WorldWideScience

Sample records for service associates conducted

  1. ClaimAssociationService

    Data.gov (United States)

    Department of Veterans Affairs — Retrieves and updates a veteranÆs claim status and claim-rating association (claim association for current rating) from the Corporate database for a claim selected...

  2. Data Resources for Conducting Health Services and Policy Research.

    Science.gov (United States)

    Blewett, Lynn A; Call, Kathleen Thiede; Turner, Joanna; Hest, Robert

    2018-04-01

    Rich federal data resources provide essential data inputs for monitoring the health and health care of the US population and are essential for conducting health services policy research. The six household surveys we document in this article cover a broad array of health topics, including health insurance coverage (American Community Survey, Current Population Survey), health conditions and behaviors (National Health Interview Survey, Behavioral Risk Factor Surveillance System), health care utilization and spending (Medical Expenditure Panel Survey), and longitudinal data on public program participation (SIPP). New federal activities are linking federal surveys with administrative data to reduce duplication and response burden. In the private sector, vendors are aggregating data from medical records and claims to enhance our understanding of treatment, quality, and outcomes of medical care. Federal agencies must continue to innovate to meet the continuous challenges of scarce resources, pressures for more granular data, and new multimode data collection methodologies.

  3. Conducting Online Behavioral Research Using Crowdsourcing Services in Japan.

    Science.gov (United States)

    Majima, Yoshimasa; Nishiyama, Kaoru; Nishihara, Aki; Hata, Ryosuke

    2017-01-01

    Recent research on human behavior has often collected empirical data from the online labor market, through a process known as crowdsourcing. As well as the United States and the major European countries, there are several crowdsourcing services in Japan. For research purpose, Amazon's Mechanical Turk (MTurk) is the widely used platform among those services. Previous validation studies have shown many commonalities between MTurk workers and participants from traditional samples based on not only personality but also performance on reasoning tasks. The present study aims to extend these findings to non-MTurk (i.e., Japanese) crowdsourcing samples in which workers have different ethnic backgrounds from those of MTurk. We conducted three surveys ( N = 426, 453, 167, respectively) designed to compare Japanese crowdsourcing workers and university students in terms of their demographics, personality traits, reasoning skills, and attention to instructions. The results generally align with previous studies and suggest that non-MTurk participants are also eligible for behavioral research. Furthermore, small screen devices are found to impair participants' attention to instructions. Several recommendations concerning this sample are presented.

  4. [Ambulance services in Copenhagen, Odense and Ringkøbing County. Results of the spot test conducted by the Ministry of Health and the County Councils Association in 1990. 1. Epidemiological data].

    Science.gov (United States)

    Trier, H; Larsen, C F

    1992-02-17

    In 1990, The Danish Ministry of Health and the County Council Association undertook a spot test investigation of the activities in connection with 3,182 emergency ambulance services (AU) in the Municipality of Copenhagen (a city), the Odense district (a large provincial town) and the County of Ringkøbing (a mixed rural and urban region). The investigation included data collected by the ambulance staff before hospitalization and the diagnoses on discharge from casualty and hospital departments. The frequency of AU per 1,000 population was found to be 101 annually in Copenhagen, 44 in Odense and 19 in the County of Ringkøbing. More than 10% of the services in all three regions did not result in transport of the patient to hospital treatment. The average age of the patients was 52 years in Copenhagen compared with 44 years in the other two regions. The age-specific frequency of AU for patients aged 0-4 year-old was nine times as great in Copenhagen than in Odense and the County of Ringkøbing and, where patients aged more than 80 years were concerned, the frequency was 4-10 times as great. In all three regions, the activities of ambulance services were most numerous between 6-16 hours and lowest during the period 0-6 hours. Services to patients' homes constituted 44-46% and to traffic regions 32-40%. Services on account of illness constituted 41-45% and, on account of accidents, 27-35%. In cases of rapid emergency transport (using signals), 78% of the ambulances had reached the patient within five minutes in Copenhagen as compared with 44% in Odense and the County of Ringkøbing.(ABSTRACT TRUNCATED AT 250 WORDS)

  5. Apparel Merchandising Students Learn Customer Service Strategies while Conducting Research.

    Science.gov (United States)

    Paulins, V, Ann

    2000-01-01

    Apparel merchandising students participated in a cooperative research project in which they observed customer service techniques by posing as customers in retail stores. The project taught research processes, collaboration, and principles of customer service. (SK)

  6. Service utilization by children with conduct disorders: findings from the 2004 Great Britain child mental health survey.

