance. To evaluate the students' social behavior, participants were asked to rate all their classmates' prosocial behavior and nominate three students with whom they preferred to do school activities; teachers also provided evaluations of students' social skills. EF measures explained 41% (p = .003, f 2 = .694) of variability in school performance and 29% (p = .005, f 2 = .401) of variance in social behavior in primary school students. The predictive power of EFs was found to be lower for secondary school students, although the TMT showed significant prediction and explained 13% (p = .004, f 2 = .149) of variance in school performance and 15% (p = .008, f 2 = .176) in peer ratings of prosocial behavior. This paper discusses the relevance of EFs in the school environment and their different predictive power in primary and secondary school students.

  13. Oral mucosal manifestations in primary and secondary Sjögren syndrome and dry mouth syndrome

    Directory of Open Access Journals (Sweden)

    Katarzyna Błochowiak

    2016-02-01

    Full Text Available Introduction : One of the most important symptoms of Sjögren syndrome is xerostomia. The oral cavity deprived of saliva and its natural lubricative, protective and antibacterial properties is prone to a number of unfavourable consequences. Aim : To present the most important lesions on the oral mucosa in primary and secondary Sjögren syndrome and in dry mouth syndrome. Material and methods: The study group comprised 55 patients including 52 women and 3 men aged 20–72 years (average: 28.25 years. Results : Basing on the accepted criteria, primary Sjögren syndrome was diagnosed in 22 (40% patients, secondary Sjögren syndrome in 18 (32.7% patients, and dry mouth syndrome in 15 (27.27% patients. The physical examination and the examination of the mouth were performed and history was elicited from every patient. Conclusions : The most common pathologies appearing on the oral mucosa in primary and secondary Sjögren syndrome are angular cheilitis, cheilitis, increased lip dryness as well as non-specific ulcerations, aphthae and aphthoid conditions.

  14. On the coexistence of primary and secondary users in spectrum-sharing broadcast channels

    KAUST Repository

    Yang, Yuli

    2013-06-01

    In this paper, we consider a broadcast channel in spectrum-sharing networks, where the base station schedules licensed primary users (PUs) and cognitive secondary users (SUs) simultaneously. Based on such a framework, we present a transmission strategy in the light of dirty paper coding. In order to promise the PUs\\' quality of service (QoS) in the broadcasting, the base station chooses codewords for the users by taking into account that the codewords pertaining to SUs can be pre-subtracted from those pertaining to PUs as if there were no interference from the secondary\\'s data to the primary\\'s data. For the purpose of performance evaluation, by taking capacity behavior and bit error rate (BER) as metrics, we study the achievable data rate regions for both types of users with the introduced design, and analyze the BER performance in corresponding systems implemented with hierarchical modulation. Numerical results substantiate that with flexible management of the spectrum resources, our proposed scheme provides more communication opportunities for SUs while maintaining PUs\\' QoS at an acceptable level. © 2013 IEEE.

  15. Optimal medical therapy for secondary prevention after an acute coronary syndrome: 18-month follow-up results at a tertiary teaching hospital in South Korea

    Directory of Open Access Journals (Sweden)

    Byeon HJ

    2016-02-01

    Full Text Available Hee Ja Byeon,1,* Young-Mo Yang,2,* Eun Joo Choi21Department of Pharmacy, Chosun University Hospital, 2Department of Pharmacy, College of Pharmacy, Chosun University, Gwangju, South Korea*These authors contributed equally to this workBackground: Acute coronary syndrome (ACS is a fatal cardiovascular disease caused by atherosclerotic plaque erosion or rupture and formation of coronary thrombus. The latest guidelines for ACS recommend the combined drug regimen, comprising aspirin, P2Y12 inhibitor, angiotensin-converting enzyme inhibitor or angiotensin II receptor blocker, β-blocker, and statin, at discharge after ACS treatment to reduce recurrent ischemic cardiovascular events. This study aimed to examine prescription patterns of secondary prevention drugs in Korean patients with ACS after hospital discharge, to access the appropriateness of secondary prevention drug therapy for ACS, and to evaluate whether to persistently use discharge medications for 18 months.Methods: This study was retrospectively conducted with the patients who were discharged from the tertiary hospital, located in South Korea, after ACS treatment between September 2009 and August 2013. Data were collected through electronic medical record.Results: Among 3,676 patients during the study period, 494 were selected based on inclusion and exclusion criteria. The regimen of aspirin + clopidogrel + β-blocker + angiotensin-converting enzyme inhibitor/angiotensin II receptor blocker + statin was prescribed to 374 (75.71% patients with ACS at discharge. Specifically, this regimen was used in 177 (69.69% unstable angina patients, 44 (70.97% non-ST-segment elevation myocardial infarction patients, and 153 (85.96% ST-segment elevation myocardial infarction patients. Compared with the number of ACS patients with all five guideline-recommended drugs at discharge, the number of ACS patients using them 12 (n=169, 34.21% and 18 (n=105, 21.26% months after discharge tended to be gradually

  16. Increased Oil Production and Reserves Utilizing Secondary/Tertiary Recovery Techniques on Small Reservoirs in the Paradox Basin, Utah

    International Nuclear Information System (INIS)

    Chidsey Jr., Thomas C.

    2003-01-01

    The primary objective of this project was to enhance domestic petroleum production by field demonstration and technology transfer of an advanced-oil-recovery technology in the Paradox Basin, southeastern Utah. If this project can demonstrate technical and economic feasibility, the technique can be applied to approximately 100 additional small fields in the Paradox Basin alone, and result in increased recovery of 150 to 200 million barrels (23,850,000-31,800,000 m3) of oil. This project was designed to characterize five shallow-shelf carbonate reservoirs in the Pennsylvanian (Desmoinesian) Paradox Formation and choose the best candidate for a pilot demonstration project for either a waterflood or carbon-dioxide-(CO2-) miscible flood project. The field demonstration, monitoring of field performance, and associated validation activities will take place within the Navajo Nation, San Juan County, Utah

  17. Increased Oil Production and Reserves Utilizing Secondary/Tertiary Recovery Techniques on Small Reservoirs in the Paradox Basin, Utah; ANNUAL

    International Nuclear Information System (INIS)

    Jr., Chidsey, Thomas C.; Allison, M. Lee

    1999-01-01

    The primary objective of this project is to enhance domestic petroleum production by field demonstration and technology transfer of an advanced- oil-recovery technology in the Paradox basin, southeastern Utah. If this project can demonstrate technical and economic feasibility, the technique can be applied to approximately 100 additional small fields in the Paradox basin alone, and result in increased recovery of 150 to 200 million barrels (23,850,000-31,800,000 m3) of oil. This project is designed to characterize five shallow-shelf carbonate reservoirs in the Pennsylvanian (Desmoinesian) Paradox Formation and choose the best candidate for a pilot demonstration project for either a waterflood or carbon-dioxide-(CO2-) miscible flood project. The field demonstration, monitoring of field performance, and associated validation activities will take place within the Navajo Nation, San Juan County, Utah

  18. Stress sources and manifestations in a nation-wide sample of pre-primary, primary and secondary educators in Greece

    Directory of Open Access Journals (Sweden)

    Nadia eKourmousi

    2016-04-01

    Full Text Available BackgroundTeachers experience high levels of stress as a result of their professional duties and research has shown a growing interest in this phenomenon during the recent years. Aim of this study was to explore the associations of stress sources and manifestations with individual and job-related characteristics in educators of all levels. MethodsIn a cross–sectional design, following an informative e-campaign on the study aims through the official and the main teachers’ portals in Greece, respondents completed online the Teachers Stress Inventory (TSI and the 14-item Perceived Stress Scale (PSS-14. 974 male and 2473 female pre-primary, primary and secondary educators with a mean age of 41.2 years responded. ResultsWomen and younger teachers reported significantly higher levels of stress, mainly due to lack of time and other work-related stressors, and also more emotional and gastronomic manifestations. Increased age and working experience were associated with lower levels of several stress sources. Teachers of administrative positions had increased time management stressors, but less professional distress, professional investment and discipline and motivation stressors. Additionally, working and residing far from family increased teachers’ stress levels associated to control, motivation and investment. Teachers of pre-primary education had reduced professional investment and motivation stress factors while vocational lyceum teachers of secondary education reported less work-related stressors and manifestations and more discipline and motivation related ones. Having students supported or in need of support from special educators and students with difficulties in speaking or comprehension was associated with most of the teachers' stress sources and manifestations (i.e. TSI subscales. Finally, colleagues’ and mainly supervisors' support seemed to provide a strong and consistent protection against both stress sources and manifestations

  19. Stress Sources and Manifestations in a Nationwide Sample of Pre-Primary, Primary, and Secondary Educators in Greece.

    Science.gov (United States)

    Kourmousi, Ntina; Alexopoulos, Evangelos C

    2016-01-01

    Teachers experience high levels of stress as a result of their professional duties, and research has shown a growing interest in this phenomenon during the recent years. Aim of this study was to explore the associations of stress sources and manifestations with individual and job-related characteristics in educators of all levels. In a cross-sectional design, following an informative e-campaign on the study aims through the official and the main teachers' portals in Greece, respondents completed online the teachers stress inventory (TSI) and the 14-item Perceived Stress Scale. Nine hundred seventy-four male and 2473 female pre-primary, primary, and secondary educators with a mean age of 41.2 years responded. Women and younger teachers reported significantly higher levels of stress, mainly due to lack of time and other work-related stressors, and also more emotional and gastronomic manifestations. Increased age and working experience were associated with lower levels of several stress sources. Teachers of administrative positions had increased time management stressors, but less professional distress, professional investment, and discipline and motivation stressors. Additionally, working and residing far from family increased teachers' stress levels associated with control, motivation, and investment. Teachers of pre-primary education had reduced professional investment and motivation stress factors, while vocational lyceum teachers of secondary education reported less work-related stressors and manifestations and more discipline and motivation-related ones. Having students supported or in need of support from special educators and students with difficulties in speaking or comprehension was associated with most of the teachers' stress sources and manifestations (i.e., TSI subscales). Finally, colleagues' and mainly supervisors' support seemed to provide a strong and consistent protection against both stress sources and manifestations. Stress factors and

  20. A web-based survey of attitudes toward epilepsy in secondary and tertiary students in Malaysia, using the Public Attitudes Toward Epilepsy (PATE) scale.

    Science.gov (United States)

    Lim, Kheng Seang; Hills, Michael D; Choo, Wan Yuen; Wong, Mee Hoo; Wu, Cathie; Tan, Chong Tin

    2013-02-01

    Students' attitudes toward epilepsy have been studied in several countries, but none of the studies used a quantitative scale. We aimed to determine the validity and reliability of the Public Attitudes Toward Epilepsy (PATE) scale in a homogenous population consisting of secondary and tertiary students in Malaysia and to quantify their attitudes toward epilepsy, using a web-based survey. A total of 227 respondents with a mean age of 19.6±2.07 years, predominantly Chinese (85%), female (62%), and in a pre-university education level (71%) completed the web-based survey. Psychometric testing showed that the PATE is a valid and reliable scale to be applied in a homogenous population. The mean score in the personal domain was significantly higher than that in the general domain (2.73±0.61 vs. 2.12±0.60, respectively, ppopulation (Lim et al., 2012 [10]), the mean score in the general domain was significantly lower (pstudents are more positive than those of the general population in the general domain but not in the personal domain. Copyright © 2012 Elsevier Inc. All rights reserved.

  1. Attitudes and practices of Chinese physicians regarding chronic kidney disease and acute kidney injury management: a questionnaire-based cross-sectional survey in secondary and tertiary hospitals.

    Science.gov (United States)

    Wu, Yanhua; Chen, Yuanhan; Chen, Shixin; He, Yani; Liang, Huaban; Dong, Wei; Liang, Xinling

    2018-05-10

    This questionnaire-based cross-sectional survey reported the attitudes and practices of Chinese doctors regarding chronic kidney disease (CKD) and acute kidney injury (AKI) management. An online questionnaire consisting of general information, awareness of CKD and AKI, education status, renal laboratory items, and clinical practices between February 20, 2017 and August 15, 2017. Among the 1289 respondents from secondary and tertiary hospitals in 30 provinces, 718 (55.7%) were nephrologists, 94.3% had the ability to evaluate glomerular filtration rates, and 98.8% could evaluate urinary protein excretion, indicating that Chinese doctors met the minimum requirements to manage CKD. However, nearly half of all respondents reported that easy methods for spot urine creatinine-adjusted urinary protein assessments were unavailable. Awareness of the CKD risk stratification system and AKI definition was inadequate, and only 54.2% of respondents reported that they had received nutritional education for renal diseases. Although most of the respondents were nephrologists at university hospitals, 66.4% and 76.3% of respondents reported nephrology referrals and nephrology consultations, respectively, after AKI, suggesting an insufficient role for nephrologists. Finally, management models differed significantly, indicating that universal guidelines for CKD and AKI management are required across China. Several considerable challenges remain regarding CKD and AKI management in China, including inadequate knowledge and training systems, an absence of clinical protocols, and insufficient multidisciplinary cooperation.

  2. Liquid vs Solid Culture Medium to Evaluate Proportion and Time to Change in Management of Suspects of Tuberculosis-A Pragmatic Randomized Trial in Secondary and Tertiary Health Care Units in Brazil.

    Directory of Open Access Journals (Sweden)

    Adriana da Silva Rezende Moreira

    Full Text Available The use of liquid medium (MGIT960 for tuberculosis (TB diagnosis was recommended by WHO in 2007. However, there has been no evaluation of its effectiveness on clinically important outcomes.A pragmatic trial was carried out in a tertiary hospital and a secondary health care unit in Rio de Janeiro City, Brazil. Participants were 16 years or older, suspected of having TB. They were excluded if only cerebral spinal fluid or blood specimens were available for analysis. MGIT960 technique was compared with the Lowenstein-Jensen (LJ method for laboratory diagnosis of active TB. Primary outcome was the proportion of patients who had their initial medical management changed within 2 months after randomisation. Secondary outcomes were: mean time for changing the procedure, patient satisfaction with the overall treatment and adverse events. Data were analysed by intention-to-treat. Between April 2008 and September 2011, 693 patients were enrolled (348 to MGIT, 345 to LJ. Smear and culture results were positive for 10% and 15.7% of participants, respectively. Patients in the MGIT arm had their initial medical management changed more frequently than those in the LJ group (10.1% MGIT vs 3.8% LJ, RR 2.67 95% CI 1.44-.96, p = 0.002, NNT 16, 95% CI 10-39. Mean time for changing the initial procedure was greater in LJ group at both sites: 20.0 and 29.6 days in MGIT group and 52.2 and 64.3 in LJ group (MD 33.5, 95% CI 30.6-36.4, p = 0.0001. No other important differences were observed.This study suggests that opting for the MGIT960 system for TB diagnosis provides a promising case management model for improving the quality of care and control of TB.Controlled-Trials.com ISRCTN79888843.

  3. Primary and secondary patient data in contrast: the use of observational studies like RABBIT.

    Science.gov (United States)

    Richter, Adrian; Meißner, Yvette; Strangfeld, Anja; Zink, Angela

    2016-01-01

    The study of secondary patient data, particularly represented by claims data, has increased in recent years. The strength of this approach involves easy access to data that have been generated for administrative purposes. By contrast, collection of primary data for research is time-consuming and may therefore appear outdated. Both administrative data and data collected prospectively in clinical care can address similar research questions concerning effectiveness and safety of treatments. Therefore, why should we invest the precious time of rheumatologists to generate primary patient data? This article will outline some features of primary patient data collection illustrated by the German biologics register RABBIT (Rheumatoid arthritis: observation of biologic therapy). RABBIT is a long-term observational cohort study that was initiated more than 15 years ago. We will discuss as quality indicators: (i) study design, (ii) type of documentation, standardisation of (iii) clinical and (iv) safety data, (v) monitoring of the longitudinal follow-up, (vi) losses to follow-up as well as (vii) the possibilities to link the data base. The impact of these features on interpretation and validity of results is illustrated using recent publications. We conclude that high quality and completeness of data prospectively-collected offers many advantages over large quantities of non-standardised data collected in an unsupervised manner. We expect the enthusiasm about the use of secondary patient data to decline with more awareness of their methodological limitations while studies with primary patient data like RABBIT will maintain and broaden their impact on daily clinical practice.

  4. Increased Oil Production and Reserves Utilizing Secondary/Tertiary Recovery Techniques on Small Reservoirs in the Paradox Basin, Utah

    International Nuclear Information System (INIS)

    Allison, M. Lee; Chidsey, Thomas Jr.

    1999-01-01

    The primary objective of this project is to enhance domestic petroleum production by demonstration and technology transfer of an advanced oil recovery technology in the Paradox basin, southeastern Utah. If this project can demonstrate technical and economic feasibility, the technique can be applied to about 100 additional small fields in the Paradox basin alone, and result in increased recovery of 150 to 200 million bbl of oil. This project is designed to characterize five shallow-shelf carbonate reservoirs in the Pennsylvanian (Desmoinesian) Paradox Formation and choose the best candidate for a pilot demonstration project for either a waterflood or carbon dioxide-(CO-) flood 2 project. The field demonstration, monitoring of field performance, and associated validation activities will take place in the Paradox basin within the Navajo Nation. The results of this project will be transferred to industry and other researchers through a petroleum extension service, creation of digital databases for distribution, technical workshops and seminars, field trips, technical presentations at national and regional professional meetings, and publication in newsletters and various technical or trade journals

  5. In vitro lipofection with novel series of symmetric 1,3-dialkoylamidopropane-based cationic surfactants containing single primary and tertiary amine polar head groups.

    Science.gov (United States)

    Sheikh, Mohammad; Feig, Jennifer; Gee, Becky; Li, Song; Savva, Michalakis

    2003-06-01

    A novel series of symmetric double-chained primary and tertiary 1,3-dialkoylamido monovalent cationic lipids were synthesized and evaluated for their transfection activities. In the absence of the helper lipid DOPE (1,2-dioleoyl-sn-glycero-3-phosphoethanolamine), only the primary and tertiary dioleoyl derivatives 1,3lmp5 and 1,3lmt5, respectively elicited transfection activity. This is a striking difference between symmetrical 1,2-diacyl glycerol-based monovalent cationic lipids that always found both dioleoyl and dimyristoyl analogues being efficient transfection reagents. In the presence of helper lipid, all cationic derivatives induced marker gene expression, except the dilauroyl analogues 1,3lmp1 and 1,3lmt1 that elicited no transfection activity. Combining electrophoretic mobility data of the lipoplexes at different charge ratios with transfection activity suggested two requirements for high transfection activity with monovalent double-chained cationic lipids, that is, binding/association of the lipid to the plasmid DNA and membrane fusion properties of the lipid layers surrounding the DNA.

  6. Neural systems underlying aversive conditioning in humans with primary and secondary reinforcers

    Directory of Open Access Journals (Sweden)

    Mauricio R Delgado

    2011-05-01

    Full Text Available Money is a secondary reinforcer commonly used across a range of disciplines in experimental paradigms investigating reward learning and decision-making. The effectiveness of monetary reinforcers during aversive learning and its neural basis, however, remains a topic of debate. Specifically, it is unclear if the initial acquisition of aversive representations of monetary losses depends on similar neural systems as more traditional aversive conditioning that involves primary reinforcers. This study contrasts the efficacy of a biologically defined primary reinforcer (shock and a socially defined secondary reinforcer (money during aversive learning and its associated neural circuitry. During a two-part experiment, participants first played a gambling game where wins and losses were based on performance to gain an experimental bank. Participants were then exposed to two separate aversive conditioning sessions. In one session, a primary reinforcer (mild shock served as an unconditioned stimulus (US and was paired with one of two colored squares, the conditioned stimuli (CS+ and CS-, respectively. In another session, a secondary reinforcer (loss of money served as the US and was paired with one of two different CS. Skin conductance responses were greater for CS+ compared to CS- trials irrespective of type of reinforcer. Neuroimaging results revealed that the striatum, a region typically linked with reward-related processing, was found to be involved in the acquisition of aversive conditioned response irrespective of reinforcer type. In contrast, the amygdala was involved during aversive conditioning with primary reinforcers, as suggested by both an exploratory fMRI analysis and a follow-up case study with a patient with bilateral amygdala damage. Taken together, these results suggest that learning about potential monetary losses may depend on reinforcement learning related systems, rather than on typical structures involved in more biologically based

  7. [Knowledge, attitude and practice on drinking water of primary and secondary students in Shenzhen].

    Science.gov (United States)

    Liu, Jiaxin; Hu, Xiaoqi; Zhang, Qian; Du, Songming; Pan, Hui; Dai, Xingbi; Ma, Guansheng

    2014-05-01

    To investigate the status on drinking water related knowledge, attitude and practice of primary and secondary students in Shenzhen. All 832 primary and secondary students from three schools in Shenzhen were selected by using multi-stage random sampling method. The information of drinking water related knowledge, time of drinking water and the type of drink chose in different situations were collected by questionnaires. 87.3% of students considered plain water being the healthiest drink in daily life, and the percent in girls (90.6%) was significantly higher than that in boys (84.4% ) (chi2 = 7.13, P = 0.0089). The awareness percent of the harm of dehydration was 84.5%. The percent in high school students (96.4%) was significantly higher than that in primary (73.9%) and middle school students (94.2%) (chi2 = 73.77, P water was in the morning with an empty stomach, and 46.3% chose when they felt thirsty. However, 63.7% drank water when they felt thirsty, and 50.6% drank water in the morning with an empty stomach. The percent of drinking plain water at school was the highest (83.4%), followed by at home (64.1%) and in public (26.2%). There were 45.2% and 53.3% of students, respectively, choosing sugary drinks as their favorite drink and most frequently drinking in public places. Primary and secondary students in Shenzhen have a good awareness of drinking water, which is inconsistent with their practice. Meanwhile, a considerable proportion of students towards choosing drinks have many misconceptions. The education of healthy drinking water should be strengthened.

  8. Quantitative evaluation of emission controls on primary and secondary organic aerosol sources during Beijing 2008 Olympics

    Directory of Open Access Journals (Sweden)

    S. Guo

    2013-08-01

    Full Text Available To assess the primary and secondary sources of fine organic aerosols after the aggressive implementation of air pollution controls during the 2008 Beijing Olympic Games, 12 h PM2.5 values were measured at an urban site at Peking University (PKU and an upwind rural site at Yufa during the CAREBEIJING-2008 (Campaigns of Air quality REsearch in BEIJING and surrounding region summer field campaign. The average PM2.5 concentrations were 72.5 ± 43.6 μg m−3 and 64.3 ± 36.2 μg m−3 (average ± standard deviation, below as the same at PKU and Yufa, respectively, showing the lowest concentrations in recent years. Combining the results from a CMB (chemical mass balance model and secondary organic aerosol (SOA tracer-yield model, five primary and four secondary fine organic aerosol sources were compared with the results from previous studies in Beijing. The relative contribution of mobile sources to PM2.5 concentrations was increased in 2008, with diesel engines contributing 16.2 ± 5.9% and 14.5 ± 4.1% and gasoline vehicles contributing 10.3 ± 8.7% and 7.9 ± 6.2% to organic carbon (OC at PKU and Yufa, respectively. Due to the implementation of emission controls, the absolute OC concentrations from primary sources were reduced during the Olympics, and the contributions from secondary formation of OC represented a larger relative source of fine organic aerosols. Compared with the non-controlled period prior to the Olympics, primary vehicle contributions were reduced by 30% at the urban site and 24% at the rural site. The reductions in coal combustion contributions were 57% at PKU and 7% at Yufa. Our results demonstrate that the emission control measures implemented in 2008 significantly alleviated the primary organic particle pollution in and around Beijing. However, additional studies are needed to provide a more comprehensive assessment of the emission control effectiveness on SOA formation.

  9. Radiation leakage monitoring method and device from primary to secondary coolant systems in nuclear reactor

    International Nuclear Information System (INIS)

    Tajiri, Yoshiaki; Umehara, Toshihiro; Yamada, Masataka.

    1993-01-01

    The present invention monitors radiation leaked from any one of primary cooling systems to secondary cooling systems in a plurality of steam generators. That is, radiation monitoring means each corresponding to steam each generators are disposed to the upstream of a position where main steam pipes are joined. With such a constitution, since the detection object of each of radiation monitoring means is secondary coolants before mixing with secondary coolants of other secondary loops or dilution, lowering of detection accuracy can be avoided. Except for the abnormal case, that is, a case neither of radiation leakage nor of background change, the device is adapted as a convenient measuring system only with calculation performance. Once abnormality occurs, a loop having a value exceeding a standard value is identified by a single channel analyzer function. The amount of radiation leakage from the steam generator belonging to the specified loop is monitored quantitatively by a multichannel analyzer function. According to the method of the present invention, since specific spectrum analysis is conducted upon occurrence of abnormality, presence of radiation leakage and the scale thereof can be judged rapidly. (I.S.)

  10. INCREASED OIL PRODUCTION AND RESERVES UTILIZING SECONDARY/TERTIARY RECOVERY TECHNIQUES ON SMALL RESERVOIRS IN THE PARADOX BASIN, UTAH

    Energy Technology Data Exchange (ETDEWEB)

    Thomas C. Chidsey, Jr.

    2002-11-01

    The Paradox Basin of Utah, Colorado, and Arizona contains nearly 100 small oil fields producing from shallow-shelf carbonate buildups or mounds within the Desert Creek zone of the Pennsylvanian (Desmoinesian) Paradox Formation. These fields typically have one to four wells with primary production ranging from 700,000 to 2,000,000 barrels (111,300-318,000 m{sup 3}) of oil per field at a 15 to 20 percent recovery rate. Five fields in southeastern Utah were evaluated for waterflood or carbon-dioxide (CO{sub 2})-miscible flood projects based upon geological characterization and reservoir modeling. Geological characterization on a local scale focused on reservoir heterogeneity, quality, and lateral continuity as well as possible compartmentalization within each of the five project fields. The Desert Creek zone includes three generalized facies belts: (1) open-marine, (2) shallow-shelf and shelf-margin, and (3) intra-shelf, salinity-restricted facies. These deposits have modern analogs near the coasts of the Bahamas, Florida, and Australia, respectively, and outcrop analogs along the San Juan River of southeastern Utah. The analogs display reservoir heterogeneity, flow barriers and baffles, and lithofacies geometry observed in the fields; thus, these properties were incorporated in the reservoir simulation models. Productive carbonate buildups consist of three types: (1) phylloid algal, (2) coralline algal, and (3) bryozoan. Phylloid-algal buildups have a mound-core interval and a supra-mound interval. Hydrocarbons are stratigraphically trapped in porous and permeable lithotypes within the mound-core intervals of the lower part of the buildups and the more heterogeneous supramound intervals. To adequately represent the observed spatial heterogeneities in reservoir properties, the phylloid-algal bafflestones of the mound-core interval and the dolomites of the overlying supra-mound interval were subdivided into ten architecturally distinct lithotypes, each of which

  11. Rescue of Primary Incomplete Microkeratome Flap with Secondary Femtosecond Laser Flap in LASIK

    Directory of Open Access Journals (Sweden)

    E. A. Razgulyaeva

    2014-01-01

    Full Text Available For laser-assisted in situ keratomileusis (LASIK retreatments with a previous unsuccessful mechanical microkeratome-assisted surgery, some surgical protocols have been described as feasible, such as relifting of the flap or the creation of a new flap and even the change to a surface ablation procedure (photorefractive keratectomy (PRK. This case shows the use of femtosecond technology for the creation of a secondary flap to perform LASIK in a cornea with a primary incomplete flap obtained with a mechanical microkeratome. As we were unable to characterize the interface of the first partial lamellar cut, a thick flap was planned and created using a femtosecond laser platform. As the primary cut was very thick in the nasal quadrant, a piece of loose corneal tissue appeared during flap lifting which was fitted in its position and not removed. Despite this condition and considering the regularity of the new femtosecond laser cut, the treatment was uneventful. This case report shows the relevance of a detailed corneal analysis with an advanced imaging technique before performing a secondary flap in a cornea with a primary incomplete flap. The femtosecond laser technology seems to be an excellent tool to manage such cases successfully.

  12. What imaging techniques should be used in primary versus secondary prevention for further risk stratification?

    Science.gov (United States)

    Schiele, François; Navarese, Eliano Pio; Visoná, Adriana; Ray, Kausik

    2017-04-01

    An accurate assessment of the cardiovascular (CV) risk of an individual is key for guiding the appropriate treatment strategy for cardiovascular disease (CVD). Although conventional risk factors for CVD are well established, there can be substantial variation in the extent of atherosclerosis between patients. The use of a variety of imaging modalities can be beneficial in the primary prevention stage and in the classification of an individual's CV risk. Therefore, appropriate implementation of these imaging techniques for risk assessment purposes, in line with clinical guidelines, can influence the outcomes of CVD prevention. The expert working group collaborated to review current invasive and non-invasive imaging techniques available to healthcare practitioners and how they can be used in the measurement of preclinical vascular damage and CV risk assessment. After evaluation of the current guideline recommendations and clinical data available, the expert working group collaborated to produce recommendations regarding the use of imaging in the risk stratification in primary prevention, CV risk in peri-acute coronary syndrome and CV risk assessment in secondary prevention. Overall, a variety of both invasive and non-invasive imaging modalities were highlighted by the expert working group as having the potential to assist in the risk assessments of patients at risk of CVD. These imaging techniques can be utilised in both primary and secondary prevention strategies and have the potential to be important risk modifiers, improving the outcome of CV risk assessment. Copyright © 2017 Elsevier B.V. All rights reserved.

  13. Evolution of Primary Fe-Rich Compounds in Secondary Al-Si-Cu Alloys

    Science.gov (United States)

    Fabrizi, Alberto; Capuzzi, Stefano; Timelli, Giulio

    Although iron is usually added in die cast Al-Si foundry alloys to prevent die soldering, primary Fe-rich particles are generally considered as "hardspot" inclusions which compromise the mechanical properties of the alloy, namely ductility and toughness. As there is no economical methods to remove the Fe excess in secondary Al-Si alloys at this time, the control of solidification process and chemical composition of the alloy is a common industrial practice to overcome the negative effects connected with the presence of Fe-rich particles. In this work, the size and morphology as well as the nucleation density of primary Fe-rich particles have been studied as function of cooling rate and alloy chemical composition for secondary Al-Si-Cu alloys. The solidification experiments were carried out using differential scanning calorimetry whereas morphology investigations were conducted using optical and scanning electron microscopy. Mcrosegregations and chemical composition of primary Fe-rich particles were examined by energy dispersive spectroscopy.

  14. Effect of primary and secondary radicals on chain breaks in ribosomal RNA in E. coli ribosomes

    International Nuclear Information System (INIS)

    Singh, H.; Bishop, J.

