WorldWideScience

Sample records for reservation communities nationwide

  1. Community-Acquired Acute Kidney Injury: A Nationwide Survey in China.

    Science.gov (United States)

    Wang, Yafang; Wang, Jinwei; Su, Tao; Qu, Zhen; Zhao, Minghui; Yang, Li

    2017-05-01

    This study aimed to describe the burden of community-acquired acute kidney injury (AKI) in China based on a nationwide survey about AKI. Cross-sectional and retrospective study. A national sample of 2,223,230 hospitalized adult patients from 44 academic/local hospitals in Mainland China was used. AKI was defined according to the 2012 KDIGO AKI creatinine criteria or an increase or decrease in serum creatinine level of 50% during the hospital stay. Community-acquired AKI was identified when a patient had AKI that could be defined at hospital admission. The rate, cause, recognition, and treatment of community-acquired AKI were stratified according to hospital type, latitude, and economic development of the regions in which the patients were admitted. All-cause in-hospital mortality and recovery of kidney function at hospital discharge. 4,136 patients with community-acquired AKI were identified during the 2 single-month snapshots (January 2013 and July 2013). Of these, 2,020 (48.8%) had cases related to decreased kidney perfusion; 1,111 (26.9%), to intrinsic kidney disease; and 499 (12.1%), to urinary tract obstruction. In the north versus the south, more patients were exposed to nephrotoxins or had urinary tract obstructions. 536 (13.0%) patients with community-acquired AKI had indications for renal replacement therapy (RRT), but only 347 (64.7%) of them received RRT. Rates of timely diagnosis and appropriate use of RRT were higher in regions with higher per capita gross domestic product. All-cause in-hospital mortality was 7.3% (295 of 4,068). Delayed AKI recognition and being located in northern China were independent risk factors for in-hospital mortality, and referral to nephrology providers was an independent protective factor. Possible misclassification of AKI and community-acquired AKI due to nonstandard definitions and missing data for serum creatinine. The features of community-acquired AKI varied substantially in different regions of China and were closely

  2. Bioinformatics in the Netherlands: the value of a nationwide community.

    Science.gov (United States)

    van Gelder, Celia W G; Hooft, Rob W W; van Rijswijk, Merlijn N; van den Berg, Linda; Kok, Ruben G; Reinders, Marcel; Mons, Barend; Heringa, Jaap

    2017-09-15

    This review provides a historical overview of the inception and development of bioinformatics research in the Netherlands. Rooted in theoretical biology by foundational figures such as Paulien Hogeweg (at Utrecht University since the 1970s), the developments leading to organizational structures supporting a relatively large Dutch bioinformatics community will be reviewed. We will show that the most valuable resource that we have built over these years is the close-knit national expert community that is well engaged in basic and translational life science research programmes. The Dutch bioinformatics community is accustomed to facing the ever-changing landscape of data challenges and working towards solutions together. In addition, this community is the stable factor on the road towards sustainability, especially in times where existing funding models are challenged and change rapidly. © The Author 2017. Published by Oxford University Press.

  3. Knowledge and pharmacological management of Alzheimer's disease by managing community pharmacists: a nationwide study.

    Science.gov (United States)

    Zerafa, Natalie; Scerri, Charles

    2016-12-01

    Background Managing community pharmacists can play a leading role in supporting community dwelling individuals with Alzheimer's disease and their caregivers. Objective The main purpose of this study was to assess knowledge of managing community pharmacists towards Alzheimer's disease and its pharmacological management. Setting Community pharmacies in the Maltese islands. Method A nationwide survey was conducted with full-time managing community pharmacists in possession of a tertiary education degree in pharmacy studies. The level of knowledge was investigated using the Alzheimer's Disease Knowledge Scale and the Alzheimer's Disease Pharmacotherapy Measure. Participants were also asked to rate a number of statements related to disease management. Results Maltese managing community pharmacists (57 % response rate) had inadequate knowledge on risk factors, caregiving issues and pharmacological management of Alzheimer's disease. Age and number of years working in a community pharmacy setting were found to be negatively correlated with increased knowledge. Conclusion The findings highlight the need of providing training and continued educational support to managing community pharmacists in order to provide quality advice to individuals with dementia and their caregivers in the community.

  4. Bird community responses to the edge between suburbs and reserves.

    Science.gov (United States)

    Ikin, Karen; Barton, Philip S; Knight, Emma; Lindenmayer, David B; Fischer, Joern; Manning, Adrian D

    2014-02-01

    New insights into community-level responses at the urban fringe, and the mechanisms underlying them, are needed. In our study, we investigated the compositional distinctiveness and variability of a breeding bird community at both sides of established edges between suburban residential areas and woodland reserves in Canberra, Australia. Our goals were to determine if: (1) community-level responses were direct (differed with distance from the edge, independent of vegetation) or indirect (differed in response to edge-related changes in vegetation), and (2) if guild-level responses provided the mechanism underpinning community-level responses. We found that suburbs and reserves supported significantly distinct bird communities. The suburban bird community, characterised by urban-adapted native and exotic species, had a weak direct edge response, with decreasing compositional variability with distance from the edge. In comparison, the reserve bird community, characterised by woodland-dependent species, was related to local tree and shrub cover. This was not an indirect response, however, as tree and shrub cover was not related to edge distance. We found that the relative richness of nesting, foraging and body size guilds also displayed similar edge responses, indicating that they underpinned the observed community-level responses. Our study illustrates how community-level responses provide valuable insights into how communities respond to differences in resources between two contrasting habitats. Further, the effects of the suburban matrix penetrate into reserves for greater distances than previously thought. Suburbs and adjacent reserves, however, provided important habitat resources for many native species and the conservation of these areas should not be discounted from continued management strategies.

  5. [A phylogenetic analysis of plant communities of Teberda Biosphere Reserve].

    Science.gov (United States)

    Shulakov, A A; Egorov, A V; Onipchenko, V G

    2016-01-01

    Phylogenetic analysis of communities is based on the comparison of distances on the phylogenetic tree between species of a community under study and those distances in random samples taken out of local flora. It makes it possible to determine to what extent a community composition is formed by more closely related species (i.e., "clustered") or, on the opposite, it is more even and includes species that are less related with each other. The first case is usually interpreted as a result of strong influence caused by abiotic factors, due to which species with similar ecology, a priori more closely related, would remain: In the second case, biotic factors, such as competition, may come to the fore and lead to forming a community out of distant clades due to divergence of their ecological niches: The aim of this' study Was Ad explore the phylogenetic structure in communities of the northwestern Caucasus at two spatial scales - the scale of area from 4 to 100 m2 and the smaller scale within a community. The list of local flora of the alpine belt has been composed using the database of geobotanic descriptions carried out in Teberda Biosphere Reserve at true altitudes exceeding.1800 m. It includes 585 species of flowering plants belonging to 57 families. Basal groups of flowering plants are.not represented in the list. At the scale of communities of three classes, namely Thlaspietea rotundifolii - commumties formed on screes and pebbles, Calluno-Ulicetea - alpine meadow, and Mulgedio-Aconitetea subalpine meadows, have not demonstrated significant distinction of phylogenetic structure. At intra level, for alpine meadows the larger share of closely related species. (clustered community) is detected. Significantly clustered happen to be those communities developing on rocks (class Asplenietea trichomanis) and alpine (class Juncetea trifidi). At the same time, alpine lichen proved to have even phylogenetic structure at the small scale. Alpine (class Salicetea herbaceae) that

  6. 21st Century Community Learning Centers: Providing Afterschool and Summer Learning Support to Communities Nationwide

    Science.gov (United States)

    Afterschool Alliance, 2014

    2014-01-01

    The 21st Century Community Learning Centers (21st CCLC) initiative is the only federal funding source dedicated exclusively to before-school, afterschool, and summer learning programs. Each state education agency receives funds based on its share of Title I funding for low-income students at high-poverty, low performing schools. Funds are also…

  7. Native Grass Community Management Plan for the Oak Ridge Reservation

    Energy Technology Data Exchange (ETDEWEB)

    Ryon, Michael G [ORNL; Parr, Patricia Dreyer [ORNL; Cohen, Kari [ORNL

    2007-06-01

    Land managers at the Department of Energy's Oak Ridge National Laboratory in East Tennessee are restoring native warm-season grasses and wildflowers to various sites across the Oak Ridge Reservation (ORR). Some of the numerous benefits to planting native grasses and forbs include improved habitat quality for wildlife, improved aesthetic values, lower long-term maintenance costs, and compliance with Executive Order 13112 (Clinton 1999). Challenges to restoring native plants on the ORR include the need to gain experience in establishing and maintaining these communities and the potentially greater up-front costs of getting native grasses established. The goals of the native grass program are generally outlined on a fiscal-year basis. An overview of some of the issues associated with the successful and cost-effective establishment and maintenance of native grass and wildflower stands on the ORR is presented in this report.

  8. The experience of a nationwide Community of Practice to set up Regional Prevention Plans in Italy.

    Science.gov (United States)

    Giusti, Angela; Perra, Alberto; Lombardo, Flavia

    2017-07-27

    In 2010, the Italian Ministry of Health decided to start the planning process to elaborate the National Plan of Prevention 2010-2012 jointly with the 21 Regions. The National Institute of Health was responsible for supporting regional planners (RPs) by an original participatory approach of a web-based Community of Practice (CoP) to set up their own Regional Plans of Prevention. In this paper, we summarise the theoretical framework adopted, the main phases characterising the lifecycle of the nationwide CoP, the evaluation approach adopted and its findings. Following the CoP theoretical framework from Wenger, an initial group of RPs were trained on Project Cycle Management as a planning method and thereafter they started interacting on a web-based Moodle platform for 8 months. The CoP evaluation mainly took into account aspects of 'immediate value', such as members interactions within the website, and several quantitative and qualitative tools were used to monitor changes over time. Data were retrieved from Moodle statistics or directly from the RPs by the means of a Knowledge, Attitude and Practice survey, a reaction survey, SWOT analysis and focus groups. The level of individual RPs knowledge increased after the initial course from 55.7% to 75%, attitudes and competence perception about the planning process method also showed an overall favourable change. During the CoP life span, the number of members increased from the original 98 RPs to include up to 600 new members on the basis of spontaneous demand. From April 2010 to January 2011, the 'vital signs' of the CoP were monitored, including RP logins (13,450 total logins and 3744 unique logins), views (27,522) and posts (1606) distributed in 326 forum discussion threads. Data and information retrieved from quantitative and qualitative evaluation approaches proved to be useful for the management and follow-up of the CoP. The CoP experience was successful as 19 out of 20 Regions submitted their Regional Preventive

  9. Role of community forest reserves in wildlife conservation in Benin ...

    African Journals Online (AJOL)

    Sacred groves and community forests are common ways for local rural African people to conserve natural resources. The importance of traditional approach in wildlife conservation was evaluated with line transect method utilized to assess five community forests. Comparable species richness with similar size protected ...

  10. Socioeconomic profiles of native American communities: Duckwater Shoshone Reservation

    Energy Technology Data Exchange (ETDEWEB)

    Hamby, M. [Cultural Resources Consultants Ltd., Reno, NV (United States)

    1991-10-01

    This report presents socioeconomic aspects of Native Americans of the Duckwater Shoshone Reservation. A survey is included concerning their views on the proposed Yucca Mountain waste repository. (CBS)

  11. Huge gap between clinical efficacy and community effectiveness in the treatment of chronic hepatitis C: a nationwide survey in Taiwan.

    Science.gov (United States)

    Yu, Ming-Lung; Yeh, Ming-Lun; Tsai, Pei-Chien; Huang, Ching-I; Huang, Jee-Fu; Huang, Chung-Feng; Hsieh, Meng-Hsuan; Liang, Po-Cheng; Lin, Yi-Hung; Hsieh, Ming-Yen; Lin, Wen-Yi; Hou, Nai-Jen; Lin, Zu-Yau; Chen, Shinn-Cherng; Dai, Chia-Yen; Chuang, Wan-Long; Chang, Wen-Yu

    2015-04-01

    Peginterferon/ribavirin provides a substantially high treatment efficacy for chronic hepatitis C virus (HCV) infections in Asians. Whether the clinical efficacy can be translated to community effectiveness remains unclear. The disease awareness, treatment accessibility, recommendations, acceptance, and barriers to anti-HCV treatment were explored to clarify the issue with a 3-step nationwide investigation in Taiwan. A crude HCV-infected population was estimated using databases from 3 large-scale surveillance studies and age-/geographic-specific population database. HCV awareness and accessibility were investigated at the patient level in 58,129 residents. The recommendations/acceptances and barriers to treatment at the provider level were evaluated using a prospective, nationwide approach to 89 gastroenterologists/hepatologists. The estimated 10-year interval age-adjusted anti-HCV-seropositive population is 745,109 (3.28%), with an anticipated HCV-viremic population of 554,361. Of anti-HCV-seropositive subjects, 36.2% had disease awareness. Among those with awareness, 39.6% had accessibility. The recommendation/acceptance rate of antiviral therapy was 70.6%. The treatment rate was 10.1% and 13.7% for the anti-HCV-seropositive and HCV-viremic population, respectively. With an anticipated treatment success rate of 80% in Taiwan, 8.1% of the anti-HCV-seropositive and 10.9% of the HCV-viremic population achieved successful treatment. The major treatment barriers were fear of adverse effects (37%), major disorders (17.6%), ineligibility for insurance reimbursement (17.6%), and lack of therapy awareness (11.3%). Despite the high rates of treatment response and nationwide coverage of insurance reimbursement, there remains a large gap between clinical efficacy and community effectiveness in anti-HCV treatment in Taiwan. Increasing disease awareness/treatment accessibility and introducing new therapeutic strategies with high tolerability are warranted.

  12. Socioeconomic profiles of native American communities: Yomba Shoshone Reservation

    International Nuclear Information System (INIS)

    Hamby, M.; Rusco, E.

    1991-10-01

    This report was written by the State of Nevada Agency for Nuclear Projects/Nuclear Waste Project Office. This office oversees the nuclear waste activities for the proposed Yucca Mountain high-level waste facility for the state of Nevada. The Yomba Shoshone Reservation socio-economic profile was the basis of this paper. It describes the life and current status of the Shoshone Indians. Population, utilities, education and social services of the Shoshone are examples of the topics which are discussed. It is intended as base-line information only. It eventually summarizes and compares data from the public opinion of the Shoshone about the high level waste repository at Yucca Mountain. (MB)

  13. Community and conservation reserves in southern India: status, challenges and opportunities

    Directory of Open Access Journals (Sweden)

    A. Kanagavel

    2013-12-01

    Full Text Available Community Reserves and Conservation Reserves illustrate a community-based co-management model, a first of its kind within the protected area (PA network of India. Such reserves mark a shift towards an inclusive and decentralised approach within PAs in the country. Three such reserves in southern India: the Aghanashini Lion-tailed Macaque Conservation Reserve, Kadalundi-Vallikunnu Community Reserve and Thirupaddaimaradur Conservation Reserve, were selected to examine the reasons for their creation, management and stakeholder dynamics, with an aim to review their productivity and potential replicability. The study was carried out through semi-structured interviews with Forest Department officials, local community members and researchers working in the three reserves. Insufficient interaction between the stakeholders appeared to be a common issue in two reserves. The functioning of the reserves was also influenced, and in some cases negatively affected, by local politics. Financial stability was crucial in the functioning of reserves, as was consistency in interaction and appropriate monitoring of management plans. These elements are recommended for sustaining such reserves and creating community-based management systems for conservation, to support an inclusive approach to PA management.

  14. Opportunities and barriers to STI testing in community health centres in China: a nationwide survey.

    Science.gov (United States)

    Ong, Jason J; Peng, Minghui; Zhu, Shanzhu; Lo, Ying-Ru J; Fairley, Christopher K; Kidd, Michael R; Roland, Martin; Jiang, Sunfang; Wong, William C W

    2017-12-01

    China has strengthened its primary care workforce and implemented a wide network of community health centres (CHCs). However, STI testing and management are not currently included in the 'Essential Package of Primary Health Care in China'. Legislation change to encourage STI service delivery would be important, but it is also critical to determine if there are also provider-related opportunities and barriers for implementing effective STI programmes through CHCs if future legislation were to change. A national representative survey was conducted between September and December 2015 in a stratified random sample of 180 CHCs based in 20 cities in China. Primary care practitioners (PCPs) provided information on current experiences of STI testing as well as the barriers and facilitators for STI testing in CHCs. Multivariate logistic regression was conducted to determine factors associated with PCPs performing STI testing. 3580 out of 4146 (86%) invited PCPs from 158 CHCs completed the survey. The majority (85%, 95% CI 84% to 87%) of doctors stated that STI testing was an important part of healthcare. However, less than a third (29%, 95% CI 27% to 31%) would perform an STI test if the patients asked. Barriers for performing STI testing included lack of training, concerns about reimbursement, concerns about damage to clinics' reputations and the stigma against key populations. Respondents who reported that they would perform an STI test were likely to be younger, received a bachelor degree or higher, received specific training in STIs, believed that STI test was an important part of healthcare or had resources to perform STI testing. There is potential for improving STI management in China through upskilling the primary care workforce in CHCs. Specific training in STIs is needed, and other structural, logistical and attitudinal barriers are needed to be addressed. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All

  15. Distribution and antimicrobial susceptibility of bacteria from adults with community-acquired pneumonia or complicated skin and soft tissue infections in France: the nationwide French PREMIUM study.

    Science.gov (United States)

    Leprince, C; Desroches, M; Emirian, A; Coutureau, C; Anais, L; Fihman, V; Soussy, C J; Decousser, J W

    2015-10-01

    The empirical therapy of community-acquired pneumonia (CAP) and complicated skin and soft tissue infections (cSSTIs) must be based on updated bacterial distribution and susceptibility data. A nationwide study consecutively collected 1288 isolates from CAP (n=467) and cSSTIs (n=821) from 18 French hospitals between 2012 and 2013. The MIC values of commonly used antimicrobial agents, including ceftaroline, were determined. Bacterial distribution featured Pneumococcus, Haemophilus influenzae, and Staphylococcus aureus for CAPs and S. aureus, β-hemolytic streptococci and Enterobacteriaceae for cSSTIs. Antimicrobial susceptibility testing indicated i) the sustained third-generation cephalosporins and levofloxacin activity against pneumococci and H. influenzae, ii) no methicillin-resistant Staphylococcus aureus emergence among respiratory pathogens, iii) the high in vitro activity of ceftaroline against staphylococci from cSSTIs (98.7% susceptibility), and iv) the worrisome decreasing fluoroquinolone and third-generation cephalosporin susceptibilities among Enterobacteriaceae. This laboratory-based survey depicts a contrasting situation and supports the scoring of patients for the resistant pathogen risk before empirical therapy. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

  16. Which part of community social capital is related to life satisfaction and self-rated health? A multilevel analysis based on a nationwide mail survey in Japan.

    Science.gov (United States)

    Inaba, Yoji; Wada, Yuri; Ichida, Yukinobu; Nishikawa, Masashi

    2015-10-01

    This paper aims to clarify the association between various social capital components at the municipal level (community social capital) and two quality-of-life factors at the individual level [individual self-rated life satisfaction and self-rated health (SRH)] based on data from a nationwide social capital survey that the authors carried out in 2013 in Japan (N = 3406 in 99 municipalities). The survey covers residents in Japan between the ages of 20 and 79 years. We focus on both contextual social capital and household income inequality in terms of the Gini coefficient at the municipality level since, to the best of our knowledge, no paper has explicitly dealt with municipalities in Japan as the units of contextual social capital and the Gini. Our analyses show that the subjective life satisfaction of individuals, after controlling for socioeconomic status and health at the individual level, is associate with both an income gap and social capital at the municipal level. Every component of community social capital in this study except for generalized reciprocity, both cognitive (generalized trust, particularized trust, and particularized reciprocity), and structural (three types of group participation and daily contacts with neighbors, friends/acquaintances, and colleagues), and the Gini coefficient on earned income were associated with self-rated life satisfaction at the individual level with statistical significance. However, SRH is associated only with cognitive social capital at the community level. SRH has no significant association with structural components of community social capital or with a community income gap in terms of the Gini coefficient on personal income. Judging from the results of estimates in the study, most of the components of community social capital at the municipal level seem to play an important role in enhancing self-rated life satisfaction. Life satisfaction may be associated with the broad atmosphere of the municipal level where one

  17. A nationwide study on reproductive function, ovarian reserve, and risk of premature menopause in female survivors of childhood cancer: design and methodological challenges

    Directory of Open Access Journals (Sweden)

    Overbeek Annelies

    2012-08-01

    Full Text Available Abstract Background Advances in childhood cancer treatment over the past decades have significantly improved survival, resulting in a rapidly growing group of survivors. However, both chemo- and radiotherapy may adversely affect reproductive function. This paper describes the design and encountered methodological challenges of a nationwide study in the Netherlands investigating the effects of treatment on reproductive function, ovarian reserve, premature menopause and pregnancy outcomes in female childhood cancer survivors (CCS, the DCOG LATER-VEVO study. Methods The study is a retrospective cohort study consisting of two parts: a questionnaire assessing medical, menstrual, and obstetric history, and a clinical assessment evaluating ovarian and uterine function by hormonal analyses and transvaginal ultrasound measurements. The eligible study population consists of adult female 5-year survivors of childhood cancer treated in the Netherlands, whereas the control group consists of age-matched sisters of the participating CCS. To date, study invitations have been sent to 1611 CCS and 429 sister controls, of which 1215 (75% and 333 (78% have responded so far. Of these responders, the majority consented to participate in both parts of the study (53% vs. 65% for CCS and sister controls respectively. Several challenges were encountered involving the study population: dealing with bias due to the differences in characteristics of several types of (non- participants and finding an adequately sized and well-matched control group. Moreover, the challenges related to the data collection process included: differences in response rates between web-based and paper-based questionnaires, validity of self-reported outcomes, interpretation of clinical measurements of women using hormonal contraceptives, and inter- and intra-observer variation of the ultrasound measurements. Discussion The DCOG LATER-VEVO study will provide valuable information about the

  18. A nationwide study on reproductive function, ovarian reserve, and risk of premature menopause in female survivors of childhood cancer: design and methodological challenges

    Science.gov (United States)

    2012-01-01

    Background Advances in childhood cancer treatment over the past decades have significantly improved survival, resulting in a rapidly growing group of survivors. However, both chemo- and radiotherapy may adversely affect reproductive function. This paper describes the design and encountered methodological challenges of a nationwide study in the Netherlands investigating the effects of treatment on reproductive function, ovarian reserve, premature menopause and pregnancy outcomes in female childhood cancer survivors (CCS), the DCOG LATER-VEVO study. Methods The study is a retrospective cohort study consisting of two parts: a questionnaire assessing medical, menstrual, and obstetric history, and a clinical assessment evaluating ovarian and uterine function by hormonal analyses and transvaginal ultrasound measurements. The eligible study population consists of adult female 5-year survivors of childhood cancer treated in the Netherlands, whereas the control group consists of age-matched sisters of the participating CCS. To date, study invitations have been sent to 1611 CCS and 429 sister controls, of which 1215 (75%) and 333 (78%) have responded so far. Of these responders, the majority consented to participate in both parts of the study (53% vs. 65% for CCS and sister controls respectively). Several challenges were encountered involving the study population: dealing with bias due to the differences in characteristics of several types of (non-) participants and finding an adequately sized and well-matched control group. Moreover, the challenges related to the data collection process included: differences in response rates between web-based and paper-based questionnaires, validity of self-reported outcomes, interpretation of clinical measurements of women using hormonal contraceptives, and inter- and intra-observer variation of the ultrasound measurements. Discussion The DCOG LATER-VEVO study will provide valuable information about the reproductive potential of

  19. Nationwide trophic cascades: changes in avian community structure driven by ungulates

    Science.gov (United States)

    Palmer, Georgina; Stephens, Philip A.; Ward, Alastair I.; Willis, Stephen G.

    2015-10-01

    In recent decades, many ungulate populations have changed dramatically in abundance, resulting in cascading effects across ecosystems. However, studies of such effects are often limited in their spatial and temporal scope. Here, we contrast multi-species composite population trends of deer-sensitive and deer-tolerant woodland birds at a national scale, across Britain. We highlight the divergent fates of these two groups between 1994 and 2011, and show a striking association between the calculated divergence and a composite population trend of woodland deer. Our results demonstrate the link between changes in deer populations and changes in bird communities. In a period when composite population trends for deer increased by 46%, the community population trend across deer-sensitive birds (those dependent on understory vegetation) declined much more than the community trend for deer-tolerant birds. Our findings suggest that ongoing changes in the populations of herbivorous ungulates in many countries worldwide may help explain patterns of community restructuring at other trophic levels. Ungulate impacts on other taxa may require more consideration by conservation practitioners than they currently receive.

  20. Phytosociology of aquilaria malaccensis lamk. and its communities from a tropical forest reserve in peninsular malaysia

    International Nuclear Information System (INIS)

    Razak, S. A.; Haron, N. W.

    2015-01-01

    A phytosociological study on the floristic and vegetation communities of Aquilaria malaccensis was carried out in Sungai Udang Forest Reserve, Malacca, Malaysia. The main objectives of this study were to identify, characterize and classify the Aquilaria malaccensis communities which were naturally distributed in the Sungai Udang Forest Reserve. A total of 25 plots (40 m x 20 m) in size were constructed according to the line transect method. The vegetation sampling and data analysis were done. A total of 80 species belonging to 79 genera and 40 families were found from all the 25 plots in Sungai Udang Forest Reserve. The most abundant family was the Euphorbiaceae with 220 individual trees, followed by Myrtaceae and Anacardiaceae representing 212 and 197 individual trees, respectively. A community which was Aquilaria malaccensis Artocarpus rigidus community with two new sub-community known as Palaquium gutta sub-community and Barringtonia racemosa sub-community were identified on the basis of statistical and phytosociological analyses. These community and sub-community also showed preference on different geographical and environmental factors such as soils and local relief. This study is useful in providing more information on the growth response of the mixed dipterocarp forest in the development of proper forest management. (author)

  1. Associations between serum uric acid levels and the incidence of nonfatal stroke: a nationwide community-based cohort study.

    Science.gov (United States)

    Kamei, Keita; Konta, Tsuneo; Hirayama, Atsushi; Ichikawa, Kazunobu; Kubota, Isao; Fujimoto, Shouichi; Iseki, Kunitoshi; Moriyama, Toshiki; Yamagata, Kunihiro; Tsuruya, Kazuhiko; Narita, Ichiei; Kondo, Masahide; Shibagaki, Yugo; Kasahara, Masato; Asahi, Koichi; Watanabe, Tsuyoshi

    2017-06-01

    Hyperuricemia is an established risk factor for cardiovascular events and mortality. This study investigated the association between serum uric acid and the incidence of nonfatal stroke in a Japanese community-based population. We used a nationwide database of 155,322 subjects (aged 40-73, male 39 %) who participated in the annual "Specific Health Check and Guidance in Japan" checkup from 2008 to 2010. We examined the relationship between the quintiles of serum uric acid levels at baseline and the incidence of nonfatal stroke during a 2-year study period using self-reported data. The crude incidence of nonfatal stroke was significantly associated with serum uric acid levels at baseline, showing the lowest values in subjects with the 3rd quintile (Q3: men, 5.0-5.6; women, 3.8-4.3) of uric acid levels (mg/dL) and the highest values in subjects with the highest quintile (Q5: men ≥7.1, women ≥5.5) both in men and women (P uric acid levels for incident stroke was high, irrespective of characteristics such as age, sex, and renal function. This study has shown that serum uric acid is independently associated with the incidence of nonfatal stroke in the general Japanese population.

  2. Community-Based Suicide Prevention Research in Remote On-Reserve First Nations Communities

    Science.gov (United States)

    Isaak, Corinne A.; Campeau, Mike; Katz, Laurence Y.; Enns, Murray W.; Elias, Brenda; Sareen, Jitender

    2010-01-01

    Suicide is a complex problem linked to genetic, environmental, psychological and community factors. For the Aboriginal population more specifically, loss of culture, history of traumatic events, individual, family and community factors may also play a role in suicidal behaviour. Of particular concern is the high rate of suicide among Canadian…

  3. Understanding local community's values, worldviews and perceptions in the Galloway and Southern Ayrshire Biosphere Reserve, Scotland.

    Science.gov (United States)

    Hernes, Maya I; Metzger, Marc J

    2017-01-15

    Biosphere reserves have been studied around the world, but methods to elicit community's values, worldviews and perceptions are missing. A greater understanding of these can help avoid tension and improve successful management. This paper used a mixed-methods survey to elicit local community's environmental values, ecological world views and perceptions of the Galloway and Southern Ayrshire Biosphere Reserve (GSABR). Over three weeks, forty participants from three communities of the GSABR responded to a semi-structured mixed-methods survey. The survey revealed that residents of the GSABR greatly value wildlife and beauty of nature, and that the majority of the respondents showed concern for the environment from an ecocentric worldview. Results also revealed that the most influential tested socio-demographic characteristic affecting people's relationship to their environment is their professional affiliation. Tourism and recreation were seen as major benefits of the recent biosphere designation. Results did highlight contrasting benefits from the designation for different stakeholder groups, which could potentially lead to tensions and should be considered in the reserve management. Given the community's supportive world views and perceptions, greater participation in the biosphere's management in likely to be welcomed and should be used to avoid or mediate any conflicts. The mixed-method survey developed for this study, proved successful in eliciting these themes in the GSABR. We recommend other biosphere reserves replicate this research, to gain better understanding of local communities and increase their support and participation in reserve management. Copyright © 2016 Elsevier Ltd. All rights reserved.

  4. Nationwide survey on the 2005 Guidelines for the Management of Community-Acquired Adult Pneumonia: validation of differentiation between bacterial pneumonia and atypical pneumonia.

    Science.gov (United States)

    Watanabe, Akira; Goto, Hajime; Kohno, Shigeru; Matsushima, Toshiharu; Abe, Shosaku; Aoki, Nobuki; Shimokata, Kaoru; Mikasa, Keiichi; Niki, Yoshihito

    2012-03-01

    The Japanese Respiratory Society Guidelines for the Management of Community-Acquired Pneumonia (CAP) in Adults (JRS 2005) was published as a revision of the Basic Concept for the Management of CAP in Adults (JRS 2000). To evaluate the JRS 2005 criteria for differentiating between disease types and assessing the status of antimicrobial agent use in initial treatment, we conducted a prospective survey. The survey was conducted from July 2006 to March 2007 as a nationwide joint study by 200 institutions. The study subjects included patients aged ≥16 years of age who had CAP, and patients who met the inclusion criteria were consecutively enrolled. Disease type differentiation based on JRS 2005 and JRS 2000 was conducted. Disease type diagnosis was also performed based on test results. The sensitivity and specificity of disease type differentiation were calculated. The antimicrobial agents used in the initial treatment were classified as recommended or non-recommended based on JRS 2005. The validity of non-recommended antimicrobial agent use was investigated. A total of 1875 patients were analyzed. Differentiation of atypical pneumonia using the JRS 2005 criteria had higher sensitivity and lower specificity than differentiation using the JRS 2000 criteria. The antimicrobial agents recommended by JRS 2005 were used as initial treatment in a low number of cases. The efficacy of the recommended antimicrobial agents was similar to that of the non-recommended agents. JRS 2005 is advantageous in terms of reducing the number of items used in disease type differentiation. The recommended antimicrobial agents used for the initial treatment are believed to be appropriate. Copyright © 2012 The Japanese Respiratory Society. Published by Elsevier B.V. All rights reserved.

  5. Loss of sexual interest and premenstrual mood change in women with postpartum versus non-postpartum depression: A nationwide community sample of Korean adults.

    Science.gov (United States)

    Kim, Kiwon; Hong, Jin Pyo; Cho, Maeng Je; Fava, Maurizio; Mischoulon, David; Lee, Dong-Woo; Heo, Jung-Yoon; Jeon, Hong Jin

    2016-02-01

    Postpartum depression (PPD) is a type of clinical depression that can affect women after childbirth. Few previous studies have explored the association of depressive and physical symptoms among women with PPD in a nationwide community study. A total of 18,807 adults, randomly selected, completed a face-to-face interview using the Korean version of Composite International Diagnostic Interview (K-CIDI) (response rate 80.2%). PPD was defined as a major depressive episode that began within 4 weeks after delivery. Of 679 female subjects with major depressive disorder (MDD), 14.0% (n=95) experienced PPD. Subjects with PPD were significantly more likely to have higher income, education, and reside in an urban area, compared to those with non-PPD. No significant differences were found in number of children. Multiple logistic regression revealed that the loss of sexual interest was the only symptom among 23 depressive symptoms that was significantly associated with depressive episodes among individuals with PPD (AOR=1.91, 95% CI 1.01-3.60) when compared with non-PPD. Loss of sexual interest was also significantly associated with the subjects with lifetime PPD regardless of depressive episode (AOR=1.93, 95% CI 1.12-3.31). Conversely, loss of confidence and loss of pleasure were less frequent in subjects with PPD. Premenstrual mood change (χ(2)=5.57, p=0.0036) and comorbid alcohol use disorder (χ(2)=5.11, p=0.031) showed a valid association with PPD. Loss of sexual interest and premenstrual mood change were associated with women with PPD, whereas those with non-PPD were not, thereby suggesting the possible link between sexual hormones and PPD. Copyright © 2015 Elsevier B.V. All rights reserved.

  6. Mother, Daughter, Teenager-Who Am I? Perceptions of Adolescent Maternity in a Navajo Reservation Community.

    Science.gov (United States)

    Dalla, Rochelle L.; Gamble, Wendy C.

    2000-01-01

    Intensive interviews focusing on perceptions of teenage parenting were conducted with Navajo teenage mothers, their mothers, and community informants. Two central themes representing commitment to maternity or adolescence were found. Factors associated with the prevalence of adolescent parenting on the Navajo reservation are discussed, as are…

  7. The woody vegetation communities of the Hluhluwe-Corridor- Umfolozi Game Reserve Complex

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    A. Whateley

    1983-11-01

    Full Text Available Land units for the 900 km- Hluhluwe-Corridor-Umfolozi Game Reserve Complex in north eastern Natal were identified on aerial photographs. The physiognomy, dominants and description of the woody vegetation for each unit were identified during ground inspections and. where necessary, the point-centred quarter method was applied. Two forest, two riverine forest, ten woodland and two thicket communities were recognized. These communities are described according to their distribution, height and percentage frequency of the components in the different canopy strata. A map at a scale of 1:25 000 was also compiled. Some of these communities are compared with other similar woodlands previously described for Natal. In some communities the frequency of certain dominant canopy species in the under tree strata was extremely low and autecological research has been suggested.

  8. Effects of marine reserves versus nursery habitat availability on structure of reef fish communities.

    Directory of Open Access Journals (Sweden)

    Ivan Nagelkerken

    Full Text Available No-take marine fishery reserves sustain commercial stocks by acting as buffers against overexploitation and enhancing fishery catches in adjacent areas through spillover. Likewise, nursery habitats such as mangroves enhance populations of some species in adjacent habitats. However, there is lack of understanding of the magnitude of stock enhancement and the effects on community structure when both protection from fishing and access to nurseries concurrently act as drivers of fish population dynamics. In this study we test the separate as well as interactive effects of marine reserves and nursery habitat proximity on structure and abundance of coral reef fish communities. Reserves had no effect on fish community composition, while proximity to nursery habitat only had a significant effect on community structure of species that use mangroves or seagrass beds as nurseries. In terms of reef fish biomass, proximity to nursery habitat by far outweighed (biomass 249% higher than that in areas with no nursery access the effects of protection from fishing in reserves (biomass 21% lower than non-reserve areas for small nursery fish (≤ 25 cm total length. For large-bodied individuals of nursery species (>25 cm total length, an additive effect was present for these two factors, although fish benefited more from fishing protection (203% higher biomass than from proximity to nurseries (139% higher. The magnitude of elevated biomass for small fish on coral reefs due to proximity to nurseries was such that nursery habitats seem able to overrule the usually positive effects on fish biomass by reef reserves. As a result, conservation of nursery habitats gains importance and more consideration should be given to the ecological processes that occur along nursery-reef boundaries that connect neighboring ecosystems.

  9. Effects of marine reserves versus nursery habitat availability on structure of reef fish communities.

    Science.gov (United States)

    Nagelkerken, Ivan; Grol, Monique G G; Mumby, Peter J

    2012-01-01

    No-take marine fishery reserves sustain commercial stocks by acting as buffers against overexploitation and enhancing fishery catches in adjacent areas through spillover. Likewise, nursery habitats such as mangroves enhance populations of some species in adjacent habitats. However, there is lack of understanding of the magnitude of stock enhancement and the effects on community structure when both protection from fishing and access to nurseries concurrently act as drivers of fish population dynamics. In this study we test the separate as well as interactive effects of marine reserves and nursery habitat proximity on structure and abundance of coral reef fish communities. Reserves had no effect on fish community composition, while proximity to nursery habitat only had a significant effect on community structure of species that use mangroves or seagrass beds as nurseries. In terms of reef fish biomass, proximity to nursery habitat by far outweighed (biomass 249% higher than that in areas with no nursery access) the effects of protection from fishing in reserves (biomass 21% lower than non-reserve areas) for small nursery fish (≤ 25 cm total length). For large-bodied individuals of nursery species (>25 cm total length), an additive effect was present for these two factors, although fish benefited more from fishing protection (203% higher biomass) than from proximity to nurseries (139% higher). The magnitude of elevated biomass for small fish on coral reefs due to proximity to nurseries was such that nursery habitats seem able to overrule the usually positive effects on fish biomass by reef reserves. As a result, conservation of nursery habitats gains importance and more consideration should be given to the ecological processes that occur along nursery-reef boundaries that connect neighboring ecosystems.

  10. Invertebrate communities of Arctic tundra ponds as related to proximity to drill site reserve pits

    International Nuclear Information System (INIS)

    Byron, E.; Williams, N.; Hoffman, R.; Elder, B.

    1994-01-01

    Aquatic invertebrate communities were assessed for diversity and abundance in North Slope tundra ponds of Prudhoe Bay, Alaska during the summer of 1992 as part of an evaluation of potential effects of exposure to petroleum drill site reserve pits (previously used for storing drill site wastes). The invertebrate communities of these shallow, tundra ponds provide abundant food for migratory, aquatic birds that use this area during the summer breeding season. The study was designed to compare abundance and diversity estimates of invertebrates in ponds surrounding the drill sites that differed in distance (and presumed exposure) to drill site reserve pits. The pits, themselves, were not sampled as part of this study. Invertebrate abundance and diversity estimates, assessed as standard biological criteria, were evaluated relative to water chemistry of the ponds, distance to the gravel pads or reserve pits, and pond morphometry. The results indicated the importance of pond morphometry in determining the structure of the invertebrate community. Shallow, exposed ponds tended to be dominated by different invertebrate communities than deeper, narrow ponds at the margins of frost polygons. In contrast, pond chemistry and relative exposure to drill sites were not predictive of invertebrate abundance or diversity

  11. An analysis of illegal mining on the Offin shelterbelt forest reserve, Ghana: Implications on community livelihood

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    Samuel Boadi

    2016-01-01

    Full Text Available Mining in tropical countries contributes significantly to the global minerals supplies but unregulated mining activities in reserved forests is associated with destruction, loss of habitats and loss of biodiversity. This study determined the area of the Offin shelterbelt forest reserve, Ghana, degraded through illegal mining (galamsey and the impacts on the livelihoods of fringe communities. Thirty-two (32 coordinates were recorded around the peripheries of disturbed site in the reserve using hand-held Global Positioning System and were then imported into a geodatabase in ArcGIS which was used to estimate the area degraded. Data was obtained from 60 purposively sampled respondents from two communities fringing the reserve and 10 key informant interviews. Increased income (13%, employment opportunities (6.7% and increased market activities (2% were some benefits of the illegal mining activities identified by the respondents. Eight respondents associated their employment with of the advent of illegal mining activities out which 6 (70% were engaged directly in mining activities, while 2 (30% were into trading. The miners earned cash income range of US $ 2.9–22.9 daily. Within 5 years, illegal mining had degraded 2.5 km2 (4.4% of the total area of the reserve and the destruction of cocoa farms and water sources (31. Farming among respondents reduced from 90% to 76% after illegal mining. The relatively high cost (US$ 6424.1 involved in flushing out and the subsequent return of such miners poses a threat to sustainable forest management and requires a more holistic approach in tackling such a problem.

  12. Invasion by Cordgrass Increases Microbial Diversity and Alters Community Composition in a Mangrove Nature Reserve

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    Min Liu

    2017-12-01

    Full Text Available Invasion by exotic plant species can alter ecosystem function and reduce native plant diversity, but relatively little is known about their effects on belowground microbial communities. Here we investigated the effects of exotic cordgrass (Spartina alterniflora invasion on the distribution of soil bacterial communities in a mangrove nature reserve of the Jiulong River Estuary, southeast China using high-throughput sequencing of 16S rRNA gene and multivariate statistical analysis. Our results showed that S. alterniflora invasion altered soil properties, and significantly increased soil bacterial taxa richness, primarily by stimulating an increase in conditionally rare or rare taxa, and changes in community composition and function. Abundant, conditionally rare and rare subcommunities exhibited similar response patterns to environment changes, with both conditionally rare and rare taxa showing a stronger response than abundant ones. Habitat generalists were detected among abundant, conditionally rare and rare taxa, whereas habitat specialists were only identified among conditionally rare taxa and rare taxa. In addition, we found that vegetation was the key factor driving these patterns. However, our comparative analysis indicated that both environmental selection, and neutral process, significantly contributed to soil bacterial community assembly. These results could improve the understanding of the microbial processes and mechanisms of cordgrass invasion, and offer empirical data of use in the restoration and management of the mangrove wetlands.

  13. Perspectives on Sustainable Resource Conservation in Community Nature Reserves: A Case Study from Senegal

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    Ferran Guallar

    2012-11-01

    Full Text Available The coalescing of development and conservation has recently given rise to community-based conservation. Under this framework, sustainable livelihood strategies are incorporated into conservation goals on the basis that the integration of local priorities into management guidelines benefits rather than impedes conservation efforts. Consistent with this approach, the Community Nature Reserve of Dindéfélo in Kédougou, Senegal endeavors to protect biodiversity without jeopardizing local people’s reliance on natural resources. In this article we provide evidence that sustainable resource conservation is a very powerful mechanism in redirecting labor and capital away from ecosystem-degrading activities. To do this, we present three examples of projects, aiming to illustrate different ways in which local people’s management and sustainable use of natural resources can be beneficial in terms of biodiversity conservation, socioeconomic development, and human well-being.

  14. Community-based Forest Resources Management in Nigeria: Case study of Ngel Nyaki Forest Reserve, Mambilla Plateau, Taraba State, Nigeria

    Directory of Open Access Journals (Sweden)

    T.I. Borokini

    2012-05-01

    Full Text Available In Nigeria, human communities are found within or beside forest ecosystems, depending onthese ecosystems for survival. Their forest exploitation is considered a threat to conservation efforts,leading to constant conflicts between Government, law enforcement agencies and the communities. Thebest solution is a win-win system of participatory community-based forest resources management, inwhich the communities are regarded as stakeholders rather than as threats. This paper explains theadoption of this approach in Ngel Nyaki Forest Reserve, Mambilla Plateau, where the communities weretrained in establishment and management of forest plantations with readily available market for theirtimber; employment for some of the community youths as well as community development projects.This paper calls for the adoption of this system in other protected areas in Nigeria, while theGovernment should provide basic amenities for the communities as alternatives to those forest products.Keywords: Community-based forest management, Ngel Nyaki Forest Reserve, Protected areas, Nigeria.

  15. Habitat dynamics, marine reserve status, and the decline and recovery of coral reef fish communities

    Science.gov (United States)

    Williamson, David H; Ceccarelli, Daniela M; Evans, Richard D; Jones, Geoffrey P; Russ, Garry R

    2014-01-01

    Severe climatic disturbance events often have major impacts on coral reef communities, generating cycles of decline and recovery, and in some extreme cases, community-level phase shifts from coral-to algal-dominated states. Benthic habitat changes directly affect reef fish communities, with low coral cover usually associated with low fish diversity and abundance. No-take marine reserves (NTRs) are widely advocated for conserving biodiversity and enhancing the sustainability of exploited fish populations. Numerous studies have documented positive ecological and socio-economic benefits of NTRs; however, the ability of NTRs to ameliorate the effects of acute disturbances on coral reefs has seldom been investigated. Here, we test these factors by tracking the dynamics of benthic and fish communities, including the important fishery species, coral trout (Plectropomus spp.), over 8 years in both NTRs and fished areas in the Keppel Island group, Great Barrier Reef, Australia. Two major disturbances impacted the reefs during the monitoring period, a coral bleaching event in 2006 and a freshwater flood plume in 2011. Both disturbances generated significant declines in coral cover and habitat complexity, with subsequent declines in fish abundance and diversity, and pronounced shifts in fish assemblage structure. Coral trout density also declined in response to the loss of live coral, however, the approximately 2:1 density ratio between NTRs and fished zones was maintained over time. The only post-disturbance refuges for coral trout spawning stocks were within the NTRs that escaped the worst effects of the disturbances. Although NTRs had little discernible effect on the temporal dynamics of benthic or fish communities, it was evident that the post-disturbance refuges for coral trout spawning stocks within some NTRs may be critically important to regional-scale population persistence and recovery. PMID:24634720

  16. Habitat dynamics, marine reserve status, and the decline and recovery of coral reef fish communities.

    Science.gov (United States)

    Williamson, David H; Ceccarelli, Daniela M; Evans, Richard D; Jones, Geoffrey P; Russ, Garry R

    2014-02-01

    Severe climatic disturbance events often have major impacts on coral reef communities, generating cycles of decline and recovery, and in some extreme cases, community-level phase shifts from coral-to algal-dominated states. Benthic habitat changes directly affect reef fish communities, with low coral cover usually associated with low fish diversity and abundance. No-take marine reserves (NTRs) are widely advocated for conserving biodiversity and enhancing the sustainability of exploited fish populations. Numerous studies have documented positive ecological and socio-economic benefits of NTRs; however, the ability of NTRs to ameliorate the effects of acute disturbances on coral reefs has seldom been investigated. Here, we test these factors by tracking the dynamics of benthic and fish communities, including the important fishery species, coral trout (Plectropomus spp.), over 8 years in both NTRs and fished areas in the Keppel Island group, Great Barrier Reef, Australia. Two major disturbances impacted the reefs during the monitoring period, a coral bleaching event in 2006 and a freshwater flood plume in 2011. Both disturbances generated significant declines in coral cover and habitat complexity, with subsequent declines in fish abundance and diversity, and pronounced shifts in fish assemblage structure. Coral trout density also declined in response to the loss of live coral, however, the approximately 2:1 density ratio between NTRs and fished zones was maintained over time. The only post-disturbance refuges for coral trout spawning stocks were within the NTRs that escaped the worst effects of the disturbances. Although NTRs had little discernible effect on the temporal dynamics of benthic or fish communities, it was evident that the post-disturbance refuges for coral trout spawning stocks within some NTRs may be critically important to regional-scale population persistence and recovery.

  17. Assessing the effect of marine reserves on household food security in Kenyan coral reef fishing communities.

    Directory of Open Access Journals (Sweden)

    Emily S Darling

    Full Text Available Measuring the success or failure of natural resource management is a key challenge to evaluate the impact of conservation for ecological, economic and social outcomes. Marine reserves are a popular tool for managing coastal ecosystems and resources yet surprisingly few studies have quantified the social-economic impacts of marine reserves on food security despite the critical importance of this outcome for fisheries management in developing countries. Here, I conducted semi-structured household surveys with 113 women heads-of-households to investigate the influence of two old, well-enforced, no-take marine reserves on food security in four coastal fishing communities in Kenya, East Africa. Multi-model information-theoretic inference and matching methods found that marine reserves did not influence household food security, as measured by protein consumption, diet diversity and food coping strategies. Instead, food security was strongly influenced by fishing livelihoods and household wealth: fishing families and wealthier households were more food secure than non-fishing and poorer households. These findings highlight the importance of complex social and economic landscapes of livelihoods, urbanization, power and gender dynamics that can drive the outcomes of marine conservation and management.

  18. Community tourism, tradition, and sustainable development reserve defending native territory: aventureiro (Ilha Grande - RJ

    Directory of Open Access Journals (Sweden)

    Helena Catão Henriques Ferreira

    2014-09-01

    Full Text Available This work aims to develop a reflection around the idea of Communitarian, or Community-based Tourism stemming from an analysis of what goes on today in the Vila do Aventureiro - Ilha Grande, in the state of Rio de Janeiro, and how it relates to the process of recategorizing the area for the Sustainable Development Reserve (RDS, currently underway in the Legislative Assembly of the State of Rio de Janeiro. The tourism which occurs in Aventureiro is today considered as communitarian, or "community-based", for being promoted and organized exclusively by the native residents and for articulating the notion of "traditional populations" so as to guarantee their right to the territory. In this sense, the recategorization of the area for the Sustainable Development Reserve (RDS has a reflexive, interdependent relationship with this type of tourism. The work is based upon two qualitative researches from an ethnographic perspective developed along the periods of 2003-2004 and 2008-2010, and capturing the perception of local population about their experience of tourism, as well as the social relations which emerged in this process, the native ways of facing the difficulties brought up by the creation of a restrictive protected area in their territory, and on the other hand, the innovative strategies for sustaining their economy and maintaining their culture.

  19. Community composition and diversity of ground beetles (Coleoptera: Carabidae) in Yaoluoping National Nature Reserve

    Science.gov (United States)

    Li, Wen-Bo; Liu, Nai-Yi; Wu, Yun-He; Zhang, Yu-Cai; Xu, Qin; Chu, Jun; Wang, Shu-Yan

    2017-01-01

    Abstract This study used pitfall trapping to examine community composition and diversity of ground beetles in five different habitats (coniferous, deciduous, mixed coniferous, farmland, and settlements) within Anhui Yaoluoping National Nature Reserve from May to September 2014. In total, 1,352 ground beetles were collected, belonging to 16 genera and 44 species. Of these, four dominant species Dolichus halensis, Harpalus pastor, Carabus casaleianus, and Pheropsophus jessoensis were identified, respectively, comprising 370, 177, 131, and 123 individuals. The deciduous forest showed greater diversity (3.78 according to Shannon–Weiner index), equitability (0.80 according to Pielou’s index), and dominance (9.52 according to Simpson’s index) when compared with farmland, but species richness in the deciduous forest (27) was lower than that in farmland (35). One-way analysis of variance showed that ground beetle species composition and abundance among different habitats varied significantly. Cluster analysis and principal coordinate analysis showed that farmland shared low community similarity with other habitat types, and coniferous and mixed coniferous forests shared similar community types. Our results indicate that species composition, abundance, and diversity of ground beetles are affected by different habitat types, with deciduous forest types being critical in maintaining the diversity of rare species. We recommend reducing cultivated farmland area and increasing the area of carefully planned deciduous forest in order to better protect ground beetle diversity in the region.

  20. Marine reserves reestablish lost predatory interactions and cause community changes in rocky reefs.

    Science.gov (United States)

    Guidetti, Paolo

    2006-06-01

    In the last decades, marine reserves have dramatically increased in number worldwide. Here I examined the potential of no-take marine reserves to reestablish lost predatory interactions and, in turn, cause community-wide changes in Mediterranean rocky reefs. Protected locations supported higher density and size of the most effective fish preying on sea urchins (the sea breams Diplodus sargus and D. vulgaris) than unprotected locations. Density of sea urchins (Paracentrotus lividus and Arbacia lixula) was lower at protected than at unprotected locations. Size structure of P. lividus was bimodal (a symptom of predation on medium-sized urchins) only at the protected locations. Coralline barrens were less extended at protected than at unprotected locations, whereas turf-forming and erect-branched algae showed an opposite pattern. Erect-unbranched and erect-calcified algae and conspicuous zoobenthic organisms did not show any pattern related to protection. Tethering experiments showed that predation impact on urchins was (1) higher at protected than at unprotected locations, (2) higher on P. lividus than on A. lixula, and (3) higher on medium-sized (2-3.5 cm test diameter) than large-sized (>3.5 cm) urchins. Sea urchins preyed on by fish in natural conditions were smaller at unprotected than at protected locations. The analysis of sea urchin remains found in Diplodus fish stomachs revealed that medium-sized P. lividus were the most frequently preyed upon urchins and that size range of consumed sea urchins expanded with increasing size of Diplodus fish. These results suggest that (1) depletion and size reduction of predatory fish caused by fishing alter patterns of predation on sea urchins, and that (2) fishing bans (e.g., within no-take marine reserves) may reestablish lost interactions among strongly interactive species in temperate rocky reefs with potential community-wide effects.

  1. Wildlife resource utilisation at Moremi Game Reserve and Khwai community area in the Okavango Delta, Botswana.

    Science.gov (United States)

    Mbaiwa, Joseph E

    2005-10-01

    This paper uses the concept of sustainable development to examine the utilisation of wildlife resources at Moremi Game Reserve (MGR) and Khwai community area (NG 18/19) in the Okavango Delta, Botswana. Using both secondary and primary data sources, results show that the establishment of MGR in 1963 led to the displacement of Khwai residents from their land; affected Basarwa's hunting and gathering economy; marked the beginning of resource conflicts between Khwai residents and wildlife managers; and, led to the development of negative attitudes of Khwai residents towards wildlife conservation. Since the late 1980s, a predominantly foreign owned tourism industry developed in and around MGR, however, Khwai residents derive insignificant benefits from it and hence resource conflicts increased. In an attempt to address problems of resource conflicts and promote sustainable wildlife utilisation, the Botswana Government adopted the Community-Based Natural Resource Management (CBNRM) programme, which started operating at Khwai village in 2000. The CBNRM programme promotes local participation in natural resource management and rural development through tourism. It is beginning to have benefits to Khwai residents such as income generation, employment opportunities and local participation in wildlife management. These benefits from CBNRM are thus having an impact in the development of positive attitudes of Khwai residents towards wildlife conservation and tourism development. This paper argues that if extended to MGR, CBNRM has the potential of minimising wildlife conflicts between Khwai residents and the wildlife-tourism sectors. This approach may in the process promote the sustainable wildlife use in and around MGR.

  2. The peculiarity of dynamic of helminth community of wild ungulate animals in the condition of Poles'e reserve

    International Nuclear Information System (INIS)

    Odintsova, T.M.

    1998-01-01

    It was analysed the dynamic of helminth community of wild animals in the condition of Poles'e reserve and it was shown that radiation contamination had great influence at the settled community of parasite worms resulting in disappearance or sharp diminution of species quantity that were common for wild ungulate animals and domestics cattle. It was concluded that stabilisation of helminth community of wild ungulate animals had not yet achieved

  3. PiSCES: Pi(scine) stream community estimation software: A tool for nationwide fish assemblage predictions

    Science.gov (United States)

    Background/Question/Methods What species of fish might someone find in a local stream? How might that community change as a result of changes to characteristics of the stream and its watershed? PiSCES is a browser-based toolkit developed to predict a fish community for any NHD-Pl...

  4. [The orchid community in the Biosphere Reserve Sierra del Rosario, Cuba].

    Science.gov (United States)

    García-González, Alfredo; Pérez Márquez, Rolando

    2011-12-01

    The Biosphere Reserve Sierra del Rosario is located in Western Cuba and two different areas can be characterized: one for tourism and forestry activities, El Taburete (ET), and the other for conservation and research, El Salón (ES). With the aim to know the effect of visitation activities on the orchid community in the Reserve, a comparative study between the disturbed area and the preserved one was undertaken. The field work, held between 2004-2005, consisted on four transects in each locality (10 x 100m, 0.1ha). For each transect, the existing orchid species (terrestrial and epiphytic), kind of phorophytes, and level of occupation were identified. Different analysis were considered: dominance-diversity, Sorensen similarity, the dominance index and the relative abundance of the most abundant species. Our results showed 27 phorophytes species, 20 species in ET (98 phorophytes), and 16 species in ES (76 phorophytes). A total of 22 genus, 26 species and 8 326 individuals of orchids were identified. In ET, 17 genus, 18 species and 5 075 individuals were found, while for ES were 15 genus, 18 species and 3 251 individuals. Both locations have a similarity of species of 57.14%. Oeceoclades maculata, an invasive species, was the most abundant. The most dominant species were Microchilus plantagineus in ES and O. maculata in ET. The dominance in ET was of 81.79%, while in ES of 69.27%. It is important to sketch management plans focused on controlling O. maculata in both areas, and the restoration of the disturbed area.

  5. Conservation, Community, and Culture? New Organizational Challenges of Community Forest Concessions in the Maya Biosphere Reserve of Guatemala

    Science.gov (United States)

    Taylor, Peter Leigh

    2010-01-01

    Community-based forestry has received much recent attention as an effort to protect threatened Southern forests by linking conservation with sustainable livelihoods. Many researchers have emphasized the importance of effective organization for successful community-based forestry. While significant attention has been paid to community-level…

  6. Community Engaged Cumulative Risk Assessment of Exposure to Inorganic Well Water Contaminants, Crow Reservation, Montana

    Science.gov (United States)

    Doyle, John T.; Lefthand, Myra J.; Young, Sara L.; Kindness, Larry; Other Medicine, Roberta; Ford, Timothy E.; Dietrich, Eric; Parker, Albert E.; Hoover, Joseph H.; Camper, Anne K.

    2018-01-01

    An estimated 11 million people in the US have home wells with unsafe levels of hazardous metals and nitrate. The national scope of the health risk from consuming this water has not been assessed as home wells are largely unregulated and data on well water treatment and consumption are lacking. Here, we assessed health risks from consumption of contaminated well water on the Crow Reservation by conducting a community-engaged, cumulative risk assessment. Well water testing, surveys and interviews were used to collect data on contaminant concentrations, water treatment methods, well water consumption, and well and septic system protection and maintenance practices. Additive Hazard Index calculations show that the water in more than 39% of wells is unsafe due to uranium, manganese, nitrate, zinc and/or arsenic. Most families’ financial resources are limited, and 95% of participants do not employ water treatment technologies. Despite widespread high total dissolved solids, poor taste and odor, 80% of families consume their well water. Lack of environmental health literacy about well water safety, pre-existing health conditions and limited environmental enforcement also contribute to vulnerability. Ensuring access to safe drinking water and providing accompanying education are urgent public health priorities for Crow and other rural US families with low environmental health literacy and limited financial resources. PMID:29304032

  7. Work-related stress, associated comorbidities and stress causes in French community pharmacies: a nationwide cross-sectional study

    Directory of Open Access Journals (Sweden)

    David Balayssac

    2017-10-01

    Full Text Available Background Like other health professionals, community pharmacists are exposed to stress factors (being efficient, avoiding mistakes and bearing emotional load, but they are also under the pressure of entrepreneurial responsibilities. The main objective was to assess the level of work-related stress in French community pharmacies. The other objectives of the study were to assess the associated comorbidities and causes of work-related stress. Methods This observational cross-sectional study was sent to all French community pharmacies by email. The survey was anonymous and designed to collect the following items: socio-demographic factors, professional status, characteristics of community pharmacy, work-related stress (visual analogic scale—VAS, fatigue (VAS, sleep disturbances (questions, anxiety and depression symptoms (hospital anxiety and depression scale, medical consultation for work-related stress, medication use for work related stress, psychoactive drug-use and causes of work-related stress. Participants were included in the survey if they were pharmacists (owner or assistant or pharmacy technicians working in a community pharmacy at the time of the survey. Exclusion criteria were defined as follows: pharmacy students or other professionals involved in a community pharmacy (e.g. dietician, beautician and lack of professional status information. There was no age limitation. Results After three months of data collection, 1,339 participants answered the survey and 1,272 participants were included in conformity with the inclusion and exclusion criteria, and to avoid missing data on the primary endpoint. Work-related stress was detected in 32.8% (417/1,272 of individuals (scores ≥70/100. Men were significantly more affected than women and there was no difference between professional statuses and no relation with the age of the participants. Work-related stress was significantly associated with anxiety, depression, fatigue, sleep

  8. Work-related stress, associated comorbidities and stress causes in French community pharmacies: a nationwide cross-sectional study

    Science.gov (United States)

    Pereira, Bruno; Virot, Julie; Lambert, Céline; Collin, Aurore; Alapini, David; Gagnaire, Jean-Marc; Authier, Nicolas; Cuny, Damien; Vennat, Brigitte

    2017-01-01

    Background Like other health professionals, community pharmacists are exposed to stress factors (being efficient, avoiding mistakes and bearing emotional load), but they are also under the pressure of entrepreneurial responsibilities. The main objective was to assess the level of work-related stress in French community pharmacies. The other objectives of the study were to assess the associated comorbidities and causes of work-related stress. Methods This observational cross-sectional study was sent to all French community pharmacies by email. The survey was anonymous and designed to collect the following items: socio-demographic factors, professional status, characteristics of community pharmacy, work-related stress (visual analogic scale—VAS), fatigue (VAS), sleep disturbances (questions), anxiety and depression symptoms (hospital anxiety and depression scale), medical consultation for work-related stress, medication use for work related stress, psychoactive drug-use and causes of work-related stress. Participants were included in the survey if they were pharmacists (owner or assistant) or pharmacy technicians working in a community pharmacy at the time of the survey. Exclusion criteria were defined as follows: pharmacy students or other professionals involved in a community pharmacy (e.g. dietician, beautician) and lack of professional status information. There was no age limitation. Results After three months of data collection, 1,339 participants answered the survey and 1,272 participants were included in conformity with the inclusion and exclusion criteria, and to avoid missing data on the primary endpoint. Work-related stress was detected in 32.8% (417/1,272) of individuals (scores ≥70/100). Men were significantly more affected than women and there was no difference between professional statuses and no relation with the age of the participants. Work-related stress was significantly associated with anxiety, depression, fatigue, sleep disturbances, medical

  9. Work-related stress, associated comorbidities and stress causes in French community pharmacies: a nationwide cross-sectional study.

    Science.gov (United States)

    Balayssac, David; Pereira, Bruno; Virot, Julie; Lambert, Céline; Collin, Aurore; Alapini, David; Gagnaire, Jean-Marc; Authier, Nicolas; Cuny, Damien; Vennat, Brigitte

    2017-01-01

    Like other health professionals, community pharmacists are exposed to stress factors (being efficient, avoiding mistakes and bearing emotional load), but they are also under the pressure of entrepreneurial responsibilities. The main objective was to assess the level of work-related stress in French community pharmacies. The other objectives of the study were to assess the associated comorbidities and causes of work-related stress. This observational cross-sectional study was sent to all French community pharmacies by email. The survey was anonymous and designed to collect the following items: socio-demographic factors, professional status, characteristics of community pharmacy, work-related stress (visual analogic scale-VAS), fatigue (VAS), sleep disturbances (questions), anxiety and depression symptoms (hospital anxiety and depression scale), medical consultation for work-related stress, medication use for work related stress, psychoactive drug-use and causes of work-related stress. Participants were included in the survey if they were pharmacists (owner or assistant) or pharmacy technicians working in a community pharmacy at the time of the survey. Exclusion criteria were defined as follows: pharmacy students or other professionals involved in a community pharmacy (e.g. dietician, beautician) and lack of professional status information. There was no age limitation. After three months of data collection, 1,339 participants answered the survey and 1,272 participants were included in conformity with the inclusion and exclusion criteria, and to avoid missing data on the primary endpoint. Work-related stress was detected in 32.8% (417/1,272) of individuals (scores ≥70/100). Men were significantly more affected than women and there was no difference between professional statuses and no relation with the age of the participants. Work-related stress was significantly associated with anxiety, depression, fatigue, sleep disturbances, medical consultations, medication use

  10. Burnout, associated comorbidities and coping strategies in French community pharmacies-BOP study: A nationwide cross-sectional study.

    Directory of Open Access Journals (Sweden)

    David Balayssac

    Full Text Available Work-related stress and burnout syndromes are unfortunately common comorbidities found in health professionals. However, burnout syndrome has only been partly and episodically assessed for community pharmacists whereas these professionals are exposed to patients' demands and difficulties every day. Prevalence of burnout, associated comorbidities and coping strategies were assessed in pharmacy teams (pharmacists and pharmacy technicians in French community pharmacies.This online survey was performed by emails sent to all French community pharmacies over 3 months. The survey assessed the prevalence of burnout (Maslach Burnout Inventory-MBI-questionnaire, anxiety, depression and strategies for coping with work-related stress.Of the 1,339 questionnaires received, 1,322 were completed and useable for the analysis. Burnout syndrome was detected in 56.2% of respondents and 10.5% of them presented severe burnout syndrome. Severe burnout syndrome was significantly associated with men, large urban areas and the number of hours worked. Depression and anxiety were found in 15.7% and 42.4% of respondents, respectively. These co-morbidities were significantly associated with severe burnout syndrome. Higher MBI scores were significantly associated with medical consultations and medicinal drug use. Conversely, respondents suffering from burnout syndrome declared they resorted less to non-medical strategies to manage their work-related stress (leisure, psychotherapy, holidays and time off.This study demonstrated that community pharmacists and pharmacy technicians presented high prevalence of burnout syndrome, such as many healthcare professionals. Unfortunately, burnout syndrome was associated with several comorbidities (anxiety, depression and alcohol abuse and the consumption of health resources. The psychological suffering of these healthcare professionals underlines the necessity to deploy a strategy to detect and manage burnout in community pharmacy.