    Science.gov (United States)

    Shivram, Raghuram; Bankart, John; Meltzer, Howard; Ford, Tamsin; Vostanis, Panos; Goodman, Robert

    2009-09-01

    Children with conduct disorders (CD) and their families are in contact with multiple agencies, but there is limited evidence on their patterns of service utilization. The aim of this study was to establish the patterns, barriers and correlates of service use by analysing the cohort of the 2004 Great Britain child mental health survey (N = 7,977). Use of social services was significantly higher by children with CD than emotional disorders (ED) in the absence of co-morbidity, while use of specialist child mental health and paediatric was significantly higher by children with hyperkinetic disorders (HD) than CD. Children who had comorbid physical disorders used more primary healthcare services compared to those without physical disorders. Utilization of specialist child mental heath and social services was significantly higher among children with unsocialized CD than socialized CD and oppositional defiant disorders. Services utilization and its correlates varied with the type of service. Overall, specialist services use was associated with co-morbidity with learning disabilities, physical and psychiatric disorders. Several correlates of services use in CD appeared non-specific, i.e. associated with use of different services indicating the possibility of indiscriminate use of different types of services. The findings led to the conclusion that there is the need for effective organization and co-ordination of services, and clear care pathways. Involvement of specialist child mental health services should be requested in the presence of mental health co-morbidity.

  7. Efficiency of workplace surveys conducted by Finnish occupational health services.

    Science.gov (United States)

    Savinainen, Minna; Oksa, Panu

    2011-07-01

    In Finland, workplace surveys are used to identify and assess health risks and problems caused by work and make suggestions for continuous improvement of the work environment. With the aid of the workplace survey, occupational health services can be tailored to a company. The aims of this study were to determine how occupational health professionals gather data via the workplace survey and the effect survey results have on companies. A total of 259 occupational health nurses and 108 occupational health physicians responded to the questionnaire: 84.2% were women and 15.8% were men. The mean age of the respondents was 48.8 years (range, 26 to 65 years). Usually occupational health nurses and foremen and sometimes occupational health physicians and occupational safety and health representatives initiate the workplace survey. More than 90% of the surveys were followed by action proposals, and about 50% of these were implemented. The proposals implemented most often concerned personal protective equipment and less often leadership. Survey respondents should have both the opportunity and the authority to affect resources, the work environment, work arrangements, and tools. Teamwork among occupational health and safety professionals, management, and employees is vital for cost-effectively solving today's complex problems at workplaces around the globe. Copyright 2011, SLACK Incorporated.

  8. Distributions of Conductance and Shot Noise and Associated Phase Transitions

    International Nuclear Information System (INIS)

    Vivo, Pierpaolo; Majumdar, Satya N.; Bohigas, Oriol

    2008-01-01

    For a chaotic cavity with two identical leads each supporting N channels, we compute analytically, for large N, the full distribution of the conductance and the shot noise power and show that in both cases there is a central Gaussian region flanked on both sides by non-Gaussian tails. The distribution is weakly singular at the junction of Gaussian and non-Gaussian regimes, a direct consequence of two phase transitions in an associated Coulomb gas problem

  9. Service delivery and ethical conduct in the public service: the missing links

    Directory of Open Access Journals (Sweden)

    L. Lues

    2007-07-01

    Full Text Available There are a multitude of policies, strategies and programmes directed at the rendering of effective services to the citizens of South Africa by public service managers. However, in spite of the pursuit of effectiveness and the condemning of unethical behaviour by public service managers, scandals still occur and allegations are still made. So, where are the missing links? In this article, a brief description is given of some ethical concepts viewed as important in addressing the question posed. The concluding remarks are twofold: public service organisations need to provide continuous commitment, enforcement, and modelling of leadership in professional ethics by means of, among other things, policy structures; and public service managers need to realise the importance of changing their own mindset and accepting the ethical standards that are established by the public service organisation, even if these differ from their own beliefs and culture.