    1984-01-01

    It has been shown previously that, in dilute aerated solutions, ribosomes are inactivated by OH radicals and by secondary radicals produced from added alcohols (Singh and Vadasz 1983 a). In de-aerated solutions, both radicalH and e - sub(aq) also inactivate ribosomes (Singh and Vadasz 1983 b). The results of these studies and other on different systems (Adams et al. 1973, Aldrich and Cundall 1969, Dewey and Stein 1970, Masuda et al. 1971, Nabben et al. 1982, 1983, Samuni et al. 1980, Singh and Singh 1982) have shown that damage to biological systems occurs by diverse mechanisms. One of these mechanisms involves chain breaks in RNA (Pollard and Weller 1967). The purpose of this study was to determine which of the primary and secondary radicals cause chain breaks in ribosomal RNA (rRNA) within the ribosomes. (author)

  15. Time course of primary and secondary hyperalgesia after heat injury to the skin

    DEFF Research Database (Denmark)

    Møiniche, S; Dahl, J B; Kehlet, H

    1993-01-01

    the injury in any volunteer. These findings suggest post-injury development of secondary hyperalgesia to be a dynamic process, closely related in time to a peripheral nociceptive input, with reversal to normal when the peripheral lesion disappears. These observations may be relevant to the concept of "pre......We have examined the time course of, and relationship between, primary and secondary hyperalgesia after thermal injury to the skin in humans. Burn injuries (15 x 25 mm rectangular thermode, 49 degrees C, 5 min) were produced in eight healthy, unmedicated male volunteers, on the medial side...... of the right calf, on two occasions at least 8 days apart. Heat pain detection thresholds (HPDT), heat pain tolerance (HPT), mechanical pain detection threshold (MPDT) and the intensity of burn-injury induced erythema (skin erythema index, SEI) were assessed inside the burn injury. HPT was assessed only in one...

  16. Primary and secondary creep in aluminum alloys as a solid state transformation

    Science.gov (United States)

    Fernández, R.; Bruno, G.; González-Doncel, G.

    2016-08-01

    Despite the massive literature and the efforts devoted to understand the creep behavior of aluminum alloys, a full description of this phenomenon on the basis of microstructural parameters and experimental conditions is, at present, still missing. The analysis of creep is typically carried out in terms of the so-called steady or secondary creep regime. The present work offers an alternative view of the creep behavior based on the Orowan dislocation dynamics. Our approach considers primary and secondary creep together as solid state isothermal transformations, similar to recrystallization or precipitation phenomena. In this frame, it is shown that the Johnson-Mehl-Avrami-Kolmogorov equation, typically used to analyze these transformations, can also be employed to explain creep deformation. The description is fully compatible with present (empirical) models of steady state creep. We used creep curves of commercially pure Al and ingot AA6061 alloy at different temperatures and stresses to validate the proposed model.

  17. Disability differentials in educational attainment in England: primary and secondary effects.

    Science.gov (United States)

    Chatzitheochari, Stella; Platt, Lucinda

    2018-04-17

    Childhood disability has been largely overlooked in social stratification and life course research. As a result, we know remarkably little about mechanisms behind well-documented disability differentials in educational outcomes. This study investigates educational transitions of disabled youth using data from the Longitudinal Study of Young People in England. We draw on social stratification literature on primary and secondary effects as well as that on stigma and labelling in order to explain disabled young people's educational outcomes. We find that disability differentials in transition rates to full-time academic upper secondary education and to university are largely the result of primary effects, reflected in differences in school performance between disabled and non-disabled young people. However, we also find evidence for secondary effects, with similarly achieving disabled young people less likely to pursue full-time academic upper secondary education compared to their non-disabled peers. We examine the extent to which these effects can be explained by disabled youth's suppressed educational expectations as well as their experiences of being bullied at school, which we link to the stigma experienced by disabled young people and their families. We find that educational expectations play an important role at crucial transitions in the English school system, while the effect of bullying is considerably smaller. By drawing attention to different social processes contributing to disability differentials in attainment, our study moves beyond medical models that implicitly assume a naturalized association of disability with poor educational outcomes, and demonstrates the parallels of disability with other ascriptive inequalities. © London School of Economics and Political Science 2018.

  18. Source Apportionment of Primary and Secondary Fine Particulate Matter in China

    Science.gov (United States)

    Hu, J.; Zhang, H.; Ying, Q.

    2015-12-01

    In the past few decades, China have been facing extreme particulate matter (PM) pollution problems due to the combination of fast increase of population, industrialization, urbanization and associated energy consumption and lagging of sufficient emission control measures. Studies have identified the major components of fine PM (PM2.5) in China include primary PM (which is directly emitted into the atmosphere), sulfate and nitrate (which are mainly secondary PM, i.e., formed from gaseous precursors), and organic aerosols (which can be primary or secondary). Contributions of different source sectors to the different PM components are substantially different; therefore source apportionment of these components can provide critical information needed for policy makers to design effective emission control strategies. In the current study, a source-oriented version of the Community Multiscale Air Quality (CMAQ) model that directly tracks the contributions from multiple emission sources to primary and secondary PM2.5 is developed, and then applied to determine the regional contributions of power, industry, transportation and residential sectors to primary PM, nitrate and sulfate concentrations in China. Four months in 2012-2013 are simulated to predict the seasonal variations of source contributions. Model predictions are evaluated with ambient measured concentrations. The source-oriented CMAQ model is capable of reproducing most of the available PM10 and PM2.5 mass, and PM2.5 EC, POC, nitrate and sulfate observations. Predicted source contributions for EC also generally agree with to the source contributions estimated by receptor models reported in previous studies. Model predictions suggest residential is a major contributor to primary PM (30-70%) in the spring and winter, and industrial contributes 40-60% of primary PM in the summer and fall; Transportation is an important source for EC (20-30%); Power sector is the dominating source of nitrate and sulfate in both

  19. Emergency management of dental trauma: knowledge of Hong Kong primary and secondary school teachers.

    Science.gov (United States)

    Young, Cecilia; Wong, K Y; Cheung, L K

    2012-10-01

    OBJECTIVES. To investigate the level of knowledge about emergency management of dental trauma among Hong Kong primary and secondary school teachers. DESIGN. Questionnaire survey. SETTING. A teachers' union that unites 90% of teachers in Hong Kong. PARTICIPANTS. Randomly selected primary and secondary school teachers. RESULTS. Only 32.8% of respondents correctly stated that a person sustaining dental trauma should go to dentists directly. In all, 73.1% of teachers correctly stated that a dental trauma patient should go for treatment immediately. Only 32.5% knew that a fractured tooth should be put in liquid. Even fewer (23.2%) realised that the displaced tooth should be repositioned back to the original position. Relatively more respondents (74.7%) understood that an avulsed baby tooth should not be put back. Disappointingly, only 16.3% of teachers knew that an avulsed permanent tooth should be replanted. Furthermore, only 29.6% of teachers thought that they were able to distinguish between deciduous teeth and permanent teeth, whilst 20.4% correctly identified at least one of the appropriate mediums: milk, physiological saline or saliva, for storing an avulsed tooth. Teachers who previously received first-aid training with dental content or acquired dental injury information from other sources, scored significantly higher than teachers without such training or acquired information. CONCLUSION. The knowledge on emergency management of dental trauma among primary and secondary school teachers in Hong Kong is insufficient, particularly on the handling of permanent tooth avulsion and the appropriate storage medium for avulsed teeth. Receipt of first-aid training with dental contents and acquisition of dental injury information from other sources were positively correlated with knowledge in managing dental trauma.

  20. Evidence for an Evolutionary Cheater Strategy--Relationships Between Primary and Secondary Psychopathy, Parenting, and Shame and Guilt.

    Science.gov (United States)

    Lyons, Minna T

    2015-01-01

    In the present study, shame and guilt proneness were investigated in relation to primary and secondary psychopathy, looking at parental care as a possible mediator. A sample of 388 volunteers participated in an on-line study, completing several self-report measurements. Primary psychopathy, robust to parental care and sex of the participant, was associated with lower guilt proneness after a private transgression and lower negative self-evaluations after a public transgression. Secondary psychopathy was not associated with guilt or shame proneness. Paternal care played a mediating role between primary psychopathy and guilt, but only in male participants. High paternal care was associated with lower guilt repair in high psychopathy males, suggesting that a positive father-son relationship might be essential for development of exploitive strategies in primary psychopathy. The results highlight the fundamental differences between primary and secondary psychopathy, and provide support for the idea that primary psychopathy is an evolutionary cheater-strategy.

  1. Interim design status and operational report for remote handling fixtures: primary and secondary burners

    International Nuclear Information System (INIS)

    Burgoyne, R.M.

    1976-12-01

    The HTGR reprocessing flowsheet consists of two basic process elements: (1) spent fuel crushing and burning and (2) solvent extraction. Fundamental to these elements is the design and development of specialized process equipment and support facilities. A major consideration of this design and development program is equipment maintenance: specifically, the design and demonstration of selected remote maintenance capabilities and the integration of these into process equipment design. This report documents the current status of the development of remote handling and maintenance fixtures for the primary and secondary burners

  2. Efficient SN2 fluorination of primary and secondary alkyl bromides by copper(I) fluoride complexes

    KAUST Repository

    Liu, Yanpin; Chen, Chaohuang; Li, Huaifeng; Huang, Kuo-Wei; Tan, Jianwei; Weng, Zhiqiang

    2013-01-01

    Copper(I) fluoride complexes ligated by phenanthroline derivatives have been synthesized and structurally characterized by X-ray crystallography. These complexes adopt as either ionic or neutral forms in the solid state, depending on the steric bulkiness of the substituent groups on the phenanthroline ligands. These complexes react with primary and secondary alkyl bromides to produce the corresponding alkyl fluorides in modest to good yields. This new method is compatible with a variety of important functional groups such as ether, thioether, amide, nitrile, methoxyl, hydroxyl, ketone, ester, and heterocycle moieties. © 2013 American Chemical Society.

  3. Genetic and clinical characteristics of primary and secondary glioblastoma is associated with differential molecular subtype distribution

    OpenAIRE

    Li, Rui; Li, Hailin; Yan, Wei; Yang, Pei; Bao, Zhaoshi; Zhang, Chuanbao; Jiang, Tao; You, Yongping

    2015-01-01

    Glioblastoma multiforme (GBM) is classified into primary (pGBM) or secondary (sGBM) based on clinical progression. However, there are some limits to this classification for insight into genetically and clinically distinction between pGBM and sGBM. The aim of this study is to characterize pGBM and sGBM associating with differential molecular subtype distribution. Whole transcriptome sequencing data was used to assess the distribution of molecular subtypes and genetic alterations in 88 pGBM and...

  4. Turbulent Mixing of Primary and Secondary Flow Streams in a Rocket-Based Combined Cycle Engine

    Science.gov (United States)

    Cramer, J. M.; Greene, M. U.; Pal, S.; Santoro, R. J.; Turner, Jim (Technical Monitor)

    2002-01-01

    This viewgraph presentation gives an overview of the turbulent mixing of primary and secondary flow streams in a rocket-based combined cycle (RBCC) engine. A significant RBCC ejector mode database has been generated, detailing single and twin thruster configurations and global and local measurements. On-going analysis and correlation efforts include Marshall Space Flight Center computational fluid dynamics modeling and turbulent shear layer analysis. Potential follow-on activities include detailed measurements of air flow static pressure and velocity profiles, investigations into other thruster spacing configurations, performing a fundamental shear layer mixing study, and demonstrating single-shot Raman measurements.

  5. Efficient SN2 fluorination of primary and secondary alkyl bromides by copper(I) fluoride complexes

    KAUST Repository

    Liu, Yanpin

    2013-11-11

    Copper(I) fluoride complexes ligated by phenanthroline derivatives have been synthesized and structurally characterized by X-ray crystallography. These complexes adopt as either ionic or neutral forms in the solid state, depending on the steric bulkiness of the substituent groups on the phenanthroline ligands. These complexes react with primary and secondary alkyl bromides to produce the corresponding alkyl fluorides in modest to good yields. This new method is compatible with a variety of important functional groups such as ether, thioether, amide, nitrile, methoxyl, hydroxyl, ketone, ester, and heterocycle moieties. © 2013 American Chemical Society.

  6. Multiple hepatic abscesses due to Yersinia enterocolitica infection secondary to primary haemochromatosis

    DEFF Research Database (Denmark)

    Bergmann, T K; Vinding, K; Hey, H

    2001-01-01

    A case of hepatic abscesses due to Yersinia enterocolitica in an immunocompetent male is presented. Re-examination after 3 months showed that the patient had primary haemochromatosis. Treatment with repeated phlebotomies was instituted. Two years after the patient was first admitted to hospital. 17...... showed that prior to this case only 45 cases of hepatic abscess secondary to Yersinia enterocolitica have been registered. Of the 45 reported cases, 64% had underlying haemochromatosis and 29% had diabetes mellitus. The overall mortality was 31%. Mortality before 1987 was 60% (n = 20) and since 1987...

  7. Collimation system for a laboratory of primary and secondary ionizing radiation calibration

    International Nuclear Information System (INIS)

    Oliveira, S.R.; David, M.G.

    2003-01-01

    This work is part of a cooperation plan between the LNMRI/IRD and the LCR/UERJ, for the a primary calibration at the IRD and a secondary laboratory at the LCR, both calibrated for mammographic beams which will be part a Calibration National Network. For the mounting of the primary laboratory, the first step was to install two additional collimators in order to guarantee that the beam area over the ionization chamber to satisfy the calibration international standards. So, the collimators were constructed obeying the geometric rules, the first being of conic format and the second of the cylindrical format, therefore avoiding the effects of the scattering radiation on the edges. By using this collimation system it was possible to verify the uniformity of the radiation field incident the ionization chamber to be over 98% of the total area, guaranteeing better precision of the measurement

  8. Failure by void coalescence in metallic materials containing primary and secondary voids subject to intense shearing

    DEFF Research Database (Denmark)

    Nielsen, Kim Lau; Tvergaard, Viggo

    2011-01-01

    Failure under intense shearing at close to zero stress triaxiality is widely observed for ductile metallic materials, and is identified in experiments as smeared-out dimples on the fracture surface. Numerical cell-model studies of equal sized voids have revealed that the mechanism governing...... this shear failure mode boils down to the interaction between primary voids which rotate and elongate until coalescence occurs under severe plastic deformation of the internal ligaments. The objective of this paper is to analyze this failure mechanism of primary voids and to study the effect of smaller...... secondary damage that co-exists with or nucleation in the ligaments between larger voids that coalesce during intense shearing. A numerical cell-model study is carried out to gain a parametric understanding of the overall material response for different initial conditions of the two void populations...

  9. Use of antihypertensive medications and diagnostic tests among privately insured adolescents and young adults with primary versus secondary hypertension.

    Science.gov (United States)

    Yoon, Esther Y; Cohn, Lisa; Freed, Gary; Rocchini, Albert; Kershaw, David; Ascione, Frank; Clark, Sarah

    2014-07-01

    To compare the use of antihypertensive medications and diagnostic tests among adolescents and young adults with primary versus secondary hypertension. We conducted retrospective cohort analysis of claims data for adolescents and young adults (12-21 years of age) with ≥3 years of insurance coverage (≥11 months/year) in a large private managed care plan during 2003-2009 with diagnosis of primary hypertension or secondary hypertension. We examined their use of antihypertensive medications and identified demographic characteristics and the presence of obesity-related comorbidities. For the subset receiving antihypertensive medications, we examined their diagnostic test use (echocardiograms, renal ultrasounds, and electrocardiograms). The study sample included 1,232 adolescents and young adults; 84% had primary hypertension and 16% had secondary hypertension. The overall prevalence rate of hypertension was 2.6%. One quarter (28%) with primary hypertension had one or more antihypertensive medications, whereas 65% with secondary hypertension had one or more antihypertensive medications. Leading prescribers of antihypertensives for subjects with primary hypertension were primary care physicians (80%), whereas antihypertensive medications were equally prescribed by primary care physicians (43%) and sub-specialists (37%) for subjects with secondary hypertension. The predominant hypertension diagnosis among adolescents and young adults is primary hypertension. Antihypertensive medication use was higher among those with secondary hypertension compared with those with primary hypertension. Further study is needed to determine treatment effectiveness and patient outcomes associated with differential treatment patterns used for adolescents and young adults with primary versus secondary hypertension. Copyright © 2014 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  10. Constraints on primary and secondary particulate carbon sources using chemical tracer and 14C methods during CalNex-Bakersfield

    Data.gov (United States)

    U.S. Environmental Protection Agency — The present study investigates primary and secondary sources of organic carbon for Bakersfield, CA, USA as part of the 2010 CalNex study. The method used here...

  11. The samarium Grignard reaction. In situ formation and reactions of primary and secondary alkylsamarium(III) reagents

    Energy Technology Data Exchange (ETDEWEB)

    Curran, D.P.; Totleben, M.J. [Univ. of Pittsburgh, PA (United States)

    1992-07-15

    This work shows that primary and secondary radicals are rapidly reduced in THF/HMPA to form primary- and secondary-alkylsamarium reagents. The primary- and secondary-radicals can be formed either by direct SmI{sup 2} reductions of primary- and secondary-halides or by a previous rapid radical cyclization. The samarium reagents have moderate stability in solution, and they react with a variety of typical electrophiles, including aldehydes and ketones. The work further shows that organosamarium intermediates can be involved in the traditional samarium Barbier reaction of aldehydes and ketones conducted in THF/HMPA. A new procedure called the {open_quotes}samarium Grignard{close_quotes} method is introduced, and it is suggested that this new procedure will have considerably more scope and generality than the samarium Barbier reaction. 37 refs., 4 tabs.

  12. Demographic and clinical characteristics of primary and secondary care patients with osteoarthritis of hip and knee are quite similar.

    NARCIS (Netherlands)

    Lanson, S.; Lucas, C.; Veenhof, C.

    2012-01-01

    Purpose: As is stated in many guidelines for patients with osteoarthritis, it is advised to treat patients conservatively before patients are referred to secondary care. Therefore, it can be expected that secondary care patietns with osteoarthritis differ from primary care patients. The purpose of

  13. A Balance of Primary and Secondary Values: Exploring a Digital Legacy

    Directory of Open Access Journals (Sweden)

    Amber L. Cushing

    2014-06-01

    Full Text Available This exploratory research explores the concept of a digital legacy as a general concept and as a collection of digital possessions with unique characteristics. The results reported in this article are part of a larger study. In Cushing (2013, the author identified the characteristics of a digital possession. In this study, these characteristics of a digital possession were utilized to explore how the characteristics of several digital possessions could form a collection, or a digital legacy. In addition to being explored as a collection of digital possessions, data was collected about the general concept of a digital legacy. In part I of the study, 23 participants from three age groups were interviewed about their general concept of a digital legacy. Five general characteristics describing a digital legacy were identified. In part II of the study, interview data from Cushing (2013 was used to create statements describing digital possessions. The statements were classified utilizing the archival concept of primary and secondary values, as well as the consumer behavior concepts of self extension to possessions and possession attachment. Primary value refers to the purpose for which the item was created, while secondary value refers to an additional value that the participants can perceive the item to hold, such as a perception that an item can represent one's identity. Using standard Q method procedure, 48 participants were directed to rank their agreement with 60 statements (written on cards, along a distribution of -5 to +5, according to the characteristics of the digital possession they would most like to maintain for a digital legacy. The ranked statements were analyzed using Q factor analysis, in order to perceive the most common statements associated with maintaining digital possessions for a digital legacy. Q method results suggested that most individuals described the digital possessions they wanted to maintain for a digital legacy using

  14. The importance of motivation factors in career development of primary and secondary school professionals

    Directory of Open Access Journals (Sweden)

    Petra Stepišnik

    2017-03-01

    Full Text Available This research examines the career motivation factors among Slovene teachers. They go hand in hand with two other processes: the psycho-social development of individuals and their family life. We present the results of the empirical research that was carried out on a sample of 360 professionals from primary and secondary schools. We established a scale for determining the importance of motivation factors by asking the professionals to grade their level of agreement with the statements considering the following motivational factors: the legislation and the organization of files in the context of school, the organisational climate and culture at schools, the school management, schools as learning organisations, the need of individuals for career development. We were interested if there exist any differences in the opinions of professionals in primary and secondary schools regarding the importance of individual motivation factors. We were also interested if there exists an interdependence between the final results and the individual variables. The findings are important for professionals and school management in schools that encourage career development. It would be sensible to take these findings into consideration when planning, as well as monitoring career development of school professionals.

  15. Survey and Research on Continuing Education Curriculum Construction for Primary and Secondary School Teachers

    Directory of Open Access Journals (Sweden)

    Yang Chao

    2015-01-01

    Full Text Available Continuing education curriculum construction is the key work to complete the teachers’ continuing education system, it is also an important part of the teachers’ specialization. This study aims to master the main problems of the current primary and secondary school teachers’ continuing education curriculum construction and put forward the corresponding improvement countermeasures. Research in Yunnan province of China as a case, through the Questionnaire Method, Interview Method and Factors Analysis Method, this study make an thorough analysis on the prominent questions of the curriculum resources informationization level, curriculum structure, curriculum practicability, curriculum management and curriculum evaluation mechanism of the primary and secondary school teachers continuing education curriculums construction. Study found that the curriculum construction should also increase the intensity of curriculum resources informatization, develop diversified curriculum resources, complete six modules, carry out a standardized and scientific management and diversified curriculum evaluation mechanism. Research data and conclusions both enrich the theory of the con-struction of the teachers continuing education curriculum, and also provide a practical reference for the admin-istrative department of education and teacher training institutions to formulate measures.

  16. Morphological studies in the diagnosis of primary and secondary bone tumors

    Directory of Open Access Journals (Sweden)

    Matveeva O.V.

    2016-12-01

    Full Text Available The aim: to show the possibility of morphological studies in the diagnosis of primary and secondary tumors of bones. Material and Methods. 105 (72% patients with primary bone tumors aged from 15 to 66 years and 42 (28% patients with metastatic bone lesions aged from 42 to 70 years were examined and treated for the period from 2008 till 2015. Material for morphological studies was prepared using an open biopsy tissue slices and a scraping resected tumor during surgery. Soft-tissue component is subjected to cytology. The material for histological study included changes in bone and soft tissue. Results. Giant cell tumor was verified in 45% of cases by histological examination. Multiple myeloma was diagnosed in 15% of patients. Osteogenic sarcoma was diagnosed in 14% of cases. Ewing's sarcoma was diagnosed in 3%, 2% of cases were matched by diagnosed chordoma. According to the data received, cancer metastasis of kidney and lung is mostly diagnosed in men from the group of patients with secondary bone defeat. Metastasis of cancer of the breast in women was predominated. Conclusion. The morphological (histological, cytological study plays an important role in the diagnosis of bone tumors. The coincidence of the cytological and histological diagnoses was 97%.

  17. Understanding radiation and risk: the importance of primary and secondary education

    Energy Technology Data Exchange (ETDEWEB)

    Tada, Junichiro [Japan Synchrotron Radiation Research Institute (SPring-8), Mikaduki, Hyogo (Japan)

    1999-09-01

    In Japan's primary and secondary schools, radiation and radioactivity are taught as part of the curriculum dealing with social science subjects. Students learn much about the hazardous features of radiation, but lack the scientific understanding necessary to build a more balanced picture. Although the same point applies to education covering the harmful effects of volcanic eruptions, earthquakes, electrical storms and so on, public understanding of these events is relatively high and students are generally able to make informed judgments about the risks involved. By contrast, their limited understanding of radiation often contributes to fears that it is evil or even supernatural. To correct this distortion, it is important that primary and secondary education includes a scientific explanation of radiation. Like heat and light, radiation is fundamental to the history of the universe; and scientific education programs should give appropriate emphasis to this important subject. Students would then be able to make more objective judgments about the useful and hazardous aspects of radiation. (author)

  18. Homeostatic migration and distribution of innate immune cells in primary and secondary lymphoid organs with ageing.

    Science.gov (United States)

    Nikolich-Žugich, J; Davies, J S

    2017-03-01

    Ageing of the innate and adaptive immune system, collectively termed immune senescence, is a complex process. One method to understand the components of ageing involves dissociating the effects of ageing on the cells of the immune system, on the microenvironment in lymphoid organs and tissues where immune cells reside and on the circulating factors that interact with both immune cells and their microenvironment. Heterochronic parabiosis, a surgical union of two organisms of disparate ages, is ideal for this type of study, as it has the power to dissociate the age of the cell and the age of the microenvironment into which the cell resides or is migrating. So far, however, it has been used sparingly to study immune ageing. Here we review the limited literature on homeostatic innate immune cell trafficking in ageing in the absence of chronic inflammation. We also review our own recent data on trafficking of innate immune subsets between primary and secondary lymphoid organs in heterochronic parabiosis. We found no systemic bias in retention or acceptance of neutrophils, macrophages, dendritic cells or natural killer cells with ageing in primary and secondary lymphoid organs. We conclude that these four innate immune cell types migrate to and populate lymphoid organs (peripheral lymph nodes, spleen and bone marrow), regardless of their own age and of the age of lymphoid organs. © 2017 British Society for Immunology.

  19. UV light selectively coinduces supply pathways from primary metabolism and flavonoid secondary product formation in parsley

    Science.gov (United States)

    Logemann, Elke; Tavernaro, Annette; Schulz, Wolfgang; Somssich, Imre E.; Hahlbrock, Klaus

    2000-01-01

    The UV light-induced synthesis of UV-protective flavonoids diverts substantial amounts of substrates from primary metabolism into secondary product formation and thus causes major perturbations of the cellular homeostasis. Results from this study show that the mRNAs encoding representative enzymes from various supply pathways are coinduced in UV-irradiated parsley cells (Petroselinum crispum) with two mRNAs of flavonoid glycoside biosynthesis, encoding phenylalanine ammonia-lyase and chalcone synthase. Strong induction was observed for mRNAs encoding glucose 6-phosphate dehydrogenase (carbohydrate metabolism, providing substrates for the shikimate pathway), 3-deoxyarabinoheptulosonate 7-phosphate synthase (shikimate pathway, yielding phenylalanine), and acyl-CoA oxidase (fatty acid degradation, yielding acetyl-CoA), and moderate induction for an mRNA encoding S-adenosyl-homocysteine hydrolase (activated methyl cycle, yielding S-adenosyl-methionine for B-ring methylation). Ten arbitrarily selected mRNAs representing various unrelated metabolic activities remained unaffected. Comparative analysis of acyl-CoA oxidase and chalcone synthase with respect to mRNA expression modes and gene promoter structure and function revealed close similarities. These results indicate a fine-tuned regulatory network integrating those functionally related pathways of primary and secondary metabolism that are specifically required for protective adaptation to UV irradiation. Although the response of parsley cells to UV light is considerably broader than previously assumed, it contrasts greatly with the extensive metabolic reprogramming observed previously in elicitor-treated or fungus-infected cells. PMID:10677554

  20. Influence of Handwriting Skills during Spelling in Primary and lower Secondary Grades

    Directory of Open Access Journals (Sweden)

    Virginie ePontart

    2013-11-01

    Full Text Available We sought to identify, the impact of handwriting skills on the efficiency and temporal course of word spelling across Grades 2-9. Eighty-four students, drawn from primary and lower secondary schools, were asked to perform a dictation task to assess their word spelling. They also had to write out the letters of the alphabet, as well as their firstnames and surnames, from memory to assess their handwriting skills. Handwriting kinematics were recorded using a digitizing tablet and a computer running Eye and Pen software. Results revealed that graphomotor skills (as assessed by the name writing task influenced the success and temporal course of spelling, but only in primary grades, whereas the influence of orthographic knowledge (as assessed by the alphabet task could still be observed in the lower secondary grades, even if it ceased to influence the temporal course and only affected errors. We discuss what these findings tell us about changes in transcription processes over the course of child development.

  1. Influence of handwriting skills during spelling in primary and lower secondary grades

    Science.gov (United States)

    Pontart, Virginie; Bidet-Ildei, Christel; Lambert, Eric; Morisset, Pauline; Flouret, Lisa; Alamargot, Denis

    2013-01-01

    We sought to identify, the impact of handwriting skills on the efficiency and temporal course of word spelling across Grades 2–9. Eighty-four students, drawn from primary and lower secondary schools, were asked to perform a dictation task to assess their word spelling. They also had to write out the letters of the alphabet, as well as their firstnames and surnames, from memory to assess their handwriting skills. Handwriting kinematics were recorded using a digitizing tablet and a computer running Eye and Pen software. Results revealed that graphomotor skills (as assessed by the name writing task) influenced the success and temporal course of spelling, but only in primary grades, whereas the influence of orthographic knowledge (as assessed by the alphabet task) could still be observed in the lower secondary grades, even if it ceased to influence the temporal course and only affected errors. We discuss what these findings tell us about changes in transcription processes over the course of child development. PMID:24204357

  2. Health promotion in schools of Primary and Secondary Education in Teresina, Piauí, Brazil

    Directory of Open Access Journals (Sweden)

    Elenita Maria Dias de Sousa Aguiar

    2011-01-01

    Full Text Available Health is a topic under discussion. It is a theme with a particular range that must be worked out and discussed since the first steps until old age. As information and education are ways of stimulating the interest and the knowledge of the population on the aspects related to the sanitary monitoring, the Brazilian National Agency for Sanitary Vigilance (Anvisa conceived the Education and Information Project. It develops educative actions in schools of Primary and Secondary Education starting from the theme health, aiming to increase the level of citizens’ awareness. It considers the multiplying factor represented by the children and the social function of school. This paper presents an experience account developed through an action defined by the Education and Information Project, which aimed to work out the health promotion with primary and secondary students of public schools. Amongst the results the following ones are highlighted: the identification of healthy practices with regard to the preservation of health; the distinction between drugs and medicines; greater awareness of the care with medicines; and obtaining more information on “selfmedication”.

  3. On the symmetry of nuclear identity between relativistic primary and secondary nuclei

    International Nuclear Information System (INIS)

    Lerman, L.