  11. Burnout, associated comorbidities and coping strategies in French community pharmacies—BOP study: A nationwide cross-sectional study

    Science.gov (United States)

    Balayssac, David; Pereira, Bruno; Virot, Julie; Collin, Aurore; Alapini, David; Cuny, Damien; Gagnaire, Jean-Marc; Authier, Nicolas; Vennat, Brigitte

    2017-01-01

    Background Work-related stress and burnout syndromes are unfortunately common comorbidities found in health professionals. However, burnout syndrome has only been partly and episodically assessed for community pharmacists whereas these professionals are exposed to patients’ demands and difficulties every day. Prevalence of burnout, associated comorbidities and coping strategies were assessed in pharmacy teams (pharmacists and pharmacy technicians) in French community pharmacies. Methods This online survey was performed by emails sent to all French community pharmacies over 3 months. The survey assessed the prevalence of burnout (Maslach Burnout Inventory—MBI—questionnaire), anxiety, depression and strategies for coping with work-related stress. Results Of the 1,339 questionnaires received, 1,322 were completed and useable for the analysis. Burnout syndrome was detected in 56.2% of respondents and 10.5% of them presented severe burnout syndrome. Severe burnout syndrome was significantly associated with men, large urban areas and the number of hours worked. Depression and anxiety were found in 15.7% and 42.4% of respondents, respectively. These co-morbidities were significantly associated with severe burnout syndrome. Higher MBI scores were significantly associated with medical consultations and medicinal drug use. Conversely, respondents suffering from burnout syndrome declared they resorted less to non-medical strategies to manage their work-related stress (leisure, psychotherapy, holidays and time off). Conclusion This study demonstrated that community pharmacists and pharmacy technicians presented high prevalence of burnout syndrome, such as many healthcare professionals. Unfortunately, burnout syndrome was associated with several comorbidities (anxiety, depression and alcohol abuse) and the consumption of health resources. The psychological suffering of these healthcare professionals underlines the necessity to deploy a strategy to detect and manage

  12. Burnout, associated comorbidities and coping strategies in French community pharmacies-BOP study: A nationwide cross-sectional study.

    Science.gov (United States)

    Balayssac, David; Pereira, Bruno; Virot, Julie; Collin, Aurore; Alapini, David; Cuny, Damien; Gagnaire, Jean-Marc; Authier, Nicolas; Vennat, Brigitte

    2017-01-01

    Work-related stress and burnout syndromes are unfortunately common comorbidities found in health professionals. However, burnout syndrome has only been partly and episodically assessed for community pharmacists whereas these professionals are exposed to patients' demands and difficulties every day. Prevalence of burnout, associated comorbidities and coping strategies were assessed in pharmacy teams (pharmacists and pharmacy technicians) in French community pharmacies. This online survey was performed by emails sent to all French community pharmacies over 3 months. The survey assessed the prevalence of burnout (Maslach Burnout Inventory-MBI-questionnaire), anxiety, depression and strategies for coping with work-related stress. Of the 1,339 questionnaires received, 1,322 were completed and useable for the analysis. Burnout syndrome was detected in 56.2% of respondents and 10.5% of them presented severe burnout syndrome. Severe burnout syndrome was significantly associated with men, large urban areas and the number of hours worked. Depression and anxiety were found in 15.7% and 42.4% of respondents, respectively. These co-morbidities were significantly associated with severe burnout syndrome. Higher MBI scores were significantly associated with medical consultations and medicinal drug use. Conversely, respondents suffering from burnout syndrome declared they resorted less to non-medical strategies to manage their work-related stress (leisure, psychotherapy, holidays and time off). This study demonstrated that community pharmacists and pharmacy technicians presented high prevalence of burnout syndrome, such as many healthcare professionals. Unfortunately, burnout syndrome was associated with several comorbidities (anxiety, depression and alcohol abuse) and the consumption of health resources. The psychological suffering of these healthcare professionals underlines the necessity to deploy a strategy to detect and manage burnout in community pharmacy.

  13. Reduction of Medical Cost through Pharmaceutical Inquiries by Community Pharmacists and Relation with Iyaku Bungyo Rates: A Nationwide Survey on Prescription Inquiries.

    Science.gov (United States)

    Shikamura, Yoshiaki; Mano, Yasunari; Komoda, Masayo; Negishi, Kenichi; Sato, Tsugumichi; Miyazaki, Satoru

    2016-01-01

    This nationwide survey aimed to evaluate reduction of drug and medical costs due to prevention of serious adverse drug reactions through pharmaceutical inquires by community pharmacist, and investigate relation with iyaku bungyo (separation of dispensing from medical practice) rates. Using the national list of pharmacies, 10% of pharmacies were randomly selected by prefecture and asked to participate in an Internet-based survey. The survey period was 7 days, from July 21 to July 27, 2015. Of the 5575 pharmacies queried, 818 responded to the survey (response rate: 14.7%). The proportion of inquiries to total prescriptions was 2.6%. Among these, the proportion of prescriptions changed in response to inquiry was 74.9%. An estimated 103 million yen was saved by reducing drug costs, and 133 million yen was saved by reducing medical costs due to prevention of serious adverse drug reactions. Comparison of prescription change rates between pharmacies with high and low iyaku bungyo rates indicated that the proportion of prescriptions changed was significantly higher in pharmacies with high iyaku bungyo rates than in those with low iyaku bungyo rates (78.2% vs. 69.9%, pprescriptions are useful in ensuring the safety of pharmacotherapy and reducing the cost of healthcare. They also suggest that iyaku bungyo promotes prescription changes through inquiries, leading to proper use of pharmaceutical products.

  14. Community carriage of ESBL-producing Escherichia coli is associated with strains of low pathogenicity: a Swedish nationwide study.

    Science.gov (United States)

    Ny, Sofia; Löfmark, Sonja; Börjesson, Stefan; Englund, Stina; Ringman, Maj; Bergström, Jakob; Nauclér, Pontus; Giske, Christian G; Byfors, Sara

    2017-02-01

    Community carriage of ESBL-producing Escherichia coli (EPE) is common worldwide and there is a need to understand the connection between carriage and infection. We compared the molecular characteristics of EPE among Swedish community carriers with those of EPE causing invasive infections. We collected 2134 faecal samples from randomly selected Swedish inhabitants and examined them for the presence of EPE. All participating volunteers answered a questionnaire about putative risk factors for EPE carriage. Suspected EPE isolates (n = 418) from patients with bloodstream infection (BSI) were collected from Swedish laboratories. Isolates were genotypically and phenotypically characterized. Our results show that the EPE population found in carriers generally had lower pathogenicity compared with the isolates from BSIs, since carriers had a lower proportion of E. coli belonging to phylogroup B2, ST131 and ST131 subclone H30-Rx. Isolates from carriers also had lower levels of multiresistance. The Swedish carriage rate of EPE was 4.7% (101/2134) among healthy volunteers. Risk factors associated with carriage were travel to countries in Asia (OR = 3.6, 95% CI = 1.4-9.2) and Africa (OR = 3.6, 95% CI = 1.7-7.7) and a diet without pork (OR = 0.5, 95% CI = 0.3-0.8 for pork eaters). E. coli host factors previously associated with higher pathogenicity were all more common in BSIs compared with carriers. This indicates that the risk of invasive infection with EPE may be relatively modest in many community carriers and that EPE carriage of high-risk strains should be the focus of attention for prevention. © The Author 2016. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy.

  15. Prevalence and burden of self-reported blindness, low vision, and visual impairment in the French community: a nationwide survey.

    Science.gov (United States)

    Brézin, Antoine Pierre; Lafuma, Antoine; Fagnani, Francis; Mesbah, Mounir; Berdeaux, Gilles

    2005-08-01

    To estimate the prevalence of self-reported visual impairment and its association with disabilities, handicaps, and socioeconomic consequences. A national survey was conducted on a random stratified sample of 359 010 French citizens living in the community; 21 760 subjects were selected at random and 16 945 persons (78%) agreed to further questioning. Four thousand ninety-one randomly selected caregivers were interviewed. Four subgroups of subjects were defined (blind or light perception only, low vision or still have form perception, other visual problems, and no visual problems). These were compared after adjustment for age, comorbidity, and household size differences. The prevalence of blindness was 0.10% and of low vision, 1.94%. Subjects with blindness needed assistance with daily activities more often than subjects with no visual problems; they also needed more house modifications. Many subjects with blindness (46.8%) and subjects with low vision (29.0%) were registered for social allowances. Subjects with blindness had fewer paid activities (4.5%) than subjects with no visual problems (20.7%). Social allowances increased considerably (by 277) between those with low vision and those with blindness. Monthly household incomes were lower (Pvisual problems (1851). Collected data included social demography, home description, household income, handicaps, disabilities, social allowances, and daily activities. The results demonstrate associations between self-reported visual impairment and daily living.

  16. Significant reduction of antibiotic use in the community after a nationwide campaign in France, 2002-2007.

    Directory of Open Access Journals (Sweden)

    Elifsu Sabuncu

    2009-06-01

    Full Text Available BACKGROUND: Overuse of antibiotics is the main force driving the emergence and dissemination of bacterial resistance in the community. France consumes more antibiotics and has the highest rate of beta-lactam resistance in Streptococcus pneumoniae than any other European country. In 2001, the government initiated "Keep Antibiotics Working"; the program's main component was a campaign entitled "Les antibiotiques c'est pas automatique" ("Antibiotics are not automatic" launched in 2002. We report the evaluation of this campaign by analyzing the evolution of outpatient antibiotic use in France 2000-2007, according to therapeutic class and geographic and age-group patterns. METHODS AND FINDINGS: This evaluation is based on 2000-2007 data, including 453,407,458 individual reimbursement data records and incidence of flu-like syndromes (FLSs. Data were obtained from the computerized French National Health Insurance database and provided by the French Sentinel Network. As compared to the preintervention period (2000-2002, the total number of antibiotic prescriptions per 100 inhabitants, adjusted for FLS frequency during the winter season, changed by -26.5% (95% confidence interval [CI] -33.5% to -19.6% over 5 years. The decline occurred in all 22 regions of France and affected all antibiotic therapeutic classes except quinolones. The greatest decrease, -35.8% (95% CI -48.3% to -23.2%, was observed among young children aged 6-15 years. A significant change of -45% in the relationship between the incidence of flu-like syndromes and antibiotic prescriptions was observed. CONCLUSIONS: The French national campaign was associated with a marked reduction of unnecessary antibiotic prescriptions, particularly in children. This study provides a useful method for assessing public-health strategies designed to reduce antibiotic use.

  17. Significant reduction of antibiotic use in the community after a nationwide campaign in France, 2002-2007.

    Science.gov (United States)

    Sabuncu, Elifsu; David, Julie; Bernède-Bauduin, Claire; Pépin, Sophie; Leroy, Michel; Boëlle, Pierre-Yves; Watier, Laurence; Guillemot, Didier

    2009-06-02

    Overuse of antibiotics is the main force driving the emergence and dissemination of bacterial resistance in the community. France consumes more antibiotics and has the highest rate of beta-lactam resistance in Streptococcus pneumoniae than any other European country. In 2001, the government initiated "Keep Antibiotics Working"; the program's main component was a campaign entitled "Les antibiotiques c'est pas automatique" ("Antibiotics are not automatic") launched in 2002. We report the evaluation of this campaign by analyzing the evolution of outpatient antibiotic use in France 2000-2007, according to therapeutic class and geographic and age-group patterns. This evaluation is based on 2000-2007 data, including 453,407,458 individual reimbursement data records and incidence of flu-like syndromes (FLSs). Data were obtained from the computerized French National Health Insurance database and provided by the French Sentinel Network. As compared to the preintervention period (2000-2002), the total number of antibiotic prescriptions per 100 inhabitants, adjusted for FLS frequency during the winter season, changed by -26.5% (95% confidence interval [CI] -33.5% to -19.6%) over 5 years. The decline occurred in all 22 regions of France and affected all antibiotic therapeutic classes except quinolones. The greatest decrease, -35.8% (95% CI -48.3% to -23.2%), was observed among young children aged 6-15 years. A significant change of -45% in the relationship between the incidence of flu-like syndromes and antibiotic prescriptions was observed. The French national campaign was associated with a marked reduction of unnecessary antibiotic prescriptions, particularly in children. This study provides a useful method for assessing public-health strategies designed to reduce antibiotic use.

  18. Poor sleep quality and suicide attempt among adults with internet addiction: A nationwide community sample of Korea.

    Science.gov (United States)

    Kim, Kiwon; Lee, Haewoo; Hong, Jin Pyo; Cho, Maeng Je; Fava, Maurizio; Mischoulon, David; Kim, Dong Jun; Jeon, Hong Jin

    2017-01-01

    Internet addiction (IA) is defined as a psychological dependence on the internet, regardless of the type of activities once logged on, and previous studies have focused on adolescents and young adults. The aim of this study was to investigate the association between suicide attempts and sleep among community-dwelling adults with IA. The Young's Internet Addiction Test (IAT), the Korean version of the Composite International Diagnostic Interview (K-CIDI) and a suicide questionnaire were used in this cross-sectional multistage, cluster sampling population-based study. A total of 3212 adults aged 18-64 years were interviewed face-to-face, and they had been randomly selected through a one-person-per-household method. Of the 3212 adults, 204 were assessed as having IA (6.35%). Adults with IA were younger, and more frequently male, unmarried, and unemployed, and had poorer sleep quality than adults without IA (32.8% vs. 19.8%), whereas there was no significant difference in the absolute duration of sleep between the two groups. Adults with IA showed more frequent difficulty initiating and maintaining sleep, non-restorative sleep, daytime functional impairment, and duration of sleep more than 10 hours on weekdays than adults without IA. IA with poor sleep quality was significantly associated with lifetime suicide attempts (AOR = 3.34, 95% CI 1.38-8.05) after adjusting for demographic covariates. Adults with IA who had more sleep problems showed more severe IA, especially those who experienced a previous suicidal attempt. Among mental disorders, IA with poor sleep quality was significantly associated with anxiety disorder and overall psychiatric disorders. Among adults with IA, poor sleep quality was found to be associated with more severe IA and lifetime suicide attempt.

  19. Teen Pregnancy Prevention Program Recommendations from Urban and Reservation Northern Plains American Indian Community Members

    Science.gov (United States)

    McMahon, Tracey R.; Hanson, Jessica D.; Griese, Emily R.; Kenyon, DenYelle Baete

    2015-01-01

    Despite declines over the past few decades, the United States has one of the highest rates of teen pregnancy compared to other industrialized nations. American Indian youth have experienced higher rates of teen pregnancy compared to the overall population for decades. Although it's known that community and cultural adaptation enhance program…

  20. Have investments in on-reserve health services and initiatives promoting community control improved First Nations' health in Manitoba?

    Science.gov (United States)

    Lavoie, Josée Gabrielle; Forget, Evelyn L; Prakash, Tara; Dahl, Matt; Martens, Patricia; O'Neil, John D

    2010-08-01

    The objective of this study was to document the relationship between First Nation's community characteristics and the rates of hospitalization for Ambulatory Care Sensitive Conditions (ACSC) in the province of Manitoba, Canada. A population-based time trend analysis of selected ACSC was conducted using the de-identified administrative data housed at the Manitoba Centre for Health Policy, including vital statistics and health information. The study population included all Manitoba residents eligible under the universal Manitoba Health Services Insurance Plan and living on First Nation reserves between 1984/85 and 2004/05. Twenty-nine ACSC defined using 3, 4 and 5 digit ICD-9-CM and ICD-10-CM codes permitted cross-sectional and longitudinal comparison of hospitalization rates. The analysis used Generalized Estimated Equation (GEE) modeling. Two variables were significant in our model: level of access to primary health care on-reserve; and level of local autonomy. Communities with local access to a broader complement of primary health care services showed a lower rate of hospitalization for ACSC. We also examined whether there was a significant trend in the rates of hospitalization for ACSC over time following the signature of an agreement increasing local autonomy over resource allocation. We found the rates of hospitalization for ACSC decreased with each year following the signature of such an agreement. This article demonstrates that communities with better local access to primary health care consistently show lower rates of ACSC. Secondly, the longer community health services have been under community control, the lower its ACSC rate. (c) 2010 Elsevier Ltd. All rights reserved.

  1. Diversity and structure of an oak community in the Cachalu Biological Reserve, Encino (Santander-Colombia)

    International Nuclear Information System (INIS)

    Avila, Fabio A; Angel, Sonia Patricia; Lopez C, Rene

    2010-01-01

    We analyzed diversity, structure and preliminary plant dynamics features (mortality and recruitment) of a one ha permanent plot in an oak forest, at the Reserva Biologica Cachalu, at an altitude of between 2100 and 2200 m. The plot was established in 2007, when all plant individuals with dbh 10 cm (first category) were tagged, measured and plotted. All individuals 1 and < 10 cm dbh (second category) were sampled in an area of 0.2 ha within the plot. In the last census (July 2009), we found 453 individuals, 23 families, 26 genera and 34 species from the first Category and 624 individuals, 34 families, 60 genera and 80 species from the second. The species-area curve showed a value of R2= 0.97. According to the structure analysis, most of the individuals, mainly tree lets, were accumulated in the first diameter, showing an up-turned J distribution, which illustrates early forest stages. Between the plot establishment and the first census (1.5 yr) the basal area of the first category decreased 1.61% while the second increased 36.6%. The most important species ac cording to IVI were Quercus humboldtii, Clusia schomburgkiana and Blakea cuatrecasii. Mortality and recruitment rates for the first category were 0.96% y 1%, respectively and in the second category these values were 2.8% y 12.2% respectively. During 1.5 yr new gaps appeared within the plot, which is associated with the decrease in total basal area. Despite high similarity in species composition compared with other neotropical montane forests, the dynamics and structure of the community in the present study appear to be distinct.

  2. Culicidae community composition and temporal dynamics in Guapiaçu Ecological Reserve, Cachoeiras de Macacu, Rio de Janeiro, Brazil.

    Science.gov (United States)

    Alencar, Jeronimo; de Mello, Cecilia Ferreira; Guimarães, Anthony Érico; Gil-Santana, Hélcio R; Silva, Júlia Dos Santos; Santos-Mallet, Jacenir R; Gleiser, Raquel M

    2015-01-01

    A temporal observational study was conducted of the Culicidae fauna in a remnant area of Atlantic Forest within a private reserve (Guapiaçu Ecological Reserve-REGUA) presenting typical vegetation cover of dense rain forest, with some patches recovering a floristic composition similar to that of the original community. Research was carried out to analyze the influence of climatic factors (mean monthly temperature, rainfall, and air relative humidity) on the temporal dynamics of the mosquito communities that occur in the reserve. The completeness of the mosquito inventory was assessed with individual-based rarefaction-extrapolation curves. Differences in species composition between sites and months were tested with PERMANOVA. True diversities of orders 0, 1, and 2 (effective numbers) were estimated and compared between sites, months, and years. Multiple stepwise regressions were used to assess relationships between climatic variables, measures of diversity, and abundances of the most common species. There were significant interactive effects between year and site on measures of diversity. However, diversity estimates showed little variation among months, and these were weakly correlated with climatic variables. Abundances of the most common species were significantly related to temperature or relative humidity, but not rainfall. The presence of mosquito species known to be vectors of human diseases combined with an intermittent flow of visitors to the study area suggests there is a risk of disease transmission that warrants further monitoring.

  3. Putting the community back in community ecology and education: the role of field schools and private reserves in the ethical training of primatologists.

    Science.gov (United States)

    Garber, P A; Molina, A; Molina, R L

    2010-09-01

    In 1993 and 1999, with the assistance of a Nicaraguan family, we founded La Suerte Biological Research Station in northeastern Costa Rica and Ometepe Biological Research Station in southern Nicaragua as a privately owned conservation-oriented business. Our goal was to develop a program of sustainable community ecology focused on education, research, and the conservation of primates and tropical forests. In order to accomplish this we developed field courses in which undergraduate and graduate students conduct scientific research, experience local cultures, and learn about conservation. Over 120 of these students have received doctoral degrees or are currently in graduate programs. Four doctoral dissertations, several MA theses, and some 20 scientific articles have been published based on research conducted at our field stations. In order to achieve our long-term goals of preserving the environment, we also needed to engage directly with local communities to address their needs and concerns. To this end, we developed a series of community-based initiatives related to health care, bilingual education, and conservation education using traditional and on-line teaching tools. In this article, we describe our efforts in Costa Rica and Nicaragua teaching conservation-oriented field courses and working with the local human communities. Building upon these experiences, we outline a set of ethical considerations and responsibilities for private reserves, conservation-oriented businesses, NGOs, and conservancies that help integrate members of the local community as stakeholders in conservation. (c) 2010 Wiley-Liss, Inc.

  4. Building ties: social capital network analysis of a forest community in a biosphere reserve in Chiapas, Mexico

    Directory of Open Access Journals (Sweden)

    Luis Rico García-Amado

    2012-09-01

    Full Text Available Governance of the commons depends on the capacity to generate collective action. Networks and rules that foster that collective action have been defined as social capital. However, their causal link is still not fully understood. We use social network analysis to assess social capital, decision-making, and collective action in a forest-based common pool resource management in La Sepultura Biosphere Reserve (Chiapas, Mexico. Our research analyzes the productive networks and the evolution of coffee groups in one community. The network shows some centrality, with richer landholders tending to occupy core positions and poorer landless peasants occupying peripheral ones. This has fostered the community's environmentally oriented development but has also caused internal conflicts. Market requirements have shaped different but complementary productive networks, where organic coffee commercialization is the main source of bridging ties, which has resulted in more connectivity and resilience. Conservation attitudes, along with the institutional setting of the community, have promoted collective action. The unresolved conflicts, however, still leave some concerns about governance in the future.

  5. Association of lifelong exposure to cognitive reserve-enhancing factors with dementia risk: A community-based cohort study.

    Science.gov (United States)

    Wang, Hui-Xin; MacDonald, Stuart W S; Dekhtyar, Serhiy; Fratiglioni, Laura

    2017-03-01

    Variation in the clinical manifestation of dementia has been associated with differences in cognitive reserve, although less is known about the cumulative effects of exposure to cognitive reserve factors over the life course. We examined the association of cognitive reserve-related factors over the lifespan with the risk of dementia in a community-based cohort of older adults. Information on early-life education, socioeconomic status, work complexity at age 20, midlife occupation attainment, and late-life leisure activities was collected in a cohort of dementia-free community dwellers aged 75+ y residing in the Kungsholmen district of Stockholm, Sweden, in 1987-1989. The cohort was followed up to 9 y (until 1996) to detect incident dementia cases. To exclude preclinical phases of disease, participants who developed dementia at the first follow-up examination 3 y after the baseline were excluded (n = 602 after exclusions). Structural equation modelling was used to generate latent factors of cognitive reserve from three periods over the life course: early (before 20 y), adulthood (around 30-55 y), and late life (75 y and older). The correlation between early- and adult-life latent factors was strong (γ = 0.9), whereas early-late (γ = 0.27) and adult-late (γ = 0.16) latent factor correlations were weak. One hundred forty-eight participants developed dementia during follow-up, and 454 remained dementia-free. The relative risk (RR) of dementia was estimated using Cox models with life-course cognitive reserve-enhancing factors modelled separately and simultaneously to assess direct and indirect effects. The analysis was repeated among carriers and noncarriers of the apolipoprotein E (APOE) ε4 allele. A reduced risk of dementia was associated with early- (RR 0.57; 95% CI 0.36-0.90), adult- (RR 0.60; 95% CI 0.42-0.87), and late-life (RR 0.52; 95% CI 0.37-0.73) reserve-enhancing latent factors in separate multivariable Cox models. In a mutually adjusted model, which may

  6. Practice Adaptive Reserve and Colorectal Cancer Screening Best Practices at Community Health Center Clinics in Seven States

    Science.gov (United States)

    Tu, Shin-Ping; Young, Vicki; Coombs, Letoynia J.; Williams, Rebecca; Kegler, Michelle; Kimura, Amanda; Risendal, Betsy; Friedman, Daniela B.; Glenn, Beth; Pfeiffer, Debbie J.; Fernandez, Maria

    2015-01-01

    Background Enhancing the capability of community health centers to implement best practices may mitigate health disparities. We investigated the association of Practice Adaptive Reserve (PAR) to implementation of Patient Centered Medical Home (PCMH) colorectal cancer (CRC) screening best practices (BPs) at community health center clinics in seven states. Methods A convenience sample of clinic staff participated in a self-administered online survey. We scored eight PCMH CRC screening BPs as a composite ranging from 0–32. The PAR composite score was scaled from 0 to 1 then categorized into three levels. Multilevel analyses examined the relationship between PAR and self-reported implementation of the PCMH BPs. Results Out of 296 respondents, 59% reported 6 or more PCMH BPs at their clinics. The mean PAR score was 0.66 (s.d. 0.18) and PCMH BP mean scores were significantly higher for respondents who reported higher clinic PAR categories. Compared to the lowest PAR level, adjusted PCMH BP means were 25.0 percent higher at the middle PAR level (Difference = 3.2, SE = 1.3, t = 2.44, p = 0.015) and 63.2 percent higher at the highest PAR level (Difference = 8.0, SE = 1.9, t = 4.86, p < 0.0001). Conclusion Higher Adaptive Reserve, as measured by the PAR score, is positively associated with self-reported implementation of PCMH CRC screening BPs by clinic staff. Future research is needed to determine PAR levels most conducive to implementing CRC screening and to develop interventions that enhance PAR in primary care settings. PMID:25524651

  7. Building a community of practice for sustainability: strengthening learning and collective action of Canadian biosphere reserves through a national partnership.

    Science.gov (United States)

    Reed, Maureen G; Godmaire, Hélène; Abernethy, Paivi; Guertin, Marc-André

    2014-12-01

    Deliberation, dialogue and systematic learning are now considered attributes of good practice for organizations seeking to advance sustainability. Yet we do not know whether organizations that span spatial scales and governance responsibilities can establish effective communities of practice to facilitate learning and action. The purpose of this paper is to generate a framework that specifies actions and processes of a community of practice designed to instill collective learning and action strategies across a multi-level, multi-partner network. The framework is then used to describe and analyze a partnership among practitioners of Canada's 16 UNESCO biosphere reserves, and additional researchers and government representatives from across Canada. The framework is a cycle of seven action steps, beginning and ending with reflecting on and evaluating present practice. It is supported by seven characteristics of collaborative environmental management that are used to gauge the success of the partnership. Our results show that the partnership successfully built trust, established shared norms and common interest, created incentives to participate, generated value in information sharing and willingness to engage, demonstrated effective flow of information, and provided leadership and facilitation. Key to success was the presence of a multi-lingual facilitator who could bridge cultural differences across regions and academia-practitioner expectations. The project succeeded in establishing common goals, setting mutual expectations and building relations of trust and respect, and co-creating knowledge. It is too soon to determine whether changes in practices that support sustainability will be maintained over the long term and without the help of an outside facilitator. Copyright © 2014 Elsevier Ltd. All rights reserved.

  8. Practice adaptive reserve and colorectal cancer screening best practices at community health center clinics in 7 states.

    Science.gov (United States)

    Tu, Shin-Ping; Young, Vicki M; Coombs, Letoynia J; Williams, Rebecca S; Kegler, Michelle C; Kimura, Amanda T; Risendal, Betsy C; Friedman, Daniela B; Glenn, Beth A; Pfeiffer, Debbie J; Fernandez, Maria E

    2015-04-15

    Enhancing the capability of community health centers to implement best practices (BPs) may mitigate health disparities. This study investigated the association of practice adaptive reserve (PAR) with the implementation of patient-centered medical home (PCMH) colorectal cancer (CRC) screening BPs at community health center clinics in 7 states. A convenience sample of clinic staff participated in a self-administered, online survey. Eight PCMH CRC screening BPs were scored as a composite ranging from 0 to 32. The PAR composite score was scaled from 0 to 1 and then categorized into 3 levels. Multilevel analyses examined the relation between PAR and self-reported implementation of PCMH BPs. There were 296 respondents, and 59% reported 6 or more PCMH BPs at their clinics. The mean PAR score was 0.66 (standard deviation, 0.18), and the PCMH BP mean scores were significantly higher for respondents who reported higher clinic PAR categories. In comparison with the lowest PAR level, adjusted PCMH BP means were 25.0% higher at the middle PAR level (difference, 3.2; standard error, 1.3; t = 2.44; P = .015) and 63.2% higher at the highest PAR level (difference, 8.0; standard error, 1.9; t = 4.86; P clinic staff. Future research is needed to determine the PAR levels most conducive to implementing CRC screening and to develop interventions that enhance PAR in primary care settings. © 2014 American Cancer Society.

  9. Medicinal use of wild fauna by mestizo communities living near San Guillermo Biosphere Reserve (San Juan, Argentina).

    Science.gov (United States)

    Hernandez, Jorge; Campos, Claudia M; Borghi, Carlos E

    2015-01-21

    Wild and domestic animals and their by-products are important ingredients in the preparation of curative, protective and preventive medicines. Despite the medicinal use of animals worldwide, this topic has received less attention than the use of medicinal plants. This study assessed the medicinal use of animals by mestizo communities living near San Guillermo MaB Reserve by addressing the following questions: What animal species and body parts are used? What ailments or diseases are treated with remedies from these species? To what extent do mestizo people use animals as a source of medicine? Is the use related to people's age? We conducted semi-structured interviews with 171 inhabitants (15-93 years old) of four villages close to the Reserve: Tudcúm, Angualasto, Malimán and Colangüil. We calculated the informant consensus factor and fidelity level to test homogeneity of knowledge and to know the importance of different medicinal uses for a given species. The medicinal use of animals was reported by 57% of the surveyed people. Seven species were mentioned: Rhea pennata, Lama guanicoe, Puma concolor, Pseudalopex sp., Lama vicugna, Lepus europaeus and Conepatus chinga. Several body parts were used: fat, leg, bezoar-stone, stomach, feather, meat, blood, feces, wool, and liver. The fat of R. pennata was the most frequently used animal part, followed by the bezoar stone and the leg of L. guanicoe. Animals were used to treat 22 ailments, with respiratory and nervous system disorders being the most frequently treated diseases with a high degree of consensus. Old people used animals as remedies more frequently than young residents, showing some differences among villages. A low number of animal species was mentioned as used for medicinal purposes, which could be explained by the perception of strong control related the legislation that bans hunting and the erosion of traditional knowledge produced by mestizaje. However, the presence of a traditional medicine is deeply

  10. Community perspectives on food insecurity and obesity: Focus groups with caregivers of metis and Off-reserve first nations children.

    Science.gov (United States)

    Bhawra, Jasmin; Cooke, Martin J; Hanning, Rhona; Wilk, Piotr; Gonneville, Shelley L H

    2015-10-16

    Aboriginal children in Canada are at a higher risk for overweight and obesity than other Canadian children. In Northern and remote areas, this has been linked to a lack of affordable nutritious food. However, the majority of Aboriginal children live in urban areas where food choices are more plentiful. This study aimed to explore the experiences of food insecurity among Métis and First Nations parents living in urban areas, including the predictors and perceived connections between food insecurity and obesity among Aboriginal children. Factors influencing children's diets, families' experiences with food insecurity, and coping strategies were explored using focus group discussions with 32 parents and caregivers of Métis and off-reserve First Nations children from Midland-Penetanguishene and London, Ontario. Four focus groups were conducted and transcribed verbatim between July 2011 and March 2013. A thematic analysis was conducted using NVivo software, and second coders ensured reliability of the results. Caregivers identified low income as an underlying cause of food insecurity within their communities and as contributing to poor nutrition among their children. Families reported a reliance on energy-dense, nutrient-poor foods, as these tended to be more affordable and lasted longer than more nutritious, fresh food options. A lack of transportation also compromised families' ability to purchase healthful food. Aboriginal caregivers also mentioned a lack of access to traditional foods. Coping strategies such as food banks and community programming were not always seen as effective. In fact, some were reported as potentially exacerbating the problem of overweight and obesity among First Nations and Métis children. Food insecurity manifested itself in different ways, and coping strategies were often insufficient for addressing the lack of fruit and vegetable consumption in Aboriginal children's diets. Results suggest that obesity prevention strategies should take a

  11. Symbiotic nitrogen fixation in the alpine community of a lichen heath of the Northwestern Caucasus Region (the Teberda Reserve)

    Science.gov (United States)

    Makarov, M. I.; Malysheva, T. I.; Ermak, A. A.; Onipchenko, V. G.; Stepanov, A. L.; Menyailo, O. V.

    2011-12-01

    The symbiotic fixation of atmospheric nitrogen by leguminous plants in the alpine community of a lichen heath at the Teberda State Biosphere Reserve is well adapted to low soil temperature characteristic for the altitude of 2800 m a.s.l. For the determination of the N fixation by isotopic methods (the method of the natural 15N abundance and the method of isotopic 15N dilution), Trifolium polyphyllum was taken as the control plant. This plant was used as it does not form symbiosis with the nitrogen-fixing bacteria in the highlands of the Northern Caucasus Region. The contribution of the N fixation to the N nutrition of different leguminous plant species as determined by the natural 15N abundance method amounted to 28-73% at δ15N0 = 0‰ and 46-117% at δ15N0 = -1‰; for the determination of the N fixation by the method of the isotopic label's dilution, it was 34-97%. The best correlation of the results obtained by these two isotopic methods was observed for the natural fractionation of the N isotopes in the course of the N fixation in the range of -0.5 to -0.7‰. The determination of the nitrogenase activity of the roots by the acetylene method confirmed the absence of N fixation in T. polyphyllum and its different contribution to the N nutrition of different species of leguminous plants.

  12. Effect of the recent land use on the plant diversity and community structure of Omayed Biosphere Reserve, Egypt

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    Dalia A. Ahmed

    2015-07-01

    Full Text Available The present study aims at describing and analysing the floristic composition and vegetation types, as well as determining the effect of recent land uses on the vegetation structure. It aims also at identifying the alien plants species and elucidating the impact of these species on the plant diversity and community structure of the study area. One hundred and ninety stands were selected monthly for this study, 145 species were recorded (69 perennials and 76 annuals related to 83 genera, 40 families in 9 identified habitats in El-Omayed Biosphere Reserve (coastal sand dunes, salt marshes, saline depression, non-saline depression, inland ridges, inland plateau, irrigation canals, road sides and cultivated lands. Therophytes were the most represented life form. Three habitat groups resulted after the application of TWINSPAN and DCA as classification and ordination techniques: 2 represented the natural habitats and one represented the urban and cultivated habitats. Group I represented coastal dunes and salt marshes GII: saline depressions, non-saline depressions, inland plateau and inland ridges and GIII: irrigation canals, road sides and cultivated lands. Coastal dunes had the highest species richness (α-diversity, followed by cultivated lands, while inland plateau had the lowest; but saline depressions had the highest species turnover (β-diversity. Non-saline depressions had the highest relative evenness, while saline depressions had the highest relative concentration of dominance. Coastal dunes had highest values of calcium carbonates and calcium ions, and salt marshes had the highest salinity, pH, potassium and sodium contents, but cultivated lands had the highest values of silt, clay and organic matter. The diagram resulting from CCA showed an influence of most soil variables, except nitrogen, calcium and potassium. Twenty two species were recorded for the first time in the study area. The recent land use (overgrazing, wood cutting and

  13. Spatial variations in the trophic structure of soil animal communities in boreal forests of Pechora-Ilych Nature Reserve

    Science.gov (United States)

    Goncharov, A. A.; Khramova, E. Yu.; Tiunov, A. V.

    2014-05-01

    Soil animal communities and detrital food webs are spatially compartmentalized. In old-growth boreal forests the dynamics of dominating plant species forms a considerable heterogeneity of edaphic conditions in the soil layer. We demonstrate a strong difference in total and relative abundance of main trophic groups of soil macrofauna in four microsites, i.e. under tree crowns, in gaps, in mounds and in pits created by fallen spruce trees. The variation in the functional structure of soil animal communities is likely related to different availability of key energy resources (leaf litter, roots and root deposits) in the microsites studied. However, results of the stable isotope analysis suggest that mobile litter-dwelling predators occupy very similar trophic positions in different microsites. The compartmentalization of soil invertebrate communities caused by the vegetation-induced mosaic of edaphic conditions seemingly does not lead to spatial isolation of local food webs that are integrated at the top trophic levels.

  14. A framework of lessons learned from community-based marine reserves and its effectiveness in guiding a new coastal management initiative in the Philippines.

    Science.gov (United States)

    Beger, Maria; Harborne, Alastair R; Dacles, Terence P; Solandt, Jean-Luc; Ledesma, Gerardo L

    2004-12-01

    Community-based coastal resource management has been widely applied within the Philippines. However, small-scale community-based reserves are often inefficient owing to management inadequacies arising because of a lack of local support or enforcement or poor design. Because there are many potential pitfalls during the establishment of even small community-based reserves, it is important for coastal managers, communities, and facilitating institutions to have access to a summary of the key factors for success. Reviewing relevant literature, we present a framework of "lessons learned" during the establishment of protected areas, mainly in the Philippines. The framework contains summary guidance on the importance of (1) an island location, (2) small community population size, (3) minimal effect of land-based development, (4) application of a bottom-up approach, (5) an external facilitating institution, (6) acquisition of title, (7) use of a scientific information database, (8) stakeholder involvement, (9) the establishment of legislation, (10) community empowerment, (11) alternative livelihood schemes, (12) surveillance, (13) tangible management results, (14) continued involvement of external groups after reserve establishment, and (15) small-scale project expansion.These framework components guided the establishment of a community-based protected area at Danjugan Island, Negros Occidental, Philippines. This case study showed that the framework was a useful guide that led to establishing and implementing a community-based marine reserve. Evaluation of the reserve using standard criteria developed for the Philippines shows that the Danjugan Island protected area can be considered successful and sustainable. At Danjugan Island, all of the lessons synthesized in the framework were important and should be considered elsewhere, even for relatively small projects. As shown in previous projects in the Philippines, local involvement and stewardship of the protected area

  15. Utilization and patterns of community healthcare services for senior residents in long-term care facilities in Taiwan: A nationwide study

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    Hsiao-Ting Chang

    2013-01-01

    Conclusion: Whether or not the replacement of nasogastric tubes and urinary catheters among the LTCF senior resident population is an appropriate use of time and targeted medical resources needs further investigation. When addressing concerns about the community healthcare needs of senior residents of LTCFs, policymakers should carefully consider the current shortage of professional healthcare workers as they assess strategies to best meet the needs of the elderly in Taiwan.

  16. Extent and quality of drug use in community-dwelling people aged ≥75 years: A Swedish nationwide register-based study.

    Science.gov (United States)

    Lagerin, Annica; Törnkvist, Lena; Nilsson, Gunnar; Johnell, Kristina; Fastbom, Johan

    2017-12-01

    It is important for district nurses and other health professionals in primary care to gain more insight into the patterns and quality of drug use in community-dwelling older people, particularly in 75-year-olds, who have been the target of preventive home visits. This study aimed to examine the extent and quality of drug use in community-dwelling older people and to compare drug use in 75-year-olds with that of older age groups. Data from 2013 on people aged ≥75 years were obtained from the Swedish Prescribed Drug Register. Those living in the community (671,940/739,734 people aged ≥75 years) were included in the study. Quality of drug use was assessed by using a selection of indicators issued by the Swedish National Board of Health and Welfare. The prevalence of polypharmacy and of many drug groups increased with age, as did several indicators of inappropriate drug use. However some drug groups, as well as inappropriate drugs, were prevalent in 75-year-olds and declined with age, for example diabetes drugs, drugs with major anticholinergic effects and nonsteroidal anti-inflammatory drugs. The substantial use of some drugs as early as 75 years of age confirms the value of including drug use as a topic in preventive home visits to 75-year-olds. The finding that polypharmacy and many measures of inappropriate drug use increased with age in community-dwelling older people also underscores the importance of district nurses' role in continuing to promote safe medication management at higher ages.

  17. Drama as a community engagement strategy for malaria in rural Cambodia [version 1; referees: 1 approved, 2 approved with reservations

    Directory of Open Access Journals (Sweden)

    Renly Lim

    2017-09-01

    Full Text Available Background: Countries in Southeast Asia are working to eliminate multidrug-resistant falciparum malaria, a major cause of mortality in tropical regions. Malaria is declining but transmission persists in many rural areas and among forest workers and isolated populations. In these remote communities, conventional health services and education are limited. Mobilising and educating these populations require new approaches as many people are illiterate and do not attend village meetings. This article describes a qualitative study to assess the feasibility of a drama project as a community engagement strategy. Methods: A drama project was conducted in twenty villages in Cambodia with three key messages: to use insecticide-treated bednets and repellents, to get early diagnosis and treatment, and to learn about risks of forest-acquired malaria. Qualitative interviews were conducted with the drama team members, village malaria workers, local health staffs and villagers, to explore the feasibility of using drama to engage the community and the associated challenges. Results: 29 people were interviewed, which included 18 semi-structured interviews and one focus group discussion. Analysis of the interviews resulted in development of the following seven themes: i exposure to malaria and engagement activities, ii readiness and barriers to participation, iii understanding and learning about malaria using drama, iv entertainment value and engagement method preferences, v challenges to community engagement, vi future participation and vii sustainability. The event saw a very positive response, with an encouraging average participation rate of 66%. The project faced several challenges including logistic problems, rescheduling due to raining season, and time- and budget-constraints. Conclusions: Our evaluation demonstrated that the drama project was feasible in promoting awareness and understanding of malaria prevention and control. Audience members perceived

  18. Racial Differences in Information Needs During and After Cancer Treatment: a Nationwide, Longitudinal Survey by the University of Rochester Cancer Center National Cancer Institute Community Oncology Research Program.

    Science.gov (United States)

    Asare, Matthew; Peppone, Luke J; Roscoe, Joseph A; Kleckner, Ian R; Mustian, Karen M; Heckler, Charles E; Guido, Joseph J; Sborov, Mark; Bushunow, Peter; Onitilo, Adedayo; Kamen, Charles

    2018-02-01

    Before treatment, cancer patients need information about side effects and prognosis, while after treatment they need information to transition to survivorship. Research documenting these needs is limited, especially among racial and ethnic minorities. This study evaluated cancer patients' needs according to race both before and after treatment. We compared white (n = 904) to black (n = 52) patients receiving treatment at 17 National Cancer Institute Community Oncology Research Program (NCORP) sites on their cancer-related concerns and need for information before and after cancer treatment. Two-sample t test and chi-squared analyses were used to assess group differences. Compared to white patients, black patients reported significantly higher concerns about diet (44.3 vs. 25.4 %,) and exercise (40.4 vs. 19.7 %,) during the course of treatment. Compared to whites, blacks also had significantly higher concern about treatment-related issues (white vs. black mean, 25.52 vs. 31.78), self-image issues (7.03 vs. 8.60), family-related issues (10.44 vs. 12.84), and financial concerns (6.42 vs. 8.90, all p information needs regarding follow-up tests (8.17 vs. 9.44), stress management (4.12 vs. 4.89), and handling stigma after cancer treatment (4.21 vs. 4.89) [all p information needs differed by race, with black patients reporting greater information needs and concerns. In clinical practice, tailored approaches may work particularly well in addressing the needs and concerns of black patients.

  19. New perspectives on community-acquired pneumonia in 388 406 patients. Results from a nationwide mandatory performance measurement programme in healthcare quality.

    Science.gov (United States)

    Ewig, S; Birkner, N; Strauss, R; Schaefer, E; Pauletzki, J; Bischoff, H; Schraeder, P; Welte, T; Hoeffken, G

    2009-12-01

    The database of the German programme for quality in healthcare including data of every hospitalised patient with community-acquired pneumonia (CAP) during a 2-year period (n = 388 406 patients in 2005 and 2006) was analysed. End points of the analysis were: (1) incidence; (2) outcome; (3) performance of the CRB-65 (C, mental confusion; R, respiratory rate >or=30/min; B, systolic blood pressure or=65 years) score in predicting death; and (4) lack of ventilatory support as a possible indicator of treatment restrictions. The CRB-65 score was calculated, resulting in three risk classes (RCs). The incidence of hospitalised CAP was 2.75 and 2.96 per 1000 inhabitants/year in 2005 and 2006, respectively, higher for males (3.21 vs 2.52), and strongly age related, with an incidence of 7.65 per 1000 inhabitants/year in patients aged >or=60 years over 2 years. Mortality (13.72% and 14.44%) was higher than reported in previous studies. The CRB-65 RCs accurately predicted death in a three-class pattern (mortality 2.40% in CRB-65 RC 1, 13.43% in CRB-65 RC 2 and 34.39% in CRB-65 RC 3). The first days after admission were consistently associated with the highest risk of death throughout all risk classes. Only a minority of patients who died had received mechanical ventilation during hospitalisation (15.74%). Hospitalised CAP basically is a condition of the elderly associated with a higher mortality than previously reported. It bears a considerable risk of early mortality, even in low risk patients. CRB-65 is a simple and powerful tool for the assessment of CAP severity. Hospitalised CAP is a frequent terminal event in chronic debilitated patients, and a limitation of treatment escalation is frequently applied.

  20. Resource management plan for the Oak Ridge Reservation. Volume 30, Oak Ridge National Environmental Research Park natural areas and reference areas--Oak Ridge Reservation environmentally sensitive sites containing special plants, animals, and communities

    Energy Technology Data Exchange (ETDEWEB)

    Pounds, L.R. [Univ. of Tennessee, Knoxville, TN (US); Parr, P.D.; Ryon, M.G. [Oak Ridge National Lab., TN (United States)

    1993-08-01

    Areas on the Oak Ridge Reservation (ORR) that contain rare plant or animal species or are special habitats are protected through National Environmental Research Park Natural Area (NA) or Reference Area (RA) designations. The US Department of Energy`s Oak Ridge National Environmental Research Park program is responsible for identifying species of vascular plants that are endangered, threatened, or rare and, as much as possible, for conserving those areas in which such species grow. This report includes a listing of Research Park NAs and RAs with general habitat descriptions and a computer-generated map with the areas identified. These are the locations of rare plant or animal species or special habitats that are known at this time. As the Reservation continues to be surveyed, it is expected that additional sites will be designated as Research Park NAs or RAs. This document is a component of a larger effort to identify environmentally sensitive areas on ORR. This report identifies the currently known locations of rare plant species, rare animal species, and special biological communities. Floodplains, wetlands (except those in RAs or NAs), and cultural resources are not included in this report.

  1. Self-Selected and Maximal Walking Speeds Provide Greater Insight Into Fall Status Than Walking Speed Reserve Among Community-Dwelling Older Adults.

    Science.gov (United States)

    Middleton, Addie; Fulk, George D; Herter, Troy M; Beets, Michael W; Donley, Jonathan; Fritz, Stacy L

    2016-07-01

    To determine the degree to which self-selected walking speed (SSWS), maximal walking speed (MWS), and walking speed reserve (WSR) are associated with fall status among community-dwelling older adults. WS and 1-year falls history data were collected on 217 community-dwelling older adults (median age = 82, range 65-93 years) at a local outpatient PT clinic and local retirement communities and senior centers. WSR was calculated as a difference (WSRdiff = MWS - SSWS) and ratio (WSRratio = MWS/SSWS). SSWS (P fall status. The cutpoints identified were 0.76 m/s for SSWS (65.4% sensitivity, 70.9% specificity), 1.13 m/s for MWS (76.6% sensitivity, 60.0% specificity), and 0.24 m/s for WSRdiff (56.1% sensitivity, 70.9% specificity). SSWS and MWS better discriminated between fallers and non-fallers (SSWS: AUC = 0.69, MWS: AUC = 0.71) than WSRdiff (AUC = 0.64). SSWS and MWS seem to be equally informative measures for assessing fall status in community-dwelling older adults. Older adults with SSWSs less than 0.76 m/s and those with MWSs less than 1.13 m/s may benefit from further fall risk assessment. Combining SSWS and MWS to calculate an individual's WSR does not provide additional insight into fall status in this population. Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME CME OBJECTIVES:: Upon completion of this article, the reader should be able to: (1) Describe the different methods for calculating walking speed reserve and discuss the potential of the metric as an outcome measure; (2) Explain the degree to which self-selected walking speed, maximal walking speed, and walking speed reserve are associated with fall status among community-dwelling older adults; and (3) Discuss potential limitations to using walking speed reserve to identify fall status in populations without mobility restrictions. Advanced : The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to

  2. Reef-fish larval dispersal patterns validate no-take marine reserve network connectivity that links human communities

    Science.gov (United States)

    Abesamis, Rene A.; Saenz-Agudelo, Pablo; Berumen, Michael L.; Bode, Michael; Jadloc, Claro Renato L.; Solera, Leilani A.; Villanoy, Cesar L.; Bernardo, Lawrence Patrick C.; Alcala, Angel C.; Russ, Garry R.

    2017-09-01

    Networks of no-take marine reserves (NTMRs) are a widely advocated strategy for managing coral reefs. However, uncertainty about the strength of population connectivity between individual reefs and NTMRs through larval dispersal remains a major obstacle to effective network design. In this study, larval dispersal among NTMRs and fishing grounds in the Philippines was inferred by conducting genetic parentage analysis on a coral-reef fish ( Chaetodon vagabundus). Adult and juvenile fish were sampled intensively in an area encompassing approximately 90 km of coastline. Thirty-seven true parent-offspring pairs were accepted after screening 1978 juveniles against 1387 adults. The data showed all types of dispersal connections that may occur in NTMR networks, with assignments suggesting connectivity among NTMRs and fishing grounds ( n = 35) far outnumbering those indicating self-recruitment ( n = 2). Critically, half (51%) of the inferred occurrences of larval dispersal linked reefs managed by separate, independent municipalities and constituent villages, emphasising the need for nested collaborative management arrangements across management units to sustain NTMR networks. Larval dispersal appeared to be influenced by wind-driven seasonal reversals in the direction of surface currents. The best-fit larval dispersal kernel estimated from the parentage data predicted that 50% of larvae originating from a population would attempt to settle within 33 km, and 95% within 83 km. Mean larval dispersal distance was estimated to be 36.5 km. These results suggest that creating a network of closely spaced (less than a few tens of km apart) NTMRs can enhance recruitment for protected and fished populations throughout the NTMR network. The findings underscore major challenges for regional coral-reef management initiatives that must be addressed with priority: (1) strengthening management of NTMR networks across political or customary boundaries; and (2) achieving adequate population

  3. Reef-fish larval dispersal patterns validate no-take marine reserve network connectivity that links human communities

    KAUST Repository

    Abesamis, Rene A.

    2017-03-24

    Networks of no-take marine reserves (NTMRs) are a widely advocated strategy for managing coral reefs. However, uncertainty about the strength of population connectivity between individual reefs and NTMRs through larval dispersal remains a major obstacle to effective network design. In this study, larval dispersal among NTMRs and fishing grounds in the Philippines was inferred by conducting genetic parentage analysis on a coral-reef fish (Chaetodon vagabundus). Adult and juvenile fish were sampled intensively in an area encompassing approximately 90 km of coastline. Thirty-seven true parent-offspring pairs were accepted after screening 1978 juveniles against 1387 adults. The data showed all types of dispersal connections that may occur in NTMR networks, with assignments suggesting connectivity among NTMRs and fishing grounds (n = 35) far outnumbering those indicating self-recruitment (n = 2). Critically, half (51%) of the inferred occurrences of larval dispersal linked reefs managed by separate, independent municipalities and constituent villages, emphasising the need for nested collaborative management arrangements across management units to sustain NTMR networks. Larval dispersal appeared to be influenced by wind-driven seasonal reversals in the direction of surface currents. The best-fit larval dispersal kernel estimated from the parentage data predicted that 50% of larvae originating from a population would attempt to settle within 33 km, and 95% within 83 km. Mean larval dispersal distance was estimated to be 36.5 km. These results suggest that creating a network of closely spaced (less than a few tens of km apart) NTMRs can enhance recruitment for protected and fished populations throughout the NTMR network. The findings underscore major challenges for regional coral-reef management initiatives that must be addressed with priority: (1) strengthening management of NTMR networks across political or customary boundaries; and (2) achieving adequate population

  4. Using a cultural-ecological framework to explore dietary beliefs and practices during pregnancy and lactation among women in Adivasi communities in the Nilgiris Biosphere Reserve, India.

    Science.gov (United States)

    Craig, Hope C; Jeyanthi, R; Pelto, Gretel; Willford, Andrew C; Stoltzfus, Rebecca J

    2018-01-01

    This article explores maternal dietary beliefs and practices gathered through interviews with mothers of infants and young children in Adivasi communities in the Nilgiris Biosphere Reserve, India. Guided by focused ethnographic study methods, interviews were conducted with 33 key informants. We used a cultural-ecological framework to analyze and interpret the texts that were elicited from women about dietary beliefs and eating patterns during pregnancy and lactation. We identify differences between what women were advised to eat, felt they should eat, and reported consuming. The findings offer guidance for interventions to improve maternal diets in this vulnerable population.

  5. The avian community of the Karen Mogensen Reserve, a wealth of biodiversity within the poorly investigated and threatened environments of northwestern Costa Rica

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    Matteo Dal Zotto

    2017-12-01

    Full Text Available Despite being characterized by some of the most threatened forest ecosystems of Mesoamerica, the Nicoya Peninsula is among the least known regions of neotropical Costa Rica in terms of its birdlife. Within this region, in the framework of an ongoing international cooperation program between Italy and Costa Rica, we had the opportunity to investigate the Karen Mogensen Reserve, a protected area distinguished by the presence of a variety of habitats, including tropical dry forest and moist forest. Species richness in the Reserve was relatively high compared with similar areas in northwestern Costa Rica. A series of surveys carried out over a 20-year period documented an avian community consisting of 207 species, of which 115 were breeding in the zone and another 14 were potentially breeding. We recorded five IUCN globally Vulnerable or Near-Threatened species, along with six species reported for the first time from the Nicoya Peninsula, each representing range extension of more than 100 km. Twenty-six species, mostly breeding in the area, are at their southernmost range borders, and are likely susceptible to global environmental alterations, such as the effects of climate change. Furthermore, our study revealed the presence of two species endemic to a restricted area of Central America and four subspecies endemic to Costa Rica, along with breeding populations of two species that are geographically isolated from the main ones. The present analysis led to the ecological characterization of the resident avian community, showing that 65% of the species are strictly associated with forested environments, and especially with the understory or middle tree level, hence more vulnerable to environmental change (climatic, anthropogenic, etc. and susceptible to local extinction. These results underscore the importance of the Karen Mogensen Reserve for bird conservation within a vulnerable environmental context, and warrant the continuation of periodic bird

  6. CEPF Western Ghats Special Series: Metazoan community composition in tree hole aquatic habitats of Silent Valley National Park and New Amarambalam Reserve Forest of the Western Ghats, India

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    K.A. Nishadh

    2012-11-01

    Full Text Available In a study of the metazoan community composition in tree hole aquatic habitat of a tropical rainforest, Silent Valley National Park, and the adjacent moist deciduous forest, New Amarambalam Reserve Forest, of the Western Ghats, 28 different species were recorded from 150 tree hole aquatic habitats with an average of 3-5 species per tree hole. Most of the recorded organisms (96.8% belong to Odonata (dragonflies and damselflies, Heteroptera (bugs, Diptera (flies, Coleoptera (beetles and Trichoptera (caddisflies. The study reports the first record of toe-winged beetle larvae (Ptilodactylidae in a tree hole aquatic habitat. The most significant observation is the prolific occurrence of trichopteran larvae as the second most abundant taxa in tree holes of Silent Valley National Park, and this stands as the first comprehensive record of the entire order in the habitat studied. The study upholds the importance of less explored microhabitats in the Western Ghats region in terms of sustaining unique community composition in the most delicate and extreme habitat conditions. It also puts forward important ecological research questions on biodiversity ecosystem functionality which could impart important lessons for managing and conserving the diminishing tropical evergreen forests which are significant for these unique habitats.

  7. Community Participation, Natural Resource Management and the Creation of Innovative Tourism Products: Evidence from Italian Networks of Reserves in the Alps

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    Umberto Martini

    2017-12-01

    Full Text Available The paper analyses value co-creation and social innovation focusing on a new approach to the management of Natura 2000 areas: the Networks of Reserves (NoRs. NoRs have been set up in Trentino (an Italian alpine area to create an ecological network within the territory, with a particular focus on the socio-economic dimensions of nature conservation and with a bottom-up approach. The research investigates the role of NoRs by using a quali-quantitative approach to analyse the attitudes and awareness of private stakeholders, public actors and local communities. In-depth interviews with NoRs coordinators and key players in tourism organizations were carried out. 167 online questionnaires were sent out to local stakeholders. The research investigates community participation and stakeholder engagement in NoRs’ projects and activities, whether and how socio-economic development has occurred, and whether and how innovative sustainable tourism offers have been created. It confirms the role of NoRs in relation to the conservation and valorisation of natural resources through the stimulation of activities such as environmental interpretation and education. The research demonstrates the effectiveness of bottom-up processes for the co-creation of sustainable tourism offers and the fostering of social innovation. NoRs have proved to be successful in overcoming the major impediments to the functioning of the Natura 2000 network highlighted in the literature.

  8. Binge Drinking – Nationwide Problem, Local Solutions

    Centers for Disease Control (CDC) Podcasts

    2012-01-03

    This podcast is based on the January 2012 CDC Vital Signs report. One in six adults binge drinks about four times a month. It's a problem nationwide but community-based strategies, such as reducing access to alcohol and increasing the price, can prevent binge drinking.  Created: 1/3/2012 by Centers for Disease Control and Prevention (CDC).   Date Released: 1/3/2012.

  9. How does vegetation community shape geomorphological evolution? Tradeoffs among tide, sediment fluxes and vegetation configuration in the Virginia Coast Reserve (VA).

    Science.gov (United States)

    Nardin, W.; Larsen, L.; Fagherazzi, S.; Wiberg, P.

    2016-12-01

    During recent decades coastlines have experienced unprecedented morphological modifications caused by sea level rise, subsidence, extreme events like hurricanes and a reduction of sediment supply. Most previous modeling studies on flow-vegetation-sediment interactions have focused on one specific vegetated community, but we lack a general understanding of the conditions that lead to the emergence of multiple vegetation species feedbacks. Using a modeling approach, this study generates new understanding of how sediment transport and ecogeomorphic interactions involving water flow, sediment, and vegetation influence landscape in coastal wetlands. The broad goal of this project is to distinguish between the influence of saltmarsh and seagrass experiencing different feedback and forcing on sediment deposition. We focus our study on the Virginia Coast Reserve LTER site, where we apply numerical modeling (Delft-3D) and subsequent analyses to determine the sets of environmental conditions under which eco-geomorphological feedbacks drive the wetland system to different landscape structures. Our numerical results show that salt marsh and seagrass reduce the volume of water in a shallow coastal bay up to 15% during each tidal cycle when compared to the case without vegetation. From a morphodynamic point of view, our study reveals the important role that vegetation plays in altering water residence times and increasing sedimentation in the bay. Vegetation also affects bay geomorphology by locally reducing bed shear stress and hence increasing sediment deposition. By evaluating alternative densities, heights and spatial distributions of seagrass and salt marsh, we develop different future projections that should be considered in the design of restoration strategies in shallow coastal bays such as those in the Virginia Coast Reserve.

  10. HUTAN DALAM KEHIDUPAN MASYARAKAT HATAM DI LINGKUNGAN CAGAR ALAM PEGUNUNGAN ARFAK (Forest In Hatam Community Live On Arfak Mountains Natural Reserve Environment

    Directory of Open Access Journals (Sweden)

    Susan Trida Salosa

    2015-01-01

    Full Text Available ABSTRAK Pegunungan Arfak adalah suatu wilayah dengan keunikan tersendiri di wilayah Propinsi Papua Barat. Wilayah ini didominasi oleh gunung-gunung yang tinggi dan ekosistemnya adalah ekosistem daerah pegunungan dan alpin, serta mengingat keunikan flora, fauna dan lingkungannya, maka wilayah ini ditetapkan sebagai Cagar AlamPegunungan Arfak. Wilayah Pegunungan Arfak ditempati oleh suku besar Arfak yang salah satu sub sukunya adalah sub suku Hatam. Hutan merupakan bagian dari kehidupan masyarakat Hatam. Terbentuknya kabupaten-kabupaten pemekaran secara tidak langsung akan berakibat terhadap kelestarian jenis yang ada di cagar alam. Analisis SWOT yang digunakan dalam studi ini dimaksudkan untuk merumuskan strategi-strategi yang memungkinkan untuk mengakomodasi kepentingan masyarakat dan menjaga kelestarian cagar alam. Penelitian dilaksanakan di kampung Anggra dan Apui di Distrik Minyambouw pada bulan Juni 2013. Hasil studi menunjukkan bahwa hutan sangat berperan dalam kehidupan masyarakat terutama dalam mengaplikasi nilai budaya dalam kehidupan masyarakat. Strategi yang tepat untuk menjaga kelestarian hutan dan mengakomodasi kepentingan masyarakat diharapkan agar didasarkan pada kearifan masyarakat dalam memanfaatkan hutan. ABSTRACT Arfak Mountains is a region with its own uniqueness in the Province of West Papua. This region is dominated by high mountains with particularities of flora and fauna in ecosystems of mountain and alpine. Therefore, it is designated as a Natural Reservation of Arfak Mountains. Arfak Mountains region is occupied by a large tribe of Arfak which is Hatam is one of its sub-tribe. Forests are part of Hatam people's lives. Establishment of districts expansion will indirectly result in the preservation of species in natural reservation. SWOT analysis used in this study is intended to look at the potential strategies in accomodating people interest and preserving the natural reservation. The study was conducted in villages of

  11. School Shootings Stun Reservation

    Science.gov (United States)

    Borja, Rhea R.; Cavanagh, Sean

    2005-01-01

    This article deals with the impact brought by the school shootings at Red Lake Indian Reservation in Minnesota to the school community. A deeply troubled 16-year-old student shot and killed seven other people and himself at a high school. The nation's deadliest school attack since the 1999 slayings at Colorado's suburban Columbine High School took…

  12. Nationwide Prevalence of Self-Reported Serious Sensory Impairments and Their Associations with Self-Reported Cognitive and Functional Difficulties.

    Science.gov (United States)

    Fuller, Spencer D; Mudie, Lucy I; Siordia, Carlos; Swenor, Bonnielin K; Friedman, David S

    2018-04-01

    To estimate the nationwide prevalence of self-reported serious vision impairment (SVI), serious hearing impairment (SHI), and serious dual sensory impairment (DSI; i.e., concomitant SVI and SHI) and to characterize their associations with self-reported cognitive, independent living, self-care, and ambulatory difficulties. The American Community Survey (ACS) is a nationwide cross-sectional survey administered by the United States Census Bureau. The 2011-2015 ACS sample contains data on 7 210 535 individuals 45 years of age or older. Descriptive statistics for each of the 4 mutually exclusive sensory impairment categories no sensory impairment (NSI), SVI, SHI, and serious DSI were calculated using the weighted sample. Adjusted odds ratios using several logistic regressions were calculated using the unweighted sample to measure the magnitude of associations between sensory impairment status and the outcome difficulties. Self-reported cognitive, independent living, self-care, and ambulatory difficulty. Among individuals 45 years of age or older, the estimated nationwide prevalence of self-reported SVI alone is 2.8%, that of SHI alone is 6.0%, and that of serious DSI is 1.6%. The prevalence of each sensory impairment increases with age. A greater proportion of American Indians or Alaskan Natives experience SVI (4.8%), SHI (8.5%), and serious DSI (3.7%) than any other race or ethnic group (P self-reported serious sensory impairment increases with age and is distributed unequally among different racial and ethnic groups. Any sensory impairment is associated with greater cognitive and functional difficulties than NSI. Additionally, serious DSI is associated with greater difficulties than SVI or SHI alone, and SVI alone is more serious than SHI alone in each of the 4 cognitive and functional difficulties. Copyright © 2018 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

  13. Developing a wintering waterfowl community baseline for environmental monitoring of Narragansett Bay, Rhode Island [version 3; referees: 1 approved, 2 approved with reservations

    Directory of Open Access Journals (Sweden)

    Betty J. Kreakie

    2015-12-01

    Full Text Available In 2004, the Atlantic Ecology Division of the US Environmental Protection Agency’s Office of Research and Development began an annual winter waterfowl survey of Rhode Island’s Narragansett Bay. Herein, we explore the survey data gathered from 2004 to 2011 in order to establish a benchmark understanding of our waterfowl communities and to establish a statistical framework for future environmental monitoring. The abundance and diversity of wintering waterfowl were relatively stable during the initial years of this survey, except in 2010 when there was a large spike in abundance and a reciprocal fall in diversity. There was no significant change in ranked abundance of most waterfowl species, with only Bufflehead (Bucephala albeola and Hooded Merganser (Lophodytes cucllatus showing a slight yet significant upward trend during the course of our survey period. Nonmetric multidimensional scaling (NMDS was used to examine the community structure of wintering waterfowl. The results of the NMDS indicate that there is a spatial structure to the waterfowl communities of Narragansett Bay and this structure has remained relatively stable since the survey began. Our NMDS analysis helps to solidify what is known anecdotally about the bay’s waterfowl ecology, and provides a formalized benchmark for long-term monitoring of Narragansett Bay’s waterfowl communities. Birds, including waterfowl, are preferred bioindicators and we propose using our multivariate approach to monitor the future health of the bay. While this research focuses on a specific area of New England, these methods can be easily applied to novel areas of concern and provide a straightforward nonparametric approach to community-level monitoring. The methods provide a statistic test to examine potential drivers of community turnover and well-suited visualization tools.

  14. Nationwide rural well water survey

    International Nuclear Information System (INIS)

    Korkka-Niemi, K.; Sipilae, A.; Hatva, T.; Hiisvirta, L.; Lahti, K.; Alfthan, G.

    1993-01-01

    The quality of water in 1 421 drinking-water wells was monitored in a nationwide well water study. Samples were taken once from all wells, and during three seasons from 421 wells. The wells were selected in such a way that me sample would be as representative as possible of the quality of the drinking-water in households' own wells in rural areas. The study comprised general water quality parameters, influence of sampling season, and factors related to the type, the condition and the pollution of the wells. In part of the well waters selenium, radioactivity and pesticides were determined. The effect of plumbing materials on the quality of water was also examined. (33 refs., 148 figs., 71 tabs.)