  10. Scallywags--An Evaluation of a Service Targeting Conduct Disorders at School and at Home

    Science.gov (United States)

    Broadhead, M. A.; Hockaday, A.; Zahra, M.; Francis, P. J.; Crichton, C.

    2009-01-01

    Conduct disorder (CD) is one of the most common childhood psychiatric disorders. Some research has focused on reducing conduct difficulties through parent training programmes. However, there has been limited research focusing on early intervention services that deal with emotional and/or conduct problems in a community setting. The aim of this…

  11. Gender differences in the association between conduct disorder and risky sexual behavior.

    Science.gov (United States)

    Brooks Holliday, Stephanie; Ewing, Brett A; Storholm, Erik D; Parast, Layla; D'Amico, Elizabeth J

    2017-04-01

    Despite suggestions that there are gender differences in the association between conduct disorder (CD) and risky sexual behavior, limited empirical research has examined this question. Youth (N = 616) were recruited from four primary care clinics and completed questions related to risky sexual behavior, alcohol and marijuana use, and CD. Results of stratified multivariate models indicated that the association between CD and having four or more lifetime partners, having two or more partners in the last 3 months, and engaging in condomless sex was stronger among female youth. However, the association between CD and alcohol and other drug use before sex was stronger in male youth. This is an important contribution to our understanding of gender-specific manifestations of conduct disorder, and has the potential to inform screening and brief intervention efforts for this population. Copyright © 2017 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

  12. 18 CFR 284.288 - Code of conduct for unbundled sales service.

    Science.gov (United States)

    2010-04-01

    ... 18 Conservation of Power and Water Resources 1 2010-04-01 2010-04-01 false Code of conduct for unbundled sales service. 284.288 Section 284.288 Conservation of Power and Water Resources FEDERAL ENERGY... information upon which it billed the prices it charged for natural gas it sold pursuant to its market based...

  13. Challenges associated with nerve conduction block using kilohertz electrical stimulation

    Science.gov (United States)

    Patel, Yogi A.; Butera, Robert J.

    2018-06-01

    Neuromodulation therapies, which electrically stimulate parts of the nervous system, have traditionally attempted to activate neurons or axons to restore function or alleviate disease symptoms. In stark contrast to this approach is inhibiting neural activity to relieve disease symptoms and/or restore homeostasis. One potential approach is kilohertz electrical stimulation (KES) of peripheral nerves—which enables a rapid, reversible, and localized block of conduction. This review highlights the existing scientific and clinical utility of KES and discusses the technical and physiological challenges that must be addressed for successful translation of KES nerve conduction block therapies.

  14. Factors associated with institutional delivery service utilization in Ethiopia

    Directory of Open Access Journals (Sweden)

    Kebede A

    2016-09-01

    Full Text Available Alemi Kebede,1 Kalkidan Hassen,2 Aderajew Nigussie Teklehaymanot1 1Department of Population and Family Health, 2College of Health Sciences, Jimma University, Ethiopia Background: Most obstetric complications occur unpredictably during the time of delivery, but they can be prevented with proper medical care in the health facilities. Despite the Ethiopian government’s efforts to expand health service facilities and promote health institution-based delivery service in the country, an estimated 85% of births still take place at home.Objective: The review was conducted with the aim of generating the best evidence on the determinants of institutional delivery service utilization in Ethiopia.Methods: The reviewed studies were accessed through electronic web-based search strategy from PubMed, HINARI, Mendeley reference manager, Cochrane Library for Systematic Reviews, and Google Scholar. Review Manager V5.3 software was used for meta-analysis. Mantel–Haenszel odds ratios (ORs and their 95% confidence intervals (CIs were calculated. Heterogeneity of the study was assessed using I2 test.Results: People living in urban areas (OR =13.16, CI =1.24, 3.68, with primary and above educational level of the mother and husband (OR =4.95, CI =2.3, 4. 8, and OR =4.43, CI =1.14, 3.36, respectively, who encountered problems during pregnancy (OR =2.83, CI =4.54, 7.39, and living at a distance <5 km from nearby health facility (OR =2.6, CI =3.33, 6.57 showed significant association with institutional delivery service utilization. Women’s autonomy was not significantly associated with institutional delivery service utilization.Conclusion and recommendation: Distance to health facility and problems during pregnancy were factors positively and significantly associated with institutional delivery service utilization. Promoting couples education beyond primary education regarding the danger signs of pregnancy and benefits of institutional delivery through available