    2002-01-01

    Do secondary hadrons, freshly created in the collision of a relativistic heavy ion nucleus, have the same properties of nuclear interaction as those of an otherwise identical primary? To explore this question two types of experiments were performed, one in fact and one in fiction. The first was the scanning and measurement of an emulsion stack exposed to a 1.8 A GeV 40 Ar beam from Lawrence Berkeley Laboratory's Bevatron. This emulsion experiment is the first full-stack scan of a major exposure ever performed and includes 1418 stars of primary interactions, 1850 secondary stars, and tens of thousands of shower and slow heavily ionizing particles. As such it constitutes a dataset uniquely powerful in exploring questions of symmetry between primary and secondary populations. One of the emulsion results is the experimental determination (and to a particularly high accuracy for Z=2) that total (geometric) cross-section does not change with generation for the secondaries under study. The 'fictional' experiments are a set of Monte-Carlo simulations based on the transport code RHIP, itself built upon the results of the emulsions experiment. RHIP is designed to attack a number of problems ranging from particle physics to NASA's need to model the nuclear cascades induced by Galactic Cosmic Rays impinging on manned spacecraft. The major version of RHIP dealt with here is BFHL, a detailed modeling of a 1.8 A GeV 40 Ar beam on cylindrically symmetric sets of Cu targets. BFHL was then applied to the Copper Calorimetry Experiments also performed at Lawrence Berkeley Laboratory. The exhaustive simulation and analysis presented here shows that all but one of the variables considered can neither quantitatively nor qualitatively explain the results of the Copper Calorimetry Experiments. Amongst many others these failures of fit include all transport variables, the total cross-section (i.e. short mean free path), and a higher than normal Pt for shower particles. Instead, the Copper

  4. Primary Metabolism during Biosynthesis of Secondary Wall Polymers of Protoxylem Vessel Elements1[OPEN

    Science.gov (United States)

    Morisaki, Keiko; Sawada, Yuji; Sano, Ryosuke; Yamamoto, Atsushi; Kurata, Tetsuya; Suzuki, Shiro; Matsuda, Mami; Hasunuma, Tomohisa; Hirai, Masami Yokota

    2016-01-01

    Xylem vessels, the water-conducting cells in vascular plants, undergo characteristic secondary wall deposition and programmed cell death. These processes are regulated by the VASCULAR-RELATED NAC-DOMAIN (VND) transcription factors. Here, to identify changes in metabolism that occur during protoxylem vessel element differentiation, we subjected tobacco (Nicotiana tabacum) BY-2 suspension culture cells carrying an inducible VND7 system to liquid chromatography-mass spectrometry-based wide-target metabolome analysis and transcriptome analysis. Time-course data for 128 metabolites showed dynamic changes in metabolites related to amino acid biosynthesis. The concentration of glyceraldehyde 3-phosphate, an important intermediate of the glycolysis pathway, immediately decreased in the initial stages of cell differentiation. As cell differentiation progressed, specific amino acids accumulated, including the shikimate-related amino acids and the translocatable nitrogen-rich amino acid arginine. Transcriptome data indicated that cell differentiation involved the active up-regulation of genes encoding the enzymes catalyzing fructose 6-phosphate biosynthesis from glyceraldehyde 3-phosphate, phosphoenolpyruvate biosynthesis from oxaloacetate, and phenylalanine biosynthesis, which includes shikimate pathway enzymes. Concomitantly, active changes in the amount of fructose 6-phosphate and phosphoenolpyruvate were detected during cell differentiation. Taken together, our results show that protoxylem vessel element differentiation is associated with changes in primary metabolism, which could facilitate the production of polysaccharides and lignin monomers and, thus, promote the formation of the secondary cell wall. Also, these metabolic shifts correlate with the active transcriptional regulation of specific enzyme genes. Therefore, our observations indicate that primary metabolism is actively regulated during protoxylem vessel element differentiation to alter the cell’s metabolic

  5. Uptake and transport of manganese in primary and secondary olfactory neurones in pike.

    Science.gov (United States)

    Tjälve, H; Mejàre, C; Borg-Neczak, K

    1995-07-01

    gamma-spectrometry and autoradiography were used to examine the axoplasmic flow of manganese in the olfactory nerves and to study the uptake of the metal in the brain after application of 54Mn2+ in the olfactory chambers of pikes. The results show that the 54Mn2+ is taken up in the olfactory receptor cells and is transported at a constant rate along the primary olfactory neurones into the brain. The maximal velocity for the transported 54Mn2+ was 2.90 +/- 0.21 mm/hr (mean +/- S.E.) at 10 degrees, which was the temperature used in the experiments. The 54Mn2+ accumulated in the entire olfactory bulbs, although most marked in central and caudal parts. The metal was also seen to migrate into large areas of the telencephalon, apparently mainly via the secondary olfactory axons present in the medial olfactory tract. A transfer along fibres of the medial olfactory tract probably also explains the labelling which was seen in the diencephalon down to the hypothalamus. The results also showed that there is a pathway connecting the two olfactory bulbs of the pike and that this can carry the metal. Our data further showed a marked accumulation of 54Mn2+ in the meningeal epithelium and in the contents of the meningeal sacs surrounding the olfactory bulbs. It appears from our study that manganese has the ability to pass the synaptic junctions between the primary and the secondary olfactory neurones in the olfactory bulbs and to migrate along secondary olfactory pathways into the telencephalon and the diencephalon.(ABSTRACT TRUNCATED AT 250 WORDS)

  6. Hypofractionated radiotherapy for primary or secondary oligometastatic lung cancer using Tomotherapy

    International Nuclear Information System (INIS)

    Chang, Heng-Jui; Ko, Hui-Ling; Lee, Cheng-Yen; Wu, Ren-Hong; Yeh, Yu-Wung; Jiang, Jiunn-Song; Kao, Shang-Jyh; Chi, Kwan-Hwa

    2012-01-01

    To retrospectively review the outcome of patients with primary or secondary oligometastatic lung cancer, treated with hypofractionated Tomotherapy. Between April 2007 and June 2011, a total of 33 patients with oligometastatic intrapulmonary lesions underwent hypofractionated radiotherapy by Tomotherapy along with appropriate systemic therapy. There were 24 primary, and 9 secondary lung cancer cases. The radiation doses ranged from 4.5 to 7.0 Gy per fraction, multiplied by 8–16 fractions. The median dose per fraction was 4.5 Gy (range, 4.5-7.0 Gy), and the median total dose was 49.5 Gy (range, 45–72 Gy). The median estimated biological effective dose at 10 Gy (BED 10 ) was 71.8 Gy (range, 65.3–119.0 Gy), and that at 3 Gy (BED 3 ) was 123.8 Gy (range, 112.5–233.3 Gy). The mean lung dose (MLD) was constrained mainly under 1200 cGy. The median gross tumor volume (GTV) was 27.9 cm 3 (range: 2.5–178.1 cm 3 ). The median follow-up period was 25.8 months (range, 3.0–60.7 months). The median overall survival (OS) time was 32.1 months for the 24 primary lung cancer patients, and >40 months for the 9 metastatic lung patients. The median survival time of the patients with extra-pulmonary disease (EPD) was 11.2 months versus >50 months (not reached) in the patients without EPD (p < 0.001). Those patients with smaller GTV (≦27.9 cm 3 ) had a better survival than those with larger GTV (>27.9 cm 3 ): >40 months versus 12.85 months (p = 0.047). The patients with ≦2 lesions had a median survival >40 months, whereas those with ≧3 lesions had 26 months (p = 0.065). The 2-year local control (LC) rate was 94.7%. Only 2 patients (6.1%) developed ≧grade 3 radiation pneumonitis. Using Tomotherapy in hypofractionation may be effective for selected primary or secondary lung oligometastatic diseases, without causing significant toxicities. Pulmonary oligometastasis patients without EPD had better survival outcomes than those with EPD. Moreover, GTV is more significant than

  7. Hypofractionated radiotherapy for primary or secondary oligometastatic lung cancer using Tomotherapy

    Science.gov (United States)

    2012-01-01

    Background To retrospectively review the outcome of patients with primary or secondary oligometastatic lung cancer, treated with hypofractionated Tomotherapy. Methods Between April 2007 and June 2011, a total of 33 patients with oligometastatic intrapulmonary lesions underwent hypofractionated radiotherapy by Tomotherapy along with appropriate systemic therapy. There were 24 primary, and 9 secondary lung cancer cases. The radiation doses ranged from 4.5 to 7.0 Gy per fraction, multiplied by 8–16 fractions. The median dose per fraction was 4.5 Gy (range, 4.5-7.0 Gy), and the median total dose was 49.5 Gy (range, 45–72 Gy). The median estimated biological effective dose at 10 Gy (BED10) was 71.8 Gy (range, 65.3–119.0 Gy), and that at 3 Gy (BED3) was 123.8 Gy (range, 112.5–233.3 Gy). The mean lung dose (MLD) was constrained mainly under 1200 cGy. The median gross tumor volume (GTV) was 27.9 cm3 (range: 2.5–178.1 cm3). Results The median follow-up period was 25.8 months (range, 3.0–60.7 months). The median overall survival (OS) time was 32.1 months for the 24 primary lung cancer patients, and >40 months for the 9 metastatic lung patients. The median survival time of the patients with extra-pulmonary disease (EPD) was 11.2 months versus >50 months (not reached) in the patients without EPD (p 27.9 cm3): >40 months versus 12.85 months (p = 0.047). The patients with ≦2 lesions had a median survival >40 months, whereas those with ≧3 lesions had 26 months (p = 0.065). The 2-year local control (LC) rate was 94.7%. Only 2 patients (6.1%) developed ≧grade 3 radiation pneumonitis. Conclusion Using Tomotherapy in hypofractionation may be effective for selected primary or secondary lung oligometastatic diseases, without causing significant toxicities. Pulmonary oligometastasis patients without EPD had better survival outcomes than those with EPD. Moreover, GTV is more significant than lesion number in

  8. Pulmonary rehabilitation in COPD – available resources and utilization in Swedish primary and secondary care

    Directory of Open Access Journals (Sweden)

    Sundh J

    2017-06-01

    Full Text Available Josefin Sundh,1 Helena Lindgren,2 Mikael Hasselgren,2 Scott Montgomery,3–5 Christer Janson,6 Björn Ställberg,7 Karin Lisspers7 1Department of Respiratory Medicine, School of Medical Sciences, 2Medical Programme, School of Medical Sciences, 3Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro, 4Clinical Epidemiology Unit, Department of Medicine, Karolinska Institutet, Stockholm, Sweden; 5Department of Epidemiology and Public Health, University College, London, UK; 6Department of Medical Sciences, Respiratory, Allergy and Sleep Research, 7Department of Public Health and Caring Science, Family Medicine and Preventive Medicine, Uppsala University, Uppsala, Sweden Introduction: Pulmonary rehabilitation is effective in all stages of COPD. The availability and utilization of pulmonary rehabilitation resources, and the characteristics of COPD patients receiving rehabilitation, were investigated in primary and secondary care in central Sweden. Materials and methods: Data on available pulmonary rehabilitation resources were collected using questionnaires, to 14 hospitals and 54 primary health care centers, and information on utilization of different rehabilitation professionals was obtained from questionnaires completed by 1,329 COPD patients from the same centers. Multivariable logistic regression examined associations with having received rehabilitation in the previous year. Results: In primary care, nurse-based asthma/COPD clinics were common (87%, with additional separate access to other rehabilitation professionals. In secondary care, rehabilitation was more often offered as part of a multidisciplinary teamwork (71%. In total, 36% of the patients met an asthma/COPD nurse in the previous year. Utilization was lower in primary than in secondary care for physiotherapists (7% vs 16%, occupational therapists (3% vs 10%, nutritionists (5% vs 13%, and counselors (1% vs 4%. A higher COPD Assessment Test score

  9. Hypofractionated radiotherapy for primary or secondary oligometastatic lung cancer using Tomotherapy

    Directory of Open Access Journals (Sweden)

    Chang Heng-Jui

    2012-12-01

    Full Text Available Abstract Background To retrospectively review the outcome of patients with primary or secondary oligometastatic lung cancer, treated with hypofractionated Tomotherapy. Methods Between April 2007 and June 2011, a total of 33 patients with oligometastatic intrapulmonary lesions underwent hypofractionated radiotherapy by Tomotherapy along with appropriate systemic therapy. There were 24 primary, and 9 secondary lung cancer cases. The radiation doses ranged from 4.5 to 7.0 Gy per fraction, multiplied by 8–16 fractions. The median dose per fraction was 4.5 Gy (range, 4.5-7.0 Gy, and the median total dose was 49.5 Gy (range, 45–72 Gy. The median estimated biological effective dose at 10 Gy (BED10 was 71.8 Gy (range, 65.3–119.0 Gy, and that at 3 Gy (BED3 was 123.8 Gy (range, 112.5–233.3 Gy. The mean lung dose (MLD was constrained mainly under 1200 cGy. The median gross tumor volume (GTV was 27.9 cm3 (range: 2.5–178.1 cm3. Results The median follow-up period was 25.8 months (range, 3.0–60.7 months. The median overall survival (OS time was 32.1 months for the 24 primary lung cancer patients, and >40 months for the 9 metastatic lung patients. The median survival time of the patients with extra-pulmonary disease (EPD was 11.2 months versus >50 months (not reached in the patients without EPD (p 3 had a better survival than those with larger GTV (>27.9 cm3: >40 months versus 12.85 months (p = 0.047. The patients with ≦2 lesions had a median survival >40 months, whereas those with ≧3 lesions had 26 months (p = 0.065. The 2-year local control (LC rate was 94.7%. Only 2 patients (6.1% developed ≧grade 3 radiation pneumonitis. Conclusion Using Tomotherapy in hypofractionation may be effective for selected primary or secondary lung oligometastatic diseases, without causing significant toxicities. Pulmonary oligometastasis patients without EPD had better survival outcomes than those with

  10. Calculation of primary and secondary dose in proton therapy of brain tumors using Monte Carlo method

    International Nuclear Information System (INIS)

    Moghbel Esfahani, F.; Alamatsaz, M.; Karimian, A.

    2012-01-01

    High-energy beams of protons offer significant advantages for the treatment of deep-seated local tumors. Their physical depth-dose distribution in tissue is characterized by a small entrance dose and a distinct maximum - Bragg peak - near the end of range with a sharp falloff at the distal edge. Therefore, research must be done to investigate the possible negative and positive effects of using proton therapy as a treatment modality. In proton therapy, protons do account for the vast majority of dose. However, when protons travel through matter, secondary particles are created by the interactions of protons and matter en route to and within the patient. It is believed that secondary dose can lead to secondary cancer, especially in pediatric cases. Therefore, the focus of this work is determining both primary and secondary dose. Dose calculations were performed by MCNPX in tumoral and healthy parts of brain. The brain tumor has a 10 mm diameter and is located 16 cm under the skin surface. The brain was simulated by a cylindrical water phantom with the dimensions of 19 x 19cm 2 (length x diameter), with 0.5 cm thickness of plexiglass (C 4 H 6 O 2 ). Then beam characteristics were investigated to ensure the accuracy of the model. Simulations were initially validated with against packages such as SRIM/TRIM. Dose calculations were performed using different configurations to evaluate depth-dose profiles and dose 2D distributions.The results of the simulation show that the best proton energy interval, to cover completely the brain tumor, is from 152 to 154 MeV. (authors)

  11. Performance modeling of a two-tier primary-secondary network with IEEE 802.11 broadcast scheme

    KAUST Repository

    Khabazian, Mehdi

    2011-03-01

    In this paper, we study the performance of a two-tier primary-secondary network based on IEEE 802.11 broadcast scheme. We assume that a number of primary and secondary users coexist in the radio environment and share a single band. To protect the primary users\\' priority, the secondary users are allowed to contend for the channel only if they sense it idle for a certain sensing time. Considering an exponential packet inter-arrival time for the primary network, we model each primary user as an independent M/G/1 queue. Subsequently, we determine the primary users\\' average medium access delay in the presence of secondary users as well as the hybrid network\\'s throughput. Numerical results and discussions show the effects of parameters pertaining to the secondary users, such as as sensing time, packet payload size and population size, on the performance of the primary network. Furthermore, we provide simulation results which confirm the accuracy of the proposed analysis. © 2011 IEEE.

  12. Performance modeling of a two-tier primary-secondary network with IEEE 802.11 broadcast scheme

    KAUST Repository

    Khabazian, Mehdi; Aissa, Sonia; El Kefi, Rania

    2011-01-01

    In this paper, we study the performance of a two-tier primary-secondary network based on IEEE 802.11 broadcast scheme. We assume that a number of primary and secondary users coexist in the radio environment and share a single band. To protect the primary users' priority, the secondary users are allowed to contend for the channel only if they sense it idle for a certain sensing time. Considering an exponential packet inter-arrival time for the primary network, we model each primary user as an independent M/G/1 queue. Subsequently, we determine the primary users' average medium access delay in the presence of secondary users as well as the hybrid network's throughput. Numerical results and discussions show the effects of parameters pertaining to the secondary users, such as as sensing time, packet payload size and population size, on the performance of the primary network. Furthermore, we provide simulation results which confirm the accuracy of the proposed analysis. © 2011 IEEE.

  13. A national day with near zero emissions and its effect on primary and secondary pollutants

    Science.gov (United States)

    Levy, Ilan

    2013-10-01

    Traffic related air pollution is a major health concern in many countries. The potential costs and benefits of different abatement policies are usually estimated by either models, case studies or previously implemented intervention measures. Such estimations have, however, limited ability to predict the effect of a reduction in primary pollutants' emissions on secondary pollutants such as ozone, because of the nonlinear nature of the photochemical reactions. This study examines the short term effects of a drastic change in emissions on a national scale during the Jewish holiday of Day of Atonement (DA) in Israel. During the holiday nearly all anthropogenic emission sources are ceased for a period of 25 h, including all vehicles, commercial, industrial and recreational activities. DAs during the 15 years period of 1998-2012 are analyzed at three sites with respect to primary and secondary air pollutants, and in greater details for 2001. A dramatic decrease in primary pollutants emissions (83-98% in NO) causes an 8 ppbv increase in ozone at the urban core. Downwind (27 km), ozone decreases by only 5 ppbv. Nighttime O3 is shown to increase to 20 ppbv at the urban sites and 30 ppbv downwind. In spite of the striking reduction in emissions, changes in ozone are not greater than what is reported in the literature about less significant events like the ozone weekend effect. Changes in ambient pollution levels observed during DA provide some indication to the possible outcomes of a major change in anthropogenic emissions. These may be considered as the best case scenario for emissions reduction intervention measures and thus aid policy makers in evaluating potential benefits of such measures.

  14. Dermis-Fat Graft in Children as Primary and Secondary Orbital Implant.

    Science.gov (United States)

    Quaranta-Leoni, Francesco M; Sposato, Sabrina; Raglione, Pietro; Mastromarino, Angelo

    2016-01-01

    To report the experience with the use of dermis-fat graft in the pediatric population and to evaluate the outcome of this procedure as a primary or secondary orbital implant. Case series. Analysis of the clinical charts of 22 patients. Age at the time of surgery ranged from 2.1 to 13 years. Three patients affected were submitted to evisceration with primary dermis-fat graft. Six patients had explantation of exposed implants and a replacement with a dermis-fat graft. Three patients had a dermis-fat graft to repair contracted sockets. Ten patients were affected by congenital anophthalmia: 4 patients had a primary dermis-fat graft, 6 patients had a removal of a socket expander, or an orbital spherical expander, or pellet expanders and a replacement with a dermis-fat graft. This study adheres to the principles outlined in the Declaration of Helsinki. The patients' follow up ranged between 2.5 and 8 years. Only 1 child who had a primary dermis-fat graft experienced excessive growth of the implant, managed by surgical debulking. In the end, all the patients showed satisfactory orbital volume along with adequate fornices. The dermis-fat graft as a primary implant may be useful in children with severe scleromalacia or following ocular trauma. It is a suitable option in children affected by congenital anophthalmia as it helps continued socket expansion. It can also be considered in the pediatric population to address the volume deficit following explantation of exposed implants and in contracted sockets.

  15. Surgical management of pilonidal sinus patients by primary and secondary repair methods: a comparative study

    Directory of Open Access Journals (Sweden)

    Haji Barati B

    2010-12-01

    Full Text Available "n Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 /* 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:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Background: Gross difference in return to work exists in pilonidal sinus patients operated by primary and secondary repair. This survey was to evaluate the results of surgical management of pilonidal sinus with primary or secondary closure."n"nMethods: In a randomized clinical trial, patients with pilonidal sinus referring to the surgical clinic of Shariati Hospital in Tehran, Iran between March 2007 and March 2009 were underwent either excision with midline closure (primary, n=40, or excision without closure (secondary, n=40. The recorded outcomes were hospital stay, healing time, time off work, postoperative pain, patient's satisfaction and the recurrence rate."n"nResults: Majority of the patients were male (87.50%. There was no significant difference in the hospital stay. Time off work (8.65±1.73 Vs. 11.53±2.33 days, p=0.001 and healing time (3.43±0.92 Vs. 5.3±0.79 days, p=0.001 were shorter in primary group; but, there were no significant differences in hospital stay and number of visits. Intensity of postoperative pain in the 1st (37.75±6.5 Vs. 43.63±5.06, p=0.001, 2nd (26.75±6.66 Vs. 34.63±5.48, p=0.001, 3rd (18.25±6.05 Vs. 27.88±6.88, p=0.001, and 7th (8.45±3.85 Vs. 17.88±6.19, p=0.001 days were

  16. Investigation of primary-to-secondary leakage accident on the PSB-VVER integral test facility

    International Nuclear Information System (INIS)

    Lipatov, I.A.; Dremin, G.I.; Galtchanskaya, S.A.; Chmal, I.I.; Moloshnikov, A.S.; Gorbunov, Y.S.; Antonova, A.I.; Elkin, I.V.

    2001-01-01

    The full text follows. The paper presents the main results from the test on primary-to-secondary leakage of 100 mm in equivalent diameter. The test was performed on the PSB-VVER integral test facility. PSB-VVER is a 4-loops scaled down model of primary system of NPP with VVER-1000 Russian type reactor. Volume - power scale is about 1/300 while elevation scale is 1/1. All components of the primary system of the reference NPP are modeled on PSB-VVER. Both passive (accumulators) and active (high and low pressure) ECCSs, pressurizer spray and relief circuits, feed water system and atmospheric dumping system (ADS) as well as the primary circuit gas remove emergency system are also simulated. The primary-to-secondary leakage was simulated using an external break line which connects the upper part of the hot header to SG water volume. The break line included a break nozzle (a cylindrical channel d = 5.8 mm, l/d = 10 with sharp inlet edge), quick-acting valve and two-phase mass flow rate measurement system. In addition loss of off-site power at the moment when a scram-signal is generated was assumed in the experiment. Thus the accident is to be considered as a beyond-design-basic one. The loss of off-site power results in the following: -main circulation pump shutdown; -pressurizer heaters switching off; -HPIS water cooling flow rate and number of points of water injection are reduced The study focuses on the adequacy of the associated accident management (AM) procedure developed by EDO ''GIDROPRESS'' as a General Designer of VVER-type reactors. The AM-procedure was adopted to the PSB-VVER test facility conditions using CATHARE (France) and DINAMIKA (Russia) codes analysis. The AM-procedure in PSB-VVER is as follows: after about 30 min of the onset of the accident, when the accident type and the localization of the SG affected become evident for the operator, he closes all the main steam isolation valves, inhibits the ADS actuation in the affected SG and begins to remove

  17. Investigation of primary-to-secondary leakage accident on the PSB-VVER integral test facility

    Energy Technology Data Exchange (ETDEWEB)

    Lipatov, I.A.; Dremin, G.I.; Galtchanskaya, S.A.; Chmal, I.I.; Moloshnikov, A.S.; Gorbunov, Y.S.; Antonova, A.I. [Electrogorsk Research and Engineering Center, EREC, Moscow (Russian Federation); Elkin, I.V. [RRC ' ' Kurchatov Institute, Moscow (Russian Federation)

    2001-07-01

    The full text follows. The paper presents the main results from the test on primary-to-secondary leakage of 100 mm in equivalent diameter. The test was performed on the PSB-VVER integral test facility. PSB-VVER is a 4-loops scaled down model of primary system of NPP with VVER-1000 Russian type reactor. Volume - power scale is about 1/300 while elevation scale is 1/1. All components of the primary system of the reference NPP are modeled on PSB-VVER. Both passive (accumulators) and active (high and low pressure) ECCSs, pressurizer spray and relief circuits, feed water system and atmospheric dumping system (ADS) as well as the primary circuit gas remove emergency system are also simulated. The primary-to-secondary leakage was simulated using an external break line which connects the upper part of the hot header to SG water volume. The break line included a break nozzle (a cylindrical channel d = 5.8 mm, l/d = 10 with sharp inlet edge), quick-acting valve and two-phase mass flow rate measurement system. In addition loss of off-site power at the moment when a scram-signal is generated was assumed in the experiment. Thus the accident is to be considered as a beyond-design-basic one. The loss of off-site power results in the following: -main circulation pump shutdown; -pressurizer heaters switching off; -HPIS water cooling flow rate and number of points of water injection are reduced The study focuses on the adequacy of the associated accident management (AM) procedure developed by EDO ''GIDROPRESS'' as a General Designer of VVER-type reactors. The AM-procedure was adopted to the PSB-VVER test facility conditions using CATHARE (France) and DINAMIKA (Russia) codes analysis. The AM-procedure in PSB-VVER is as follows: after about 30 min of the onset of the accident, when the accident type and the localization of the SG affected become evident for the operator, he closes all the main steam isolation valves, inhibits the ADS actuation in the affected SG

  18. Improving care planning and coordination for service users with medical co-morbidity transitioning between tertiary medical and primary care services.

    Science.gov (United States)

    Cranwell, K; Polacsek, M; McCann, T V

    2017-08-01

    WHAT IS KNOWN ON THE SUBJECT?: Mental health service users with medical co-morbidity frequently experience difficulties accessing and receiving appropriate treatment in emergency departments. Service users frequently experience fragmented care planning and coordinating between tertiary medical and primary care services. Little is known about mental health nurses' perspectives about how to address these problems. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: Emergency department clinicians' poor communication and negative attitudes have adverse effects on service users and the quality of care they receive. The findings contribute to the international evidence about mental health nurses' perspectives of service users feeling confused and frustrated in this situation, and improving coordination and continuity of care, facilitating transitions and increasing family and caregiver participation. Intervention studies are needed to evaluate if adoption of these measures leads to sustainable improvements in care planning and coordination, and how service users with medical co-morbidity are treated in emergency departments in particular. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Effective planning and coordination of care are essential to enable smooth transitions between tertiary medical (emergency departments in particular) and primary care services for service users with medical co-morbidity. Ongoing professional development education and support is needed for emergency department clinicians. There is also a need to develop an organized and systemic approach to improving service users' experience in emergency departments. Introduction Mental health service users with medical co-morbidity frequently experience difficulties accessing appropriate treatment in medical hospitals, and often there is poor collaboration within and between services. Little is known about mental health nurses' perspectives on how to address these problems. Aim To explore mental health nurses

  19. Grade differences in reading motivation among Hong Kong primary and secondary students.

    Science.gov (United States)

    Lau, Kit-Ling

    2009-12-01

    Most previous studies in Western societies have demonstrated a general decline in school motivation. However, it is not clear whether motivational decline occurs uniformly for all students. The moderating effects of individual and cultural differences on students' motivational decline need to be further explored. This study aimed to examine the grade differences in students' reading motivation, including self-efficacy, intrinsic motivation, extrinsic motivation, and social motivation, in a Chinese educational context. Grade by gender and grade by school-average achievement interactions were also checked to explore the role of individual differences in students' motivational changes. A total of 1,794 students (860 boys and 934 girls) volunteered to take part in this study, of whom 648 were Grade 4-6 students from 11 primary schools, 627 were Grade 7-9 students from 12 junior secondary schools, and 519 Grade 10-11 students from 6 senior secondary schools. A Chinese version of the Motivation for Reading Questionnaire (CRMQ) was administered to all participants during regular class periods by their teachers. Reliability analyses and confirmatory factor analysis (CFA) were first undertaken to assess the psychometric quality of the CRMQ. Then, multisample CFA was conducted to examine whether the factor structure of the CRMQ was equivalent across students at different grade levels. Grade differences in various reading motivation constructs as well as grade x gender and grade x school-average achievement interactions were examined using multiple-indicator-multiple-causes modelling. The findings of this study supported the reliability and the factor structure of the CRMQ in measuring the reading motivation of Chinese students at different grade levels. The factor pattern of the CRMQ was invariant across primary, junior secondary, and senior secondary students in multisample CFA. As far as the scores on the four reading motivation constructs were concerned, students scored

  20. Rare earth metals-primary resources and prospects of processing secondary resources in India

    International Nuclear Information System (INIS)

    Pandey, B.D.

    2015-01-01

    The importance of Rare earth metals (REMs) in modern technological applications is associated with their spectroscopic and magnetic properties. The occurrence of rare earths in mixed form is commonly reported and their separation to the individual metal is a challenging task because of the similar chemical properties. The economical processing of the primary ores of rare earths is limited to a few countries and their supply at the international level is currently dominated by China. Hence assessing the present scenario of the primary resources of rare earths vis-à-vis their applications and demand is crucial at this stage, besides looking at the alternate resources to ensure availability of REMs; such aspects are covered in the manuscript. In view of the environmental concerns in the processing of ores such as monazite, xenotime, bastnasite, etc, and increasing demand of REMs, corresponding increase in demand of the raw materials has been recorded. It is therefore, necessary to utilize the end-of the-life rare earth containing materials as a rich resource by developing an appropriate recycling technology, which is emerging as a high priority area. To recover the REMs, major secondary resources such as electronic wastes, industrial wastes, spent catalysts and magnets, and phosphors powder, etc, have been considered for now. This will not only open the prospects of utilizing the wastes containing REMs, but will also limit the imports while lowering the production cost and decreasing the load on the primary reserves. The paper also examines the efficient recycling methods to recover a fairly good amount of rare earths which are relevant to India in view of the limited exploitation of the ores. Recovery of REMs from secondary resources using mechanical treatment followed by hydrometallurgical methods is prevalent and the same is reviewed in some detail. The recent R and D work pursued at CSIR-NML to extract (leaching and metal separation using some phosphatic reagents

  1. Thermal pre-treatment of primary and secondary sludge at 70ºC prior to anaerobic digestion

    DEFF Research Database (Denmark)

    Skiadas, Ioannis V.; Gavala, H.N.; Lu, Jingquan

    2005-01-01

    . The present study investigates the effect of the pre-treatment at 70 degrees C on thermophilic (55 degrees C) anaerobic digestion of primary and secondary sludge in continuously operated digesters. Thermal pre-treatment of primary and secondary sludge at 70 degrees C enhanced the removal of organic matter...... and the methane production during the subsequent anaerobic digestion step at 55 degrees C. It also greatly contributed to the destruction of pathogens present in primary sludge. Finally it results in enhanced microbial activities of the subsequent anaerobic step suggesting that the same efficiencies in organic...... matter removal and methane recovery could be obtained at lower HRTs....

  2. A multicentre, randomised controlled, non-inferiority trial, comparing nasal high flow with nasal continuous positive airway pressure as primary support for newborn infants with early respiratory distress born in Australian non-tertiary special care nurseries (the HUNTER trial): study protocol.