  15. A nationwide medication incidents reporting system in The Netherlands.

    Science.gov (United States)

    Cheung, Ka-Chun; van den Bemt, Patricia M L A; Bouvy, Marcel L; Wensing, Michel; De Smet, Peter A G M

    2011-01-01

    Many Dutch hospitals have established internal systems for reporting incidents. However, such internal systems do not allow learning from incidents that occur in other hospitals. Therefore a multicenter, information technology (IT) supported reporting system named central medication incidents registration (CMR) was developed. This article describes the architecture, implementation and current status of the CMR in The Netherlands and compare it with similar systems in other countries. Adequate IT is required to sufficiently support a multicenter reporting system. The CMR system consists of a website, a database, a web-based reporting form, an application to import reports generated in other reporting systems, an application to generate an overview of reported medication incidents, and a national warning system for healthcare providers. From the start of CMR 90 of all 93 (96.8%) hospitals and 872 of 1948 (44.8%) community pharmacies participated. Between March 2006 and March 2010 the CMR comprised 15,694 reports of incidents. In the period from March 2010 to March 2011, 1642 reports were submitted by community pharmacies in CMR and the hospitals submitted 2517 reports. CMR is similar to various systems in other countries, but it seems to use more IT applications. The CMR is developing into a nationwide reporting system of medication incidents in The Netherlands, in which hospitals, community pharmacies, mental healthcare organizations and general practitioners participate. The architecture of the system met the requirements of a nationwide reporting system across different healthcare providers.

  16. Response of the soil microbial community and soil nutrient bioavailability to biomass harvesting and reserve tree retention in northern Minnesota aspen-dominated forests

    Science.gov (United States)

    Tera E. Lewandowski; Jodi A. Forrester; David J. Mladenoff; Anthony W. D' Amato; Brian J. Palik

    2016-01-01

    Intensive forest biomass harvesting, or the removal of harvesting slash (woody debris from tree branches and tops) for use as biofuel, has the potential to negatively affect the soil microbial community (SMC) due to loss of carbon and nutrient inputs from the slash, alteration of the soil microclimate, and increased nutrient leaching. These effects could result in...

  17. Community.

    Science.gov (United States)

    Grauer, Kit, Ed.

    1995-01-01

    Art in context of community is the theme of this newsletter. The theme is introduced in an editorial "Community-Enlarging the Definition" (Kit Grauer). Related articles include: (1) "The Children's Bridge is not Destroyed: Heart in the Middle of the World" (Emil Robert Tanay); (2) "Making Bridges: The Sock Doll…

  18. 2008 TIGER/Line Nationwide Dataset

    Data.gov (United States)

    California Department of Resources — This dataset contains a nationwide build of the 2008 TIGER/Line datasets from the US Census Bureau downloaded in April 2009. The TIGER/Line Shapefiles are an extract...

  19. An Investigation of How Culture Shapes Curriculum in Early Care and Education Programs on a Native American Indian Reservation: "The Drum Is Considered the Heartbeat of the Community"

    Science.gov (United States)

    Gilliard, Jennifer L.; Moore, Rita A.

    2007-01-01

    This article investigates how culture shapes instruction in three early care and education programs on the Flathead Indian Reservation. Interviews with eight early childhood teachers as well as classroom observations were conducted. The investigation is framed by the following research question: How does the culture of the family and community…

  20. Price promotions for food and beverage products in a nationwide sample of food stores.

    Science.gov (United States)

    Powell, Lisa M; Kumanyika, Shiriki K; Isgor, Zeynep; Rimkus, Leah; Zenk, Shannon N; Chaloupka, Frank J

    2016-05-01

    Food and beverage price promotions may be potential targets for public health initiatives but have not been well documented. We assessed prevalence and patterns of price promotions for food and beverage products in a nationwide sample of food stores by store type, product package size, and product healthfulness. We also assessed associations of price promotions with community characteristics and product prices. In-store data collected in 2010-2012 from 8959 food stores in 468 communities spanning 46 U.S. states were used. Differences in the prevalence of price promotions were tested across stores types, product varieties, and product package sizes. Multivariable regression analyses examined associations of presence of price promotions with community racial/ethnic and socioeconomic characteristics and with product prices. The prevalence of price promotions across all 44 products sampled was, on average, 13.4% in supermarkets (ranging from 9.1% for fresh fruits and vegetables to 18.2% for sugar-sweetened beverages), 4.5% in grocery stores (ranging from 2.5% for milk to 6.6% for breads and cereals), and 2.6% in limited service stores (ranging from 1.2% for fresh fruits and vegetables to 4.1% for breads and cereals). No differences were observed by community characteristics. Less-healthy versus more-healthy product varieties and larger versus smaller product package sizes generally had a higher prevalence of price promotion, particularly in supermarkets. On average, in supermarkets, price promotions were associated with 15.2% lower prices. The observed patterns of price promotions warrant more attention in public health food environment research and intervention. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. Disaster Vulnerability of Hospitals: A Nationwide Surveillance in Japan.

    Science.gov (United States)

    Ochi, Sae; Kato, Shigeaki; Kobayashi, Kenichi; Kanatani, Yasuhiro

    2015-12-01

    Hospital preparedness against disasters is key to achieving disaster mitigation for health. To gain a holistic view of hospitals in Japan, one of the most disaster-prone countries, a nationwide surveillance of hospital preparedness was conducted. A cross-sectional, paper-based interview was conducted that targeted all of the 8701 registered hospitals in Japan. Preparedness was assessed with regard to local hazards, compliance to building code, and preparation of resources such as electricity, water, communication tools, and transportation tools. Answers were obtained from 6122 hospitals (response rate: 70.3%), among which 20.5% were public (national or city-run) hospitals and others were private. Eight percent were the hospitals assigned as disaster-base hospitals and the others were non-disaster-base hospitals. Overall compliance to building code, power generators, water tanks, emergency communication tools, and helicopter platforms was 90%, 84%, 95%, 43%, and 22%, respectively. Major vulnerabilities in logistics in mega-cities and stockpiles required for chronic care emerged from the results of this nationwide surveillance of hospitals in Japan. To conduct further intensive surveillance to meet community health needs, appropriate sampling methods should be established on the basis of this preliminary study. Holistic vulnerability analysis of community hospitals will lead to more robust disaster mitigation at the local level.

  2. Thermophilous fringe communities as an indicator of vegetation changes: a case study of the “Murawy Dobromierskie” steppe reserve (Poland

    Directory of Open Access Journals (Sweden)

    Szygendowski Tomasz

    2015-12-01

    Full Text Available In this paper, changes of the non-forest xerothermic vegetation of the “Murawy Dobromierskie” steppe reserve which occurred in the period 1993-2012 are examined. The material comprises 50 relevés, of which 43 date from 2012 and the other 7 - from 1993. Reléves were arranged in 5 analytic tables. A synoptic table was also compiled, and for each syntaxonomical species group distinguished, values of the cover coefficient (C, the collective group share index (G, and the systematic group value (D were estimated and compared. On the basis of the obtained results, a significant decline in abundancy and/or constancy was observed within the following groups: Ch. Artemisietea vulgaris, Ch. Cirsio-Brachypodion pinnati, Ch. Festuco-Brometea, Ch. Geranion sanguinei, Ch. Koelerio-Corynephoretea, and Ch. Origanetalia and Trifolio-Geranietea sanguinei, whereas for the taxa of the Rhamno-Prunetea, a notable increase in the share of the reserve vegetation was recorded. A sizeable expansion of the moss layer was also observed in this period. The results are discussed with special regard to differences in the methodical background of both field studies.

  3. Comunidade de aves da Reserva Estadual de Gurjaú, Pernambuco, Brasil Bird communities of the Gurjaú Reserve, Pernambuco State, Brazil

    Directory of Open Access Journals (Sweden)

    Rachel Maria de Lyra-Neves

    2004-09-01

    Full Text Available Estudos quali-quantitativos foram realizados em um fragmento florestal da Reserva Estadual de Gurjaú, Cabo de Santo Agostinho, Pernambuco, Brasil. Foram registradas 220 espécies de aves no levantamento qualitativo. Através da contagem por pontos, foram identificadas 175 espécies em 6.470 contatos (270 amostras. A freqüência de ocorrência de 75% foi registrada para 43 espécies (19,6%; para a maioria das espécies a freqüência de ocorrência esteve abaixo de 25%.A qualitative and quantitative bird surveys were carried out in a forest fragment in Gurjau Reserve, Santo Agostinho Cape, Pernambuco State, Brazil. By qualitative census were registered 220 different bird species. Concerning the point counts, were identified 175 different species in 6.470 contacts (270 samples. A frequency of occurrence of 75% was registered for 43 species (19,6%; the most part of species had a frequency of occurrence below 25%.

  4. Domestic carnivore interactions with wildlife in the Cape Horn Biosphere Reserve, Chile: husbandry and perceptions of impact from a community perspective.

    Science.gov (United States)

    Schüttler, Elke; Saavedra-Aracena, Lorena; Jiménez, Jaime E

    2018-01-01

    Hundreds of millions of domestic carnivores worldwide have diverse positive affiliations with humans, but can provoke serious socio-ecological impacts when free-roaming. Unconfined dogs ( Canis familiaris ) and cats ( Felis catus ) interact with wildlife as predators, competitors, and disease-transmitters; their access to wildlife depends on husbandry, perceptions, attitudes, and behaviors of pet owners and non-owners. To better understand husbandry and perceptions of impacts by unconfined, domestic carnivores, we administered questionnaires ( n  = 244) to pet owners and non-owners living in one of the last wilderness areas of the world, the Cape Horn Biosphere Reserve, located in southern Chile. We used descriptive statistics to provide demographic pet and husbandry information, quantify free-roaming dogs and cats, map their sightings in nature, and report experiences and perceptions of the impact of free-roaming dogs and cats on wildlife. We corroborated our results with an analysis of prey remains in dog feces ( n  = 53). With generalized linear models, we examined which factors (i.e., food provisioning, reproductive state, rural/village households, sex, and size) predicted that owned dogs and cats bring wildlife prey home. Thirty-one percent of village dogs ( n  = 121) and 60% of dogs in rural areas ( n  = 47) roamed freely day and/or night. Free-roaming dog packs were frequently observed (64% of participants) in the wild, including a feral dog population on Navarino Island. Dogs (31 of 168) brought home invasive muskrats ( Ondatra zibethicus ) and avian prey, and over half of all cats (27 of 51) brought home mainly avian prey. Birds were also the most harassed wildlife category, affected by one third of all dogs and cats. Nevertheless, dog-wildlife conflicts were hardly recognized (<9% of observed conflicts and suspected problems), and only 34% of the participants thought that cats might impact birds. Diet analysis revealed that dogs consumed livestock

  5. Domestic carnivore interactions with wildlife in the Cape Horn Biosphere Reserve, Chile: husbandry and perceptions of impact from a community perspective

    Science.gov (United States)

    Saavedra-Aracena, Lorena; Jiménez, Jaime E.

    2018-01-01

    Background Hundreds of millions of domestic carnivores worldwide have diverse positive affiliations with humans, but can provoke serious socio-ecological impacts when free-roaming. Unconfined dogs (Canis familiaris) and cats (Felis catus) interact with wildlife as predators, competitors, and disease-transmitters; their access to wildlife depends on husbandry, perceptions, attitudes, and behaviors of pet owners and non-owners. Methods To better understand husbandry and perceptions of impacts by unconfined, domestic carnivores, we administered questionnaires (n = 244) to pet owners and non-owners living in one of the last wilderness areas of the world, the Cape Horn Biosphere Reserve, located in southern Chile. We used descriptive statistics to provide demographic pet and husbandry information, quantify free-roaming dogs and cats, map their sightings in nature, and report experiences and perceptions of the impact of free-roaming dogs and cats on wildlife. We corroborated our results with an analysis of prey remains in dog feces (n = 53). With generalized linear models, we examined which factors (i.e., food provisioning, reproductive state, rural/village households, sex, and size) predicted that owned dogs and cats bring wildlife prey home. Results Thirty-one percent of village dogs (n = 121) and 60% of dogs in rural areas (n = 47) roamed freely day and/or night. Free-roaming dog packs were frequently observed (64% of participants) in the wild, including a feral dog population on Navarino Island. Dogs (31 of 168) brought home invasive muskrats (Ondatra zibethicus) and avian prey, and over half of all cats (27 of 51) brought home mainly avian prey. Birds were also the most harassed wildlife category, affected by one third of all dogs and cats. Nevertheless, dog-wildlife conflicts were hardly recognized (cats might impact birds. Diet analysis revealed that dogs consumed livestock (64% of 59 prey occurrences), beavers (Castor canadensis, 14%), and birds (10

  6. Domestic carnivore interactions with wildlife in the Cape Horn Biosphere Reserve, Chile: husbandry and perceptions of impact from a community perspective

    Directory of Open Access Journals (Sweden)

    Elke Schüttler

    2018-01-01

    Full Text Available Background Hundreds of millions of domestic carnivores worldwide have diverse positive affiliations with humans, but can provoke serious socio-ecological impacts when free-roaming. Unconfined dogs (Canis familiaris and cats (Felis catus interact with wildlife as predators, competitors, and disease-transmitters; their access to wildlife depends on husbandry, perceptions, attitudes, and behaviors of pet owners and non-owners. Methods To better understand husbandry and perceptions of impacts by unconfined, domestic carnivores, we administered questionnaires (n = 244 to pet owners and non-owners living in one of the last wilderness areas of the world, the Cape Horn Biosphere Reserve, located in southern Chile. We used descriptive statistics to provide demographic pet and husbandry information, quantify free-roaming dogs and cats, map their sightings in nature, and report experiences and perceptions of the impact of free-roaming dogs and cats on wildlife. We corroborated our results with an analysis of prey remains in dog feces (n = 53. With generalized linear models, we examined which factors (i.e., food provisioning, reproductive state, rural/village households, sex, and size predicted that owned dogs and cats bring wildlife prey home. Results Thirty-one percent of village dogs (n = 121 and 60% of dogs in rural areas (n = 47 roamed freely day and/or night. Free-roaming dog packs were frequently observed (64% of participants in the wild, including a feral dog population on Navarino Island. Dogs (31 of 168 brought home invasive muskrats (Ondatra zibethicus and avian prey, and over half of all cats (27 of 51 brought home mainly avian prey. Birds were also the most harassed wildlife category, affected by one third of all dogs and cats. Nevertheless, dog-wildlife conflicts were hardly recognized (<9% of observed conflicts and suspected problems, and only 34% of the participants thought that cats might impact birds. Diet analysis revealed that

  7. 77 FR 16021 - Reissuance of Nationwide Permits

    Science.gov (United States)

    2012-03-19

    .... David Olson at 202-761-4922 or by email at david.b[email protected] or access the U.S. Army Corps of... Department of the Army, Corps of Engineers RIN 0710-AA71 Reissuance of Nationwide Permits AGENCY: Army Corps of Engineers, DoD. ACTION: Final notice; correction. SUMMARY: The U.S. Army Corps of Engineers...

  8. Electric power and traditional communities in the state of Amazonas: learning from the experience of the Roque Community in the Middle Jurua extractive reserve; Energia eletrica e as populacoes tradicionais do Estado do Amazonas: aprendizados a partir da experiencia na Comunidade do Roque na Reserva Extrativista do Medio Jurua

    Energy Technology Data Exchange (ETDEWEB)

    Andrade, Celia Salama

    2010-09-15

    This work aims to bring new ideas for expanding access to electricity services to traditional communities in the state of Amazonas including strategies for income generation and improvement of local living conditions. To this end, the main achievements in the community of Roque in the implementation of the project Vegetable Oil for Electricity Generation and Valuation of Biodiversity in Isolated Communities of Extractive Reserve in the Middle Jurua, Carauari, Amazon state were identified and evaluated. Based on the results, a proposal for planning electrification works is formulated that takes into account local knowledge on socioeconomic and environmental conditions. In order to be implemented, such a proposal will require an improvement of the existing regulatory system and the establishment of partnerships or institutional articulation with broad stake holder involvement, including representatives of communities and local power utilities. (author)

  9. Performance of clinical mammography: a nationwide study from Denmark

    DEFF Research Database (Denmark)

    Jensen, Allan; Vejborg, Ilse; Severinsen, Niels

    2006-01-01

    in Denmark in the year 2000 were collected and linked to cancer outcome. Use of the National Institute of Radiation Hygiene register for identification of radiology clinics ensured comprehensive nationwide registration. We used the final mammographic assessment at the end of the imaging work-up to determine...... sensitivity, specificity and accuracy, the latter using a receiver-operating characteristics (ROC) analysis. In 96,534 clinical mammography examinations, sensitivity was 75% and specificity 99%. The presence of at least one high volume-reading radiologist in the clinic increased accuracy (AUC = 0.91 for ... that clinical mammography worked best in patient populations of purely symptomatic women. Our data indicate that to increase the accuracy of clinical mammography at the community level, the presence of an experienced radiologist should be prioritized ahead of raising the clinic size....

  10. Binge Drinking – Nationwide Problem, Local Solutions PSA (:60)

    Centers for Disease Control (CDC) Podcasts

    2012-01-03

    This 60 second PSA is based on the January 2012 CDC Vital Signs report. One in six adults binge drinks about four times a month. It's a problem nationwide but community-based strategies, such as reducing access to alcohol and increasing the price, can prevent binge drinking.  Created: 1/3/2012 by Centers for Disease Control and Prevention (CDC).   Date Released: 1/3/2012.

  11. Infections as risk factor for autoimmune diseases - A nationwide study.

    Science.gov (United States)

    Nielsen, Philip Rising; Kragstrup, Tue Wenzel; Deleuran, Bent Winding; Benros, Michael Eriksen

    2016-11-01

    Viruses, bacteria and other infectious pathogens are the major postulated environmental triggers of autoimmunity. In the present nation-wide study we describe the association between infections and 29 autoimmune diseases. We used the Danish Civil Registration System to identify 4.5 million persons born between 1945 and 2000. Information on infections and autoimmune diseases was obtained from the Danish Hospital Register. The cohort was followed from 1977 to 2012. Incidence rate ratios for developing an autoimmune disease were estimated using poisson regression. We found an association between hospital admission for an infection and 29 autoimmune diseases. This study shows that infections are risk factors for a broad spectrum of autoimmune diseases in a dose-response and temporal manner, in agreement with the hypothesis that infections are an environmental risk factor contributing to the etiology of autoimmune diseases together with genetic factors. Copyright © 2016 Elsevier Ltd. All rights reserved.

  12. Nationwide patient registry for GNE myopathy in Japan.

    Science.gov (United States)

    Mori-Yoshimura, Madoka; Hayashi, Yukiko K; Yonemoto, Naohiro; Nakamura, Harumasa; Murata, Miho; Takeda, Shin'ichi; Nishino, Ichizo; Kimura, En

    2014-10-11

    GNE myopathy is a slowly progressive autosomal recessive myopathy caused by mutations in the GNE (glucosamine (UDP-N-acetyl)-2-epimerase/N-acetylmannosamine kinase) gene. This study aimed to (1) develop a nationwide patient registry for GNE myopathy in order to facilitate the planning of clinical trials and recruitment of candidates, and (2) gain further insight into the disease for the purpose of improving therapy and care. Medical records of genetically-confirmed patients with GNE myopathy at the National Center Hospital of the National Center of Neurology and Psychiatry (NCNP) were retrospectively reviewed in order to obtain data reflecting the severity and progression of the disease. We also referred to items in the datasheet of the nationwide registry of dystrophinopathy patients in the Registry of Muscular Dystrophies (Remudy). Items selected for the registration sheet included age, sex, age at onset, past history and complications, family history, body weight and height, pathological findings of muscle biopsy, grip power, walking ability, respiratory function, cardiac function, willingness to join upcoming clinical trials, and participation in patient associations. A copy of the original genetic analysis report was required of each patient. We successfully established the Remudy-GNE myopathy. Currently, 121 patients are registered nationwide, and 93 physicians from 73 hospitals collaborated to establish the registry. The mean age at onset was 27.7 ± 9.6 years, and 19.8% (24/121) of patients could walk without assistance. Mean presumed durations from onset to use of assistive devices (cane and/or braces) and a wheelchair, and loss of ambulation were 12.4, 15.2, and 21.1 years, respectively. Three patients had a past history and/or complication of idiopathic thrombocytopenia. To share the progress of this study with the community, newsletters were published on a regular basis, and included information regarding new phase I clinical trials for GNE

  13. Bioinformatics in the Netherlands : The value of a nationwide community

    NARCIS (Netherlands)

    van Gelder, Celia W.G.; Hooft, Rob; van Rijswijk, Merlijn; van den Berg, Linda; Kok, Ruben; Reinders, M.J.T.; Mons, Barend; Heringa, Jaap

    2017-01-01

    This review provides a historical overview of the inception and development of bioinformatics research in the Netherlands. Rooted in theoretical biology by foundational figures such as Paulien Hogeweg (at Utrecht University since the 1970s), the developments leading to organizational structures

  14. 47 CFR 36.602 - Calculation of non-rural carrier portion of nationwide loop cost expense adjustment.

    Science.gov (United States)

    2010-10-01

    ... 47 Telecommunication 2 2010-10-01 2010-10-01 false Calculation of non-rural carrier portion of... SEPARATING TELECOMMUNICATIONS PROPERTY COSTS, REVENUES, EXPENSES, TAXES AND RESERVES FOR TELECOMMUNICATIONS COMPANIES 1 Universal Service Fund General § 36.602 Calculation of non-rural carrier portion of nationwide...

  15. Indian Reserves: Canada's Developing Nations

    OpenAIRE

    Musto, Richard J.

    1990-01-01

    Indian reserves are the most visible reminder of the separation of aboriginal people from the rest of Canada and other Canadians. Illness patterns and social conditions in Native communities closely parallel those in developing nations. While they continue to have a large burden of infectious diseases, these groups also have an increased incidence of chronic and lifestyle diseases as well as environment-related conditions. Similarities can be seen in urban areas between immigrants from abroad...

  16. Natural radon reduction rate of the community groundwater system in South Korea.

    Science.gov (United States)

    Yun, Uk; Seong Kim, Tae; Kim, Hyun Koo; Kim, Moon Su; Cho, Soo Young; Choo, Chang Oh; Cho, Byong Wook

    2017-08-01

    Tank waters from 13 Community Groundwater Systems (CGS) showed average radon reduction rate of 26.5% (varying from -17.9% to 63.3%). When applying the reduction rate of 26.5% to the nationwide CGS, the percentage of CGS having radon level above 100Bq/L decreases from 28.8% to 22.0%. The natural radon reduction method would be applied to the CGS having radon level slightly exceeding guideline of WHO, as an alternative for aeration or GAC. Copyright © 2017 Elsevier Ltd. All rights reserved.

  17. Maternal versus adolescent reports of suicidal behaviors: a nationwide survey in Israel.

    Science.gov (United States)

    Zalsman, Gil; Shoval, Gal; Mansbach-Kleinfeld, Ivonne; Farbstein, Ilana; Kanaaneh, Rasim; Lubin, Gad; Apter, Alan

    2016-12-01

    Community and nationwide surveys on adolescent suicidal behaviors using clinical interviews are not abundant. Rates of self-reported suicide attempts in community samples vary greatly between 1 and 20 %. In general, adolescent and parental agreement in child psychiatry practice is low, and their agreement with regard to suicidal behavior is unknown. The current study assesses the rates of suicidal ideation and behaviors as well as the rate of agreement between adolescents and their mothers in a representative nationwide sample. The survey included a representative and randomized community sample of 14- to 17-year-old adolescents (n = 957), and their mothers who were interviewed using the Development and Well-Being Assessment Inventory (DAWBA). The prevalence of suicidal ideation and self-initiated behaviors was 4.9 and 1.9 %, respectively. The concordance between mothers' and adolescents' reporting on ideation was low (7.3 %). There was no concordance between mothers' and adolescents' reports of suicidal acts. Adolescents reported self-initiated behaviors nearly three times more frequently than their mothers. Paternal unemployment, care by welfare agencies and having a psychiatric disorder, specifically depression or post-traumatic stress disorder, was associated with a higher risk for both suicidal ideation and attempts. In this nationwide community study, by evaluating information gathered by clinical interviews, it was found that the lifetime rates of suicidal ideation were moderate. The rates of suicide attempts were lower than have been previously reported. The concordance between the reports of adolescents and their mothers was low for ideation and nonexistent for attempts. Thus, clinicians should interview adolescents separately from their mothers regarding their suicidality.

  18. Comment on the article titled "Increased Incidence of Amyotrophic Lateral Sclerosis in Polymyositis: A Nationwide Cohort Study".

    Science.gov (United States)

    Parperis, Konstantinos

    2017-10-03

    With interest, I read the recent article in Arthritis Care and Research titled "Increased Incidence of Amyotrophic Lateral Sclerosis in Polymyositis: A Nationwide Cohort Study" (1). Tseng at al (1) conducted a retrospective cohort study in Taiwan, exploring a link between amyotrophic lateral sclerosis (ALS) and polymyositis (PM). This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  19. Cognitive reserve in aging.

    Science.gov (United States)

    Tucker, A M; Stern, Y

    2011-06-01

    Cognitive reserve explains why those with higher IQ, education, occupational attainment, or participation in leisure activities evidence less severe clinical or cognitive changes in the presence of age-related or Alzheimer's disease pathology. Specifically, the cognitive reserve hypothesis is that individual differences in how tasks are processed provide reserve against brain pathology. Cognitive reserve may allow for more flexible strategy usage, an ability thought to be captured by executive functions tasks. Additionally, cognitive reserve allows individuals greater neural efficiency, greater neural capacity, and the ability for compensation via the recruitment of additional brain regions. Taking cognitive reserve into account may allow for earlier detection and better characterization of age-related cognitive changes and Alzheimer's disease. Importantly, cognitive reserve is not fixed but continues to evolve across the lifespan. Thus, even late-stage interventions hold promise to boost cognitive reserve and thus reduce the prevalence of Alzheimer's disease and other age-related problems.

  20. Study on Online Hotel Reservation Systems

    OpenAIRE

    Alleweldt, Frank; Tonner, Klaus; McDonald, Marc

    2009-01-01

    This study, conducted by Civic Consulting, looks at both pre-contractual and contractual matters concerning online hotel reservation systems, examines relevant Community rules, identifies gaps and, where needed, discusses possible policy options. Key conclusions The study shows that the impact of Community law on online hotel

  1. 7 CFR 1709.2 Policy. - [Reserved

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 11 2010-01-01 2010-01-01 false [Reserved] 1709.2 Policy. Section 1709.2 Policy. Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE ASSISTANCE TO HIGH ENERGY COST COMMUNITIES General Requirements § 1709.2 Policy. [Reserved] ...

  2. 7 CFR 1709.202 Policy. - [Reserved

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 11 2010-01-01 2010-01-01 false [Reserved] 1709.202 Policy. Section 1709.202 Policy... AGRICULTURE ASSISTANCE TO HIGH ENERGY COST COMMUNITIES Bulk Fuel Revolving Fund Grant Program § 1709.202 Policy. [Reserved] ...

  3. COGNITIVE RESERVE IN AGING

    Science.gov (United States)

    Tucker, Adrienne M.; Stern, Yaakov

    2011-01-01

    Cognitive reserve explains why those with higher IQ, education, occupational attainment, or participation in leisure activities evidence less severe clinical or cognitive changes in the presence of age-related or Alzheimer’s disease pathology. Specifically, the cognitive reserve hypothesis is that individual differences in how tasks are processed provide reserve against brain pathology. Cognitive reserve may allow for more flexible strategy usage, an ability thought to be captured by executive functions tasks. Additionally, cognitive reserve allows individuals greater neural efficiency, greater neural capacity, and the ability for compensation via the recruitment of additional brain regions. Taking cognitive reserve into account may allow for earlier detection and better characterization of age-related cognitive changes and Alzheimer’s disease. Importantly, cognitive reserve is not fixed but continues to evolve across the lifespan. Thus, even late-stage interventions hold promise to boost cognitive reserve and thus reduce the prevalence of Alzheimer’s disease and other age-related problems. PMID:21222591

  4. HYDROCARBONS RESERVES IN VENEZUELA

    Energy Technology Data Exchange (ETDEWEB)

    Gonzalez Cruz, D.J.

    2007-07-01

    Venezuela is an important player in the energy world, because of its hydrocarbons reserves. The process for calculating oil and associated gas reserves is described bearing in mind that 90% of the gas reserves of Venezuela are associated to oil. Likewise, an analysis is made of the oil reserves figures from 1975 to 2003. Reference is also made to inconsistencies found by international experts and the explanations offered in this respect by the Ministry of Energy and Petroleum (MENPET) and Petroleos de Venezuela (PDVSA) regarding the changes that took place in the 1980s. In turn, Hubbert's Law is explained to determine peak production of conventional oil that a reservoir or field will reach, as well as its relationship with remaining reserves. Emphasis is placed on the interest of the United Nations on this topic. The reserves of associated gas are presented along with their relationship with the different crude oils that are produced and with injected gas, as well as with respect to the possible changes that would take place in the latter if oil reserves are revised. Some recommendations are submitted so that the MENPET starts preparing the pertinent policies ruling reserves. (auth)

  5. Ovarian reserve parameters

    DEFF Research Database (Denmark)

    Bentzen, J G; Forman, Julie Lyng; Pinborg, Anja

    2012-01-01

    2-5 of the menstrual cycle or during withdrawal bleeding, blood sampling and transvaginal sonography was performed. After adjusting for age, ovarian reserve parameters were lower among users than among non-users of hormonal contraception: serum AMH concentration by 29.8% (95% CI 19.9 to 38...... was observed between duration of hormonal-contraception use and ovarian reserve parameters. No dose-response relation was found between the dose of ethinyloestradiol and AMH or AFC. This study indicates that ovarian reserve markers are lower in women using sex steroids for contraception. Thus, AMH...... concentration and AFC may not retain their accuracy as predictors of ovarian reserve in women using hormonal contraception. Serum anti-Müllerian hormone (AMH) concentration is an indirect marker of the number of small follicles in the ovary and thereby the ovarian reserve. The AMH concentration is now widely...

  6. Incident asthma and Mycoplasma pneumoniae: A nationwide cohort study.

    Science.gov (United States)

    Yeh, Jun-Jun; Wang, Yu-Chiao; Hsu, Wu-Huei; Kao, Chia-Hung

    2016-04-01

    Previous studies investigating the relationship between Mycoplasma pneumoniae and incident asthma in the general population have been inconclusive. We conducted a nationwide cohort study to clarify this relationship. Using the National Health Insurance Research Database of Taiwan, we identified 1591 patients with M pneumoniae infection (International Classification of Diseases, Ninth Revision, Clinical Modification code 4830) given diagnoses between 2000 and 2008. We then frequency matched 6364 patients without M pneumoniae infection from the general population according to age, sex, and index year. Cox proportional hazards regression analysis was performed to determine the adjusted hazard ratio (aHR) of the occurrence of asthma in the M pneumoniae cohort compared with that in the non-M pneumoniae cohort. Regardless of comorbidities and the use of antibiotic or steroid therapies, patients with M pneumonia infection had a higher risk of incident asthma than those without it. The aHR of asthma was 3.35 (95% CI, 2.71-4.15) for the M pneumoniae cohort, with a significantly higher risk when patients were stratified by age, sex, follow-up time, and comorbidities, including allergic rhinitis, atopic dermatitis, or allergic conjunctivitis. Patients with M pneumoniae infection had a higher risk of having early-onset (age, incident cases of early-onset and late-onset asthma are closely related to M pneumoniae infection, even in nonatopic patients. Copyright © 2015 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  7. Decentralizing Education in Guatemala : School Management by Local Communities

    OpenAIRE

    Carlos Rojas; Alexandria Valerio; Angela Demas

    2005-01-01

    Guatemala set out in 1992 to increase access to education in remote areas. Its National Community-managed Program for Educational Development (PRONADE) has evolved from a small, innovative pilot program in 19 rural communities, to a nationwide program reaching over 4,100 communities and 445,000 children. PRONADE is one of the most proactive managerial, administrative, and financial decentr...

  8. Nationwide Twin Birth Weight Percentiles by Gestational Age in Taiwan

    Directory of Open Access Journals (Sweden)

    I-Jan Hu

    2015-10-01

    Conclusion: This is the first nationwide birth weight norm for twins in Taiwan, which is particularly useful for investigation into the predictors and outcomes of altered fetal growth through twin studies in the Taiwanese population.

  9. Healthcare Cost and Utilization Project Nationwide Readmissions Database (NRD)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Nationwide Readmissions Database (NRD) is a unique and powerful database designed to support various types of analyses of national readmission rates for all...

  10. HCUP Nationwide Emergency Department Database (NEDS) Restricted Access File

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Nationwide Emergency Department Sample (NEDS) was created to enable analyses of emergency department (ED) utilization patterns and support public health...

  11. Skyline Reservation System

    Data.gov (United States)

    US Agency for International Development — Flight reservation application used for in-country flights by USAID and DoS staff in Afghanistan. The application is managed and maintained by the vendor and USAID...

  12. Intrauterine adhesions following an induced abortion: a nationwide cohort study.

    Science.gov (United States)

    Mentula, M; Männistö, J; Gissler, M; Heikinheimo, O; Niinimäki, M

    2018-03-13

    Intrauterine adhesions (IUA) are a problematic complication after abortion, but their incidence is unknown. Our objective was to assess the incidence of IUA following induced abortion and the risk factors for IUA. Retrospective cohort study. A nationwide registry study. All women undergoing induced abortion (n = 80 015) in Finland between 2000 and 2008. The data were retrieved from the Finnish Abortion Registry and the Hospital Discharge Registry. The diagnosis of IUA or complications was based on the diagnostic codes (ICD-10) and operative codes according to the NOMESCO Classification of Surgical Procedures (NCSP). IUA were defined as ICD-10 code N85.6 or operative code LCG02. A sub-analysis of IUA cases and five matched controls was performed. The incidence of and risk factors for IUA. A total of 12 (1.5 per 10 000) IUA diagnoses were identified from 79 960 eligible induced abortions. The rate of IUA was 1.5 and 2.0 cases per 10 000 abortions following medically and surgically induced abortion, respectively (P = 0.19). In a subgroup analysis of IUA cases and five matched controls, surgical treatment of the remaining products of conception following abortion significantly increased the risk of IUA [odds ratio 5.50 (95% CI 1.46-20.79; P = 0.012)]. IUA that require further treatment are rare after induced abortion. Surgical evacuation following medical or surgical abortion was a risk factor for diagnosis of IUA. These results suggest that trauma to a recently pregnant uterus is an important risk factor for IUA. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  13. Nationwide public-access defibrillation in Japan.

    Science.gov (United States)

    Kitamura, Tetsuhisa; Iwami, Taku; Kawamura, Takashi; Nagao, Ken; Tanaka, Hideharu; Hiraide, Atsushi

    2010-03-18

    It is unclear whether dissemination of automated external defibrillators (AEDs) in public places can improve the rate of survival among patients who have had an out-of-hospital cardiac arrest. From January 1, 2005, through December 31, 2007, we conducted a prospective, population-based, observational study involving consecutive patients across Japan who had an out-of-hospital cardiac arrest and in whom resuscitation was attempted by emergency responders. We evaluated the effect of nationwide dissemination of public-access AEDs on the rate of survival after an out-of-hospital cardiac arrest. The primary outcome measure was the 1-month rate of survival with minimal neurologic impairment. A multivariate logistic-regression analysis was performed to assess factors associated with a good neurologic outcome. A total of 312,319 adults who had an out-of-hospital cardiac arrest were included in the study; 12,631 of these patients had ventricular fibrillation and had an arrest that was of cardiac origin and that was witnessed by bystanders. In 462 of these patients (3.7%), shocks were administered by laypersons with the use of public-access AEDs, and the proportion increased, from 1.2% to 6.2%, as the number of public-access AEDs increased (Ppublic-access AEDs, 31.6% were alive at 1 month with minimal neurologic impairment. Early defibrillation, regardless of the type of provider (bystander or emergency-medical-services personnel), was associated with a good neurologic outcome after a cardiac arrest with ventricular fibrillation (adjusted odds ratio per 1-minute increase in the time to administration of shock, 0.91; 95% confidence interval, 0.89 to 0.92; Ppublic-access AEDs increased from fewer than 1 per square kilometer of inhabited area to 4 or more. Nationwide dissemination of public-access AEDs in Japan resulted in earlier administration of shocks by laypersons and in an increase in the 1-month rate of survival with minimal neurologic impairment after an out

  14. Handbook on loss reserving

    CERN Document Server

    Schmidt, Klaus; Schnaus, Anja

    2016-01-01

    This handbook presents the basic aspects of actuarial loss reserving. Besides the traditional methods, it also includes a description of more recent ones and a discussion of certain problems occurring in actuarial practice, like inflation, scarce data, large claims, slow loss development, the use of market statistics, the need for simulation techniques and the task of calculating best estimates and ranges of future losses. In property and casualty insurance the provisions for payment obligations from losses that have occurred but have not yet been settled usually constitute the largest item on the liabilities side of an insurer's balance sheet. For this reason, the determination and evaluation of these loss reserves is of considerable economic importance for every property and casualty insurer. Actuarial students, academics as well as practicing actuaries will benefit from this overview of the most important actuarial methods of loss reserving by developing an understanding of the underlying stochastic models...

  15. Variation in interoperability across clinical laboratories nationwide.

    Science.gov (United States)

    Patel, Vaishali; McNamara, Lauren; Dullabh, Prashila; Sawchuk, Megan E; Swain, Matthew

    2017-12-01

    To characterize nationwide variation and factors associated with clinical laboratories': (1) capabilities to send structured test results electronically to ordering practitioners' EHR systems; and (2) their levels of exchange activity, as measured by whether they sent more than three-quarters of their test results as structured data to ordering practitioners' EHR systems. A national survey of all independent and hospital laboratories was conducted in 2013. Using an analytic weighted sample of 9382 clinical laboratories, a series of logistic regression analyses were conducted to identify organizational and area characteristics associated with clinical laboratories' exchange capability and activity. Hospital-based clinical laboratories (71%) and larger clinical laboratories (80%) had significantly higher levels of capability compared to independent (58%) and smaller laboratories (48%), respectively; though all had similar levels of exchange activity, with 30% of clinical laboratories sending 75% or more of their test results electronically. In multivariate analyses, hospital and the largest laboratories had 1.87 and 4.40 higher odds, respectively, of possessing the capability to send results electronically compared to independent laboratories (pLaboratories located in areas with a higher share of potential exchange partners had a small but significantly greater capability to send results electronically and higher levels of exchange activity(pClinical laboratories' capability to exchange varied by size and type; however, all clinical laboratories had relatively low levels of exchange activity. The role of exchange partners potentially played a small but significant role in driving exchange capability and activity. Published by Elsevier B.V.

  16. Lithium reserves and resources

    International Nuclear Information System (INIS)

    Evans, R.K.

    1978-01-01

    As a result of accelerating research efforts in the fields of secondary batteries and thermonuclear power generation, concern has been expressed in certain quarters regarding the availability, in sufficient quantities, of lithium. As part of a recent study by the National Research Council on behalf of the Energy Research and Development Administration, a subpanel was formed to consider the outlook for lithium. Principal areas of concern were reserves, resources and the 'surplus' available for energy applications after allowing for the growth in current lithium applications. Reserves and resources were categorized into four classes ranging from fully proved reserves to resources which are probably dependent upon the marketing of co-products to become economically attractive. Because of the proprietary nature of data on beneficiation and processing recoveries, the tonnages of available lithium are expressed in terms of plant feed. However, highly conservative assumptions have been made concerning mining recoveries and these go a considerable way to accounting for total losses. Western World reserves and resources of all classes are estimated at 10.6 million tonnes Li of which 3.5 million tonnes Li are located in the United States. Current United States capacity, virtually equivalent to Western World capacity, is 4700 tonnes Li and production in 1976 approximated to 3500 tonnes Li. Production for current applications is expected to grow to approx. 10,000 tonnes in year 2000 and 13,000 tonnes a decade later. The massive excess of reserves and resources over that necessary to support conventional requirements has limited the amount of justifiable exploration expenditures; on the last occasion, there was a a major increase in demand (by the USAEA) reserves and capacity were increased rapidly. There are no foreseeable reasons why this shouldn't happen again when the need is clear. (author)

  17. SUIKERBOSRAND NATURE RESERVE

    African Journals Online (AJOL)

    Suikerbosrand Nature Reserve and fts educational facilities are run by the Transvaal. Division of. Nature Conservation. ... tion and the education facilities provided. The former are utilized mainly by the general public ... artist Paul Bosman (already reviewed in the EEASA newsletter). The co-founders of the Foundation are.

  18. Session 7: Reserve

    International Nuclear Information System (INIS)

    Bailey, R.; Crockford, G.

    2001-01-01

    The reserve session was devoted to some issues that came up through the workshop, which were grouped into three main areas: The Global Accelerator Network, Problems of stress and how to get organized to minimize them, What should an operations group be responsible for? This paper summarizes the discussions that took place. (author)

  19. SUIKERBOSRAND NATURE RESERVE

    African Journals Online (AJOL)

    reserve, the total length being 66 km with six overnight huts. There are also the BokmakiePie. Nature Troil. and the Cheetah Interpretive Troil. which can be used by day visitors. The former has two loops, one of 10 km and another of 17 km. The. Cheetah Troil. is much shorter and various points of interest are interpreted en ...

  20. The effect of the introduction of a nationwide DUR system where local DUR systems are operating--The Korean experience.

    Science.gov (United States)

    Yang, Ju-Hyun; Kim, Mira; Park, Young-Taek; Lee, Eui-Kyung; Jung, Chai Young; Kim, Sukil

    2015-11-01

    Outpatient clinics in Korea usually have local DUR (drug utilisation review) systems, which are integrated with EMRs or health insurance claims submission systems. Whenever, the government announces a list of drug contraindications, each local DUR system loads the list and applies it in practice. In December 2010, a nationwide DUR system was introduced. This study is to investigate the impact of the nationwide DUR system on prescribing practices where local DUR systems are already operating. Between January 2009 and December 2012 the monthly number of drugs per prescription was retrieved from the health insurance claims data warehouse at the Health Insurance Review and Assessment (HIRA). The monthly proportions of 3 DDI (drug-drug interaction) pairs, 6 drug-age contraindications, and 3 drug-pregnancy contraindications from January 2007 to December 2012, at the outpatient clinic level, were also retrieved. An interrupted time series analysis was used for controlling government announcements of drug contraindications. There was no difference in the number of drugs per prescription before and after the introduction of the nationwide DUR system. Most proportions of the 3 DDI pairs, 6 drug-age contraindications, and 3 drug-pregnancy contraindications, were significantly reduced following the government announcement of drug contraindications in the short term and/or long term. The number of drugs per prescription was not related to the nationwide DUR introduction in places where local DUR systems are operating. The introduction of duplicate guidelines, in locations where the guidelines were already well followed, is considered to be the main reason for this. Furthermore, the Doctor's ignorance of alerts, and their continued substitution of regulated drugs, for non-regulated drugs, likely played a role in nullifying the effectiveness of the nationwide DUR system. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  1. The Strategic Petroleum Reserve

    Energy Technology Data Exchange (ETDEWEB)

    1991-01-01

    The Strategic Petroleum Reserve program was set into motion by the 1975 Energy Policy and Conservation Act (EPCA). By 1990, 590 million barrels of oil had been placed in storage. Salt domes along the Gulf Coast offered ideal storage. Both sweet'' and sour'' crude oil have been acquired using various purchase options. Drawdown, sale, and distribution of the oil would proceed according to guidelines set by EPCA in the event of a severe energy supply disruption. (SM)

  2. [Hypertrophy and coronary reserve].

    Science.gov (United States)

    Motz, W; Scheler, S

    2008-12-01

    Left ventricular hypertrophy represents the structural mechanism of adaptation of the left ventricle as the answer of a chronic pressure overload in arterial hypertension. Initially an increment in left ventricular wall thickness occurs. In this stadium of "concentric hypertrophy" LV systolic wall stress, LV ejection fraction and myocardial oxygen consumption per weight unit myocardium remain unchanged. In the further time course of disease LV dilatation will be present. In this phase of "excentric hypertrophy" LV systolic wall stress and myocardial oxygen consumption per weight unit myocardium rise and LV ejection fraction decreases. Patients with arterial hypertension frequently complain of angina pectoris. Angina pectoris and the positive exercise tolerance test or the positive myocardial scintigraphy are the consequence of the impaired coronary flow reserve. The coronary flow reserve is diminished due to structural and functional changes of the coronary circulation. ACE-inhibitors and AT1-receptor blockers cause a significant improvement of coronary flow reserve and regression of both left ventricular hypertrophy and myocardial fibrosis.

  3. Stress resilience and cancer risk: a nationwide cohort study.

    Science.gov (United States)

    Kennedy, Beatrice; Fang, Fang; Valdimarsdóttir, Unnur; Udumyan, Ruzan; Montgomery, Scott; Fall, Katja

    2017-10-01

    Stress resilience is recognised as a determinant of both psychiatric and somatic health, but the potential link between stress resilience and cancer development has not been explored. In this nationwide cohort study, we examined the association between stress resilience in adolescence and subsequent cancer risk. We identified a cohort of 284 257 Swedish men, born 1952-1956, who underwent compulsory military enlistment examinations including measures of psychological stress resilience (median age 18 years). The resulting score was categorised as low, moderate and high stress resilience. Individuals diagnosed with cancer during the follow-up time were identified through data linkage to the Swedish Cancer Register. Lowest stress resilience, compared with the highest, was associated with increased risks of liver (HR: 4.73, 95% CI 2.73 to 8.19) and lung (HR: 2.75, 95% CI 2.02 to 3.74) cancer after adjusting for markers of socioeconomic circumstances in childhood (p for trend cancer types). Further adjustment for cognitive and physical fitness at conscription assessment had a marginal influence. In contrast, men with low stress resilience had a decreased risk of being diagnosed with prostate cancer (HR: 0.65, 95% CI 0.56 to 0.76) and malignant melanoma (HR: 0.65, 95% CI 0.55 to 0.76). We conclude that adolescent stress resilience, plausibly by influencing behavioural choices and social patterns, constitutes an important determinant of adult cancer occurrence. Increased awareness of long-term consequences in susceptible individuals may help direct future efforts to reduce cancer burden in adults. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  4. Nationwide survey of US integrated 6-year cardiothoracic surgical residents.

    Science.gov (United States)

    Lebastchi, Amir H; Yuh, David D

    2014-08-01

    Integrated 6-year cardiothoracic surgical residency programs have recently been implemented in the United States. We report the results of the first published nationwide survey assessing the motivations, satisfaction, and ambitions of integrated 6-year residents. A 63-question web-based survey was distributed to 83 residents enrolled in 21 Accreditation Council for Graduate Medical Education-accredited integrated 6-year programs in November 2013. There was an outstanding 69% response rate. The median age of integrated 6-year residents was 29 years with women comprising 24%. A clear majority had faculty mentorship (95%) and significant clinical exposure in medical school. Focused (100%) and abbreviated (74%) training curricula were identified as the top advantages of integrated 6-year programs; the format itself was a significant factor (46%) in career choice. Most integrated 6-year residents (95%) were satisfied with their program; 80.7% were satisfied with their operative experience thus far. Career plans skewed toward adult cardiac surgery (67%), followed by pediatric cardiac (24%) and general thoracic (9%) surgery; 49% were not particularly concerned about future employment, with 65% foreseeing an increase in opportunities. Specialized training (eg, aortic, heart failure, minimally invasive, congenital) was anticipated by 77%. Most integrated 6-year residents envision an academic career (94.7%). This survey takes an important snapshot of the nascent integrated 6-year format. Mentorship and intense clinical exposure are critical in attracting applicants. Purported advantages of the format are holding true among integrated 6-year residents, with the majority satisfied with their programs. These early data indicate that this format holds significant promise in attracting and retaining highly qualified trainees to academic cardiothoracic surgery. Copyright © 2014 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

  5. A General Business Model for Marine Reserves

    Science.gov (United States)

    Sala, Enric; Costello, Christopher; Dougherty, Dawn; Heal, Geoffrey; Kelleher, Kieran; Murray, Jason H.; Rosenberg, Andrew A.; Sumaila, Rashid

    2013-01-01

    Marine reserves are an effective tool for protecting biodiversity locally, with potential economic benefits including enhancement of local fisheries, increased tourism, and maintenance of ecosystem services. However, fishing communities often fear short-term income losses associated with closures, and thus may oppose marine reserves. Here we review empirical data and develop bioeconomic models to show that the value of marine reserves (enhanced adjacent fishing + tourism) may often exceed the pre-reserve value, and that economic benefits can offset the costs in as little as five years. These results suggest the need for a new business model for creating and managing reserves, which could pay for themselves and turn a profit for stakeholder groups. Our model could be expanded to include ecosystem services and other benefits, and it provides a general framework to estimate costs and benefits of reserves and to develop such business models. PMID:23573192

  6. Fractional Reserve Banking

    OpenAIRE

    Andreasen, Niels; Bjerregaard, Mads; Lund, Jonas; Olsen, Ove Bitsch; Rasmussen, Andreas Dalgas

    2012-01-01

    Projektet er bygget op omkring kritisk realisme, som er det gennemgående videnskabelige fundament til undersøgelsen af hvilke strukturelle grunde der er til finansiel ustabilitet i Danmark. Projektet går i dybden med Fractional Reserve Banking og incitamentsstrukturen i banksystemet. Vi bevæger os både på det makro- og mikroøkonomiske niveau i analysen. På makro niveau bruger vi den østrigske skole om konjunktur teori (The Positive Theory of the Cycle). På mikro niveau arbejder vi med princip...

  7. An Australian nationwide survey on medicinal cannabis use for epilepsy: History of antiepileptic drug treatment predicts medicinal cannabis use.

    Science.gov (United States)

    Suraev, Anastasia S; Todd, Lisa; Bowen, Michael T; Allsop, David J; McGregor, Iain S; Ireland, Carol; Lintzeris, Nicholas

    2017-05-01

    Epilepsy Action Australia conducted an Australian nationwide online survey seeking opinions on and experiences with the use of cannabis-based products for the treatment of epilepsy. The survey was promoted via the Epilepsy Action Australia's main website, on their Facebook page, and by word of mouth. The survey consisted of 39 questions assessing demographics, clinical factors, including diagnosis and seizure types, and experiences with and opinions towards cannabis use in epilepsy. A total of 976 responses met the inclusion criteria. Results show that 15% of adults with epilepsy and 13% of parents/guardians of children with epilepsy were currently using, or had previously used, cannabis products to treat epilepsy. Of those with a history of cannabis product use, 90% of adults and 71% of parents reported success in reducing seizure frequency after commencing cannabis products. The main reasons for medicinal cannabis use were to manage treatment-resistant epilepsy and to obtain a more favorable side-effect profile compared to standard antiepileptic drugs. The number of past antiepileptic drugs tried was a significant predictor of medicinal cannabis use in both adults and children with epilepsy. Fifty-six percent of adults with epilepsy and 62% of parents/guardians of children with epilepsy expressed willingness to participate in clinical trials of cannabinoids. This survey provides insight into the use of cannabis products for epilepsy, in particular some of the likely factors influencing use, as well as novel insights into the experiences of and attitudes towards medicinal cannabis in people with epilepsy in the Australian community. This article is part of a Special Issue entitled "Cannabinoids and Epilepsy". Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  8. 78 FR 53732 - National Estuarine Research Reserve System

    Science.gov (United States)

    2013-08-30

    ... including climate change, threats to reserve resources and ecological functions, watershed development, and... reserve to serve as a model site for sustainable community stewardship. Notable changes in the revised... facility development to support reserve operations. The Grand Bay Reserve takes an integrated approach to...

  9. 78 FR 26617 - National Estuarine Research Reserve System

    Science.gov (United States)

    2013-05-07

    ... including climate change, threats to reserve resources and ecological functions, watershed development, and... reserve to serve as a model site for sustainable community stewardship. Notable changes in the revised... facility development to support reserve operations. The Grand Bay Reserve takes an integrated approach to...

  10. Socioeconomic conditions in cultural communities: The Nez Perce Tribe, the confederated Tribes of the Umatilla Indian Reservation and the confederated tribes and bands of the Yakima Indian Nation: Interim profile report

    International Nuclear Information System (INIS)

    Stokowski, P.A.; Friedli, E.A.

    1987-11-01

    A series of BWIP Socioeconomic Profile Reports are being prepared. This report is one of the first set of five separate BWIP Profile Reports, which cover: economic/demographic conditions; fiscal conditions; housing characteristics; public services and facilities; and socioeconomic conditions in cultural communities. The BWIP Socioeconomic Profile Reports are designed to provide information about the characteristics of the communities in which socioeconomic impacts from BWIP may occur. The Profile Reports present a compilation of historical information about socioeconomic conditions in the affected communities. These reports are designed to provide a transition between the BWIP EA, published in 1986, the Monitoring Reports, and other technical reports associated with the BWIP SMMP and CSP. The principal objectives of the Profile Reports are to update the DOE BWIP socioeconomic database by compiling available secondary and primary data and to make this information available to both the DOE program and other interested parties. The initial Profile Reports will help identify the need for additional data. The database developed for the profiles will assemble socioeconomic data in a uniform, readily accessible format. 16 refs., 1 fig., 17 tabs

  11. Methadone and buprenorphine prescribing and referral practices in US prison systems: results from a nationwide survey.

    Science.gov (United States)

    Nunn, Amy; Zaller, Nickolas; Dickman, Samuel; Trimbur, Catherine; Nijhawan, Ank; Rich, Josiah D

    2009-11-01

    More than 50% of incarcerated individuals have a history of substance use, and over 200,000 individuals with heroin addiction pass through American correctional facilities annually. Opiate replacement therapy (ORT) with methadone or buprenorphine is an effective treatment for opiate dependence and can reduce drug-related disease and recidivism for inmates. Provision of ORT is nevertheless a frequently neglected intervention in the correctional setting. We surveyed the 50 state; Washington, District of Columbia (DC); and Federal Department of Corrections' medical directors or their equivalents about their facilities' ORT prescribing policies and referral programs for inmates leaving prison. We received responses from 51 of 52 prison systems nationwide. Twenty-eight prison systems (55%) offer methadone to inmates in some situations. Methadone use varies widely across states: over 50% of correctional facilities that offer methadone do so exclusively for pregnant women or for chronic pain management. Seven states' prison systems (14%) offer buprenorphine to some inmates. The most common reason cited for not offering ORT was that facilities "prefer drug-free detoxification over providing methadone or buprenorphine." Twenty-three states' prison systems (45%) provide referrals for some inmates to methadone maintenance programs after release, which increased from 8% in 2003; 15 states' prison systems (29%) provide some referrals to community buprenorphine providers. Despite demonstrated social, medical, and economic benefits of providing ORT to inmates during incarceration and linkage to ORT upon release, many prison systems nationwide still do not offer pharmacological treatment for opiate addiction or referrals for ORT upon release.

  12. Nationwide cross-sectional survey of schistosomiasis and soil-transmitted helminthiasis in Sudan: study protocol.

    Science.gov (United States)

    Cha, Seungman; Hong, Sung-Tae; Lee, Young-Ha; Lee, Keon Hoon; Cho, Dae Seong; Lee, Jinmoo; Chai, Jong-Yil; Elhag, Mousab Siddig; Khaled, Soheir Gabralla Ahmad; Elnimeiri, Mustafa Khidir Mustafa; Siddig, Nahid Abdelgadeir Ali; Abdelrazig, Hana; Awadelkareem, Sarah; Elshafie, Azza Tag Eldin; Ismail, Hassan Ahmed Hassan Ahmed; Amin, Mutamad

    2017-09-12

    the status and policy formulation and updates to the control strategies. This paper, which describes a feasible and practical study protocol, is to be shared with the global health community, especially those who are planning to perform nationwide mapping of NTDs by feces or urine sampling.

  13. Aortic events in a nationwide Marfan syndrome cohort

    DEFF Research Database (Denmark)

    Groth, Kristian A; Krag, Kirstine Stochholm; Hove, Hanne

    2017-01-01

    BACKGROUND: Marfan syndrome is associated with morbidity and mortality due to aortic dilatation and dissection. Preventive aortic root replacement has been the standard treatment in Marfan syndrome patients with aortic dilatation. In this study, we present aortic event data from a nationwide Marfan...... syndrome cohort. METHOD: The nationwide cohort of Danish Marfan syndrome patients was established from the Danish National Patient Registry and the Cause of Death Register, where we retrieved information about aortic surgery and dissections. We associated aortic events with age, sex, and Marfan syndrome...

  14. Nationwide and population-based prescription patterns in bipolar disorder

    DEFF Research Database (Denmark)

    Kessing, Lars Vedel; Vradi, Eleni; Andersen, Per Kragh

    2016-01-01

    OBJECTIVES: The aim of the present study was to describe prescription patterns and changes in these patterns over the last decade for patients diagnosed with bipolar disorder in mental healthcare, using population-based and nationwide data, and to relate the findings to recommendations from...... international guidelines. METHODS: A population-based, nationwide study was carried out. It included register-based longitudinal data on all patients with a first-ever contact with mental healthcare with a diagnosis of mania/bipolar disorder from the entire Danish population, and all prescription data...

  15. Implementing a nationwide criteria-based emergency medical dispatch system

    DEFF Research Database (Denmark)

    Andersen, Mikkel; Johnsen, Søren Paaske; Sørensen, Jan Nørtved

    2013-01-01

    A criteria-based nationwide Emergency Medical Dispatch (EMD) system was recently implemented in Denmark. We described the system and studied its ability to triage patients according to the severity of their condition by analysing hospital admission and case-fatality risks.......A criteria-based nationwide Emergency Medical Dispatch (EMD) system was recently implemented in Denmark. We described the system and studied its ability to triage patients according to the severity of their condition by analysing hospital admission and case-fatality risks....

  16. The Value of Green Technology at ABC Community College

    Science.gov (United States)

    McAllister, Bernadette

    2012-01-01

    A challenge facing community colleges nationwide is to reduce the carbon footprint of campuses by initiating green technology initiatives. This case study assessed the effect of switching from paper assignments to a learning management system at ABC Community College. The topic is important because federal and state funding, as well as…

  17. Are uranium reserves adequate?

    International Nuclear Information System (INIS)

    Anon.

    2006-01-01

    Against a backdrop of growing concerns about global warming and geopolitical pressures on fossil energies, especially natural gas and oil, interest in nuclear power has revived considerably. Conscious of its addiction to oil and reeling from a series of gigantic blackouts, the United States, in the words of its president, must 'aggressively move forward with the construction of nuclear power plants'. Some European countries have approved new power plant construction (Finland and France), while the more reserved ones (Belgium, Germany and Sweden) have begun to show a change in attitude. Asia, meanwhile, is host to the planet's largest number of potential nuclear construction projects in this first half of the 21. century. All these signs point to a sharp rise in uranium consumption, the basic fuel for these plants. But are there enough resources to support a nuclear revival on a planetary scale? The publication of the Red Book on uranium in late May 2006 was an opportunity for Thierry Dujardin, Deputy Director of Science and Development at the OECD's Nuclear Energy Agency, to take stock of resources. He gives his opinion in this paper

  18. Language Identity among Iranian English Language Learners: A Nationwide Survey

    Science.gov (United States)

    Rezaei, Saeed; Khatib, Mohammad; Baleghizadeh, Sasan

    2014-01-01

    The present study is a nationwide survey of language identity among English language learners in Iran. The participants who completed the survey in this research included 1851 English language learners from different parts of the country who belonged to different genders, age groups and English language proficiency levels. The main instrument was…

  19. 76 FR 43696 - Nationwide Cyber Security Review (NCSR) Assessment

    Science.gov (United States)

    2011-07-21

    ... all levels of government to complete a cyber network security assessment so that a full measure of... DEPARTMENT OF HOMELAND SECURITY [Docket No. DHS-2011-0012] Nationwide Cyber Security Review (NCSR... comments; New Information Collection Request. SUMMARY: The Department of Homeland Security (DHS), National...

  20. 76 FR 22409 - Nationwide Cyber Security Review (NCSR) Assessment

    Science.gov (United States)

    2011-04-21

    ... for all levels of government to complete a cyber network security assessment so that a full measure of... DEPARTMENT OF HOMELAND SECURITY [Docket No. DHS-2011-0012] Nationwide Cyber Security Review (NCSR... comments; New Information Collection Request: 1670-NEW. SUMMARY: The Department of Homeland Security (DHS...

  1. Exclusive breastfeeding and partial breastfeeding reduce the risk of overweight in childhood: A nationwide longitudinal study in Korea.

    Science.gov (United States)

    Park, Seon-Joo; Lee, Hae-Jeung

    2018-01-27

    Breastfeeding is generally known to reduce the risk of childhood overweight and obesity. However, the results are controversial between countries, and nationwide data are rare. This study assessed the relationship between breastfeeding types and overweight incidence using nationwide longitudinal data in Korea. We analysed 774,764 infants who participated in the longitudinal nationwide data from the Korea National Children's Health Examination 2007-2013. Childhood overweight was defined by a Z-score≥1.64 (95th centile) for infants under 24 months and Z-scores≥1.04 (85th centile) for children over 24 months. Cox proportional hazard model was used to analyse the relationship between breastfeeding types and overweight incidence. Infants who were exclusively breastfed at 4-6 months of age had the multivariate-adjusted hazard ratio (HRs) for overweight of 0.78 (95% CI 0.77-0.79) and infants who were partially breastfed had the HRs for overweight of 0.96 (95% CI 0.94-0.98), which was lower compared to that of the exclusively formula fed group. Similar results were obtained for stratified analysis by boys and girls. Exclusive and partial breastfeeding have preventive effect on childhood overweight in Korea. Therefore, it is necessary to encourage breastfeeding to prevent childhood obesity and its consequences in developed Asian countries. Copyright © 2018 Asia Oceania Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.

  2. Treatment Effectiveness of PMTO for Children's Behavior Problems in Iceland: Child Outcomes in a Nationwide Randomized Controlled Trial.

    Science.gov (United States)

    Sigmarsdóttir, Margrét; Thorlacius, Örnólfur; Guðmundsdóttir, Edda Vikar; DeGarmo, David S

    2015-09-01

    Well-documented treatment methods must be tested following their implementation in community service agencies and across different cultures to ensure continuing effectiveness. This study was a randomized controlled trial (RCT) of Parent Management Training-the Oregon model (PMTO), conducted within a nationwide implementation in Iceland. Families of 102 clinically referred children with behavior problems were recruited from five municipalities throughout Iceland. Child age ranged from 5 to 12; 73% were boys. Families were randomly assigned to either PMTO or services usually offered in the communities (SAU). Child adjustment was measured with a latent construct based on parent, child, and teacher reports of externalizing and internalizing problems and social skills. Prepost intent-to-treat analyses showed that PMTO treatment led to greater reductions in child adjustment problems relative to the comparison group, obtaining a modest to medium effect size based on the construct score. Only one indicator (parent-rated Social Skills) showed significant change independently and information on amount and kind of treatment in the SAU was limited. Overall, findings indicate that PMTO is an effective method to treat children's behavior problems in a Northern European culture and supply evidence for the method's successful implementation in community settings in Iceland. This is one of few nationwide implementation studies of PMTO outside the United States and the first RCT in Iceland to test a treatment model for children's behavior problems. © 2014 Family Process Institute.

  3. Biofortified orange maize is as efficacious as a vitamin A supplement in Zambian children even in the presence of high liver reserves of vitamin A: a community-based, randomized placebo-controlled trial123456

    Science.gov (United States)

    Gannon, Bryan; Kaliwile, Chisela; Arscott, Sara A; Schmaelzle, Samantha; Chileshe, Justin; Kalungwana, Ngándwe; Mosonda, Mofu; Pixley, Kevin; Masi, Cassim; Tanumihardjo, Sherry A

    2014-01-01

    Background: Biofortification is a strategy to relieve vitamin A (VA) deficiency. Biofortified maize contains enhanced provitamin A concentrations and has been bioefficacious in animal and small human studies. Objective: The study sought to determine changes in total body reserves (TBRs) of vitamin A with consumption of biofortified maize. Design: A randomized, placebo-controlled biofortified maize efficacy trial was conducted in 140 rural Zambian children. The paired 13C-retinol isotope dilution test, a sensitive biomarker for VA status, was used to measure TBRs before and after a 90-d intervention. Treatments were white maize with placebo oil (VA−), orange maize with placebo (orange), and white maize with VA in oil [400 μg retinol activity equivalents (RAEs) in 214 μL daily] (VA+). Results: In total, 133 children completed the trial and were analyzed for TBRs (n = 44 or 45/group). Change in TBR residuals were not normally distributed (P calculated liver reserves at baseline were 1.04 (0.97, 1.12) μmol/g liver, with 59% >1 μmol/g, the subtoxicity cutoff; none were calculated bioconversion factor was 10.4 μg β-carotene equivalents/1 μg retinol by using the middle 3 quintiles of change in TBRs from each group. Serum retinol did not change in response to intervention (P = 0.16) but was reduced with elevated C-reactive protein (P = 0.0029) and α-1-acid glycoprotein (P = 0.0023) at baseline. Conclusions: β-Carotene from maize was efficacious when consumed as a staple food in this population and could avoid the potential for hypervitaminosis A that was observed with the use of preformed VA from supplementation and fortification. Use of more sensitive methods other than serum retinol alone, such as isotope dilution, is required to accurately assess VA status, evaluate interventions, and investigate the interaction of VA status and infection. This trial was registered at clinicaltrials.gov as NCT01814891. PMID:25411289

  4. Timely referral saves the lives of mothers and newborns: Midwifery led continuum of care in marginalized teagarden communities – A qualitative case study in Bangladesh [version 1; referees: 1 approved, 2 approved with reservations

    Directory of Open Access Journals (Sweden)

    Animesh Biswas

    2018-03-01

    Full Text Available Background: Prompt and efficient identification, referral of pregnancy related complications and emergencies are key factors to the reduction of maternal and newborn morbidity and mortality. As a response to this critical need, a midwifery led continuum of reproductive health care was introduced in five teagardens in the Sylhet division, Bangladesh during 2016. Within this intervention, professional midwives provided reproductive healthcare to pregnant teagarden women in the community.  This study evaluates the effect of the referral of pregnancy related complications. Methods: A qualitative case study design by reviewing records retrospectively was used to explore the effect of deploying midwives on referrals of pregnancy related complications from the selected teagardens to the referral health facilities in Moulvibazar district of the Sylhet division during 2016.  In depth analyses was also performed on 15 randomly selected cases to understand the facts behind the referral. Results: Out of a total population of 450 pregnant women identified by the midwives, 72 complicated mothers were referred from the five teagardens to the facilities. 76.4% of mothers were referred to conduct delivery at facilities, and 31.1% of them were referred with the complication of prolonged labour. Other major complications were pre-eclampsia (17.8%, retention of the placenta with post-partum hemorrhage (11.1% and premature rupture of the membrane (8.9%. About 60% of complicated mothers were referred to the primary health care centre, and among them 14% of mothers were delivered by caesarean section. 94% deliveries resulted in livebirths and only 6% were stillbirths. Conclusions: This study reveals that early detection of pregnancy complications by skilled professionals and timely referral to a facility is beneficial in saving the majority of baby’s as well as mother’s lives in resource-poor teagardens with a considerable access barrier to health facilities.