  15. 75 FR 70162 - Presumptive Service Connection for Diseases Associated With Persian Gulf War Service: Functional...

    Science.gov (United States)

    2010-11-17

    ... Diseases Associated With Persian Gulf War Service: Functional Gastrointestinal Disorders AGENCY: Department... theater of operations during the Persian Gulf War. DATES: Comments must be received by VA on or before... Service Connection for Diseases Associated With Persian Gulf War Service: Functional Gastrointestinal...

  16. Fuel cell assembly unit for promoting fluid service and electrical conductivity

    Science.gov (United States)

    Jones, Daniel O.

    1999-01-01

    Fluid service and/or electrical conductivity for a fuel cell assembly is promoted. Open-faced flow channel(s) are formed in a flow field plate face, and extend in the flow field plate face between entry and exit fluid manifolds. A resilient gas diffusion layer is located between the flow field plate face and a membrane electrode assembly, fluidly serviced with the open-faced flow channel(s). The resilient gas diffusion layer is restrained against entering the open-faced flow channel(s) under a compressive force applied to the fuel cell assembly. In particular, a first side of a support member abuts the flow field plate face, and a second side of the support member abuts the resilient gas diffusion layer. The support member is formed with a plurality of openings extending between the first and second sides of the support member. In addition, a clamping pressure is maintained for an interface between the resilient gas diffusion layer and a portion of the membrane electrode assembly. Preferably, the support member is spikeless and/or substantially flat. Further, the support member is formed with an electrical path for conducting current between the resilient gas diffusion layer and position(s) on the flow field plate face.

  17. An inexpensive, interdisciplinary, methodology to conduct an impact study of homeless persons on hospital based services.

    Science.gov (United States)

    Parker, R David; Regier, Michael; Brown, Zachary; Davis, Stephen

    2015-02-01

    Homelessness is a primary concern for community health. Scientific literature on homelessness is wide ranging and diverse. One opportunity to add to existing literature is the development and testing of affordable, easily implemented methods for measuring the impact of homeless on the healthcare system. Such methodological approaches rely on the strengths in a multidisciplinary approach, including providers, both healthcare and homeless services and applied clinical researchers. This paper is a proof of concept for a methodology which is easily adaptable nationwide, given the mandated implementation of homeless management information systems in the United States and other countries; medical billing systems by hospitals; and research methods of researchers. Adaptation is independent of geographic region, budget restraints, specific agency skill sets, and many other factors that impact the application of a consistent methodological science based approach to assess and address homelessness. We conducted a secondary data analysis merging data from homeless utilization and hospital case based data. These data detailed care utilization among homeless persons in a small, Appalachian city in the United States. In our sample of 269 persons who received at least one hospital based service and one homeless service between July 1, 2012 and June 30, 2013, the total billed costs were $5,979,463 with 10 people costing more than one-third ($1,957,469) of the total. Those persons were primarily men, living in an emergency shelter, with pre-existing disabling conditions. We theorize that targeted services, including Housing First, would be an effective intervention. This is proposed in a future study.

  18. [Factors associated with the use of dental health services].