    Science.gov (United States)

    Manley, Brett J; Roberts, Calum T; Arnolda, Gaston R B; Wright, Ian M R; Owen, Louise S; Dalziel, Kim M; Foster, Jann P; Davis, Peter G; Buckmaster, Adam G

    2017-06-23

    Nasal high-flow (nHF) therapy is a popular mode of respiratory support for newborn infants. Evidence for nHF use is predominantly from neonatal intensive care units (NICUs). There are no randomised trials of nHF use in non-tertiary special care nurseries (SCNs). We hypothesise that nHF is non-inferior to nasal continuous positive airway pressure (CPAP) as primary support for newborn infants with respiratory distress, in the population cared for in non-tertiary SCNs. The HUNTER trial is an unblinded Australian multicentre, randomised, non-inferiority trial. Infants are eligible if born at a gestational age ≥31 weeks with birth weight ≥1200 g and admitted to a participating non-tertiary SCN, are 1 hour. Infants are randomised to treatment with either nHF or CPAP. The primary outcome is treatment failure within 72 hours of randomisation, as determined by objective oxygenation, apnoea or blood gas criteria or by a clinical decision that urgent intubation and mechanical ventilation, or transfer to a tertiary NICU, is required. Secondary outcomes include incidence of pneumothorax requiring drainage, duration of respiratory support, supplemental oxygen and hospitalisation, costs associated with hospital care, cost-effectiveness, parental stress and satisfaction and nursing workload. Multisite ethical approval for the study has been granted by The Royal Children's Hospital, Melbourne, Australia (Trial Reference No. 34222), and by each participating site. The trial is currently recruiting in eight centres in Victoria and New South Wales, Australia, with one previous site no longer recruiting. The trial results will be published in a peer-reviewed journal and will be presented at national and international conferences. Australian and New Zealand Clinical Trials Registry (ANZCTR): ACTRN12614001203640; pre-results. © 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

  3. Assessment of knowledge, attitude and practice of adverse drug reaction reporting among healthcare professionals in secondary and tertiary hospitals in the capital of Pakistan

    Directory of Open Access Journals (Sweden)

    Zaka Un Nisa

    2018-05-01

    Full Text Available Adverse Drug Reactions (ADRs underreporting is a great challenge to pharmacovigilance. Healthcare professionals should consider ADR reporting as their professional obligation because the effective system of ADR reporting is important to improve patient care and safety. This study was designed to assess the knowledge, attitude, practice and factors associated with ADR reporting by healthcare professionals (physicians and pharmacists in secondary and tertiary hospitals of Islamabad. A pretested questionnaire comprising of 27 questions (knowledge 12, attitude 4, practice 9 and factors influencing ADR reporting 2 was administered to 384 physicians and pharmacists in public and private hospitals. Respondents were evaluated for their knowledge, attitude and practice related to ADR reporting. Additionally, the factors which encourage and discourage respondents to report ADRs were also determined. The data was analysed by using SPSS statistical software. Among 384 respondents, 367 provided responses to questionnaire, giving a response rate of 95.5%. The mean age was 28.3 (SD = 6.7. Most of the respondents indicated poor ADR reporting knowledge (83.1%. The majority of respondents (78.2% presented a positive attitude towards ADR reporting and only a few (12.3% hospitals have good ADR reporting practice. The seriousness of ADR, unusualness of reaction, new drug involvement and confidence in the diagnosis of ADR are the factors which encourage respondents to report ADR whereas lack of knowledge regarding where and how to report ADR, lack of access to ADR reporting form, managing patient is more important than reporting ADR legal liability issues were the major factors which discourage respondents to report ADR. The study reveals poor knowledge and practice regarding ADR reporting. However, most of the respondents have shown a positive attitude towards ADR reporting. There is a serious need for educational training as well as sincere and sustained

  4. DESIGNING EDUCATIONAL PROCESS OF FORMING SOCIAL AND PEDAGOGICAL COMPETENCE OF FUTURE PRIMARY SCHOOL TEACHERS IN INCLUSIVE SECONDARY SCHOOL

    Directory of Open Access Journals (Sweden)

    Zoia Shevtsiv

    2017-04-01

    Full Text Available The article is devoted to the issue of social and pedagogical competence of future primary school teacher in inclusive secondary schools. The aim of the article is to define the concept “design” and “pedagogical design”; to disclose methodological approaches and main features of pedagogical design of forming of social and pedagogical competence of future primary school teacher in inclusive secondary schools; to identify structural elements of social and pedagogical competence. The article analyzes the essence of the concept “design”. The process of designing educational system of social and pedagogical competence of future primary school teacher in inclusive secondary school is based on several interrelated methodological approaches, including systematic, axiological, active, person-centered, contextual acmeological, and competential ones. Important factors and theoretical starting positions are designing general principles of education: humanism and democracy; principles of teaching, scientific, professional orientation, integrity, communication theory and practice, consistency and systematic, variability, pedagogical creativity. The special principles are the following: problematic, technologizing, dialogization, and competence ones. Social and pedagogical competence of future primary school teachers in inclusive secondary school is structured by the cognitive, active, professional and personal components. Structure components are defined as a synthesis of social and pedagogical competences, educational and developmental, communicative, diagnostic, organizational, predictive, preventive, security and defense, correctional and rehabilitation, adaptation items. Established continuity of the educational process of forming social and pedagogical competence of future primary school teacher in inclusive secondary school takes place during the period of study in higher education establishments. The following conclusions are drawn that

  5. Platelet aggregation inhibitors in primary and secondary prevention of ischemic stroke

    Directory of Open Access Journals (Sweden)

    von der Schulenburg, Johann-Matthias

    2006-04-01

    Full Text Available Background: The ischaemic stroke (IS is one of the most frequent cause of death in Germany. Besides of non-drug many drug-based interventions are used in primary or secondary prevention of IS, among them the thrombocyte aggregation inhibitors (TAI. Objectives: The evaluation addresses the questions on medical efficacy and cost-effectiveness of the TAI administration in the prevention of IS as compared to the management of risk factors alone as well as to the use of anticoagulant drugs. Methods: The literature search for articles published after 1997 was conducted in December 2003 in the most important medical and economic databases. The medical analysis was performed on the basis of the most up-to date meta-analyses of randomised controlled trials (RCT as well as of new published RCT. The data from the studies for stroke, bleeding complications as well as for the combined endpoint "severe vascular events" (SVE: death or stroke or myocardial infarction were summarised in meta-analyses.In order to include grey literature contact has been taken up with the pharmaceutical manufacturers of TAI. Results are presented in a descriptive way. Results: The medical analysis included data from 184 RCT (vs. placebo and from 22 RCT (vs. anticoagulant drugs. The absolute reduction of IS (4.8% vs. 6.6%; p<0,00001 and SVE (10.0% vs. 12.4%; p<0,00001 were definitely higher than the absolute increase of bleeding complications (1.6% vs. 0.9%; p<0,00001, but relatively similar to this absolute increase in a subpopulation with a low risk for SVE. With regard to the stroke prevention, evidence of efficacy could be yielded for acetylsalicil acid (ASA, dipyridamole, cilostazol, ridogrel and the combination ASA with dipyridamole. ASA is less effective than anticoagulants in the prevention of ischaemic stroke in atrial fibrillation, however, it causes fewer bleeding complications.Low dosed ASA can be considered cost-effective in secondary prevention of ischemic stroke

  6. The Simplest Chronoscope V: A Theory of Dual Primary and Secondary Reaction Time Systems.

    Science.gov (United States)

    Montare, Alberto

    2016-12-01

    Extending work by Montare, visual simple reaction time, choice reaction time, discriminative reaction time, and overall reaction time scores obtained from college students by the simplest chronoscope (a falling meterstick) method were significantly faster as well as significantly less variable than scores of the same individuals from electromechanical reaction timers (machine method). Results supported the existence of dual reaction time systems: an ancient primary reaction time system theoretically activating the V5 parietal area of the dorsal visual stream that evolved to process significantly faster sensory-motor reactions to sudden stimulations arising from environmental objects in motion, and a secondary reaction time system theoretically activating the V4 temporal area of the ventral visual stream that subsequently evolved to process significantly slower sensory-perceptual-motor reactions to sudden stimulations arising from motionless colored objects. © The Author(s) 2016.

  7. MENTORING IN THE PROFESSIONAL DEVELOPMENT OF PRIMARY AND SECONDARY SCHOOL TEACHERS

    Directory of Open Access Journals (Sweden)

    SUCHÁNKOVÁ, Eliška

    2017-03-01

    Full Text Available The contribution presents the results of research focused on analysing methodical support for teacher education via mentoring, and familiarizes itself with the ascertained efficiency of the established mentoring programme in pilot schools in the Zlín region from the perspective of primary and secondary school teachers. The research shows that teachers’ evaluation of their own professional coaching competencies plays an important role in the perception of the mentoring’s efficiency. The higher the level of mastery of these competencies that the teachers attain in their own opinion, the better mentors they feel they are, the more they perceive mentoring as beneficial, and the more they use it in practice. At the same time, it is shown that the evaluation of own professional coaching competencies depends on the level of inner motivation to become involved in the mentoring course.

  8. Discerning Primary and Secondary Factors Responsible for Clinical Fatigue in Multisystem Diseases

    Directory of Open Access Journals (Sweden)

    David Maughan

    2014-09-01

    Full Text Available Fatigue is a common symptom of numerous acute and chronic diseases, including myalgic encephalomyelitis/chronic fatigue syndrome, multiple sclerosis, heart failure, cancer, and many others. In these multi-system diseases the physiological determinants of enhanced fatigue encompass a combination of metabolic, neurological, and myofibrillar adaptations. Previous research studies have focused on adaptations specific to skeletal muscle and their role in fatigue. However, most have neglected the contribution of physical inactivity in assessing disease syndromes, which, through deconditioning, likely contributes to symptomatic fatigue. In this commentary, we briefly review disease-related muscle phenotypes in the context of whether they relate to the primary disease or whether they develop secondary to reduced physical activity. Knowledge of the etiology of the skeletal muscle adaptations in these conditions and their contribution to fatigue symptoms is important for understanding the utility of exercise rehabilitation as an intervention to alleviate the physiological precipitants of fatigue.

  9. Student dropout in primary and secondary education in the Republic of Serbia

    Directory of Open Access Journals (Sweden)

    Krstić Ksenija

    2017-01-01

    Full Text Available Student dropout from school is a serious problem in educational systems all over the world. This paper will provide an overview of the various dropout definitions and their consequences for measuring and monitoring. Since a diversity of factors (individual, familial, school and systematic is connected with student attrition in foreign research, the attempt has been made to systematise their results and provide data regarding similar Serbian studies. Considering the fact that there are no systematic analyses of students’ dropout rate in Serbia, the existing data from primary and secondary schools from a variety of statistical sources will be presented. We conclude that one way to reduce dropout in Serbia is to further develop research interest in the topic, as well as the strategies for monitoring, prevention and intervention.

  10. Coronary cineangiography and ionizing radiation exposure to patients: analysis of primary and secondary beam

    International Nuclear Information System (INIS)

    Ramirez, Alfredo; Leyton, Fernando; Silva, Ana Maria; Farias, Eric

    2001-01-01

    The purpose of this work was to determine the level of exposure dose to patients during coronariographies in different areas of body. This study has presented the medical surveillance of 18 cases and the radiation monitoring of these patients by TLD in thyroid and pelvis (secondary beam) and, in the right and left scapular region (primary beam) for each one of these procedures. The ionizing radiation received was 215 ± 200 mGy in left scapular region (range 1-710) and 255±213 mGy in the right scapular region (range 22-635) p=NS. In the pelvic region the ionizing radiation was 0,22±0,06 mGy and in the thyroid region was 3,62±2,44 mGy

  11. The websites of primary and secondary schools in Portugal: an evaluation proposal

    Directory of Open Access Journals (Sweden)

    Ana Maria SANTOS

    2017-10-01

    Full Text Available This article proposes an evaluation the quality in educational websites of two degrees of education, Primary School and the High school. To stablish this analysis was used a Model of Evaluation of the Quality of Educational Websites (EQEWS divided into Functional Aspects, with five criteria: authority, update, usability, accessibility and communication; and Technical-Aesthetic Aspects, with five principles: graphic design and multimedia quality, content, navigation, speed of access and interaction. This propose model of evaluation applied to 57 websites, according to the Likert scale of 0 to 4. We conclude that Secondary School web sites achieved better results in most of the evaluated criteria, it is verified that the authors of these resources are entirely identified with the needs and with the requirement that this degree of education requires the students, with levels of focused on achieving excellent results for university entrance.

  12. Mass media and marketing communication promoting primary and secondary cancer prevention.

    Science.gov (United States)

    Hannon, Peggy; Lloyd, Gareth P; Viswanath, K; Smith, Tenbroeck; Basen-Engquist, Karen; Vernon, Sally W; Turner, Gina; Hesse, Bradford W; Crammer, Corinne; von Wagner, Christian; Backinger, Cathy L

    2009-01-01

    People often seek and receive cancer information from mass media (including television, radio, print media, and the Internet), and marketing strategies often inform cancer information needs assessment, message development, and channel selection. In this article, we present the discussion of a 2-hour working group convened for a cancer communications workshop held at the 2008 Society of Behavioral Medicine meeting in San Diego, CA. During the session, an interdisciplinary group of investigators discussed the current state of the science for mass media and marketing communication promoting primary and secondary cancer prevention. We discussed current research, new research areas, methodologies and theories needed to move the field forward, and critical areas and disciplines for future research.

  13. Primary and Secondary Prevention Trials in Alzheimer Disease: Looking Back, Moving Forward

    Science.gov (United States)

    Hsu, David C.; Marshall, Gad A.

    2015-01-01

    The field of Alzheimer disease (AD) prevention has been a culmination of basic science, clinical, and translational research. In the past three years since the new 2011 AD diagnostic guidelines, large-scale collaborative efforts have embarked on new clinical trials with the hope of someday preventing AD. This review will shed light on the historical and scientific contexts in which these trials were based on, as well as discuss potential challenges these trials may face in the coming years. Primary preventive measures, such as lifestyle, multidomain, medication, and supplemental interventions, will be analyzed. Secondary prevention as represented by disease-modifying interventions, such as anti-amyloid therapy and pioglitazone, will also be reviewed. Finally, hypotheses on future directions for AD prevention trials will be proposed. PMID:27697063

  14. An axisymmetric method of creep analysis for primary and secondary creep

    International Nuclear Information System (INIS)

    Jahed, Hamid; Bidabadi, Jalal

    2003-01-01

    A general axisymmetric method for elastic-plastic analysis was previously proposed by Jahed and Dubey [ASME J Pressure Vessels Technol 119 (1997) 264]. In the present work the method is extended to the time domain. General rate type governing equations are derived and solved in terms of rate of change of displacement as a function of rate of change in loading. Different types of loading, such as internal and external pressure, centrifugal loading and temperature gradient, are considered. To derive specific equations and employ the proposed formulation, the problem of an inhomogeneous non-uniform rotating disc is worked out. Primary and secondary creep behaviour is predicted using the proposed method and results are compared to FEM results. The problem of creep in pressurized vessels is also solved. Several numerical examples show the effectiveness and robustness of the proposed method

  15. The role of primary and secondary air on wood combustion in cookstoves

    Science.gov (United States)

    Kirch, Thomas; Birzer, Cristian H.; Medwell, Paul R.; Holden, Liam

    2018-03-01

    A two-stage solid fuel research furnace was used to examine the claim that through forced draught greater mixing and more complete combustion could be achieved. By varying the primary air (PA) and secondary air (SA) flow the influence on the combustion process was investigated. In the first part of the combustion, when the release of volatile compounds predominates, the variation of neither PA nor SA had a significant influence. In the second part when mainly char is oxidised an increase in both PA and SA lead to a rising nominal combustion efficiency (?)), with a greater impact observed with SA. Furthermore higher air flows caused the heat transfer, to a pot above the furnace, to decline. Therefore forced draught does lead to greater mixing and mitigation of emissions, but in the presented configuration a trade-off between a higher NCE and a lower heat transfer needs consideration.

  16. Lipoproteins as modulators of atherothrombosis: From endothelial function to primary and secondary coagulation.

    Science.gov (United States)

    Ouweneel, Amber B; Van Eck, Miranda

    2016-07-01

    Atherothrombosis is a complication of atherosclerosis that causes acute cardiovascular events such as myocardial infarction and stroke. Circulating lipid levels are highly correlated with atherosclerotic plaque development. In addition, experimental evidence suggests that lipids also directly influence thrombosis and influence the risk and the outcome of acute cardiovascular events. Plasma lipoproteins influence three aspects important to atherothrombosis: endothelial function, platelet aggregation (primary coagulation) and secondary coagulation. Overall, VLDL, LDL and oxLDL promote thrombus formation, whereas HDL shows antithrombotic actions. In this review we will address the current knowledge about modulation of atherothrombosis by lipoproteins, summarizing findings from in vitro and in vivo animal studies, as well as from observational and interventional studies in humans. We will conclude with future perspectives for lipid modulation in the prevention of atherothrombosis. Copyright © 2015 Elsevier Inc. All rights reserved.

  17. Patients' perspectives on the medical primary-secondary care interface: systematic review and synthesis of qualitative research.

    Science.gov (United States)

    Sampson, Rod; Cooper, Jamie; Barbour, Rosaline; Polson, Rob; Wilson, Philip

    2015-10-15

    To synthesise the published literature on the patient experience of the medical primary-secondary care interface and to determine priorities for future work in this field aimed at improving clinical outcomes. Systematic review and metaethnographic synthesis of primary studies that used qualitative methods to explore patients' perspectives of the medical primary-secondary care interface. International primary-secondary care interface. EMBASE, MEDLINE, CINAHL Plus with Full text, PsycINFO, Psychology and Behavioural Sciences Collection, Health Business Elite, Biomedica Reference Collection: Comprehensive Library, Information Science & Technology Abstracts, eBook Collection, Web of Science Core Collection: Citation Indexes and Social Sciences Citation Index, and grey literature. Studies were eligible for inclusion if they were full research papers employing qualitative methodology to explore patients' perspectives of the medical primary-secondary care interface. The 7-step metaethnographic approach described by Noblit and Hare, which involves cross-interpretation between studies while preserving the context of the primary data. The search identified 690 articles, of which 39 were selected for full-text review. 20 articles were included in the systematic review that encompassed a total of 689 patients from 10 countries. 4 important areas specific to the primary-secondary care interface from the patients' perspective emerged: barriers to care, communication, coordination, and 'relationships and personal value'. Patients should be the focus of any transfer of care between primary and secondary systems. From their perspective, areas for improvement may be classified into four domains that should usefully guide future work aimed at improving quality at this important interface. PROSPERO CRD42014009486. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  18. Computed tomography-guided percutaneous catheter drainage of primary and secondary iliopsoas abscesses

    International Nuclear Information System (INIS)

    Cantasdemir, M.; Kara, B.; Cebi, D.; Selcuk, N.D.; Numan, F.

    2003-01-01

    AIM: To report our experience with computed tomography (CT)-guided percutaneous catheter drainage (PCD) of iliopsoas abscesses. MATERIALS AND METHODS: Twenty-two iliopsoas abscesses in 21 patients (11 women, 10 men) aged between 18 and 66 years (mean 36 years) were treated with PCD. Abdominal CT demonstrated the iliopsoas abscesses, which were definitively determined by Gram staining and aspirate cultures. Twenty of the 22 iliopsoas abscesses were primary and two were secondary. All PCD procedures were performed under local anaesthesia using a single-step trocar technique (n=19) or Seldinger technique (n=3). RESULTS: PCD was an effective treatment in 21 out of the 22 iliopsoas abscesses. Recurrence was seen in three abscesses as minimal residual collections. Two of them resolved spontaneously with anti-tuberculous regimen. One required percutaneous needle aspiration. The procedure failed in a diabetic patient with a secondary abscess, who died due to sepsis. The length of time that catheters remained in place ranged from 21 to 75 days (mean 59.7 days). Complications included catheter dislocation in four abscesses, which required removal of dislocated catheters and indwelling new ones. CONCLUSION: CT-guided PCD is a safe and effective front-line treatment of iliopsoas abscesses. Surgery should be reserved for failure of PCD and presence of contraindications to PCD

  19. Involvement in sports clubs and informal sport activities of primary and secondary school children in Liechtenstein

    Directory of Open Access Journals (Sweden)

    Jürgen Kühnis

    2016-04-01

    Full Text Available Sport involvement among children and adolescents has been a central field of research in sport science since years. This paper documents the participation of 11- to 15-year-olds in sport clubs and informal sport activities in Liechtenstein and examines possible gender- and age-specific differences. The analysis is based on four cross-sectional studies from 2004 to 2015 and includes the data of 1’262 children in primary (5th grade and secondary (7th and 9th grades school. According to our findings sports and exercise are considered to be one of the main leisure-time activities for all school levels (irrespective of gender. The percentage of fully sport-abstinent adolescents by 11- and 13-year-olds is about 5 %; by 15-year-olds is around 10 %. The culmination of sports club membership (with current 84.7 % appears to be at the age of 11 (5th grade. After the switch to secondary school the sports club commitment tends to decrease, while the high attendance of the informal sport activities (>85 % shows relatively stable age development. In contrast to other child and youth studies, our data indicates a levelling tendency and dissolution of classic gender differences not only in sports club commitment but also in informal sports among girls and boys.

  20. Secondary and multiple primary cancers relating radiation therapy for cancer of the oral region

    International Nuclear Information System (INIS)

    Horiuchi, Junichi; Shibuya, Hitoshi; Takeda, Masamune; Takagi, Minoru.

    1985-01-01

    Secondary and multiple primary cancers relating radiation therapy for squamous cell carcinoma (s.c.c.) of the oral region including lip, oral cavity and oropharynx were analyzed. Out of 1,197 patients with s.c.c. treated with radiation during about 30 years from 1955 to 1983 June, 56 patients (4.7 %) were regarded as double or multiple cancer. The multiple cancer (s.c.c.) was observed frequently in the multicentric zone such as hypopharynx, esophagus and bronchus as well as in other sites of the oral cavity; 67.7 % (42 out of 62 sites). Frequency of synchronous double cancers was increased in recent ten years; 47.1 % (16/34). Careful examination to the above mentioned multicentric zone leads to early detection of secondary cancer and could be expected cure of the disease. Although possibility of radiation-induced cancer could not be ruled out as for 17 patients with late recurrence (more than 8 years), different histologic diagnosis from s.c.c. was obtained in only one (malignant fibrous histiocytoma). Therefore, it was difficult to discriminate radiation-induced cancer from late recurrence in the present study. (author)

  1. Assessment of the potential consequences of a large primary to secondary leakage accident. Final report

    International Nuclear Information System (INIS)

    D'Auria, F.S.; Sartmadjiev, A.; Spalj, S.; Macek, J.; Kantee, H.; Elter, J.; Kostka, P.; Bukin, N.; Alexandrov, A.G.; Kristof, M.; Kvizda, B.; Matejovic, P.; Makihara, Y.

    2006-01-01

    The present paper discusses one of the IAEA's Coordinated Research Projects (CRPs). The CRP was started in 2003 to evaluate complex phenomena of primary to secondary leakage (PRISE) accidents for WWER-440 reactors. The first Research Coordination Meeting (RCM), held in March 2003, identified the possible consequences of PRISE accidents (radioactive release to the atmosphere, pressurized thermal shock, boron dilution, loss of integrity of secondary systems and severe accidents) and designated six task groups to evaluate these, as well as uncertainties associated with PRISE analyses. The second RCM, held in March 2004, discussed the preliminary results of each task group and addressed the main safety concerns related to PRISE phenomena as well as providing recommendations on modelling for PRISE analyses and on operator actions. The third RCM, held in March 2005, discussed the results of the work performed in 2004. The CRP was concluded in 2005. Publication of the final results of the CRP is planned as an IAEA TECDOC. The paper provides a review of the final results of the project. (author)

  2. Tracing the social gradient in the health of Canadians: primary and secondary determinants.

    Science.gov (United States)

    Kosteniuk, Julie G; Dickinson, Harley D

    2003-07-01

    The social gradient in heath refers to the fact that inequalities in population health status are related to inequalities in social status. This study advances and tests a model of the relationships between what we term primary and secondary determinants of the social gradient in health. The primary determinants of health include socioeconomic and demographic indicators. Secondary determinants include stressors, control, self-esteem, social support, and social involvement. Health status is indicated by measures of physical health, self-reported health status, and mental distress. Data are taken from the Canadian National Population Health (NPH) Survey (1994-1995). The study sample consists of 7720 men and 9269 women 15 to over 80 years of age. Using path analysis, we found that higher household income, being retired and growing older are significantly associated with lower stressor levels. Higher stressor levels are associated with lower levels of control, self-esteem, and social support. Higher income Canadians experience greater levels of control and social support, while older Canadians experience lower rates of social support but higher rates of social involvement. Being employed and caring for one's family are positively associated with better physical and self-reported health status. Higher household income, being retired, and aging are associated with better physical health and lower mental distress when accounting for their role in lowering stressor levels and bolstering control, self-esteem, social support, and social involvement. Replicating this study with future samples of the NPH Survey should be of benefit in ascertaining whether the social gradient in Canadians' health status shows signs of declining.

  3. Primary and Secondary Yield Losses Caused by Pests and Diseases: Assessment and Modeling in Coffee.

    Science.gov (United States)

    Cerda, Rolando; Avelino, Jacques; Gary, Christian; Tixier, Philippe; Lechevallier, Esther; Allinne, Clémentine

    2017-01-01

    The assessment of crop yield losses is needed for the improvement of production systems that contribute to the incomes of rural families and food security worldwide. However, efforts to quantify yield losses and identify their causes are still limited, especially for perennial crops. Our objectives were to quantify primary yield losses (incurred in the current year of production) and secondary yield losses (resulting from negative impacts of the previous year) of coffee due to pests and diseases, and to identify the most important predictors of coffee yields and yield losses. We established an experimental coffee parcel with full-sun exposure that consisted of six treatments, which were defined as different sequences of pesticide applications. The trial lasted three years (2013-2015) and yield components, dead productive branches, and foliar pests and diseases were assessed as predictors of yield. First, we calculated yield losses by comparing actual yields of specific treatments with the estimated attainable yield obtained in plots which always had chemical protection. Second, we used structural equation modeling to identify the most important predictors. Results showed that pests and diseases led to high primary yield losses (26%) and even higher secondary yield losses (38%). We identified the fruiting nodes and the dead productive branches as the most important and useful predictors of yields and yield losses. These predictors could be added in existing mechanistic models of coffee, or can be used to develop new linear mixed models to estimate yield losses. Estimated yield losses can then be related to production factors to identify corrective actions that farmers can implement to reduce losses. The experimental and modeling approaches of this study could also be applied in other perennial crops to assess yield losses.

  4. Historical intensity VIII earthquakes along the Rhone valley (Valais, Switzerland): primary and secondary effects

    Energy Technology Data Exchange (ETDEWEB)

    Fritsche, S.; Faeh, D.; Schwarz-Zanetti, G.

    2012-06-15

    In recent years the upper Rhone Valley has been one of the most intensively investigated regions by the Swiss Seismological Service. The high seismicity in the region encourages research in the seismological field and one main focus has been historical seismology. This report presents the state of the art of our historical investigations by giving an overview of the effects of four damaging earthquakes with intensity larger than VII, for which a fairly large number of documents could be found and analyzed. The overview includes the events of 1584 (Aigle, epicentral intensity VIII), 1755 (Brig, epicentral intensity VIII), 1855 (Visp, epicentral intensity VIII), and 1946 (Sierre, epicentral intensity VIII for the main shock and intensity VII for the largest aftershock). The paper focuses mainly on primary and secondary effects in the epicentral region, providing the key data and a general characterization of the event. Generally, primary effects such as the reaction of the population and impact on buildings took more focus in the past. Thus building damage is more frequently described in historic documents. However, we also found a number of sources describing secondary effects such as landslides, snow avalanches, and liquefaction. Since the sources may be useful, we include citations of these documents. The 1584 Aigle event, for example, produced exceptional movements in the Lake of Geneva, which can be explained by an expanded sub aquatic slide with resultant tsunami and seiche. The strongest of the aftershocks of the 1584 event triggered a destructive landslide covering the villages Corbeyrier and Yvorne, Vaud. All macroseismic data on the discussed events are accessible through the web page of the Swiss Seismological Service (http://www.seismo.ethz.ch). (authors)

  5. Psychopathy in Detained Boys: The Search for Primary and Secondary Variants in a Clinical Setting.

    Science.gov (United States)

    Colins, Olivier F; Fanti, Kostas A; Salekin, Randall T; Mulder, Eva; Andershed, Henrik

    2017-12-14

    This study investigates whether primary and secondary variants of psychopathy can be identified in an applied, forensic setting based on self-reports of psychopathy and anxiety. Data were available for two samples of detained boys (Sample A: N = 847, Sample B: N = 749). Using three psychopathy dimensions and anxiety as clustering variables, latent profile analysis arrived at 4 latent classes (LCs) that were tentatively labeled as control (LC1), high anxiety (LC2), moderate psychopathy (LC3), and high psychopathy (LC4). Boys in LC4 engaged in higher levels of alcohol/drug use, conduct problems, reactive and proactive aggression than their counterparts in LC1 and in higher levels of conduct problems, alcohol/drug use, and proactive aggression than boys in LC3. Findings further indicated that the risk for future nonviolent arrests was the highest in LC4 as compared with LC2 and LC3, though no class differences in risk for future violent arrests emerged. Overall, these findings were well replicated in Sample B. Exploratory analyses included additional measures of negative affect (depressed feeling and anger-irritability), maltreatment, and/or number of past arrests (as proxy of a 4th psychopathy dimension) as clustering variables and identified all but 1 (LC3) of the 4 aforementioned LCs. Notwithstanding that our findings challenge the expected relevance of differentiating primary and secondary variants of youth psychopathy, they do suggest that it is possible to identify detained boys with high levels of psychopathic traits who display features associated with adult psychopathy. Implications for theory, research, and practice are discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  6. Tertiary work-up of apparent treatment-resistant hypertension.

    Science.gov (United States)

    Heimark, Sondre; Eskås, Per Anders; Mariampillai, Julian Eek; Larstorp, Anne Cecilie K; Høieggen, Aud; Fadl Elmula, Fadl Elmula M

    2016-10-01

    Treatment-resistant hypertension (TRH) has regained attention with development of new methods for treatment. However, the prevalence of TRH varies considerably from primary to secondary and tertiary care. We aimed to assess the prevalence of true TRH in a population of patients with apparent TRH in a university hospital setting of tertiary work-up and also investigate reasons for poor BP control and evaluate how work-up can be performed in general practice and secondary care. In this cohort study, we characterize a study population from Oslo Renal Denervation (RDN) Study. Patients (n = 83) were referred for RDN from secondary care. All patients underwent thorough medical investigation and 24-h ambulatory blood pressure measurements (24ABPM) after directly observed therapy (DOT). We then assessed reasons for lack of BP control. Fifty-three of 83 patients did not have true TRH. Main reasons for non-TRH were poor drug adherence (32%), secondary hypertension (30%) and white coat hypertension (15%). Forty-seven percent achieved blood pressure control after DOT with subsequent 24ABPM. There were otherwise no statistically significant differences in patient characteristics between the true TRH and the non-TRH group. Despite being a highly selected cohort referred for tertiary work-up of apparent TRH, BP control was achieved or secondary causes were identified in almost two thirds of the patients. Thorough investigation according to guidelines and DOT with subsequent 24ABPM is needed in work-up of apparent TRH.