  5. Income inequality, perceived happiness, and self-rated health: evidence from nationwide surveys in Japan.

    Science.gov (United States)

    Oshio, Takashi; Kobayashi, Miki

    2010-05-01

    In this study, we examined how regional inequality is associated with perceived happiness and self-rated health at an individual level by using micro-data from nationwide surveys in Japan. We estimated the bivariate ordered probit models to explore the associations between regional inequality and two subjective outcomes, and evaluated effect modification to their sensitivities to regional inequality using the categories of key individual attributes. We found that individuals who live in areas of high inequality tend to report themselves as both unhappy and unhealthy, even after controlling for various individual and regional characteristics and taking into account the correlation between the two subjective outcomes. Gender, age, educational attainment, income, occupational status, and political views modify the associations of regional inequality with the subjective assessments of happiness and health. Notably, those with an unstable occupational status are most affected by inequality when assessing both perceived happiness and health. Copyright 2010 Elsevier Ltd. All rights reserved.

  6. 1990 Nationwide Truck Activity and Commodity Survey selected tabulations

    Energy Technology Data Exchange (ETDEWEB)

    1993-06-01

    The Nationwide Truck Activity and Commodity Survey (NTACS) provides detailed activity data for a sample of trucks covered in the 1987 Truck Inventory and Use Survey (TIUS) for days selected at random over a 12-month period ending in 1990. The NTACS was conducted by the US Bureau of the Census for the US Department of Transportation (DOT). A Public Use File for the NTACS was developed by Oak Ridge National Laboratory (ORNL) under a reimbursable agreement with the DOT. The content of the Public Use File and the detailed design of the NTACS are described in the ORNL Report [open quotes]Technical Documentation for the 1990 Nationwide Truck Activity and Commodity Survey Public Use File[close quotes]. (1992). ORNL Technical Report No. TM-12188, Oak Ridge National Laboratory, Oak Ridge, TN 37831. The main purpose of this summary report is to provide selected tables based on the public use file.

  7. Nationwide Prospective Study of Outcomes after Elective Incisional Hernia Repair

    DEFF Research Database (Denmark)

    Helgstrand, Frederik; Rosenberg, Jacob; Kehlet, Henrik

    2013-01-01

    BACKGROUND: Incisional hernia repair is a frequent surgical procedure, but perioperative risk factors and outcomes have not been prospectively assessed in large-scale studies. The aim of this nationwide study was to analyze surgical risk factors for early and late outcomes after incisional hernia...... repair. STUDY DESIGN: We conducted a prospective nationwide study on all elective incisional hernia repairs registered in the Danish Ventral Hernia Database between January 1, 2007 and December 31, 2010. Main outcomes measures were surgical risk factors for 30-day readmission, reoperation (excluding...... recurrence), and mortality after incisional hernia repair. Late outcomes included reoperation for recurrence during the follow-up period. Follow-up was obtained by merging the Danish Ventral Hernia Database with the Danish National Patient Register. Results were evaluated by multivariate analyses. RESULT...

  8. LP-gas marketers nationwide reveal hardships encountered during crisis

    Energy Technology Data Exchange (ETDEWEB)

    1990-04-01

    The authors report on a survey of 150 randomly-selected LP-gas marketers nationwide. Replies were solicited from every major geographical region. The purpose of the survey was to obtain a comprehensive sampling of information on local price increases, shipping difficulties, relations with customers, and strategies for the future. This paper presents a profile that sums up the effects of the propane emergency on marketers and customers.

  9. Nation-Wide Mobile Network Energy Evolution Analysis

    DEFF Research Database (Denmark)

    Perez, Eva; Frank, Philipp; Micallef, Gilbert

    2013-01-01

    be supported. In most cases, these upgrades increase the energy consumption of the network even further. This paper presents a nation-wide case study, based on a commercial network of a leading European operator, intended to provide a clear understanding of how the energy consumption of mobile networks...... is expected to evolve from 2012 until 2020. The study also considers an efficient network capacity evolution path, including base station equipment improvement forecasts....

  10. Polydrug use among college students in Brazil: a nationwide survey

    OpenAIRE

    Oliveira,Lúcio Garcia de; Alberghini,Denis Guilherme; Santos,Bernardo dos; Andrade,Arthur Guerra de

    2013-01-01

    Objective: To estimate the frequency of polydrug use (alcohol and illicit drugs) among college students and its associations with gender and age group. Methods: A nationwide sample of 12,544 college students was asked to complete a questionnaire on their use of drugs according to three time parameters (lifetime, past 12 months, and last 30 days). The co-use of drugs was investigated as concurrent polydrug use (CPU) and simultaneous polydrug use (SPU), a subcategory of CPU that involves the ...

  11. A Nationwide Study of Pharmacists' Perception of the Impact of Medicare Part D on the Pharmacist-Patient Relationship.

    Science.gov (United States)

    Spooner, Joshua J; Spotts, Harlan; Khan, Shamima

    2017-10-01

    Medicare Part D was implemented in 2006, introducing change to the community pharmacy marketplace, with profound disruption to independent pharmacy operations across the United States. To understand pharmacist perceptions about Part D and their perceived obligation to address Part D issues on behalf of their beneficiaries. A nationwide, cross-sectional survey of pharmacists was conducted between April and July 2013. The 43-item online survey collected information about demographics, implications of Part D on community pharmacy and patients, and beliefs about ideal pharmacy practice. Pharmacists reported more responsibility to address prior authorization issues (55.3% strongly agree or agree) than dispensing preferred medications (43.5%) or addressing patient copayment issues (38.1%). Predictors of the perceived responsibility to assist patients varied and included practice site, pharmacist age, pharmacy prescription volume, and pharmacy financial performance. Financial concerns continue to be the most significant issue following Part D implementation. The degree to which pharmacists feel responsible for addressing patient Part D concerns is variable and dependent on a variety of factors. Pharmacists who felt a personal responsibility to address patient copayment issues reported a better pharmacy financial performance, a larger increase in prescription volume, and a better pharmacist-patient relationship since Part D implementation. Nationwide, Part D financial concerns remain significant. Pharmacists can assist patients with managing cost issues, which can help alleviate pharmacy financial concerns. Many pharmacists practicing at independent locations do not feel responsible for addressing patient cost concerns, which may inadvertently impart a negative financial effect upon their pharmacy.

  12. Fractional Reserve in Banking System

    OpenAIRE

    Valkonen, Maria

    2016-01-01

    This thesis is aimed to provide understanding of the role of the fractional reserve in the mod-ern banking system worldwide and particularly in Finland. The fractional reserve banking is used worldwide, but the benefits of this system are very disputable. On the one hand, experts say that the fractional reserve is a necessary instrument for the normal business and profit making. On the other hand, sceptics openly criticize the fractional reserve system and blame it for fiat money (money n...

  13. Sense and Sensibility: The Case for the Nationwide Inclusion of Engineering in the K-12 Curriculum

    Science.gov (United States)

    Lindberg, Robert E.; Pinelli, Thomas E.; Batterson, James G.

    2008-01-01

    The competitive status of the United States is inextricably linked to innovation just as innovation is inseparable from science, technology, engineering, and mathematics. To stay competitive in innovation requires that the United States produce a 21st century workforce complete with requisite education, training, skills, and motivation. If we accept a priori that science, technology, engineering, and mathematics education are crucial to competitiveness and innovation and that, in terms of innovation, mathematics, science, and engineering are interdependent, why are mathematics and science uniformly ubiquitous in the K-12 curriculum while engineering is conspicuously absent? We are passionate in our belief that the uniform addition of engineering to the K-12 curriculum will help ensure that the nation has "the right" 21st Century workforce. Furthermore, we believe that a nationwide effort, led by a coalition of engineering academics, practitioners, and societies is required to turn this goal into reality. However, accomplishing this goal necessitates, as we are reminded by the title of Jane Austen's timeless novel, "Sense and Sensibility", a workable solution that seeks the "middle ground" between passion and reason. We begin our paper by making two essential points: Engineers are not scientists. Engineering exists separate from science, has its own specialized knowledge community apart from science, and it is largely responsible for many of the most significant advancements and improvements in the quality of our life. Our workable solution requires that K-12 education, nationwide, accommodate the inclusion of engineering as a stand alone curriculum and we offer three reasons to support our position: (1) workforce development, (2) stimulating interest in STEM (science, technology, engineering, and mathematics) courses and careers, and (3) creating a technologically literate society. We conclude with some thoughts on how this important goal can be accomplished.

  14. Indian reservation safety improvement program : a methodology and case study.

    Science.gov (United States)

    2015-11-01

    Improving roadway safety on Indian reservations requires a comprehensive approach. Limited : resources, lack of crash data, and few cross-jurisdictions coordination has made it difficult for : Native American communities to address their roadway safe...

  15. Characterization of Turkish coals. A nationwide perspective

    Energy Technology Data Exchange (ETDEWEB)

    Palmer, Curtis A.; Dennen, Kristen O.; Finkelman, Robert B. [U.S. Geological Survey, Mail Stop 956, Reston, VA 20192 (United States); Tuncali, Ertem [Directorate of Mineral Research and Exploration 06520, Ankara (Turkey); Coburn, Timothy C. [Abilene Christian University, Abilene, TX 79699 (United States)

    2004-12-03

    The U.S. Geological Survey (USGS) and the Turkish General Directorate of Mineral Research and Exploration (Maden Tetkik ve Arama Genel Mudurlugu, MTA) are working together to provide a better understanding of the chemical properties of Turkish coals from major Turkish lignite producing areas.The coals in Turkey are generally low rank (lignite or subbituminous) formed in several different depositional environments at different geologic times and have differing chemical properties. Eocene coals are limited to northern Turkey; Oligocene coals, found in the Thrace Basins of northwestern Turkey, are intercalated with marine sediments; Miocene coals are generally located in Western Turkey. The coal deposits, which have limnic characteristics, have relatively abundant reserves. Pliocene-Pleistocene coals are found in the eastern part of Turkey. Most of these coals have low calorific values, high moisture, and high ash contents. Analysis of 143 coal channel samples (most are lignite and subbituminous in rank, but a few are bituminous and one is anthracitic in rank) has been completed for up to 54 elements and other coal properties using a variety of analytical techniques, including inductively coupled plasma emission and mass spectrometry, instrumental neutron activation analysis, and various single element techniques and ASTM standard procedures. Many of these coals have elemental concentrations similar to U.S. lignites found in the Gulf Coast and Fort Union regions. However, maximum or mean concentrations of B, Cr, Cs, Ni, As, Br, Sb, Cs, and U in Turkey are higher than the corresponding maximum or mean values found in either the Fort Union or Gulf Coast regions.

  16. Biosphere reserves: Attributes for success.

    Science.gov (United States)

    Van Cuong, Chu; Dart, Peter; Hockings, Marc

    2017-03-01

    Biosphere reserves established under the UNESCO Man and the Biosphere Program aim to harmonise biodiversity conservation and sustainable development. Concerns over the extent to which the reserve network was living up to this ideal led to the development of a new strategy in 1995 (the Seville Strategy) to enhance the operation of the network of reserves. An evaluation of effectiveness of management of the biosphere reserve network was called for as part of this strategy. Expert opinion was assembled through a Delphi Process to identify successful and less successful reserves and investigate common factors influencing success or failure. Ninety biosphere reserves including sixty successful and thirty less successful reserves in 42 countries across all five Man and the Biosphere Program regions were identified. Most successful sites are the post-Seville generation while the majority of unsuccessful sites are pre-Seville that are managed as national parks and have not been amended to conform to the characteristics that are meant to define a biosphere reserve. Stakeholder participation and collaboration, governance, finance and resources, management, and awareness and communication are the most influential factors in the success or failure of the biosphere reserves. For success, the biosphere reserve concept needs to be clearly understood and applied through landscape zoning. Designated reserves then need a management system with inclusive good governance, strong participation and collaboration, adequate finance and human resource allocation and stable and responsible management and implementation. All rather obvious but it is difficult to achieve without commitment to the biosphere reserve concept by the governance authorities. Copyright © 2016 Elsevier Ltd. All rights reserved.

  17. Community - based management in two biosphere reserves in ...

    African Journals Online (AJOL)

    The paper presents the characteristics of both sites and explores traditional natural resource use, local associations, and their role in collective action, as well as customary institutional arrangements. The results provide insight into strengthening local management capacities and cooperation. They also highlight the need to ...

  18. Establishment of a community managed marine reserve in the Bay ...

    African Journals Online (AJOL)

    la pollution et le tourisme. Le déclin de l'état de santé du récif corallien se reflète dans la diminution de la productivité des pêcheries et dans les suivis de la biodiversité marine. La situation est à présent critique car les ressources marines associées au récif assurent la subsistance des populations côtières vivant le long de ...

  19. Impact of Forest Reserves on Livelihoods of Fringe Communities...

    African Journals Online (AJOL)

    User

    ber of relatively new and old settlements and have potential for socio-economic activities. (agricultural production and ecotourism). Two main research approaches, structured question- naire and semi-structured interviews were ... parts of South-East Asia and Africa (Whitmore. 1997). For instance, at the beginning of the ...

  20. Risk of breast cancer in risperidone users: A nationwide cohort study.

    Science.gov (United States)

    Reutfors, Johan; Wingård, Louise; Brandt, Lena; Wang, Yiting; Qiu, Hong; Kieler, Helle; Bahmanyar, Shahram

    2017-04-01

    Several antipsychotics, especially risperidone, are known to increase serum prolactin. Hyperprolactinemia has been linked to the development of mammary gland tumors in animal studies. We therefore investigated the risk of breast cancer in a nationwide cohort of women using risperidone or other antipsychotics. All women, 18years or older, who initiated treatment with risperidone or any other antipsychotic between 2006 and 2012 were identified in Swedish nationwide registers. Patients with two consecutive dispensations of the same antipsychotic within 3months, no previous cancer diagnosis, and no previous dispensations of paliperidone were included. The final cohort consisted of 55976 women of whom 22908, 24524, and 8544 were exposed to risperidone, other atypical antipsychotics, and typical antipsychotics, respectively. A Cox regression model was used to estimate the hazard ratio (HR) and 95% confidence interval (CI) for the association between antipsychotics and breast cancer. Patients were followed prospectively, the mean follow-up time ranging from 2.4 to 2.8years between treatment groups. After adjusting for age, there was no increased risk for breast cancer among risperidone users compared to patients exposed to another atypical antipsychotic (HR 0.94, 95% CI 0.72-1.22) or a typical antipsychotic (HR 1.25, 95% CI 0.94-1.66). Analyses stratified by tumor stage, using active treatment follow-up time, or including only treatment naïve patients did not reveal any noteworthy change in the results. Risperidone use does not confer an increased short-term risk of breast cancer compared to other antipsychotic agents. Copyright © 2016 Elsevier B.V. All rights reserved.

  1. Patterns of skin prick test positivity in allergic patients: usefulness of a nationwide SPT chart review.

    Science.gov (United States)

    Larenas-Linnemann, D E; Fogelbach, G A Guidos; Alatorre, A Monteverde; Cruz, A Arias; Colín, D D Hernández; Pech, J A Luna; Hernández, A Medina; Imperial, D Alberto García; del Prado, M L Cid; Zapién, F J Linares; Huerta, R E; Martell, J A Ortega

    2011-01-01

    A previous survey on allergens used by Mexican allergists in their skin prick test (SPT) panel showed wide variation. Humidity varies in different zones of Mexico. This might lead to differences in natural exposure and allergic sensitisation throughout the country. We aim to describe the SPT sensitivity patterns in the different climatic zones in Mexico and to show the usefulness of a structured SPT chart-review including multiple clinics in obtaining these allergen sensitisation patterns. A retrospective, structured chart-review of SPT results was undertaken in allergy clinics throughout Mexico. Ratios of SPT positivity were calculated for individual allergens, per climatic zone and nation-wide. Per allergen group the most important allergens were identified. Statistically significant differences between zones and the nation-wide data were tested with Pearson's Chi-squares test. 4169 skin test charts were recollected. The most important allergens causing sensitisation were very similar in different zones, despite climate variation. The allergen with highest ratio of SPT positivity was Dermatophagoides pteronyssinus (51%), with trees (Ash-27%, Alder-22%, Oak19%), and Bermuda grass (26%) as second and third. In the hot zones (humid and dry) Aspergillus was statistically significant more frequently than in more temperate zones. Cockroaches thrive in big cities and humid zones and Mesquite and Poplar in dry zones. Weeds are less important. Mexico has its own SPT sensitisation pattern, which is different from America and Europe. A structured chart-review of SPT results is able to show this and might be a tool for allergists in other countries. Copyright © 2010 SEICAP. Published by Elsevier Espana. All rights reserved.

  2. Complications and operative spine fusion construct length in Parkinson's disease: A nationwide population-based analysis.

    Science.gov (United States)

    McClelland, Shearwood; Baker, Joseph F; Smith, Justin S; Line, Breton G; Hart, Robert A; Ames, Christopher P; Bess, R Shay

    2017-09-01

    There remains a dearth of information regarding the surgical complications following multilevel spine surgery in Parkinson's disease (PD) patients. This retrospective cohort study was performed to address this issue on a nationwide level using the Nationwide Inpatient Sample from 2001 to 2012. More than 25 postoperative variables were analyzed to assess the impact of fusion construct length on each variable. Subsequently, the same analysis was performed on admissions without PD. 4301 PD patients with spine fusion were identified, of whom 934 (21.7%) underwent fusion of at least three levels; the remaining 3367 underwent fusion of 1-2 levels. Patients with 3+ level fusions were more likely to suffer paraplegia (P=.001; OR=3.0; 95%CI=1.5-6.1), hematoma/seroma (P=.009; OR=1.9; 95%CI=1.2-3.2), IVC filter placement (P=.018; OR=2.1; 95%CI=1.1-3.9), RBC transfusion (Panemia (P1week (P<.001; OR=2.1; 95%CI=1.8-2.5), and a nonroutine discharge (P=.005; OR=1.9; 95%CI=1.4-2.4). 692,173 non-PD patients with spine fusion were identified; 123,964 (17.9%) underwent 3+ level fusion. Differences between 3+ versus 1-2 level fusions were similar to those in PD patient, but unlike PD patients, postoperative infection was significant while in-hospital mortality, PE and VTE were not. Fusion of at least three levels increased morbidity, mortality, and adverse discharge disposition compared with 1-2 level fusions. Nearly 80% of all spine fusions performed in the United States are fewer than three levels. These findings are worth considering during operative decision-making in both PD and non-PD patients. Copyright © 2017 Elsevier Ltd. All rights reserved.

  3. Nuclear, uranium, reserves, sustainability, independence; Nucleaire, Uranium, reserves, durabilite, independance

    Energy Technology Data Exchange (ETDEWEB)

    Acket, C

    2007-06-15

    In order to evaluate the energy independence concerning the nuclear energy, the author takes the state of the art about the uranium. He details the fuel needs, the reserves on the base of the today available techniques, the reserves on the base of the future techniques and concludes positively on the energy independence for the nuclear. (A.L.B.)

  4. American Indian Community Colleges.

    Science.gov (United States)

    One Feather, Gerald

    With the emergence of reservation based community colleges (th Navajo Community College and the Dakota Community Colleges), the American Indian people, as decision makers in these institutions, are providing Indians with the technical skills and cultural knowledge necessary for self-determination. Confronted with limited numbers of accredited…

  5. Bird checklist, Guánica Biosphere Reserve, Puerto Rico

    Science.gov (United States)

    Wayne J. Arendt; John Faaborg; Miguel Canals; Jerry Bauer

    2015-01-01

    This research note compiles 43 years of research and monitoring data to produce the first comprehensive checklist of the dry forest avian community found within the Guánica Biosphere Reserve. We provide an overview of the reserve along with sighting locales, a list of 185 birds with their resident status and abundance, and a list of the available bird habitats....

  6. Oak Ridge Reservation Annual Site environmental report summary for 1994

    International Nuclear Information System (INIS)

    1995-09-01

    This document presents a summary of the information collected for the Oak Ridge Reservation 1994 site environmental report. Topics discussed include: Oak Ridge Reservation mission; ecology; environmental laws; community participation; environmental restoration; waste management; radiation effects; chemical effects; risk to public; environmental monitoring; and radionuclide migration

  7. Oak Ridge Reservation Annual Site environmental report summary for 1994

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-09-01

    This document presents a summary of the information collected for the Oak Ridge Reservation 1994 site environmental report. Topics discussed include: Oak Ridge Reservation mission; ecology; environmental laws; community participation; environmental restoration; waste management; radiation effects; chemical effects; risk to public; environmental monitoring; and radionuclide migration.

  8. Long-term outcome in anorexia nervosa in the community

    NARCIS (Netherlands)

    Mustelin, Linda; Raevuori, Anu; Bulik, Cynthia M.; Rissanen, Aila; Hoek, Hans W.; Kaprio, Jaakko; Keski-Rahkonen, Anna

    2015-01-01

    ObjectiveFew studies have assessed outcomes of anorexia nervosa (AN) outside clinical settings. We aimed to assess mortality, recovery, and socio-demographic outcomes of AN in a community sample. MethodWomen in the nationwide FinnTwin16 cohort (born 1975-1979) were followed for 10 years after

  9. Hydrocephalus in adults with community-acquired bacterial meningitis

    NARCIS (Netherlands)

    Soemirien Kasanmoentalib, E.; Brouwer, Matthijs C.; van der Ende, Arie; van de Beek, Diederik

    2010-01-01

    Objective: To evaluate the occurrence, treatment, and outcome of hydrocephalus complicating community-acquired bacterial meningitis in adults. Methods: Case series from a prospective nationwide cohort study from Dutch hospitals from 2006 to 2009. Results: Hydrocephalus was diagnosed in 26 of 577

  10. The first nationwide surveillance of antibacterial susceptibility patterns of pathogens isolated from skin and soft-tissue infections in dermatology departments in Japan.

    Science.gov (United States)

    Watanabe, Shinichi; Ohnishi, Takamitsu; Yuasa, Akira; Kiyota, Hiroshi; Iwata, Satoshi; Kaku, Mitsuo; Watanabe, Akira; Sato, Junko; Hanaki, Hideaki; Manabe, Motomu; Suzuki, Tamio; Otsuka, Fujio; Aihara, Michiko; Iozumi, Ken; Tamaki, Takeshi; Funada, Yuichi; Shinozaki, Mikio; Kobayashi, Motoko; Okuda, Masaru; Kikyo, Go; Kikuchi, Kumi; Okada, Yoshitane; Takeshima, Masanori; Kaneko, Osamu; Ogawa, Natsuki; Ito, Rie; Okuyama, Ryuhei; Shimada, Shinji; Shimizu, Tadamichi; Hatta, Naohito; Manabu, Maeda; Tsutsui, Kiyohiro; Tanaka, Toshihiro; Miyachi, Yoshiki; Asada, Hideo; Furukawa, Fukumi; Kurokawa, Ichiro; Iwatsuki, Keiji; Hide, Michihiro; Muto, Masahiko; Yamamoto, Osamu; Niihara, Hiroyuki; Takagaki, Kenji; Kubota, Yasuo; Sayama, Koji; Sano, Shigetoshi; Furue, Masutaka; Kanekura, Takuro

    2017-08-01

    To investigate the trends of antimicrobial resistance in pathogens isolated from skin and soft-tissue infections (SSTI) at dermatology departments in Japan, a Japanese surveillance committee conducted the first nationwide survey in 2013. Three main organisms were collected from SSTI at 30 dermatology departments in medical centers and 10 dermatology clinics. A total of 860 strains - 579 of Staphylococcus aureus, 240 of coagulase-negative Staphylococci, and 41 of Streptococcus pyogenes - were collected and shipped to a central laboratory for antimicrobial susceptibility testing. The patient profiles were also studied. Among all 579 strains of S. aureus, 141 (24.4%) were methicillin-resistant (MRSA). Among 97 Staphylococcus epidermidis strains, 54 (55.7%) were methicillin-resistant (MRSE). MRSA and MRSE were more frequently isolated from inpatients than from outpatients. Furthermore, these methicillin-resistant strains were also isolated more frequently from patients with histories of taking antibiotics within 4 weeks and hospitalization within 1 year compared to those without. However, there were no significant differences in MIC values and susceptibility patterns of the MRSA strains between patients with a history of hospitalization within 1 year and those without. Therefore, most of the isolated MRSA cases at dermatology departments are not healthcare-acquired, but community-acquired MRSA. S. pyogenes strains were susceptible to most antibiotics except macrolides. The information in this study is not only important in terms of local public health but will also contribute to an understanding of epidemic clones of pathogens from SSTI. Copyright © 2017 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  11. STEM Summer Academy on the Navajo Reservation

    Science.gov (United States)

    Alexander, C. J.

    2012-12-01

    The US Rosetta Project is the NASA contribution to the International Rosetta Mission, an ESA cornerstone mission to comet Churyumov-Gerasimenko. While the project's outreach efforts span multi-media, and a variety of age and ethnic groups, a special emphasis has been made to find a way to provide meaningful outreach to the reservation communities. Because language preservation is an issue of urgent concern to the reservation communities, and because Rosetta, uniquely among NASA missions, has been named after the notion that keys to missing understanding of elements of the ancient past were found in the language on the original Rosetta stone, the US Rosetta Project has embarked upon outreach with a focus on STEM vocabulary in ancient US languages of the Navajo, Hopi, Ojibwe, and other tribal communities as the project expands. NASA image and science are used and described in the native language, alongside lay English and scientific English curriculum elements. Additionally, science (geology/chemistry/botany/physics) elements drawn from the reservation environment, including geomorphology, geochemistry, soil physics, are included and discussed in the native language as much as possible — with their analogs in other planetary environments (such as Mars). In this paper we will report on the most recent Summer Science Academy [2012], a four week summer course for middle school children, created in collaboration with teachers and administrators in the Chinle Unified School District. The concept of the Academy was initiated in 2011, and the first Academy was conducted shortly thereafter, in June 2011 with 14 children, 3 instructors, and a NASA teacher workshop. The community requested three topics: geology, astronomy, and botany. The 2012 Academy built on the curriculum already developed with more robust field trips, addressed to specific science topics, additional quantitative measurements and activities, with more written material for the cultural components from

  12. Youth Problems on Indian Reservations.

    Science.gov (United States)

    Underhill, Ruth M., Ed.

    Juvenile delinquency was identified as the major problem affecting youth on Indian reservations. Causes for delinquency which were discussed included culture conflict, expectation of failure, unemployment, failure of homes and parents, discrimination, inadequate education, off-reservation schools, and alcoholism. Needs identified by tribal leaders…

  13. Can Creativity Predict Cognitive Reserve?

    Science.gov (United States)

    Palmiero, Massimiliano; Di Giacomo, Dina; Passafiume, Domenico

    2016-01-01

    Cognitive reserve relies on the ability to effectively cope with aging and brain damage by using alternate processes to approach tasks when standard approaches are no longer available. In this study, the issue if creativity can predict cognitive reserve has been explored. Forty participants (mean age: 61 years) filled out: the Cognitive Reserve…

  14. A nationwide low-level waste management system

    International Nuclear Information System (INIS)

    1985-01-01

    The National Governors' Association, in conjunction with the Department of Energy's National Low-Level Waste Management Program, invited various representatives of states, regions, and federal agencies to comment on their perceptions of what major features would constitute a nationwide low-level waste management system. Three meetings were conducted and this report summarizes results of those meetings. The Low-Level Radioactive Waste Policy Act of 1980 placed primary responsibility on the states for disposal of low-level waste. Although initial efforts of states have been directed toward establishing compacts, it is evident that a successful long term system requires significant cooperation and communication among states, regions, federal agencies, and Congress

  15. A Nationwide Census of ICU Capacity and Admissions in Mongolia

    OpenAIRE

    Mendsaikhan, Naranpurev; Begzjav, Tsolmon; Lundeg, Ganbold; Brunauer, Andreas; D?nser, Martin W.

    2016-01-01

    In Mongolia, a Central Asian lower-middle income country, intensive care medicine is an under-resourced and-developed medical specialty. The burden of critical illness and capacity of intensive care unit (ICU) services in the country is unknown. In this nationwide census, we collected data on adult and pediatric/neonatal ICU capacities and the number of ICU admissions in 2014. All hospitals registered to run an ICU service in Mongolia were surveyed. Data on the availability of an adult and/or...

  16. A nationwide study on anastomotic leakage after colonic cancer surgery

    DEFF Research Database (Denmark)

    Krarup, Peter-Martin; Jorgensen, L N; Andreasen, A H

    2012-01-01

    Aim: Anastomotic leakage (AL) is a major challenge in colorectal cancer surgery due to increased morbidity and mortality. Possible risk factors should be investigated differentially, distinguishing between rectal and colonic surgery in large-scale studies to avoid selection bias and confounding....... Method: The incidence and risk factors associated with AL were analysed in an unselected nation-wide prospective cohort of patient subjected to curative colonic cancer surgery with primary anastomosis and entered into The Danish Colorectal Cancer Group database between May 2001 and December 2008. Results...

  17. Dysejaculation after laparoscopic inguinal herniorrhaphy: a nationwide questionnaire study

    DEFF Research Database (Denmark)

    Bischoff, Joakim Mutahi; Linderoth, Gitte; Aasvang, Eske Kvanner

    2012-01-01

    BACKGROUND: Dysejaculation and pain from the groin and genitals during sexual activity represent a clinically significant problem in up to 4% of younger males after open inguinal herniorrhaphy. The aim of this questionnaire study is to assess the prevalence of dysejaculation and pain during sexual...... activity after laparoscopic inguinal herniorrhaphy on a nationwide basis. METHODS: The study population comprised all men aged 18-50 years registered in the Danish Hernia Database (n = 1,671) who underwent primary laparoscopic herniorrhaphy between January 1, 1998 and November 30, 2009. Questionnaires...

  18. Infections as risk factor for autoimmune diseases - A nationwide study

    DEFF Research Database (Denmark)

    Nielsen, Philip Rising; Kragstrup, Tue Wenzel; Deleuran, Bent Winding

    2016-01-01

    Viruses, bacteria and other infectious pathogens are the major postulated environmental triggers of autoimmunity. In the present nation-wide study we describe the association between infections and 29 autoimmune diseases. We used the Danish Civil Registration System to identify 4.5 million persons...... to the etiology of autoimmune diseases together with genetic factors....... born between 1945 and 2000. Information on infections and autoimmune diseases was obtained from the Danish Hospital Register. The cohort was followed from 1977 to 2012. Incidence rate ratios for developing an autoimmune disease were estimated using poisson regression. We found an association between...

  19. Leveraging the Power of a Community of Practice to Improve Teaching and Learning about the Earth

    Science.gov (United States)

    Kastens, Kim; Manduca, Cathryn

    2017-01-01

    Faculty Communities of Practice (CoP) have been promoted as a way to improve education in both K-12 and higher education. Over the last two decades, faculty who teach undergraduate geoscience in the United States have built a thriving nationwide community of practice, characterized by individual learning, supportive colleagues, group…

  20. A phytosociological classification of the Nylsvley Nature Reserve

    Directory of Open Access Journals (Sweden)

    B. J. Coetzee

    1976-11-01

    Full Text Available The vegetation of the Nylsvley Nature Reserve in the Transvaal Mixed Bushveld is classified hierarchically by the Braun-Blanquet Method of vegetation survey. The vegetation is seasonal grassland and deciduous savanna with four floristically distinct major groups of plant communities: (I grasslands and broad-leaved savannas on non calcareous sandy soils on elevated sandstone and felsite areas; (2 microphyllous thorn savannas on calcareous, clayey, bottomland alluvial soils and termitaria thickets; (3 grassland and thorn savanna on calcareous self-mulching vertic soils; and (4 secondary communities on long abandoned native settlements and recently ploughed land. Seven primary communities with 12 community variations and 4 subvariations, and three secondary communities are described on the basis of 216 releves. The survey was carried out at two levels of detail, an ecosystem study area in the broad-leaved savanna being surveyed in more detail, floristically and structurally, than the rest of the Reserve.

  1. A Department of Homeland Security Reserves (DHS-R): Simultaneously Protecting the Homeland While Alleviating the Increased DoD Role in Homeland Defense and Security

    National Research Council Canada - National Science Library

    Schulz, David V

    2007-01-01

    .... The Department of Homeland Security does not directly address a conceited volunteer effort; instead it provides limited support for volunteer initiatives like Citizen Corps, which can be improved by a more concerted nation-wide effort like a DHS-Reserve...

  2. Squamous cell carcinoma of the nasal vestibule 1993-2002: a nationwide retrospective study from DAHANCA

    DEFF Research Database (Denmark)

    Agger, Andreas; von Buchwald, Christian; Madsen, Anders Rørbaek

    2009-01-01

    A retrospective nationwide study of cancer of the nasal vestibule was conducted to evaluate classification systems and prognostic factors for treatment outcome.......A retrospective nationwide study of cancer of the nasal vestibule was conducted to evaluate classification systems and prognostic factors for treatment outcome....

  3. 75 FR 9277 - Proposed Information Collection (Nation-Wide Customer Satisfaction Surveys) Activity: Comment...

    Science.gov (United States)

    2010-03-01

    ... DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900-0712] Proposed Information Collection (Nation-Wide Customer Satisfaction Surveys) Activity: Comment Request AGENCY: Veterans Health Administration... use of other forms of information technology. Title: Nation-wide Customer Satisfaction Surveys, VA...

  4. 77 FR 64382 - Agency Information Collection (Nation-Wide Customer Satisfaction Surveys) Activities Under OMB...

    Science.gov (United States)

    2012-10-19

    ... DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900-0712] Agency Information Collection (Nation-Wide Customer Satisfaction Surveys) Activities Under OMB Review AGENCY: Veterans Health Administration... ``OMB Control No. 2900-0712.'' SUPPLEMENTARY INFORMATION: Title: Nation-wide Customer Satisfaction...

  5. 75 FR 25320 - Agency Information Collection (Nation-wide Customer Satisfaction Surveys) Activities Under OMB...

    Science.gov (United States)

    2010-05-07

    ... DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900-0712] Agency Information Collection (Nation-wide Customer Satisfaction Surveys) Activities Under OMB Review AGENCY: Veterans Health Administration... ``OMB Control No. 2900-0712.'' SUPPLEMENTARY INFORMATION: Title: Nation-wide Customer Satisfaction...

  6. 77 FR 2349 - Proposed Information Collection (Nation-wide Customer Satisfaction Surveys) Activity: Comment...

    Science.gov (United States)

    2012-01-17

    ... DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900-0712] Proposed Information Collection (Nation-wide Customer Satisfaction Surveys) Activity: Comment Request AGENCY: Veterans Health Administration... techniques or the use of other forms of information technology. Title: Nation-wide Customer Satisfaction...

  7. Denmark's planned nationwide warning system for fallout from nuclear accidents

    International Nuclear Information System (INIS)

    Walmod-Larsen, O.; Ryder, H.P.

    1988-01-01

    Denmark has no nuclear power plants, and has decided politically not to build any in the foreseeable future. However, within 150 km of its territory there are several plants in operation. After the Chernobyl accident, it was decided that the existing emergency plan for accidents at Sweden's Barsebaeck plant should be extended to cover the whole of Denmark, taking the above mentioned plants into consideration. Such a nation-wide emergency plan is now under preparation and is expected to be operational in 1989. Ten permanent, automatic, on-line monitoring stations are planned. The stations are required to be highly sensitive, able to detect an increase from man-made radioactivity of to 20 % of the usual natural radiation level. In case of an emergency, the ARGOS (Accident Reporting and Guiding Operational System) computer system will be connected to the central computer. ARGOS facilitates transmission, registration, evaluation and presentation of monitoring data from a large number of locations. The data are presented on color screens, prints or plots on suitable maps with the possibility of showing isocurves, population data and estimated doses. Another element in the proposed nation-wide emergency plan is the introduction of about 60 mobile radiation monitors, carried on vehicles or airborne, for use in alert situations. 1 ref., 1 fig

  8. Autoimmune hepatitis in Japan: trends in a nationwide survey.

    Science.gov (United States)

    Takahashi, Atsushi; Arinaga-Hino, Teruko; Ohira, Hiromasa; Torimura, Takuji; Zeniya, Mikio; Abe, Masanori; Yoshizawa, Kaname; Takaki, Akinobu; Suzuki, Yoshiyuki; Kang, Jong-Hon; Nakamoto, Nobuhiro; Fujisawa, Tomoo; Yonemoto, Koji; Tanaka, Atsushi; Takikawa, Hajime

    2017-05-01

    A nationwide survey of autoimmune hepatitis (AIH) patients was performed in Japan in 2015. The aims of this study were to elucidate the trends and characteristics of AIH in Japan, in addition to identifying differences in AIH between acute hepatitis and chronic hepatitis. Questionnaires about patients with AIH diagnosed from 2009 to 2013 were sent to 437 hospitals or clinics with hepatology specialists. A total of 1682 patients were enrolled. The mean age at diagnosis was 60.0 years, and 87.1 % of patients were female. Serum immunoglobulin G levels were high, peaking at 1.5-2.0 g/dL. Histological diagnoses of chronic hepatitis, acute hepatitis, and cirrhosis were seen in 79.6, 11.7, and 6.7 % of patients respectively. In addition to elevation of aminotransferase levels, the frequencies of emperipolesis and human leukocyte antigen (HLA)-DR2 positivity were higher in patients with acute hepatitis than in those with chronic hepatitis. Approximately 80 % of patients were treated with corticosteroids, and in 97.7 % of them, their condition improved. Steroid pulse therapy was more frequently given to patients with acute hepatitis than to those with chronic hepatitis. In the present nationwide survey of AIH patients in Japan, patients with acute hepatitis had clinical features different from those of patients with chronic hepatitis.

  9. Low cost satellite land mobile service for nationwide applications

    Science.gov (United States)

    Weiss, J. A.

    1978-01-01

    A satellite land mobile system using mobile radios in the UHF band, and Ku-band Communications Routing Terminals (earth stations) for a nationwide connection from any mobile location to any fixed or mobile location, and from any fixed location to any mobile location is proposed. The proposed nationwide satellite land mobile service provides: telephone network quality (1 out of 100 blockage) service, complete privacy for all the users, operation similar to the telephone network, alternatives for data services up to 32 Kbps data rates, and a cost effective and practical mobile radio compatible with system sizes ranging from 10,000 to 1,000,000 users. Seven satellite alternatives (ranging from 30 ft diameter dual beam antenna to 210 ft diameter 77 beam antenna) along with mobile radios having a sensitivity figure of merit (G/T) of -15 dB/deg K are considered. Optimized mobile radio user costs are presented as a function of the number of users with the satellite and mobile radio alternatives as system parameters.

  10. Nationwide trends in the surgical management of lumbar spinal stenosis.

    Science.gov (United States)

    Bae, Hyun W; Rajaee, Sean S; Kanim, Linda E

    2013-05-15

    Retrospective analysis using national administrative data. This study presents US nationwide trends in the surgical management of patients with lumbar spinal stenosis (LSS) with and without coexisting spondylolisthesis and scoliosis from 2004 to 2009. Lack of consensus and wide variability exists in surgical decision making for patients with LSS. Data were obtained from the Nationwide Inpatient Sample, a database developed as part of the Healthcare Cost and Utilization Project. All discharged patients with a primary diagnosis of LSS were identified. Three subgroups were studied: (1) LSS alone, (2) LSS with spondylolisthesis, and (3) LSS with scoliosis. Surgical treatment was divided into 3 groups: (1) decompression only (laminectomy, discectomy), (2) simple fusion (1-2 disc levels, single approach), and (3) complex fusion (>2 disc levels or a combined posterior and anterior approach). Between 2004 and 2009, national estimates for the annual number of discharged inpatients with a primary diagnosis of LSS increased from 94,011 (population rate, [the age adjusted population rate per 100,000] 32.1) to 102,107 (population rate, 33.3). The rate of decompressions decreased from 58.5% to 49.2% for discharged patients with LSS from 2004 to 2009 (P spondylolisthesis and 67.6% of patients with coexisting scoliosis underwent a fusion procedure. This study demonstrates that the rate of simple fusion surgery has increased for treatment of LSS compared with decompression only. 4.

  11. Estimating Foreign Exchange Reserve Adequacy

    Directory of Open Access Journals (Sweden)

    Abdul Hakim

    2013-04-01

    Full Text Available Accumulating foreign exchange reserves, despite their cost and their impacts on other macroeconomics variables, provides some benefits. This paper models such foreign exchange reserves. To measure the adequacy of foreign exchange reserves for import, it uses total reserves-to-import ratio (TRM. The chosen independent variables are gross domestic product growth, exchange rates, opportunity cost, and a dummy variable separating the pre and post 1997 Asian financial crisis. To estimate the risky TRM value, this paper uses conditional Value-at-Risk (VaR, with the help of Glosten-Jagannathan-Runkle (GJR model to estimate the conditional volatility. The results suggest that all independent variables significantly influence TRM. They also suggest that the short and long run volatilities are evident, with the additional evidence of asymmetric effects of negative and positive past shocks. The VaR, which are calculated assuming both normal and t distributions, provide similar results, namely violations in 2005 and 2008.

  12. Cognitive Reserve Scale and ageing

    Directory of Open Access Journals (Sweden)

    Irene León

    2016-01-01

    Full Text Available The construct of cognitive reserve attempts to explain why some individuals with brain impairment, and some people during normal ageing, can solve cognitive tasks better than expected. This study aimed to estimate cognitive reserve in a healthy sample of people aged 65 years and over, with special attention to its influence on cognitive performance. For this purpose, it used the Cognitive Reserve Scale (CRS and a neuropsychological battery that included tests of attention and memory. The results revealed that women obtained higher total CRS raw scores than men. Moreover, the CRS predicted the learning curve, short-term and long-term memory, but not attentional and working memory performance. Thus, the CRS offers a new proxy of cognitive reserve based on cognitively stimulating activities performed by healthy elderly people. Following an active lifestyle throughout life was associated with better intellectual performance and positive effects on relevant aspects of quality of life.

  13. Fractional Reserve Banking: Some Quibbles

    OpenAIRE

    Bagus, Philipp; Howden, David

    2010-01-01

    We explore several unaddressed issues in George Selgin’s (1988) claim that the best monetary system to maintain monetary equilibrium is a fractional reserve free banking one. The claim that adverse clearing balances would limit credit expansion in a fractional reserve free banking system is more troublesome than previously reckoned. Both lengthened clearing periods and interbank agreements render credit expansion unrestrained. “The theory of free banking” confuses increases in money held with...

  14. Reserve Retirement Equality: Treating Reserves Fairly While Saving Taxpayer Dollars

    Science.gov (United States)

    2010-06-09

    rata .121 For example, a Reserve who performs the equivalent of five years of active duty, will receive one-fourth the retired pay of his active duty...4,225 per month.124 But because reserve-retirement benefits are based on pro rata years of service, this officer’s years of service for retirement...purposes are 3,146 retirement points divided by 360.125 This results in 8.74 years pro rata years of service.126 His retirement benefits thus are

  15. Demand as frequency controlled reserve

    Energy Technology Data Exchange (ETDEWEB)

    Xu, Z.; Togeby, M.; OEstergaard, J.

    2008-09-15

    Using demand as frequency controlled reserve (DFR) is an emerging technology which allow demand to participate actively in maintaining the system operation without reducing the energy service delivered to the customer and without need of user interaction. The basic premise is that traditional frequency controlled reserves from power plants and interconnections with neighbouring systems can be costly, slow and not fulfil the need for future power grids with a high share of wind power and fewer central power plants, and an intention to perform flexible operation such as is landing. Electricity demands, on the other hand, have advantages as frequency reserve including fast activation speed, smooth linear activation, low expected costs, and well-dispersed in the distribution grid. The main challenge of DFR is new methods for monitoring the available capacity. This project has investigated the technology of using electricity demands for providing frequency reserve to power systems. Within the project the potential and economy of DFR compatible loads in Denmark has been investigated, control logic has been designed, power system impact has been investigated, potential business models has been evaluated and an implementation strategy has been suggested. The tasks and goals of the project have been successfully accomplished based on which the conclusion and future recommendation are made. This project has developed the DFR technology that enables electricity demands to autonomously disconnect or reconnect to the grid in response to system frequency variations. The developed DFR technology is proved to be a promising technology from several perspectives. Technically, using DFR is feasible to provide reserves and enhance power system frequency control, while fulfilling technical requirements such as linear activation (or reconnection) according to frequency (or time). Environmentally, the DFR technology is pollution free in contrast to traditional reserves from generation

  16. Improved Effectiveness of Reserve Forces During Reserve Duty Training.

    Science.gov (United States)

    Treadaway, Harry H.

    The problem areas of motivation, job enrichment, recruiting, and retention are addressed from the viewpoint of the behavioral scientist. Special attention is given to relating job enrichment and motivation techniques, as successfully demonstrated in industry, to the United State Army Reserve. Research method utilized was a literature review…

  17. Spinning Reserve From Responsive Loads

    Energy Technology Data Exchange (ETDEWEB)

    Kirby, B.J.

    2003-04-08

    Responsive load is the most underutilized reliability resource available to the power system today. It is currently not used at all to provide spinning reserve. Historically there were good reasons for this, but recent technological advances in communications and controls have provided new capabilities and eliminated many of the old obstacles. North American Electric Reliability Council (NERC), Federal Energy Regulatory Commission (FERC), Northeast Power Coordinating Council (NPCC), New York State Reliability Council (NYSRC), and New York Independent System Operator (NYISO) rules are beginning to recognize these changes and are starting to encourage responsive load provision of reliability services. The Carrier ComfortChoice responsive thermostats provide an example of these technological advances. This is a technology aimed at reducing summer peak demand through central control of residential and small commercial air-conditioning loads. It is being utilized by Long Island Power Authority (LIPA), Consolidated Edison (ConEd), Southern California Edison (SCE), and San Diego Gas and Electric (SDG&E). The technology is capable of delivering even greater response in the faster spinning reserve time frame (while still providing peak reduction). Analysis of demand reduction testing results from LIPA during the summer of 2002 provides evidence to back up this claim. It also demonstrates that loads are different from generators and that the conventional wisdom, which advocates for starting with large loads as better ancillary service providers, is flawed. The tempting approach of incrementally adapting ancillary service requirements, which were established when generators were the only available resources, will not work. While it is easier for most generators to provide replacement power and non-spinning reserve (the slower response services) than it is to supply spinning reserve (the fastest service), the opposite is true for many loads. Also, there is more financial

  18. Cerebral correlates of cognitive reserve.

    Science.gov (United States)

    Whalley, Lawrence J; Staff, Roger T; Fox, Helen C; Murray, Alison D

    2016-01-30

    Cognitive reserve is a hypothetical concept introduced to explain discrepancies between severity of clinical dementia syndromes and the extent of dementia pathology. We examined cognitive reserve in a research programme that followed up a non-clinical sample born in 1921 or 1936 and IQ-tested age 11 years in 1932 or 1947. Structural MRI exams were acquired in about 50% of the sample from whom a subsample were recruited into an additional fMRI study. Here, we summarise findings from seven inter-related studies. These support an understanding of cognitive reserve as a balance between positive life course activity-driven experiences and the negative effects of brain pathologies including cerebrovascular disease and total and regional brain volume loss. Hypothesised structural equation models illustrate the relative causal effects of these positive and negative contributions. Cognitive reserve is considered in the context of choice of interventions to prevent dementia and the opposing effects of cerebrovascular disease and Alzheimer like brain appearances. Crown Copyright © 2015. Published by Elsevier Ireland Ltd. All rights reserved.

  19. Extractive reserves in Brazilian Amazonia

    Energy Technology Data Exchange (ETDEWEB)

    Fearnside, P.M (National Institute for Research in the Amazon, Manaus-Amazonas (Brazil))

    1989-06-01

    In 1985 an opportunity arose for maintaining tracts of Amazonian forest under sustainable use. Brazil's National Council of Rubber Tappers and the Rural Worker's Union proposed the creation of a set of reserves of a new type, called extractive reserves. The first six are being established in one of the Brazilian states most threatened by deforestatation. The creation of extractive reserves grants legal protection to forest land traditionally used by rubber tappers, Brazil-nut gatherers, and other extractivists. The term extrativismo (extractivism) in Brazil refers to removing nontimber forest products, such as latex, resins, and nuts, without felling the trees. Approximately 30 products are collected for commercial sale. Many more types of forest materials are gathered, for example as food and medicines, for the extractivists' own use. The reserve proposal is attractive for several reasons related to social problems. It allows the rubber tappers to continue their livelihood rather than be expelled by deforestation. However, it is unlikely that sufficient land will be set aside as extractive reserves to employ all the tappers. Displaced rubber tappers already swell the ranks of urban slum dwellers in Brazil's Amazonian cities, and they have become refugees to continue their profession in the forests of neighboring countries, such as Bolivia.

  20. Is atmospheric pollution exposure during pregnancy associated with individual and contextual characteristics? A nationwide study in France.

    Science.gov (United States)

    Ouidir, Marion; Lepeule, Johanna; Siroux, Valérie; Malherbe, Laure; Meleux, Frederik; Rivière, Emmanuel; Launay, Ludivine; Zaros, Cécile; Cheminat, Marie; Charles, Marie-Aline; Slama, Rémy

    2017-10-01

    Exposure to atmospheric pollutants is a danger for the health of pregnant mother and children. Our objective was to identify individual (socioeconomic and behavioural) and contextual factors associated with atmospheric pollution pregnancy exposure at the nationwide level. Among 14 921 women from the French nationwide ELFE (French Longitudinal Study of Children) mother-child cohort recruited in 2011, outdoor exposure levels of PM 2.5 , PM 10 (particulate matter pollutants with individual (maternal age, body mass index, parity, education level, relationship status, smoking status) and contextual (European Deprivation Index, urbanisation level) factors. Patterns of associations were globally similar across pollutants. For the CART approach, the highest tertile of exposure included mainly women not in a relationship living in urban and socially deprived areas, with lower education level. Linear regression models identified different determinants of atmospheric pollutants exposure according to the residential urbanisation level. In urban areas, atmospheric pollutants exposure increased with social deprivation, while in rural areas a U-shaped relationship was observed. We highlighted social inequalities in atmospheric pollutants exposure according to contextual characteristics such as urbanisation level and social deprivation and also according to individual characteristics such as education, being in a relationship and smoking status. In French urban areas, pregnant women from the most deprived neighbourhoods were those most exposed to health-threatening atmospheric pollutants. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  1. Predictors of travel-related hepatitis A and B among native adult Danes: a nationwide case-control study.

    Science.gov (United States)

    Nielsen, Ulla Schierup; Thomsen, Reimar Wernich; Cowan, Susan; Larsen, Carsten Schade; Petersen, Eskild

    2012-04-01

    To assess journey length and other predictors of travel-related acute hepatitis A (HAV) and B (HBV) virus infection among native Danes and determine the sensitivity and specificity of current pre-travel vaccination guidelines. A nationwide case-control study was perfomed involving 60 Danes with HAV and 14 with HBV who acquired hepatitis in non-western countries from 2000 to 2010. Non-immune travellers from a nationwide survey (1188 HAV and 1709 HBV) served as controls. The odds ratios (ORs) for HAV and HBV increased with increasing journey length (p<0.0001). However, 90% of HAV and 62% of HBV cases travelled for less than 4 weeks, and the daily infection rate did not increase with journey length; rather, for HAV it decreased. Increasing age (p<0.0001) and journeys to Africa (OR 6.1 (3.2-11)) raised the risk of acute HAV. Travelling alone or with friends as compared to travelling with a partner/family (OR: 15 (3.2-134)) strongly predicted HBV risk. Danish vaccination guidelines had HAV/HBV sensitivities of 86%/31%, and specificities of 27%/95%, respectively. Incidence rates were 12.8 (HAV) and 10.2 (HBV) per 100,000 non-immune travel months, and acute disease severity affected HAV and HBV cases equally. These results may support revision of current pre-travel vaccination guidelines. Copyright © 2011 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

  2. Hydrocarbon Reserves: Abundance or Scarcity

    International Nuclear Information System (INIS)

    2005-01-01

    IFP and the OAPEC jointly organize a regular international seminar dealing with world oil-related problems appearing in the news. For the first time, this seminar has been opened to oil and gas company specialists, service companies, research centers and independents. This year's theme concerns oil and gas reserves: are they abundant or are we headed towards the shortages announced by some experts? This theme is especially topical in that: oil and gas currently meet two thirds of world energy needs and almost completely dominate the transport sector; the reserves declared by the OAPEC countries account for nearly half of world reserves; the price of a barrel of oil went through the roof in 2004; world energy demand is growing fast and alternative sources of energy are far from ready to take over from oil and gas in the next few decades. Since the reserves correspond to the volume it is technically and economically viable to produce, the seminar has, of course, dealt with the technical and economic questions that arise in connection with exploration and production, but it has also considered changes in the geopolitical context. Presentations by the leading companies of the OAPEC countries and by the IFP group were completed by presentation from the International Energy Agency (IEA), the United States Geological Survey (USGS), the IHS Energy Group, Total and Gaz de France. This document gathers the transparencies of the following presentations: Hydrocarbon reserves in OAPEC members countries: current and future (M. Al-Lababidi); Non OAPEC liquid reserves and production forecasts (Y. Mathieu); World oil and gas resources and production outlook (K. Chew); Global investments in the upstream (F. Birol); Total's policy in the oil and gas sector (C. de Margerie); Gaz de France's policy in the oil and gas sector (J. Abiteboul); NOC/IOC's opportunities in OPEC countries (I. Sandrea); Relationships between companies, countries and investors: How they may impact on the growth

  3. Hydrocarbon Reserves: Abundance or Scarcity

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2005-07-01

    IFP and the OAPEC jointly organize a regular international seminar dealing with world oil-related problems appearing in the news. For the first time, this seminar has been opened to oil and gas company specialists, service companies, research centers and independents. This year's theme concerns oil and gas reserves: are they abundant or are we headed towards the shortages announced by some experts? This theme is especially topical in that: oil and gas currently meet two thirds of world energy needs and almost completely dominate the transport sector; the reserves declared by the OAPEC countries account for nearly half of world reserves; the price of a barrel of oil went through the roof in 2004; world energy demand is growing fast and alternative sources of energy are far from ready to take over from oil and gas in the next few decades. Since the reserves correspond to the volume it is technically and economically viable to produce, the seminar has, of course, dealt with the technical and economic questions that arise in connection with exploration and production, but it has also considered changes in the geopolitical context. Presentations by the leading companies of the OAPEC countries and by the IFP group were completed by presentation from the International Energy Agency (IEA), the United States Geological Survey (USGS), the IHS Energy Group, Total and Gaz de France. This document gathers the transparencies of the following presentations: Hydrocarbon reserves in OAPEC members countries: current and future (M. Al-Lababidi); Non OAPEC liquid reserves and production forecasts (Y. Mathieu); World oil and gas resources and production outlook (K. Chew); Global investments in the upstream (F. Birol); Total's policy in the oil and gas sector (C. de Margerie); Gaz de France's policy in the oil and gas sector (J. Abiteboul); NOC/IOC's opportunities in OPEC countries (I. Sandrea); Relationships between companies, countries and investors: How they may

  4. Patterns of maternal tobacco use among Cambodian women: findings from a nationwide sample.

    Science.gov (United States)

    Singh, Pramil N; Kheam, They; Lopez, Jaime; Job, Jayakaran S; Yel, Daravuth

    2013-09-01

    Although current trends indicate that the rate of cigarette smoking tends to be low among women in the Western Pacific Region (Malaysia) identify that a large proportion of women of reproductive age and older chew tobacco--often as part of a betel quid mixture that includes other potentially harmful ingredients (eg, areca nut). Our findings from currently pregnant women identified during a nationwide survey of adult tobacco use in Cambodia indicate that 13.0% (95% confidence interval [CI] = 8% to 17%) were current users of smoked or smokeless (in the form of a betel quid) tobacco. Most pregnant women who used tobacco indicated that their habit was either initiated (29.1%; 95% CI = 16.3-46.3) or increased (33.7%; 95% CI = 18.3-53.5) during pregnancy. Pregnancy-related symptoms such as morning sickness were reported as the reason for more than half (54.9%; 95% CI = 34.8-73.4) of the currently pregnant users to have started a tobacco habit during their lifetime. Among those pregnant women who did not use tobacco, we found strong associations (odds ratios from 2 to 14) with beliefs about the harmful effects of tobacco on adult health, faith-based beliefs in addictive substances, and beliefs that influential members of the community, health professionals, and children should not use tobacco. Our findings indicate that tobacco cessation and prevention programs in Cambodia should specifically target pregnant and reproductive-age women.

  5. Bacterial Meningitis in Patients using Immunosuppressive Medication: a Population-based Prospective Nationwide Study.

    Science.gov (United States)

    van Veen, Kiril E B; Brouwer, Matthijs C; van der Ende, Arie; van de Beek, Diederik

    2017-06-01

    We studied occurrence, presentation, disease course, effect of adjunctive dexamethasone, and prognosis of bacterial meningitis in patients using immunosuppressive medication. Patients were selected from our nationwide, prospective cohort on community-acquired bacterial meningitis performed from March 1, 2006 through October 31, 2014. Eighty-seven of 1447 episodes (6 %) of bacterial meningitis occurred in patients using immunosuppressive medication, and consisted of corticosteroids in 82 %. Patients with bacterial meningitis using immunosuppressive medication were less likely to present with headache (P = 0.02) or neck stiffness (P = 0.005), as compared those not on immunosuppressive medication. In 46 % of episodes CSF leukocyte count was below 1000/mm 3 . CSF cultures revealed S. pneumoniae in 41 % and L. monocytogenes in 40 % of episodes. Outcome was unfavorable in 39 of 87 episodes (45 %) and death occurred in 22 of 87 episodes (25 %). Adjunctive dexamethasone was administered in 52 of 87 (60 %) episodes, and mortality tended to be lower in those on adjunctive dexamethasone therapy as compared to those without dexamethasone therapy (10 of 52 [19 %] vs 12 of 35 [34 %], P = 0.14). We conclude that bacterial meningitis in patients using immunosuppressive medication is likely to present with atypical clinical and laboratory features, and is often caused by atypical bacteria, mainly L. monocytogenes. Adjunctive dexamethasone is widely prescribed in these patients and was not associated with harm in this study.

  6. Cranial CT, Lumbar Puncture, and Clinical Deterioration in Bacterial Meningitis: A Nationwide Cohort Study.

    Science.gov (United States)

    Costerus, Joost M; Brouwer, Matthijs C; Sprengers, Marieke E S; Roosendaal, Stefan D; van der Ende, Arie; van de Beek, Diederik

    2018-03-07

    It is unclear how often lumbar puncture (LP) is complicated by cerebral herniation in patients with bacterial meningitis and whether cranial CT can be used to identify patients at risk for herniation. We performed a nationwide prospective cohort study of patients with community-acquired bacterial meningitis from 2006 to 2014 and identified patients with clinical deterioration possibly caused by LP. For systematic evaluation of contraindications for LP on cranial CT, these patients were matched to patients in the cohort without deterioration. Four experts, blinded for outcome, scored cranial CT results for contraindications for LP. A Fleiss' generalized Kappa for this assessment was determined. Of 1533 episodes, 47 (3.1%) had deterioration possibly caused by LP. Two patients deteriorated within 1 hour after LP (0.1%). In 43 of 47 patients with deterioration cranial CT was performed prior to LP, so CT results were matched with 43 patients without deterioration. The interrater reliability of assessment of contraindications for LP on cranial CT was moderate (Fleiss' generalized Kappa 0.47). A contraindication for LP was reported by all 4 raters in 6 patients with deterioration (14%) and in 5 without deterioration (11%). LP can be performed safely in the large majority of patients with bacterial meningitis, as it is only very rarely complicated by cerebral herniation. Cranial CT can be considered a screening method for contraindications for LP, but the interrater reliability of this assessment is moderate.

  7. Internet use in radiology: results of a nationwide survey

    International Nuclear Information System (INIS)

    Vorbeck, F.; Zimmermann, C.; Vorbeck-Meister, I.; Kainberger, F.; Imhof, H.

    1999-01-01

    Purpose: To determine the number of radiologists who currently have Internet access, their use patterns on the Internet for Radiology purposes, the web sites they would recommend, and the potential site access to the Internet that they would like to see in the future. In addition, this study analyzed the best way to find nationwide radiological sites and their content. Materials and Methods: In a nationwide survey, 854 Austrian radiologist were asked to fill out and return a questionnaire about Internet access, current problems, current and future use, which web site they recommend, and about the use of e-mail. Next, the available nationwide radiological sites were searched with seven major search engines using 37 different keywords, as well as by category search, and by searching for links on the homepages of the radiological departments of all Universities of Austria. Then, the offered information of the founded pages was classified in categories. Results: Of the 210 (24.6%) radiologists who returned the questionnaire, 154 (73%) had Internet access. Time expenditure was considered the main problem using the Internet. The Internet was used for literature research by 69% of the radiologists with Internet access, for e-mail by 60%, and for congress information by 57%. In future, 43% would like to read electronic journals more often and 39% would like to use the web more intensively for scientific congresses. At the present time, we found 17 radiological web sites in Austria. The most promising way to find these sites was to use the search engines Alta Vista and Hotbot. Fifteen (88%) sites offered information for patients, seven (41%) for radiologists, five (29%) for students, and four (24%) for researchers. Summary: Many radiologists in Austria already have Internet access, although time expenditure was considered the main problem with Internet use. Survey responses showed a need for electronic journals. To our point of view, Universities and radiological societies

  8. Demand as Frequency Controlled Reserve

    DEFF Research Database (Denmark)

    Xu, Zhao; Østergaard, Jacob; Togeby, Mikael

    2011-01-01

    Relying on generation side alone is deemed insufficient to fulfill the system balancing needs for future Danish power system, where a 50% wind penetration is outlined by the government for year 2025. This paper investigates using the electricity demand as frequency controlled reserve (DFR) as a new...... balancing measure, which has a high potential and can provide many advantages. Firstly, the background of the research is reviewed, including conventional power system reserves and the electricity demand side potentials. Subsequently, the control logics and corresponding design considerations for the DFR...

  9. Napping and associated factors: a Japanese nationwide general population survey.

    Science.gov (United States)

    Furihata, Ryuji; Kaneita, Yoshitaka; Jike, Maki; Ohida, Takashi; Uchiyama, Makoto

    2016-04-01

    The objective of this study was to investigate napping habits and their associated factors in the Japanese adult general population. The cross-sectional survey was conducted in November 2007 for subjects selected randomly from among 300 districts throughout Japan. Data from 7664 people (3527 men and 4137 women), aged 20-99 years, were analyzed. Participants completed a self-administered questionnaire on frequency and duration of napping. The percentage of responders for high-frequency napping, four or more days per week, was 21.2% among men and 17.1% among women. The percentage of responders for long-duration napping, 2 h or more per one nap, was 2.9% among men and 2.6% among women. Multivariate logistic regression analyses revealed that men, older age, smoking, insomnia symptoms, long sleep duration, excessive daytime sleepiness, and having sufficient rest obtained by sleep were positively associated with high-frequency napping, whereas alcohol drinking showed a negative association. Older age was negatively associated with long-duration napping whereas living in a large community, smoking, long sleep duration, excessive daytime sleepiness, and psychological stress showed a positive association. These findings provide important data for future studies aimed at improvement of sleep habits. Copyright © 2016 Elsevier B.V. All rights reserved.

  10. Unintentional injury mortality among indigenous communities of Taiwan: trends from 2002 to 2013 and evaluation of a community-based intervention.