    Science.gov (United States)

    Dho, María Silvina

    2018-02-01

    This paper seeks to analyze the factors associated with the use of dental health services (UDHS) by adults in the city of Corrientes, Argentina. A cross-sectional study was conducted. Information concerning the study variables was collected via a home survey. The sample size was established with a 95% confidence interval level (381 individuals). A simple random sampling design was used, which was complemented with a non-probability quota sampling. The data was analyzed using SPSS version 21.0 and Epidat version 3.1 softwares. Socio-economic level, dental health coverage, perception of oral health care, perception of oral health, knowledge about oral health, and oral hygiene habits were significantly associated with the UDHS over the last twelve months. These same factors, excluding dental health coverage and knowledge about oral health, were associated with the UDHS for routine dental check-ups. Measures should be implemented to increase the UDHS for prevention purposes in men and women of all socio-economic levels, particularly in less-privileged individuals.

  19. Factors Associated With Service Use for Young Adolescents With Mental Health Problems

    Directory of Open Access Journals (Sweden)

    Siobhan M. Ryan

    2014-11-01

    Full Text Available The objective of the study wasto identify factors associated with use of services for adolescent mental health problems in an Australian community-based sample. Logistic regression analysis was conducted on data collected from 636 parents and their adolescent child to identify individual and family variables predicting parent report of service use for mental health problems in the adolescent 12 months later. The services most reported by parents to have been accessed were school-based ones. Multivariate analysis found that the following were associated with service use 12 months later: the adolescent being female, parent report of peer problems and hyperactivity, single-parent household, the parent being Australian born, and prior service use by the adolescent. Parental overcontrol was associated with reduced likelihood of service use at follow-up. No association was found between service use at follow-up and parent gender, socioeconomic status, number of siblings, parent psychopathology, family social connectedness, and prior service use by the parent. No association was also found for family environment factors, parental attachment, or for the adolescent’s emotional competence or use of social support. The results indicate that families provide a potential target for interventions aimed at increasing use of professional services for adolescent mental health problems.

  20. Factors associated with adolescent mental health service need and utilization

    NARCIS (Netherlands)

    Zwaanswijk, Marieke; Ende, J. van der; Verhaak, P.F.M.; Bensing, J.; Verhulst, F.C.

    2003-01-01

    Objective: To determine the association of parent, family, and adolescent variables with adolescent mental health service need and utilization. Method: Correlates of adolescent mental health service utilization, self-perceived need and unmet need were investigated in a general population sample of

  1. original article health services utilization and associated factors

    African Journals Online (AJOL)

    Abrham

    utilization of health services and associated factors in Jimma zone, south west Ethiopia. METHODS: A cross .... The sample size was calculated using Epi-Info 3.3.2 ... Before the start of data collection, the proposal was submitted to the ... Table 1. Health services access in Jimma zone, Southwest Ethiopia, February 2007.

  2. Job coding (PCS 2003): feedback from a study conducted in an Occupational Health Service

    Science.gov (United States)

    Henrotin, Jean-Bernard; Vaissière, Monique; Etaix, Maryline; Malard, Stéphane; Dziurla, Mathieu; Lafon, Dominique

    2016-10-19

    Aim: To examine the quality of manual job coding carried out by occupational health teams with access to a software application that provides assistance in job and business sector coding (CAPS). Methods: Data from a study conducted in an Occupational Health Service were used to examine the first-level coding of 1,495 jobs by occupational health teams according to the French job classification entitled “PSC- Professions and socio-professional categories” (INSEE, 2003 version). A second level of coding was also performed by an experienced coder and the first and second level codes were compared. Agreement between the two coding systems was studied using the kappa coefficient (κ) and frequencies were compared by Chi2 tests. Results: Missing data or incorrect codes were observed for 14.5% of social groups (1 digit) and 25.7% of job codes (4 digits). While agreement between the first two levels of PCS 2003 appeared to be satisfactory (κ=0.73 and κ=0.75), imbalances in reassignment flows were effectively noted. The divergent job code rate was 48.2%. Variation in the frequency of socio-occupational variables was as high as 8.6% after correcting for missing data and divergent codes. Conclusions: Compared with other studies, the use of the CAPS tool appeared to provide effective coding assistance. However, our results indicate that job coding based on PSC 2003 should be conducted using ancillary data by personnel trained in the use of this tool.