  7. Suppressed hepatic bile acid signalling despite elevated production of primary and secondary bile acids in NAFLD.

    Science.gov (United States)

    Jiao, Na; Baker, Susan S; Chapa-Rodriguez, Adrian; Liu, Wensheng; Nugent, Colleen A; Tsompana, Maria; Mastrandrea, Lucy; Buck, Michael J; Baker, Robert D; Genco, Robert J; Zhu, Ruixin; Zhu, Lixin

    2017-08-03

    Bile acids are regulators of lipid and glucose metabolism, and modulate inflammation in the liver and other tissues. Primary bile acids such as cholic acid and chenodeoxycholic acid (CDCA) are produced in the liver, and converted into secondary bile acids such as deoxycholic acid (DCA) and lithocholic acid by gut microbiota. Here we investigated the possible roles of bile acids in non-alcoholic fatty liver disease (NAFLD) pathogenesis and the impact of the gut microbiome on bile acid signalling in NAFLD. Serum bile acid levels and fibroblast growth factor 19 (FGF19), liver gene expression profiles and gut microbiome compositions were determined in patients with NAFLD, high-fat diet-fed rats and their controls. Serum concentrations of primary and secondary bile acids were increased in patients with NAFLD. In per cent, the farnesoid X receptor (FXR) antagonistic DCA was increased, while the agonistic CDCA was decreased in NAFLD. Increased mRNA expression for cytochrome P450 7A1, Na + -taurocholate cotransporting polypeptide and paraoxonase 1, no change in mRNA expression for small heterodimer partner and bile salt export pump, and reduced serum FGF19 were evidence of impaired FXR and fibroblast growth factor receptor 4 (FGFR4)-mediated signalling in NAFLD. Taurine and glycine metabolising bacteria were increased in the gut of patients with NAFLD, reflecting increased secondary bile acid production. Similar changes in liver gene expression and the gut microbiome were observed in high-fat diet-fed rats. The serum bile acid profile, the hepatic gene expression pattern and the gut microbiome composition consistently support an elevated bile acid production in NAFLD. The increased proportion of FXR antagonistic bile acid explains, at least in part, the suppression of hepatic FXR-mediated and FGFR4-mediated signalling. Our study suggests that future NAFLD intervention may target the components of FXR signalling, including the bile acid converting gut microbiome. © Article

  8. Our experience using primary oral antibiotics in the management of orbital cellulitis in a tertiary referral centre.

    Science.gov (United States)

    Cannon, P S; Mc Keag, D; Radford, R; Ataullah, S; Leatherbarrow, B

    2009-03-01

    Orbital cellulitis is conventionally managed by intravenous (i.v.) antibiotic therapy, followed by oral antibiotics once the infection shows signs of significant improvement. We report 4 years of experience using primary oral ciprofloxacin and clindamycin in cases of orbital cellulitis. Oral ciprofloxacin and clindamycin have a similar bioavailability to the i.v. preparations and provide an appropriate spectrum of antibiotic cover for the pathogens responsible for orbital cellulitis. A retrospective review was performed that identified all patients with orbital cellulitis and treated with primary oral antibiotic therapy admitted to the Manchester Royal Eye Hospital between March 2003 and March 2007. Age, stage of disease, surgical intervention, hospital duration, and complications were obtained. A comparison was made with patients admitted to our unit with orbital cellulitis and treated with primary i.v. antibiotics between March 2000 and March 2003. Nineteen patients were included in the review for the period March 2003 to March 2007, which comprised of 7 children and 12 adults. Five patients required surgical intervention. All patients responded to the oral regimen, 18 patients had no change to their oral antibiotic therapy. Mean hospital stay was 4.4 days. There were no complications. Empirical oral ciprofloxacin and clindamycin combination may be as safe and effective as i.v. therapy in the management of orbital cellulitis. Oral treatment can offer the advantages of rapid delivery of the first antibiotic dose, fewer interruptions in treatment, and simplified delivery of medication particularly in children.

  9. Dynamic modeling of primary and secondary systems of IRIS reactor for transient analysis using SIMULINK

    International Nuclear Information System (INIS)

    Magalhaes, Mardson Alencar de Sa; Lira, Carlos Alberto Brayner de Oliveira; Silva, Mario Augusto Bezerra da

    2011-01-01

    The IRIS project has significantly advanced in the last few years in response to a demand for a new generation reactor, that could fulfill the essential requirements for a future nuclear power plant: better economics, safety-by-design, low proliferation risk and environmental sustainability. IRIS reactor is a integral type PWR in which all primary components are arranged inside the pressure vessel. This configuration involves important changes in relation to a conventional PWR. These changes require several studies to comply with the safe operational limits for the reactor. In this paper, a study has been conducted to develop a dynamic model (named MODIRIS) for transient analysis, implemented in the MATLAB'S software SIMULINK, allowing the analysis of IRIS behavior by considering the neutron point kinetics for power production. The methodology is based on generating a set of differential equations of neutronic and thermal-hydraulic balances which describes the dynamics of the primary circuit, as well as a set of differential equations describing the dynamics of secondary circuit. The equations and initialization parameters at full power were into the SIMULINK and the code was validated by the confrontation with RELAP simulations for a transient of feedwater reduction in the steam generators. (author)

  10. Free Diced Cartilage: A New Application of Diced Cartilage Grafts in Primary and Secondary Rhinoplasty.

    Science.gov (United States)

    Kreutzer, Christian; Hoehne, Julius; Gubisch, Wolfgang; Rezaeian, Farid; Haack, Sebastian

    2017-09-01

    Irregularities or deformities of the nasal dorsum after hump reduction account for a significant number of revision rhinoplasties. The authors therefore developed a technique of meticulously dicing and exactly placing free diced cartilage grafts, harvested from septum, rib, or ear cartilage. The cartilage paste is used for smoothening, augmentation, or camouflaging of the nasal dorsum in primary or revision rhinoplasties. A retrospective analysis of multisurgeon consecutive open approach rhinoplasties from January to December of 2014 was conducted at a single center. The authors compared the outcome of three different techniques to augment or cover the nasal dorsum after an observation period of 7 months. In group I, 325 patients with free diced cartilage grafts as the only onlay were included. In group II, consisting of 73 patients, the dorsal onlay was either fascia alone or in combination with free diced cartilage grafts. Forty-eight patients in group III received a dorsal augmentation with the classic diced cartilage in fascia technique. Four hundred forty-six patients undergoing primary and secondary rhinoplasties in which one of the above-mentioned diced cartilage techniques was used were included in the study. The authors found revision rates for dorsal irregularities within the 7-month postoperative observation period of 5.2, 8.2, and 25 percent for groups I, II, and III, respectively. The authors' findings strongly support their clinical experience that the free diced cartilage graft technique presents an effective and easily reproducible method for camouflage and augmentation in aesthetic and reconstructive rhinoplasty.

  11. Artifacts Generated During Azoalkane Peroxy Radical Oxidative Stress Testing of Pharmaceuticals Containing Primary and Secondary Amines.

    Science.gov (United States)

    Nefliu, Marcela; Zelesky, Todd; Jansen, Patrick; Sluggett, Gregory W; Foti, Christopher; Baertschi, Steven W; Harmon, Paul A

    2015-12-01

    We report artifactual degradation of pharmaceutical compounds containing primary and secondary amines during peroxy radical-mediated oxidative stress carried out using azoalkane initiators. Two degradation products were detected when model drug compounds dissolved in methanol/water were heated to 40°C with radical initiators such as 2,2'-azobis(2-methylpropionitrile) (AIBN). The primary artifact was identified as an α-aminonitrile generated from the reaction of the amine group of the model drug with formaldehyde and hydrogen cyanide, generated as byproducts of the stress reaction. A minor artifact was generated from the reaction between the amine group and isocyanic acid, also a byproduct of the stress reaction. We report the effects of pH, initiator/drug molar ratio, and type of azoalkane initiator on the formation of these artifacts. Mass spectrometry and nuclear magnetic resonance were used for structure elucidation, whereas mechanistic studies, including stable isotope labeling experiments, cyanide analysis, and experiments exploring the effects of butylated hydroxyanisole addition, were employed to support the degradation pathways. © 2015 Wiley Periodicals, Inc. and the American Pharmacists Association.

  12. A Unique Case of Acute Cerebral Venous Sinus Thrombosis Secondary to Primary Varicella Zoster Virus Infection.

    Science.gov (United States)

    Imam, Syed F; Lodhi, Omair Ul Haq; Fatima, Zainab; Nasim, Saneeya; Malik, Waseem T; Saleem, Muhammad Sabih

    2017-09-16

    Primary varicella zoster virus (VZV) infection, predominantly in the pediatric population, presents with pyrexia and a classic pruritic vesicular rash. In adults, although less common, it is more severe and linked to more complications. Neurological complications, which account for less than 1% of all VZV complications, include meningitis, encephalitis, arterial vasculopathy, and venous thrombosis. We present a case of a 39-year-old male who developed extensive cerebral venous sinus thrombosis following primary VZV infection. Venous thrombosis in VZV has been suggested to be caused by autoantibodies against protein S, pre-existing hypercoagulability, or endothelial damage. The patient was acutely managed using intravenous acyclovir and heparin. Long-term anticoagulation therapy with warfarin was continued after discharge. We concluded that clinicians should be aware of the rare complications of this common pathology so that a timely diagnosis can be made, followed by prompt management. Further studies need to be done to better understand acute cerebral venous sinus thrombosis secondary to VZV.

  13. Surgical management of secondary hyperparathyroidism: how to effectively reduce recurrence at the time of primary surgery.

    Science.gov (United States)

    Xu, D; Yin, Y; Hou, L; Dai, W

    2016-05-01

    Successful parathyroidectomy (PTX) often results in a dramatic drop in the parathyroid hormone (PTH) levels, relieves the patient from clinical symptoms, and reduces mortality. Although PTX is generally a successful treatment for progressive secondary hyperparathyroidism (SHPT) patients subjected to surgery, a significant proportion develops recurrent SHPT following PTX. SHPT requiring PTX occurs more commonly in progressive chronic kidney disease and in long-term lithium therapy. Operative approaches include subtotal PTX, total PTX with or without autotransplantation, and possible thymectomy. Each approach has its proponents, advantages, and disadvantages. Although PTX offers the highest percentage cure for SHPT, compared to all other medical and surgical treatment, recurrent hyperparathyroidism can be observed in some patients dependent on follow-up time. A literature review and analysis of recent data regarding how to reduce recurrence of SHPT at the time of primary surgery was performed. The current literature and our own experience in the field have confirmed that pre-operative imaging, thymectomy, stereo magnifier, and surgical procedure may effectively reduce recurrence of SHPT at the time of primary surgery.

  14. Scientific basis for the choice of primary/secondary water chemistry

    International Nuclear Information System (INIS)

    Garnsey, R.

    1988-01-01

    The purpose of this paper is to illustrate the common scientific basis for the chemistry control strategies which have been developed. The evolution of chemistry control philosophies in some plant designs are outlined as examples. The essential requirement of water chemistry control is to preserve integrity of the circuit under all the environmental conditions experienced within that circuit. There may be specific additional requirements, as in the case of a PWR primary circuit, where boron concentration is used to control reactivity. The crucial requirement or concern can vary. In the primary circuit of a light water reactor the crucial requirement is to supress the activation and transportation of corrosion products and so minimize radiation fields around the circuit. On the secondary side of recirculating steam generators the critical requirement has been to preserve the integrity of generator tubing. In once-through steam generators the critical requirement may be the control of pressure losses associated with corrosion product deposits in the steam generator and the integrity of the turbine in addition to boiler integrity. (Nogami, K.)

  15. Professionals' perception of circuits of care for hypertensive or diabetic patients between primary and secondary care.

    Science.gov (United States)

    Alonso-Moreno, Francisco Javier; Martell-Claros, Nieves; de la Figuera, Mariano; Escalada, Javier; Rodríguez, Marta; Orera, Luisa

    2016-01-01

    To determine the flow of care for patients with type 2 diabetes mellitus (T2DM) and hypertension between primary care (PC) and specialized care (SC) in clinical practice, and the criteria used for referral and follow-up within the Spanish National Health System (NHS). A descriptive, cross-sectional, multicenter study. A probability convenience sampling stratified by number of physicians participating in each Spanish autonomous community was performed. Nine hundred and ninety-nine physicians were surveyed, of whom 78.1% (n=780) were primary care physicians (PCPs), while 11.9% (n=119) and 10.0% (n=100) respectively were specialists in hypertension and diabetes. KEY MEASUREMENTS: was conducted using two self administered online surveys. A majority of PCPs (63.7% and 55.5%) and specialists (79.8% and 45.0%) reported the lack of a protocol to coordinate the primary and specialized settings for both hypertension and T2DM respectively. The most widely used method for communication between specialists was the referral sheet (94.6% in PC and 92.4% in SC). The main reasons for referral to a specialist were refractory hypertension (80.9%) and suspected secondary hypertension (75.6%) in hypertensive patients, and suspicion of a specific diabetes (71.9%) and pregnancy (71.7%) in T2DM patients. Although results showed some common characteristics between PCPs and specialists in disease management procedures, the main finding was a poor coordination between PC and SC. Copyright © 2015. Published by Elsevier España, S.L.U.

  16. System for radiation emergency medicine. Activities of tertiary radiation emergency hospitals

    International Nuclear Information System (INIS)

    Kamiya, Kenji; Tanigawa, Koichi; Hosoi, Yoshio

    2011-01-01

    Japanese system for radiation emergency medicine is primarily built up by Cabinet Nuclear Safety Commission in 2001 based on previous Tokai JCO Accident (1999) and is composed from the primary, secondary and tertiary medical organizations. This paper describes mainly about roles and actions of the tertiary facilities at Fukushima Nuclear Power Plant Accident and tasks to be improved in future. The primary and secondary organizations in the system above are set up in the prefectures with or neighboring the nuclear facility, and tertiary ones, in two parts of western and eastern Japan. The western organization is in Hiroshima University having its cooperating 7 hospitals, and is responsible for such patients as exposed to high dose external radiation, having serious complication, and difficult to treat in the primary/secondary hospitals. The eastern is in National Institute of Radiological Sciences (NIRS) with 6 cooperating hospitals and responsible for patients with internal radiation exposure difficult to treat, with contaminated body surface with difficulty in decontamination and/or with causable of secondary contamination, and difficult to treat in the secondary hospitals. The tertiary organizations have made efforts for the education and training of medical staff, for network construction among the primary, secondary and other medicare facilities, for establishment of transferring system of patients, and for participation to the international network by global organizations like Response Assistance Network (RANET) in International Atomic Energy Agency (IAEA), and Radiation Emergency Preparedness and Network (REMPAN) in World Health Organization (WHO). At the Fukushima Accident, staffs of the two tertiary hospitals began to conduct medicare on site (Mar. 12-) and learned following tasks to be improved in future: the early definition of medicare and its network system, and Emergency Planning Zone (EPZ); urgent evacuation of residents weak to disaster like elderly

  17. Heterogeneous movement of insectivorous Amazonian birds through primary and secondary forest: A case study using multistate models with radiotelemetry data

    Science.gov (United States)

    Hines, James; Powell, Luke L.; Wolfe, Jared D.; Johnson, Erik l.; Nichols, James D.; Stouffer, Phillip C.

    2015-01-01

    Given rates of deforestation, disturbance, and secondary forest accumulation in tropical rainforests, there is a great need to quantify habitat use and movement among different habitats. This need is particularly pronounced for animals most sensitive to disturbance, such as insectivorous understory birds. Here we use multistate capture–recapture models with radiotelemetry data to determine the successional stage at which within-day movement probabilities of Amazonian birds in secondary forest are similar to those in primary forest. We radio-tracked three common understory insectivore species in primary and secondary forest at the Biological Dynamics of Forest Fragments project near Manaus, Brazil: two woodcreepers, Glyphorynchus spirurus (n = 19) andXiphorhynchus pardalotus (n = 18), and the terrestrial antthrush Formicarius colma(n = 19). Forest age was a strong predictor of fidelity to a given habitat. All three species showed greater fidelity to primary forest than to 8–14-year-old secondary forest, indicating the latter’s relatively poor quality. The two woodcreeper species used 12–18-year-old secondary forest in a manner comparable to continuous forest, but F. colmaavoided moving even to 27–31-year-old secondary forest—the oldest at our site. Our results suggest that managers concerned with less sensitive species can assume that forest reserves connected by 12–18-year-old secondary forest corridors are effectively connected. On the other hand, >30 years are required after land abandonment before secondary forest serves as a primary forest-like conduit for movement by F. colma; more sensitive terrestrial insectivores may take longer still.

  18. Primary and Secondary Organic Marine Aerosol and Oceanic Biological Activity: Recent Results and New Perspectives for Future Studies

    Directory of Open Access Journals (Sweden)

    Matteo Rinaldi

    2010-01-01

    Full Text Available One of the most important natural aerosol systems at the global level is marine aerosol that comprises both organic and inorganic components of primary and secondary origin. The present paper reviews some new results on primary and secondary organic marine aerosol, achieved during the EU project MAP (Marine Aerosol Production, comparing them with those reported in the recent literature. Marine aerosol samples collected at the coastal site of Mace Head, Ireland, show a chemical composition trend that is influenced by the oceanic biological activity cycle, in agreement with other observations. Laboratory experiments show that sea-spray aerosol from biologically active sea water can be highly enriched in organics, and the authors highlight the need for further studies on the atmospheric fate of such primary organics. With regard to the secondary fraction of organic aerosol, the average chemical composition and molecular tracer (methanesulfonic-acid, amines distribution could be successfully characterized by adopting a multitechnique analytical approach.

  19. A New Classification for Pathologies of Spinal Meninges-Part 2: Primary and Secondary Intradural Arachnoid Cysts.

    Science.gov (United States)

    Klekamp, Jörg

    2017-08-01

    Spinal intradural arachnoid cysts are rare causes of radiculopathy or myelopathy. Treatment options include resection, fenestration, or cyst drainage. To classify intradural spinal arachnoid cysts and present results of their treatment. Among 1519 patients with spinal space occupying lesions, 130 patients demonstrated intradural arachnoid cysts. Neuroradiological and surgical features were reviewed and clinical data analyzed. Twenty-one patients presented arachnoid cysts as a result of an inflammatory leptomeningeal reaction related to meningitis, subarachnoid hemorrhage, intrathecal injections, intradural surgery, or trauma, ie, secondary cysts. For the remaining 109 patients, no such history could be elucidated, ie, primary cysts. Forty-six percent of primary and 86% of secondary cysts were associated with syringomyelia. Patients presented after an average history of 53 ± 88 months. There were 122 thoracic and 7 lumbar cysts plus 1 cervical cyst. Fifty-nine patients with primary and 15 patients with secondary cysts underwent laminotomies with complete or partial cyst resection and duraplasty. Mean follow-up was 57 ± 52 months. In the first postoperative year, profound improvements for primary cysts were noted, in contrast to marginal changes for secondary cysts. Progression-free survival for 10 years following surgery was determined as 83% for primary compared to 15% for secondary cysts. Despite differences in clinical presentation, progression-free survival was almost identical for patients with or without syringomyelia. Complete or partial resection leads to favorable short- and long-term results for primary arachnoid cysts. For secondary cysts, surgery can only provide clinical stabilization for a limited time due to the often extensive arachnoiditis. Copyright © 2017 by the Congress of Neurological Surgeons

  20. Effect of Primary Recrystallized Microstructure and Nitriding on Secondary Recrystallization in Grain Oriented Silicon Steel by Low Temperature Slab Reheating

    Directory of Open Access Journals (Sweden)

    LIU Gong-tao

    2018-01-01

    Full Text Available Different primary recrystallized grain sizes were obtained by controlling decarburization process in grain oriented silicon steel produced by low temperature slab reheating technique. The effect of primary grain size on secondary recrystallization and magnetic properties was studied. The appropriate nitrogen content after nitriding was explored in case of very large primary grain size, and the effect of {411}〈148〉 primary recrystallized texture on the abnormal growth behavior was discussed. The results show that an increase in average primary grain size from 10μm to 15μm leads to an increase of secondary recrystallization temperature and a sharper Goss texture with higher magnetic permeability, in the condition of a very large average primary grain size of 28μm, the suitable amount of nitrogen increases to about 6×10-4. The {411}〈148〉 oriented grains in primary recrystallized microstructure can easily grow into larger sizes due to their size advantage, and thus hinder the abnormal growth of secondary grains, moreover, the hindering effect is more pronounced in the abnormal growth of Brass-oriented grains due to their misorientation with low migration rate other than Goss grains.

  1. Primary and secondary aerosols in Beijing in winter: sources, variations and processes

    Science.gov (United States)

    Sun, Yele; Du, Wei; Fu, Pingqing; Wang, Qingqing; Li, Jie; Ge, Xinlei; Zhang, Qi; Zhu, Chunmao; Ren, Lujie; Xu, Weiqi; Zhao, Jian; Han, Tingting; Worsnop, Douglas R.; Wang, Zifa

    2016-07-01

    Winter has the worst air pollution of the year in the megacity of Beijing. Despite extensive winter studies in recent years, our knowledge of the sources, formation mechanisms and evolution of aerosol particles is not complete. Here we have a comprehensive characterization of the sources, variations and processes of submicron aerosols that were measured by an Aerodyne high-resolution aerosol mass spectrometer from 17 December 2013 to 17 January 2014 along with offline filter analysis by gas chromatography/mass spectrometry. Our results suggest that submicron aerosols composition was generally similar across the winter of different years and was mainly composed of organics (60 %), sulfate (15 %) and nitrate (11 %). Positive matrix factorization of high- and unit-mass resolution spectra identified four primary organic aerosol (POA) factors from traffic, cooking, biomass burning (BBOA) and coal combustion (CCOA) emissions as well as two secondary OA (SOA) factors. POA dominated OA, on average accounting for 56 %, with CCOA being the largest contributor (20 %). Both CCOA and BBOA showed distinct polycyclic aromatic hydrocarbons (PAHs) spectral signatures, indicating that PAHs in winter were mainly from coal combustion (66 %) and biomass burning emissions (18 %). BBOA was highly correlated with levoglucosan, a tracer compound for biomass burning (r2 = 0.93), and made a considerable contribution to OA in winter (9 %). An aqueous-phase-processed SOA (aq-OOA) that was strongly correlated with particle liquid water content, sulfate and S-containing ions (e.g. CH2SO2+) was identified. On average aq-OOA contributed 12 % to the total OA and played a dominant role in increasing oxidation degrees of OA at high RH levels (> 50 %). Our results illustrate that aqueous-phase processing can enhance SOA production and oxidation states of OA as well in winter. Further episode analyses highlighted the significant impacts of meteorological parameters on aerosol composition, size

  2. Cognitive ability of preschool, primary and secondary school children in Costa Rica.

    Science.gov (United States)

    Rindermann, Heiner; Stiegmaier, Eva-Maria; Meisenberg, Gerhard

    2015-05-01

    Cognitive abilities of children in Costa Rica and Austria were compared using three age groups (N = 385/366). Cognitive ability tests (mental speed, culture reduced/fluid intelligence, literacy/crystallized intelligence) were applied that differed in the extent to which they refer to school-related knowledge. Preschool children (kindergarten, 5-6 years old, N(CR) = 80, N(Au) = 51) were assessed with the Coloured Progressive Matrices (CPM), primary school children (4th grade, 9-11 years old, N(CR) = 71, N(Au) = 71) with ZVT (a trail-making test), Standard Progressive Matrices (SPM) and items from PIRLS-Reading and TIMSS-Mathematics, and secondary school students (15-16 years old, N(CR) = 48, N(Au) = 48) with ZVT, Advanced Progressive Matrices (APM) and items from PISA-Reading and PISA-Mathematics. Additionally, parents and pupils were given questionnaires covering family characteristics and instruction. Average cognitive abilities were higher in Austria (Greenwich-IQ M(CR) = 87 and M(Au) = 99, d(IQ) = 12 points) and differences were smaller in preschool than in secondary school (d(IQ) = 7 vs 20 points). Differences in crystallized intelligence were larger than in fluid intelligence (mental speed: d(IQ) = 12, Raven: d(IQ) = 10, student achievement tests: d(IQ) = 17 IQ points). Differences were larger in comparisons at the level of g-factors. Austrian children were also taller (6.80 cm, d = 1.07 SD), but had lower body mass index (BMI(CR) = 19.35 vs BMI(Au) = 17.59, d = -0.89 SD). Different causal hypotheses explaining these differences are compared.

  3. Primary antibiotic resistance of Helicobacter pylori strains among adults and children in a tertiary referral centre in Lithuania

    DEFF Research Database (Denmark)

    Dargiene, Gintare; Kupcinskas, Juozas; Jonaitis, Laimas

    2018-01-01

    The study evaluated primary antibiotic resistance of Helicobacter pylori within the period 2013-2015 and trends of antibiotic consumption over the last decade in Lithuania; 242 adults and 55 children were included in the study. E-tests were performed for amoxicillin, metronidazole, clarithromycin......, ciprofloxacin, rifampicin and tetracycline. The presence of H. pylori and clarithromycin resistance was additionally tested by PCR. Helicobacter pylori culture was positive in 67 of 242 (28%) adult and in 12 of 55 (21.8%) children samples. Resistance rates among adults by E-tests were as follows: metronidazole......, while it has doubled from 1.10 to 2.22 DDD/1000/children/day in children within 2003-2015. There are no significant changes in the susceptibility of H. pylori to the most widely used antibiotics in adults over the last years in Lithuania; however, clarithromycin resistance among children exceeds 15...

  4. Local source impacts on primary and secondary aerosols in the Midwestern United States

    Science.gov (United States)

    Jayarathne, Thilina; Rathnayake, Chathurika M.; Stone, Elizabeth A.

    2016-04-01

    Atmospheric particulate matter (PM) exhibits heterogeneity in composition across urban areas, leading to poor representation of outdoor air pollutants in human exposure assessments. To examine heterogeneity in PM composition and sources across an urban area, fine particulate matter samples (PM2.5) were chemically profiled in Iowa City, IA from 25 August to 10 November 2011 at two monitoring stations. The urban site is the federal reference monitoring (FRM) station in the city center and the peri-urban site is located 8.0 km to the west on the city edge. Measurements of PM2.5 carbonaceous aerosol, inorganic ions, molecular markers for primary sources, and secondary organic aerosol (SOA) tracers were used to assess statistical differences in composition and sources across the two sites. PM2.5 mass ranged from 3 to 26 μg m-3 during this period, averaging 11.2 ± 4.9 μg m-3 (n = 71). Major components of PM2.5 at the urban site included organic carbon (OC; 22%), ammonium (14%), sulfate (13%), nitrate (7%), calcium (2.9%), and elemental carbon (EC; 2.2%). Periods of elevated PM were driven by increases in ammonium, sulfate, and SOA tracers that coincided with hot and dry conditions and southerly winds. Chemical mass balance (CMB) modeling was used to apportion OC to primary sources; biomass burning, vegetative detritus, diesel engines, and gasoline engines accounted for 28% of OC at the urban site and 24% of OC at the peri-urban site. Secondary organic carbon from isoprene and monoterpene SOA accounted for an additional 13% and 6% of OC at the urban and peri-urban sites, respectively. Differences in biogenic SOA across the two sites were associated with enhanced combustion activities in the urban area and higher aerosol acidity at the urban site. Major PM constituents (e.g., OC, ammonium, sulfate) were generally well-represented by a single monitoring station, indicating a regional source influence. Meanwhile, nitrate, biomass burning, food cooking, suspended dust, and

  5. Evaluation of primary and secondary stability of titanium implants using different surgical techniques.

    Science.gov (United States)

    Tabassum, Afsheen; Meijer, Gert J; Walboomers, X Frank; Jansen, John A

    2014-04-01

    To investigate the influence of different surgical techniques on the primary and secondary implant stability using trabecular bone of goats as an implantation model. In the iliac crest of eight goats, 48 cylindrical-screw-type implants with a diameter of 4.2 mm (Dyna(®) ; Bergen op Zoom, the Netherlands) were installed, using three different surgical techniques: (i) 5% undersized, using a final drill diameter of 4 mm; (ii) 15% undersized, using a final drill diameter of 3.6 mm; and (iii) 25% undersized, using a final drill diameter of 3.2 mm. Peak insertion torque values were measured by a Digital(®) (MARK-10 Corporation, New York, NY, USA) torque gauge instrument during placement. At 3 weeks after implantation, removal torque was measured. Histomorphometrically, the peri-implant bone volume was measured in three zones; the inner zone (0-500 μm), the middle zone (500-1000 μm) and the outer zone (1000-1500 μm). Evaluation of the obtained data demonstrated no statistically significant difference between different surgical techniques regarding removal torque values. With respect to the percentage peri-implant bone volume (%BV), also no significant difference could be observed between all three applied surgical techniques for both the inner, middle and outer zone. However, irrespective of the surgical technique, it was noticed that the %BV was significantly higher for the inner zone as compared to middle and outer zone (P < 0.05) around the implant. At 3 weeks after implant installation, independent of the used undersized surgical technique, the %BV in the inner zone (0-500 μm) peri-implant area was improved due to both condensation of the surrounding bone as also the translocation of host bone particles along the implant surface. Surprisingly, no mechanical beneficial effect of the 25% undersized surgical technique could be observed as compared to the 5% or 15% undersized surgical technique to improve primary or secondary implant stability. © 2013

  6. Utility of electronic patient records in primary care for stroke secondary prevention trials

    Directory of Open Access Journals (Sweden)

    Ashworth Mark

    2011-02-01

    Full Text Available Abstract Background This study aimed to inform the design of a pragmatic trial of stroke prevention in primary care by evaluating data recorded in electronic patient records (EPRs as potential outcome measures. The study also evaluated achievement of recommended standards of care; variation between family practices; and changes in risk factor values from before to after stroke. Methods Data from the UK General Practice Research Database (GPRD were analysed for 22,730 participants with an index first stroke between 2003 and 2006 from 414 family practices. For each subject, the EPR was evaluated for the 12 months before and after stroke. Measures relevant to stroke secondary prevention were analysed including blood pressure (BP, cholesterol, smoking, alcohol use, body mass index (BMI, atrial fibrillation, utilisation of antihypertensive, antiplatelet and cholesterol lowering drugs. Intraclass correlation coefficients (ICC were estimated by family practice. Random effects models were fitted to evaluate changes in risk factor values over time. Results In the 12 months following stroke, BP was recorded for 90%, cholesterol for 70% and body mass index (BMI for 47%. ICCs by family practice ranged from 0.02 for BP and BMI to 0.05 for LDL and HDL cholesterol. For subjects with records available both before and after stroke, the mean reductions from before to after stroke were: mean systolic BP, 6.02 mm Hg; diastolic BP, 2.78 mm Hg; total cholesterol, 0.60 mmol/l; BMI, 0.34 Kg/m2. There was an absolute reduction in smokers of 5% and heavy drinkers of 4%. The proportion of stroke patients within the recommended guidelines varied from less than a third (29% for systolic BP, just over half for BMI (54%, and over 90% (92% on alcohol consumption. Conclusions Electronic patient records have potential for evaluation of outcomes in pragmatic trials of stroke secondary prevention. Stroke prevention interventions in primary care remain suboptimal but important

  7. Secondary stressors and extreme events and disasters: a systematic review of primary research from 2010-2011

    Science.gov (United States)

    Lock, Sarah; Rubin, G. James; Murray, Virginia; Rogers, M. Brooke; Amlôt, Richard; Williams, Richard

    2012-01-01

    Introduction Extreme events and disasters, such as earthquakes and floods, cause distress and are associated with some people developing mental disorders. Primary stressors inherent in many disasters can include injuries sustained or watching someone die. The literature recognises the distress which primary stressors cause and their association with mental disorders. Secondary stressors such as a lack of financial assistance, the gruelling process of submitting an insurance claim, parents’ worries about their children, and continued lack of infrastructure can manifest their effects shortly after a disaster and persist for extended periods of time. Secondary stressors, and their roles in affecting people’s longer-term mental health, should not be overlooked. We draw attention in this review to the nature of secondary stressors that are commonly identified in the literature, assess how they are measured, and develop a typology of these stressors that often affect people after extreme events. Methods We searched for relevant papers from 2010 and 2011 using MEDLINE®, Embase and PsycINFO®. We selected primary research papers that evaluated the associations between secondary stressors and distress or mental disorders following extreme events, and were published in English. We extracted information on which secondary stressors were assessed, and used thematic analysis to group the secondary stressors into a typology. Results Thirty-two relevant articles published in 2010 and 2011 were identified. Many secondary stressors were poorly defined and difficult to differentiate from primary stressors or other life events. We identified 11 categories of secondary stressors, though some extend over more than one category. The categories include: economic stressors such as problems with compensation, recovery of and rebuilding homes; loss of physical possessions and resources; health-related stressors; stress relating to education and schooling; stress arising from media

  8. Distribution of Ca, Fe, Cu and Zn in primary colorectal cancer and secondary colorectal liver metastases

    International Nuclear Information System (INIS)

    Al-Ebraheem, A.; Mersov, A.; Gurusamy, K.; Farquharson, M.J.