    Science.gov (United States)

    Pan, Stephen W; Chong, Hiu Ha; Kao, Hui-Chuan

    2017-11-27

    Indigenous communities in Taiwan shoulder a disproportionate burden of unintentional injury fatalities. We compare unintentional injury mortality rate trends among Taiwan's indigenous communities and the general population from 2002 to 2013, and evaluate potential impact of a community-based injury prevention programme on indigenous unintentional injury death rates. Standardised and crude unintentional injury mortality rates were obtained from Taiwan government reports. Segmented linear regression was used to estimate and compare unintentional injury mortality rate trends before and after the intervention. Between 2002 and 2013, unintentional injury mortality rates among Taiwan's indigenous population significantly declined by about 4.5 deaths per 100 000 each year (pindigenous Taiwanese and the general population significantly decreased by approximately 1% each successive year (p=0.02). However, we were unable to detect evidence that the 'Healthy and Safe Tribe' programme was associated with a statistically significant decrease in the unintentional injury mortality rate trend among indigenous persons (p=0.81). Taiwanese indigenous communities remain at significantly higher risk of unintentional injury death, though the gap may be slowly narrowing. We found no evidence that the 'Healthy and Safe Tribe' indigenous injury-prevention programme significantly contributed to the nationwide decline in unintentional injury mortality among indigenous Taiwanese communities from 2009 to 2013. Future interventions to address the disproportionate burden of unintentional injury fatalities among indigenous Taiwanese should consider interventions with wider coverage of the indigenous population, and complementing grass roots led community-based interventions with structural policy interventions as well. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise

  11. 77 FR 40253 - Reserve Account

    Science.gov (United States)

    2012-07-09

    .... The commentators represented Rural Development employees who work with the Multi-Family Housing Direct... their annual over-inflated tax bills and assessments. As a result, rent income funding that could be..., as rents cannot be raised to an amount that will cover all current and future reserve expenses...

  12. Demand as Frequency Controlled Reserve

    DEFF Research Database (Denmark)

    Xu, Zhao; Togeby, Mikael; Østergaard, Jacob

    This report summaries the research outcomes of the project ‘Demand as Frequency Controlled Reserve (DFR)’, which has received the support from Energinet.dk’s PSO program, Grant no. 2005-2-6380. The objective of this project is to investigate the technology of using electricity demands for providing...

  13. Nationwide reduction in the frequency of severe hypoglycemia by half

    DEFF Research Database (Denmark)

    Fredheim, S.; Johansen, A.; Thorsen, S. U.

    2015-01-01

    -years. The incidence rate peaked with 16.0 per 100 person-years in 2008 reaching a nadir of 4.9 in 2011. Overall, insulin pump reduced the rate of SH with 27 % compared to any pen treatment (P = 0.003). When stratifying pen treatment, premixed insulin increased the rate of SH by 1.9-fold (P = 0.0015) and NPH increased...... the rate by 1.6-fold (P = 0.003) versus pump treatment, whereas long-acting insulin analogues were comparable with pump treatment (P = 0.1485). We found no association of SH with glycemic control (P > 0.05). Conclusions: A nationwide halving in rates of severe hypoglycemia was observed during the study...

  14. Ambulatory Care Visits to Pediatricians in Taiwan: A Nationwide Analysis.

    Science.gov (United States)

    Yang, Ling-Yu; Lynn, An-Min; Chen, Tzeng-Ji

    2015-11-02

    Pediatricians play a key role in the healthy development of children. Nevertheless, the practice patterns of pediatricians have seldom been investigated. The current study analyzed the nationwide profiles of ambulatory visits to pediatricians in Taiwan, using the National Health Insurance Research Database. From a dataset that was randomly sampled one out of every 500 records among a total of 309,880,000 visits in 2012 in the country, 9.8% (n = 60,717) of the visits were found paid to pediatricians. Children and adolescents accounted for only 69.3% of the visits to pediatricians. Male pediatricians provided 80.5% of the services and the main workforces were those aged 40-49 years. The most frequent diagnoses were respiratory tract diseases (64.7%) and anti-histamine agents were prescribed in 48.8% of the visits to pediatricians. Our detailed results could contribute to evidence-based discussions on health policymaking.

  15. Ambulatory Care Visits to Pediatricians in Taiwan: A Nationwide Analysis

    Directory of Open Access Journals (Sweden)

    Ling-Yu Yang

    2015-11-01

    Full Text Available Pediatricians play a key role in the healthy development of children. Nevertheless, the practice patterns of pediatricians have seldom been investigated. The current study analyzed the nationwide profiles of ambulatory visits to pediatricians in Taiwan, using the National Health Insurance Research Database. From a dataset that was randomly sampled one out of every 500 records among a total of 309,880,000 visits in 2012 in the country, 9.8% (n = 60,717 of the visits were found paid to pediatricians. Children and adolescents accounted for only 69.3% of the visits to pediatricians. Male pediatricians provided 80.5% of the services and the main workforces were those aged 40–49 years. The most frequent diagnoses were respiratory tract diseases (64.7% and anti-histamine agents were prescribed in 48.8% of the visits to pediatricians. Our detailed results could contribute to evidence-based discussions on health policymaking.

  16. Acceptable nationwide outcome after paediatric inguinal hernia repair

    DEFF Research Database (Denmark)

    Bisgaard, Thue; Kehlet, H; Oehlenschlager, J

    2014-01-01

    PURPOSE: The primary objective was to describe 30-day outcomes after primary inguinal paediatric hernia repair. METHODS: Prospectively collected data from the National Patient Registry covering a 2-year study period 1 January 2005 to 31 December 2006 were collected. Unexpected outcomes were defined...... was not associated with the inguinal hernia repair. The usual technique was a simple sutured plasty (96.5 %). Emergency repair was performed in 54 patients (2.2 %) mainly in children between 0 and 2 years (79.6 %). During the 1 year follow-up, reoperation for recurrent inguinal hernia was performed in 8 children...... after elective repair (recurrence rate 0.3 %). Paediatric repairs were for most parts performed in surgical public hospitals, and most departments performed less than 10 inguinal hernia repairs within the 2 years study period. CONCLUSION: These nationwide results are acceptable with low numbers...

  17. Familial aggregation of congenital hydrocephalus in a nationwide cohort

    DEFF Research Database (Denmark)

    Munch, Tina Nørgaard; Rostgaard, Klaus; Rasmussen, Marie-Louise Hee

    2012-01-01

    The objective of the study was to investigate familial aggregation of primary congenital hydrocephalus in an unselected, nationwide population. Based on the Danish Central Person Register, we identified all children born in Denmark between 1978 and 2008 and their family members (up to third......-degree relatives). Information on primary congenital hydrocephalus was obtained from the National Patient Discharge Register. Using binomial log-linear regression, we estimated recurrence risk ratios of congenital hydrocephalus. An alternative log-linear regression model was applied to quantify the genetic effect...... and the maternal effect. Of 1 928 683 live-born children, 2194 had a diagnosis of idiopathic congenital hydrocephalus (1.1/1000). Of those, 75 (3.4%) had at least one other family member with primary congenital hydrocephalus. Significantly increased recurrence risk ratios of primary congenital hydrocephalus were...

  18. Aortic events in a nationwide Marfan syndrome cohort.

    Science.gov (United States)

    Groth, Kristian A; Stochholm, Kirstine; Hove, Hanne; Kyhl, Kasper; Gregersen, Pernille A; Vejlstrup, Niels; Østergaard, John R; Gravholt, Claus H; Andersen, Niels H

    2017-02-01

    Marfan syndrome is associated with morbidity and mortality due to aortic dilatation and dissection. Preventive aortic root replacement has been the standard treatment in Marfan syndrome patients with aortic dilatation. In this study, we present aortic event data from a nationwide Marfan syndrome cohort. The nationwide cohort of Danish Marfan syndrome patients was established from the Danish National Patient Registry and the Cause of Death Register, where we retrieved information about aortic surgery and dissections. We associated aortic events with age, sex, and Marfan syndrome diagnosis prior or after the first aortic event. From the total cohort of 412 patients, 150 (36.4 %) had an aortic event. Fifty percent were event free at age 49.6. Eighty patients (53.3 %) had prophylactic surgery and seventy patients (46.7 %) a dissection. The yearly event rate was 0.02 events/year/patient in the period 1994-2014. Male patients had a significant higher risk of an aortic event at a younger age with a hazard ratio of 1.75 (CI 1.26-2.42, p = 0.001) compared with women. Fifty-three patients (12.9 %) were diagnosed with MFS after their first aortic event which primarily was aortic dissection [n = 44 (83.0 %)]. More than a third of MFS patients experienced an aortic event and male patients had significantly more aortic events than females. More than half of the total number of dissections was in patients undiagnosed with MFS at the time of their event. This emphasizes that diagnosing MFS is lifesaving and improves mortality risk by reducing the risk of aorta dissection.

  19. Anger and Impulsivity Among Japanese Adolescents: A Nationwide Representative Survey.

    Science.gov (United States)

    Itani, Osamu; Kaneita, Yoshitaka; Munezawa, Takeshi; Ikeda, Maki; Osaki, Yoneatsu; Higuchi, Susumu; Kanda, Hideyuki; Nakagome, Sachi; Suzuki, Kenji; Ohida, Takashi

    2016-07-01

    This study aimed to clarify the prevalence of anger and impulsivity and its associated factors through a nationwide survey of junior and senior high school adolescent students in Japan. A self-administered questionnaire covering (1) personal data, (2) lifestyle, (3) mental health status, and (4) feelings of anger and impulsivity was distributed to junior and senior high school students in Japan. Among the total of 10,955 junior high schools and 5,115 senior high schools nationwide, 130 and 110 were randomly selected, respectively. Of those, 92 junior and 80 senior high schools participated in the survey. The survey period was from December 2008 to the end of January 2009. A total of 95,680 questionnaires were collected. After excluding invalid responses, the remaining 94,777 responses (response rate: 62.3%) were analyzed. From the questions regarding anger and impulsivity, 8.7% (95% CI, 8.5%-8.9%) and 7.5% (95% CI, 7.3%-7.7%) of the participants were considered to have experienced intense anger and impulsivity, respectively. Logistic regression analysis indicated that the odds ratios for experiencing intense feelings of anger were significantly higher (all P values breakfast, did not wish to go to university, had short sleep duration, had decreased positive feelings, had increased depressive feelings, or used mobile phones for longer hours. The odds ratios for experiencing intense impulsivity were significantly higher among students who smoked, consumed alcohol, skipped breakfast, did not participate in club activities, had short sleep duration, had decreased positive feelings, had increased depressive feelings, or used mobile phones for longer hours. The results suggest that healthy lifestyle habits, good sleep habits, and improved mental health are important for preventing intense feelings of anger and impulsivity among adolescents. © Copyright 2016 Physicians Postgraduate Press, Inc.

  20. Farming and incidence of motor neuron disease: French nationwide study.

    Science.gov (United States)

    Kab, S; Moisan, F; Elbaz, A

    2017-09-01

    The association of farming with motor neuron disease (MND) is unclear, with conflicting studies. We performed a French nationwide study of the association of farming with MND incidence, and compared findings with those for Parkinson's disease (PD), which has been shown to be more frequent in farmers. We used the French national health insurance and hospital discharge databases to identify MND/PD incident cases. The Mutualité Sociale Agricole (MSA) guarantees health insurance for farmers and agricultural workers. We compared the incidence of MND (2010-2014) and PD (2011-2012) in MSA farmers, MSA workers and non-MSA affiliates, and estimated relative risks (RRs) and 95% confidence intervals (CIs). Probabilistic sensitivity analyses were used for external smoking adjustment. Analyses relied on 8931 MND (MSA, 9%) and 45 409 PD (MSA,11%) cases. There was a trend towards higher MND incidence in MSA farmers compared with non-MSA affiliates (RR,1.08; 95% CI,0.99-1.18) and MSA workers (RR, 1.13; 95% CI, 0.97-1.31) that strengthened after smoking adjustment (if associated with MND). PD incidence was higher in MSA farmers than non-MSA affiliates (RR, 1.13; 95% CI, 1.08-1.17) and MSA workers (RR, 1.10; 95% CI, 1.02-1.18); this association remained after smoking adjustment (RR, 1.09; 95% CI, 1.05-1.14). This French nationwide study suggested an association between farming and MND, and confirmed higher PD incidence in farmers in France, a country with high pesticide use. © 2017 EAN.

  1. Uranium reserves and exploration activity

    International Nuclear Information System (INIS)

    Meehan, R.J.

    1975-01-01

    The strategy that ERDA plans to employ regarding resource appraisal is outlined. All types of uranium occurrences will be evaluated as sources of domestic ore reserves. Industry's exploration efforts will be compiled. These data will include information on land acquisition and costs, footage drilled and costs, estimates of exploration activities and expenditures, exploration for non-sandstone deposits, exploration in non-established areas, and foreign exploration plans and costs. Typical data in each of these areas are given

  2. Gas reserves, discoveries and production

    International Nuclear Information System (INIS)

    Saniere, A.

    2006-01-01

    Between 2000 and 2004, new discoveries, located mostly in the Asia/Pacific region, permitted a 71% produced reserve replacement rate. The Middle East and the offshore sector represent a growing proportion of world gas production Non-conventional gas resources are substantial but are not exploited to any significant extent, except in the United States, where they account for 30% of U.S. gas production. (author)

  3. Demand Response Spinning Reserve Demonstration

    Energy Technology Data Exchange (ETDEWEB)

    Eto, Joseph H.; Nelson-Hoffman, Janine; Torres, Carlos; Hirth,Scott; Yinger, Bob; Kueck, John; Kirby, Brendan; Bernier, Clark; Wright,Roger; Barat, A.; Watson, David S.

    2007-05-01

    The Demand Response Spinning Reserve project is a pioneeringdemonstration of how existing utility load-management assets can providean important electricity system reliability resource known as spinningreserve. Using aggregated demand-side resources to provide spinningreserve will give grid operators at the California Independent SystemOperator (CAISO) and Southern California Edison (SCE) a powerful, newtool to improve system reliability, prevent rolling blackouts, and lowersystem operating costs.

  4. Subsequent vitiligo after hematopoietic stem cell transplantation: A nationwide population-based cohort study from Korea.

    Science.gov (United States)

    Bae, Jung Min; Choi, Kwang Hyun; Jung, Han Mi; Kim, Sook Young; Kim, Miri; Kim, Gyung Moon; Yu, Dong Soo; Lee, Young Bok

    2017-03-01

    Subsequent vitiligo after hematopoietic stem cell transplantation (HSCT) has been described sporadically in case series. To investigate the incidence and risk factors of subsequent vitiligo after HSCT. A nationwide, population-based cohort study was performed using the Korean National Health Insurance Claims Database from 2009 to 2013. All HSCT recipients who had undergone HSCT between 2010 and 2011 and not treatment for vitiligo in 2009 (to exclude preexisting active vitiligo) were included in the HSCT recipient group, and an age- and sex-matched control group without HSCT was also established. A total of 2747 HSCT recipients and 8241 controls were enrolled. Newly acquired vitiligo occurred in 1.06% of HSCT recipients between 2010 and 2013, and there was a significant increase (OR 3.130, 95% CI 1.859-5.271) in cases of vitiligo in HSCT recipients compared with controls (0.34%). Allogeneic HSCT (OR 5.593, 95% CI 1.628-19.213) and bone marrow-sourced stem cells (as compared with peripheral blood-sourced stem cells; OR 2.492, 95% CI 1.114-5.576) were independently associated with the development of vitiligo after HSCT. Medical record review was not available. Vitiligo developed at a significantly increased rate after HSCT compared with controls. Allogeneic HSCT and bone marrow-sourced stem cells were independent risk factors. Copyright © 2016 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  5. Socioeconomic and occupational risk factors for venous thromboembolism in Sweden: a nationwide epidemiological study.

    Science.gov (United States)

    Zöller, Bengt; Li, Xinjun; Sundquist, Jan; Sundquist, Kristina

    2012-05-01

    Our aims were to investigate possible associations between hospitalisation for venous thromboembolism (VTE) and socioeconomic and occupational factors. A nationwide database was constructed by linking Swedish census data to the Hospital Discharge Register (1990-2007). Hospital diagnoses of VTE were based on the International Classification of Diseases. Standardised incidence ratios were calculated for different socioeconomic and occupational groups. A total of 43063 individuals aged >20 years were hospitalised for VTE. Individuals with >12 years of education were at lower risk for VTE. Blue-collar workers, farmers, and non-employed individuals had higher risks for VTE, and white collar workers and professionals lower risks. In males and/or females, risks for VTE were increased for assistant nurses; farmers; miners and quarry workers; mechanics, iron and metalware workers; wood workers; food manufacture workers; packers; loaders and warehouse workers; public safety and protection workers; cooks and stewards; home helpers; building caretakers; and cleaners. Decreased risks were observed for technical, chemical, physical, and biological workers; physicians; dentists; nurses; other health and medical workers; teachers, religious, juridical, and other social science-related workers; artistic workers; clerical workers; sale agents; and fishermen, whalers and sealers. High educational level and several occupations requiring high levels of education were protective against VTE, while the risks for VTE were increased for farmers, blue-collar workers and non-employed individuals. The mechanisms are unknown but it might involve persistent psychosocial stress related to low socioeconomic and occupational status. Copyright © 2011 Elsevier Ltd. All rights reserved.

  6. Impact of bundled payments on hip fracture outcomes: a nationwide population-based study.

    Science.gov (United States)

    Tung, Yu-Chi; Chang, Hsien-Yen; Chang, Guann-Ming

    2018-02-01

    Establishing one price for all bundled services for a particular illness, which has become the key to healthcare reform efforts, is designed to encourage health professionals to coordinate their care for patients. Limited information is available, however, concerning whether bundled payments are associated with changes in patient outcomes. Nationwide longitudinal population-based data were used to examine the effect of bundled payments on hip fracture outcomes. An interrupted time series design with a comparison group. General acute care hospitals throughout Taiwan. A total of 178 586 hip fracture patients admitted over the period 2007-12 identified from the Taiwan's National Health Insurance Research Database. Bundled payments for hip fractures were implemented in Taiwan in January 2010. The 30-day unplanned readmission and postdischarge mortality. Segmented generalized estimating equation regression models were used after adjustment for trends, patient, physician and hospital characteristics to assess the effect of bundled payments on 30-day outcomes for hip fracture compared with a reference condition. The 30-day unplanned readmission rate for hip fracture showed a relative decreasing trend after the implementation of bundled payments compared with the trend before the implementation relative to that of the reference condition. This finding might imply that the implementation of bundled payments encourages health professionals to coordinate their care, leading to reduced readmission for hip fracture. © The Author 2017. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  7. Suicidal ideation at 1-year post-stroke: A nationwide survey in China.

    Science.gov (United States)

    Yang, Yang; Shi, Yu-Zhi; Zhang, Ning; Wang, Shuo; Ungvari, Gabor S; Ng, Chee H; Wang, Yi-Long; Zhao, Xing-Quan; Wang, Yong-Jun; Wang, Chun-Xue; Xiang, Yu-Tao

    Few studies on suicidal ideation have been conducted in post-stroke patients in China. This national study examined suicidal ideation at 1-year post-stroke and explored its demographic and clinical correlates. A total of 1418 patients with ischemic stroke were included in 56 hospitals nationwide. Demographic, clinical characteristics and neuro-imaging information were collected with standardized instruments, including assessment of stroke severity, depression, cognitive impairment, stroke recurrence, physical disability and insomnia. Suicidal ideation was measured using item 3 of the Hamilton Rating Scale for Depression. The frequency of suicidal ideation in this study was 6.6%. Multivariate analyses revealed that disability (OR=2.07, 95% CI=1.09-3.05), stroke recurrence (OR=4.13, 95% CI=1.74-9.77) and insomnia early (OR=1.87, 95% CI=1.03-3.39), middle (OR=2.66, 95% CI=1.46-4.85) and late (OR=2.35, 95% CI=1.31-4.19) at the 1-year follow-up and post-stroke depression (OR=2.16, 95% CI=1.23-3.82) were significantly associated with post-stroke suicidal ideation. Post-stroke depression, disability, insomnia and stroke recurrence are possible risk factors of suicidal ideation that warrant attention in clinical practice. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. Antipsychotic medications and dental caries in newly diagnosed schizophrenia: A nationwide cohort study.

    Science.gov (United States)

    Hu, Kai-Fang; Chou, Yu-Hsiang; Wen, Yen-Hsia; Hsieh, Kun-Pin; Tsai, Jui-Hsiu; Yang, Pinchen; Yang, Yi-Hsin; Lin, Chun-Hung Richard

    2016-11-30

    We investigated the association between antipsychotic medications and the risk of dental caries in patients with schizophrenia. We enroled a nationwide cohort of patients with newly diagnosed schizophrenia within 1 year of dental caries development. Exposure to antipsychotics and other medications was categorised according to their type and duration, and the association between exposure and dental caries was assessed through logistic regressions. Of the 3610 patients with newly diagnosed schizophrenia, 2149 (59.5%) exhibited an incidence of treated dental caries. Logistic regression analysis identified a younger age, female sex, high income, a 2-year history of dental caries, and exposure to first-generation antipsychotics, and antihypertensives as independent risk factors for treated dental caries in patients with schizophrenia. Hyposalivation, the adverse effect of first-generation antipsychotics and antihypertensives, was associated with an increased risk of treated dental caries. However, hypersalivation from first-generation antipsychotics for dental caries was associated with a protective factor. These findings suggest that clinicians should pay attention to the aforementioned risk factors for dental caries in patients with schizophrenia, particularly while prescribing first-generation antipsychotics and antihypertensives to such patients. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  9. Cardiovascular comorbidities in patients with rosacea: A nationwide case-control study from Taiwan.

    Science.gov (United States)

    Hua, Tuan-Chun; Chung, Pei-I; Chen, Yi-Ju; Wu, Lung-Chi; Chen, Yen-Da; Hwang, Chian-Yaw; Chu, Szu-Yin; Chen, Chih-Chiang; Lee, Ding-Dar; Chang, Yun-Ting; Liu, Han-Nan

    2015-08-01

    Rosacea is a chronic inflammatory skin disease. Inflammation plays a prominent role in atherosclerosis and its complications. We sought to investigate the associations of rosacea with cardiovascular disease risk factors and cardiovascular diseases from a nationwide population-based database. A total of 33,553 patients with rosacea and 67,106 age- and gender-matched control subjects were identified from the National Health Insurance Research Database in Taiwan from 1997 to 2010. Multivariate logistic regressions were performed to compare the odds of comorbidities between the 2 groups. Dyslipidemia (odds ratio 1.41; 95% confidence interval 1.36-1.46), coronary artery disease (odds ratio 1.35, 95% confidence interval 1.29-1.41), and hypertension (odds ratio 1.17, 95% confidence interval 1.12-1.21) were significantly associated with rosacea. Coronary artery disease remained independently associated with rosacea after adjustment for hypertension, diabetes mellitus, and dyslipidemia. Male patients with rosacea had higher risks for all comorbidities than female patients with rosacea. The National Health Insurance Research Database does not contain information regarding rosacea subtypes or disease severity, or laboratory data. Patients with rosacea are more likely to have dyslipidemia and hypertension. They are also at increased risk of coronary artery disease after adjustment for cardiovascular disease risk factors. Copyright © 2015 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  10. From Toques to Tokes: Two challenges facing nationwide legalization of cannabis in Canada.

    Science.gov (United States)

    Bear, Daniel

    2017-04-01

    In 2015, a new Liberal Government came to power in Canada, elected on a platform that included legalization and regulation of cannabis for recreational purposes. Their legislation, based on recommendations from a Federal Task Force on Marijuana Legalization and Regulation, is due in early April 2017. This commentary utilizes Canadian Federal policy papers, previous literature, and internal and international agreements to examine two key areas critical to the development of a nationwide regulated market for cannabis in Canada; the need to overcome restrictions to legalizing cannabis in United Nations' drug control treaties, and the unique challenges that non-medical cannabis creates for navigating interprovincial trade policies in Canada. Irrespective of UN conventions that appear to prohibit legalization of cannabis the Government is preparing to bring forward legislation as this article goes to print. At the same time significant squabbles impede the selling of even beer and wine inter-provincially in Canada. This paper identifies the challenges facing Canadian legalization efforts, but also shows how the legalization legislation may provide opportunities to engender significant change beyond the simple legalization of a specific drug. This commentary does not argue for any specific course of action for Canada, but rather explores the nuance of legalization absent from the declaration in the Liberal party platform. The paper argues that Canada's efforts may hasten the dismantling of the UN drug control structure, and provide renewed opportunities for intern-provincial trade in Canada. Copyright © 2017 Elsevier B.V. All rights reserved.

  11. Splenectomy and increased subsequent cancer risk: a nationwide population-based cohort study.

    Science.gov (United States)

    Sun, Li-Min; Chen, Hsuan-Ju; Jeng, Long-Bin; Li, Tsai-Chung; Wu, Shih-Chi; Kao, Chia-Hung

    2015-08-01

    Splenectomy has been suggested to have an impact on immunological function, and subsequent development of cancer has been recognized as a possible adverse effect of splenectomy. This study evaluated the possible association between splenectomy and malignancy in Taiwan. A cohort study consisted of including 2,603 patients with nontraumatic and 2,295 patients with traumatic splenectomy, and then randomly frequency matched with 4 participants without splenectomy. The Cox proportional hazard regression analysis was conducted to estimate the influence of splenectomy on cancer risk. Both nontraumatic and traumatic splenectomy had a significantly higher risk for overall cancer development (adjusted hazard ratios are 2.64 and 1.29 for nontraumatic and traumatic reasons, respectively). After adjusting for age, sex, and comorbidities, patients with splenectomy were associated with significantly higher risks for developing certain gastrointestinal tract cancers, other head and neck cancers, and hematological malignancies, and the phenomenon is more prominent in nontraumatic splenectomy group. This nationwide population-based study found that people with splenectomy have higher risks of developing overall cancer, as well as certain site-specific cancers, especially for patients with nontraumatic reasons. Copyright © 2015 Elsevier Inc. All rights reserved.

  12. Effect of Gender on Unplanned Readmissions After Percutaneous Coronary Intervention (from the Nationwide Readmissions Database).

    Science.gov (United States)

    Kwok, Chun Shing; Potts, Jessica; Gulati, Martha; Alasnag, Mirvat; Rashid, Muhammad; Shoaib, Ahmad; Ul Haq, Muhammad Ayyaz; Bagur, Rodrigo; Mamas, Mamas Andreas

    2018-04-01

    Women who undergo percutaneous coronary intervention (PCI) are at higher risk of adverse outcomes compared with men, but it is unknown whether gender affects early unplanned rehospitalization. We analyzed 832,753 patients who underwent PCI from 2013 to 2014 in the Nationwide Readmissions Database. We compared gender differences in incidences, predictors, causes, and cost of unplanned 30-day readmissions and examined the effect of co-morbidity. A total of 832,753 men and women who survived the index PCI and were not admitted for a planned readmission were included in the analysis. Overall, 9.4% of patients had an unplanned readmission within 30 days. Thirty-day readmission rates were higher in women compared with men (11.5% vs 8.4%, p exist in rates of unplanned rehospitalization after PCI, where more than 1 in 10 women who undergo PCI are readmitted within 30 days. Gender differences were not observed for causes of noncardiac readmissions, whereas important differences were observed for cardiovascular causes. Copyright © 2018 Elsevier Inc. All rights reserved.

  13. Resource Management plan for the Oak Ridge Reservation. Volume 28, Wetlands on the Oak Ridge Reservation

    Energy Technology Data Exchange (ETDEWEB)

    Cunningham, M. [Science Applications International Corp., Oak Ridge, TN (United States); Pounds, Larry [Tennessee Univ., Knoxville, TN (United States)

    1991-12-01

    A survey of wetlands on the Oak Ridge Reservation (ORR) was conducted in 1990. Wetlands occurring on ORR were identified using National Wetlands Inventory (NWI) maps and field surveys. More than 120 sites were visited and 90 wetlands were identified. Wetland types on ORR included emergent communities in shallow embayments on reservoirs, emergent and aquatic communities in ponds, forested wetland on low ground along major creeks, and wet meadows and marshes associated with streams and seeps. Vascular plant species occurring on sites visited were inventoried, and 57 species were added to the checklist of vascular plants on ORR. Three species listed as rare in Tennessee were discovered on ORR during the wetlands survey. The survey provided an intensive ground truth of the wetlands identified by NWI and offered an indication of wetlands that the NWI remote sensing techniques did not detect.

  14. Primary Sjogren's syndrome and the risk of acute pancreatitis: a nationwide cohort study.

    Science.gov (United States)

    Chang, Chi-Ching; Chang, Yu-Sheng; Wang, Shu-Hung; Lin, Shyr-Yi; Chen, Yi-Hsuan; Chen, Jin Hua

    2017-08-11

    Studies on the risk of acute pancreatitis in patients with primary Sjogren's syndrome (pSS) are limited. We evaluated the effects of pSS on the risk of acute pancreatitis in a nationwide, population-based cohort in Taiwan. Population-based retrospective cohort study. We studied the claims data of the >97% Taiwan population from 2002 to 2012. We identified 9468 patients with pSS by using the catastrophic illness registry of the National Health Insurance Database in Taiwan. We also selected 37 872 controls that were randomly frequency matched by age (in 5 year bands), sex and index year from the general population. We analysed the risk of acute pancreatitis by using Cox proportional hazards regression models including sex, age and comorbidities. From 23.74 million people in the cohort, 9468 patients with pSS (87% women, mean age=55.6 years) and 37 872 controls were followed-up for 4.64 and 4.74 years, respectively. A total of 44 cases of acute pancreatitis were identified in the pSS cohort versus 105 cases in the non-pSS cohort. Multivariate Cox regression analysis indicated that the incidence rate of acute pancreatitis was significantly higher in the pSS cohort than in the non-pSS cohort (adjusted HR (aHR) 1.48, 95% CI 1.03 to 2.12). Cyclophosphamide use increased the risk of acute pancreatitis (aHR 5.27, 95% CI 1.16 to 23.86). By contrast, hydroxychloroquine reduced the risk of acute pancreatitis (aHR 0.23, 95% CI 0.09 to 0.55). This nationwide, retrospective cohort study demonstrated that the risk of acute pancreatitis was significantly higher in patients with pSS than in the general population. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  15. Reservation Wages, Search Duration, and Accepted Wages in Europe

    OpenAIRE

    Addison, John T.; Centeno, Mário; Portugal, Pedro

    2004-01-01

    This paper uses data from the European Community Household Panel, 1994-99, to investigate the arrival rate of job offers, the determinants of reservation wages, transitions out of unemployment, and accepted wages. In this exploratory treatment, we report that the arrival rate of job offers declines precipitously with jobless duration and age; that reservation wages do decline with the jobless spell (and aggregate unemployment); that transitions out of unemployment exhibit strong negative dura...

  16. Foreign Exchange Reserves: Bangladesh Perspective

    Directory of Open Access Journals (Sweden)

    Md Zahangir Alam

    2013-10-01

    Full Text Available This study is about foreign exchangereserves of Bangladesh. The mainpurpose of this study is to the influence of exchange rates on foreign exchangereserves to the Bangladesh context.  Both the primary and secondary data has been used inthis study. The primary data has been collected through a structuredquestionnaire from 50 respondents. The secondary data, namely Bangladeshforeign exchange reserves (FER, Bangladesh current account balance (CAB,Bangladesh capital andfinancial account balance (CFAB, and BDT/USD exchange rates (ER.  This study covers yearly data from July 01,1996 to June 30, 2005 and quarterly data from July 01, 2005 to June 30, 2012. Findingsof this study shows that out of the selected 16 factors affecting foreignexchange reserves, exchange rates occupy the first position, weighted averagescore (WAS being 4.56. Foreign exchange reserves (FER and current accountbalance (CAB have increased by 502.9087% and 1451.218%,whereas capital and financial account (CFAB has decreased by -649.024% on June30, 2012 compared to June 30, 1997. The influence of other factors heldconstant, as ER changes by 285.6894 units due to one unit change in FER, onaverage in the same direction which represents that ER has positive effect on theFER and this relationship is statistically significant.  62.1526 percentof the variation in FER is explained by ER. The outcomes of Breusch-Godfrey test (LM test, ARCHtest, and the Normality test are that there is a serial correlation among residuals, the variance of residuals is notconstant, and the residuals are not normally distributed.

  17. Brain reserve and cognitive reserve in multiple sclerosis

    Science.gov (United States)

    Rocca, Maria A.; Leavitt, Victoria M.; Riccitelli, Gianna; Comi, Giancarlo; DeLuca, John; Filippi, Massimo

    2013-01-01

    Objective: We first tested the brain reserve (BR) hypothesis in multiple sclerosis (MS) by examining whether larger maximal lifetime brain volume (MLBV; determined by genetics) protects against disease-related cognitive impairment, and then investigated whether cognitive reserve (CR) gained through life experience (intellectually enriching leisure activities) protects against cognitive decline independently of MLBV (BR). Methods: Sixty-two patients with MS (41 relapsing-remitting MS, 21 secondary progressive MS) received MRIs to estimate BR (MLBV, estimated with intracranial volume [ICV]) and disease burden (T2 lesion load; atrophy of gray matter, white matter, thalamus, and hippocampus). Early-life cognitive leisure was measured as a source of CR. We assessed cognitive status with tasks of cognitive efficiency and memory. Hierarchical regressions were used to investigate whether higher BR (ICV) protects against cognitive impairment, and whether higher CR (leisure) independently protects against cognitive impairment over and above BR. Results: Cognitive status was positively associated with ICV (R2 = 0.066, p = 0.017). An ICV × disease burden interaction (R2 = 0.050, p = 0.030) revealed that larger ICV attenuated the impact of disease burden on cognition. Controlling for BR, higher education (R2 = 0.047, p = 0.030) and leisure (R2 = 0.090, p = 0.001) predicted better cognition. A leisure × disease burden interaction (R2 = 0.037, p = 0.030) showed that leisure independently attenuated the impact of disease burden on cognition. Follow-up analyses revealed that BR protected against cognitive inefficiency, not memory deficits, whereas CR was more protective against memory deficits than cognitive inefficiency. Conclusion: We provide evidence of BR in MS, and show that CR independently protects against disease-related cognitive decline over and above BR. Lifestyle choices protect against cognitive impairment independently of genetic factors outside of one's control

  18. A Nationwide Cohort Study of Stage I Seminoma Patients Followed on a Surveillance Program

    DEFF Research Database (Denmark)

    Mortensen, Mette Saksø; Lauritsen, Jakob; Gundgaard, Maria Gry

    2014-01-01

    BACKGROUND: Increasing concerns about late effects after adjuvant treatment for stage I seminoma have made surveillance an attractive alternative. OBJECTIVE: To evaluate the surveillance strategy in a nationwide cohort study. DESIGN, SETTING, AND PARTICIPANTS: A retrospective, population-based st...

  19. Report to Congress : recapitalization plan for the nationwide differential global positioning system (NDGPS).

    Science.gov (United States)

    2010-06-01

    The U.S. Department of Transportation (DOT) has developed a recpitlaization plan to reduce technical, cost, and programmatic risks of the DOT-funded inland segment of the Nationwide Differential Global Positioning System (NDGPS)

  20. Community pharmacists, Internet and social media: an empirical investigation.

    Science.gov (United States)

    Shcherbakova, Natalia; Shepherd, Marv

    2014-01-01

    community pharmacists in Texas. Future studies conducted in other states as well as nationwide will contribute to a better understanding of the use of electronic communication, Internet, and social media in the daily professional activities of independent community pharmacists. Copyright © 2014 Elsevier Inc. All rights reserved.

  1. Phytosociological classification of the Nylsvley nature reserve

    CSIR Research Space (South Africa)

    Coetzee, BJ

    1977-12-01

    Full Text Available ; grassland and thorn savanna on calcareous self-mulching vertic soils; and secondary communities on long abandoned native settlements and recently ploughed land. Seven primary communities with 12 community variations and four subvaria-tions, and three...

  2. Two decades of nation-wide community-based stroke support - The Singapore National Stroke Association.

    Science.gov (United States)

    Venketasubramanian, Narayanaswamy; Yin, Ann; Lee, Lay B; De Silva, Deidre A

    2017-04-01

    The Singapore National Stroke Association, registered in 1996, offers support and information to stroke survivors and caregivers, and aims to raise public stroke awareness. In the last 20 years, we have developed programs to equip stroke survivors and caregivers with knowledge, life skills, comfort, and opportunities for socialization and reintegration. We have on-going public education and advocacy initiatives. Obtaining funding, member recruitment, volunteer retention, and leadership renewal are on-going challenges. Singapore National Stroke Association will continue to strive for the betterment of stroke survivors, their caregivers, and the public.

  3. Pediatric Medication Safety in Adult Community Hospital Settings: A Glimpse Into Nationwide Practice.

    Science.gov (United States)

    Alvarez, Francisco; Ismail, Lana; Markowsky, Allison

    2016-12-01

    Most children in the United States are treated in adult settings. Studies show that the pediatric population is vulnerable to medication errors. It can be extrapolated that children cared for in adult settings are at equal or higher risk for errors. The goal of this study was to assess the existing pediatric medication safety infrastructure within adult hospitals. Questionnaire developed through Research Electronic Data Capture (REDCap) and distributed to pediatric hospitalist programs listed on the American Academy of Pediatrics, Section on Hospital Medicine web site and members of the American Academy of Pediatrics Quality Improvement Innovation Networks listserv. There were >20 questions regarding the use of various safety measures and characteristics of the hospital. Thirty-eight program staff and 26 Quality Improvement Innovation Networks listserv members completed the survey (total = 64). Of these, 90.6% use order sets or computerized provider order entry with pediatric weight-based dosing, 79.7% review pediatric medication safety events or concerns, 58.7% were aware that their hospital had defined or documented maximum doses on orders, and 50.0% had milligram-per-kilogram dosing required to be in the order. A majority of respondents document weights only in the metric system (kilograms or grams) in both the emergency department and the pediatric unit (84.4% and 92.1%, respectively). A total of 57.8% of hospitals had pharmacists trained in pediatrics, with hospitals with >300 beds more likely to have a pediatric pharmacist than those with Pediatric medication safety infrastructure shows variations within the sites surveyed. Our results indicate that certain deficiencies are more widespread than others, providing opportunities for targeted, but hospital-specific interventions. Copyright © 2016 by the American Academy of Pediatrics.

  4. Clinicians performing cosmetic surgery in the community: a nationwide analysis of physician certification.

    Science.gov (United States)

    Barr, Jason S; Sinno, Sammy; Cimino, Marcus; Saadeh, Pierre B

    2015-01-01

    Practitioners who are not board-certified by the American Board of Plastic Surgery are practicing cosmetic surgery. The extent of this issue across the United States has yet to be examined in detail. A systematic search using Google was performed to evaluate the qualifications of clinicians marketing themselves as plastic surgeons. For every U.S. state, the following searches were performed: [state] plastic surgery, [state] cosmetic surgery, and [state] aesthetic surgery. The first 50 Web sites returned for each search were visited and scrutinized using the American Society of Plastic Surgeons and American Board of Plastic Surgery Web sites. In total, 7500 Web sites were visited, yielding 2396 board-certified plastic surgeons (77.9 percent of all practitioners). There were 284 board-certified ear, nose, and throat surgeons, 61 (21.5 percent) of whom practice outside their scope; 106 board-certified general surgeons, 100 (94.3 percent) of whom practice outside their scope; 104 board-certified oral and maxillofacial surgery surgeons, 68 (65.4 percent) of whom practice outside their scope; 70 board-certified ophthalmologists/oculoplastic surgeons, 49 (70 percent) of whom practice outside their scope; and 74 board-certified dermatologists, 36 (48.6 percent) of whom practice outside their scope. There were also 16 internal medicine doctors, 13 obstetrics and gynecology physicians, six emergency medicine physicians, three pediatricians, two urologists, two anesthesiologists, and finally one phlebotomist; all of these practitioners practice outside their scope as defined by Accreditation Council for Graduate Medical Education core competencies. Many clinicians performing cosmetic surgery are not board-certified. This finding has important implications for patient safety.

  5. Comparison of interventional cardiology in two European countries: a nationwide Internet based registry study.

    Science.gov (United States)

    Gudnason, T; Gudnadottir, G S; Lagerqvist, B; Eyjolfsson, K; Nilsson, T; Thorgeirsson, G; Thorgeirsson, G; Andersen, K; James, S

    2013-09-30

    The practice of interventional cardiology differs between countries and regions. In this study we report the results of the first nation-wide long-term comparison of interventional cardiology in two countries using a common web-based registry. The Swedish Coronary Angiography and Angioplasty Registry (SCAAR) was used to prospectively and continuously collect background-, quality-, and outcome parameters for all coronary angiographies (CA) and percutaneous coronary interventions (PCI) performed in Iceland and Sweden during one year. The rate of CA per million inhabitants was higher in Iceland than in Sweden. A higher proportion of patients had CA for stable angina in Iceland than in Sweden, while the opposite was true for ST elevation myocardial infarction. Left main stem stenosis was more commonly found in Iceland than in Sweden. The PCI rate was similar in the two countries as was the general success rate of PCI, achievement of complete revascularisation and the overall stent use. Drug eluting stents were more commonly used in Iceland (23% vs. 19%). The use of fractional flow reserve (0.2% vs. 10%) and the radial approach (0.6% vs. 33%) was more frequent in Sweden than in Iceland. Serious complications and death were very rare in both countries. By prospectively comparing interventional cardiology in two countries, using a common web based registry online, we have discovered important differences in technique and indications. A discovery such as this can lead to a change in clinical practice and inspire prospective multinational randomised registry trials in unselected, real world populations. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  6. Ecotourism and its effects on wildlife of Pachmarhi Biosphere Reserve

    African Journals Online (AJOL)

    use

    sustainable use of wildlife in the Manu Biosphere. Reserve and Puero Maldonado National Parks of Peru in. (Groom et al., 2000), recognizes the benefits of ecotourism as it helps to .... leading tour companies that collaborate with lodges and tour groups. Therefore, the local communities do not benefit from the revenue.

  7. Evaluation of the contributions of Ikere Forest Reserve to ...

    African Journals Online (AJOL)

    The use of forest products in the recent times has involved provision of employment opportunity, provision of food and provision of health care delivery for the rural people. This study examined contributions of Ikere forest reserve to adjoining communities in Ekiti-State. Ninety pre-tested questionnaire were administered to ...

  8. Avifauna of Boni-Dodori National Reserves, Lamu and Garissa ...

    African Journals Online (AJOL)

    Summary. A comprehensive avian survey was conducted between April 2012 and November. 2013 in Boni and Dodori National reserves, the connecting Aweer Community. Conservancy corridor, and the adjacent forests. Survey methods were Timed Species. Counts (TSCs), mist netting and opportunistic observations.

  9. Z' reservation at LEP2

    CERN Document Server

    Montagna, G.; Piccinini, F.; Renard, F.M.; Verzegnassi, C.

    1995-01-01

    We consider the possibility that one extra Z\\equiv Z' exists with arbitrary mass and fermion couplings that do not violate (charged) lepton universality. We show that, in such a situation, a functional relationship is generated between the \\underline{deviations} from the SM values of three leptonic observables of two-fermion production at future e^+e^- colliders that is completely independent of the values of the Z' mass and couplings. This selects a certain region in the 3-d space of the deviations that is \\underline{characteristic} of the model (Z' "reservation"). As a specific and relevant example, we show the picture that would emerge at LEP2 under realistic experimental conditions.

  10. Nationwide Genomic Study in Denmark Reveals Remarkable Population Homogeneity.

    Science.gov (United States)

    Athanasiadis, Georgios; Cheng, Jade Y; Vilhjálmsson, Bjarni J; Jørgensen, Frank G; Als, Thomas D; Le Hellard, Stephanie; Espeseth, Thomas; Sullivan, Patrick F; Hultman, Christina M; Kjærgaard, Peter C; Schierup, Mikkel H; Mailund, Thomas

    2016-10-01

    Denmark has played a substantial role in the history of Northern Europe. Through a nationwide scientific outreach initiative, we collected genetic and anthropometrical data from ∼800 high school students and used them to elucidate the genetic makeup of the Danish population, as well as to assess polygenic predictions of phenotypic traits in adolescents. We observed remarkable homogeneity across different geographic regions, although we could still detect weak signals of genetic structure reflecting the history of the country. Denmark presented genomic affinity with primarily neighboring countries with overall resemblance of decreasing weight from Britain, Sweden, Norway, Germany, and France. A Polish admixture signal was detected in Zealand and Funen, and our date estimates coincided with historical evidence of Wend settlements in the south of Denmark. We also observed considerably diverse demographic histories among Scandinavian countries, with Denmark having the smallest current effective population size compared to Norway and Sweden. Finally, we found that polygenic prediction of self-reported adolescent height in the population was remarkably accurate (R 2 = 0.639 ± 0.015). The high homogeneity of the Danish population could render population structure a lesser concern for the upcoming large-scale gene-mapping studies in the country. Copyright © 2016 by the Genetics Society of America.

  11. Sunray project - A long-term, nationwide educational process

    International Nuclear Information System (INIS)

    Nikula, Anneli

    2000-01-01

    The Sunray project is a nationwide educational process coordinated by the Economic Information Bureau (TaT Group) for ninth graders in Finnish comprehensive schools. The project aims at giving thorough and versatile information on radiation within the framework of various subjects (physics, biology, domestic science, history, European languages, mother tongue, health education etc.). The Sunray project covers all ninth graders of the existing 600 Finnish comprehensive schools; in all involving some 65 000 pupils. The project, which has been repeated five times, was initiated as part of the European Science and Technology week in 1995. During the first two years it was strongly linked with the science week as natural sciences were seen as a good framework for the chosen perspective. Since 1997, the project has been run as an event in its own right. The project has applied the method of processing integrated groups of themes, which is an objective of the comprehensive school system and the experimental method of science. As schools make their own decisions about the educational programmes to be adopted every semester, the project has been marketed to schools at the beginning of May. The TaT Group has arranged marketing events in some 10 localities in Finland. The Economic Information Bureau of Finland coordinates the project and in 1995-2000 the Radiation and Nuclear Safety Authority (STUK), the Finnish Energy Industries' Federation, the Finnish Electricity Association, Fortum Oyj and Teollisuuden Voima Oy have participated in the project

  12. Nationwide Drinking Water Sampling Campaign for Exposure Assessments in Denmark

    Science.gov (United States)

    Voutchkova, Denitza Dimitrova; Hansen, Birgitte; Ernstsen, Vibeke; Kristiansen, Søren Munch

    2018-01-01

    Nationwide sampling campaign of treated drinking water of groundwater origin was designed and implemented in Denmark in 2013. The main purpose of the sampling was to obtain data on the spatial variation of iodine concentration and speciation in treated drinking water, which was supplied to the majority of the Danish population. This data was to be used in future exposure and epidemiologic studies. The water supply sector (83 companies, owning 144 waterworks throughout Denmark) was involved actively in the planning and implementation process, which reduced significantly the cost and duration of data collection. The dataset resulting from this collaboration covers not only iodine species (I−, IO3−, TI), but also major elements and parameters (pH, electrical conductivity, DOC, TC, TN, F−, Cl−, NO3−, SO42−, Ca2+, Mg2+, K+, Na+) and a long list of trace elements (n = 66). The water samples represent 144 waterworks abstracting about 45% of the annual Danish groundwater abstraction for drinking water purposes, which supply about 2.5 million Danes (45% of all Danish residents). This technical note presents the design, implementation, and limitations of such a sampling design in detail in order (1) to facilitate the future use of this dataset, (2) to inform future replication studies, or (3) to provide an example for other researchers. PMID:29518987

  13. Workplace Victimization and Discrimination in China: A Nationwide Survey.

    Science.gov (United States)

    Zhang, Huiping

    2017-09-01

    Workplace victimization and discrimination have been intensively studied in the West, especially on the antecedents and consequences of this phenomenon. Surprisingly, little is known about the incidence and associated health problems of workplace victimization and discrimination in contemporary China. Using a representative nationwide sample of 1,138 Chinese employees conducted in 2015, this study attempted to estimate the prevalence, risk factors, and associated consequences of workplace victimization and discrimination in China. It is found that the prevalence rate of preceding 5-year workplace discrimination and victimization was 33% and 12.9%, respectively. Male employees who perceived higher work gains were less likely to experience workplace victimization and those who had higher career efficacy and unemployment anxiety were more likely to experience job discrimination or victimization. Female employees who received tertiary education were less likely to experience job discrimination and being married tended not to experience workplace victimization. Perceived job discrimination had negative impact on male employees' job satisfaction as well as on female employees' happiness. The implications of these findings are finally discussed in the Chinese context.

  14. Nationwide survey of cobalt-60 teletherapy. Final report

    International Nuclear Information System (INIS)

    Thompson, D.L.; Kearly, F.E.; Wyckoff, H.O.; Gitlin, J.N.; Reffit, E.B.; Shangold, E.J.

    1980-08-01

    The Bureau of Radiological Health and the National Bureau of Standards conducted a nationwide survey of cobalt-60 teletherapy facilities to determine their accuracy in delivery of a prescribed dose to a phantom. Participation was obtained from 684 respondents or 75 percent of US facilities. For each cobalt-60 unit the average dose recorded on five dosimeters was within 5 percent of the prescribed value for 83 percent of the respondents and only exceeded a 10 percent difference for 3 percent of the respondents. Sufficient information for reconstruction of dose calculations was available for 87 percent of the participating facilities. Of these reconstructed calculations, 56 percent were within 1 percent of the prescribed dose of 300 rads. The analysis of data from the survey showed that better performance were related to a number of factors. Among these were expressing the machine calibration in terms of dose rate, performing the machine calibration on an annual basis, and correcting for source decay on a monthly basis. Larger facilities achieved better results than smaller facilities when calculating the absorbed dose rate. Also, each 4 machine characteristics (isocentric mounting, short exposure time, high normalized output, and long treatment distance) were related to better performance with regard to both dosimeter readings and calculated doses. Larger facilities were more likely to be using a cobalt-60 unit having those characteristics

  15. Polydrug use among college students in Brazil: a nationwide survey

    Directory of Open Access Journals (Sweden)

    Lúcio Garcia de Oliveira

    2013-09-01

    Full Text Available Objective: To estimate the frequency of polydrug use (alcohol and illicit drugs among college students and its associations with gender and age group. Methods: A nationwide sample of 12,544 college students was asked to complete a questionnaire on their use of drugs according to three time parameters (lifetime, past 12 months, and last 30 days. The co-use of drugs was investigated as concurrent polydrug use (CPU and simultaneous polydrug use (SPU, a subcategory of CPU that involves the use of drugs at the same time or in close temporal proximity. Results: Almost 26% of college students reported having engaged in CPU in the past 12 months. Among these students, 37% had engaged in SPU. In the past 30 days, 17% college students had engaged in CPU. Among these, 35% had engaged in SPU. Marijuana was the illicit drug mostly frequently used with alcohol (either as CPU or SPU, especially among males. Among females, the most commonly reported combination was alcohol and prescribed medications. Conclusions: A high proportion of Brazilian college students may be engaging in polydrug use. College administrators should keep themselves informed to be able to identify such use and to develop educational interventions to prevent such behavior.

  16. Patterns of Psychiatric Outpatient Practice in Taiwan: A Nationwide Survey

    Directory of Open Access Journals (Sweden)

    Ying-Xiu Dai

    2016-09-01

    Full Text Available (1 Background: Limited studies have utilized nationwide data to assess the patterns of psychiatric practice in other countries. In this study, data from the National Health Insurance Research Database in Taiwan (NHIRD-TW for 2012 was analyzed to determine the patterns of psychiatric outpatient practice in Taiwan; (2 Methods: To determine the patterns of psychiatric outpatient practice in Taiwan, the data were drawn from the datasets of Taiwan’s National Health Insurance Research Database for 2012, with 619,760 records of outpatient visits representing 1/500 of all the claims in Taiwan for that year. The analysis of psychiatric outpatient visits included patient demographics, diagnoses, and prescribed medications; (3 Results: Neurotic disorders were the most prevalent diagnoses (43.1%, n = 5714. Hypnotics-sedatives and anxiolytics were prescribed in 51.7% (n = 6850 and 39.1% (n = 5181 of psychiatric visits, respectively, with zolpidem being the most commonly prescribed drug (22.6%, n = 2998; and (4 Conclusion: Hypnotics and sedatives were widely prescribed for the outpatient population, and zolpidem had the highest annual prevalence of use. These findings deserve the attention of clinicians and policy makers for monitoring the abuse and dependence of these agents and subsequent adverse events.

  17. Internet addiction among Iranian adolescents: a nationwide study.

    Science.gov (United States)

    Ahmadi, Khodabakhsh

    2014-01-01

    Problematic use of the Internet by children and adolescents is a newly emerging disorder that has alerted health authorities throughout the world. In Iran, despite the very high speed rate of Internet spread, there is not enough data on the rate of Internet addiction among the adolescents. This study is the first nationwide study that addresses this issue. Overall 4500 students of high school or pre-college schools were recruited from 13/31 provinces of Iran by a cluster sampling method and 4342 (96%) participated. Two self-rated questionnaires (one demographics and one Young's Internet addiction scale) were filled b the participants. Data were analyzed by SPSS software. 962 (22.2%) of the study participants were labeled as having "internet addiction." Males were significantly more likely to be an internet addict (PInternet addiction (Pinternet addiction, and the least rate of addiction was observed when the mother was a housewife (PInternet addiction (PInternet addiction. This study showed that Internet addiction in Iranian adolescents is prevalent, and has several independent factors, from which, family relations is most likely to be modifiable. Improvements in family relations and more strict parental supervision, especially when mothers have active job employment, are recommended.

  18. Fertility Treatment and Childhood Epilepsy - a Nationwide Cohort Study

    DEFF Research Database (Denmark)

    Kettner, Laura Ozer; Kesmodel, Ulrik Schiøler; Ramlau-Hansen, Cecilia Høst

    2017-01-01

    BACKGROUND: Fertility treatment includes hormonal stimulation of the woman and in vitro manipulation of gametes and embryos that may influence prenatal brain development. We aimed to investigate the association between fertility treatment and childhood epilepsy, including specific types of treatm......BACKGROUND: Fertility treatment includes hormonal stimulation of the woman and in vitro manipulation of gametes and embryos that may influence prenatal brain development. We aimed to investigate the association between fertility treatment and childhood epilepsy, including specific types...... of treatment and indications, as well as subtypes of epilepsy. METHODS: In this nationwide birth cohort study, we included all pregnancies in Denmark resulting in live-born singletons, 1995-2003. Children conceived by fertility treatment and children developing epilepsy (until 2013) were identified from Danish...... national registers. RESULTS: A total of 565,116 pregnancies were included; 8,071 children (1.4%) developed epilepsy. Children conceived after ovulation induction or intrauterine insemination had a slightly higher risk of childhood epilepsy (hazard ratio [HR]: 1.15; 95% confidence interval [CI]: 1.00, 1...

  19. Polydrug use among college students in Brazil: a nationwide survey.

    Science.gov (United States)

    Oliveira, Lúcio Garcia de; Alberghini, Denis Guilherme; Santos, Bernardo dos; Andrade, Arthur Guerra de

    2013-01-01

    To estimate the frequency of polydrug use (alcohol and illicit drugs) among college students and its associations with gender and age group. A nationwide sample of 12,544 college students was asked to complete a questionnaire on their use of drugs according to three time parameters (lifetime, past 12 months, and last 30 days). The co-use of drugs was investigated as concurrent polydrug use (CPU) and simultaneous polydrug use (SPU), a subcategory of CPU that involves the use of drugs at the same time or in close temporal proximity. Almost 26% of college students reported having engaged in CPU in the past 12 months. Among these students, 37% had engaged in SPU. In the past 30 days, 17% college students had engaged in CPU. Among these, 35% had engaged in SPU. Marijuana was the illicit drug mostly frequently used with alcohol (either as CPU or SPU), especially among males. Among females, the most commonly reported combination was alcohol and prescribed medications. A high proportion of Brazilian college students may be engaging in polydrug use. College administrators should keep themselves informed to be able to identify such use and to develop educational interventions to prevent such behavior.

  20. Social media adoption in local health departments nationwide.

    Science.gov (United States)

    Harris, Jenine K; Mueller, Nancy L; Snider, Doneisha

    2013-09-01

    We examined whether characteristics of local health departments (LHD) and their geographic region were associated with using Facebook and Twitter. We also examined the number of tweets per month for Twitter accounts as an indicator of social media use by LHDs. In 2012, we searched for Facebook and Twitter accounts for 2565 LHDs nationwide, and collected adoption date and number of connections for each account. Number of tweets sent indicated LHD use of social media. LHDs were classified as innovators, early adopters, or nonadopters. Characteristics of LHDs were compared across adoption categories, and we examined geographic characteristics, connections, and use. Twenty-four percent of LHDs had Facebook, 8% had Twitter, and 7% had both. LHDs serving larger populations were more likely to be innovators, tweeted more often, and had more social media connections. Frequency of tweeting was not associated with adoption category. There were differences in adoption across geographic regions, with western states more likely to be innovators. Innovation was also higher in states where the state health department adopted social media. Social media has the potential to aid LHDs in disseminating information across the public health system. More evidence is needed to develop best practices for this emerging tool.

  1. [Health care provisions for asylum-seekers : A nationwide survey of public health authorities in Germany].

    Science.gov (United States)

    Bozorgmehr, Kayvan; Nöst, Stefan; Thaiss, Heidrun M; Razum, Oliver

    2016-05-01

    Nation-wide studies on the health care situation of asylum-seekers in Germany are lacking, but decision-makers increasingly need such information. The aim of the study was to assess structures, processes and needs related to the health care provision for asylum-seekers along the continuum of reception centres to community dwellings from the perspective of the German public health authorities. A nation-wide cross-sectional mixed-methods survey was carried out. All heads of public health authorities in Germany (N = 389) were invited to complete a standardized questionnaire related to: (1) medical procedures and screening; (2) prevention and health promotion; (3) communication; (4) documentation and information; (5) coordination; (6) structural resources and needs. The quantitative survey was complemented by qualitative semi-structured interviews. In total, 123 heads of public health authorities (response rate: 31,6 %) completed the questionnaire, and 29 were interviewed. Priority areas to improve the health care situation were better coordination and standardisation of care, enhancing vaccination capacities, standardised documentation, better health information exchange (in line with data protection laws), and a stronger focus on a few relevant infectious diseases in the scope of compulsory health entry examinations. The instruments proved useful to assess the health care situation of asylum-seekers in a decentralized health care system. Repeated surveys with a focus on selected domains of the questionnaire could help monitor the health care situation on a regular basis.

  2. Particulate Air Pollution, Exceptional Aging, and Rates of Centenarians: A Nationwide Analysis of the United States, 1980-2010.

    Science.gov (United States)

    Baccarelli, Andrea A; Hales, Nick; Burnett, Richard T; Jerrett, Michael; Mix, Carter; Dockery, Douglas W; Pope, C Arden

    2016-11-01

    Exceptional aging, defined as reaching age 85 years, shows geographic inequalities that may depend on local environmental conditions. Links between particulate pollution-a well-recognized environmental risk factor-and exceptional aging have not been investigated. We conducted a nationwide analysis of ~28 million adults in 3,034 United States counties to determine whether local PM2.5 levels (particulate matter migration variables. On average, 2,295 and 71.4 per 10,000 of the 55- to 64- and 70- to 74-year-olds in 1980, respectively, remained in the 85- to 94- and 100- to 104-year-old population in 2010. An interquartile range (4.19 μg/m3) increase in PM2.5 was associated with 93.7 fewer 85- to 94-year-olds (p national standard. Exceptional aging was strongly associated with smoking, with an interquartile range (4.77%) increase in population who smoked associated with 181.9 fewer 85- to 94-year-olds (p income. Communities with the most exceptional aging have low ambient air pollution and low rates of smoking, poverty, and obesity. Improvements in these determinants may contribute to increasing exceptional aging. Citation: Baccarelli AA, Hales N, Burnett RT, Jerrett M, Mix C, Dockery DW, Pope CA III. 2016. Particulate air pollution, exceptional aging, and rates of centenarians: a nationwide analysis of the United States, 1980-2010. Environ Health Perspect 124:1744-1750; http://dx.doi.org/10.1289/EHP197.

  3. Home healthcare services in Taiwan: a nationwide study among the older population.

    Science.gov (United States)

    Chang, Hsiao-Ting; Lai, Hsiu-Yun; Hwang, I-Hsuan; Ho, Mei-Man; Hwang, Shinn-Jang

    2010-09-21

    Home healthcare services are important in aging societies worldwide. The present nationwide study of health insurance data examined the utilization and delivery patterns, including diagnostic indications, for home healthcare services used by seniors in Taiwan. Patients ≥65 years of age who received home healthcare services during 2004 under the Taiwanese National Health Insurance Program were identified and reimbursement claims were analyzed. Age, gender, disease diagnoses, distribution of facilities providing home healthcare services, and patterns of professional visits, including physician and skilled nursing visits, were also explored. Among 2,104,978 beneficiaries ≥65 years of age, 19,483 (0.9%) patients received 127,753 home healthcare visits during 2004 with a mean number of 6.0 ± 4.8 visits per person. The highest prevalence of home healthcare services was in the 75-84 year age group in both sexes. Females received more home healthcare services than males in all age groups. Cerebrovascular disease was the most frequent diagnosis in these patients (50.7%). More than half of home healthcare visits and around half of the professional home visits were provided by community home nursing care institutions. The majority of the home skilled nursing services were tube replacements, including nasogastric tubes, Foley catheter, tracheostomy, nephrostomy or cystostomy tubes (95%). Nine out of 1,000 older patients in Taiwan received home healthcare services during 2004, which was much lower than the rate of disabled older people in Taiwan. Females used home healthcare services more frequently than males and the majority of skilled nursing services were tube replacements. The rate of tube replacement of home healthcare patients in Taiwan deserves to be paid more attention.

  4. Factors affecting stigma toward suicide and depression: A Korean nationwide study.

    Science.gov (United States)

    Park, Soowon; Kim, Min-Ji; Cho, Maeng Je; Lee, Jun-Young

    2015-12-01

    Suicide attempts and depression are considerably misunderstood by Korean society. Studies regarding factors should provide basic information concerning the factors that should be considered when examining stigmatization. This study aimed to investigate sociodemographic factors related to the social stigma toward people with a history of suicide attempts or depression in a Korean nationwide community sample. Face-to-face interviews were conducted with participants selected via a multi-stage cluster sampling method; 779 respondents completed Link's Perceived Devaluation and Discrimination (PDD) scale to assess the social stigma they attached to suicide attempts, and another 743 completed PDD scale to assess the social stigma they attached to depression. Multiple regression analysis, including socioeconomic and psychiatric variables, was performed to identify the factors predictive of social stigma. Results of multiple regressions revealed that age (β = .12, p = .018), sex (β = .08, p = .038), years of education (β = -.31, p = .006) and history of suicide attempts (β = -.11, p = .009) significantly predicted the degree of stigma toward people who had made suicide attempts, whereas age (β = .15, p = .003) and education (β = -.40, p = .001) also predicted the social stigma toward people with depression, sex and history of a depressive episode did not. Older men with less education and no experience with suicide perceived suicide attempts more negatively. Similarly, older people with less education placed a greater stigma on people suffering from depression. These results suggest that greater access to higher education may reduce stigma toward people with mental illness. © The Author(s) 2015.

  5. Home healthcare services in Taiwan: a nationwide study among the older population

    Directory of Open Access Journals (Sweden)

    Lai Hsiu-Yun

    2010-09-01

    Full Text Available Abstract Background Home healthcare services are important in aging societies worldwide. The present nationwide study of health insurance data examined the utilization and delivery patterns, including diagnostic indications, for home healthcare services used by seniors in Taiwan. Methods Patients ≥65 years of age who received home healthcare services during 2004 under the Taiwanese National Health Insurance Program were identified and reimbursement claims were analyzed. Age, gender, disease diagnoses, distribution of facilities providing home healthcare services, and patterns of professional visits, including physician and skilled nursing visits, were also explored. Results Among 2,104,978 beneficiaries ≥65 years of age, 19,483 (0.9% patients received 127,753 home healthcare visits during 2004 with a mean number of 6.0 ± 4.8 visits per person. The highest prevalence of home healthcare services was in the 75-84 year age group in both sexes. Females received more home healthcare services than males in all age groups. Cerebrovascular disease was the most frequent diagnosis in these patients (50.7%. More than half of home healthcare visits and around half of the professional home visits were provided by community home nursing care institutions. The majority of the home skilled nursing services were tube replacements, including nasogastric tubes, Foley catheter, tracheostomy, nephrostomy or cystostomy tubes (95%. Conclusions Nine out of 1,000 older patients in Taiwan received home healthcare services during 2004, which was much lower than the rate of disabled older people in Taiwan. Females used home healthcare services more frequently than males and the majority of skilled nursing services were tube replacements. The rate of tube replacement of home healthcare patients in Taiwan deserves to be paid more attention.

  6. Nationwide high-resolution mapping of hazards in the Philippines (Plinius Medal Lecture)

    Science.gov (United States)

    Lagmay, Alfredo Mahar Francisco A.

    2015-04-01

    The Philippines being a locus of typhoons, tsunamis, earthquakes, and volcanic eruptions, is a hotbed of disasters. Situated in a region where severe weather and geophysical unrest is common, the Philippines will inevitably suffer from calamities similar to those experienced recently. With continued development and population growth in hazard prone areas, it is expected that damage to infrastructure and human losses would persist and even rise unless appropriate measures are immediately implemented by government. Recently, the Philippines put in place a responsive program called the Nationwide Operational Assessment of Hazards (NOAH) for disaster prevention and mitigation. The efforts of Project NOAH are an offshoot of lessons learned from previous disasters that have inflicted massive loss of lives and costly damage to property. Several components of the NOAH program focus on mapping of landslide, riverine flood and storm surge inundation hazards. By simulating hazards phenomena over IFSAR- and LiDAR-derived digital terrain models (DTMs) using high-performance computers, multi-hazards maps of 1:10,000 scale, have been produced and disseminated to local government units through a variety of platforms. These detailed village-level (barangay-level) maps are useful to identify safe evacuation sites, planning emergency access routes and prepositioning of search and rescue and relief supplies during times of crises. They are also essential for long-term development planning of communities. In the past two years, NOAH was instrumental in providing timely, site-specific, and understandable hazards information to the public, considered as best practice in disaster risk reduction management (DRR). The use of advanced science and technology in the country's disaster prevention efforts is imperative to successfully mitigate the adverse impacts of natural hazards and should be a continuous quest - to find the best products, put forth in the forefront of battle against

  7. Pharmacological treatments and risk of readmission to hospital for unipolar depression in Finland: a nationwide cohort study.