  3. Farmers’ Awareness of Ecosystem Services and the Associated Policy Implications

    Directory of Open Access Journals (Sweden)

    Fangfang Xun

    2017-09-01

    Full Text Available This study analyzes the primary factors influencing farmers’ awareness of ecosystem services. This study, through questionnaires, conducts research on farmers’ awareness of and demand for ecosystem service functions. The research encapsulates 156 households from 21 groups of villagers in the Guangxi Karst Ecological Immigration District in China. The results of the factors influencing farmers’ awareness of ecosystem services, analyzed using a regression model, show that: (1 Farmers are concerned with ecosystem service functions that directly benefit them; however, they do not sufficiently understand the ecosystem’s ecological security maintenance or cultural landscape functions; (2 Farmers’ awareness of ecosystem service functions is not consistent with their corresponding demand, including the ecosystem’s leisure and entertainment, social security, disaster prevention and water purification services; (3 Education level, land area cultivated by the household, proportion of the household’s income from agriculture and immigration status directly affect farmers’ awareness of ecosystem services; (4 Farmers’ personal characteristics, family characteristics and subjective attitudes have different effects on the level of ecological service cognition. Understanding farmers’ awareness of ecosystem services, and the influencing factors can help policymakers and development managers plan local development and policies, and enable harmonious development of the human-earth system in immigration regions of China.

  4. Is the negative evaluation of dental services among the Brazilian elderly population associated with the type of service?

    Science.gov (United States)

    Martins, Andréa Maria Eleutério de Barros Lima; Jardim, Lorena Amaral; Souza, João Gabriel Silva; Rodrigues, Carlos Alberto Quintão; Ferreira, Raquel Conceição; Pordeus, Isabela Almeida

    2014-01-01

    This study aimed at identifying the prevalence of the negative evaluation of dental services among elderly Brazilians and at investigating whether the prevalence was higher among those using public or philanthropic provider services than among those paying privately or using private health plans. Additionally, factors associated with this negative assessment were identified. Interview and survey data were collected in the residences of participants by trained and calibrated examiners as part of a national epidemiological survey of oral health conditions of the Brazilian population in 2002/2003. The dependent variable was obtained in response to questions regarding whether the participant had ever used dental services, the frequency of use, and the quality of this service. Potential responses to the questions regarding the quality of service were very poor or poor, fair, and good or very good. The main independent variable was the system of health care used with potential responses being health plan or private, public, and philanthropic services. We conducted univariate (linear tendency χ2 test) and multiple descriptive analyses, and the partial proportional Odds model for ordinal logistic regression. Among the elderly, 196 (3.7%) evaluated the provided services negatively (very poor or poor). Participants with the following responses were more likely to evaluate the services negatively: those who had used public or philanthropic services, men, those with higher education, the ones who had not received information about preventing dental problems, those who perceived pain in their teeth and gums in the last six months, and those who self-reported their oral health and speech was poor. In conclusion, elderly Brazilian users of public and philanthropic services were more likely than users of private or insurance-based plans to evaluate their dental services negatively, regardless of the other investigated variables.

  5. 17 CFR 250.88 - Approval of mutual service companies; organization and conduct of business of subsidiary service...

    Science.gov (United States)

    2010-04-01

    ... and economical performance of services or construction or sale of goods by the company for or to its.... (a) Application for approval of a company as a mutual service company shall be filed by the company... finds that the company is so organized as to capitalization, ownership by, and representation of, member...

  6. Antenatal care service utilization and associated factors in Metekel ...

    African Journals Online (AJOL)

    socioeconomic and some obstetric factors have been stated by few studies in other areas, the factors associated with low utilization of Antenatal care in Metekel Zone are not well assed before. Therefore, the objective of this study was to assess the status of Antenatal care service utilization and associated factors among ...