    2010-01-01

    A microbeam synchrotron X-ray fluorescence (μSRXRF) technique has been used to determine the localization and the relative concentrations of Zn, Cu, Fe and Ca in primary colorectal cancer and secondary colorectal liver metastases. 24 colon and 23 liver samples were examined, all of which were formalin fixed tissues arranged as microarrays of 1.0 mm diameter and 10 μm thickness. The distribution of these metals was compared with light transmission images of adjacent sections that were H and E stained to reveal the location of the cancer cells. Histological details were provided for each sample which enable concentrations of all elements in different tissue types to be compared. In the case of liver, significant differences have been found for all elements when comparing tumour, normal, necrotic, fibrotic, and blood vessel tissues (Kruskal Wallis Test, P<0.0001). The concentrations of all elements have also been found to be significantly different among tumour, necrotic, fibrotic, and mucin tissues in the colon samples (Kruskal Wallis Test, P<0.0001). The concentrations of all elements have been compared between primary colorectal samples and colorectal liver metastases. Concentration of Zn, Cu, Fe and Ca are higher in all types of liver tissues compared to those in the colon tissues. Comparing liver tumour and colon tumour samples, significant differences have been found for all elements (Mann Whitney, P<0.0001). For necrotic tissues, significant increase has been found for Zn, Ca, Cu and Fe (Mann Whitney, P<0.0001 for Fe and Zn, 0.014 for Ca, and 0.001 for Cu). The liver fibrotic levels of Zn, Ca, Cu and Fe were higher than the fibrotic colon areas (independent T test, P=0.007 for Zn and Mann Whitney test P<0.0001 for Cu, Fe and Ca). For the blood vessel tissue, the analysis revealed that the difference was only significant for Fe (P=0.009) from independent T test.

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

    Science.gov (United States)

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

    2017-09-01

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

  10. [Primary and secondary data on dementia care as an example of regional health planning].

    Science.gov (United States)

    Ulrich, Lisa-R; Schatz, Tanja R; Lappe, Veronika; Ihle, Peter; Barthen, Linda; Gerlach, Ferdinand M; Erler, Antje

    2017-12-01

    Health service planning that takes into account as far as possible the regional needs and regional discrepancies is a controversial health issue in Germany. In a pilot scheme, we tested a planning process for regional healthcare services, based on the example of dementia care. The aim of this article is to present the strengths and limitations of this planning process. We developed an indicator set for dementia care based on routine regional data obtained from two German statutory health insurance companies. Additionally, primary data based on a questionnaire sent to all GPs in the area were evaluated. These data were expanded through the addition of official socio-demographic population data. Procedures and evaluation strategies, discussion of the results and the derivation of planning measures followed, in close agreement with a group of local experts. Few epidemiological data on regional variations in health care planning are publicly available. Secondary data from statutory health insurance companies can be assessed to support the estimation of regional health care needs, but interpretation is difficult. The use of surveys to collect primary data, and the assessment of results by the local health board may facilitate interpretation and may contribute towards more valid statements regarding regional health planning. Despite the limited availability of data and the considerable efforts involved in data analysis, the project demonstrates how needs-based health service planning can be carried out in a small region, taking into account the increasing demands of the local health care providers and the special local features.

  11. Comprehensive genetic testing for primary immunodeficiency disorders in a tertiary hospital: 10-year experience in Auckland, New Zealand.

    Science.gov (United States)

    Woon, See-Tarn; Ameratunga, Rohan

    2016-01-01

    New Zealand is a developed geographically isolated country in the South Pacific with a population of 4.4 million. Genetic diagnosis is the standard of care for most patients with primary immunodeficiency disorders (PIDs). Since 2005, we have offered a comprehensive genetic testing service for PIDs and other immune-related disorders with a published sequence. Here we present results for this program, over the first decade, between 2005 and 2014. We undertook testing in 228 index cases and 32 carriers during this time. The three most common test requests were for X-linked lymphoproliferative (XLP), tumour necrosis factor receptor associated periodic syndrome (TRAPS) and haemophagocytic lymphohistiocytosis (HLH). Of the 32 suspected XLP cases, positive diagnoses were established in only 2 patients. In contrast, genetic defects in 8 of 11 patients with suspected X-linked agammaglobulinemia (XLA) were confirmed. Most XLA patients were initially identified from absence of B cells. Overall, positive diagnoses were made in about 23% of all tests requested. The diagnostic rate was lowest for several conditions with locus heterogeneity. Thorough clinical characterisation of patients can assist in prioritising which genes should be tested. The clinician-driven customised comprehensive genetic service has worked effectively for New Zealand. Next generation sequencing will play an increasing role in disorders with locus heterogeneity.

  12. Basic Education from Early Childhood: Impacts of Free Primary Education and Subsidized Secondary Education on Public ECDE Centers in Nyahururu District, Kenya

    Science.gov (United States)

    Mwangi, Peter Murage; Serem, T. D. K.

    2013-01-01

    Kenya must invest more in education to realize her vision 2030. The government commitment to Education for All's goal has been expressed through provision of basic education in pre-primary, primary and secondary school levels. To this end, the government introduced two kitties; Free Primary Education in 2003 and Subsidized Secondary Education in…

  13. A view from the top : a study on educational leadership in Roman Catholic Church primary and secondary schools in Malta

    OpenAIRE

    Cauchi Cuschieri, Rose Anne

    2007-01-01

    This paper takes a view and discusses the author’s current doctoral research on leadership in Roman Catholic primary and secondary schools in Malta. The study is taking a grounded approach in order to investigate what it is like to be a headteacher in a church-run school, through an exploration of attitudes, behaviours, leadership styles and managerial skills and approaches. The initial phase of the project involved interviews with 10 Roman Catholic school headteachers (5 primary and 5 second...

  14. Primary ciliary dyskinesia in the paediatric population: range and severity of radiological findings in a cohort of patients receiving tertiary care

    Energy Technology Data Exchange (ETDEWEB)

    Jain, K. [Department of Radiology, Royal Brompton and Harefield NHS Trust, London (United Kingdom); Padley, S.P.G. [Department of Radiology, Royal Brompton and Harefield NHS Trust, London (United Kingdom)], E-mail: s.padley@ic.ac.uk; Goldstraw, E.J.; Kidd, S.J. [Department of Radiology, Royal Brompton and Harefield NHS Trust, London (United Kingdom); Hogg, C.; Biggart, E.; Bush, A. [Department of Paediatric Respiratory Medicine, Royal Brompton and Harefield NHS Trust, London (United Kingdom)

    2007-10-15

    Aim: To investigate the clinical range and severity of radiological findings in a cohort of patients with primary ciliary dyskinesia (PCD) receiving tertiary care. Materials and methods: The case notes and clinical test results of 89 children attending the paediatric respiratory disease clinic at our institution were retrospectively analysed. Demographic details including age at diagnosis and common presenting signs and symptoms were studied. Results of chest radiographs, microscopy, and high-resolution computed tomography (HRCT) for quantification of lung damage were analysed. Results: In a cohort of 89 children with PCD, a presentation chest radiograph was available in 62% of patients (n = 55), with all but one demonstrating changes of bronchial wall thickening. HRCT of the lungs, available in 26 patients, were scored using the system described by Brody et al. analysing five specific features of lung disease, including bronchiectasis, mucus plugging, peribronchial thickening, parenchymal changes of consolidation, and ground-glass density, and focal air-trapping in each lobe. Peribronchial thickening was observed using HRCT in 25 patients, while 20 patients had bronchiectasis. Severity scores were highest for the middle and the lingular lobes. Conclusion: The radiographic findings of the largest reported cohort of patients with PCD are presented, with associated clinical findings. Dextrocardia remains the commonest finding on chest radiography. HRCT demonstrates peribronchial thickening and bronchiectasis, which is most marked in the lower zones. Radiological scoring techniques developed for assessment of cystic fibrosis can also be applied for the assessment of disease severity in this patient population.

  15. Visual disability in newly diagnosed primary open angle glaucoma (POAG) patients in a tertiary hospital in Nigeria.

    Science.gov (United States)

    Awoyesuku, E A; Ejimadu, C S

    2012-01-01

    Glaucoma remains the second leading cause of blindness worldwide and the highes cause of irreversible blindness worldwide. In N Glaucoma accounts for 16% of blindness and primary open angle glaucoma is the most prevalent clinical type. The aim of this study is to assess the visual disability resulting from glaucoma in newly diagnosed POAG patients in University of Port Harcourt Teaching Hospital. This is a retrospective study of newly diagnosed glaucoma patients referred from the general ophthalmology clinic to the glaucoma clinic over a 12 month period (January-December 2010). All patients had a glaucoma workup includin Snellen distant visual acuity, slit lamp examination, Goldman applanation tonometry, gonioscopy, dilated fundoscopy with +78 diopter lens as well as perimetry. All examinations were carried out by both authors. Patients with other co-morbidities such as cataract and retinal/macular pathologies were excluded from the study. A total of 98 patients were reviewed. The were 34 males and 27 females, giving a male to female ratio of 1.3:1. The average age was 54.2 years and most patients (>80%) were in the 40-59 year age group. Of the 98 patients reviewed, 62.2% had POAG. 30 patients were-blind by distant visual acuity criteria while 45 patients were blind by central visual field criteria. POAG is the most prevalent clinical subtype of glaucoma in Nigeria and sub-Saharan Africa Paucity of symptoms in early stages of the disease at late presentation is a characteristic finding in our clinic environment. Our study showed that POAG in our environment is associated with marked visual disability at the time of presentation.

  16. Imaging the cranial nerves: part II: primary and secondary neoplastic conditions and neurovascular conflicts

    Energy Technology Data Exchange (ETDEWEB)

    Borges, Alexandra [Instituto Portugues de Oncologia Francisco Gentil- Centro de Lisboa, Radiology Department, Lisboa Codex (Portugal); Casselman, Jan [A. Z. St Jan Brugge and A. Z. St Augustinus Antwerpen Hospitals, Department of Radiology, Antwerp (Belgium)

    2007-09-15

    There have been unprecedented improvements in cross-sectional imaging in the last decades. The emergence of volumetric CT, higher field MR scanners and higher resolution MR sequences is largely responsible for the increasing diagnostic yield of imaging in patients presenting with cranial nerve deficits. The introduction of parallel MR imaging in combination with small surface coils allows the depiction of submillimetric nerves and nerve branches, and volumetric CT and MR imaging is able to provide high quality multiplanar and curved reconstructions that can follow the often complex course of cranial nerves. Seeking the cause of a cranial nerve deficit is a common indication for imaging, and it is not uncommon that radiologists are the first specialists to see a patient with a cranial neuropathy. To increase the diagnostic yield of imaging, high-resolution studies with smaller fields of view are required. To keep imaging studies within a reasonable time frame, it is mandatory to tailor the study according to neuro-topographic testing. This review article focuses on the contribution of current imaging techniques in the depiction of primary and secondary neoplastic conditions affecting the cranial nerves as well as on neurovascular conflicts, an increasingly recognized cause of cranial neuralgias. (orig.)

  17. Primary and secondary organic aerosol origin by combined gas-particle phase source apportionment

    Directory of Open Access Journals (Sweden)

    M. Crippa

    2013-08-01

    Full Text Available Secondary organic aerosol (SOA, a prominent fraction of particulate organic mass (OA, remains poorly constrained. Its formation involves several unknown precursors, formation and evolution pathways and multiple natural and anthropogenic sources. Here a combined gas-particle phase source apportionment is applied to wintertime and summertime data collected in the megacity of Paris in order to investigate SOA origin during both seasons. This was possible by combining the information provided by an aerosol mass spectrometer (AMS and a proton transfer reaction mass spectrometer (PTR-MS. A better constrained apportionment of primary OA (POA sources is also achieved using this methodology, making use of gas-phase tracers. These tracers made possible the discrimination between biogenic and continental/anthropogenic sources of SOA. We found that continental SOA was dominant during both seasons (24–50% of total OA, while contributions from photochemistry-driven SOA (9% of total OA and marine emissions (13% of total OA were also observed during summertime. A semi-volatile nighttime component was also identified (up to 18% of total OA during wintertime. This approach was successfully applied here and implemented in a new source apportionment toolkit.

  18. Gender differences in primary and secondary education: Are girls really outperforming boys?

    Science.gov (United States)

    Driessen, Geert; van Langen, Annemarie

    2013-06-01

    A moral panic has broken out in several countries after recent studies showed that girls were outperforming boys in education. Commissioned by the Dutch Ministry of Education, the present study examines the position of boys and girls in Dutch primary education and in the first phase of secondary education over the past ten to fifteen years. On the basis of several national and international large-scale databases, the authors examined whether one can indeed speak of a gender gap, at the expense of boys. Three domains were investigated, namely cognitive competencies, non-cognitive competencies, and school career features. The results as expressed in effect sizes show that there are hardly any differences with regard to language and mathematics proficiency. However, the position of boys in terms of educational level and attitudes and behaviour is much more unfavourable than that of girls. Girls, on the other hand, score more unfavourably with regard to sector and subject choice. While the present situation in general does not differ very much from that of a decade ago, it is difficult to predict in what way the balances might shift in the years to come.

  19. Imaging the cranial nerves: part II: primary and secondary neoplastic conditions and neurovascular conflicts

    International Nuclear Information System (INIS)

    Borges, Alexandra; Casselman, Jan

    2007-01-01

    There have been unprecedented improvements in cross-sectional imaging in the last decades. The emergence of volumetric CT, higher field MR scanners and higher resolution MR sequences is largely responsible for the increasing diagnostic yield of imaging in patients presenting with cranial nerve deficits. The introduction of parallel MR imaging in combination with small surface coils allows the depiction of submillimetric nerves and nerve branches, and volumetric CT and MR imaging is able to provide high quality multiplanar and curved reconstructions that can follow the often complex course of cranial nerves. Seeking the cause of a cranial nerve deficit is a common indication for imaging, and it is not uncommon that radiologists are the first specialists to see a patient with a cranial neuropathy. To increase the diagnostic yield of imaging, high-resolution studies with smaller fields of view are required. To keep imaging studies within a reasonable time frame, it is mandatory to tailor the study according to neuro-topographic testing. This review article focuses on the contribution of current imaging techniques in the depiction of primary and secondary neoplastic conditions affecting the cranial nerves as well as on neurovascular conflicts, an increasingly recognized cause of cranial neuralgias. (orig.)

  20. Social Isolation and Mental Health at Primary and Secondary School Entry: A Longitudinal Cohort Study

    Science.gov (United States)

    Matthews, Timothy; Danese, Andrea; Wertz, Jasmin; Ambler, Antony; Kelly, Muireann; Diver, Ashleen; Caspi, Avshalom; Moffitt, Terrie E.; Arseneault, Louise

    2015-01-01

    Objective We tested whether children who are socially isolated early in their schooling develop mental health problems in early adolescence, taking into account their mental health and family risk at school entry. Method We used data from the Environmental Risk (E-Risk) Longitudinal Twin Study, a birth cohort of 2,232 children born in England and Wales in 1994 and 1995. We measured social isolation using mothers’ and teachers’ reports at ages 5 and 12 years. We assessed mental health symptoms via mothers’ and teachers’ ratings at age 5 and self-report measures at age 12. We collected mother-reported information about the family environment when children were 5 years old. We conducted regression analyses to test concurrent and longitudinal associations between early family factors, social isolation, and mental health difficulties. Results At both primary and secondary school, children who were socially isolated experienced greater mental health difficulties. Children with behavioral problems or attention-deficit/hyperactivity disorder (ADHD) symptoms at age 5 years had an elevated risk of becoming more socially isolated at age 12. However, children who were isolated at age 5 did not have greater mental health symptoms at age 12, over and above pre-existing difficulties. Conclusion Although social isolation and mental health problems co-occur in childhood, early isolation does not predict worse mental health problems later on. However, children who exhibit problematic behaviors may struggle to cope with the social challenges that accompany their progression through the early school years. PMID:25721188

  1. Exploring EFL Teachers’ Motivation in Greek State Primary and Secondary Schools

    Directory of Open Access Journals (Sweden)

    Despoena Gemelou

    2010-02-01

    Full Text Available Although many studies within the field of educational psychology have addressed the issue of students’ motivation, not as much attention has been given to teacher motivation. The present study aims at examining the factors that motivate EFL teachers working at Greek State Primary and Secondary schools, highlighting the importance of these factors for the improvement and enhancement of the teaching performance. The results of the study indicated that EFL teachers are quite motivated. Motivating factors are mostly intrinsic in nature, while demotivation rises mainly from extrinsic factors. Among the most powerful motivators were the teachers’ relation with their students and the subject matter itself, while frequent educational reforms and poor remuneration were identified as highly demotivating factors. Given that teachers’ motivation directly influences students’ motivation, highly motivated teachers are crucial for an effective educational system. Consequently, an important part of education policy-making should be the enhancement of teacher motivation as well as the reduction or elimination of any factors that impede teachers’ performance.

  2. Clinical experience with RF thermotherapy for nonresectable primary and secondary liver tumors

    International Nuclear Information System (INIS)

    Yonemura, Yutaka; Fujimura, Takashi; Takegawa, Shigeru; Miyata, Ryuwa; Kamata, Toru; Miyazaki, Itsuo; Nakajima, Kazuyoshi; Hisazumi, Haruo; Saito, Yasuo

    1987-01-01

    Twenty two patients with primary or secondary liver tumors were treated by radiofrequency hyperthermia (8 MHz) combined with radiation or chemotherapy. Hyperthermia was administered twice a week for 40 - 60 minutes per session up to a total of 5 - 48 sessions. Five fractions per week of irradiation (10 MV X ray) at 180 - 200 cGy or intraarterial chemotherapy using mitomycin C, cis-diamminedichroloplatinum or adriamycine were carried out. Intratumor temperature over 42.5 deg C were obtained in 9 of 17 patients. Of the 22 patients treated, 2 (9 %) showed complete response, 8 (36 %) partial response, 3 (14 %) minor response, 7 (32 %) no change and 2 (9 %) progressive disease. 7 out of 14 tumors, heated over 42.5 deg C showed complete or partial response but only 1 out of 5 tumors, heated under 42.5 deg C was responder. Complication observed were thrombocytopenia and leukopenia in 30 % of cases. These results showed that combined treatment of hyperthermia radiation and chemotherapy appear to be useful from of therapy for the patients with liver tumor. (author)

  3. Reactivity of Primary Soil Minerals and Secondary Precipitates Beneath Leaking Hanford Waste Tanks

    International Nuclear Information System (INIS)

    Nagy, Kathryn L.; Sturchio, Neil C.

    2003-01-01

    This project, renewal of a previous EMSP project of the same title, is in its first year of funding at the University of Illinois at Chicago. The purpose is to continue investigating rates and mechanisms of reactions between primary sediment minerals found in the Hanford subsurface and leaked waste tank solutions. The goals are to understand processes that result in (1) changes in porosity and permeability of the sediment and resultant changes in flow paths of the contaminant plumes, (2) formation of secondary precipitates that can take up contaminants in their structures, and (3) release of mineral components that can drive redox reactions affecting dissolved contaminant mobility. A post-doctoral scientist, Dr. Sherry Samson, has been hired and two masters of science students are beginning to conduct experimental research. One research project that is underway is focused on measurement of the dissolution rates of plagioclase feldspar in high pH, high nitrate, high Al-bearing solutions characteristic of the BX tank farms. The first set of experiments is being conduced at room temperature. Subsequent experiments will examine the role of temperature because tank solutions in many cases were near boiling when leakage is thought to have occurred and temperature gradients have been observed beneath the SX and BX tank farms. The dissolution experiments are being conducted in stirred-flow kinetic reactors using powdered labradorite feldspar from Pueblo Park, New Mexico

  4. Preliminary clinical results of locoregional hyperthermia for primary and secondary bone tumors

    Energy Technology Data Exchange (ETDEWEB)

    Zhu, J.L.; Nagata, Yasushi; Kanamori, Shuichi; Mitsumori, Michihide; Okuno, Yoshishige; Horii, Naotoshi; Nishimura, Yasumasa; Masunaga, Shinitiro; Hiraoka, Masahiro [Kyoto Univ. (Japan). Graduate School of Medicine

    2000-03-01

    Nineteen primary and secondary bone tumors in 16 patients were treated with hyperthermia plus radiotherapy and/or chemotherapy between 1982 and 1997 at Kyoto University Hospital. The thermometric and clinical results were analyzed retrospectively. In 55 of 86 hyperthermia sessions, the intratumor temperature was measured using a thermometer. Of the 19 tumors, 16 (84%) received heat treatment 4-7 times, and 3 (16%) received 1 or 2 treatments of hyperthermia. The mean maximum, mean minimum and average intratumor temperatures were 42.9, 40.4 and 41.6 deg C, respectively, and 12 (67%) reached a tumor maximum temperature above 42.5 deg C. The durations that intratumor points exceeded 42, 41 and 40 deg C were 27, 34 and 38 min, respectively. The local tumor response to treatment was assessed using X-ray computed tomography. The local response rate was 16% and the local pain relief rate was 63%. The 1-year cumulative survival rate was 60%. Our preliminary results indicated that thermoradiotherapy and thermochemotherapy are clinicaly feasible and potentially beneficial in the management of locally advanced bone tumors. (author)

  5. Dislocation based controlling of kinematic hardening contribution to simulate primary and secondary stages of uniaxial ratcheting

    Science.gov (United States)

    Bhattacharjee, S.; Dhar, S.; Acharyya, S. K.

    2017-07-01

    The primary and secondary stages of the uniaxial ratcheting curve for the C-Mn steel SA333 have been investigated. Stress controlled uniaxial ratcheting experiments were conducted with different mean stresses and stress amplitudes to obtain curves showing the evolution of ratcheting strain with number of cycles. In stage-I of the ratcheting curve, a large accumulation of ratcheting strain occurs, but at a decreasing rate. In contrast, in stage-II a smaller accumulation of ratcheting strain is found and the ratcheting rate becomes almost constant. Transmission electron microscope observations reveal that no specific dislocation structures are developed during the early stages of ratcheting. Rather, compared with the case of low cycle fatigue, it is observed that sub-cell formation is delayed in the case of ratcheting. The increase in dislocation density as a result of the ratcheting strain is obtained using the Orowan equation. The ratcheting strain is obtained from the shift of the plastic strain memory surface. The dislocation rearrangement is incorporated in a functional form of dislocation density, which is used to calibrate the parameters of a kinematic hardening law. The observations are formulated in a material model, plugged into the ABAQUS finite element (FE) platform as a user material subroutine. Finally the FE-simulated ratcheting curves are compared with the experimental curves.

  6. Adverse effects of the antimalaria drug, mefloquine: due to primary liver damage with secondary thyroid involvement?

    Directory of Open Access Journals (Sweden)

    Herxheimer Andrew

    2002-03-01

    Full Text Available Abstract Background Mefloquine is a clinically important antimalaria drug, which is often not well tolerated. We critically reviewed 516 published case reports of mefloquine adverse effects, to clarify the phenomenology of the harms associated with mefloquine, and to make recommendations for safer prescribing. Presentation We postulate that many of the adverse effects of mefloquine are a post-hepatic syndrome caused by primary liver damage. In some users we believe that symptomatic thyroid disturbance occurs, either independently or as a secondary consequence of the hepatocellular injury. The mefloquine syndrome presents in a variety of ways including headache, gastrointestinal disturbances, nervousness, fatigue, disorders of sleep, mood, memory and concentration, and occasionally frank psychosis. Previous liver or thyroid disease, and concurrent insults to the liver (such as from alcohol, dehydration, an oral contraceptive pill, recreational drugs, and other liver-damaging drugs may be related to the development of severe or prolonged adverse reactions to mefloquine. Implications We believe that people with active liver or thyroid disease should not take mefloquine, whereas those with fully resolved neuropsychiatric illness may do so safely. Mefloquine users should avoid alcohol, recreational drugs, hormonal contraception and co-medications known to cause liver damage or thyroid damage. With these caveats, we believe that mefloquine may be safely prescribed in pregnancy, and also to occupational groups who carry out safety-critical tasks. Testing Mefloquine's adverse effects need to be investigated through a multicentre cohort study, with small controlled studies testing specific elements of the hypothesis.

  7. Impact of shelf life on content of primary and secondary metabolites in apple (Malus domestica Borkh.).

    Science.gov (United States)

    Veberic, Robert; Schmitzer, Valentina; Petkovsek, Maja M; Stampar, Franci

    2010-01-01

    In this study, we evaluated the changes in apple fruit quality during shelf life. After a month of cold storage, apples of cultivars "Jonagold" and "Golden Delicious" were exposed to ambient temperatures for 21 d, with subsequent sampling every 3 or 4 d. Fruit firmness, changes in amounts of sugars, malic acid, and phenolics were observed during shelf life. Chemical analyses were done with HPLC-PDA system. An interchange between various sugars was noticed, but in general, the sum of sugars remained at the same level. The content of malic acid remained stable or dropped, resulting in sweeter fruit. Levels of phenolics were more constant in the pulp of both cultivars analyzed, while in the peel, the changes were more pronounced. In the pulp, a peak in the content of hydroxycinnamic acids and flavanols was noticed on the 2nd or 3rd sampling and afterwards, the amounts remained constant. In the peel an initial decrease of all analyzed phenolic groups was observed in both cultivars, however it was more pronounced in "Jonagold." It can be concluded that changes in primary and secondary metabolites are not the main reason for the lower quality of fruit exposed to ambient temperatures. On the other hand, fruit firmness might be the limiting factor for shelf life duration. © 2010 Institute of Food Technologists®

  8. Obesity and its cardio-metabolic co-morbidities among adult Nigerians in a primary care clinic of a tertiary hospital in South-Eastern, Nigeria

    Directory of Open Access Journals (Sweden)

    Gabriel Uche Pascal Iloh

    2013-01-01

    Full Text Available Background: Obesity once thought the medical problem of affluent countries now exist in Nigeria and has been described as a time bomb for the future explosion in the frequency of cardio-metabolic diseases. The most deleterious health consequences of obesity are on the cardiovascular system and associated disorder of lipid and glucose homeostasis. Aim: This study was designed to determine the magnitude of obesity and its cardio-metabolic co-morbidities among adult Nigerians in a primary care clinic of a tertiary hospital South-Eastern, Nigeria. Materials and Methods: A cross-sectional study carried out on 2391 adult Nigerians who were assessed for obesity using body mass index (BMI criterion. 206 patients who had BMI ΃30kg/m 2 were screened for cardio-metabolic co-morbidities. The data collected included basic demographic variables, weight, height, blood pressure; fasting plasma glucose and lipid profile. Results: The prevalence of obesity was 8.6%. Grade I obesity (67.5% was the most common pattern; others included grade II obesity (23.3% and grade III obesity (9.2%. Hypertension (42.7% was the most common cardio-metabolic morbidity. Others included low HDL-cholesterol (22.8%, diabetes mellitus (15.1%, high triglyceride (12.6%, high total cholesterol (9.2%, and high LDL-cholesterol (6.8%. Conclusion: Obesity and its cardio-metabolic morbidities exist among the study population. Anthropometric determination of obesity and screening for its associated cardio-metabolic co-morbidities should constitute clinical targets for intervention in primary care clinics.

  9. [Compliance with recommendations in secondary prevention of stroke in primary care].

    Science.gov (United States)

    Tamayo-Ojeda, Carmen; Parellada-Esquius, Neus; Salvador-González, Betlem; Oriol-Torón, Pilar Ángeles; Rodríguez-Garrido, M Dolores; Muñoz-Segura, Dolores

    Knowing compliance with secondary prevention recommendations of stroke in primary care and to identify factors associated with compliance. Multi-centre cross-sectional. Health primary care centres in a metropolitan area (944,280 inhabitants). Patients aged 18years and over with ischemic brain disease diagnosis prior to 6months before the study. Clinical history records of demographic variables, risk factors and cardiovascular comorbidity, drugs, blood pressure values (BP), LDL-cholesterol and medical visits by doctor and nurses after the event. Good adherence was considered when BP <140/90 mmHg, LDL-cholesterol <100 mg/dL, smoking abstention and preventive drugs prescription (anti-platelet/anticoagulants, statins and angiotensin-converting-enzyme inhibitors/angiotensin-receptor-antagonists or diuretics) during the last 18months. A total of 21,976 patients, mean age 73.12 years (SD: 12.13), 48% women, 72.7% with stroke. Co-morbidity: hypertension 70.8%, dyslipidemia 55.1%, DM 30.9%, atrial fibrillation 14.1%, ischemic heart disease 13.5%, chronic renal failure 12.5%, heart failure 8.8%, peripheral arterial disease 6.2%, dementia 7.8%. No record was found for smoking in 3.7%, for BP in 3.5% and for LDL in 6.5%. Optimal control: abstention smoking in 3.7%, BP <140/90 in 65.7% and LDL <100 mg/dL in 41.0%. 86.2% anti-platelet/anticoagulants, 61.3% statins and 61.8% angiotensin-converting-enzyme inhibitors, angiotensin-receptor-antagonists or diuretic. Registration and risk factors control was higher in 66-79years aged and lower in 18-40years aged. The implementation of clinical guidelines recommendations for stroke prevention in primary care must be improved, especially among younger population. Organizational changes and more active involvement by professionals and strategies against therapeutic inertia must be taken. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

  10. Cardiovascular disease treatment among patients with severe mental illness: a data linkage study between primary and secondary care.