    Science.gov (United States)

    Tiihonen, Jari; Tanskanen, Antti; Hoti, Fabian; Vattulainen, Pia; Taipale, Heidi; Mehtälä, Juha; Lähteenvuo, Markku

    2017-07-01

    Little is known about the comparative effectiveness of long-term pharmacological treatments for severe unipolar depression. We aimed to study the effectiveness of pharmacological treatments in relapse prevention in a nationwide cohort of patients who had been admitted to hospital at least once as a result of unipolar depression. Our nationwide cohort study investigated the risk of readmission to hospital in 1996-2012 in all patients in Finland who had been admitted to hospital at least once for unipolar depression (without a diagnosis of schizophrenia or bipolar disorder) in Finland between Jan 1, 1987, and Dec 31, 2012. We used nationwide databases to obtain data for hospital admission, mortality, and dispensed medications. Exposure and non-exposure periods for medications were established using the PRE2DUP method. The primary analysis was within-individual analysis of readmission to hospital in the total cohort, in which each individual was used as his or her own control to eliminate selection bias. Putative survival and protopathic biases were controlled in sensitivity analyses. Since 33 independent statistical comparisons were done for specific medications, the level of statistical significance was set at pHR] 0·47 [95% CI 0·40-0·55]; pHR 1·10 [1·06-1·13]; pHR 1·16 [1·12-1·20]; pHR 0·31 [0·21-0·47]; pHR 0·50 [0·43-0·59]; pHR 0·65 [0·46-0·90]; p=0·010) and amitriptyline (HR 0·75 [0·70-0·81]; pcontrolling for survival and protopathic biases, all drugs were associated with lower rates of readmission to hospital than they were in the primary analysis, showing the same rank order in comparative effectiveness. The lowest mortality was observed during antidepressant use (HR 0·56 [0·54-0·58]; p<0·0001). Our results indicate that lithium, especially without concomitant antidepressant use, is the pharmacological treatment associated with the lowest risk of hospital readmission for mental illness in patients with severe unipolar depression, and

  8. Occurrence and in vitro bioactivity of estrogen, androgen, and glucocorticoid compounds in a nationwide screen of United States stream waters

    Data.gov (United States)

    U.S. Environmental Protection Agency — In vitro bioactivity concentrations and chemical concentrations of estrogens, androgens, and glucocorticoids from a nationwide screen of United States stream water...

  9. Providing Consultation to Primary Prevention Programs: Applying the Technology of Community Psychology.

    Science.gov (United States)

    Weed, David S.

    Nationwide attention to the problems of teenage pregnancy and suicide, Acquired Immune Deficiency Syndrome (AIDS), substance abuse, domestic violence, child abuse, dropping out of school, and other conditions is resulting in a proliferation of primary prevention programs, projects, and activities. In too many communities, however, the growth of…

  10. Two Years of Case Management: Final Findings from the Communities in Schools Random Assignment Evaluation

    Science.gov (United States)

    Parise, Leigh M.; Corrin, William; Granito, Kelly; Haider, Zeest; Somers, Marie-Andrée; Cerna, Oscar

    2017-01-01

    While high school graduation rates are on the rise nationwide, too many students still never reach that milestone, with 7,000 on average dropping out every day. Recognizing that many students need additional support to succeed in school, Communities In Schools (CIS) works to provide and connect students with integrated support services to keep…

  11. Strategic Partnerships that Strengthen Extension's Community-Based Entrepreneurship Programs: An Example from Maine

    Science.gov (United States)

    Bassano, Louis V.; McConnon, James C., Jr.

    2011-01-01

    This article explains how Extension can enhance and expand its nationwide community-based entrepreneurship programs by developing strategic partnerships with other organizations to create highly effective educational programs for rural entrepreneurs. The activities and impacts of the Down East Micro-Enterprise Network (DEMN), an alliance of three…

  12. Measurement Instruments for Assessing the Performance of Professional Learning Communities. REL 2016-144

    Science.gov (United States)

    Blitz, Cynthia L.; Schulman, Rebecca

    2016-01-01

    For more than a decade education practitioners have promoted the professional learning community (PLC) as an effective way to provide professional development to teachers. As more PLCs are established in schools and districts nationwide, education stakeholders--researchers, practitioners, administrators, and policymakers--are interested in…

  13. Arthritis in adults with community-acquired bacterial meningitis: a prospective cohort study

    NARCIS (Netherlands)

    Weisfelt, M.; van de Beek, D.; Spanjaard, L.; de Gans, J.

    2006-01-01

    Background: Although the coexistence of bacterial meningitis and arthritis has been noted in several studies, it remains unclear how often both conditions occur simultaneously. Methods: We evaluated the presence of arthritis in a prospective nationwide cohort of 696 episodes of community-acquired

  14. A Nation-Wide Study on the Percentage of Schizophrenia and Bipolar Disorder Patients Who Earn Minimum Wage or Above.

    Science.gov (United States)

    Davidson, Michael; Kapara, Ori; Goldberg, Shira; Yoffe, Rinat; Noy, Shlomo; Weiser, Mark

    2016-03-01

    Although it is undisputable that patients with severe mental illness have impaired ability to work, the extent of this is unclear. This is a nation-wide, cross-sectional survey of patients who have been hospitalized with severe mental illness earning minimum wage or above. Data from the Israeli Psychiatric Hospitalization Case Registry were linked with nation-wide data from the National Insurance Institute (the equivalent of US Social Security) on personal income. Hospitalization data were obtained on all consecutive admissions to any psychiatric hospital in the country between 1990-2008 with a diagnosis of schizophrenia, other nonaffective psychotic disorders, or bipolar disorder (N = 35 673). Earning minimum wage or more was defined as earning at least 1000 USD/month, which was equivalent to minimum wage in Israel in December 2010. The percentages of patients with only 1 admission who were earning minimum wage or above in December 2010 were as follows: 10.6% of patients with a diagnosis of schizophrenia; 21.6% of patients with a diagnosis of nonaffective psychotic disorders; and 24.2% of patients with bipolar disorder. The percentages of patients with multiple admissions who were earning minimum wage or above were as follows: 5.8% of patients with schizophrenia; 11.2% of patients with nonaffective psychotic disorders; and 19.9% of patients with bipolar disorder. Despite potential confounders, the results indicate that patients with schizophrenia, nonaffective psychotic disorders, or bipolar disorder have a poor employment outcome, even if they have only been admitted once. These results emphasize the importance of improving interventions to re-integrate these individuals into the work force. © The Author 2015. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  15. Comparative analysis of perioperative complications between a multicenter prospective cervical deformity database and the Nationwide Inpatient Sample database.

    Science.gov (United States)

    Passias, Peter G; Horn, Samantha R; Jalai, Cyrus M; Poorman, Gregory; Bono, Olivia J; Ramchandran, Subaraman; Smith, Justin S; Scheer, Justin K; Sciubba, Daniel M; Hamilton, D Kojo; Mundis, Gregory; Oh, Cheongeun; Klineberg, Eric O; Lafage, Virginie; Shaffrey, Christopher I; Ames, Christopher P

    2017-11-01

    Complication rates for adult cervical deformity are poorly characterized given the complexity and heterogeneity of cases. To compare perioperative complication rates following adult cervical deformity corrective surgery between a prospective multicenter database for patients with cervical deformity (PCD) and the Nationwide Inpatient Sample (NIS). Retrospective review of prospective databases. A total of 11,501 adult patients with cervical deformity (11,379 patients from the NIS and 122 patients from the PCD database). Perioperative medical and surgical complications. The NIS was queried (2001-2013) for cervical deformity discharges for patients ≥18 years undergoing cervical fusions using International Classification of Disease, Ninth Revision (ICD-9) coding. Patients ≥18 years from the PCD database (2013-2015) were selected. Equivalent complications were identified and rates were compared. Bonferroni correction (pdatabases. A total of 11,379 patients from the NIS database and 122 patiens from the PCD database were identified. Patients from the PCD database were older (62.49 vs. 55.15, pdatabase. The PCD database had an increased risk of reporting overall complications than the NIS (odds ratio: 2.81, confidence interval: 1.81-4.38). Only device-related complications were greater in the NIS (7.1% vs. 1.1%, p=.007). Patients from the PCD database displayed higher rates of the following complications: peripheral vascular (0.8% vs. 0.1%, p=.001), gastrointestinal (GI) (2.5% vs. 0.2%, pdatabases (p>.004). Based on surgicalapproach, the PCD reported higher GI and neurologic complication rates for combined anterior-posterior procedures (pdatabase revealed higher overall and individual complication rates and higher data granularity. The nationwide database may underestimate complications of patients with adult cervical deformity (ACD) particularly in regard to perioperative surgical details owing to coding and deformity generalizations. The surgeon-maintained database

  16. A nationwide classification of New Zealand aquifer properties

    Science.gov (United States)

    Westerhoff, Rogier; Tschritter, Constanze; Rawlinson, Zara; White, Paul

    2017-04-01

    Groundwater plays an essential role in water provision for domestic, industrial and agricultural use. Groundwater is also vital for ecology and environment, since it provides baseflow to many streams, rivers and wetlands. As groundwater is a 'hidden' resource that is typically poorly understood by the public, simple and informative maps can assist to enhance awareness for understanding groundwater and associated environmental issues. The first national aquifer map for New Zealand (2001) identified 200 aquifers at a scale of approximately 1:5 Million. Subsequently, regional councils and unitary authorities have updated their aquifer boundaries using a variety of methods. However, with increasing demand of groundwater in New Zealand and drought impacts expected to be more significant in the future, more consistent and more advanced aquifer characterisation and mapping techniques are needed to improve our understanding of the available resources. Significant resources have gone into detailed geological mapping in recent years, and the New Zealand 1:250,000 Geological Map (QMAP) was developed and released as a seamless GIS database in 2014. To date, there has been no national assessment of this significant data set for aquifer characterisation purposes. This study details the use of the QMAP lithological and chrono-stratigraphic information to develop a nationwide assessment of hydrogeological units and their properties. The aim of this study is to map hydrogeological units in New Zealand, with a long-term goal to use this as a basis for a nationally-consistent map of aquifer systems and aquifer properties (e.g., hydraulic conductivity estimates). Internationally accepted aquifer mapping studies were reviewed and a method was devised that classifies hydrogeological units based on the geological attributes of the QMAP ArcGIS polygons. The QMAP attributes used in this study were: main rock type; geological age; and secondary rock type. The method was mainly based on

  17. Nationwide lithological interpretation of cone penetration tests using neural networks

    Science.gov (United States)

    van Maanen, Peter-Paul; Schokker, Jeroen; Harting, Ronald; de Bruijn, Renée

    2017-04-01

    The Geological Survey of the Netherlands (GSN) systematically produces 3D stochastic geological models of the Dutch subsurface. These voxel models are regarded essential in answering subsurface-related questions on, for example, aggregate resource potential, groundwater flow, land subsidence hazard and the planning and realization of large-scale infrastructural works. GeoTOP is the most recent and detailed generation of 3D voxel models. This model describes 3D stratigraphical and lithological variability up to a depth of 50 m using voxels of 100 × 100 × 0.5 m. Currently, visually described borehole samples are the primary input of these large-scale 3D geological models, both when modeling architecture and composition. Although tens of thousands of cone penetration tests (CPTs) are performed each year, mainly in the reconnaissance phase of construction activities, these data are hardly used as geological model input. There are many reasons why it is of interest to utilize CPT data for geological and lithological modeling of the Dutch subsurface, such as: 1) CPTs are more abundant than borehole descriptions, 2) CPTs are cheaper and easier to gather, and 3) CPT data are more quantitative and uniform than visual sample descriptions. This study uses CPTs and the lithological descriptions of associated nearby undisturbed drilling cores collected by the GSN to establish a nationwide reference dataset for physical and chemical properties of the shallow subsurface. The 167 CPT-core pairs were collected at 160 locations situated in the North, West and South of the Netherlands. These locations were chosen to cover the full extent of geological units and lithological composition in the upper 30 to 40 m of the subsurface in these areas. The distance between the CPT location and associated borehole is small, varying between 0 and 30 m, with an average of 6 m. For each 2 cm CPT interval the data was automatically annotated with the lithoclass from the associated core using a

  18. Marital Status, Lifestyle and Dementia: A Nationwide Survey in Taiwan.

    Directory of Open Access Journals (Sweden)

    Ling-Yun Fan

    Full Text Available Evidence of an association between lifestyle and marital status and risk of dementia is limited in Asia.In this nationwide population-based cross-sectional survey, participants were selected by computerized random sampling from all 19 counties in Taiwan. A total of 10432 residents were assessed by a door-to-door in-person survey, among whom 7035 were normal and 929 were diagnosed with dementia using the criteria recommended by National Institute on Aging-Alzheimer's Association. Premorbid lifestyle habits and demographic data including marital status were compared between normal subjects and participants with dementia.After adjustment for age, gender, education, body mass index, smoking, drinking, marital status, sleep habits, exercise, social engagement and co-morbidities including hypertension, diabetes and cerebrovascular diseases, an increased risk for dementia was found in people with widow or widower status (OR 1.42, 95% CI 1.15-1.77 and people who used to take a nap in the afternoon (OR 1.33, 95% CI 1.02-1.72. Decreased risk was found in people with the habit of regular exercise (OR 0.12, 95% CI 0.09-0.16, adequate night sleep (OR 0.55, 95% CI 0.39-0.76 and regular social engagement (OR 0.53, 95% CI 0.36-0.77.Our results provide preliminary evidence of possible risk-reduction effects for dementia, including regular exercise even in modest amounts, social engagement and adequate night sleep, whereas people with the widow/widower status or who used to take an afternoon nap might have increased risk of dementia.

  19. Total pancreatectomy and islet autotransplantation: A decade nationwide analysis.

    Science.gov (United States)

    Fazlalizadeh, Reza; Moghadamyeghaneh, Zhobin; Demirjian, Aram N; Imagawa, David K; Foster, Clarence E; Lakey, Jonathan R; Stamos, Michael J; Ichii, Hirohito

    2016-03-24

    To investigate outcomes and predictors of in-hospital morbidity and mortality after total pancreatectomy (TP) and islet autotransplantation. The nationwide inpatient sample (NIS) database was used to identify patients who underwent TP and islet autotransplantation (IAT) between 2002-2012 in the United States. Variables of interest were inherent variables of NIS database which included demographic data (age, sex, and race), comorbidities (such as diabetes mellitus, hypertension, and deficiency anemia), and admission type (elective vs non-elective). The primary endpoints were mortality and postoperative complications according to the ICD-9 diagnosis codes which were reported as the second to 25(th) diagnosis of patients in the database. Risk adjusted analysis was performed to investigate morbidity predictors. Multivariate regression analysis was used to identify predictors of in-hospital morbidity. We evaluated a total of 923 patients who underwent IAT after pancreatectomy during 2002-2012. Among them, there were 754 patients who had TP + IAT. The most common indication of surgery was chronic pancreatitis (86%) followed by acute pancreatitis (12%). The number of patients undergoing TP + IAT annually significantly increased during the 11 years of study from 53 cases in 2002 to 155 cases in 2012. Overall mortality and morbidity of patients were 0% and 57.8 %, respectively. Post-surgical hypoinsulinemia was reported in 42.3% of patients, indicating that 57.7% of patients were insulin independent during hospitalization. Predictors of in-hospital morbidity were obesity [adjusted odds ratio (AOR): 3.02, P = 0.01], fluid and electrolyte disorders (AOR: 2.71, P < 0.01), alcohol abuse (AOR: 2.63, P < 0.01), and weight loss (AOR: 2.43, P < 0.01). TP + IAT is a safe procedure with no mortality, acceptable morbidity, and achieved high rate of early insulin independence. Obesity is the most significant predictor of in-hospital morbidity.

  20. Birth order and paediatric allergic disease: A nationwide longitudinal survey.

    Science.gov (United States)

    Kikkawa, T; Yorifuji, T; Fujii, Y; Yashiro, M; Okada, A; Ikeda, M; Doi, H; Tsukahara, H

    2018-05-01

    Environmental factors seem to be related to the incidence of allergic disease. Children with a later birth order are often exposed to environments, where pathogens and endotoxins can be found, and thus have a higher risk of developing infectious diseases. Therefore, birth order is regarded as an indicator that reflects post-natal environment. However, longitudinal studies are limited on this subject. This study sought to elucidate the relationships between birth order and allergic disease. From a nationwide longitudinal study that followed children born in 2001 (n = 47 015), we selected doctors' visits for 3 types of allergic disease-bronchial asthma, food allergy and atopic dermatitis-from infancy to 12 years of age and conducted binomial log-linear regression analysis to evaluate the associations between birth order and these diseases. We adjusted for the child and parental factors and estimated risk ratio (RR) and 95% confidence interval (CI) for each outcome. The associations between birth order and bronchial asthma were diverse; later birth order increased the risk in early childhood, but decreased the risks during school age. For example, the adjusted RR comparing third-born or higher and first-born children was 1.19 (95% CI, 1.05-1.35) between 30 and 42 months of age, but was 0.76 (95% CI, 0.65-0.89) between 10 and 11 years. Later birth order was generally protective for food allergy but increased the risk of atopic dermatitis. The influence of birth order depended on the type of allergic disease and the childhood period. Childhood is unique in terms of physical and immunological development, and the immune response to the post-natal environment in childhood appears to be heterogeneous. © 2018 John Wiley & Sons Ltd.

  1. Hypothyroidism incidence in and around pregnancy: a Danish nationwide study.

    Science.gov (United States)

    Andersen, S L; Carlé, A; Olsen, J; Laurberg, P

    2016-11-01

    Immunological changes in and after a pregnancy may influence the onset of autoimmune diseases. An increased incidence of hyperthyroidism has been observed both in early pregnancy and postpartum, but it remains to be studied if the incidence of hypothyroidism varies in a similar way. Population-based cohort study using Danish nationwide registers. All women who gave birth to a singleton live-born child in Denmark from 1999 to 2008 (n = 403 958) were identified, and data on hospital diagnosis of hypothyroidism and redeemed prescriptions of thyroid hormone were extracted. The overall incidence rate (IR) of hypothyroidism during 1997-2010 and the IR in three-month intervals before, during and after the woman's first pregnancy in the study period were calculated and compared with the IR of hyperthyroidism. Altogether 5220 women were identified with onset of hypothyroidism from 1997 to 2010 (overall IR 92.3/100 000/year) and 1572 women developed hypothyroidism in the period from 2 years before to 2 years after birth of the first child in the study period. The incidence of hypothyroidism decreased during the pregnancy (incidence rate ratio (IRR) vs overall IR in the rest of the study period: first trimester: 0.89 (95% CI: 0.66-1.19), second trimester: 0.71 (0.52-0.97), third trimester: 0.29 (0.19-0.45)) and increased after birth with the highest level at 4-6 months postpartum (IRR 3.62 (2.85-4.60)). These are the first population-based data on the incidence of hypothyroidism in and around pregnancy. The incidence declined during pregnancy followed by a sharp increase postpartum. Notably, hypothyroidism as opposed to hyperthyroidism showed no early pregnancy increase. © 2016 European Society of Endocrinology.

  2. Survival after out-of-hospital cardiac arrest in nursing homes - A nationwide study.

    Science.gov (United States)

    Pape, Marianne; Rajan, Shahzleen; Hansen, Steen Møller; Mortensen, Rikke Nørmark; Riddersholm, Signe; Folke, Fredrik; Karlsson, Lena; Lippert, Freddy; Køber, Lars; Gislason, Gunnar; Søholm, Helle; Wissenberg, Mads; Gerds, Thomas A; Torp-Pedersen, Christian; Kragholm, Kristian

    2018-02-07

    Survival among nursing home residents who suffers out-of-hospital cardiac arrest (OHCA) is sparsely studied. Deployment of automated external defibrillators (AEDs) in nursing home facilities in Denmark is unknown. We examined 30-day survival following OHCA in nursing and private home residents. This register-based, nationwide, follow-up study identified OHCA-patients ≥18 years of age with a resuscitation attempt in nursing homes and private homes using Danish Cardiac Arrest Register data from June 1, 2001 to December 31, 2014. The primary outcome measure was 30-day survival. Multiple logistic regression analyses were used to assess factors potentially associated with survival among nursing and private home residents separately. Of 26,999 OCHAs, 2516 (9.3%) occurred in nursing homes, and 24,483 (90.7%) in private homes. Nursing home residents were older (median 83 (Q1-Q3: 75-89) vs. 71 (Q1-Q3: 61-80) years), had more witnessed arrest (55.4% vs. 43.4%), received more bystander cardiopulmonary resuscitation (CPR) (49.7% vs. 35.3%), but less pre-hospital defibrillation (15.1% vs. 29.8%). Registered AEDs increased in the period 2007-2014 from 1 to 211 in nursing homes vs. 1 to 488 in private homes. Average 30-day survival in nursing homes was 1.7% [95%CI: 1.2-2.2%] vs. 4.9% [95%CI: 4.6-5.2%] in private homes (P nursing vs. private home residents. Average 30-day survival after OHCA was very low in nursing home residents, but those who received early resuscitative efforts had higher chance of survival. Copyright © 2018 Elsevier B.V. All rights reserved.

  3. Lower perinatal mortality in preterm born twins than in singletons: a nationwide study from The Netherlands.

    Science.gov (United States)

    Vasak, Blanka; Verhagen, Jessica J; Koenen, Steven V; Koster, Maria P H; de Reu, Paul A O M; Franx, Arie; Nijhuis, Jan G; Bonsel, Gouke J; Visser, Gerard H A

    2017-02-01

    Twin pregnancies are at increased risk for perinatal morbidity and death because of many factors that include a high incidence of preterm delivery. Compared with singleton pregnancies, overall perinatal risk of death is higher in twin pregnancies; however, for the preterm period, the perinatal mortality rate has been reported to be lower in twins. The purpose of this study was to compare perinatal mortality rates in relation to gestational age at birth between singleton and twin pregnancies, taking into account socioeconomic status, fetal sex, and parity. We studied perinatal mortality rates according to gestational age at birth in 1,502,120 singletons pregnancies and 51,658 twin pregnancies without congenital malformations who were delivered between 2002 and 2010 after 28 weeks of gestation. Data were collected from the nationwide Netherlands Perinatal Registry. Overall the perinatal mortality rate in twin pregnancies (6.6/1000 infants) was higher than in singleton pregnancies (4.1/1000 infants). However, in the preterm period, the perinatal mortality rate in twin pregnancies was substantially lower than in singleton pregnancies (10.4 per 1000 infants as compared with 34.5 per 1000 infants, respectively) for infants who were born at <37 weeks of gestation; this held especially for antepartum deaths. After 39 weeks of gestation, the perinatal mortality rate was higher in twin pregnancies. Differences in parity, fetal sex, and socioeconomic status did not explain the observed differences in outcome. Overall the perinatal mortality rate was higher in twin pregnancies than in singleton pregnancies, which is most likely caused by the high preterm birth rate in twins and not by a higher mortality rate for gestation, apart from term pregnancies. During the preterm period, the antepartum mortality rate was much lower in twin pregnancies than in singleton pregnancies. We suggest that this might be partially due to a closer monitoring of twin pregnancies, which indirectly

  4. Long-term mortality after Staphylococcus aureus spondylodiscitis: a Danish nationwide population-based cohort study.

    Science.gov (United States)

    Aagaard, Theis; Roed, Casper; Larsen, Anders R; Petersen, Andreas; Dahl, Benny; Skinhøj, Peter; Obel, Niels

    2014-09-01

    To determine the long-term mortality and the causes of death after Staphylococcus aureus spondylodiscitis. Nationwide, population-based cohort study using national registries of adults diagnosed with non postoperative S. aureus spondylodiscitis from 1994-2009 and alive 1 year after diagnosis (n Z 313). A comparison cohort from the background population individually matched on sex and age was identified (n Z 1565). Kaplan-Meier survival curves were constructed and Poisson regression analyses used to estimate mortality rate ratios (MRR) adjusted for comorbidity. 88 patients (28.1%) and 267 individuals from the population-based comparison cohort (17.1%) died. Un-adjusted MRR for S. aureus spondylodiscitis patients was 1.77 (95% CI, 1.39-2.25) and 1.32 (95% CI, 1.02-1.71) after adjustment for comorbidity. We observed increased mortality due to infectious (MRR 8.57; 95% CI, 2.80-26.20), endocrine (MRR 3.57; 95%CI, 1.01-12.66), cardiovascular (MRR 1.59; 95% CI, 1.02-2.49), gastrointestinal (MRR 3.21; 95% CI, 1.178.84) and alcohol and drug abuse-related (MRR 10.71; 95% CI, 3.23-35.58) diseases. Patients diagnosed with S. aureus spondylodiscitis have substantially increased long-term mortality, mainly due to comorbidity. To improve survival after S. aureus spondylodiscitis these patients should be screened for comorbidity and substance abuse predisposing to the disease [corrected]. Copyright © 2014 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

  5. Association between colonic diverticular disease and colorectal cancer: a nationwide population-based study.

    Science.gov (United States)

    Huang, Wen-Yen; Lin, Che-Chen; Jen, Yee-Min; Chang, Yen-Jung; Hsiao, Cheng-Wen; Yang, Muh-Hwa; Lin, Chun-Shun; Sung, Fung-Chang; Liang, Ji-An; Kao, Chia-Hung

    2014-08-01

    We investigated whether a diagnosis of colonic diverticular disease is associated with an increased risk for subsequent development of colorectal cancer (CRC) in a nationwide population-based retrospective study. We identified 41,359 individuals diagnosed with colonic diverticular disease as inpatients from 2000 through 2009 from the Taiwan National Health Insurance Research Database (study cohort) and collected data for 165,436 randomly selected additional subjects, matched by sex, age, and baseline year (comparison cohort). Data were collected until individuals developed CRC or withdrew from the National Health Insurance system, or until December 31, 2010. Cumulative incidences and hazard ratios (HRs) of CRC development were determined. To assess for ascertainment bias, we conducted an analysis excluding the first 12 months of follow-up evaluation. The risk of CRC was significantly higher in the study cohort than in the comparison cohort (HR adjusted for age, sex, and comorbidities, 4.54; 95% confidence interval, 4.19-4.91; P diagnosis of colonic diverticular disease; subsequent incidence rates for CRC in the study and comparison cohorts were 15.13 and 15.74 per 10,000 person-years, respectively (adjusted HR, 0.96; 95% confidence interval, 0.83-1.11). Colonic diverticular disease is not associated with an increased risk of subsequent CRC after the first year of diagnosis of colonic diverticular disease. An increased risk was observed in the first year, possibly owing to misclassification and screening effects. Copyright © 2014 AGA Institute. Published by Elsevier Inc. All rights reserved.

  6. The Association Between Barium Examination and Subsequent Appendicitis: A Nationwide Population-Based Study.

    Science.gov (United States)

    Li, Hao-Ming; Yeh, Lee-Ren; Huang, Ying-Kai; Lin, Cheng-Li; Kao, Chia-Hung

    2017-01-01

    The incidence and association between appendicitis and barium examination (BE) remain unclear. Such potential risk may be omitted. We conducted a longitudinal, nationwide, population-based cohort study to investigate the association between BE and appendicitis risk. From the Taiwan National Health Insurance Research Database, a total of 24,885 patients who underwent BE between January 1, 2000 and December 31, 2010 were enrolled in a BE cohort; an additional 98,384 subjects without BE exposure were selected as a non-BE cohort, matched by age, sex, and index date. The cumulative incidences of subsequent appendicitis in the BE and non-BE cohorts were assessed using the Kaplan-Meier curves and log-rank test. Cox proportional hazards regression analyses were employed to calculate the appendicitis risk between the groups. The cumulative incidence of appendicitis was higher in the BE cohort than in the non-BE cohort (P = .001). The overall incidence rates of appendicitis for the BE and non-BE cohorts were 1.19 and 0.80 per 1000 person-years, respectively. After adjustment for sex, age, and comorbidities, the risk of appendicitis was higher in the BE cohort (adjusted hazard ratio = 1.46, 95% confidence interval = 1.23-1.73) compared with the non-BE cohort, especially in the first 2 months (adjusted hazard ratio = 9.72, 95% confidence interval = 4.65-20.3). BE was associated with an increased, time-dependent appendicitis risk. Clinicians should be aware of this potential risk to avoid delayed diagnoses. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Relationship between physical activity and mental health in a nationwide sample of Korean adults.

    Science.gov (United States)

    Park, Subin; Cho, Maeng Je; Cho, Seong-Jin; Bae, Jae Nam; Lee, Jun-Young; Park, Jong Ik; Kim, Jin Yeong; Lee, Dong-Woo; Hong, Jin Pyo

    2011-01-01

    There is widespread recognition of the effect of physical activity on mental health. The authors examined the relationships between physical activity and mental health in a nationwide sample of Korean adults. A total of 6,510 subjects aged 18 to 64 years participated in the study. The short form of the International Physical Activity Questionnaire was used to estimate the level of physical activity. Mental health was assessed using the Composite International Diagnostic Interview, the Epidemiological Studies Depression Scale (CES-D), and the General Health Questionnaire (GHQ). Logistic regression analysis was used to compare the prevalence of CES-D and GHQ cases and psychiatric disorders among the following physical activity categories: inactive, minimally active, and health-enhancing physical activity (HEPA) active. HEPA-active or minimally active subjects were less likely to be classified as "depressed" on the CES-D (≥21) and "psychologically distressed" on the GHQ (≥3) than were physically inactive subjects. HEPA was associated with a significantly decreased 1-year prevalence of major depressive disorder and obsessive-compulsive disorder, and with a significantly increased 1-year prevalence of alcohol abuse, relative to physical inactivity. In addition, HEPA was associated with a significantly increased 1 year prevalence of alcohol abuse, relative to minimal physical activity. Physical inactivity was associated with a significantly increased 1-year prevalence of alcohol dependence, relative to physical inactivity. The results indicate a negative association between physical activity and depressive and anxiety disorders. A high level of physical activity seems to be associated with alcohol abuse, but a moderate level of physical activity may play a role in preventing alcohol dependence. Copyright © 2011 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.

  8. A nationwide survey of past hepatitis A infections among Canadian adults.

    Science.gov (United States)

    Scheifele, David W; De Serres, Gaston; Gilca, Vladimir; Duval, Bernard; Milner, Ruth; Ho, Margaret; Ochnio, Jan J

    2010-07-19

    Hepatitis A virus (HAV) infection rates in Canada are low and declining. A nationwide pediatric serosurvey in 2003 confirmed that HAV infection is uncommon in children. Additional seroepidemiological data for adults would help to guide domestic use of HAV vaccines. A country-wide survey of HAV antibody positivity and selected risk factors was conducted among 18-69 year olds identified by random digit dialing, in samples proportional to regional populations. Volunteers were sent study materials and returned oral fluid and completed questionnaires by mail. An ultra-sensitive assay was used to detect HAV antibody in oral fluid. Multiple logistic regression was used for risk factor assessment. Of 2104 potential study participants, 1552 (74%) returned an adequate oral fluid specimen and questionnaire. Anti-HAV was detected in 509 individuals (33%) and was associated with birth in HAV endemic areas, self-reported hepatitis A vaccination, prior travel to endemic areas, and increasing age. Only 15% reported having been vaccinated. Among Canadian-born, non-vaccinated participants anti-HAV was present in 20%, ranging regionally from 14% to 30%. Age-specific positivity rates in this subset were: 18-29 years 2.6%; 30-39 years 6.1%; 40-49 years 11.4%; 50-59 years 26.4% and 60-69 years 45.9%. Travel to HAV-endemic countries was reported by 55% of participants but only 24% of travelers had been vaccinated. Past HAV infection rates among Canadian-born, non-vaccinated individuals are low in young adults and increase by two-fold per age decade. Travel to endemic areas is a significant risk factor, amenable to prevention by greater use of HAV vaccine. (c) 2010 Elsevier Ltd. All rights reserved.

  9. Low-dose aspirin use and survival in breast cancer patients: A nationwide cohort study.

    Science.gov (United States)

    Mc Menamin, Úna C; Cardwell, Chris R; Hughes, Carmel M; Murray, Liam J

    2017-04-01

    Preclinical evidence from breast cancer cell lines and animal models suggest that aspirin could have anti-cancer properties. In a large breast cancer patient cohort, we investigated whether post-diagnostic low-dose aspirin use was associated with a reduction in the risk of breast cancer-specific mortality. We identified 15,140 newly diagnosed breast cancer patients within the Scottish Cancer Registry. Linkages to the Scottish Prescribing Information System provided data on dispensed medications and breast cancer-specific deaths were identified from National Records of Scotland Death Records. Time-dependent Cox regression models were used to calculate hazard ratios (HR) and 95% CIs for breast cancer-specific and all-cause mortality by post-diagnostic low-dose aspirin use. HRs were adjusted for a range of potential confounders including age at diagnosis, year of diagnosis, cancer stage, grade, cancer treatments received, comorbidities, socioeconomic status and use of statins. Secondary analysis investigated the association between pre-diagnostic low-dose aspirin use and breast cancer-specific and all-cause mortality. Post-diagnostic users of low-dose aspirin appeared to have increased breast cancer-specific mortality compared with non-users (HR 1.44, 95% CI 1.26, 1.65) but this association was entirely attenuated after adjustment for potential confounders (adjusted HR 0.92, 95% CI 0.75, 1.14). Findings were similar in analysis by increasing duration of use and in analysis of pre-diagnostic low-dose aspirin use. In this large nationwide study of breast cancer patients, we found little evidence of an association between post-diagnostic low-dose aspirin use and cancer-specific mortality. Copyright © 2016 Elsevier Ltd. All rights reserved.

  10. Infliximab for the Treatment of Refractory Kawasaki Disease: A Nationwide Survey in Japan.

    Science.gov (United States)

    Masuda, Hiroshi; Kobayashi, Tohru; Hachiya, Akira; Nakashima, Yasutaka; Shimizu, Hiroyuki; Nozawa, Tomo; Ogihara, Yoshihito; Ito, Shuichi; Takatsuki, Shinichi; Katsumata, Nobuyuki; Suzuki, Yasuo; Takenaka, Satoshi; Hirono, Keiichi; Kobayashi, Tomio; Suzuki, Hiroshi; Suganuma, Eisuke; Takahashi, Kei; Saji, Tsutomu

    2018-04-01

    To assess the safety and efficacy of infliximab (IFX) for the treatment of patients with Kawasaki disease (KD). This was a nationwide survey of 274 Japanese institutions exploring how IFX was used to treat patients with KD. The patients' sex, age, treatment course, pre- and post-IFX therapy blood test results, coronary artery lesions (CALs), and adverse events (AEs) were evaluated. We analyzed 434 patients with KD who received IFX between March 2005 and November 2014. The median age at onset was 33 months (range 1-138), and 66 patients (15.2%) were under 1 year old. In all cases, IFX was administered as additional treatment. The median days of illness at the initiation of IFX was 9 days. In 275 patients (63.4%), IFX was administered as third-line treatment, and in 106 patients (24.4%), IFX was administered as fourth-line treatment. Single dose IFX 5 mg/kg was administered to 412 patients (94.9%). After IFX, 363 patients (83.6%) became afebrile within 2 days, and the white blood cell count, percentage of neutrophils, and serum C-reactive protein levels significantly decreased (P < .001), although 119 patients (27.4%) received additional treatment. Before IFX, 132 patients (30.4%) had already developed CALs. In patients without CALs before IFX, 31 patients (10.3%) newly developed CAL after IFX, whereas 32 patients (24.2%) with CAL before IFX showed increased CAL severity. Eighty AEs were observed in 69 patients (15.9%); however, serious AEs were few and reversible. IFX might be an effective and tolerable treatment for refractory KD. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. Postnatal Risk of Acquiring Kawasaki Disease: A Nationwide Birth Cohort Database Study.

    Science.gov (United States)

    Wu, Mei-Hwan; Lin, Min-Tai; Chen, Hui-Chi; Kao, Feng-Yu; Huang, San-Kuei

    2017-01-01

    To investigate the postnatal risk of Kawasaki disease and coronary complications from a nationwide birth cohort in Taiwan, a country with the third-highest incidence of Kawasaki disease worldwide. We enrolled children born between 2000 and 2009 with complete postnatal medical care records for 2000-2014 in the Taiwan national database. Out of a total of 2 150 590 live births, we identified 6690 (62.6% boys) patients with Kawasaki disease. The onset was mostly (93.9%) within the first 5 years of life (median, 16 months; 38% during infancy), but was rare within the first 3 months of life. The overall cumulative incidence of Kawasaki disease by age 5 years was 2.78‰ (3.33‰ for boys and 2.17‰ for girls; P Kawasaki disease recurred more often in younger patients (cumulative incidence, 2.3% in infants vs 1.7% in children aged 1-4 years). Coronary complications occurred in 16.2% of the patients, including 4 cases of acute myocardial infarction (3 occuring during the acute stage and 1 occurring 5 years later). The probability of a major cardiac event (infarction, undergoing percutaneous coronary intervention or coronary artery bypass grafting, or death) by adolescence was 1.9%. The postnatal risk of Kawasaki disease was 3‰-4‰ and increased with every birth year. Patients with Kawasaki disease are at substantial risk for a major cardiac events during childhood. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. [Nationwide survey on pediatric infectious disease organisation and antibiotic management in French hospitals].

    Science.gov (United States)

    Angoulvant, F; Dubos, F; Cohen, R; Martinot, A

    2015-05-01

    Skills in pediatric infectious disease (PID) and antibiotic management are of critical importance in hospitals. This nationwide survey aimed to assess the characteristics, training, and tasks of PID consultants in French hospitals. The management of PID and antibiotic therapy was also analyzed in hospitals lacking PID consultants. An electronic survey linked to a dedicated website was sent to French hospitals with a pediatric department in June 2012. In hospitals where PID consultants were available, they were asked to answer the questionnaire. In hospitals lacking PID consultants, pediatricians were asked to send the questionnaire to their infectious disease consultant, if available. A total of 86 individual responses were received from 76 hospitals (including 26 academic hospitals). The existence of a PID consultant was declared in 53 hospitals. Responses were received from the person claiming to be "the" or "one of the" PID consultants in 46 cases, representing 39 centers. PID consultants had a degree in PID (46%) or antibiotic therapy (37%), or a complementary qualification as a specialist in infectious diseases (13%). The PID consultants worked in departments of general pediatrics (61%) and emergency medicine (15%), or neonatology (15%). They were involved in the Nosocomial Infection Prevention Committee (43%) or the Antimicrobial Therapy Committee (63%) and had teaching activities (65%). There was a specific unit with a PID label in 10% of the 39 centers reporting at least one consultant and consultations of infectious diseases took place in 28%. PID consultants are rare. Their important role in patient care should be recognized. Efforts should focus on recruiting and training such specialists. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  13. Organisation of in-hospital cardiac arrest teams - a nationwide study.

    Science.gov (United States)

    Lauridsen, Kasper Glerup; Schmidt, Anders Sjørslev; Adelborg, Kasper; Løfgren, Bo

    2015-04-01

    In-hospital cardiac arrests are treated by a team of health care providers. Improving team performance may increase survival. Currently, no international standards for cardiac arrest teams exist in terms of member composition and allocation of tasks. To describe the composition of in-hospital cardiac arrest teams and review pre-arrest allocation of tasks. A nationwide cross-sectional study was performed. Data on cardiac arrest teams and pre-arrest allocation of tasks were collected from protocols on resuscitation required for hospital accreditation in Denmark. Additional data were collected through telephone interviews and email correspondence. Psychiatric hospitals and hospitals serving outpatients only were excluded. Data on the cardiac arrest team were available from 44 of 47 hospitals. The median team size was 5 (25th percentile; 75th percentile: 4; 6) members. Teams included a nurse anaesthetist (100%), a medical house officer (82%), an orderly (73%), an anaesthesiology house officer (64%) and a medical assistant (20%). Less likely to participate was a cardiology house officer (23%) or a cardiology specialist registrar (5%). Overall, a specialist registrar was represented on 20% of teams and 20% of cardiac arrest teams had a different team composition during nights and weekends. In total, 41% of teams did not define a team leader pre-arrest, and the majority of the teams did not define the tasks of the remaining team members. In Denmark, there are major differences among cardiac arrest teams. This includes team size, profession of team members, medical specialty and seniority of the physicians. Nearly half of the hospitals do not define a cardiac arrest team leader and the majority do not define the tasks of the remaining team members. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  14. Carbapenem use in French hospitals: A nationwide survey at the patient level.

    Science.gov (United States)

    Gauzit, Rémy; Pean, Yves; Alfandari, Serge; Bru, Jean-Pierre; Bedos, Jean-Pierre; Rabaud, Christian; Robert, Jérôme

    2015-12-01

    The objective of this study was to evaluate the characteristics of carbapenem use in French healthcare settings in order to guide future actions. Healthcare facilities voluntarily participated in a nationwide cross-sectional survey in 2011. Medical data and reasons for carbapenem treatment (CPR) and discontinuation were recorded for all patients treated with carbapenems. A total of 2338 patients were recorded by 207 facilities. The median duration of CPR was 8 days, and 31.4% of patients received CPR for >10 days. An antibiotic consultant was involved in the initial choice of CPR in 36.8% of cases. CPR was chosen on an empirical (EP) basis for 1229 patients (52.6%), mainly because of severe sepsis (48.6%) or a perceived risk of bacterial resistance (33.7%). Among EP patients, de-escalation was more frequent in the case of intervention of an antibiotic consultant (35.1%) than without intervention (22.9%) (Pcarbapenems or to fluoroquinolones. Among the latter, de-escalation was performed in 59 cases (14.9%). The intervention of an antibiotic consultant did not favour de-escalation in this group. In conclusion, carbapenems are frequently used for treating suspected or confirmed multidrug-resistant bacteria, and overall CPR duration is long. De-escalation is frequently not implemented despite isolates being susceptible to other drugs. More frequent antibiotic consultant intervention may help to decrease carbapenem use in the case of EP treatment. Copyright © 2015 Elsevier B.V. and the International Society of Chemotherapy. All rights reserved.

  15. Nationwide Healthcare utilization among children with epilepsy in the United States: 2003-2014.

    Science.gov (United States)

    Lekoubou, Alain; Bishu, Kinfe G; Ovbiagele, Bruce

    2018-02-27

    Epilepsy is particularly frequent among children, yet updated and nationwide healthcare utilization estimates are scanty in the United States. To analyze healthcare utilization among children with epilepsy. Data on children (≤17-year-old) were extracted from the Medical Expenditure Panel Survey (MEPS) 2003-2014. Epilepsy was identified using the clinical classification code 83. Healthcare utilization (Inpatient admission, outpatient visits, prescription medication including refill, emergency room visits, and home health provider visits) was compared between children with epilepsy and those without epilepsy. A negative binomial model was used to assess the relationship between epilepsy and healthcare utilizations accounting for the influence of extraneous factors. In all, a weighted 457,873 children (0.84%) had epilepsy in United States. The unadjusted proportion and the mean annual number of health care service utilization were higher in children with epilepsy compared to those without epilepsy. Children with epilepsy had almost 3.3 more outpatient visits (95% CI: 2.281-4.274), 7.9 more medication prescriptions including refills (95% CI: 6.058-9.662), nearly 0.4 more emergency department visits (95% CI: 0.278-0.438) and nearly 12 more home health provider visits (95% CI: 1.988-21.756) than those without epilepsy. The adjusted marginal effect of epilepsy on inpatient admission was not statistically significant. unadjusted and adjusted healthcare utilization is considerably higher in children with epilepsy compared to those without epilepsy in the United States with heterogeneity across individual services. Copyright © 2018 Elsevier B.V. All rights reserved.

  16. Nationwide Trends and Variations in Urological Surgical Interventions and Renal Outcome in Patients with Spina Bifida.

    Science.gov (United States)

    Wang, Hsin-Hsiao S; Lloyd, Jessica C; Wiener, John S; Routh, Jonathan C

    2016-04-01

    Bladder dysfunction in patients with spina bifida can lead to significant morbidity due to renal insufficiency. Indications for surgery vary among institutions and the impact is unclear. We examined trends and variations in urological interventions and chronic renal insufficiency in patients with spina bifida. We reviewed NIS (Nationwide Inpatient Sample) for all patients with spina bifida treated from 1998 to 2011. We used ICD-9-CM codes to identify urological surgery and chronic renal insufficiency. We calculated the Spearman correlation coefficients between rates of spina bifida related bladder surgeries and rates of chronic renal insufficiency outcomes by state. Linear regression models were fitted to investigate the associations between rates of spina bifida related surgery and chronic renal insufficiency across treatment years. We identified 427,616 spina bifida hospital admissions. Mean patient age was 26 years and 56% of patients were female. Of the admissions 35,249 (8%) were for chronic renal insufficiency and 11,078 (3%) were for surgery. During the study period chronic renal insufficiency rates doubled from 6% to 12% and surgery rates decreased from 2.0% to 1.8%. There was a moderately weak inverse association between surgery and chronic renal insufficiency rates with time (r = -0.3, p = 0.06) and by state (r = -0.3, p = 0.04). On multivariate analysis higher rates of surgery were associated with the state in which the patient was treated (p spina bifida related surgery (p = 0.67). We observed a temporal and geographic trend toward decreasing urological surgery and increasing chronic renal insufficiency rates in spina bifida and a wide variation in urological surgical rates among states. Further study is needed to determine the factors behind these trends and variations in spina bifida management. Copyright © 2016 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  17. Fibromyalgia and Risk of Dementia-A Nationwide, Population-Based, Cohort Study.

    Science.gov (United States)

    Tzeng, Nian-Sheng; Chung, Chi-Hsiang; Liu, Feng-Cheng; Chiu, Yu-Hsiang; Chang, Hsin-An; Yeh, Chin-Bin; Huang, San-Yuan; Lu, Ru-Band; Yeh, Hui-Wen; Kao, Yu-Chen; Chiang, Wei-Shan; Tsao, Chang-Hui; Wu, Yung-Fu; Chou, Yu-Ching; Lin, Fu-Huang; Chien, Wu-Chien

    2018-02-01

    Fibromyalgia is a syndrome of chronic pain and other symptoms and is associated with patient discomfort and other diseases. This nationwide matched-cohort population-based study aimed to investigate the association between fibromyalgia and the risk of developing dementia, and to clarify the association between fibromyalgia and dementia. A total of 41,612 patients of age ≥50 years with newly diagnosed fibromyalgia between January 1, and December 31, 2000 were selected from the National Health Insurance Research Database of Taiwan, along with 124,836 controls matched for sex and age. After adjusting for any confounding factors, Fine and Gray competing risk analysis was used to compare the risk of developing dementia during the 10 years of follow-up. Of the study subjects, 1,704 from 41,612 fibromyalgia patients (21.23 per 1,000 person-years) developed dementia when compared to 4,419 from 124,836 controls (18.94 per 1,000 person-years). Fine and Gray competing risk analysis revealed that the study subjects were more likely to develop dementia (hazard ratio: 2.29, 95% CI: 2.16-2.42; P dementia in this study. The study subjects with fibromyalgia had a 2.77-fold risk of dementia in comparison to the control group. Therefore, further studies are needed to elucidate the underlying mechanisms of the association between fibromyalgia and the risk of dementia. Copyright © 2018 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.

  18. Rate of humidifier and humidifier disinfectant usage in Korean children: A nationwide epidemiologic study.

    Science.gov (United States)

    Yoon, Jisun; Cho, Hyun-Ju; Lee, Eun; Choi, Yean Jung; Kim, Young-Ho; Lee, Jung Lym; Lee, Ye Jin; Hong, Soo-Jong

    2017-05-01

    In South Korea, a cluster of humidifier disinfectant-induced lung injury (HDLI) cases developed between 2006 and 2011. There are no existing reports regarding the rate of humidifier disinfectant (HD) usage in the general population of Korean children. The purpose of this study was to investigate the rate of humidifier and HD usage in the general population of Korean children. This is a general population-based birth cohort multicenter study, Panel Study of Korean Children (PSKC) from 2008, a humidifier and HD-related questionnaire administered to 1577 subjects (809 male, 768 female) in 2015 (n=1577). The questionnaire consisted of four categories (humidifier usage, HD usage, exposure duration, and type of HD brands). A total of 75.6% (1192/1577) had used a humidifier, and the rate of HD usage was found to be 31.1% (409/1316). Polyhexamethylene guanidine (PHMG), used as a disinfectant, was found to have the highest usage rate (62.0%). HD was used for less than 3 months of the entire lifetime of most of the subjects. In conclusion, approximately 30% of young Korean children were exposed to HD. PHMG-containing HD was the most commonly used. These results suggest that a nationwide epidemiologic investigation is needed urgently, and children exposed to HD should be investigated regarding their status of lung injury, including a pulmonary function test. Moreover, a long-term follow-up period may be required to evaluate HD usage-associated lung injury. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. Ultraviolet Radiation and Kaposi Sarcoma Incidence in a Nationwide US Cohort of HIV-Infected Men.

    Science.gov (United States)

    Cahoon, Elizabeth K; Engels, Eric A; Freedman, D Michal; Norval, Mary; Pfeiffer, Ruth M

    2017-05-01

    Although ultraviolet radiation (UVR) is established as both an inducer of herpes simplex virus reactivation and as the primary risk factor for many common skin cancers, its relationship with human herpes virus 8 (HHV8) infection or risk of Kaposi sarcoma (KS) is unknown. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated for the association between ambient UVR, history of nonmelanoma skin cancer (NMSC; as a biomarker of personal cumulative UVR dose), and incidence of first primary KS in a nationwide US cohort of white and African American male veterans infected with HIV between 1986 and 1996 (prior to the widespread availability of treatment) using Cox regression. All statistical tests were two-sided. Based on discharge records, there were 422 newly diagnosed KS cases among 17 597 HIV-infected veterans. Cohort members with prior NMSC had a statistically significantly increased risk of KS (HR = 8.64, 95% CI = 6.23 to 11.96) in the total population. Risk of KS was higher for quartile 4 vs 1 among the total population (HR = 1.49, 95% CI = 1.02 to 2.16, P trend UVR quartile [coded 1 to 4] = .02) and among whites (HR = 1.75, 95% CI = 1.11 to 2.78, P trend = .009), but not among African Americans (HR = 1.23, 95% CI = 0.71 to 2.15, P trend = .23). KS risk was elevated among HIV-infected men with NMSC diagnosis and in those living in locations with high ambient UVR at time of HIV diagnosis. Our novel findings suggesting that UVR exposure may increase KS risk warrant further investigation. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  20. First nationwide study regarding ceftriaxone resistance and molecular epidemiology of Neisseria gonorrhoeae in China.

    Science.gov (United States)

    Chen, Shao-Chun; Yin, Yue-Ping; Dai, Xiu-Qin; Unemo, Magnus; Chen, Xiang-Sheng

    2016-01-01

    Antimicrobial resistance (AMR) in Neisseria gonorrhoeae is a major public health concern worldwide. This is the first nationwide study, performed within the China Gonococcal Antimicrobial Susceptibility Programme (China-GASP), regarding AMR, including ceftriaxone genetic resistance determinants, and molecular epidemiology of gonococci in China. Gonococcal isolates (n = 1257) from consecutive patients were collected at 11 sentinel sites distributed across China during 2012-13. Susceptibility to ceftriaxone, spectinomycin, ciprofloxacin and tetracycline was determined using the agar dilution method. Ceftriaxone resistance determinants penA and penB were examined using sequencing. N. gonorrhoeae multiantigen sequence typing (NG-MAST) was performed for molecular epidemiology. Among isolates, 0.2% were resistant to spectinomycin, 4.4% to ceftriaxone, 42.9% to tetracyclines (high-level resistance) and 99.8% to ciprofloxacin. Among 890 sequenced isolates, 16 (1.8%) possessed a penA mosaic allele; 4 of these isolates belonged to the MDR internationally spread NG-MAST genogroup G1407 (first description in China). Non-mosaic penA alleles with an A501T mutation and an A102D alteration in porB1b were statistically associated with decreased susceptibility/resistance to ceftriaxone. NG-MAST G10339, G1424 and G1053 were associated with decreased susceptibility/resistance to ceftriaxone. In China, ceftriaxone and spectinomycin can continue to be recommended for gonorrhoea treatment, with the possible exception of Hainan and Sichuan provinces where ceftriaxone resistance exceeded 5% and AMR surveillance needs to be strengthened. Molecular approaches including genotyping and AMR determinant analysis can be valuable to supplement and enhance conventional surveillance of gonococcal AMR in China. © The Author 2015. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  1. Nationwide cohort study of the leukotriene receptor antagonist montelukast and incident or recurrent cardiovascular disease.

    Science.gov (United States)

    Ingelsson, Erik; Yin, Li; Bäck, Magnus

    2012-03-01

    The leukotriene pathway has been associated with an increased cardiovascular risk. However, the effects of the antileukotriene treatment used in asthmatic patients on cardiovascular outcomes have remained largely unexplored. We sought to examine a potential protective role of the leukotriene receptor antagonist montelukast on future risk of incident and recurrent myocardial infarction and ischemic stroke. A nationwide population-based cohort of approximately 7 million persons integrating data from the Prescribed Drug, Patient, Cause of Death, Income, Educational, and Emigration Registers was followed from July 1, 2005, to December 31, 2008. Analyses were performed in the whole population after exclusion of subjects with a prior cardiovascular diagnosis (incident events; sample size, n = 6,910,923 for myocardial infarction and n = 6,932,578 for stroke) and in subjects with a prior diagnosis (recurrent events; n = 153,937 and n = 132,291 for stroke and myocardial infarction, respectively). Cox proportional hazard ratios (HRs) did not reveal an association of montelukast use with incident events. In contrast to these findings, montelukast use was associated with a lower risk for recurrent stroke (HR, 0.62; 95% CI, 0.38-0.99) accounting for age, sex, education level, and yearly income. Adjusting the latter finding also for respiratory and cardiovascular medications and diagnoses revealed similar point estimates (HR, 0.62; 95% CI, 0.39-1.0). Post hoc analyses revealed a significant association of montelukast use with a lower risk for recurrent myocardial infarction in male subjects (HR, 0.65; 95% CI, 0.43-0.99). These data provide a first indication for a potential role of the antiasthma drug montelukast for secondary prevention of cardiovascular disease. Copyright © 2012 American Academy of Allergy, Asthma & Immunology. Published by Mosby, Inc. All rights reserved.

  2. Maternal bipolar disorder increased low birthweight and preterm births: a nationwide population-based study.

    Science.gov (United States)

    Lee, Hsin-Chien; Lin, Herng-Ching

    2010-02-01

    To investigate pregnancy outcomes, including low birthweight, preterm births, and small-for-gestational-age (SGA) among women with bipolar disorder, schizophrenia compared with women with no history of mental illness using nationwide population-based data. This study linked the Taiwan National Health Insurance Research Dataset with the national birth certificate registry. A total of 528,398 singleton births between 2001 and 2003 were included; 337 were diagnosed with bipolar disorder. Multivariate logistic regression analyses were carried out to examine the relationship between maternal bipolar disorder, schizophrenia and the odds of low birthweight, preterm births, and SGA, after adjusting for characteristics of infant, mother and father. It shows that pregnant women with bipolar disorder were more likely to have LBW infants (9.8% vs. 5.7%), preterm births (14.2% vs. 6.9%) and SGA (22.3% vs. 15.7%) than pregnant women with no history of mental illness. The adjusted odds of low birthweight for women with bipolar disorder was 1.66 times (95% CI, 1.16-2.38) that of women with no history of mental illness. In terms of preterm births and SGA, the adjusted odds ratios were 2.08 (95% CI, 1.53-2.83) and 1.47 (95% CI, 1.14-1.91) respectively, for women with bipolar disorder, compared to their counterparts with no history of mental illness. We conclude that women with bipolar disorder had increased risk of low birthweight, preterm births, and SGA than women without a history of mental illness. More active monitoring and early intervention to counter potential adverse pregnancy outcomes for pregnant women with bipolar disorder should be initiated. 2009 Elsevier B.V. All rights reserved.

  3. Challenges, Strategies, and Lessons Learned from a Participatory Community Intervention Study to Promote Female Condoms among Rural Sex Workers in Southern China

    Science.gov (United States)

    Weeks, Margaret R.; Liao, Susu; Li, Fei; Li, Jianghong; Dunn, Jennifer; He, Bin; He, Qiya; Feng, Weiping; Wang, Yanhong

    2010-01-01

    China faces a rapidly emerging HIV epidemic and nationwide resurgence of sexually transmitted infections associated with a growing sex industry. Community empowerment and capacity building through community-based participatory research partnerships show promise for developing, testing, and refining multilevel interventions suited to the local…

  4. Sex-based differences in adults with community-acquired bacterial meningitis: a prospective cohort study.

    Science.gov (United States)

    Dias, S P; Brouwer, M C; Bijlsma, M W; van der Ende, A; van de Beek, D

    2017-02-01

    To investigate sex-based differences in clinical features, causative pathogens, outcome and treatment of adult community-acquired meningitis. From January 2006 to July 2014, we prospectively investigated sex-based differences in clinical features, causative pathogens, outcome and treatment of adult community-acquired meningitis in a nationwide cohort study in the Netherlands. Sex was analysed along with known predictors of unfavourable outcome using logistic regression. We evaluated 1412 episodes of meningitis, 707 (50%) in men. Men more often presented with a history of remote head injury (41/667 (6%) versus 14/658 (2%) women, p 0.0002) or alcoholism (61/652 (9%) versus 21/660 (3%) women, p bacterial meningitis. Male sex is an independent risk factor for adverse outcome. It is possible that sex-based differences in immune reaction could determine a distinct response to corticosteroids. Copyright © 2016 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  5. Federal Reserve System Semiannual Regulatory Agenda

    Science.gov (United States)

    2010-12-20

    ... [The Regulatory Plan and Unified Agenda of Federal Regulatory and Deregulatory Actions] [Federal Reserve System Semiannual Regulatory Agenda ] Part XXI Federal Reserve System Semiannual Regulatory Agenda... Flexibility Agenda AGENCY: Board of Governors of the Federal Reserve System. ACTION: Semiannual regulatory...

  6. Changes in Nurses' Knowledge, Difficulties, and Self-reported Practices Toward Palliative Care for Cancer Patients in Japan: An Analysis of Two Nationwide Representative Surveys in 2008 and 2015.

    Science.gov (United States)

    Nakazawa, Yoko; Kato, Masashi; Miyashita, Mitsunori; Morita, Tatsuya; Kizawa, Yoshiyuki

    2018-02-01

    The Cancer Control Act was passed in Japan in 2007, and various additional programs on palliative care have been implemented to improve quality of life and relieve pain and suffering in patients with cancer. However, how clinical settings have changed remains unclear. The primary aim of the present study was to determine changes in nurses' palliative care knowledge, difficulties, and self-reported practices between 2008 and 2015. This study was an analysis of two nationwide observational studies from 2008 to 2015. We conducted two questionnaire surveys for representative samples of nurses in designated cancer hospitals, community hospitals, and district nurse services. The measurements used the Palliative Care Knowledge Test (PCKT, range 1-100), the Palliative Care Difficulties Scale (PCDS, range 1-5), and the Palliative Care Self-Reported Practice Scale (PCPS, range 1-5). Comparisons were made using the nonpaired Student t-test and a multivariate linear regression model using two cohorts. We analyzed survey results for 2707 nurses in 2008 and 3649 nurses in 2015. Significant improvements were seen in PCKT, PCDS, and PCPS total scores for nurses in every work location over the seven-year study period, with PCKT total scores of 53 vs. 65 (P nurse services, respectively. Nurses' palliative care knowledge, difficulties, and self-reported practices improved over the seven-year study period, especially in terms of expert support in designated cancer hospitals and knowledge among nurses in designated cancer hospitals. Copyright © 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  7. Pharmacy Customers’ Experiences With Electronic Prescriptions: Cross-Sectional Survey on Nationwide Implementation in Finland

    Science.gov (United States)

    Timonen, Johanna; Ahonen, Riitta

    2018-01-01

    Background One of the forerunners in electronic health, Finland has introduced electronic prescriptions (ePrescriptions) nationwide by law. This has led to significant changes for pharmacy customers. Despite the worldwide ambition to develop ePrescription services, there are few reports of nationally adopted systems and particularly on the experiences of pharmacy customers. Objective The aim of this study was to investigate Finnish pharmacy customers’ (1) experiences with purchasing medicines with ePrescriptions; (2) experiences with renewing ePrescriptions and acting on behalf of someone else at the pharmacy; (3) ways in which customers keep up to date with their ePrescriptions; and (4) overall satisfaction with ePrescriptions. Methods Questionnaires were distributed to 2913 pharmacy customers aged ≥18 years purchasing prescription medicines for themselves with an ePrescription in 18 community pharmacies across Finland in autumn 2015. Customers’ experiences were explored with 10 structured questions. The data were stored in SPSS for Windows and subjected to descriptive analysis, chi-square, Fisher exact, Kolmogorov-Smirnov, the Mann-Whitney U, and Kruskal-Wallis tests. Results Completed questionnaires were returned by 1288 customers, a response rate of 44.19% (1288/2913). The majority of the respondents did not encounter any problems during pharmacy visits (1161/1278, 90.85%) and were informed about the current status of their ePrescriptions after their medication was dispensed (1013/1276, 79.44%). Over half of the respondents had usually received a patient instruction sheet from their physician (752/1255, 59.92%), and nearly all of them regarded its content as clear (711/724, 98.2%). Half of the respondents had renewed their ePrescriptions through the pharmacy (645/1281, 50.35%), and one-third of them had acted on behalf of someone else with ePrescriptions (432/1280, 33.75%). Problems were rarely encountered in the renewal process (49/628, 7.8%) or when

  8. Pharmacy Customers' Experiences With Electronic Prescriptions: Cross-Sectional Survey on Nationwide Implementation in Finland.

    Science.gov (United States)

    Lämsä, Elina; Timonen, Johanna; Ahonen, Riitta

    2018-02-23

    One of the forerunners in electronic health, Finland has introduced electronic prescriptions (ePrescriptions) nationwide by law. This has led to significant changes for pharmacy customers. Despite the worldwide ambition to develop ePrescription services, there are few reports of nationally adopted systems and particularly on the experiences of pharmacy customers. The aim of this study was to investigate Finnish pharmacy customers' (1) experiences with purchasing medicines with ePrescriptions; (2) experiences with renewing ePrescriptions and acting on behalf of someone else at the pharmacy; (3) ways in which customers keep up to date with their ePrescriptions; and (4) overall satisfaction with ePrescriptions. Questionnaires were distributed to 2913 pharmacy customers aged ≥18 years purchasing prescription medicines for themselves with an ePrescription in 18 community pharmacies across Finland in autumn 2015. Customers' experiences were explored with 10 structured questions. The data were stored in SPSS for Windows and subjected to descriptive analysis, chi-square, Fisher exact, Kolmogorov-Smirnov, the Mann-Whitney U, and Kruskal-Wallis tests. Completed questionnaires were returned by 1288 customers, a response rate of 44.19% (1288/2913). The majority of the respondents did not encounter any problems during pharmacy visits (1161/1278, 90.85%) and were informed about the current status of their ePrescriptions after their medication was dispensed (1013/1276, 79.44%). Over half of the respondents had usually received a patient instruction sheet from their physician (752/1255, 59.92%), and nearly all of them regarded its content as clear (711/724, 98.2%). Half of the respondents had renewed their ePrescriptions through the pharmacy (645/1281, 50.35%), and one-third of them had acted on behalf of someone else with ePrescriptions (432/1280, 33.75%). Problems were rarely encountered in the renewal process (49/628, 7.8%) or when acting on behalf of another person (25

  9. Distribución y abundancia de la comunidad de peces en la porción litoral de la Reserva de la Biósfera Los Petenes, Campeche, México Distribution and abundance of fish community in the littoral area of "Los Petenes" Biosphere Reserve, Campeche, Mexico

    Directory of Open Access Journals (Sweden)

    Sandra Muñoz-Rojas

    2013-03-01

    describe the ichthyofauna diversity in the littoral coastal area of the RBLP, to identify the ecological dominant species, and to analyze the abundance of the fish community and its temporal and spatial changes, and their relationship with some environmental variables. Monthly fish samples were obtained with the aid of trawl nets, from 24 samplings sites distributed along the reserve, between May 2009 and April 2010. The trawl net was operated 288 times and 21 795 individuals with 279.5kg of weight were collected. A total of 46 fish species grouped in 34 genera and 23 families were identified. In a spatial scale, the abundance showed the next ranges: 0.018-0.094ind./m²; 0.249-1.072 g/m² and 9.75-19.32g/ind.; the diversity indexes obtained were: Hn=1.46-2.15, J=0.45-0.71 and D=2.08-3.92. In a temporal scale, the abundance and diversity ranged between: 0.026-0.066ind./m2; 0.342-0.764g/m² and 6.49-22.98g/ind.; Hn=1.76-2.08; J’=0.52-0.64 and D=3.07-4.18. Eleven dominant species were identified with a representation of the 94.39% in number of individuals, and 89.66% in weight of the total catch. From the total, eight species had economic or commercial importance, especially Lagodon rhomboides and Haemulon plumierii. The cluster analyses identified four fish associations; these results are discussed in order to identify relationships between habitat-species. Finally, the canonical correspondence analysis evidenced an association between H. plumierii with salinity and dissolved solids. The RBLP has high habitat diversity and its fish community has developed strategies to use all the spatial and temporal conditions and to satisfy the needs of their life cycles.