  7. Characteristics of school-based health services associated with students' mental health.

    Science.gov (United States)

    Denny, Simon; Howie, Hamish; Grant, Sue; Galbreath, Ross; Utter, Jennifer; Fleming, Theresa; Clark, Terryann

    2018-01-01

    Objective School-based health services (SBHS) have been shown to improve access to mental health services but the evidence of their effectiveness on students' mental health is lacking. Our objective was to examine associations between variation in the provision of SBHS and students' mental health. Methods A cross-sectional analysis of a nationally representative health and well-being survey of 8500 New Zealand high school students conducted in March-November 2012. Students' mental health is related to data on school health services obtained from clinic leaders and clinicians from 90 participating high schools. Results After adjustment for socio-demographic differences in students between schools, increasing levels of services were associated with progressively lower levels of student-reported depressive symptoms (p = 0.002), emotional and behavioural difficulties (p = 0.004) and suicidality (p = 0.008). Services with greater levels of nursing hours (p = 0.02) and those that performed routine, comprehensive psychosocial assessments (p = 0.01) were both associated with lower levels of student-reported depressive symptoms. Greater levels of nursing hours and doctor hours were associated with lower self-reported suicidality among students. Conclusions Although a causal association between school-based health services and students' mental health cannot be demonstrated, these findings support the benefit of such services and the need for a cluster randomized trial.

  8. Beyond Assessment: Conducting Theoretically Grounded Research on Service-Learning in Gerontology Courses.

    Science.gov (United States)

    Kruger, Tina M; Pearl, Andrew J

    2016-01-01

    Service-learning is a useful pedagogical tool and high-impact practice, providing multiple benefits. Gerontology (and other) courses frequently include service-learning activities but lack theory-based, intentional research on outcomes. Here, the authors define service-learning and contextualize it in higher education, provide an overview of research and assessment in service-learning and gerontology courses, demonstrate the shortcomings of program evaluations, and offer suggestions for future research to advance and generate theory.

  9. 77 FR 37959 - Financial Management Service; Proposed Collection of Information: Pools and Associations-Annual...

    Science.gov (United States)

    2012-06-25

    ... DEPARTMENT OF THE TREASURY Fiscal Service Financial Management Service; Proposed Collection of Information: Pools and Associations--Annual Letter AGENCY: Financial Management Service, Fiscal Service, Treasury. ACTION: Notice and request for comments. SUMMARY: The Financial Management Service, as part of...

  10. Ectrodactyly, Ectodermal dysplasia, and Cleft Lip-Palate Syndrome; Its Association with Conductive Hearing Loss

    Science.gov (United States)

    Robinson, Geoffrey C.; And Others

    1973-01-01

    Conductive hearing loss associated with the ectrodactyly, ectodermal dysplasia, and cleft lip palate syndrome was reported in one sporadic case and in a pedigree with four cases in three generations. (GW)

  11. Test of Association Between 10 SNPs in the Oxytocin Receptor Gene and Conduct Disorder

    OpenAIRE

    Sakai, Joseph T.; Crowley, Thomas J.; Stallings, Michael C.; McQueen, Matthew; Hewitt, John K.; Hopfer, Christian; Hoft, Nicole R.; Ehringer, Marissa A.

    2012-01-01

    Animal and human studies have implicated oxytocin (OXT) in affiliative and prosocial behaviors. We tested whether genetic variation in the OXT receptor (OXTR) gene is associated with conduct disorder (CD).

  12. Childhood Conduct Problems Are Associated with Increased Partnership and Parenting Difficulties in Adulthood

    Science.gov (United States)

    Raudino, Alessandra; Woodward, Lianne J.; Fergusson, David M.; Horwood, L. John

    2012-01-01

    This paper uses data from a sample of 337 parents studied at age 30 to examine the linkages between childhood conduct problems assessed at ages 7-9 and later partnership and parenting outcomes. The key findings of this study were: 1) increasing levels of childhood conduct problems were associated with increased risk of partnership difficulties,…

  13. Integrated Regulatory Review Service (IRRS) Guidelines for the Preparation and Conduct of IRRS Missions

    International Nuclear Information System (INIS)