    Science.gov (United States)

    Woodhead, Charlotte; Ashworth, Mark; Broadbent, Matthew; Callard, Felicity; Hotopf, Matthew; Schofield, Peter; Soncul, Murat; Stewart, Robert J; Henderson, Max J

    2016-06-01

    Suboptimal treatment of cardiovascular diseases (CVD) among patients with severe mental illness (SMI) may contribute to physical health disparities. To identify SMI characteristics associated with meeting CVD treatment and prevention guidelines. Population-based electronic health record database linkage between primary care and the sole provider of secondary mental health care services in south east London, UK. Cardiovascular disease prevalence, risk factor recording, and Quality and Outcomes Framework (QOF) clinical target achievement were compared among 4056 primary care patients with SMI whose records were linked to secondary healthcare records and 270 669 patients without SMI who were not known to secondary care psychiatric services, using multivariate logistic regression modelling. Data available from secondary care records were then used to identify SMI characteristics associated with QOF clinical target achievement. Patients with SMI and with coronary heart disease and heart failure experienced reduced prescribing of beta blockers and angiotensin-converting enzyme inhibitor/angiotensin receptor blockers (ACEI/ARB). A diagnosis of schizophrenia, being identified with any indicator of risk or illness severity, and being prescribed with depot injectable antipsychotic medication was associated with the lowest likelihood of prescribing. Linking primary and secondary care data allows the identification of patients with SMI most at risk of undertreatment for physical health problems. © British Journal of General Practice 2016.

  11. Blood transfusion for preventing primary and secondary stroke in people with sickle cell disease

    Science.gov (United States)

    Estcourt, Lise J; Fortin, Patricia M; Hopewell, Sally; Trivella, Marialena; Wang, Winfred C

    2017-01-01

    Background Sickle cell disease is one of the commonest severe monogenic disorders in the world, due to the inheritance of two abnormal haemoglobin (beta globin) genes. Sickle cell disease can cause severe pain, significant end-organ damage, pulmonary complications, and premature death. Stroke affects around 10% of children with sickle cell anaemia (HbSS). Chronic blood transfusions may reduce the risk of vaso-occlusion and stroke by diluting the proportion of sickled cells in the circulation. This is an update of a Cochrane Review first published in 2002, and last updated in 2013. Objectives To assess risks and benefits of chronic blood transfusion regimens in people with sickle cell disease for primary and secondary stroke prevention (excluding silent cerebral infarcts). Search methods We searched for relevant trials in the Cochrane Library, MEDLINE (from 1946), Embase (from 1974), the Transfusion Evidence Library (from 1980), and ongoing trial databases; all searches current to 04 April 2016. We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group Haemoglobinopathies Trials Register: 25 April 2016. Selection criteria Randomised controlled trials comparing red blood cell transfusions as prophylaxis for stroke in people with sickle cell disease to alternative or standard treatment. There were no restrictions by outcomes examined, language or publication status. Data collection and analysis Two authors independently assessed trial eligibility and the risk of bias and extracted data. Main results We included five trials (660 participants) published between 1998 and 2016. Four of these trials were terminated early. The vast majority of participants had the haemoglobin (Hb)SS form of sickle cell disease. Three trials compared regular red cell transfusions to standard care in primary prevention of stroke: two in children with no previous long-term transfusions; and one in children and adolescents on long-term transfusion. Two trials compared the drug

  12. Blood transfusion for preventing primary and secondary stroke in people with sickle cell disease.

    Science.gov (United States)

    Estcourt, Lise J; Fortin, Patricia M; Hopewell, Sally; Trivella, Marialena; Wang, Winfred C

    2017-01-17

    Sickle cell disease is one of the commonest severe monogenic disorders in the world, due to the inheritance of two abnormal haemoglobin (beta globin) genes. Sickle cell disease can cause severe pain, significant end-organ damage, pulmonary complications, and premature death. Stroke affects around 10% of children with sickle cell anaemia (HbSS). Chronic blood transfusions may reduce the risk of vaso-occlusion and stroke by diluting the proportion of sickled cells in the circulation.This is an update of a Cochrane Review first published in 2002, and last updated in 2013. To assess risks and benefits of chronic blood transfusion regimens in people with sickle cell disease for primary and secondary stroke prevention (excluding silent cerebral infarcts). We searched for relevant trials in the Cochrane Library, MEDLINE (from 1946), Embase (from 1974), the Transfusion Evidence Library (from 1980), and ongoing trial databases; all searches current to 04 April 2016.We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group Haemoglobinopathies Trials Register: 25 April 2016. Randomised controlled trials comparing red blood cell transfusions as prophylaxis for stroke in people with sickle cell disease to alternative or standard treatment. There were no restrictions by outcomes examined, language or publication status. Two authors independently assessed trial eligibility and the risk of bias and extracted data. We included five trials (660 participants) published between 1998 and 2016. Four of these trials were terminated early. The vast majority of participants had the haemoglobin (Hb)SS form of sickle cell disease.Three trials compared regular red cell transfusions to standard care in primary prevention of stroke: two in children with no previous long-term transfusions; and one in children and adolescents on long-term transfusion.Two trials compared the drug hydroxyurea (hydroxycarbamide) and phlebotomy to long-term transfusions and iron chelation therapy: one in

  13. 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

  14. Teacher Salaries and the Shortage of High-Quality Teachers in China's Rural Primary and Secondary Schools

    Science.gov (United States)

    Xuehui, An

    2018-01-01

    Teacher salary level and structure are not only important factors affecting the supply of primary and secondary school teachers, but they are also crucial to attracting, training, and retaining high-quality teachers, thereby impacting the overall quality of education and teaching in schools. The reform of China's basic education management system…

  15. The Contributions of Primary and Secondary Memory to Working Memory Capacity: An Individual Differences Analysis of Immediate Free Recall

    Science.gov (United States)

    Unsworth, Nash; Spillers, Gregory J.; Brewer, Gene A.

    2010-01-01

    The present study tested the dual-component model of working memory capacity (WMC) by examining estimates of primary memory and secondary memory from an immediate free recall task. Participants completed multiple measures of WMC and general intellectual ability as well as multiple trials of an immediate free recall task. It was demonstrated that…

  16. Console Game-Based Pedagogy: A Study of Primary and Secondary Classroom Learning through Console Video Games

    Science.gov (United States)

    Groff, Jennifer S.; Howells, Cathrin; Cranmer, Sue

    2012-01-01

    The main focus of this research project was to identify the educational benefits of console game-based learning in primary and secondary schools. The project also sought to understand how the benefits of educational gaming could transfer to other settings. For this purpose, research was carried out in classrooms in Scotland to explore learning…

  17. Complex of primary and secondary parasitoids (Hymenoptera: Encyrtidae and Signiphoridae) of Hypogeoccoccus spp. mealybugs (Hemiptera: Pseudococcidae) in the New World

    Science.gov (United States)

    Parasitoids, both primary and secondary (hyperparasitoids), of Hypogeococcus spp. mealybugs (Hemiptera: Pseudococcidae) are reviewed to report results of the surveys in the New World conducted during 2009–2017 for perspective natural enemies of the Harrisia cactus mealybug, Hypogeococcus sp., which ...

  18. The Social and Emotional Functioning of Students with an Autistic Spectrum Disorder during the Transition between Primary and Secondary Schools

    Science.gov (United States)

    Fortuna, Ron

    2014-01-01

    The transition from the primary to the secondary phase in education can be a pivotal moment for many students, but for students who have autism, their difficulties with socialisation and emotional regulation can make this time period especially challenging. This article explores the experiences of key stakeholders regarding the issue of students…

  19. Self-beliefs mediate mathematical performance between primary and lower secondary school: A large scale longitudinal cohort study

    NARCIS (Netherlands)

    Reed, Helen; Kirschner, Paul A.; Jolles, Jelle

    2016-01-01

    It is often argued that enhancement of self-beliefs should be one of the key goals ofeducation. However, very little is known about the relation between self-beliefs and performance when students move from primary to secondary school in highly differentiated educational systems with early tracking.

  20. The Construct of Teachers' Pay Satisfaction: A Case Study of Primary and Secondary Schools in China

    Science.gov (United States)

    Cai, Yonghong; Bi, Yan; Wang, Li; Cravens, Xiu Chen; Li, Yanli

    2018-01-01

    The construct of teachers' pay satisfaction is important to the systemic appraisal of teachers' compensation. The study aims to probe the components of teachers' pay satisfaction and verify this construct in primary and secondary schools in China. In-depth interviews with 24 teachers were conducted to propose a construct model for teachers' pay…

  1. Physical Activity Patterns and Psychological Correlates of Physical Activity among Singaporean Primary, Secondary, and Junior College Students

    Science.gov (United States)

    Wang, C. K. John; Koh, K. T.; Biddle, Stuart J. H.; Liu, W. C.; Chye, Stefanie

    2011-01-01

    The purpose of this research was to examine physical activity patterns and psychological correlates of physical activity among primary, secondary, and junior college students in Singapore. A sample of 3,333 school students aged 10 to 18 years took part in the study. Results showed that the younger students had significantly higher physical…

  2. Does the Implant Surgical Technique Affect the Primary and/or Secondary Stability of Dental Implants? A Systematic Review

    Science.gov (United States)

    Shadid, Rola Muhammed; Sadaqah, Nasrin Rushdi; Othman, Sahar Abdo

    2014-01-01

    Background. A number of surgical techniques for implant site preparation have been advocated to enhance the implant of primary and secondary stability. However, there is insufficient scientific evidence to support the association between the surgical technique and implant stability. Purpose. This review aimed to investigate the influence of different surgical techniques including the undersized drilling, the osteotome, the piezosurgery, the flapless procedure, and the bone stimulation by low-level laser therapy on the primary and/or secondary stability of dental implants. Materials and methods. A search of PubMed, Cochrane Library, and grey literature was performed. The inclusion criteria comprised observational clinical studies and randomized controlled trials (RCTs) conducted in patients who received dental implants for rehabilitation, studies that evaluated the association between the surgical technique and the implant primary and/or secondary stability. The articles selected were carefully read and classified as low, moderate, and high methodological quality and data of interest were tabulated. Results. Eight clinical studies were included then they were classified as moderate or high methodological quality and control of bias. Conclusions. There is a weak evidence suggesting that any of previously mentioned surgical techniques could influence the primary and/or secondary implant stability. PMID:25126094

  3. Does the Implant Surgical Technique Affect the Primary and/or Secondary Stability of Dental Implants? A Systematic Review

    Directory of Open Access Journals (Sweden)

    Rola Muhammed Shadid

    2014-01-01

    Full Text Available Background. A number of surgical techniques for implant site preparation have been advocated to enhance the implant of primary and secondary stability. However, there is insufficient scientific evidence to support the association between the surgical technique and implant stability. Purpose. This review aimed to investigate the influence of different surgical techniques including the undersized drilling, the osteotome, the piezosurgery, the flapless procedure, and the bone stimulation by low-level laser therapy on the primary and/or secondary stability of dental implants. Materials and methods. A search of PubMed, Cochrane Library, and grey literature was performed. The inclusion criteria comprised observational clinical studies and randomized controlled trials (RCTs conducted in patients who received dental implants for rehabilitation, studies that evaluated the association between the surgical technique and the implant primary and/or secondary stability. The articles selected were carefully read and classified as low, moderate, and high methodological quality and data of interest were tabulated. Results. Eight clinical studies were included then they were classified as moderate or high methodological quality and control of bias. Conclusions. There is a weak evidence suggesting that any of previously mentioned surgical techniques could influence the primary and/or secondary implant stability.

  4. Development of a Mobile-Optimised Website to Support Students with Special Needs Transitioning from Primary to Secondary Settings

    Science.gov (United States)

    Chambers, Dianne; Coffey, Anne

    2013-01-01

    With an increasing number of students with special needs being included in regular classroom environments, consideration of, and planning for, a smooth transition between different school settings is important for parents, classroom teachers and school administrators. The transition between primary and secondary school can be difficult for…

  5. Examination of Primary and Secondary School Teachers' Aspects towards Educational Use of Video Sharing Websites

    Science.gov (United States)

    Usta, Ertugrul; Atun, Handan

    2017-01-01

    Daily use of video has increased by televisions, but lately people have been using video sharing websites most frequently. This extended use of video sharing websites has emerged a new era for education; teachers and learners can use them to enhance learning in education. Hence, the purpose of this study is to examine primary and secondary school…

  6. The Influence of Surface and Deep Cues on Primary and Secondary School Students' Assessment of Relevance in Web Menus

    Science.gov (United States)

    Rouet, Jean-Francois; Ros, Christine; Goumi, Antonine; Macedo-Rouet, Monica; Dinet, Jerome

    2011-01-01

    Two experiments investigated primary and secondary school students' Web menu selection strategies using simulated Web search tasks. It was hypothesized that students' selections of websites depend on their perception and integration of multiple relevance cues. More specifically, students should be able to disentangle superficial cues (e.g.,…

  7. 40 CFR 50.11 - National primary and secondary ambient air quality standards for oxides of nitrogen (with...

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 2 2010-07-01 2010-07-01 false National primary and secondary ambient air quality standards for oxides of nitrogen (with nitrogen dioxide as the indicator). 50.11 Section 50.11 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS NATIONAL...

  8. Investigating the Relationship among the Level of Mobbing Experience, Job Satisfaction and Burnout Levels of Primary and Secondary School Teachers

    Science.gov (United States)

    Okçu, Veysel; Çetin, Hakan

    2017-01-01

    The aim of this study is to examine the level of mobbing experienced by primary and secondary school teachers and to determine how and to what extent this affects their job satisfaction and burnout levels. This research used a relational survey model. As a result of the study, it has been determined that there is a negative and medium-level…

  9. Processing of primary and secondary rewards: a quantitative meta-analysis and review of human functional neuroimaging studies

    NARCIS (Netherlands)

    Sescousse, G.T.; Caldu, X.; Segura, B.; Dreher, J.C.

    2013-01-01

    One fundamental question concerning brain reward mechanisms is to determine how reward-related activity is influenced by the nature of rewards. Here, we review the neuroimaging literature and explicitly assess to what extent the representations of primary and secondary rewards overlap in the human

  10. [Nurse involvement in primary care: it is the key to improve the outcomes in primary and secondary prevention?].

    Science.gov (United States)

    Scardi, Sabino; Gori, Pierpaolo; Umari, Paolo

    2010-06-01

    Difficulties in management of risk factors, lifestyle and medications adherence to achieve secondary prevention of ischemic heart disease were described. Many studies indicate that the benefit of cardiac rehabilitation therapy after acute coronary events is only partially maintained during the following year. Thereafter, new strategies of medical care are needed to improve the long-term outcomes in coronary patients. Nurse co-ordinated, multidisciplinary cardiac rehabilitative programme could help patients to improve their lifestyle, to control their risk factors and to achieve their therapeutic goals for secondary prevention of ischemic heart disease.

  11. Retinal genes are differentially expressed in areas of primary versus secondary degeneration following partial optic nerve injury.

    Directory of Open Access Journals (Sweden)

    Wissam Chiha

    Full Text Available Partial transection (PT of the optic nerve is an established experimental model of secondary degeneration in the central nervous system. After a dorsal transection, retinal ganglion cells (RGCs with axons in ventral optic nerve are intact but vulnerable to secondary degeneration, whereas RGCs in dorsal retina with dorsal axons are affected by primary and secondary injuries. Using microarray, we quantified gene expression changes in dorsal and ventral retina at 1 and 7 days post PT, to characterize pathogenic pathways linked to primary and secondary degeneration.In comparison to uninjured retina Cryba1, Cryba2 and Crygs, were significantly downregulated in injured dorsal retina at days 1 and 7. While Ecel1, Timp1, Mt2A and CD74, which are associated with reducing excitotoxicity, oxidative stress and inflammation, were significantly upregulated. Genes associated with oxygen binding pathways, immune responses, cytokine receptor activity and apoptosis were enriched in dorsal retina at day 1 after PT. Oxygen binding and apoptosis remained enriched at day 7, as were pathways involved in extracellular matrix modification. Fewer changes were observed in ventral retina at day 1 after PT, most associated with the regulation of protein homodimerization activity. By day 7, apoptosis, matrix organization and signal transduction pathways were enriched. Discriminant analysis was also performed for specific functional gene groups to compare expression intensities at each time point. Altered expression of selected genes (ATF3, GFAP, Ecel1, TIMP1, Tp53 and proteins (GFAP, ECEL1 and ATF3 were semi-quantitatively assessed by qRT-PCR and immunohistochemistry respectively.There was an acute and complex primary injury response in dorsal retina indicative of a dynamic interaction between neuroprotective and neurodegenerative events; ventral retina vulnerable to secondary degeneration showed a delayed injury response. Both primary and secondary injury resulted in the

  12. Primary aerosol and secondary inorganic aerosol budget over the Mediterranean Basin during 2012 and 2013

    Science.gov (United States)

    Guth, Jonathan; Marécal, Virginie; Josse, Béatrice; Arteta, Joaquim; Hamer, Paul

    2018-04-01

    In the frame of the Chemistry-Aerosol Mediterranean Experiment (ChArMEx), we analyse the budget of primary aerosols and secondary inorganic aerosols over the Mediterranean Basin during the years 2012 and 2013. To do this, we use two year-long numerical simulations with the chemistry-transport model MOCAGE validated against satellite- and ground-based measurements. The budget is presented on an annual and a monthly basis on a domain covering 29 to 47° N latitude and 10° W to 38° E longitude. The years 2012 and 2013 show similar seasonal variations. The desert dust is the main contributor to the annual aerosol burden in the Mediterranean region with a peak in spring, and sea salt being the second most important contributor. The secondary inorganic aerosols, taken as a whole, contribute a similar level to sea salt. The results show that all of the considered aerosol types, except for sea salt aerosols, experience net export out of our Mediterranean Basin model domain, and thus this area should be considered as a source region for aerosols globally. Our study showed that 11 % of the desert dust, 22.8 to 39.5 % of the carbonaceous aerosols, 35 % of the sulfate and 9 % of the ammonium emitted or produced into the study domain are exported. The main sources of variability for aerosols between 2012 and 2013 are weather-related variations, acting on emissions processes, and the episodic import of aerosols from North American fires. In order to assess the importance of the anthropogenic emissions of the marine and the coastal areas which are central for the economy of the Mediterranean Basin, we made a sensitivity test simulation. This simulation is similar to the reference simulation but with the removal of the international shipping emissions and the anthropogenic emissions over a 50 km wide band inland along the coast. We showed that around 30 % of the emissions of carbonaceous aerosols and 35 to 60 % of the exported carbonaceous aerosols originates from the marine and

  13. Primary and secondary aerosols in Beijing in winter: sources, variations and processes

    Directory of Open Access Journals (Sweden)

    Y. Sun

    2016-07-01

    Full Text Available Winter has the worst air pollution of the year in the megacity of Beijing. Despite extensive winter studies in recent years, our knowledge of the sources, formation mechanisms and evolution of aerosol particles is not complete. Here we have a comprehensive characterization of the sources, variations and processes of submicron aerosols that were measured by an Aerodyne high-resolution aerosol mass spectrometer from 17 December 2013 to 17 January 2014 along with offline filter analysis by gas chromatography/mass spectrometry. Our results suggest that submicron aerosols composition was generally similar across the winter of different years and was mainly composed of organics (60 %, sulfate (15 % and nitrate (11 %. Positive matrix factorization of high- and unit-mass resolution spectra identified four primary organic aerosol (POA factors from traffic, cooking, biomass burning (BBOA and coal combustion (CCOA emissions as well as two secondary OA (SOA factors. POA dominated OA, on average accounting for 56 %, with CCOA being the largest contributor (20 %. Both CCOA and BBOA showed distinct polycyclic aromatic hydrocarbons (PAHs spectral signatures, indicating that PAHs in winter were mainly from coal combustion (66 % and biomass burning emissions (18 %. BBOA was highly correlated with levoglucosan, a tracer compound for biomass burning (r2 = 0.93, and made a considerable contribution to OA in winter (9 %. An aqueous-phase-processed SOA (aq-OOA that was strongly correlated with particle liquid water content, sulfate and S-containing ions (e.g. CH2SO2+ was identified. On average aq-OOA contributed 12 % to the total OA and played a dominant role in increasing oxidation degrees of OA at high RH levels (> 50 %. Our results illustrate that aqueous-phase processing can enhance SOA production and oxidation states of OA as well in winter. Further episode analyses highlighted the significant impacts of meteorological parameters on

  14. Monte Carlo study of radial energy deposition from primary and secondary particles for narrow and large proton beamlet source models

    International Nuclear Information System (INIS)

    Peeler, Christopher R; Titt, Uwe

    2012-01-01

    In spot-scanning intensity-modulated proton therapy, numerous unmodulated proton beam spots are delivered over a target volume to produce a prescribed dose distribution. To accurately model field size-dependent output factors for beam spots, the energy deposition at positions radial to the central axis of the beam must be characterized. In this study, we determined the difference in the central axis dose for spot-scanned fields that results from secondary particle doses by investigating energy deposition radial to the proton beam central axis resulting from primary protons and secondary particles for mathematical point source and distributed source models. The largest difference in the central axis dose from secondary particles resulting from the use of a mathematical point source and a distributed source model was approximately 0.43%. Thus, we conclude that the central axis dose for a spot-scanned field is effectively independent of the source model used to calculate the secondary particle dose. (paper)

  15. Interpreting stream sediment fingerprints against primary and secondary source signatures in agricultural catchments

    Science.gov (United States)

    Blake, Will H.; Haley, Steve; Smith, Hugh G.; Taylor, Alex; Goddard, Rupert; Lewin, Sean; Fraser, David

    2013-04-01

    Many sediment fingerprinting studies adopt a black box approach to source apportionment whereby the properties of downstream sediment are compared quantitatively to the geochemical fingerprints of potential catchment sources without consideration of potential signature development or modification during transit. Working within a source-pathway-receptor framework, this study aimed to undertake sediment source apportionment within 6 subcatchments of an agricultural river basin with specific attention to the potential role of contaminants (vehicle emissions and mine waste) in development of stream sediment signatures. Fallout radionuclide (FRN) and geochemical fingerprinting methods were adopted independently to establish source signatures for primary sediment sources of surface and subsurface soil materials under various land uses plus reworked mine and 'secondary' soil material deposited, in transit, along road networks. FRN data demonstrated expected variability between surface soil (137Cs = 14 ± 3 Bq kg-1; 210Pbxs = 40 ± 7 Bq kg-1) and channel bank materials (137Cs = 3 ± 1 Bq kg-1; 210Pbxs = 24 ± 5 Bq kg-1) but road transported soil material was considerably elevated in 210Pbxs (up to 673 ± 51 Bq kg-1) due to sediment interaction with pluvial surface water within the road network. Geochemical discrimination between surface and subsurface soil materials was dominated by alkaline earth and alkali metals e.g. Ba, Rb, Ca, K, Mg which are sensitive to weathering processes in soil. Magnetic susceptibility and heavy metals were important discriminators of road transported material which demonstrated transformation of the signatures of material transported via the road network. Numerical unmixing of stream sediment indicated that alongside channel bank erosion, road transported material was an important component in some systems in accord with FRN evidence. While mining spoil also ranked as a significant source in an affected catchment, perhaps related to legacy

  16. The most important structures utilizing primary and secondary hydroenergetic potential for electric energy production

    International Nuclear Information System (INIS)

    Zacharovsky, M.

    1997-01-01

    In this paper the construction, technological parameters and operation of Gabcikovo (primary hydro energy power) and Cierny Vah (secondary hydro energy power) are described. Construction of the hydroelectric power plant (HPP) Gabcikovo started in 1978 as a part of a system of hydro power projects Gabcikovo-Nagymaros. Basic technical data are: installed capacity 8 x 90 MW, production in an average aqueous year 2.650 GWh, number of hydroelectric generating sets (HGS) 8, turbine flow 8 x 413-636 m 3 /s, head 12.9-24 m.The Gabcikovo plant produced 9.163 GWh of electricity from the beginning of its operation till the end of 1966. The construction of the pumped storage plant (PSP) Cierny Vah started in 1976 and it was put into operation at the end of 1980. The main goal of the PSP Cierny Vah is to meet the control functions of an electrification system of the Slovak Republic, a substitute function in the cases of unexpected power outages and a planned electricity production from re-pumping. Technological parts are: six re-pumping vertical HGS in a three machine arrangement - a motor-generator, a turbine, a pump - are located in three double-blocks. Basic technical data: installed capacity 6 x 122.4 MW + 0.768 MW, yearly production 1,281 GWh, number of HGS 6, number of domestic hydroelectric generating sets 1, turbine flow 3 x 30 m / s, pump flow 6 x 22 m 3 /s, upper reservoir volume 3.7 mil. m 3 , max. head 434 m, peak time 5.71 hour, pumping time 7.78 hour, re-pumping cycle efficiency 74.36%. From putting the PSP into operation till the end of 1996, the HGS in operation 145,269 hours in total, including 53,332 hours in a turbine mode of operation, 70,293 hours in a pumping mode operation and 21,644 hours in a compensation mode operation. Whereas they supplied 5,346 GWh in the mains and the consumed 6,933 GWh of electricity for pumping. Hydroenergetic potential is a primary source of energy which is recyclable, i.e. unexhaustible and also ecologically the most tolerable

  17. The most important structures utilizing primary and secondary hydroenergetic potential for electric energy production

    Energy Technology Data Exchange (ETDEWEB)

    Zacharovsky, M [Slovenske elektrarne, a.s., Vodne elektrarne Trencin (Slovakia)

    1997-12-01

    In this paper the construction, technological parameters and operation of Gabcikovo (primary hydro energy power) and Cierny Vah (secondary hydro energy power) are described. Construction of the hydroelectric power plant (HPP) Gabcikovo started in 1978 as a part of a system of hydro power projects Gabcikovo-Nagymaros. Basic technical data are: installed capacity 8 x 90 MW, production in an average aqueous year 2.650 GWh, number of hydroelectric generating sets (HGS) 8, turbine flow 8 x 413-636 m{sup 3}/s, head 12.9-24 m.The Gabcikovo plant produced 9.163 GWh of electricity from the beginning of its operation till the end of 1966. The construction of the pumped storage plant (PSP) Cierny Vah started in 1976 and it was put into operation at the end of 1980. The main goal of the PSP Cierny Vah is to meet the control functions of an electrification system of the Slovak Republic, a substitute function in the cases of unexpected power outages and a planned electricity production from re-pumping. Technological parts are: six re-pumping vertical HGS in a three machine arrangement - a motor-generator, a turbine, a pump - are located in three double-blocks. Basic technical data: installed capacity 6 x 122.4 MW + 0.768 MW, yearly production 1,281 GWh, number of HGS 6, number of domestic hydroelectric generating sets 1, turbine flow 3 x 30 m{sup /}s, pump flow 6 x 22 m{sup 3}/s, upper reservoir volume 3.7 mil. m{sup 3}, max. head 434 m, peak time 5.71 hour, pumping time 7.78 hour, re-pumping cycle efficiency 74.36%. From putting the PSP into operation till the end of 1996, the HGS in operation 145,269 hours in total, including 53,332 hours in a turbine mode of operation, 70,293 hours in a pumping mode operation and 21,644 hours in a compensation mode operation. Whereas they supplied 5,346 GWh in the mains and the consumed 6,933 GWh of electricity for pumping. Hydroenergetic potential is a primary source of energy which is recyclable, i.e. unexhaustible and also ecologically the

  18. Socioeconomic variation in incidence of primary and secondary major cardiovascular disease events: an Australian population-based prospective cohort study.

    Science.gov (United States)

    Korda, Rosemary J; Soga, Kay; Joshy, Grace; Calabria, Bianca; Attia, John; Wong, Deborah; Banks, Emily

    2016-11-21

    Cardiovascular disease (CVD) disproportionately affects disadvantaged people, but reliable quantitative evidence on socioeconomic variation in CVD incidence in Australia is lacking. This study aimed to quantify socioeconomic variation in rates of primary and secondary CVD events in mid-age and older Australians. Baseline data (2006-2009) from the 45 and Up Study, an Australian cohort involving 267,153 men and women aged ≥ 45, were linked to hospital and death data (to December 2013). Outcomes comprised first event - death or hospital admission - for major CVD combined, as well as myocardial infarction and stroke, in those with and without prior CVD (secondary and primary events, respectively). Cox regression estimated hazard ratios (HRs) for each outcome in relation to education (and income and area-level disadvantage), separately by age group (45-64, 65-79, and ≥ 80 years), adjusting for age and sex, and additional sociodemographic factors. There were 18,207 primary major CVD events over 1,144,845 years of follow-up (15.9/1000 person-years), and 20,048 secondary events over 260,357 years (77.0/1000 person-years). For both primary and secondary events, incidence increased with decreasing education, with the absolute difference between education groups largest for secondary events. Age-sex adjusted hazard ratios were highest in the 45-64 years group: for major CVDs, HR (no qualifications vs university degree) = 1.62 (95% CI: 1.49-1.77) for primary events, and HR = 1.49 (1.34-1.65) for secondary events; myocardial infarction HR = 2.31 (1.87-2.85) and HR = 2.57 (1.90-3.47) respectively; stroke HR = 1.48 (1.16-1.87) and HR = 1.97 (1.42-2.74) respectively. Similar but attenuated results were seen in older age groups, and with income. For area-level disadvantage, CVD gradients were weak and non-significant in older people (> 64 years). Individual-level data are important for quantifying socioeconomic variation in CVD incidence, which

  19. Regulation of hemeoxygenase-1 gene expression by Nrf2 and c-Jun in tertiary butylhydroquinone-stimulated rat primary astrocytes

    International Nuclear Information System (INIS)

    Park, Jin-Sun; Kim, Hee-Sun

    2014-01-01

    Highlights: • tBHQ increased HO-1 mRNA and protein levels in rat primary astrocytes. • tBHQ enhanced HO-1 gene transcription in an ARE-dependent manner. • tBHQ increased the nuclear translocation and DNA binding of Nrf2 and c-Jun to ARE. • Nrf2 and c-Jun are involved in the differential modulation of HO-1 expression. • Nrf2 and c-Jun regulate HO-1 expression via their coordinated interaction. - Abstract: Hemeoxygenase-1 (HO-1) is a phase II antioxidant enzyme that is primarily involved in detoxification and cytoprotection in a variety of tissues. However, the mechanism underlying HO-1 gene expression remains unclear. In the present study, we investigated the regulation of HO-1 expression in primary cultured astrocytes by using the natural antioxidant compound tertiary butylhydroquinone (tBHQ). We found that tBHQ increased HO-1 mRNA and protein levels. Promoter analysis revealed that tBHQ enhanced HO-1 gene transcription in an antioxidant response element (ARE)-dependent manner. In addition, tBHQ increased the nuclear translocation and DNA binding of Nrf2 and c-Jun to ARE. Small interfering RNA (siRNA) experiments demonstrated that Nrf2 and c-Jun are involved in the differential modulation of HO-1 expression. Thus, Nrf2 knockdown reduced the basal level of HO-1 expression but did not affect the fold induction by tBHQ. On the other hand, knockdown of c-Jun diminished tBHQ-mediated induction of HO-1 without affecting basal expression. The data suggest that Nrf2 generally modulates the basal expression of HO-1, while c-Jun mediates HO-1 induction in response to tBHQ. The results of co-immunoprecipitation assays demonstrated a physical interaction between Nrf2 and c-Jun in tBHQ-treated astrocytes. The results suggest that Nrf2 and c-Jun regulate HO-1 expression via their coordinated interaction in tBHQ-treated rat primary astrocytes

  20. Specific serum protein changes associated with primary and secondary Strongylus vulgaris infections in pony yearlings.