  10. Gender differences in sudden cardiac death in the young-a nationwide study

    DEFF Research Database (Denmark)

    Winkel, Bo Gregers; Risgaard, Bjarke; Bjune, Thea

    2017-01-01

    was to report gender differences in SCD in the young in a nationwide (Denmark) setting. Methods: All deaths in persons aged 1-35 years nationwide in Denmark between 2000 and 2009 were included. Death certificates and autopsy reports were obtained. The extensive health care registries in Denmark were used......=0.02) and died less often in a public place (16 vs. 26%, p=0.01). Age at death, ratios of autopsies and sudden unexplained deaths, and comorbidities, did not differ. Causes of SCD were largely comparable between genders. The incidence rate of SCDw was half of that of SCDm (1.8 vs. 3.6 per 100......Background: Hitherto, sudden cardiac death (SCD) in the young has been described with no distinction between genders. SCD occurs more often in men (SCDm) than women (SCDw), but this disparity is not understood and has not been investigated systematically in a nationwide setting. Our objective...

  11. Evaluating a nationwide recreational football intervention: Recruitment, attendance, adherence, exercise intensity, and health effects

    DEFF Research Database (Denmark)

    Fløtum, Liljan av; Ottesen, Laila; Krustrup, Peter

    2016-01-01

    The present study evaluated a nationwide exercise intervention with Football Fitness in a small-scale society. In all, 741 adult participants (20–72 yrs) were successfully recruited for Football Fitness training in local football clubs, corresponding to 2.1% of the adult population. A preinterven......-promoting nationwide training intervention for adult participants with an extraordinary recruitment, a high attendance rate, moderate adherence, high exercise intensity, and marked benefits in cardiovascular health profile and fitness.......The present study evaluated a nationwide exercise intervention with Football Fitness in a small-scale society. In all, 741 adult participants (20–72 yrs) were successfully recruited for Football Fitness training in local football clubs, corresponding to 2.1% of the adult population...

  12. A security framework for nationwide health information exchange based on telehealth strategy.

    Science.gov (United States)

    Zaidan, B B; Haiqi, Ahmed; Zaidan, A A; Abdulnabi, Mohamed; Kiah, M L Mat; Muzamel, Hussaen

    2015-05-01

    This study focuses on the situation of health information exchange (HIE) in the context of a nationwide network. It aims to create a security framework that can be implemented to ensure the safe transmission of health information across the boundaries of care providers in Malaysia and other countries. First, a critique of the major elements of nationwide health information networks is presented from the perspective of security, along with such topics as the importance of HIE, issues, and main approaches. Second, a systematic evaluation is conducted on the security solutions that can be utilized in the proposed nationwide network. Finally, a secure framework for health information transmission is proposed within a central cloud-based model, which is compatible with the Malaysian telehealth strategy. The outcome of this analysis indicates that a complete security framework for a global structure of HIE is yet to be defined and implemented. Our proposed framework represents such an endeavor and suggests specific techniques to achieve this goal.

  13. Development and nationwide scale-up of Climate Matters, a localized climate change education program delivered by TV weathercasters.

    Science.gov (United States)

    Cullen, H. M.; Maibach, E.

    2016-12-01

    Most Americans view climate change as a threat that is distant in space (i.e., not here), time (i.e., not now), and species (i.e., not us). TV weathercasters are ideally positioned to educate Americans about the current and projected impacts of climate change in their community: they have tremendous reach, are trusted sources of climate information, and are highly skilled science communicators. In 2009, we learned that many weathercasters were potentially interested in reporting on climate change, but few actually were, citing significant barriers including a lack of time to prepare and air stories, and lack of access to high quality content. To test the premise that TV weathercasters can be effective climate educators - if supported with high quality localized climate communication content - in 2010 George Mason University, Climate Central and WLTX-TV (Columbia, SC) developed and pilot-tested Climate Matters, a series of short on-air (and online) segments about the local impacts of climate change, delivered by the station's chief meteorologist. During the first year, more than a dozen stories aired. To formally evaluate Climate Matters, we conducted pre- and post-test surveys of local TV news viewers in Columbia. After one year, WLTX viewers had developed a more science-based understanding of climate change than viewers of other local news stations, confirming our premise that when TV weathercasters report on the local implications of climate change, their viewers learn. Through a series of expansions, including the addition of important new partners - AMS, NASA, NOAA & Yale University - Climate Matters has become a comprehensive nationwide climate communication resource program for American TV weathercasters. As of March 2016, a network of 313 local weathercasters nationwide (at 202 stations in 111 media markets) are participating in the program, receiving new content on a weekly basis. This presentation will review the theoretical basis of the program, detail

  14. Community Solar Value Project

    Energy Technology Data Exchange (ETDEWEB)

    Powers, John T [Extensible Energy; Cliburn, Jill [Cliburn and Associates

    2017-11-30

    The Community Solar Value Project (CSVP) is designed to assist electric utilities in designing better community solar programs. Better programs seek new sources of value to promote “win-win” solutions between utilities and their customers. The CSVP focused on five “challenge areas” in identifying new sources of value: - Strategic solar design for community solar projects (including technology choices, siting, orientation, and related issues) - Market research and targeted marketing approaches (for program design and for customer recruitment) - Procurement and financing (for establishing best practices that can bring economies of scale and economies of expertise) - Integration of “companion measures” (such as storage and demand-response options that can benefit customer and utility net load shapes) - Pricing in program design (including best practices for integration of identified value in program prices or credits) The CSVP directly engaged the Sacramento Municipal Utility District (SMUD), the Public Service Company of New Mexico (PNM), and more than a dozen other utilities to develop improved community solar program designs. The outcomes include a plan at SMUD for over 100 MW or more of community and shared solar and support for new or expanded programs at 15 other utilities so far. Resulting best-practice solutions have not only informed program applications, but also have generated discussion among experts and industry associations about the new opportunities and challenges CSVP has brought forth. In these ways, the CSVP has impacted community solar programs and DER plans, competitive innovations and policies nationwide. The CSVP team has been led by Extensible Energy under John Powers, President and CEO. Jill Cliburn, of Santa Fe, NM-based Cliburn and Associates, has served as Principal Investigator. The team also benefitted from expertise from Navigant, Olivine Inc. and Millennium Energy, LLC, in addition to the collaborative and cost

  15. A Nationwide Census of ICU Capacity and Admissions in Mongolia.

    Directory of Open Access Journals (Sweden)

    Naranpurev Mendsaikhan

    Full Text Available In Mongolia, a Central Asian lower-middle income country, intensive care medicine is an under-resourced and-developed medical specialty. The burden of critical illness and capacity of intensive care unit (ICU services in the country is unknown. In this nationwide census, we collected data on adult and pediatric/neonatal ICU capacities and the number of ICU admissions in 2014. All hospitals registered to run an ICU service in Mongolia were surveyed. Data on the availability of an adult and/or pediatric/neonatal ICU service, the number of available ICU beds, the number of available functional mechanical ventilators, the number of patients admitted to the ICU, and the number of patients admitted to the study hospital were collected. In total, 70 ICUs with 349 ICU beds were counted in Mongolia (11.7 ICU beds/100,000 inhabitants; 1.7 ICU beds/100 hospital beds. Of these, 241 (69% were adult and 108 (31% pediatric/neonatal ICU beds. Functional mechanical ventilators were available for approximately half of the ICU beds (5.1 mechanical ventilators/100,000 inhabitants. While all provincial hospitals ran a pediatric/neonatal ICU, only dedicated pediatric hospitals in Ulaanbaatar did so. The number of adult and pediatric/neonatal ICU admissions varied between provinces. The number of adult ICU beds and adult ICU admissions per 100,000 inhabitants correlated (r = 0.5; p = 0.02, while the number of pediatric/neonatal ICU beds and pediatric/neonatal ICU admissions per 100,000 inhabitants did not (r = 0.25; p = 0.26. In conclusion, with 11.7 ICU beds per 100,000 inhabitants the ICU capacity in Mongolia is higher than in other low- and lower-middle-income countries. Substantial heterogeneities in the standardized ICU capacity and ICU admissions exist between Mongolian provinces. Functional mechanical ventilators are available for only half of the ICU beds. Pediatric/neonatal ICU beds make up one third of the national ICU capacity and appear to meet or even

  16. A Nationwide Census of ICU Capacity and Admissions in Mongolia.

    Science.gov (United States)

    Mendsaikhan, Naranpurev; Begzjav, Tsolmon; Lundeg, Ganbold; Brunauer, Andreas; Dünser, Martin W

    2016-01-01

    In Mongolia, a Central Asian lower-middle income country, intensive care medicine is an under-resourced and-developed medical specialty. The burden of critical illness and capacity of intensive care unit (ICU) services in the country is unknown. In this nationwide census, we collected data on adult and pediatric/neonatal ICU capacities and the number of ICU admissions in 2014. All hospitals registered to run an ICU service in Mongolia were surveyed. Data on the availability of an adult and/or pediatric/neonatal ICU service, the number of available ICU beds, the number of available functional mechanical ventilators, the number of patients admitted to the ICU, and the number of patients admitted to the study hospital were collected. In total, 70 ICUs with 349 ICU beds were counted in Mongolia (11.7 ICU beds/100,000 inhabitants; 1.7 ICU beds/100 hospital beds). Of these, 241 (69%) were adult and 108 (31%) pediatric/neonatal ICU beds. Functional mechanical ventilators were available for approximately half of the ICU beds (5.1 mechanical ventilators/100,000 inhabitants). While all provincial hospitals ran a pediatric/neonatal ICU, only dedicated pediatric hospitals in Ulaanbaatar did so. The number of adult and pediatric/neonatal ICU admissions varied between provinces. The number of adult ICU beds and adult ICU admissions per 100,000 inhabitants correlated (r = 0.5; p = 0.02), while the number of pediatric/neonatal ICU beds and pediatric/neonatal ICU admissions per 100,000 inhabitants did not (r = 0.25; p = 0.26). In conclusion, with 11.7 ICU beds per 100,000 inhabitants the ICU capacity in Mongolia is higher than in other low- and lower-middle-income countries. Substantial heterogeneities in the standardized ICU capacity and ICU admissions exist between Mongolian provinces. Functional mechanical ventilators are available for only half of the ICU beds. Pediatric/neonatal ICU beds make up one third of the national ICU capacity and appear to meet or even exceed the

  17. 24 CFR 891.605 - Replacement reserve.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Replacement reserve. 891.605... 8 Assistance § 891.605 Replacement reserve. (a) Establishment of reserve. The Borrower shall establish and maintain a replacement reserve to aid in funding extraordinary maintenance, and repair and...

  18. 24 CFR 891.405 - Replacement reserve.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Replacement reserve. 891.405....405 Replacement reserve. (a) Establishment of reserve. The Owner shall establish and maintain a replacement reserve to aid in funding extraordinary maintenance and repair and replacement of capital items...

  19. Building Nation-Wide Information Infrastructures in Healthcare through Modular Implementation Strategies

    DEFF Research Database (Denmark)

    Aanestad, Margunn; Jensen, Tina Blegind

    2011-01-01

    Initiatives that seek to realize the vision of nation-wide information infrastructures (II) in healthcare have often failed to achieve their goals. In this paper, we focus on approaches used to plan, conduct, and manage the realization of such visions. Our empirical material describes two Danish...... and Lyytinen, to contrast the organization and implementation strategies of the two projects. Our findings highlight how implementation strategies differ with respect to how stakeholders are mobilized. We argue that the realization of nation-wide IIs for healthcare not only requires a gradual transition...

  20. Pregnancy with prosthetic heart valves - 30 years' nationwide experience in Denmark

    DEFF Research Database (Denmark)

    Sillesen, Martin; Hjortdal, Vibeke; Vejlstrup, Niels

    2011-01-01

    Pregnancy in women with prosthetic heart valves remains a risk factor for both mother and fetus, but unselected and unbiased outcome and complication data remain scarce. We analyzed nationwide outcome data from 1977 to 2007 for all pregnancies in women with prosthetic valves.......Pregnancy in women with prosthetic heart valves remains a risk factor for both mother and fetus, but unselected and unbiased outcome and complication data remain scarce. We analyzed nationwide outcome data from 1977 to 2007 for all pregnancies in women with prosthetic valves....

  1. Nationwide trends in surgery and radioiodine treatment for benign thyroid disease during iodization of salt

    DEFF Research Database (Denmark)

    Cerqueira, C.; Knudsen, N.; Ovesen, L.

    2010-01-01

    Objective: Iodization of salt was introduced in Denmark in 1998 because of mild-to-moderate iodine deficiency (ID). The aim of this study was to analyze the utilization rate of surgery and radioiodine therapy for benign thyroid disorders before and after the introduction of iodization, and to study...... a possible association between the changes and the raised iodine intake. Design: A nationwide register study. Methods: Information on operations and radioiodine treatments for benign thyroid disorders was extracted from nationwide registers in the years 1990 to 2007. Treatment rates are presented for surgery...

  2. Cognitive Reserve: Implications for Assessment and Intervention

    OpenAIRE

    Stern, Yaakov

    2013-01-01

    The concept of reserve is used to explain the observation that some individuals function better than others in the presence of brain pathology. This paper reviews the concept of reserve from its theoretical basis to the implication of reserve for clinical practice. A distinction between brain reserve, referring to individual differences in the anatomic substrate, and cognitive reserve, referring to differences in the flexibility or adaptivity of cognitive networks, is useful. Epidemiologic ev...

  3. Sudden cardiac death: a nationwide cohort study among the young.

    Science.gov (United States)

    Risgaard, Bjarke

    2016-12-01

    Sudden cardiac death (SCD) is a tragic event affecting millions of individuals worldwide. Although several studies have investigated the epidemiology of SCD, these studies may have been affected by reporting and referral biases, which are reflected in the very different incidence rates and causes of deaths that have previously been reported. Among SCD victims aged children is of particular interest. These deaths are often described as a part of the deaths of young adolescents up to 40 years of age, and the focus has recently shifted towards the prevention of these deaths. The SCD incidence rate among patients with psychiatric disease has also gained significant attention. Finally, the incidence rate of sports-related sudden cardiac death (SrSCD) has been thoroughly investigated in young competitive athletes. However, whether competitive athletes are at increased risk for SrSCD compared with non-competitive athletes remains unknown. These data should be available prior to discussing optimal screening strategies for (competitive) athletes. In this thesis, we investigated the SCD burden in Danes aged 1-49 years between 2007 and 2009. By using the unique Danish death certificates, autopsy reports, discharge summaries, and registries, we included all deaths in a nationwide setting. We described the incidence rates and causes of death, and we performed a sub-group analysis of SCD in children (1-18 years, 2000-2006). Furthermore, we described the SCD burden in competitive and non-competitive athletes and investigated how often SCD occurred in patients with previous psychiatric disease. SCD has an incidence rate of 8.6 (95% confidence interval (CI) 8.0-9.2) per 100,000 person-years in persons aged 1-49 years. We found a steep increase in the incidence rate with increasing age, reaching 38.5 (95% CI 32.9-44.7) per 100,000 person-years in persons aged 48-49 years. The most common causes of death were coronary artery disease (CAD) (n = 158) and sudden unexplained death (SUD

  4. The Family-Environment Connection: Filling a Nationwide Program Gap

    Science.gov (United States)

    Santiago, Anthony; Franz, Nancy; Christoffel, Rebecca; Cooper, Kristi; Schmitt, Brenda

    2013-01-01

    Since its inception, Extension has focused on helping individuals, families, and communities change economic, environmental, and social conditions. Over the organization's history, environmental condition change programming has been mostly the purview of natural resource educators and less often conducted by family and consumer science…

  5. Management and outcomes of ST-elevation myocardial infarction in nursing home versus community-dwelling older patients: a propensity matched study.

    Science.gov (United States)

    Khera, Sahil; Kolte, Dhaval; Gupta, Tanush; Mujib, Marjan; Aronow, Wilbert S; Agarwal, Pallak; Palaniswamy, Chandrasekar; Jain, Diwakar; Ahmed, Ali; Fonarow, Gregg C; Frishman, William H; Panza, Julio A

    2014-08-01

    The influence of admission source (nursing home [NH] versus community-dwelling) on treatment strategies and outcomes among elderly patients with ST-elevation myocardial infarction (STEMI) has not been investigated. Nationwide Inpatient Sample databases from 2003 to 2010 were used to identify 270,117 community-dwelling and 4082 NH patients 75 years of age or older with STEMI. Retrospective observational study. Propensity scores for admission source were used to assemble a matched cohort of 3081 community-dwelling and 3132 NH patients, who were balanced on baseline demographic and clinical characteristics. Bivariate logistic regression models were then used to determine the associations of NH with in-hospital outcomes among matched patients. In-hospital mortality was significantly higher in patients with STEMI presenting from a NH as compared with community-dwelling patients (30.5% versus 27.6%; odds ratio [OR] 1.15, 95% confidence interval [CI] 1.03-1.29; P = .012). Overall, NH patients were less likely to receive reperfusion (thrombolysis, percutaneous coronary intervention, or coronary artery bypass grafting) (11.5% versus 13.4%; OR 0.84, 95% CI 0.72-0.98; P = .022). However, rates of percutaneous coronary intervention alone were similar in both groups (9.9% in NH versus 9.1% in community-dwelling; OR 1.10, 95% CI 0.93-1.30; P = .276). Mean length of stay was also similar in both groups (5.68 ± 5.40 days in NH versus 5.69 ± 4.98 days in community-dwelling, P = .974). Compared with their community-dwelling counterparts, older NH patients are less likely to receive reperfusion therapy for STEMI and have higher in-hospital mortality. Copyright © 2014 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

  6. Assessment of secondary aluminum reserves of nations

    DEFF Research Database (Denmark)

    Maung, Kyaw Nyunt; Yoshida, Tomoharu; Liu, Gang

    2017-01-01

    A classification framework of the secondary resources was applied to evaluate the framework's applicability and to assess secondary aluminum reserves for 19 countries. Estimated amounts of secondary aluminum reserves in 2010 were 85 million tonnes in the United States, 65 million tonnes in China......, 29 million tonnes in Japan, and 413 million tonnes globally. For the United States, its secondary reserves are larger than its primary reserves, although the global primary reserves (28,000 million tonnes) are much larger than the estimated secondary reserves. Considerable amounts of secondary...

  7. A nationwide study of the epidemiology of relapsing polychondritis

    Directory of Open Access Journals (Sweden)

    Horváth A

    2016-06-01

    Full Text Available Anna Horváth,1 Nóra Páll,2 Katalin Molnár,1 Tamás Kováts,3 György Surján,3 Tamás Vicsek,4,5 Péter Pollner2,4 13rd Department of Internal Medicine, Semmelweis University, 2Regional Science Center, Faculty of Science, Eötvös Loránd University, 3National Healthcare Service Center, 4MTA-ELTE Statistical and Biological Physics Research Group, 5Department of Biological Physics, Eötvös Loránd University Budapest, HungaryObjective: Relapsing polychondritis (RP is a rare autoimmune inflammatory disease that attacks mainly cartilaginous structures or causes serious damage in proteoglycan-rich structures (the eyes, heart, blood vessels, inner ear. This study shows results regarding the epidemiology, progression, and associations of this highly variable disease by collecting all cases from a 124-million-person-year Central European nationwide cohort.Methods: We used the Hungarian Health Care Database to identify all persons with possible RP infection. We followed patients who had International Classification of Diseases 10th edition code M94.1 at least once in their inpatient or outpatient records between January 1, 2002 and December 31, 2013 in Hungary. We classified these patients into disease severity groups by their drug consumption patterns between January 1, 2010 and December 31, 2013. We analyzed the regional distribution of RP incidences as well. Overall maps of comorbidity are presented with network layouts.Results: We identified 256 patients with RP among cumulatively 11.5 million registered inhabitants. We classified these patients into four severity classes as "extremely mild" (n=144, "mild" (n=22, "moderate" (n=41, and "severe" (n=4. Two additional groups were defined for patients without available drug data as "suspected only" (n=23 and "confirmed but unknown treatment" (n=22. The age and sex distributions of patients were similar to worldwide statistics. Indeed, the overall survival was good (95% confidence interval for 5

  8. Cognitive Reserve: Implications for Assessment and Intervention

    Science.gov (United States)

    Stern, Yaakov

    2014-01-01

    The concept of reserve is used to explain the observation that some individuals function better than others in the presence of brain pathology. This paper reviews the concept of reserve from its theoretical basis to the implication of reserve for clinical practice. A distinction between brain reserve, referring to individual differences in the anatomic substrate, and cognitive reserve, referring to differences in the flexibility or adaptivity of cognitive networks, is useful. Epidemiologic evidence indicates that a set of life exposures including higher educational and occupational attainment, and engaging in leisure activities is associated with a lower risk of incident dementia, suggesting that these life exposures may enhance cognitive reserve. This provides a basis for controlled clinical studies can test specific exposures that may enhance reserve. The concept of cognitive reserve also has important implications for clinical practice in terms of diagnosis and prognosis. PMID:23941972

  9. Clipboard: Unraveling the mystery of cognitive reserve

    Indian Academy of Sciences (India)

    Home; Journals; Journal of Biosciences; Volume 40; Issue 2. Clipboard : Unraveling the mystery of cognitive reserve ... Keywords. Aging; Alzheimer's; bilingualism; cognitive reserve; dementia; Down's; education; enrichment; environment; learning; long term potentiation; LTP; memory; neuroepigenetics; plasticity ...

  10. Transforming the Reserve Component: Four Essays

    National Research Council Canada - National Science Library

    Binnendijk, Hans; Baranick, Michael J; Bell, Raymond E., Jr; Cordero, Gina; Duncan, Stephen M; Holshek, Christopher; Wentz, Larry

    2005-01-01

    This volume contains four essays on various aspects of the Reserve Component. We publish it at a time when Reserves are serving overseas at historically high rates and when new missions like homeland security demand their attention...

  11. 5 CFR 330.610 - [Reserved

    Science.gov (United States)

    2010-01-01

    ... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false [Reserved] 330.610 Section 330.610 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS RECRUITMENT, SELECTION, AND... Employees § 330.610 [Reserved] ...

  12. 5 CFR 330.603 - [Reserved

    Science.gov (United States)

    2010-01-01

    ... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false [Reserved] 330.603 Section 330.603 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS RECRUITMENT, SELECTION, AND... Employees § 330.603 [Reserved] ...

  13. Renewable Energy Development on Fort Mojave Reservation Feasiblity Study

    Energy Technology Data Exchange (ETDEWEB)

    Russell Gum, ERCC analytics LLC

    2008-03-17

    The Ft. Mojave tribe, whose reservation is located along the Colorado River in the states of Arizona, California, and Nevada near the point where all three states meet, has a need for increased energy supplies. This need is a direct result of the aggressive and successful economic development projects undertaken by the tribe in the last decade. While it is possible to contract for additional energy supplies from fossil fuel sources it was the desire of the tribal power company, AHA MACAV Power Service (AMPS) to investigate the feasibility and desirability of producing power from renewable sources as an alternative to increased purchase of fossil fuel generated power and as a possible enterprise to export green power. Renewable energy generated on the reservation would serve to reduce the energy dependence of the tribal enterprises on off reservation sources of energy and if produced in excess of reservation needs, add a new enterprise to the current mix of economic activities on the reservation. Renewable energy development would also demonstrate the tribe’s support for improving environmental quality, sustainability, and energy independence both on the reservation and for the larger community.

  14. Psoriasis is associated with clinically significant cardiovascular risk: a Danish nationwide cohort study

    DEFF Research Database (Denmark)

    Ahlehoff, O; Gislason, G H; Charlot, M

    2011-01-01

    of Southern Denmark, Copenhagen; Copenhagen University Hospital Gentofte, Hellerup; University of Copenhagen, Copenhagen, Denmark) Psoriasis is associated with clinically significant cardiovascular risk: a Danish nationwide cohort study. J Intern Med 2010; doi: 10.1111/j.1365-2796.2010.02310.x. Objective...

  15. Incidence and outcomes of bulimia nervosa : a nationwide population-based study

    NARCIS (Netherlands)

    Keski-Rahkonen, A.; Hoek, H. W.; Linna, M. S.; Raevuori, A.; Sihvola, E.; Bulik, C. M.; Rissanen, A.; Kaprio, J.

    Background. Little is known about the epidemiology of bulimia nervosa outside clinical settings. We report the incidence, prevalence and outcomes of bulimia nervosa using for the first time a nationwide Study design. Method. To assess the incidence and natural course and outcomes of DSM-IV bulimia

  16. Evaluating quantitative and qualitative models: An application for nationwide water erosion assessment in Ethiopia

    NARCIS (Netherlands)

    Sonneveld, B.G.J.S.; Keyzer, M.A.; Stroosnijder, L

    2011-01-01

    This paper tests the candidacy of one qualitative response model and two quantitative models for a nationwide water erosion hazard assessment in Ethiopia. After a descriptive comparison of model characteristics the study conducts a statistical comparison to evaluate the explanatory power of the

  17. Evaluating quantitative and qualitative models: an application for nationwide water erosion assessment in Ethiopia

    NARCIS (Netherlands)

    Sonneveld, B.G.J.S.; Keyzer, M.A.; Stroosnijder, L.

    2011-01-01

    This paper tests the candidacy of one qualitative response model and two quantitative models for a nationwide water erosion hazard assessment in Ethiopia. After a descriptive comparison of model characteristics the study conducts a statistical comparison to evaluate the explanatory power of the

  18. The State of Teacher Professional Learning: Results from a Nationwide Survey

    Science.gov (United States)

    Learning Forward, 2017

    2017-01-01

    Effective teacher learning is vital to student success. Teachers who continually improve their practice by using data to inform instructional decisions see improved results for their students. In the tradition of supporting effective professional learning, in 2016 Corwin launched a nationwide survey in partnership with Learning Forward and the…

  19. 76 FR 56165 - Soliciting Input on Research and Development Priorities for Desirable Features of a Nationwide...

    Science.gov (United States)

    2011-09-12

    ... data in the network.\\5\\ \\5\\ http://en.wikipedia.org/wiki/Mesh_networking . Adaptability: The ability of... Public Safety Broadband Network AGENCY: National Institute of Standards and Technology, Department of... nationwide interoperable public safety broadband network. This input will be used by NIST to help determine...

  20. Improving Physics Teaching through Action Research: The Impact of a Nationwide Professional Development Programme

    Science.gov (United States)

    Grace, Marcus; Rietdijk, Willeke; Garrett, Caro; Griffiths, Janice

    2015-01-01

    This article presents an independent evaluation of the Action Research for Physics (ARP) programme, a nationwide professional development programme which trains teachers to use action research to increase student interest in physics and encourage them to take post-compulsory physics. The impact of the programme was explored from the perspective of…

  1. 47 CFR Appendix B to Part 1 - Nationwide Programmatic Agreement for the Collocation of Wireless Antennas

    Science.gov (United States)

    2010-10-01

    ... GENERAL PRACTICE AND PROCEDURE Pt. 1, App. B Appendix B to Part 1—Nationwide Programmatic Agreement for... Programmatic Agreement to better manage the Section 106 consultation process and streamline reviews for... Federal Register. C. In the event that the Programmatic Agreement is terminated, the FCC shall advise its...

  2. The Dutch Perinatal Audit Project : a feasibility study for nationwide perinatal audit in the Netherlands

    NARCIS (Netherlands)

    De Reu, Paul; Van Diem, Mariet; Eskes, Martine; Oosterbaan, Herman; Smits, Luc; Merkus, Hans; Nijhuis, Jan

    2009-01-01

    Objective. To investigate the feasibility of nationwide perinatal mortality audits in the Netherlands. Study design. Over a one-year period, data for all cases of perinatal mortality were collected. Six perinatal audit panels of professionals within perinatal care investigated and classified causes

  3. Impact of a Nationwide Training Program in Minimally Invasive Distal Pancreatectomy (LAELAPS)

    NARCIS (Netherlands)

    de Rooij, Thijs; van Hilst, Jony; Boerma, Djamila; Bonsing, Bert A.; Daams, Freek; van Dam, Ronald M.; Dijkgraaf, Marcel G.; van Eijck, Casper H.; Festen, Sebastiaan; Gerhards, Michael F.; Koerkamp, Bas Groot; van der Harst, Erwin; de Hingh, Ignace H.; Kazemier, Geert; Klaase, Joost; de Kleine, Ruben H.; van Laarhoven, Cornelis J.; Lips, Daan J.; Luyer, Misha D.; Molenaar, I. Quintus; Patijn, Gijs A.; Roos, Daphne; Scheepers, Joris J.; van der Schelling, George P.; Steenvoorde, Pascal; Vriens, Menno R.; Wijsman, Jan H.; Gouma, Dirk J.; Busch, Olivier R.; Hilal, Mohammed Abu; Besselink, Marc G.; de Boer, Marieke T.

    2016-01-01

    Objective:To study the feasibility and impact of a nationwide training program in minimally invasive distal pancreatectomy (MIDP).Summary of Background Data:Superior outcomes of MIDP compared with open distal pancreatectomy have been reported. In the Netherlands (2005 to 2013) only 10% of distal

  4. Liverpool Care Pathway: evaluation of a nationwide implementation program in the Netherlands.

    NARCIS (Netherlands)

    Dekkers, A.; Raijmakers, N.; Galesloot, C.; Heide, A. van der

    2013-01-01

    Introduction: The Dutch version of the Liverpool Care Pathway for the dying patient (LCP), Zorgpad Stervensfase, is a quality instrument for the care of dying people in the Netherlands. Since 2009 this pathway has been implemented nationwide in hospitals, nursing homes, hospices and homecare

  5. A nationwide population analysis of antenatal and perinatal complications among nurses and nonmedical working women

    Directory of Open Access Journals (Sweden)

    Chun-Che Huang

    2016-10-01

    Conclusion: Our nationwide population-based study revealed increased risks of antenatal and perinatal complications among nurses compared with those among nonmedical working women. The large-scale observation of the increased antenatal and perinatal complications draws attention to the health issues faced by nursing personnel who represent one of the most important workforces in the healthcare system.

  6. Gender-Specific Risk Factors for Intimate Partner Homicide: A Nationwide Register-Based Study

    Science.gov (United States)

    Weizmann-Henelius, Ghitta; Gronroos, Matti; Putkonen, Hanna; Eronen, Markku; Lindberg, Nina; Hakkanen-Nyholm, Helina

    2012-01-01

    The present study examined gender differences in intimate partner homicide (IPH) and offender characteristics with the focus on putative gender-specific risk factors in a nationwide consecutive sample of homicide offenders. Data on all offenders (N = 642; 91 females, 551 males) convicted of homicide and subjected to a forensic psychiatric…

  7. Configuration of the nationwide-grid expansion in Cuba for the period 2000-2015

    International Nuclear Information System (INIS)

    Garcia Rodirguez, B

    1999-01-01

    Using the prediction of the growth in electric energy consumption, a study is made of the configuration of the Nationwide-Grid (NWG) for that period. The study makes due consideration of the principle of diversity of the Energy Sources, assessing among the candidates; biomass, fossil fuels and nuclear energy

  8. Nationwide Network of TalentPoints: The Hungarian Approach to Talent Support

    Science.gov (United States)

    Csermely, Peter; Rajnai, Gabor; Sulyok, Katalin

    2013-01-01

    In 2006 a novel approach to talent support was promoted by several talent support programmes in Hungary. The new idea was a network approach. The nationwide network of so-called TalentPoints and its framework, the Hungarian Genius Program, gained substantial European Union funding in 2009, and today it is growing rapidly. A novel concept of talent…

  9. Reliability of nationwide prevalence estimates of dementia : A critical appraisal based on Brazilian surveys

    NARCIS (Netherlands)

    Chaimowicz, F. (Flávio); A. Burdorf (Alex)

    2015-01-01

    textabstractBackground: The nationwide dementia prevalence is usually calculated by applying the results of local surveys to countries' populations. To evaluate the reliability of such estimations in developing countries, we chose Brazil as an example. We carried out a systematic review of dementia

  10. Asthma and Attention-Deficit/Hyperactivity Disorder: A Nationwide Population-Based Prospective Cohort Study

    Science.gov (United States)

    Chen, Mu-Hong; Su, Tung-Ping; Chen, Ying-Sheue; Hsu, Ju-Wei; Huang, Kai-Lin; Chang, Wen-Han; Chen, Tzeng-Ji; Bai, Ya-Mei

    2013-01-01

    Background: Previous cross-sectional studies have suggested an association between asthma and attention-deficit/hyperactivity disorder (ADHD), but the temporal relationship was not determined. Using a nationwide population-based prospective case-control cohort study (1:4, age-/gender-matched), we hypothesized that asthma in infanthood or early…

  11. Heritability of Schizophrenia and Schizophrenia Spectrum Based on the Nationwide Danish Twin Register

    DEFF Research Database (Denmark)

    Hilker, Rikke; Helenius, Dorte; Fagerlund, Birgitte

    2018-01-01

    BACKGROUND: Twin studies have provided evidence that both genetic and environmental factors contribute to schizophrenia (SZ) risk. Heritability estimates of SZ in twin samples have varied methodologically. This study provides updated heritability estimates based on nationwide twin data...... is not solely indicated by genetic factors....

  12. 75 FR 52323 - Nationwide Categorical Waivers Under Section 1605 (Buy American) of the American Recovery and...

    Science.gov (United States)

    2010-08-25

    ... solar experts employed by the Department of Energy's National Renewable Energy Laboratory. EERE's... DEPARTMENT OF ENERGY Office of Energy Efficiency and Renewable Energy Nationwide Categorical... Act) AGENCY: Office of Energy Efficiency and Renewable Energy, U.S. Department of Energy (DOE). ACTION...

  13. 76 FR 47566 - Nationwide Categorical Waivers Under Section 1605 (Buy American) of the American Recovery and...

    Science.gov (United States)

    2011-08-05

    ... efforts, including utilizing the solar experts employed by the Department of Energy's National Renewable... DEPARTMENT OF ENERGY Office of Energy Efficiency and Renewable Energy Nationwide Categorical... Act) AGENCY: Office of Energy Efficiency and Renewable Energy, U.S. Department of Energy (DOE). ACTION...

  14. Epidemiological characteristics of varicella from 2000 to 2008 and the impact of nationwide immunization in Taiwan

    Directory of Open Access Journals (Sweden)

    Chang Luan-Yin

    2011-12-01

    Full Text Available Abstract Background Varicella has an important impact on public health. Starting in 2004 in Taiwan, nationwide free varicella vaccinations were given to 1-year-old children. Methods Our study investigated the epidemiological characteristics of varicella from 2000 to 2008, and assessed the change of varicella epidemiology after the mass varicella immunization. ICD-9-CM codes related to varicella or chickenpox (052, 052.1, 052.2, 052.7, 052.8, 052.9 were analyzed for all young people under 20 years of age through the National Health Insurance database of Taiwan from 2000 to 2008. Results Case numbers of varicella or chickenpox significantly declined after the nationwide immunization in 2004. Winter, particularly January, was the epidemic season of varicella. We found a significant post-vaccination decrease in incidence among preschool children, especially 3 to 6 year-old children-- the peak incidence was 66 per thousand for 4 and 5 year-old children before the nationwide immunization (2000 to 2003, and the peak incidence was 23 per thousand for 6 year-old children in 2008 (p Conclusion The varicella annual incidence and varicella-related hospitalization markedly declined in preschool children after nationwide varicella immunization in 2004.

  15. Compilation of a soil map for Nigeria: a nation-wide soil resource ...

    African Journals Online (AJOL)

    This paper presents the results of a nation-wide soil and land form inventory of Nigeria. The data compilation was conducted in the framework of two projects with the objective to calculate agricultural production potential under different input levels and assess the water erosion hazard. The information on spatial distribution ...

  16. Trends in birth asphyxia, obstetric interventions and perinatal mortality among term singletons: a nationwide cohort study

    NARCIS (Netherlands)

    Ensing, Sabine; Abu-Hanna, Ameen; Schaaf, Jelle M.; Mol, Ben Willem J.; Ravelli, Anita C. J.

    2015-01-01

    The objective of the present study is to investigate trends in birth asphyxia and perinatal mortality in the Netherlands over the last decade. A nationwide cohort study among women with a term singleton pregnancy. We assessed trends in birth asphyxia in relation to obstetric interventions for fetal

  17. Alcohol Education Provided to Opioid Treatment Program Patients: Results of a Nationwide Survey

    Science.gov (United States)

    Strauss, Shiela M.; Harris, Gavin; Katigbak, Carina; Rindskopf, David M.; Singh, Sheena; Greenblum, Ilana; Brown, Lawrence S.; Kipnis, Steven; Kritz, Steven A.; Parrino, Mark W.

    2010-01-01

    Alcohol-related problems are especially common among opioid treatment program (OTP) patients, suggesting that educating OTP patients about alcohol and its harmful effects needs to be a priority in OTPs. Using data collected in interviews with a nationwide U.S. sample of OTP directors (N = 200) in 25 states, we identified factors that differentiate…

  18. Problem behavior of individuals with down syndrome in a nationwide cohort assessed in late adolescence

    NARCIS (Netherlands)

    Gameren-Oosterom, H.B.M.; Fekkes, M.; Wouwe, J.P. van; Detmar, S.B.; Oudesluys-Murphy, A.M.; Verkerk, P.H.

    2013-01-01

    OBJECTIVE: To assess problem behavior in adolescents with Down syndrome and examine the association with sex and severity of intellectual disability. STUDY DESIGN: Cross-sectional data of a Dutch nationwide cohort of Down syndrome children aged 16-19 years were collected using a written parental

  19. Statin use after acute myocardial infarction: a nationwide study in Denmark

    DEFF Research Database (Denmark)

    Rasmussen, Jeppe Nørgaard; Gislason, Gunnar H; Abildstrom, Steen Z

    2005-01-01

    AIMS: To study outpatient statin use after first acute myocardial infarction (AMI) in Denmark between 1995 and 2002 and to determine the predictors of statin use. METHODS: This is a nationwide population-based study using administrative registries. Patients with first AMI between 1995 and 2002 ol...

  20. The ICD Survey II: Employing Disabled Americans. A Nationwide Survey of 920 Employers. Study No. 864009.

    Science.gov (United States)

    National Council on the Handicapped, Washington, DC.

    A survey explored what 921 managers nationwide are doing to employ disabled people and return disabled employees to work. It identified barriers that prevent employers from hiring disabled people and steps public and private sectors could take to increase their employment. Employers gave their disabled employees high marks as hard working,…

  1. Fat watch: A nationwide campaign in the Netherlands to reduce fat intake-effect evaluation

    NARCIS (Netherlands)

    Wechem, S.N. van; Brug, J.; Assema, P. van; Kistemaker, C.; Riedstra, M.; Löwik, M.R.H.

    1998-01-01

    In the Netherlands, the nationwide Fat Watch campaign aiming at a reduction in fat consumption was organized from 1991 onwards. This study describes the effects of the first three consecutive campaign years on attention to fat, diet and health, attitudes, self-efficacy expectations and intentions

  2. A nationwide planning of analytical chemistry in universities: possibilities and problems

    NARCIS (Netherlands)

    Visser, R.

    1979-01-01

    A nationwide planning of Analytical Chemistry in universities should meet two requirements: formulation of a common minimum programme for all universities and a well-balanced spread of research themes over the different universities. In the Netherlands this planning is the object of “ISOAN”, the

  3. Relative Income and Happiness in Asia: Evidence from Nationwide Surveys in China, Japan, and Korea

    Science.gov (United States)

    Oshio, Takashi; Nozaki, Kayo; Kobayashi, Miki

    2011-01-01

    This study attempts to examine relative income effects on perceived happiness in three major Asian countries--China, Japan, and Korea--in comparison with the United Sates, on the basis of largely comparable nationwide surveys in these countries. Consistent with the results from previous studies in Western countries, comparisons with an…

  4. Child Poverty as a Determinant of Life Outcomes: Evidence from Nationwide Surveys in Japan

    Science.gov (United States)

    Oshio, Takashi; Sano, Shinpei; Kobayashi, Miki

    2010-01-01

    We attempt to examine the extent to which poverty in childhood adversely affects success in adulthood, using micro data from nationwide surveys in Japan and taking into account the recursive structure of life outcomes. We use retrospective assessments of income class at the age of 15, because longitudinal data on household income are not…

  5. Approaching target: A service for nationwide deformation monitoring in Denmark using Sentinel-1

    DEFF Research Database (Denmark)

    Fredenslund Levinsen, Joanna; Sørensen, Carlo Sass; Broge, Niels Henrik

    Building upon decades of experience with deformation monitoring from repeated precision leveling and GNSS measurements as well as more recent time series analyses of ERS, Envisat, and Sentinel-1 imagery, we are now working towards a nationwide mapping using Sentinel-1 Interferometric Wide Swath...

  6. Factors associated with free adult preventive health care utilization among physically disabled people in Taiwan: nationwide population-based study.

    Science.gov (United States)

    Yen, Suh-May; Kung, Pei-Tseng; Tsai, Wen-Chen

    2014-12-05

    Few previous studies have specifically addressed the health care utilization situation of the physically disabled. This study aimed to investigate the utilization of free adult preventive health care for physically disabled people and its' affecting factors. The data was obtained from three nationwide databases from 2006 to 2008. This study comprised 329,264 physically disabled people in Taiwan above the age of 40 who had eligible health checks during 2008. We employed descriptive statistics to analyze the use and rate of free preventive health care use by physically disabled adults. Logistic regression analysis was used to explore the factors that affect physically disabled adults' use of free adult preventive health care. 16.37% of the physically disabled adults used free adult preventive health care. Women (17.66%), married (17.16%), a junior high education level (17.89%), and mildly disabled adults (18.77%) had the highest use rate among various participant subgroups. The variables that significantly influenced the use of free adult preventive health care by the physically disabled included gender, age, education, marital status, urbanization of the residence areas, monthly payroll, aboriginal status, catastrophic illnesses status, relevant chronic diseases, and severity of disability. Physically disabled using preventive health care tend to be low. Governments should use the media to reinforce propagation and education of these services to specific, low-utilization groups, and encourage doctors to actively provide preventive health care to communities.

  7. Nation-wide, web-based, geographic information system for the integrated surveillance and control of dengue fever in Mexico.

    Science.gov (United States)

    Hernández-Ávila, Juan Eugenio; Rodríguez, Mario-Henry; Santos-Luna, René; Sánchez-Castañeda, Veronica; Román-Pérez, Susana; Ríos-Salgado, Víctor Hugo; Salas-Sarmiento, Jesús Alberto

    2013-01-01

    Dengue fever incidence and its geographical distribution are increasing throughout the world. Quality and timely information is essential for its prevention and control. A web based, geographically enabled, dengue integral surveillance system (Dengue-GIS) was developed for the nation-wide collection, integration, analysis and reporting of geo-referenced epidemiologic, entomologic, and control interventions data. Consensus in the design and practical operation of the system was a key factor for its acceptance. Working with information systems already implemented as a starting point facilitated its acceptance by officials and operative personnel. Dengue-GIS provides the geographical detail needed to plan, asses and evaluate the impact of control activities. The system is beginning to be adopted as a knowledge base by vector control programs. It is used to generate evidence on impact and cost-effectiveness of control activities, promoting the use of information for decision making at all levels of the vector control program. Dengue-GIS has also been used as a hypothesis generator for the academic community. This GIS-based model system for dengue surveillance and the experience gathered during its development and implementation could be useful in other dengue endemic countries and extended to other infectious or chronic diseases.

  8. Crowdsourcing-based nationwide tick collection reveals the distribution of Ixodes ricinus and I. persulcatus and associated pathogens in Finland.

    Science.gov (United States)

    Laaksonen, Maija; Sajanti, Eeva; Sormunen, Jani J; Penttinen, Ritva; Hänninen, Jari; Ruohomäki, Kai; Sääksjärvi, Ilari; Vesterinen, Eero J; Vuorinen, Ilppo; Hytönen, Jukka; Klemola, Tero

    2017-05-10

    A national crowdsourcing-based tick collection campaign was organized in 2015 with the objective of producing novel data on tick distribution and tick-borne pathogens in Finland. Nearly 20 000 Ixodes ticks were collected. The collected material revealed the nationwide distribution of I. persulcatus for the first time and a shift northwards in the distribution of I. ricinus in Finland. A subset of 2038 tick samples containing both species was screened for Borrelia burgdorferi sensu lato (the prevalence was 14.2% for I. ricinus and 19.8% for I. persulcatus), B. miyamotoi (0.2% and 0.4%, respectively) and tick-borne encephalitis virus (TBEV; 0.2% and 3.0%, respectively). We also report new risk areas for TBEV in Finland and, for the first time, the presence of B. miyamotoi in ticks from mainland Finland. Most importantly, our study demonstrates the overwhelming power of citizen science in accomplishing a collection effort that would have been impossible with the scientific community alone.

  9. Reserving by detailed conditioning on individual claim

    Science.gov (United States)

    Kartikasari, Mujiati Dwi; Effendie, Adhitya Ronnie; Wilandari, Yuciana

    2017-03-01

    The estimation of claim reserves is an important activity in insurance companies to fulfill their liabilities. Recently, reserving method of individual claim have attracted a lot of interest in the actuarial science, which overcome some deficiency of aggregated claim method. This paper explores the Reserving by Detailed Conditioning (RDC) method using all of claim information for reserving with individual claim of liability insurance from an Indonesian general insurance company. Furthermore, we compare it to Chain Ladder and Bornhuetter-Ferguson method.

  10. Spatial Identity of the Bolgarian Community in the Polyethnic Moldova

    Directory of Open Access Journals (Sweden)

    G. I. Ostapenko

    2015-01-01

    Full Text Available Ethnopolitical processes in Moldova have provided for actualization of local ethnoses’ national identities. Ethnoses, which have formed own territorial community, have got a chance to become valid political actors on the nationwide level. Such status allows ethnoses to consider own future in context of geopolitical perspectives, produce own unique interpretations of space, where they are placed, or modify them depending on external conditions. This paper investigates Moldova’s Bulgarians’ spatial identity and ethnonational self-identification on the example Bulgarian territorial community, which is in a position of choice one of spatial interpretations. 

  11. Poverty and corruption compromise tropical forest reserves.

    Science.gov (United States)

    Wright, S Joseph; Sanchez-Azofeifa, G Arturo; Portillo-Quintero, Carlos; Davies, Diane

    2007-07-01

    We used the global fire detection record provided by the satellite-based Moderate Resolution Imaging Spectroradiometer (MODIS) to determine the number of fires detected inside 823 tropical and subtropical moist forest reserves and for contiguous buffer areas 5, 10, and 15 km wide. The ratio of fire detection densities (detections per square kilometer) inside reserves to their contiguous buffer areas provided an index of reserve effectiveness. Fire detection density was significantly lower inside reserves than in paired, contiguous buffer areas but varied by five orders of magnitude among reserves. The buffer: reserve detection ratio varied by up to four orders of magnitude among reserves within a single country, and median values varied by three orders of magnitude among countries. Reserves tended to be least effective at reducing fire frequency in many poorer countries and in countries beset by corruption. Countries with the most successful reserves include Costa Rica, Jamaica, Malaysia, and Taiwan and the Indonesian island of Java. Countries with the most problematic reserves include Cambodia, Guatemala, Paraguay, and Sierra Leone and the Indonesian portion of Borneo. We provide fire detection density for 3964 tropical and subtropical reserves and their buffer areas in the hope that these data will expedite further analyses that might lead to improved management of tropical reserves.

  12. 24 CFR 572.125 - Replacement reserves.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 3 2010-04-01 2010-04-01 false Replacement reserves. 572.125...) Homeownership Program Requirements-Implementation Grants § 572.125 Replacement reserves. (a) Purpose. A single replacement reserve may be established for the homeownership program only if HUD determines it is necessary to...

  13. 24 CFR 880.602 - Replacement reserve.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Replacement reserve. 880.602... Replacement reserve. (a) A replacement reserve must be established and maintained in an interest-bearing account to aid in funding extraordinary maintenance and repair and replacement of capital items. (1) Part...

  14. 24 CFR 891.745 - Replacement reserve.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Replacement reserve. 891.745... and Individuals-Section 162 Assistance § 891.745 Replacement reserve. The general requirements for the replacement reserve are provided in § 891.605. For projects funded under §§ 891.655 through 891.790, the...

  15. Reserve evaluation of minerals at NUCLEBRAS

    International Nuclear Information System (INIS)

    Marques, J.P.M.; Guerra, P.A.G.; Vinha, C.A.G. da

    1980-10-01

    The method used for the reserve evaluation of minerals, particularly of uranium, as used worldwide, and specially at NUCLEBRAS is described. This is done through a series of procedures envolving basic definitions, reserve evaluation methods (conventional, statistical and geoestatistical), data management, use of computer systems, classification and evaluation of reserves. (Author) [pt

  16. John Brainerd and the First Indian Reservation.

    Science.gov (United States)

    Harper, Susanne Banta

    1979-01-01

    Describes the humanitarian founding in 1758 of the nation's first reservation--the Brotherton reservation for New Jersey's Lenni Lenape (Algonquin) Indians. The people were demoralized, sick, and decimated in numbers; and so the venture failed. In 1801 those few remaining sold the reservation and moved to join related tribes in New York. (DS)

  17. May 2003 Status of Forces Survey of Reserve Component Members: Tabulations of Responses

    National Research Council Canada - National Science Library

    2003-01-01

    ...). HRSAP is designed to measure the attitudes and opinions of the entire DoD community--Active and Reserve Service members, their families and DoD civilian--on the full range of personnel issues...

  18. What happens to soil ecological properties when conservation reserve program land is disturbed

    Science.gov (United States)

    Each year, expiring Conservation Reserve Program (CRP) contracts results in the conversion of restored CRP land back to croplands, potentially reversing multiple ecological benefits including C sequestration potential and microbial biodiversity. We evaluated microbial community composition (fatty ac...

  19. Macrufungi flora oft the "Perkuć" Reservation in the Puszcza Augustowska Forest

    Directory of Open Access Journals (Sweden)

    Maria Lisiewska

    2014-08-01

    Full Text Available The paper contains a list of 160 macrofungi species (mainly Basidiomycetes, Agaricales. collected from the "Perkuć" Reservation with regard lo the substratum, forest community and seasonal occurrence.

  20. Community Policing: A Preliminary Assessment of Environmental Impact with Panel Data on Program Implementation in U.S. Cities

    Science.gov (United States)

    He, Ni; Zhao, Jihong; Lovrich, Nicholas P.

    2005-01-01

    This article examines the environmental impact on the programmatic implementation of community-oriented policing (COP) in large municipal police agencies during the 1990s. Three waves of nationwide surveys (1993, 1996, and 2000) based on a random sample of 281 municipalities and the corresponding police agencies were used for our analysis. Based…

  1. Kawasaki Disease in Mongolia: Results From 2 Nationwide Retrospective Surveys, 1996–2008

    Science.gov (United States)

    Davaalkham, Dambadarjaa; Nakamura, Yosikazu; Baigalmaa, Davaakhuu; Davaa, Gombojav; Chimedsuren, Ochir; Sumberzul, Nyamjav; Lkhagvasuren, Tserenkhuu; Uehara, Ritei; Yanagawa, Hiroshi; Kawasaki, Tomisaku

    2011-01-01

    Background Kawasaki disease (KD) has been reported in many countries. However, the incidence of KD in Mongolia is not known. This is the first report of incident cases of KD in Mongolia, which were identified using data from 2 nationwide surveys. Methods Two nationwide retrospective surveys were conducted: medical histories were collected from patients aged 0 to 16 years who were hospitalized countrywide between 1996 and 2008. Hospital records for these patients were also reviewed. Nationwide training seminars on KD were conducted before each survey. Results For the nationwide surveys, the participation rates among all hospitals with pediatric wards were 97% and 94%. Inpatient medical histories from 1996 through 2008 were reviewed, and, among children younger than 16 years, 9 patients with KD were investigated. The age of KD patients ranged from 1.4 to 14 years; 7 of 9 patients were male. Six (67%) patients fulfilled all 6 clinical diagnostic criteria; the other 3 (33%) were defined as having KD based on the presence of 5 such criteria. Fever persisting 5 or more days, bilateral conjunctival congestion, and changes of the lips and oral cavity were the most common symptoms, and cervical lymphadenopathy was the least common symptom. Cardiac sequelae developed in 5 of the patients, 4 of whom were older than 10 years. Conclusions The results of these nationwide surveys reveal that KD cases do exist in Mongolia. However, knowledge of KD among Mongolian pediatricians is likely to be poor. Thus, there is a need to augment their understanding to improve management of KD patients. Further studies are crucial to clarify the epidemiologic characteristics of KD in Mongolia. PMID:21691035

  2. Kawasaki disease in Mongolia: results from 2 nationwide retrospective surveys, 1996-2008.

    Science.gov (United States)

    Davaalkham, Dambadarjaa; Nakamura, Yosikazu; Baigalmaa, Davaakhuu; Davaa, Gombojav; Chimedsuren, Ochir; Sumberzul, Nyamjav; Lkhagvasuren, Tserenkhuu; Uehara, Ritei; Yanagawa, Hiroshi; Kawasaki, Tomisaku

    2011-01-01

    Kawasaki disease (KD) has been reported in many countries. However, the incidence of KD in Mongolia is not known. This is the first report of incident cases of KD in Mongolia, which were identified using data from 2 nationwide surveys. Two nationwide retrospective surveys were conducted: medical histories were collected from patients aged 0 to 16 years who were hospitalized countrywide between 1996 and 2008. Hospital records for these patients were also reviewed. Nationwide training seminars on KD were conducted before each survey. For the nationwide surveys, the participation rates among all hospitals with pediatric wards were 97% and 94%. Inpatient medical histories from 1996 through 2008 were reviewed, and, among children younger than 16 years, 9 patients with KD were investigated. The age of KD patients ranged from 1.4 to 14 years; 7 of 9 patients were male. Six (67%) patients fulfilled all 6 clinical diagnostic criteria; the other 3 (33%) were defined as having KD based on the presence of 5 such criteria. Fever persisting 5 or more days, bilateral conjunctival congestion, and changes of the lips and oral cavity were the most common symptoms, and cervical lymphadenopathy was the least common symptom. Cardiac sequelae developed in 5 of the patients, 4 of whom were older than 10 years. The results of these nationwide surveys reveal that KD cases do exist in Mongolia. However, knowledge of KD among Mongolian pediatricians is likely to be poor. Thus, there is a need to augment their understanding to improve management of KD patients. Further studies are crucial to clarify the epidemiologic characteristics of KD in Mongolia.

  3. Cognitive reserve in ageing and Alzheimer's disease

    Science.gov (United States)

    Stern, Yaakov

    2012-01-01

    The concept of reserve accounts for individual differences in susceptibility to age-related brain changes or Alzheimer's disease-related pathology. There is evidence that some people can tolerate more of these changes than others and still maintain function. Epidemiologic studies suggest that lifetime exposures including educational and occupational attainment, and leisure activities in late life, can increase this reserve. For example, there is a reduced risk of developing Alzheimer's disease in individuals with higher educational or occupational attainment. It is convenient to think of two types of reserve: brain reserve, which refers to actual differences in the brain itself that may increase tolerance of pathology, and cognitive reserve. Cognitive reserve refers to individual differences in how tasks are performed that may allow some people to be more resilient than others. The concept of cognitive reserve holds out the promise of interventions that could slow cognitive aging or reduce the risk of dementia. PMID:23079557

  4. Effects of risk factors on periodontal disease defined by calibrated community periodontal index and loss of attachment scores.

    Science.gov (United States)

    Su, C-W; Yen, Am-F; Lai, H; Lee, Y; Chen, H-H; Chen, Sl-S

    2017-10-01

    We evaluated whether and how the effects of risk factors on periodontal disease (PD) were modified by measurement errors using community periodontal index (CPI) and loss attachment (LA) in the community-based survey. A pilot validation study was performed to estimate the rates of false negative and false positive for both CPI and LA in 31 subjects from different regions using measurements from 12 well-trained dentists and a senior periodontist as a gold standard. Afterward, a Taiwanese nationwide survey was conducted by enrolling 3,860 participants to estimate the effect of each risk factor on PD calibrated with both sensitivity and specificity of two indices. The values obtained for the sensitivity to false-positive ratio for CPI ranged widely from 1.12 to 7.71, indicating regional variation in both errors. The calibrated adjusted odds ratio for smoking vs non-smoking was higher than the uncalibrated odds ratio for PD defined by CPI (2.75 (2.01, 3.77) vs 2.02 (1.63, 2.52)) and LA (3.85 (2.44, 6.13) vs 1.93 (1.47, 2.54)) scores. Similar underestimation was noted for other risk factors. The effects of risk factors on PD measured using CPI and LA in a large population-based survey were underestimated without correcting for measurement errors. © 2017 The Authors. Oral Diseases Published by John Wiley & Sons Ltd. All rights reserved.

  5. Biosphere reserves in action: Case studies of the American experience

    Energy Technology Data Exchange (ETDEWEB)

    None

    1995-06-26

    For nearly 20 years, biosphere reserves have offered a unique framework for building the knowledge, skills, and attitudes required for conservation and sustainable use of ecosystems. The 12 case studies in this volume chronicle many of the cooperative efforts to implement the biosphere reserve concept in the United States. Considered together, these efforts involve more than 20 types of protected areas, and the participation of all levels of government, and many private organizations, academic institutions, citizens groups, and individuals. Biosphere reserves are multi-purpose areas that are nominated by the national committee of the Man and the Biosphere Program (MAB) and designated by the United Nations Educational, Scientific and Cultural Organization (UNESCO) to serve as demonstration areas for cooperation in building harmonious relationships between human activities and the conservation of ecosystems and biological diversity. Each biosphere reserve exemplifies the characteristic ecosystems of one of the worlds biogeographical regions. It is a land or coas%arine area involving human communities as integral components and including resources managed for objectives ranging from complete protection to intensive, yet sustainable development. A biosphere reserve is envisioned as a regional ''landscape for learning'' in which monitoring, research, education, and training are encouraged to support sustainable conservation of natural and managed ecosystems. It is a framework for regional cooperation involving government decisionmakers, scientists, resource managers, private organizations and local people (i.e., the biosphere reserve ''stakeholders''). Finally, each biosphere reserve is part of a global network for sharing information and experience to help address complex problems of conservation and development. The 12 case studies presented in this report represent only a few of the possible evolutions of a biosphere reserve in

  6. Osteoarthritis in Spain: A nationwide survey of medical specialists.

    Science.gov (United States)

    Arriaza, Rafael; Sancho, Carlos; Fernandez-Gutierrez, Benjamin

    2017-11-25

    To determine the reality of the resources and care needs in Spain for the management of patients with osteoarthritis. An online survey. Description of 190 responses to a structured questionnaire (141 orthopedic surgeons and 49 rheumatologists). Osteoarthritis has yet to receive appropriate medical attention and a patient management model. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

  7. Natural Areas Analysis and Evaluation: Oak Ridge Reservation

    Energy Technology Data Exchange (ETDEWEB)

    Baranski, Micahel J [self

    2009-11-01

    EXECUTIVE SUMMARY The Oak Ridge Reservation, encompassing 33,639 acres in the Valley and Ridge Physiographic Province of East Tennessee, has long been known for its unfragmented forests and high biodiversity. Many areas on the Reservation have been recognized as important natural areas, but no comprehensive treatment has been performed to evaluate the relative significance and importance of these areas compared to each other. The present study was conducted to develop a set of guidelines for evaluating the natural value of specific areas, to evaluate all the terrestrial areas that are currently delineated, and to rank all areas according to their relative biodiversity importance. All available data, reports and site-specific information relevant to Reservation lands, including Tennessee Division of Natural Areas database information, were evaluated and field work was conducted. Methodologies and criteria for assessment and evaluation of areas were developed; categories of criteria were devised; and a ranking system for evaluation of natural areas was produced. There were 70 areas evaluated during the study. The system is flexible, dynamic and easily revised to reflect updated and new information and interpretations. Eight categories of evaluation factors were established and used to characterize each site. These were the following: size of area, number or status taxa present, number of Endangered and Threatened taxa present, rarity of the Endangered and Threatened taxa on the Reservation, community diversity, site integrity and quality, disturbance and threat levels, and other significant features and factors. Each category generally consisted of a 5-point ranking scale from 0-4, allowing for a possible composite score of 32, with higher ranked, more important, sites attaining higher scores. Highly ranked sites are representative of regional natural diversity; contain outstanding natural features, communities or geology and/or very rare taxa or other elements; are

  8. Strategic Petroleum Reserve annual/quarterly report

    Energy Technology Data Exchange (ETDEWEB)

    1993-02-16

    During 1992 the Department continued planning activities for the expansion of the Strategic Petroleum Reserve to one billion barrels. A draft Environmental Impact Statement for the five candidate sites was completed in October 1992, and a series of public hearings was held during December 1992. Conceptual design engineering activities, life cycle cost estimates and geotechnical studies to support the technical requirements for an Strategic Petroleum Reserve Plan Amendment were essentially completed in December 1992. At the end of 1992, the Strategic Petroleum Reserve crude oil inventory was 574.7 million barrels and an additional 1.7 million barrels was in transit to the Reserve. During 1992 approximately 6.2 million barrels of crude oil were acquired for the Reserve. A Department of Energy Tiger Team Environmental, Safety and Health (ES&H) Assessment was conducted at the Strategic Petroleum Reserve from March 9 through April 10, 1992. In general, the Tiger Team found that Strategic Petroleum Reserve activities do not pose undue environmental, safety or health risks. The Strategic Petroleum Reserve`s Final Corrective Action Plan, prepared in response to the Tiger Team assessment, was submitted for Department approval in December 1992. On November 18, 1992, the Assistant Secretary for Fossil Energy selected DynMcDennott Petroleum Operations Company to provide management and operating services for the Strategic Petroleum Reserve for a period of 5 years commencing April 1, 1993. DynMcDermott will succeed Boeing Petroleum Services, Inc.

  9. Demand for International Reserves in Turkey

    Directory of Open Access Journals (Sweden)

    Yimaz Sinem

    2014-06-01

    Full Text Available Having an important place in the international monetary system, international reserves held by central bank usually reflect country’s economic strength in terms of international finance and trade. There are many reasons for holding international reserves by central banks such as financing the deficit in the balance of payment, managing the monetary and exchange rate policies, minimizing the negative effects of external shocks and reducing the cost of borrowing. Continuously changing and diversifying characteristics of these reasons affect the demand for reserves depending to the economic conditions of the country. Over the last ten years, there has been a tremendous increase in international reserves held by Turkish Central Bank. From 2002 to 2012, the reserves of the bank have risen from 20 billion dollars to 96 billion dollars, showing an increase more than four times. This sudden and huge increase in the foreign reserves drove us to determine and investigate the factors which induce the Turkish Central Bank to hold high level of reserves. Thus, the purpose of this study is to estimate and analyze the demand for international reserves held by central banks using the buffer stock model in the case of Turkey. The data used in the study is monthly and cover the period of 1990:03-2012:10. The buffer stock model was econometrically estimated by using the OLS method for three different models. Our findings indicate that the opportunity cost affected reserve demand much stronger than the reserve volatility in Turkish case.

  10. Naval Petroleum and Oil Shale Reserves

    International Nuclear Information System (INIS)

    1992-01-01

    During fiscal year 1992, the reserves generated $473 million in revenues, a $181 million decrease from the fiscal year 1991 revenues, primarily due to significant decreases in oil and natural gas prices. Total costs were $200 million, resulting in net cash flow of $273 million, compared with $454 million in fiscal year 1991. From 1976 through fiscal year 1992, the Naval Petroleum and Oil Shale Reserves generated more than $15 billion in revenues and a net operating income after costs of $12.5 billion. In fiscal year 1992, production at the Naval Petroleum Reserves at maximum efficient rates yielded 26 million barrels of crude oil, 119 billion cubic feet of natural gas, and 164 million gallons of natural gas liquids. From April to November 1992, senior managers from the Naval Petroleum and Oil Shale Reserves held a series of three workshops in Boulder, Colorado, in order to build a comprehensive Strategic Plan as required by Secretary of Energy Notice 25A-91. Other highlights are presented for the following: Naval Petroleum Reserve No. 1--production achievements, crude oil shipments to the strategic petroleum reserve, horizontal drilling, shallow oil zone gas injection project, environment and safety, and vanpool program; Naval Petroleum Reserve No. 2--new management and operating contractor and exploration drilling; Naval Petroleum Reserve No. 3--steamflood; Naval Oil Shale Reserves--protection program; and Tiger Team environmental assessment of the Naval Petroleum and Oil Shale Reserves in Colorado, Utah, and Wyoming

  11. Challenges for nationwide vaccine delivery in African countries.

    Science.gov (United States)

    Songane, Mario

    2017-10-19

    Vaccines are very effective in providing individual and community (herd) immunity against a range of diseases. In addition to protection against a range of diseases, vaccines also have social and economic benefits. However, for vaccines to be effective, routine immunization programmes must be undertaken regularly to ensure individual and community protection. Nonetheless, in many countries in Africa, vaccination coverage is low because governments struggle to deliver vaccines to the most remote areas, thus contributing to constant outbreaks of various vaccine-preventable diseases. African governments fail to deliver vaccines to a significant percentage of the target population due to many issues in key areas such as policy setting, programme management and financing, supply chain, global vaccine market, research and development of vaccines. This review gives an overview of the causes of these issues and what is currently being done to address them. This review will discuss the role of philanthropic organisations such as the Bill and Melinda Gates Foundation and global partnerships such as the global alliance for vaccines and immunizations in the development, purchase and delivery of vaccines.