    Science.gov (United States)

    Kent, J E

    1987-03-01

    The concentrations of haptoglobin, immunoglobin (Ig)G(T) and IgG were measured in the serum of four previously parasite-free pony yearlings following a single dose of 700 (Group H) or 200 (Group L) stage three Strongylus vulgaris larvae (L3) and following a reinfection with the same doses 34 weeks later. The results are compared with an uninfected control pony. The haptoglobin concentration increased during Weeks 1 to 6 and 14 to 17 after infection in the serum of the ponies receiving 200 L3, but in only one pony dosed with 700 L3 (during Weeks 1 to 16). The serum haptoglobin also increased during the first seven weeks after the second infection, in three of the four ponies following the second dose of larvae. The serum IgG(T) concentration started to increase from Week 6 or 9 in the ponies given 700 L3, reaching peaks of 44 and 32 g/litre respectively, eight to nine weeks later, compared with a peak of 16 g/litre 20 to 22 weeks after infection in ponies dosed with 200 L3. The IgG(T) concentration increased to a maximum of 25 g/litre in the serum of only one of the four ponies after the reinfection. The serum IgG concentration in all ponies increased nearly twofold during the first eight weeks after both the primary and secondary dose of larvae. It is concluded that the measurement of specific proteins is more reliable and quicker than the electrophoretic separation and quantitation of protein bands, in tracing changes in serum proteins following the artificial infection of ponies with S vulgaris larvae.

  1. Knocking down mitochondrial iron transporter (MIT) reprograms primary and secondary metabolism in rice plants.

    Science.gov (United States)

    Vigani, Gianpiero; Bashir, Khurram; Ishimaru, Yasuhiro; Lehmann, Martin; Casiraghi, Fabio Marco; Nakanishi, Hiromi; Seki, Motoaki; Geigenberger, Peter; Zocchi, Graziano; Nishizawa, Naoko K

    2016-03-01

    Iron (Fe) is an essential micronutrient for plant growth and development, and its reduced bioavailability strongly impairs mitochondrial functionality. In this work, the metabolic adjustment in the rice (Oryza sativa) mitochondrial Fe transporter knockdown mutant (mit-2) was analysed. Biochemical characterization of purified mitochondria from rice roots showed alteration in the respiratory chain of mit-2 compared with wild-type (WT) plants. In particular, proteins belonging to the type II alternative NAD(P)H dehydrogenases accumulated strongly in mit-2 plants, indicating that alternative pathways were activated to keep the respiratory chain working. Additionally, large-scale changes in the transcriptome and metabolome were observed in mit-2 rice plants. In particular, a strong alteration (up-/down-regulation) in the expression of genes encoding enzymes of both primary and secondary metabolism was found in mutant plants. This was reflected by changes in the metabolic profiles in both roots and shoots of mit-2 plants. Significant alterations in the levels of amino acids belonging to the aspartic acid-related pathways (aspartic acid, lysine, and threonine in roots, and aspartic acid and ornithine in shoots) were found that are strictly connected to the Krebs cycle. Furthermore, some metabolites (e.g. pyruvic acid, fumaric acid, ornithine, and oligosaccharides of the raffinose family) accumulated only in the shoot of mit-2 plants, indicating possible hypoxic responses. These findings suggest that the induction of local Fe deficiency in the mitochondrial compartment of mit-2 plants differentially affects the transcript as well as the metabolic profiles in root and shoot tissues. © The Author 2015. Published by Oxford University Press on behalf of the Society for Experimental Biology.

  2. Sun protective behaviour and sunburn prevalence in primary and secondary schoolchildren in western Switzerland.

    Science.gov (United States)

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

    2016-01-01

    Although solar overexposure during childhood and adolescence increases the risk of melanoma, determinants of sunburn and sun protective behaviours of Swiss children have scarcely been explored. We investigated sunburn occurrence and sun protective behaviours of schoolchildren in western Switzerland, the region with the highest incidence of melanoma in Europe. Self-reported questionnaires were administered during regular classes to pupils in 5th (primary school, n = 431), 8th and 11th grades (secondary school, n = 837) in the 18 public schools of La Chaux-de-Fonds. Descriptive statistics and multivariate logistic regression analyses were performed to assess predictors of sunburns and of three sun protective behaviours (sunscreen, shade, wear of covering clothes). Response rate was 91%. Sunburn prevalence over the preceding year was high (60% at least one sunburn, 30% at least two, 43% at least one severe sunburn). Younger age, fair skin, regular sunscreen use, higher sun-related knowledge and preference for a tanned skin were predictors of sunburn. Sunscreen was the most used protective measure (69%), followed by seeking shade (33%) and wearing long-sleeved shirts (32%). Decline in all protective measures was observed in older pupils and those with pro-tan attitudes. The wear of covering clothes was significantly associated with sunscreen use and seeking shade. Parental encouragement favoured sunscreen use and wearing of protective clothes. Sunscreen use as a last protective barrier against ultraviolet radiation should be better emphasised in prevention campaigns targeting children and adolescents. Multi-faceted interventions, including role models, parents and peers should help to improve children's sun protective behaviours.

  3. Social isolation and mental health at primary and secondary school entry: a longitudinal cohort study.

    Science.gov (United States)

    Matthews, Timothy; Danese, Andrea; Wertz, Jasmin; Ambler, Antony; Kelly, Muireann; Diver, Ashleen; Caspi, Avshalom; Moffitt, Terrie E; Arseneault, Louise

    2015-03-01

    We tested whether children who are socially isolated early in their schooling develop mental health problems in early adolescence, taking into account their mental health and family risk at school entry. We used data from the Environmental Risk (E-Risk) Longitudinal Twin Study, a birth cohort of 2,232 children born in England and Wales in 1994 and 1995. We measured social isolation using mothers' and teachers' reports at ages 5 and 12 years. We assessed mental health symptoms via mothers' and teachers' ratings at age 5 and self-report measures at age 12. We collected mother-reported information about the family environment when children were 5 years old. We conducted regression analyses to test concurrent and longitudinal associations between early family factors, social isolation, and mental health difficulties. At both primary and secondary school, children who were socially isolated experienced greater mental health difficulties. Children with behavioral problems or attention-deficit/hyperactivity disorder (ADHD) symptoms at age 5 years had an elevated risk of becoming more socially isolated at age 12. However, children who were isolated at age 5 did not have greater mental health symptoms at age 12, over and above pre-existing difficulties. Although social isolation and mental health problems co-occur in childhood, early isolation does not predict worse mental health problems later on. However, children who exhibit problematic behaviors may struggle to cope with the social challenges that accompany their progression through the early school years. Copyright © 2015 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

  4. Simultaneous acoustic stimulation of human primary and secondary somatosensory cortices using transcranial focused ultrasound.

    Science.gov (United States)

    Lee, Wonhye; Chung, Yong An; Jung, Yujin; Song, In-Uk; Yoo, Seung-Schik

    2016-10-26

    Transcranial focused ultrasound (FUS) is gaining momentum as a novel non-invasive brain stimulation method, with promising potential for superior spatial resolution and depth penetration compared to transcranial magnetic stimulation or transcranial direct current stimulation. We examined the presence of tactile sensations elicited by FUS stimulation of two separate brain regions in humans-the primary (SI) and secondary (SII) somatosensory areas of the hand, as guided by individual-specific functional magnetic resonance imaging data. Under image-guidance, acoustic stimulations were delivered to the SI and SII areas either separately or simultaneously. The SII areas were divided into sub-regions that are activated by four types of external tactile sensations to the palmar side of the right hand-vibrotactile, pressure, warmth, and coolness. Across the stimulation conditions (SI only, SII only, SI and SII simultaneously), participants reported various types of tactile sensations that arose from the hand contralateral to the stimulation, such as the palm/back of the hand or as single/neighboring fingers. The type of tactile sensations did not match the sensations that are associated with specific sub-regions in the SII. The neuro-stimulatory effects of FUS were transient and reversible, and the procedure did not cause any adverse changes or discomforts in the subject's mental/physical status. The use of multiple FUS transducers allowed for simultaneous stimulation of the SI/SII in the same hemisphere and elicited various tactile sensations in the absence of any external sensory stimuli. Stimulation of the SII area alone could also induce perception of tactile sensations. The ability to stimulate multiple brain areas in a spatially restricted fashion can be used to study causal relationships between regional brain activities and their cognitive/behavioral outcomes.

  5. Evaluation of primary and secondary metabolites in selected varieties of potatoes.

    Directory of Open Access Journals (Sweden)

    Ján Mareček

    2016-01-01

    Full Text Available The aim of study was to determine primary and secondary metabolites in selected varieties of potatoes. Potatoes (Solanum tuberosum L. are good source of bioactive compounds, mainly phenols as one of the most important components. The chemical composition with reducing sugar, starch, ascorbic acid, total polyphenol and flavonoid content were analyzed in five potato varieties (Agria, Marabel, Red Anna, Picasso, Princess. Values of dry matter content ranged from 20.34 to 23.64%. In terms of tubers storage, its content above 20% is required. The highest level of starch was detected in variety Princess (16.82%. The lowest reducing sugar content was recorded by variety Marabel (0.08%. Similarly, low values reached varieties Princess (0.12%, Agria (0.14 and Red Anna (0.16%. These would be appropriate to use for food processing and for production of fried potato chips or fries. Variety Red Anna reached the highest amount of vitamin C (73.72 mg.kg-1. The lower levels of this vitamin showed tubers of varieties Picasso (35.02 mg.kg-1 and Princess (36.89 mg.kg-1. The antioxidant activity was measured with radical scavenging assays using 1,1-diphenyl-2-picrylhydrazyl (DPPH radical as well as phosphomolybdenic assay. Potato varieties contained high levels of total polyphenols (0.474 – 1.550 mg GAE per dry weight and flavonoids (1.407 – 15.933 μg QE per dry weight. The consumption of potatoes can provide nutritional value along with antioxidant potential that can be helpful for proper functioning of the body physiological systems. Statistical evaluation by the single factor analysis of variance detected high significant impact of variety on the content of all the analytical parameters in evaluated varieties of potato tubers. Normal 0 21 false false false SK X-NONE X-NONE

  6. Content Analysis of Primary and Secondary School Textbooks Regarding Malaria Control: A Multi-Country Study

    Science.gov (United States)

    Nonaka, Daisuke; Jimba, Masamine; Mizoue, Tetsuya; Kobayashi, Jun; Yasuoka, Junko; Ayi, Irene; Jayatilleke, Achini C.; Shrestha, Sabina; Kikuchi, Kimiyo; Haque, Syed E.; Yi, Siyan

    2012-01-01

    Background In tropical settings, malaria education at school is potentially useful, but textbook content related to malaria education has so far received little attention. This study aimed to examine whether school textbooks contain sufficient knowledge and skills to help children in primary and lower secondary schools and their family members to cope with malaria. Methodology/Principal Findings This was a descriptive, cross-country study. We collected textbooks that were used by children in grades one to nine from nine countries endemic for malaria: Laos, Cambodia, Nepal, Bangladesh, Sri Lanka, Zambia, Niger, Benin, and Ghana. Two reviewers per country identified descriptions about malaria by seeking the term “malaria” or a local word that corresponds to malaria in languages other than English. The authors categorized the identified descriptions according to the content of the descriptions. Additionally, the authors examined whether the identified contents addressed life skill messages. Of a total of 474 textbooks collected, 35 contained descriptions about malaria. The most commonly included content was transmission mode/vector (77.1%), followed by preventive measures (60.0%), epidemiology (57.1%), cause/agent (54.3%), signs/symptoms (37.1%) and treatment (22.9%). Treatment-related content was not included in any textbooks from four countries and textbooks failed to recommend the use of insecticide-treated bed nets in five countries. Very few textbooks included content that facilitated prompt treatment, protection of risk groups, and use of recommended therapy. Conclusion/Significance Textbooks rarely included knowledge and skills that are crucial to protect schoolchildren and their families from malaria. This study identified the need for improvement to textbook contents regarding malaria. PMID:22574203

  7. Cultivar and Year Rather than Agricultural Practices Affect Primary and Secondary Metabolites in Apple Fruit

    Science.gov (United States)

    Renard, Catherine M. G. C.; Plenet, Daniel; Gautier, Hélène; Touloumet, Line; Girard, Thierry; Simon, Sylvaine

    2015-01-01

    Many biotic and abiotic parameters affect the metabolites involved in the organoleptic and health value of fruits. It is therefore important to understand how the growers' decisions for cultivar and orchard management can affect the fruit composition. Practices, cultivars and/or year all might participate to determine fruit composition. To hierarchize these factors, fruit weight, dry matter, soluble solids contents, titratable acidity, individual sugars and organics acids, and phenolics were measured in three apple cultivars (‘Ariane’, ‘Melrose’ and ‘Smoothee’) managed under organic, low-input and conventional management. Apples were harvested at commercial maturity in the orchards of the cropping system experiment BioREco at INRA Gotheron (Drôme, 26) over the course of three years (2011, 2012 and 2013). The main factors affecting primary and secondary metabolites, in both apple skin and flesh, were by far the cultivar and the yearly conditions, while the management system had a very limited effect. When considering the three cultivars and the year 2011 to investigate the effect of the management system per se, only few compounds differed significantly between the three systems and in particular the total phenolic content did not differ significantly between systems. Finally, when considering orchards grown in the same pedoclimatic conditions and of the same age, instead of the usual organic vs. conventional comparison, the effect of the management system on the apple fruit quality (Fruit weight, dry matter, soluble solids content, titratable acidity, individual sugars, organic acids, and phenolics) was very limited to non-significant. The main factors of variation were the cultivar and the year of cropping rather than the cropping system. More generally, as each management system (e.g. conventional, organic…) encompasses a great variability of practices, this highlights the importance of accurately documenting orchard practices and design beside the

  8. Cultivar and Year Rather than Agricultural Practices Affect Primary and Secondary Metabolites in Apple Fruit.

    Directory of Open Access Journals (Sweden)

    Carine Le Bourvellec

    Full Text Available Many biotic and abiotic parameters affect the metabolites involved in the organoleptic and health value of fruits. It is therefore important to understand how the growers' decisions for cultivar and orchard management can affect the fruit composition. Practices, cultivars and/or year all might participate to determine fruit composition. To hierarchize these factors, fruit weight, dry matter, soluble solids contents, titratable acidity, individual sugars and organics acids, and phenolics were measured in three apple cultivars ('Ariane', 'Melrose' and 'Smoothee' managed under organic, low-input and conventional management. Apples were harvested at commercial maturity in the orchards of the cropping system experiment BioREco at INRA Gotheron (Drôme, 26 over the course of three years (2011, 2012 and 2013. The main factors affecting primary and secondary metabolites, in both apple skin and flesh, were by far the cultivar and the yearly conditions, while the management system had a very limited effect. When considering the three cultivars and the year 2011 to investigate the effect of the management system per se, only few compounds differed significantly between the three systems and in particular the total phenolic content did not differ significantly between systems. Finally, when considering orchards grown in the same pedoclimatic conditions and of the same age, instead of the usual organic vs. conventional comparison, the effect of the management system on the apple fruit quality (Fruit weight, dry matter, soluble solids content, titratable acidity, individual sugars, organic acids, and phenolics was very limited to non-significant. The main factors of variation were the cultivar and the year of cropping rather than the cropping system. More generally, as each management system (e.g. conventional, organic… encompasses a great variability of practices, this highlights the importance of accurately documenting orchard practices and design beside

  9. Meibomian Gland Dysfunction in Primary and Secondary Sjögren Syndrome.

    Science.gov (United States)

    Sullivan, David A; Dana, Reza; Sullivan, Rose M; Krenzer, Kathleen L; Sahin, Afsun; Arica, Beril; Liu, Yang; Kam, Wendy R; Papas, Athena S; Cermak, Jennifer M

    2018-01-01

    We hypothesized that women with primary (pSS) and secondary Sjögren syndrome (sSS; with systemic lupus erythematosus [SLE] or rheumatoid arthritis [RA]) have meibomian gland dysfunction (MGD). We sought to test our hypothesis. Subjects with pSS, sSS + SLE, sSS + RA, and non-SS-related MGD were recruited from the Sjögren's Syndrome Foundation or outpatient clinics at Tufts University School of Dental Medicine or Brigham and Women's Hospital. The control population was recruited from the Greater Boston area. After providing written informed consent, the subjects underwent an eye examination and/or completed two questionnaires that assess symptoms of dry eye disease (DED). Our results demonstrate that pSS and sSS patients have MGD. These subjects had meibomian gland orifice metaplasia, an increased number of occluded meibomian gland orifices, and a reduced quality of meibomian gland secretions. Further, patients with pSS, sSS + SLE, sSS + RA, and MGD had significant alterations in their tear film, lid margin, cornea, and conjunctiva. Symptoms of DED were increased ∼10-fold in all pSS, sSS, and MGD groups relative to controls. Our findings support our hypothesis and show that individuals with pSS, sSS + SLE, and sSS + RA have MGD. In addition, our study indicates that patients with pSS and sSS have both aqueous-deficient and evaporative DED. © 2018 S. Karger AG, Basel.

  10. [Individual linkage of primary data with secondary and registry data within large cohort studies - capabilities and procedural proposals].

    Science.gov (United States)

    Stallmann, C; Ahrens, W; Kaaks, R; Pigeot, I; Swart, E; Jacobs, S

    2015-02-01

    Some German cohort studies have already linked secondary and registry data with primary data from interviews and medical examinations. This offers the opportunity to obtain more valid information by taking advantage of the strengths of these data synergistically and overcome their individual weaknesses at the same time. The potential and the requirements for linking secondary and registry data with primary data from cohort studies is described generally and illustrated by the example of the "German National Cohort" (GNC). The transfer and usage of secondary and registry data require that administrative and logistic efforts be made over the whole study period. In addition, rigid data protection regulations for using social data have to be observed. The particular strengths of secondary and registry data, namely their objectivity and independence from recall bias, add to the strengths of newly collected primary data and improve the assessment of morbidity endpoints, exposure history and need of patient care. Moreover, new insights on quality and on the added value of linking different data sources may be obtained. © Georg Thieme Verlag KG Stuttgart · New York.

  11. The evaluation of mean platelet volume levels in patients with primary and secondary Raynaud’s Phenomenon

    Directory of Open Access Journals (Sweden)

    Mehmet Erdem Memetoğlu

    2014-03-01

    Full Text Available Background — Mean platelet volume (MPV is an indicator of platelet activation. The pathophysiology of the primary and secondary Raynaud’s Phenomenon (RP have not been completely established. The aim of this study was to investigate the relationship between MPV and RP. Materials and Methods — Our study was a prospective randomized study carried out from January 2011 to March 2012. The study group consisted of 39 patients: 27 (70% patients having primary, 12 (30% patients having secondary RP. An age-, gender-, and body mass index-matched control group consisted of 40 healthy participants. We compared the MPV in patients with RP and control participants statistically. Results — MPV of RP group was 8.79±1.37 femtoliter (fL while MPV of control group was 8.39±1.36 fL. Comparison of MPV of RP group and control group showed no difference (p=0.274. The mean of MPV was significantly higher among patients with secondary RP (9.76±1.68 fl when compared with patients with primary RP (8.37±0.96 fl (p=0.018. Conclusion — The results of our study suggest that MPV may be used as a marker in secondary RP.

  12. Poverty of Primary Education in Nigeria: The Way Forward

    Science.gov (United States)

    Ige, Akindele Matthew

    2014-01-01

    Inspite of the fact that primary education forms the foundation on which education at the secondary and tertiary levels rests, the issue of poverty is undermining its roles in Nigeria. In this paper, this issue of poverty of primary education was examined, from the perspectives of its history, scope, indicators, in terms of inadequacy of resource…

  13. Surgical Treatment of Primary Intracardiac Myxoma: 20-Year Experience in “Shahid Modarres Hospital”—A Tertiary University Hospital—Tehran, Iran

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    Zahra Ansari Aval

    2015-01-01

    Full Text Available Although cardiac tumors are not common they may vary in terms of race and surgical approach in different countries. Method. Patients data of 20 years was collected and evaluated in the “Shahid Modarres Hospital”—a tertiary university hospital—Tehran, Iran. Results. 42 patients with cardiac myxoma (all cases in 20 years were included in study, 17 males and 25 females, age difference: 13 to 76 years (mean 50.6. Most of patients were in functional classes I, II. 35 patients complained of dyspnea and 3 patients had embolic events. 97.6% of tumors were primary (41 patients and one tumor was recurrent (2.4%, 85.7% of tumors (36 cases were located in LA, and 88.1% of tumors (37 cases were pediculated. 40 patients (95% had one tumor. In 22 patients (52.3% after tumor resection septal defects were repaired primarily while in 18 patients (42.8% the defects were repaired with pericardial patch and In one patient, tumor resected without any septal defect. Mean tumor size was about 5.22 cm (range of 2.2 to 8.2 cm. Postoperatively, 33 patients discharged from hospital without any complication. Discussion. The research reveals that patients’ age and gender were similar to that of other studies in other countries while tumor’s incidence seems to be higher. 3 patients were diagnosed after remote embolic event and one patient was diagnosed after MI reflecting relatively high tumor complications and late diagnosis. Conclusion. In our study mean time from diagnosis to operation was too long. The patients had more preoperative embolic events and complication. However, size of myxoma and location of that was as same as its rate in the other literature. As recommendation we suggested that in all patients with vague chest pain or remote embolic events cardiac myxomas should be ruled out.

  14. Comparison of primary and secondary particle formation from natural gas engine exhaust and of their volatility characteristics

    Science.gov (United States)

    Alanen, Jenni; Simonen, Pauli; Saarikoski, Sanna; Timonen, Hilkka; Kangasniemi, Oskari; Saukko, Erkka; Hillamo, Risto; Lehtoranta, Kati; Murtonen, Timo; Vesala, Hannu; Keskinen, Jorma; Rönkkö, Topi

    2017-07-01

    Natural gas usage in the traffic and energy production sectors is a growing trend worldwide; thus, an assessment of its effects on air quality, human health and climate is required. Engine exhaust is a source of primary particulate emissions and secondary aerosol precursors, which both contribute to air quality and can cause adverse health effects. Technologies, such as cleaner engines or fuels, that produce less primary and secondary aerosols could potentially significantly decrease atmospheric particle concentrations and their adverse effects. In this study, we used a potential aerosol mass (PAM) chamber to investigate the secondary aerosol formation potential of natural gas engine exhaust. The PAM chamber was used with a constant UV-light voltage, which resulted in relatively long equivalent atmospheric ages of 11 days at most. The studied retro-fitted natural gas engine exhaust was observed to form secondary aerosol. The mass of the total aged particles, i.e., particle mass measured downstream of the PAM chamber, was 6-268 times as high as the mass of the emitted primary exhaust particles. The secondary organic aerosol (SOA) formation potential was measured to be 9-20 mg kgfuel-1. The total aged particles mainly consisted of organic matter, nitrate, sulfate and ammonium, with the fractions depending on exhaust after-treatment and the engine parameters used. Also, the volatility, composition and concentration of the total aged particles were found to depend on the engine operating mode, catalyst temperature and catalyst type. For example, a high catalyst temperature promoted the formation of sulfate particles, whereas a low catalyst temperature promoted nitrate formation. However, in particular, the concentration of nitrate needed a long time to stabilize - more than half an hour - which complicated the conclusions but also indicates the sensitivity of nitrate measurements on experimental parameters such as emission source and system temperatures. Sulfate was

  15. Comparison of primary and secondary particle formation from natural gas engine exhaust and of their volatility characteristics

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    J. Alanen

    2017-07-01

    Full Text Available Natural gas usage in the traffic and energy production sectors is a growing trend worldwide; thus, an assessment of its effects on air quality, human health and climate is required. Engine exhaust is a source of primary particulate emissions and secondary aerosol precursors, which both contribute to air quality and can cause adverse health effects. Technologies, such as cleaner engines or fuels, that produce less primary and secondary aerosols could potentially significantly decrease atmospheric particle concentrations and their adverse effects. In this study, we used a potential aerosol mass (PAM chamber to investigate the secondary aerosol formation potential of natural gas engine exhaust. The PAM chamber was used with a constant UV-light voltage, which resulted in relatively long equivalent atmospheric ages of 11 days at most. The studied retro-fitted natural gas engine exhaust was observed to form secondary aerosol. The mass of the total aged particles, i.e., particle mass measured downstream of the PAM chamber, was 6–268 times as high as the mass of the emitted primary exhaust particles. The secondary organic aerosol (SOA formation potential was measured to be 9–20 mg kgfuel−1. The total aged particles mainly consisted of organic matter, nitrate, sulfate and ammonium, with the fractions depending on exhaust after-treatment and the engine parameters used. Also, the volatility, composition and concentration of the total aged particles were found to depend on the engine operating mode, catalyst temperature and catalyst type. For example, a high catalyst temperature promoted the formation of sulfate particles, whereas a low catalyst temperature promoted nitrate formation. However, in particular, the concentration of nitrate needed a long time to stabilize – more than half an hour – which complicated the conclusions but also indicates the sensitivity of nitrate measurements on experimental parameters such as emission

  16. 40 CFR Appendix I to Part 50 - Interpretation of the 8-Hour Primary and Secondary National Ambient Air Quality Standards for Ozone

    Science.gov (United States)

    2010-07-01

    ... Secondary National Ambient Air Quality Standards for Ozone 1. General. This appendix explains the data.... Primary and Secondary Ambient Air Quality Standards for Ozone. 2.1 Data Reporting and Handling Conventions... and Secondary National Ambient Air Quality Standards for Ozone I Appendix I to Part 50 Protection of...

  17. The localisation of treponemes and characterisation of the inflammatory infiltrate in skin biopsies from patients with primary or secondary syphilis, or early infectious yaws

    NARCIS (Netherlands)

    Engelkens, H. J.; ten Kate, F. J.; Judanarso, J.; Vuzevski, V. D.; van Lier, J. B.; Godschalk, J. C.; van der Sluis, J. J.; Stolz, E.

    1993-01-01

    To study the localisation of treponemes and to analyse the inflammatory infiltrate in biopsy specimens from patients with primary or secondary syphilis, or early infectious yaws. Skin biopsies originating from human lesions of primary (29x) or secondary (15x) syphilis (Rotterdam), or early yaws

  18. Sun protective behaviour of primary and secondary school students in North-Western Switzerland.

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    Reinau, Daphne; Meier, Christoph; Gerber, Nathalie; Hofbauer, Günther F L; Surber, Christian

    2012-02-24

    The skin cancer incidence in Switzerland is one of the highest in Europe and still on the rise. Sun protection is the main preventive measure and of utmost importance during childhood and adolescence, since sunburns within these early phases of life increase the risk of developing skin cancer in adulthood. The aim of this prospective study, the first of its kind in Switzerland, was to investigate the sun protective behaviour of primary and secondary school students in Basel (North-Western Switzerland) and to test their knowledge about adverse health effects of solar radiation and about protective measures. Between March and April 2010, supervised classroom surveys during regular school lessons were conducted in 13 public schools using a multiple-choice questionnaire. 960 questionnaires were handed out to 48 school classes. Descriptive statistics and logistic regression analyses were performed on the data of 887 (>90%) students from three different grades (3rd, 6th and 9th grade). Sun-related knowledge was high in one third of all respondents only and significantly depended on student's age and educational background. Although the oldest students reached the highest knowledge scores, they protected themselves the least from the sun. Sunscreen was the principal form of sun protection mentioned, but was insufficiently applied. Seeking shade and wearing clothing as protective measures were hardly used. High educational background (i.e., of the parents) was a determinant for routine use of sunscreen but was not associated with following other sun protective measures. The desire for a suntan had no impact on the use of sunscreen, but was a significant predictor for not seeking shade and wearing shoulderless shirts when in the sun. More than half of all study participants experienced at least one sunburn during the year preceding the survey. Fair skin type, higher grade, not seeking shade and wearing shoulderless shirts were directly associated with increased odds of

  19. Imbalance in Spatial Accessibility to Primary and Secondary Schools in China: Guidance for Education Sustainability

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    Yuan Gao

    2016-11-01

    Full Text Available Compulsory education is an important aspect of the societal development. Meanwhile, education equality safeguards the effectiveness of education systems and is an important part of social equality. This study analyzes the inequality of compulsory education from the perspective of imbalanced spatial distribution. Unlike previous studies that have measured the spatial distribution of education simply based on the spatial position of primary and secondary schools, we explore spatial accessibility based on the shortest travel distance from residents to schools, and then analyze the inequality of compulsory education through the distribution of spatial accessibility. We use 2873 Chinese counties as statistical units, and perform a statistical and graphical analysis of their spatial accessibility using the Theil index and spatial autocorrelation analyses. To analyze the differences in the spatial accessibility distribution on the national and regional levels, we use three partitioned modes: the terrain partitioned mode, the economic development partitioned mode, and the province-level partitioned mode. We then analyze the spatial agglomeration characteristics and distribution patterns of compulsory education accessibility through global autocorrelation, local autocorrelation, and hot-spot and cold-spot analysis. The results demonstrate an obvious imbalance in the distribution of spatial accessibility to compulsory education at the national level. Accessibility and equality in eastern and central regions are significantly better than those in the western region; both are significantly better in coastal regions than in inland regions; and equality alone is better in the municipalities, such as Shanghai, Tianjin, and Chongqing, than in other provinces and autonomous regions. The spatial pattern analysis shows significant global autocorrelation and obvious clusters. Counties in cold-spot areas (clusters of good spatial accessibility are large in number

  20. Body image in women with primary and secondary provoked vestibulodynia: a controlled study.

    Science.gov (United States)

    Maillé, Delphine L; Bergeron, Sophie; Lambert, Bernard

    2015-02-01

    Provoked vestibulodynia (PVD) is a women's genito-pelvic pain condition associated with psychosexual impairments, including depression. Body image (BI) has been found to be different in women with primary (PVD1) and secondary (PVD2) PVD. No controlled study has compared BI in women with PVD1 and PVD2 and investigated its associations with sexual satisfaction, sexual function, and pain. The aims of this study were to (i) compare BI in women with PVD1, PVD2, and asymptomatic controls and (ii) to examine associations between BI and sexual satisfaction, sexual function, and pain during intercourse in women with PVD. Fifty-seven women (20 with PVD1, 19 with PVD2, and 18 controls) completed measures of BI, sexual satisfaction, sexual function, pain during intercourse, and depression. The main outcome measures were (i) Global Measure of Sexual Satisfaction Scale, (ii) Female Sexual Function Index, and (iii) pain numerical rating scale. Controlling for depression, women with PVD1 reported more body exposure anxiety during sexual activities than women with PVD2 and controls F(2,51)=4.23, P=0.02. For women with PVD, more negative BI during sexual activities was associated with lower sexual satisfaction (β=-0.45, P=0.02) and function (β=-0.39, P=0.04) and higher pain during intercourse (β=0.59, P=0.004). More positive body esteem was associated with higher sexual function (β=0.34, P=0.05). Findings suggest that women with PVD1 present more body exposure anxiety during sexual activities than women with PVD2 and asymptomatic women. Body esteem and general attitudes toward women's genitalia were not significantly different between groups. Higher body exposure anxiety during sexual activities was associated with poorer sexual outcomes in women with PVD. Further studies assessing interventions targeting BI during sexual activities in this population are needed, as improving BI during sexual interactions may enhance sexual outcomes in women with PVD. © 2014 International