  12. A nationwide study on reproductive function, ovarian reserve, and risk of premature menopause in female survivors of childhood cancer: Design and methodological challenges

    NARCIS (Netherlands)

    A. Overbeek; M.H. van den Berg (Marleen); L.C.M. Kremer (Leontien); M.M. van den Heuvel-Eibrink (Marry); W.J.E. Tissing (Wim); J.J. Loonen; B. Versluys; D. Bresters; G.J. Kaspers (Gertjan); C.B. Lambalk (Cornelius); F.E. van Leeuwen (Flora); E. van Dulmen-den Broeder (E.); C.C.M. Beerendonk (Catharina); J.P. Bökkerink (Jos); C. van den Bos (Cor); W. van Dorp (Wendy); M.P. van Engelen (M.); G.A. Huizinga (G.); M.W.M. Jaspers (Monique); J.S.E. Laven (Joop); M. Louwerens M. (M.); H.J.H. van der Pal (Heleen); C.M. Ronckers (Cécile); A.H.M. Simons; N. Tonch (Nino); E.C.M. Verkerk (E. C M)

    2012-01-01

    textabstractBackground: Advances in childhood cancer treatment over the past decades have significantly improved survival, resulting in a rapidly growing group of survivors. However, both chemo- and radiotherapy may adversely affect reproductive function. This paper describes the design and

  13. A nationwide study on reproductive function, ovarian reserve, and risk of premature menopause in female survivors of childhood cancer : design and methodological challenges

    NARCIS (Netherlands)

    Overbeek, Annelies; van den Berg, Marleen H.; Kremer, Leontien C. M.; van den Heuvel-Eibrink, Marry M.; Tissing, Wim J. E.; Loonen, Jacqueline J.; Versluys, Birgitta; Bresters, Dorine; Kaspers, Gertjan J. L.; Lambalk, Cornelis B.; van Leeuwen, Flora E.; van Dulmen-den Broeder, Eline

    2012-01-01

    Background: Advances in childhood cancer treatment over the past decades have significantly improved survival, resulting in a rapidly growing group of survivors. However, both chemo- and radiotherapy may adversely affect reproductive function. This paper describes the design and encountered

  14. A nationwide study on reproductive function, ovarian reserve, and risk of premature menopause in female survivors of childhood cancer: design and methodological challenges

    NARCIS (Netherlands)

    Overbeek, A.; van den Berg, M.H.; Kremer, L.C.; van den Heuvel-Eibrink, M.; Tissing, W.J.; Loonen, J.J.; Versluys, B.; Bresters, D.; Kaspers, G.J.L.; Lambalk, C.B.; van Leeuwen, F.E.; van Dulmen-den Broeder, E.

    2012-01-01

    Background: Advances in childhood cancer treatment over the past decades have significantly improved survival, resulting in a rapidly growing group of survivors. However, both chemo- and radiotherapy may adversely affect reproductive function. This paper describes the design and encountered

  15. Spatial distribution and partitioning behavior of selected poly- and perfluoroalkyl substances in freshwater ecosystems: a French nationwide survey.

    Science.gov (United States)

    Munoz, Gabriel; Giraudel, Jean-Luc; Botta, Fabrizio; Lestremau, François; Dévier, Marie-Hélène; Budzinski, Hélène; Labadie, Pierre

    2015-06-01

    The spatial distribution and partitioning of 22 poly- and perfluoroalkyl substances (PFASs) in 133 selected rivers and lakes were investigated at a nationwide scale in mainland France. ΣPFASs was in the rangePFAS levels were significantly lower at "reference" sites than at urban, rural or industrial sites. Although perfluorooctane sulfonate (PFOS) was found to be the prevalent compound on average, a multivariate analysis based on neural networks revealed noteworthy trends for other compounds at specific locations and, in some cases, at watershed scale. For instance, several sites along the Rhône River displayed a peculiar PFAS signature, perfluoroalkyl carboxylates (PFCAs) often dominating the PFAS profile (e.g., PFCAs>99% of ΣPFASs in the sediment, likely as a consequence of industrial point source discharge). Several treatments for data below detection limits (non-detects) were used to compute descriptive statistics, differences among groups, and correlations between congeners, as well as log Kd and log Koc partition coefficients; in that respect, the Regression on Order Statistics (robust ROS) method was preferred for descriptive statistics computation while the Akritas-Theil-Sen estimator was used for regression and correlation analyses. Multiple regression results suggest that PFAS levels in the dissolved phase and sediment characteristics (organic carbon fraction and grain size) may be significant controlling factors of PFAS levels in the sediment. Copyright © 2015 Elsevier B.V. All rights reserved.

  16. Physical exercise and cognitive function across the life span: Results of a nationwide population-based study.

    Science.gov (United States)

    Gaertner, Beate; Buttery, Amanda K; Finger, Jonas D; Wolfsgruber, Steffen; Wagner, Michael; Busch, Markus A

    2018-05-01

    To examine cross-sectional and longitudinal associations between physical exercise and cognitive function across different age groups in a nationwide population-based sample of adults aged 18-79 years in Germany. Cross-sectional/prospective. Cognitive function was assessed in the mental health module of the German Health Interview and Examination Survey for Adults (DEGS1-MH, 2009-2012, n=3535), using a comprehensive neuropsychological test battery. Cognitive domain scores for executive function and memory were derived from confirmatory factor analysis. Regular physical exercise in the last three months was assessed by self-report and defined as no exercise, exercise per week. A subgroup of DEGS1-MH participants who previously participated in the German National Health Interview and Examination Survey 1998 (GNHIES98, 1997-1999, n=1624) enabled longitudinal analyses with a mean follow-up of 12.4 years. Compared to no exercise, more weekly physical exercise was associated with better executive function in cross-sectional (physical exercise and age. Higher levels of physical exercise were associated with better executive function and memory in cross-sectional and longitudinal analyses with no evidence for differential effects by age. Copyright © 2017 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  17. Cardiac symptoms before sudden cardiac death caused by hypertrophic cardiomyopathy: a nationwide study among the young in Denmark.

    Science.gov (United States)

    Lynge, Thomas Hadberg; Risgaard, Bjarke; Jabbari, Reza; Glinge, Charlotte; Bundgaard, Henning; Maron, Barry; Haunsø, Stig; Winkel, Bo Gregers; Tfelt-Hansen, Jacob

    2016-12-01

    Hypertrophic cardiomyopathy (HCM) is a frequent cause of sudden cardiac death (SCD) among the young (SCDY). The aim of this study was to characterize symptoms before SCDY due to HCM. Through review of all death certificates, we identified all SCDs in Danes aged 1-35 years in 2000-2009. Nationwide we included all deaths (n = 8756) and identified 431 autopsied SCDYs. All available records from hospitals and general practitioners were retrieved. To compare symptoms, we included a control groups consisting of traffic accident victims (n = 74). In the 10-year study period, 431 autopsied SCDY cases were reviewed and 38 cases (9%) were included, of which 22 (58%) had morphologic findings diagnostic of HCM and 16 (42%) had findings suggestive, but not diagnostic, of HCM ('possible HCM'). Cardiac symptoms >1 h prior to death were reported in 21 (55%) of cases, and 16 (42%) sought medical attention. One (1%) control had cardiac symptoms before death. Consequently, a significantly higher proportion of cases had cardiac symptoms before death and cases more often sought medical attention than controls (P symptoms prior to death in SCDY cases who died of HCM, as 55% had cardiac symptoms and nearly half of the cases sought medical attention. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2016. For permissions please email: journals.permissions@oup.com.

  18. The second nationwide surveillance of the antimicrobial susceptibility of Neisseria gonorrhoeae from male urethritis in Japan, 2012-2013.

    Science.gov (United States)

    Hamasuna, Ryoichi; Yasuda, Mitsuru; Ishikawa, Kiyohito; Uehara, Shinya; Hayami, Hiroshi; Takahashi, Satoshi; Matsumoto, Tetsuro; Yamamoto, Shingo; Minamitani, Shinichi; Watanabe, Akira; Iwata, Satoshi; Kaku, Mitsuo; Kadota, Junichi; Sunakawa, Keisuke; Sato, Junko; Hanaki, Hideaki; Tsukamoto, Taiji; Kiyota, Hiroshi; Egawa, Shin; Tanaka, Kazushi; Arakawa, Soichi; Fujisawa, Masato; Kumon, Hiromi; Kobayashi, Kanao; Matsubara, Akio; Naito, Seiji; Kuroiwa, Kentaro; Hirayama, Hideo; Narita, Harunori; Hosobe, Takahide; Ito, Shin; Ito, Kenji; Kawai, Shuichi; Ito, Masayasu; Chokyu, Hirofumi; Matsumura, Masaru; Yoshioka, Masaru; Uno, Satoshi; Monden, Koichi; Takayama, Kazuo; Kaji, Shinichi; Kawahara, Motoshi; Sumii, Toru; Kadena, Hitoshi; Yamaguchi, Takamasa; Maeda, Shinichi; Nishi, Shohei; Nishimura, Hirofumi; Shirane, Takeshi; Yoh, Mutsumasa; Akiyama, Kikuo; Imai, Toshio; Kano, Motonori

    2015-05-01

    Worldwide, the most important concern in the treatment of sexually transmitted infections is the increase in antimicrobial resistant Neisseria gonorrhoeae strains including resistance to cephalosporins, penicillins, fluoroquinolones or macrolides. To investigate the trends of antimicrobial susceptibility among N. gonorrhoeae strains isolated from male patients with urethritis, a Japanese surveillance committee conducted the second nationwide surveillance study. Urethral discharge was collected from male patients with urethritis at 26 medical facilities from March 2012 to January 2013. Of the 151 specimens, 103 N. gonorrhoeae strains were tested for susceptibility to 20 antimicrobial agents. None of the strains was resistant to ceftriaxone, but the minimum inhibitory concentration (MIC) 90% of ceftriaxone increased to 0.125 μg/ml, and 11 (10.7%) strains were considered less susceptible with an MIC of 0.125 μg/ml. There were 11 strains resistant to cefixime, and the MICs of these strains were 0.5 μg/ml. The distributions of the MICs of fluoroquinolones, such as ciprofloxacin, levofloxacin and tosufloxacin, were bimodal. Sitafloxacin, a fluoroquinolone, showed strong activity against all strains, including strains resistant to other three fluoroquinolones, such as ciprofloxacin, levofloxacin and tosufloxacin. The azithromycin MICs in 2 strains were 1 μg/ml. Copyright © 2015 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  19. Volume-controlled versus short drainage after inguinofemoral lymphadenectomy in vulvar cancer patients: A Dutch nationwide prospective study.

    Science.gov (United States)

    Pouwer, A W; Hinten, F; van der Velden, J; Smolders, R G V; Slangen, B F M; Zijlmans, H J M A A; IntHout, J; van der Zee, A G J; Boll, D; Gaarenstroom, K N; Arts, H J; de Hullu, J A

    2017-09-01

    Inguinofemoral lymphadenectomy for patients with vulvar squamous cell carcinoma is associated with a high incidence of postoperative wound complications, which may be influenced by inguinal drain management. The aim of this nationwide prospective study (MAMBO: Morbidity And Measurement of the BOdy) was to assess the feasibility and the incidence of complications after volume-controlled versus short drainage. The MAMBO study consisted of two observational studies in all eight oncology centers in the Netherlands, conducted between 2012 and 2016. In the first study, the drain was removed when the production was drainage protocols, adjusting for possible confounders. We included 77 patients (139 groins) for volume-controlled drainage and 64 patients (112 groins) for short drainage. Volume-controlled drainage was associated with significant less lymphocele formation. Moreover, we found no difference in wound infection or primary wound breakdown. The estimated incidence of one or more complications was 46% per groin after volume-controlled drainage versus 75% after short drainage, (RD 29% (95% CI 8, 49) p=0.006). This prospective study shows that volume-controlled drainage is associated with significantly less complications compared to short drainage. We therefore recommend volume-controlled drainage after inguinofemoral lymphadenectomy in patients with vulvar squamous cell carcinoma. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. Risk of venous thromboembolism in patients with mycosis fungoides and parapsoriasis: A Danish nationwide population-based cohort study.

    Science.gov (United States)

    Lindahl, Lise M; Schmidt, Morten; Farkas, Dora K; Sørensen, Henrik T; Iversen, Lars

    2017-12-01

    Mycosis fungoides (MF) and parapsoriasis are characterized by malignant proliferation and chronic inflammation, which may affect the risk for venous thromboembolism (VTE). To examine the risk for VTE in patients with MF and parapsoriasis. We conducted a nationwide population-based cohort study in Denmark to examine the relative risk (RR) of VTE in 525 patients with MF and 634 patients with parapsoriasis compared with that in sex- and age-matched controls from the general population. In patients with MF, the 10-year absolute risk for VTE was 3.4% (95% confidence interval [CI], 2.0-5.4). The adjusted RRs were 2.41 (95% CI, 1.49-3.90) for VTE and 4.01 (95% CI, 2.16-7.46) for pulmonary embolism. Notably, within the first 5 years after diagnosis with MF, the RR of pulmonary embolism was increased 6.7-fold (to 6.71 [95% CI, 2.86-15.72]). Patients with parapsoriasis had a 2.7-fold increased RR of VTE (to 2.67 [95% CI, 1.32-5.40]) in the absence of other established VTE risk factors. We had no information regarding disease stage of MF and prescribed drugs. Patients with MF and parapsoriasis had an increased RR of VTE, although the absolute risk remained low. These findings should increase awareness of comorbidities in patients with MF and parapsoriasis. Copyright © 2017 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  1. Increased risk for complications following diagnostic cerebral angiography in older patients: Trends from the Nationwide Inpatient Sample (1999-2009).

    Science.gov (United States)

    Choudhri, Omar; Schoen, Matthew; Mantha, Aditya; Feroze, Abdullah; Ali, Rohaid; Lawton, Michael T; Do, Huy M

    2016-10-01

    The full utility of diagnostic cerebral angiography, an invasive cerebrovascular imaging technique, is currently debated. Our goal was to determine trends in diagnostic cerebral angiography utilization and associated complications from 1999 through 2009. The National Inpatient Sample (NIS) was used to identify patients who received primary cerebral angiography from 1999-2009 in the United States. We observed trends in discharge volume, total mean charge, and post-procedural complications for this population. Data was based on sample projections and analyzed using univariate and multivariate regression. There were a total of 424,105 discharges indicating primary cerebral angiography nationwide from 1999-2009. The majority of these cases (65%) were in patients older than 55years. Embolic stroke was the most frequent complication, particularly in the oldest age bracket, occurring in 16,304 patients. The risk for complications increased with age (p<0.0001) and with other underlying health conditions. Pulmonary, deep vein thrombosis, and renal associated comorbidities resulted in the greatest risk for developing post-procedural complications. Throughout the study period case volume for cerebral angiography remained constant while total charge per patient increased from $17,365 in 1999 to $45,339 in 2009 (p<0.001). While the overall complication rate for this invasive procedure is relatively low, the potential risk for embolic stroke in older patients is significant. It is worth considering less invasive diagnostic techniques for an older and at risk patient population. Copyright © 2016 Elsevier Ltd. All rights reserved.

  2. Childhood bullying behaviors at age eight and substance use at age 18 among males. A nationwide prospective study.

    Science.gov (United States)

    Niemelä, S; Brunstein-Klomek, A; Sillanmäki, L; Helenius, H; Piha, J; Kumpulainen, K; Moilanen, I; Tamminen, T; Almqvist, F; Sourander, A

    2011-03-01

    Childhood bullying behaviors (bullying and victimization) were studied as risk factors for substance use among Finnish males. The study design was a nationwide prospective general population study, where information was collected in 1989 and 1999. Bullying behaviors and childhood psychopathology at age eight were collected from teachers, parents and boys themselves. At age 18, self-reports of frequent drunkenness (once a week or more often), daily heavy smoking (10 cigarettes or more per day), and illicit drug use during the past six months were obtained from 78% of the boys attending the study at age eight (n=2946). Being frequently victimized at age eight predicted daily heavy smoking, and this was evident even after adjusting for childhood family background, psychopathology at age eight and at age 18, and other forms of substance use. In multivariate analysis, bullying others frequently predicted illicit drug use, while being a victim of bullying associated with a lower occurrence of illicit drug use. Bullying behaviors had no association with frequent drunkenness independent of other factors. Accordingly, being a victim of bullying predisposes in particular to subsequent smoking. Bullying others in childhood can be regarded as an early indicator to illicit drug use later in life. The screening and intervention possibilities in order to recognize the risk group for later health compromising behaviors are emphasized. Copyright © 2010 Elsevier Ltd. All rights reserved.

  3. Risk of inflammatory bowel disease in patients with rosacea: Results from a nationwide cohort study in Taiwan.

    Science.gov (United States)

    Wu, Chun-Ying; Chang, Yun-Ting; Juan, Chao-Keui; Shieh, Jeng-Jer; Lin, Yu-Pu; Liu, Han-Nan; Lin, Jaw-Town; Chen, Yi-Ju

    2017-05-01

    A link between rosacea and inflammatory bowel disease (IBD) has been proposed with unknown mechanisms. Epidemiologic evidence of this association needs to be examined. In this nationwide cohort study, a total of 89,356 patients with rosacea and 178,712 matched patients without rosacea between 1997 and 2013 were identified in the Taiwanese National Health Insurance Research Database. Cumulative incidences of IBD were compared between these 2 cohorts. Frailty Cox proportional hazard model was used and subgroup analyses were conducted to examine the risk factors for IBD. The 15-year cumulative incidences of IBD were 0.036% (95% confidence interval [CI] 0.00%-1.57%) and 0.019% (95% CI 0.00%-0.83%) in rosacea and nonrosacea cohorts, respectively (P = .05). Rosacea (adjusted hazard ratio 1.94, 95% CI 1.04-3.63, P = .04) and male gender (adjusted hazard ratio 3.52, 95% CI 2.03-6.11, P rosacea, but without statistical significance. Information related to lifestyle, diet, alcohol, and smoking was not included in the database. Patients with rosacea may have an increased risk of IBD. Copyright © 2016 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  4. Fertility treatment and childhood type 1 diabetes mellitus: a nationwide cohort study of 565,116 live births.

    Science.gov (United States)

    Kettner, Laura Ozer; Matthiesen, Niels Bjerregaard; Ramlau-Hansen, Cecilia Høst; Kesmodel, Ulrik Schiøler; Bay, Bjørn; Henriksen, Tine Brink

    2016-12-01

    To investigate the association between specific types of fertility treatment and childhood type 1 diabetes mellitus. Nationwide birth cohort study. Not applicable. All pregnancies resulting in a live-born singleton child in Denmark from 1995 to 2003. Not applicable. Childhood type 1 diabetes mellitus identified from redeemed prescriptions for insulin until 2013. The study included 565,116 singleton pregnancies. A total of 14,985 children were conceived by ovulation induction or intrauterine insemination, and 8,490 children were conceived by in vitro fertilization or intracytoplasmic sperm injection. During the follow-up period, 2,011 (0.4%) children developed type 1 diabetes mellitus. The primary analyses showed no association between fertility treatment and childhood type 1 diabetes mellitus. In secondary analyses, ovulation induction or intrauterine insemination with follicle-stimulating hormone was associated with an increased risk of type 1 diabetes mellitus (hazard ratio 3.22; 95% confidence interval 1.20 to 8.64). No clear associations were seen with other types of fertility treatment or with specific treatment indications. No association between fertility treatment and childhood type 1 diabetes mellitus was found. Ovulation induction or intrauterine insemination with follicle-stimulating hormone may be associated with an increased risk of childhood type 1 diabetes mellitus. However, this finding may be due to chance or to confounding by indication and thus requires further investigation. Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  5. Large-scale machine learning of media outlets for understanding public reactions to nation-wide viral infection outbreaks.

    Science.gov (United States)

    Choi, Sungwoon; Lee, Jangho; Kang, Min-Gyu; Min, Hyeyoung; Chang, Yoon-Seok; Yoon, Sungroh

    2017-10-01

    From May to July 2015, there was a nation-wide outbreak of Middle East respiratory syndrome (MERS) in Korea. MERS is caused by MERS-CoV, an enveloped, positive-sense, single-stranded RNA virus belonging to the family Coronaviridae. Despite expert opinions that the danger of MERS might be exaggerated, there was an overreaction by the public according to the Korean mass media, which led to a noticeable reduction in social and economic activities during the outbreak. To explain this phenomenon, we presumed that machine learning-based analysis of media outlets would be helpful and collected a number of Korean mass media articles and short-text comments produced during the 10-week outbreak. To process and analyze the collected data (over 86 million words in total) effectively, we created a methodology composed of machine-learning and information-theoretic approaches. Our proposal included techniques for extracting emotions from emoticons and Internet slang, which allowed us to significantly (approximately 73%) increase the number of emotion-bearing texts needed for robust sentiment analysis of social media. As a result, we discovered a plausible explanation for the public overreaction to MERS in terms of the interplay between the disease, mass media, and public emotions. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. Effect of planning for connectivity on linear reserve networks.

    Science.gov (United States)

    Lentini, Pia E; Gibbons, Philip; Carwardine, Josie; Fischer, Joern; Drielsma, Michael; Martin, Tara G

    2013-08-01

    Although the concept of connectivity is decades old, it remains poorly understood and defined, and some argue that habitat quality and area should take precedence in conservation planning instead. However, fragmented landscapes are often characterized by linear features that are inherently connected, such as streams and hedgerows. For these, both representation and connectivity targets may be met with little effect on the cost, area, or quality of the reserve network. We assessed how connectivity approaches affect planning outcomes for linear habitat networks by using the stock-route network of Australia as a case study. With the objective of representing vegetation communities across the network at a minimal cost, we ran scenarios with a range of representation targets (10%, 30%, 50%, and 70%) and used 3 approaches to account for connectivity (boundary length modifier, Euclidean distance, and landscape-value [LV]). We found that decisions regarding the target and connectivity approach used affected the spatial allocation of reserve systems. At targets ≥50%, networks designed with the Euclidean distance and LV approaches consisted of a greater number of small reserves. Hence, by maximizing both representation and connectivity, these networks compromised on larger contiguous areas. However, targets this high are rarely used in real-world conservation planning. Approaches for incorporating connectivity into the planning of linear reserve networks that account for both the spatial arrangement of reserves and the characteristics of the intervening matrix highlight important sections that link the landscape and that may otherwise be overlooked. © 2013 Society for Conservation Biology.

  7. Habitat damage, marine reserves, and the value of spatial management

    KAUST Repository

    Moeller, Holly V.

    2013-07-01

    The biological benefits of marine reserves have garnered favor in the conservation community, but "no-take" reserve implementation is complicated by the economic interests of fishery stakeholders. There are now a number of studies examining the conditions under which marine reserves can provide both economic and ecological benefits. A potentially important reality of fishing that these studies overlook is that fishing can damage the habitat of the target stock. Here, we construct an equilibrium bioeconomic model that incorporates this habitat damage and show that the designation of marine reserves, coupled with the implementation of a tax on fishing effort, becomes both biologically and economically favorable as habitat sensitivity increases. We also study the effects of varied degrees of spatial control on fisheries management. Together, our results provide further evidence for the potential monetary and biological value of spatial management, and the possibility of a mutually beneficial resolution to the fisherman-conservationist marine reserve designation dilemma. © 2013 by the Ecological Society of America.

  8. Substantiating the Incurred but not Reported Reserve

    Directory of Open Access Journals (Sweden)

    Georgeta Vintilã

    2009-12-01

    Full Text Available In order to handle past and future liability taken by insurance contracts concluded, any insurance company must constitute and maintain technical reserves. Substantiating technical reserves is done through actuarial methods and its over-evaluation or under-evaluation influence solvency and financial performance of the insurance companies, in the sense of reducing solvency through over-evaluating reserves and, respectively, influencing profit (hence of outstanding tax through under-evaluating reserves. An important reserve for insurance companies is represented by the incurred but not reported reserve, as it allows the estimation of the liability the company may confront in the future, generated by events occurred in the past, which are not currently known in the present but will be reported in the future.

  9. Planting local seed for growth to nationwide E/PO efforts

    Science.gov (United States)

    Fox, N.; Beisser, K.; Mendez, F.; Cockrell, D.; Wilhide, B.

    The Johns Hopkins University Applied Physics Laboratory (JHU/APL) is the home to hundreds of scientists and engineers, all involved in research, design and implementation of space missions. Many of these people actively seek out ways to raise awareness and interest in the local community by visiting schools, giving public lectures and supporting events held at the laboratory. During the past few years, APL has begun to foster a number of firm partnerships with organizations to further these community opportunities and provide a test bed for both formal and informal education activities through the Space Department E/PO office One of our ongoing partnerships is with the Maryland Science Center in Baltimore. A continual challenge faced by museums is how to stay current and allow visitors to experience the immediacy and excitement of scientific discovery. To help meet these challenges, the Maryland Science Center houses "SpaceLink", the Nation's first space, science and astronomy update center. Part media center, part discovery room, and part newsroom, the exhibit is a multi-purpose Professional Development Site for educators and a "classroom of the future" for K 12 students. APL scientists and- engineers regularly support SpaceLink's flexible programming, including scientist in residence, monthly credited seminars for educators (Teachers' Thursdays), a menu of Classroom Programs on request, Distance Learning Teacher Presentations, and special Live Events to highlight mission milestones and space-related anniversaries. This allows the guest scientists and engineers to interact directly with the public. These events also compliment the APL exhibits housed at the Science Center. JHU/APL offers an exciting environment for the study of applications in space by hosting the annual Maryland Summer Center for Space Science sponsored by the Maryland State Department of Education. Rising 6t h and 7t h grade students learn to harness the power of technology and keep pace with

  10. A Policy Analysis of Reserve Retirement Reform

    Science.gov (United States)

    2013-01-01

    adapted their manning requirements to this retention. Perhaps tasks and jobs have been designed to accommodate the reten - tion profile produced by the...a reward for a long career of service, a benefit to help transition to the civilian economy, and a means of securing the reten - tion of career...to determine their likely effect on active reten - tion, reserve affiliation after leaving an active component, reserve retention, and reserve

  11. IGT calculates world reserves of fossil fuels

    International Nuclear Information System (INIS)

    Anon.

    1986-01-01

    The Institute of Gas Technology has published the IGT World Reserves Survey, giving their latest tabulation of world reserves of fossil fuels and uranium. The report contains 120 Tables and 41 Figures. Estimates are provided for proved reserves, resources, current production, and life indexes of the non-renewable energy sources of the US and of the world as a whole. World regional data are also provided in many cases. The data are summarized here. 2 figures, 5 tables

  12. Reserve valuation in electric power systems

    Science.gov (United States)

    Ruiz, Pablo Ariel

    Operational reliability is provided in part by scheduling capacity in excess of the load forecast. This reserve capacity balances the uncertain power demand with the supply in real time and provides for equipment outages. Traditionally, reserve scheduling has been ensured by enforcing reserve requirements in the operations planning. An alternate approach is to employ a stochastic formulation, which allows the explicit modeling of the sources of uncertainty. This thesis compares stochastic and reserve methods and evaluates the benefits of a combined approach for the efficient management of uncertainty in the unit commitment problem. Numerical studies show that the unit commitment solutions obtained for the combined approach are robust and superior with respect to the traditional approach. These robust solutions are especially valuable in areas with a high proportion of wind power, as their built-in flexibility allows the dispatch of practically all the available wind power while minimizing the costs of operation. The scheduled reserve has an economic value since it reduces the outage costs. In several electricity markets, reserve demand functions have been implemented to take into account the value of reserve in the market clearing process. These often take the form of a step-down function at the reserve requirement level, and as such they may not appropriately represent the reserve value. The value of reserve is impacted by the reliability, dynamic and stochastic characteristics of system components, the system operation policies, and the economic aspects such as the risk preferences of the demand. In this thesis, these aspects are taken into account to approximate the reserve value and construct reserve demand functions. Illustrative examples show that the demand functions constructed have similarities with those implemented in some markets.

  13. Reserve reporting from a banker's perspective

    International Nuclear Information System (INIS)

    Larson, B.O.

    1996-01-01

    A banker's perspective of oil and gas reserve reporting was presented. Topics chosen for discussion emphasized oil and gas lending, and the type of capital which is most relevant to the oil and gas industry. The concept of capital differentiation, potential worst case, and least specialization, were explained. An explanation of the reasons for the lender's different perspective on reserves was given. Methods that banks use to limit risk, and the role that reserve reports play in loan approvals were also reviewed

  14. When will fossil fuel reserves be diminished?

    International Nuclear Information System (INIS)

    Shafiee, Shahriar; Topal, Erkan

    2009-01-01

    Crude oil, coal and gas are the main resources for world energy supply. The size of fossil fuel reserves and the dilemma that 'when non-renewable energy will be diminished' is a fundamental and doubtful question that needs to be answered. This paper presents a new formula for calculating when fossil fuel reserves are likely to be depleted and develops an econometrics model to demonstrate the relationship between fossil fuel reserves and some main variables. The new formula is modified from the Klass model and thus assumes a continuous compound rate and computes fossil fuel reserve depletion times for oil, coal and gas of approximately 35, 107 and 37 years, respectively. This means that coal reserves are available up to 2112, and will be the only fossil fuel remaining after 2042. In the Econometrics model, the main exogenous variables affecting oil, coal and gas reserve trends are their consumption and respective prices between 1980 and 2006. The models for oil and gas reserves unexpectedly show a positive and significant relationship with consumption, while presenting a negative and significant relationship with price. The econometrics model for coal reserves, however, expectedly illustrates a negative and significant relationship with consumption and a positive and significant relationship with price. Consequently, huge reserves of coal and low-level coal prices in comparison to oil and gas make coal one of the main energy substitutions for oil and gas in the future, under the assumption of coal as a clean energy source. (author)

  15. Reservation system with graphical user interface

    KAUST Repository

    Mohamed, Mahmoud A. Abdelhamid

    2012-01-05

    Techniques for providing a reservation system are provided. The techniques include displaying a scalable visualization object, wherein the scalable visualization object comprises an expanded view element of the reservation system depicting information in connection with a selected interval of time and a compressed view element of the reservation system depicting information in connection with one or more additional intervals of time, maintaining a visual context between the expanded view and the compressed view within the visualization object, and enabling a user to switch between the expanded view and the compressed view to facilitate use of the reservation system.

  16. Resource Management plan for the Oak Ridge Reservation

    International Nuclear Information System (INIS)

    Cunningham, M.; Pounds, L.

    1991-12-01

    A survey of wetlands on the Oak Ridge Reservation (ORR) was conducted in 1990. Wetlands occurring on ORR were identified using National Wetlands Inventory (NWI) maps and field surveys. More than 120 sites were visited and 90 wetlands were identified. Wetland types on ORR included emergent communities in shallow embayments on reservoirs, emergent and aquatic communities in ponds, forested wetland on low ground along major creeks, and wet meadows and marshes associated with streams and seeps. Vascular plant species occurring on sites visited were inventoried, and 57 species were added to the checklist of vascular plants on ORR. Three species listed as rare in Tennessee were discovered on ORR during the wetlands survey. The survey provided an intensive ground truth of the wetlands identified by NWI and offered an indication of wetlands that the NWI remote sensing techniques did not detect

  17. A phyt osociological classification of the vegetation of the Jack Scott Nature Reserve*

    Directory of Open Access Journals (Sweden)

    B. J. Coetzee

    1974-12-01

    Full Text Available The vegetation of the Jack Scott Nature Reserve in the Central Bankenveld Veld Type is classified chiefly by the Braun-Blanquet Table Method. Habitat features, physiognomy, total floristic composition, differentiating species, woody plants and prominent grasses and forbs are presented for each community. Characterizing habitat features, in order of importance for the communities, are: exposure, soil texture, geology, slope, aspect, degree of rockiness and previous ploughing. The classification correlates well with the major physiographic and climatic variation in the Reserve and generally does not cut across main physiognomic types. The communities are potentially homogeneous management units.

  18. 77 FR 65533 - Proposed Information Collection; Comment Request; National Estuarine Research Reserve System...

    Science.gov (United States)

    2012-10-29

    ...) Science Collaborative was created in 2009 to put Reserve-based science to work for coastal communities... Collection; Comment Request; National Estuarine Research Reserve System Science Collaborative Evaluation... funded by the NERRS Science Collaborative are designed to bring the intended users of the science into...

  19. 48 CFR 4.501 - [Reserved

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false [Reserved] 4.501 Section 4.501 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION GENERAL ADMINISTRATIVE MATTERS Electronic Commerce in Contracting 4.501 [Reserved...

  20. 7 CFR 300.1 - [Reserved

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 5 2010-01-01 2010-01-01 false [Reserved] 300.1 Section 300.1 Agriculture Regulations of the Department of Agriculture (Continued) ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE INCORPORATION BY REFERENCE § 300.1 [Reserved...

  1. 7 CFR 305.4 - [Reserved

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 5 2010-01-01 2010-01-01 false [Reserved] 305.4 Section 305.4 Agriculture Regulations of the Department of Agriculture (Continued) ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE PHYTOSANITARY TREATMENTS § 305.4 [Reserved...

  2. 50 CFR 216.42 - Photography. [Reserved

    Science.gov (United States)

    2010-10-01

    ... 50 Wildlife and Fisheries 7 2010-10-01 2010-10-01 false Photography. [Reserved] 216.42 Section 216.42 Wildlife and Fisheries NATIONAL MARINE FISHERIES SERVICE, NATIONAL OCEANIC AND ATMOSPHERIC... MAMMALS Special Exceptions § 216.42 Photography. [Reserved] ...

  3. 9 CFR 73.1a - [Reserved

    Science.gov (United States)

    2010-01-01

    ... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false [Reserved] 73.1a Section 73.1a Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE INTERSTATE TRANSPORTATION OF ANIMALS (INCLUDING POULTRY) AND ANIMAL PRODUCTS SCABIES IN CATTLE § 73.1a [Reserved] ...

  4. 12 CFR 614.4710 - [Reserved

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 6 2010-01-01 2010-01-01 false [Reserved] 614.4710 Section 614.4710 Banks and Banking FARM CREDIT ADMINISTRATION FARM CREDIT SYSTEM LOAN POLICIES AND OPERATIONS Banks for Cooperatives and Agricultural Credit Banks Financing International Trade § 614.4710 [Reserved] ...

  5. 40 CFR 406.43 - [Reserved

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 28 2010-07-01 2010-07-01 true [Reserved] 406.43 Section 406.43 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS GRAIN MILLS POINT SOURCE CATEGORY Bulgur Wheat Flour Milling Subcategory § 406.43 [Reserved] ...

  6. 40 CFR 406.23 - [Reserved

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 28 2010-07-01 2010-07-01 true [Reserved] 406.23 Section 406.23 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS GRAIN MILLS POINT SOURCE CATEGORY Corn Dry Milling Subcategory § 406.23 [Reserved] ...

  7. 40 CFR 406.13 - [Reserved

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 28 2010-07-01 2010-07-01 true [Reserved] 406.13 Section 406.13 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS GRAIN MILLS POINT SOURCE CATEGORY Corn Wet Milling Subcategory § 406.13 [Reserved] ...

  8. 24 CFR 891.855 - Replacement reserves.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Replacement reserves. 891.855... § 891.855 Replacement reserves. (a) The mixed-finance owner shall establish and maintain a replacement... the funds will be used to pay for capital replacement costs for the Section 202 or 811 supportive...

  9. 22 CFR 40.69 - [Reserved

    Science.gov (United States)

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false [Reserved] 40.69 Section 40.69 Foreign Relations DEPARTMENT OF STATE VISAS REGULATIONS PERTAINING TO BOTH NONIMMIGRANTS AND IMMIGRANTS UNDER THE IMMIGRATION AND NATIONALITY ACT, AS AMENDED Illegal Entrants and Immigration Violators § 40.69 [Reserved] ...

  10. Body reserves in intra-African migrants

    NARCIS (Netherlands)

    Nwaogu, Chima; Cresswell, Will

    Avian migration has been shown to be a life history strategy for surviving environmental resource variability, but it requires increased body reserves for long distance flight. Fat reserves make excellent energy stores for barrier crossing, whereas proteins generate less energy for the same mass of

  11. 21 CFR 211.170 - Reserve samples.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 4 2010-04-01 2010-04-01 false Reserve samples. 211.170 Section 211.170 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS: GENERAL... of deterioration unless visual examination would affect the integrity of the reserve sample. Any...

  12. 8 CFR 325.1 - [Reserved

    Science.gov (United States)

    2010-01-01

    ... 8 Aliens and Nationality 1 2010-01-01 2010-01-01 false [Reserved] 325.1 Section 325.1 Aliens and Nationality DEPARTMENT OF HOMELAND SECURITY NATIONALITY REGULATIONS NATIONALS BUT NOT CITIZENS OF THE UNITED STATES; RESIDENCE WITHIN OUTLYING POSSESSIONS § 325.1 [Reserved] ...

  13. 30 CFR 253.44 - [Reserved

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 2 2010-07-01 2010-07-01 false [Reserved] 253.44 Section 253.44 Mineral Resources MINERALS MANAGEMENT SERVICE, DEPARTMENT OF THE INTERIOR OFFSHORE OIL SPILL FINANCIAL RESPONSIBILITY FOR OFFSHORE FACILITIES Requirements for Submitting OSFR Information § 253.44 [Reserved] ...

  14. 14 CFR 33.13 - [Reserved

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false [Reserved] 33.13 Section 33.13 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRWORTHINESS STANDARDS: AIRCRAFT ENGINES Design and Construction; General § 33.13 [Reserved] ...

  15. 14 CFR 35.13 - [Reserved

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false [Reserved] 35.13 Section 35.13 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRWORTHINESS STANDARDS: PROPELLERS Design and Construction § 35.13 [Reserved] ...

  16. 14 CFR 35.11 - [Reserved

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false [Reserved] 35.11 Section 35.11 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRWORTHINESS STANDARDS: PROPELLERS Design and Construction § 35.11 [Reserved] ...

  17. Reserve selection using nonlinear species distribution models.

    Science.gov (United States)

    Moilanen, Atte

    2005-06-01

    Reserve design is concerned with optimal selection of sites for new conservation areas. Spatial reserve design explicitly considers the spatial pattern of the proposed reserve network and the effects of that pattern on reserve cost and/or ability to maintain species there. The vast majority of reserve selection formulations have assumed a linear problem structure, which effectively means that the biological value of a potential reserve site does not depend on the pattern of selected cells. However, spatial population dynamics and autocorrelation cause the biological values of neighboring sites to be interdependent. Habitat degradation may have indirect negative effects on biodiversity in areas neighboring the degraded site as a result of, for example, negative edge effects or lower permeability for animal movement. In this study, I present a formulation and a spatial optimization algorithm for nonlinear reserve selection problems in grid-based landscapes that accounts for interdependent site values. The method is demonstrated using habitat maps and nonlinear habitat models for threatened birds in the Netherlands, and it is shown that near-optimal solutions are found for regions consisting of up to hundreds of thousands grid cells, a landscape size much larger than those commonly attempted even with linear reserve selection formulations.

  18. 7 CFR 3560.65 - Reserve account.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 15 2010-01-01 2010-01-01 false Reserve account. 3560.65 Section 3560.65 Agriculture... DIRECT MULTI-FAMILY HOUSING LOANS AND GRANTS Direct Loan and Grant Origination § 3560.65 Reserve account... account that meets requirements of § 3560.306. At a minimum, the borrower must agree to make monthly...

  19. 21 CFR 720.5 - [Reserved

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 7 2010-04-01 2010-04-01 false [Reserved] 720.5 Section 720.5 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) COSMETICS VOLUNTARY FILING OF COSMETIC PRODUCT INGREDIENT COMPOSITION STATEMENTS § 720.5 [Reserved] ...

  20. 39 CFR 111.5 - [Reserved

    Science.gov (United States)

    2010-07-01

    ... 39 Postal Service 1 2010-07-01 2010-07-01 false [Reserved] 111.5 Section 111.5 Postal Service UNITED STATES POSTAL SERVICE POST OFFICE SERVICES [DOMESTIC MAIL] GENERAL INFORMATION ON POSTAL SERVICE § 111.5 [Reserved] ...

  1. 75 FR 44067 - Conservation Reserve Program

    Science.gov (United States)

    2010-07-28

    ... amending the Conservation Reserve Program (CRP) regulations to implement provisions of the Food, Conservation, and Energy Act of 2008 (the 2008 Farm Bill). The 2008 Farm Bill generally extends the existing... Commodity Credit Corporation 7 CFR Part 1410 RIN 0560-AH80 Conservation Reserve Program AGENCY: Commodity...

  2. 7 CFR 1780.8 - [Reserved

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 12 2010-01-01 2010-01-01 false [Reserved] 1780.8 Section 1780.8 Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE (CONTINUED) WATER AND WASTE LOANS AND GRANTS General Policies and Requirements § 1780.8 [Reserved] ...

  3. 7 CFR 1779.79 - [Reserved

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 12 2010-01-01 2010-01-01 false [Reserved] 1779.79 Section 1779.79 Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE (CONTINUED) WATER AND WASTE DISPOSAL PROGRAMS GUARANTEED LOANS § 1779.79 [Reserved] ...

  4. 7 CFR 1780.5 - [Reserved

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 12 2010-01-01 2010-01-01 false [Reserved] 1780.5 Section 1780.5 Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE (CONTINUED) WATER AND WASTE LOANS AND GRANTS General Policies and Requirements § 1780.5 [Reserved] ...

  5. 7 CFR 1779.82 - [Reserved

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 12 2010-01-01 2010-01-01 false [Reserved] 1779.82 Section 1779.82 Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE (CONTINUED) WATER AND WASTE DISPOSAL PROGRAMS GUARANTEED LOANS § 1779.82 [Reserved] ...

  6. 7 CFR 1779.74 - [Reserved

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 12 2010-01-01 2010-01-01 false [Reserved] 1779.74 Section 1779.74 Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE (CONTINUED) WATER AND WASTE DISPOSAL PROGRAMS GUARANTEED LOANS § 1779.74 [Reserved] ...

  7. 7 CFR 1780.12 - [Reserved

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 12 2010-01-01 2010-01-01 false [Reserved] 1780.12 Section 1780.12 Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE (CONTINUED) WATER AND WASTE LOANS AND GRANTS General Policies and Requirements § 1780.12 [Reserved] ...

  8. 7 CFR 1779.26 - [Reserved

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 12 2010-01-01 2010-01-01 false [Reserved] 1779.26 Section 1779.26 Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE (CONTINUED) WATER AND WASTE DISPOSAL PROGRAMS GUARANTEED LOANS § 1779.26 [Reserved] ...

  9. 20 CFR 410.394 - [Reserved

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false [Reserved] 410.394 Section 410.394 Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL COAL MINE HEALTH AND SAFETY ACT OF 1969, TITLE IV-BLACK LUNG BENEFITS (1969- ) Relationship and Dependency § 410.394 [Reserved] ...

  10. 40 CFR 26.1124 - [Reserved

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 1 2010-07-01 2010-07-01 false [Reserved] 26.1124 Section 26.1124 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY GENERAL PROTECTION OF HUMAN SUBJECTS Basic Ethical...-nursing Adults § 26.1124 [Reserved] ...

  11. 26 CFR 1.46-10 - [Reserved

    Science.gov (United States)

    2010-04-01

    ... 26 Internal Revenue 1 2010-04-01 2010-04-01 true [Reserved] 1.46-10 Section 1.46-10 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY INCOME TAX INCOME TAXES Rules for Computing Credit for Investment in Certain Depreciable Property § 1.46-10 [Reserved] ...

  12. 34 CFR 97.121 - [Reserved

    Science.gov (United States)

    2010-07-01

    ... 34 Education 1 2010-07-01 2010-07-01 false [Reserved] 97.121 Section 97.121 Education Office of the Secretary, Department of Education PROTECTION OF HUMAN SUBJECTS Federal Policy for the Protection of Human Subjects (Basic ED Policy for Protection of Human Research Subjects) § 97.121 [Reserved] ...

  13. Running on Empty? The Compensatory Reserve Index

    Science.gov (United States)

    2013-12-01

    and HR,31 more blood pressure oscillations,32 and greater vasoconstrictor reserve,33 compared with low-tolerant individuals. By leveraging recent... vasoconstrictor reserves. Clin Auton Res. 2012; 22:123Y130. 32. Rickards CA, Ryan KL, Cooke WH, Convertino VA. Tolerance to central hypovolemia: the

  14. 77 FR 66980 - Federal Reserve Bank Services

    Science.gov (United States)

    2012-11-08

    ... earn net income of $15.3 million, compared with the target of $9.1 million. While the check service and... upgrades, and increase product revenue. 4. 2013 Pricing--The following summarizes the Reserve Banks... the office closed. The Reserve Banks also will introduce incentive pricing for depository institutions...

  15. 15 CFR 2003.3 - [Reserved

    Science.gov (United States)

    2010-01-01

    ... 15 Commerce and Foreign Trade 3 2010-01-01 2010-01-01 false [Reserved] 2003.3 Section 2003.3 Commerce and Foreign Trade Regulations Relating to Foreign Trade Agreements OFFICE OF THE UNITED STATES TRADE REPRESENTATIVE REGULATIONS OF TRADE POLICY STAFF COMMITTEE § 2003.3 [Reserved] ...

  16. The impact of socioeconomic factors on 30-day mortality following elective colorectal cancer surgery: A nationwide study

    DEFF Research Database (Denmark)

    Frederiksen, B L; Osler, M; Harling, H

    2009-01-01

    We investigated postoperative mortality in relation to socioeconomic status (SES) in electively operated colorectal cancer patients, and evaluated whether social inequalities were explained by factors related to patient, disease or treatment. Data from the nationwide database of Danish Colorectal...

  17. A Nationwide Survey on Some Hygienic Behaviors of Iranian Children and Adolescents: The CASPIAN-IV Study

    Directory of Open Access Journals (Sweden)

    Morteza Sadinejad

    2014-01-01

    Conclusions: This nationwide survey revealed that Iranian students have an acceptable level of hygienic behaviors both in urban and rural areas; however, still it is necessary to improve school health facilities and hygienic habits in Iranian students.

  18. The Economics of NASA Mission Cost Reserves

    Science.gov (United States)

    Whitley, Sally; Shinn, Stephen

    2012-01-01

    Increases in NASA mission costs are well-noted but not well-understood, and there is little evidence that they are decreasing in frequency or amount over time. The need to control spending has led to analysis of the causes and magnitude of historical mission overruns, and many program control efforts are being implemented to attempt to prevent or mitigate the problem (NPR 7120). However, cost overruns have not abated, and while some direct causes of increased spending may be obvious (requirements creep, launch delays, directed changes, etc.), the underlying impetus to spend past the original budget may be more subtle. Gaining better insight into the causes of cost overruns will help NASA and its contracting organizations to avoid .them. This paper hypothesizes that one cause of NASA mission cost overruns is that the availability of reserves gives project team members an incentive to make decisions and behave in ways that increase costs. We theorize that the presence of reserves is a contributing factor to cost overruns because it causes organizations to use their funds less efficiently or to control spending less effectively. We draw a comparison to the insurance industry concept of moral hazard, the phenomenon that the presence of insurance causes insureds to have more frequent and higher insurance losses, and we attempt to apply actuarial techniques to quantifY the increase in the expected cost of a mission due to the availability of reserves. We create a theoretical model of reserve spending motivation by defining a variable ReserveSpending as a function of total reserves. This function has a positive slope; for every dollar of reserves available, there is a positive probability of spending it. Finally, the function should be concave down; the probability of spending each incremental dollar of reserves decreases progressively. We test the model against available NASA CADRe data by examining missions with reserve dollars initially available and testing whether

  19. Community Development through Community Education.

    Science.gov (United States)

    Palmer, Jim

    1982-01-01

    Cites ERIC documents describing the community education and development programs of two-year colleges. Documents cover building a neighborhood coalition, an approach to marketing vocational programs, community education and development, and educational alternatives. (DMM)

  20. A coordinated national model for diabetes prevention: linking health systems to an evidence-based community program.

    Science.gov (United States)

    Vojta, Deneen; Koehler, Timothy B; Longjohn, Matt; Lever, Jonathan A; Caputo, Nadine F

    2013-04-01

    Twenty-six million U.S. adults have diabetes, and 79 million have prediabetes. A 2002 Diabetes Prevention Program research study proved the effectiveness of a lifestyle intervention that yielded a 58% reduction in conversion to type 2 diabetes. However, cost per participant was high, complicating efforts to scale up the program. UnitedHealth Group (UHG) and the YMCA of the USA, in collaboration with the CDC, sought to develop the infrastructure and business case to scale the congressionally authorized National Diabetes Prevention Program nationwide. Emphasis was placed on developing a model that maintained fidelity to the original 2002 Diabetes Prevention Program research study and could be deployed for a lower cost per participant while yielding similar outcomes. The UHG created the business case and technical and operational infrastructure necessary for nationwide dissemination of the YMCA's Diabetes Prevention Program (YMCA's DPP), as part of the National Diabetes Prevention Program. The YMCA's DPP is a group-based model of 16 core sessions with monthly follow-up delivered by trained lifestyle coaches. A variety of mechanisms were used to identify, screen, and encourage enrollment for people with prediabetes into the YMCA's DPP. Substantial investments were made in relationship building, business planning, technology, development, and operational design to deliver an effective and affordable 12-month program. The program intervention was conducted July 2010-December 2011. Data were collected on the participants over a 15-month period between September 2010 and December 2011. Data were analyzed in February 2012. The main outcome measures were infrastructure (communities involved and personnel trained); engagement (screening and enrollment of people with prediabetes); program outcomes (attendance and weight loss); and service delivery cost of the intervention. In less than 2 years, the YMCA's DPP was effectively scaled to 46 communities in 23 states. More than 500

  1. Cause-Specific Cardiovascular Risk Associated with Nonsteroidal Anti-Inflammatory Drugs among Myocardial Infarction Patients - A Nationwide Study

    DEFF Research Database (Denmark)

    Olsen, Anne-Marie Schjerning; Fosbøl, Emil L; Lindhardsen, Jesper

    2013-01-01

    Non steroidal anti-inflammatory drugs (NSAIDs) increase mortality and morbidity after myocardial infarction (MI). We examined cause-specific mortality and morbidity associated with NSAIDs in a nationwide cohort of MI patients.......Non steroidal anti-inflammatory drugs (NSAIDs) increase mortality and morbidity after myocardial infarction (MI). We examined cause-specific mortality and morbidity associated with NSAIDs in a nationwide cohort of MI patients....

  2. Part I, Introduction: Ecology and Regional Context of Tidal Wetlands in the San Francisco Bay National Estuarine Research Reserve

    Directory of Open Access Journals (Sweden)

    Matthew C. Ferner

    2011-12-01

    Full Text Available This two-part special issue reviews the basic ecology of tidal wetlands in the San Francisco Estuary. Several articles highlight the well-preserved tracts of historic tidal marsh found at China Camp State Park and Rush Ranch Open Space Preserve. These two protected areas serve as important reference sites for wetland restoration and conservation and also comprise San Francisco Bay National Estuarine Research Reserve (SF Bay NERR. SF Bay NERR is part of the National Oceanic and Atmospheric Administration’s nationwide network of 28 estuarine research reserves (http://www.nerrs.noaa.gov that all share common goals: (1 conducting standardized long-term monitoring, (2 supporting applied environmental research, (3 providing stewardship of estuarine natural resources, and (4 linking science with decision making in pursuit of effective solutions to coastal management problems.

  3. Prenatal stress and cerebral palsy: a nationwide cohort study in Denmark

    DEFF Research Database (Denmark)

    Li, Jiong; Vestergaard, Mogens; Obel, Carsten

    2009-01-01

    the loss of a child during the prenatal period was associated with an increased risk of CP among children born preterm without intrauterine growth retardation (HR 2.26, 95% CI, 1.09-3.79) and among children born at term with intrauterine growth retardation (HR 2.01, 95% CI, 1.04-3.89). Prenatal stress......OBJECTIVES: Exposure to prenatal stress may affect neurodevelopment of the fetus, but whether this exposure increases the risk of cerebral palsy (CP) later in life is unknown. We aimed to examine the association between maternal bereavement during the prenatal time period and CP in childhood....... METHODS: We conducted a nationwide cohort study by linking information from nationwide registers. All 1,501,894 singletons born in Denmark from 1979 to 2004 were followed up from birth to the end of 2006. We identified 39,601 children whose mothers lost a close relative (child, spouse, parent, sibling...

  4. 1990 Nationwide Truck Activity and Commodity Survey selected tabulations. Summary report

    Energy Technology Data Exchange (ETDEWEB)

    1993-06-01

    The Nationwide Truck Activity and Commodity Survey (NTACS) provides detailed activity data for a sample of trucks covered in the 1987 Truck Inventory and Use Survey (TIUS) for days selected at random over a 12-month period ending in 1990. The NTACS was conducted by the US Bureau of the Census for the US Department of Transportation (DOT). A Public Use File for the NTACS was developed by Oak Ridge National Laboratory (ORNL) under a reimbursable agreement with the DOT. The content of the Public Use File and the detailed design of the NTACS are described in the ORNL Report {open_quotes}Technical Documentation for the 1990 Nationwide Truck Activity and Commodity Survey Public Use File{close_quotes}. (1992). ORNL Technical Report No. TM-12188, Oak Ridge National Laboratory, Oak Ridge, TN 37831. The main purpose of this summary report is to provide selected tables based on the public use file.

  5. Antiarrhythmic therapy and risk of death in patients with atrial fibrillation: a nationwide study

    DEFF Research Database (Denmark)

    Andersen, Søren Skøtt; Hansen, Morten Lock; Gislason, Gunnar H

    2009-01-01

    AIMS: To examine the risk of death associated with antiarrhythmic drug (AAD) therapy in a nationwide unselected cohort of patients with atrial fibrillation (AF). METHODS AND RESULTS: All patients admitted with AF in Denmark from 1995 to 2004 and their subsequent use of AADs were identified...... by individual-level linkage of nationwide registries. Multivariable Cox proportional-hazard models with time-dependent covariates were used to analyse the risk of death associated with AAD therapy. A total of 141,500 patients were included in the study; of these 3356 (2.4%) patients received treatment...... increased risk of death associated with any of the AADs. Hazard ratio (95% confidence interval) for flecainide 0.38 (0.32-0.44), propafenone 0.65 (0.58-0.71), sotalol 0.65 (0.63-0.67), and amiodarone 0.94 (0.89-1.00). CONCLUSION: In an unselected cohort of patients with AF, antiarrhythmic treatment...

  6. Danish nationwide registers for public health and health-related research

    DEFF Research Database (Denmark)

    Erlangsen, Annette; Fedyszyn, Izabela

    2015-01-01

    AIMS: The Nordic countries have a strong tradition of using nationwide social and health registers for research purposes. The aim of the current paper is to provide an overview of the Danish population-based registers in public health and health-related research, and to discuss their strengths...... and limitations. METHODS: Danish registers on somatic and psychiatric hospital contacts as well as care provided by general practitioners were reviewed. The availability of demographic, individual-level variables of relevance for health-related research was summarized. RESULTS: Since 1968, every person living...... in Denmark has a unique identifier. This identifier is listed in Danish registers enabling linkage of information from a range of registers on an individual level. The nationwide coverage of all patient contacts at somatic and psychiatric hospitals, consultations with general practitioners, purchases...

  7. 76 FR 64250 - Reserve Requirements of Depository Institutions: Reserves Simplification and Private Sector...

    Science.gov (United States)

    2011-10-18

    ... D; Docket No. R-1433] RIN No. 7100 AD 83 Reserve Requirements of Depository Institutions: Reserves Simplification and Private Sector Adjustment Factor AGENCY: Board of Governors of the Federal Reserve System... public comment on proposed amendments to Regulation D, Reserve Requirements of Depository Institutions...

  8. Swiss nation-wide survey on radiation doses in diagnostic radiology

    International Nuclear Information System (INIS)

    Aroua, A.; Valley, J.F.; Vader, J.-P.; Burnand, B.

    2001-01-01

    A nation-wide survey on radiation doses in diagnostic radiology was conducted in Switzerland in 1998-1999. More than 250 types of examinations were considered, covering conventional and interventional radiology, angiography, CT, mammography, osteodensitometry, conventional tomography and dental radiology. This survey aimed at establishing the collective radiological impact of radiodiagnostics on the Swiss population. The methodology of the survey is described. The examination frequencies and integral dosimetric results associated with diagnostic radiology in Switzerland are presented. (author)

  9. Oral Health Status and Behavior among Cancer Survivors in Korea Using Nationwide Survey

    OpenAIRE

    Han, Mi Ah

    2017-01-01

    Cancer survivors remain at life-long risk of developing oral complications. This study investigated the oral health status and behavior among cancer survivors in comparison to subjects without a history of cancer using a nationwide survey. Cancer survivors and control subjects were selected from the sixth Korean National Health and Nutrition Examination Survey (2013–2015). Survivors reported chewing (34.8%) and speaking difficulties (15.3%) resulting from oral health problems. More than 36% o...

  10. A nationwide analysis of socioeconomic outcomes after hip and knee replacement

    DEFF Research Database (Denmark)

    Kjellberg, Jakob; Kehlet, Henrik

    2016-01-01

    exist on income and total health expenses before and after THA and TKA compared with a matched reference population (RP). METHODS: From the unique nationwide Danish registers, a total of 128,109 patients undergoing primary THA and TKA were followed from up to 12 years before to up to 12 years after...... income levels than the RP after surgery. These data should be taken into account in future studies of patient expectations and strategies for enhanced rehabilitation. FUNDING: none. TRIAL REGISTRATION: none....

  11. Cognitive reserve and appraisal in multiple sclerosis.

    Science.gov (United States)

    Schwartz, Carolyn E; Snook, Erin; Quaranto, Brian; Benedict, Ralph H B; Rapkin, Bruce D; Vollmer, Timothy

    2013-01-01

    Cognitive appraisal processes underlying self-report affect the interpretation of patient-reported outcomes. These processes are relevant to resilience and adaptability, and may relate to how cognitive reserve protects against disability in multiple sclerosis (MS). To describe how passive and active indicators of cognitive reserve relate to QOL appraisal processes in MS. Cross-sectional data (n=860) were drawn from the North American Research Committee on MS (NARCOMS) Registry, from whom additional survey data were collected. Cognitive reserve was measured using the Stern and Sole-Padulles measures. Using the quality of life appraisal profile (QOLAP), we assessed how MS patients conceptualize their experiences and how that impacts how they report their quality of life. Multivariate analysis of variance was used to compare groups within sets of appraisal parameters, and t-tests or chi-square tests were used to compare mean item responses within appraisal parameters for continuous or dichotomous variables, respectively. People high in passive or active reserve report different conceptualizations of QOL, different types of goals, and considering different types of experiences and standards of comparison in responding to QOL questionnaires, as compared to low-reserve individuals. Although item response patterns were slightly different between passive and active indicators, they generally reflect a tendency in high-reserve individuals to emphasize the positive, focus on aspects of their life that are more controllable, and less based in fantasy. MS patients high in cognitive reserve differ in their cognitive appraisals from their low reserve counterparts. These appraisal metrics may predict disease course and other important clinical outcomes in MS patients. Copyright © 2012 Elsevier B.V. All rights reserved.

  12. Strategic Petroleum Reserve: Annual/quarterly report

    Energy Technology Data Exchange (ETDEWEB)

    1994-02-16

    Section 165 of the Energy Policy and Conservation Act (Public Law 94-163), as amended, requires the Secretary of Energy to submit annual and quarterly reports to the President and the Congress on activities of the Strategic Petroleum Reserve. This report combines the fourth quarter 1993 Quarterly Report with the 1993 Annual Report. Key activities described include appropriations; life extension planning; expansion planning; Strategic Petroleum Reserve oil acquisition; the oil stabilization program; and the refined petroleum product reserve test programs. Sections of this report also describe the program mission; the storage facility development program; environmental compliance; budget and finance; and drawdown and distribution.

  13. Níveis de mercúrio em peixes consumidos pela comunidade indígena de Sai Cinza na Reserva Munduruku, Município de Jacareacanga, Estado do Pará, Brasil Mercury levels in fish consumed by the Sai Cinza indigenous community, Munduruku Reservation, Jacareacanga County, State of Pará, Brazil

    Directory of Open Access Journals (Sweden)

    Edilson da Silva Brabo

    1999-04-01

    Full Text Available O estudo consiste em avaliar os níveis de mercúrio no pescado consumido pela comunidade indígena de Sai Cinza (Reserva Munduruku no Estado do Pará, e associá-los com os hábitos de consumo da população. Um total de oitenta espécimes de peixes foram capturados. As determinações de Hg foram realizadas por absorção atômica. A concentração média de Hg nas espécies carnívoras foi de 0,293 µg/g (DP = 0,104 enquanto nas não carnívoras foi de 0,112 µg/g (DP = 0,036. As espécies referidas como de maior consumo ente os 330 indivíduos entrevistados foram: tucunaré, pacu, jaraqui, traíra, aracu, matrinchã e caratinga. As espécies com concentrações mais elevadas de Hg foram tucunaré e traíra, que estão entre os peixes mais consumidos. A freqüência de consumo constitui-se num fator importante na avaliação de risco de contaminação por mercúrio em comunidades que não têm outras alternativas de alimentação.This study evaluated fish consumption and mercury levels in fish consumed by an indigenous community in the State of Pará. Eighty fish samples were collected (barbado, surubim, traíra, tucunaré, piranha, aruanã, caratinga, aracu, mandiá, jandiá, and pacu. Mercury analysis was performed using a Mercury Analyzer HG-3500. Average mercury concentration in carnivorous species was 0.293 µg/g (SD = 0.104, while in non-carnivorous species it was 0.112 µg/g (SD = 0.036. Brazilian legislation establishes a maximum permissible limit of 0.5 µg/g for fish consumption. No significant correlation was found between fish length or weight and mercury concentration. Types of fish most frequently consumed by the community were tucunaré, pacu, jaraqui, traíra, aracu, matrinchã, and caratinga. Carnivorous species, especially tucunaré and traíra, amongst the most frequently eaten, had higher mercury levels than non-carnivorous species. Frequency of consumption is crucial to assess the risk of mercury contamination in

  14. Computerized reserves assessment improves colliery planning. [Poland

    Energy Technology Data Exchange (ETDEWEB)

    Pozor, L.; Wrobel, R.

    1984-01-01

    The authors describe systems developed in Poland for the computerised assessment of coal reserves. The Zasoby system calculates coal reserves and evaluates selected natural properties of seams within the boundaries of an arbitrary mining property, based entirely on exploratory borehole data. The IOS-10 system is based on the Polish data bank for bituminous coal deposits. It is not suitable for use in mine design procedures, but is widely used for the statistical recording of reserves in areas currently being worked. The major part of the paper is devoted to a description of the Geo-3 system, used for the computation of reserves in prospective areas from borehole data, as well as in active mining areas or partially worked-out deposits. The computation method is explained and examples of the results obtained are given.

  15. Operational Army Reserve Implications for Organizational Health

    National Research Council Canada - National Science Library

    Dahms, Jonathan A

    2007-01-01

    The Army Reserve has been in a constant state of mobilization since 1995 with the advent of the Bosnia crisis and the pace of mobilization increased exponentially after the terrorist attacks of September 11, 2001...

  16. Communicating marine reserve science to diverse audiences

    Science.gov (United States)

    Grorud-Colvert, Kirsten; Lester, Sarah E.; Airamé, Satie; Neeley, Elizabeth; Gaines, Steven D.

    2010-01-01

    As human impacts cause ecosystem-wide changes in the oceans, the need to protect and restore marine resources has led to increasing calls for and establishment of marine reserves. Scientific information about marine reserves has multiplied over the last decade, providing useful knowledge about this tool for resource users, managers, policy makers, and the general public. This information must be conveyed to nonscientists in a nontechnical, credible, and neutral format, but most scientists are not trained to communicate in this style or to develop effective strategies for sharing their scientific knowledge. Here, we present a case study from California, in which communicating scientific information during the process to establish marine reserves in the Channel Islands and along the California mainland coast expanded into an international communication effort. We discuss how to develop a strategy for communicating marine reserve science to diverse audiences and highlight the influence that effective science communication can have in discussions about marine management. PMID:20427745

  17. 48 CFR 9904.404-10 - [Reserved

    Science.gov (United States)

    2010-10-01

    ... Section 9904.404-10 Federal Acquisition Regulations System COST ACCOUNTING STANDARDS BOARD, OFFICE OF FEDERAL PROCUREMENT POLICY, OFFICE OF MANAGEMENT AND BUDGET PROCUREMENT PRACTICES AND COST ACCOUNTING STANDARDS COST ACCOUNTING STANDARDS 9904.404-10 [Reserved] ...

  18. 48 CFR 9904.401-10 - [Reserved

    Science.gov (United States)

    2010-10-01

    ... Section 9904.401-10 Federal Acquisition Regulations System COST ACCOUNTING STANDARDS BOARD, OFFICE OF FEDERAL PROCUREMENT POLICY, OFFICE OF MANAGEMENT AND BUDGET PROCUREMENT PRACTICES AND COST ACCOUNTING STANDARDS COST ACCOUNTING STANDARDS 9904.401-10 [Reserved] ...

  19. 48 CFR 9904.400 - [Reserved

    Science.gov (United States)

    2010-10-01

    ... Section 9904.400 Federal Acquisition Regulations System COST ACCOUNTING STANDARDS BOARD, OFFICE OF FEDERAL PROCUREMENT POLICY, OFFICE OF MANAGEMENT AND BUDGET PROCUREMENT PRACTICES AND COST ACCOUNTING STANDARDS COST ACCOUNTING STANDARDS 9904.400 [Reserved] ...

  20. 48 CFR 9904.402-10 - [Reserved

    Science.gov (United States)

    2010-10-01

    ... Section 9904.402-10 Federal Acquisition Regulations System COST ACCOUNTING STANDARDS BOARD, OFFICE OF FEDERAL PROCUREMENT POLICY, OFFICE OF MANAGEMENT AND BUDGET PROCUREMENT PRACTICES AND COST ACCOUNTING STANDARDS COST ACCOUNTING STANDARDS 9904.402-10 [Reserved] ...