    2013-01-01

    : International Basic Safety Standards (IAEA Safety Standards Series No. GSR Part 3 - Interim Edition), may be used in conjunction with GSR Part 1 in order to conduct a thorough review of a national legal and governmental infrastructure. The IRRS recognizes that organizational structure and regulatory processes vary from country to country depending on national legal and administrative systems, the size and structure of the nuclear and radiation protection programme, financial resources available to the regulatory body, social customs and cultural traditions. The IRRS process allows for such variations within a single integrated review service. The IRRS process includes performance and prescriptive approaches to varying degrees. It is performance oriented in that it accepts various approaches to the organization and practices of a regulatory framework and body that contribute to a strong national nuclear and radiation safety regime. At the same time the review process is prescriptive in its objective comparison against IAEA standards and guidance. These IRRS guidelines have been published to encourage consistency and comprehensiveness in the preparation for, conduct and follow-up of an IRRS mission. During an IRRS mission, recommendations and suggestions may be offered to the host country. Recommendations made are related to items of direct relevance to safety as referenced in IAEA Safety Requirements, while suggestions made are related to items which are not be essential to compatibility with IAEA standards but may enhance the effectiveness of the national nuclear and radiation safety regime and/or improve the organization or performance of the regulatory body. Good practices identified may be documented for consideration by other States.

  14. Identification of heart rate-associated loci and their effects on cardiac conduction and rhythm disorders

    DEFF Research Database (Denmark)

    den Hoed, Marcel; Eijgelsheim, Mark; Esko, Tõnu

    2013-01-01

    of dilated cardiomyopathy, congenital heart failure and/or sudden cardiac death. In addition, genetic susceptibility to increased heart rate is associated with altered cardiac conduction and reduced risk of sick sinus syndrome, and both heart rate-increasing and heart rate-decreasing variants associate...

  15. Tactical Web Services: Using XML and Java Web Services to Conduct Real-Time Net-Centric Sonar Visualization

    National Research Council Canada - National Science Library

    Rosetti, Scott

    2004-01-01

    With the unveiling of ForceNet, the Navy's architectural framework for how naval warfare is to be conducted in the information age, much of the technological focus has been placed on Web technology...

  16. 76 FR 22293 - Supplemental Standards of Ethical Conduct for Employees of the Court Services and Offender...

    Science.gov (United States)

    2011-04-21

    ... employment involves solicitation or advertising services. (f) Appeal. If the Designated Agency Ethics... the prospective employment involves solicitation or advertising services. The request must be... 8001.102(f) describes the appeal process if the request is denied by the DAEO. The employee may appeal...

  17. The Association between Freedom of Choice and Effectiveness of Home Care Services.

    Science.gov (United States)

    Steffansson, Marina; Pulliainen, Marjo; Kettunen, Aija; Linnosmaa, Ismo; Halonen, Miikka

    2016-03-31

    The aim of this paper is to study home care clients' freedom to choose their services, as well the association between the effectiveness of home care services and freedom of choice, among other factors. A structured postal survey was conducted among regular home care clients (n = 2096) aged 65 or older in three towns in Finland. Freedom of choice was studied based on clients' subjective experiences. The effectiveness of the services was evaluated by means of changes in the social-care-related quality of life. Regression analyses were used to test associations. As much as 62% of home care recipients reported having some choice regarding their services. Choosing meals and visiting times for the care worker were associated with better effectiveness. The basic model, which included needs and other factors expected to have an impact on quality of life, explained 15.4% of the changes in quality of life, while the extended model, which included the freedom-of-choice variables, explained 17.4%. The inclusion of freedom-of-choice variables increased the adjusted coefficient of determination by 2%. There was a significant positive association between freedom of choice and the effectiveness of public home care services. Freedom of choice does not exist for all clients of home care who desire it. By changing social welfare activities and structures, it is possible to show respect for clients' opinions and to thereby improve the effectiveness of home care services.

  18. Petroleum Services Association of Canada 1996 annual report

    International Nuclear Information System (INIS)

    Anon.

    1996-01-01

    The Petroleum Services Association of Canada (PSAC) is the national trade association of the Canadian oilfield service, supply and manufacturing industry. The Association's mandate is to protect and promote the interests of its members. This annual review for 1996 details the activities undertaken by the Board of Directors on behalf of the membership. Achievements in the area of health, safety and the environment included the Safety Statistics Program, the establishment of the Petroleum Safety Council, the Voluntary Incentive Plan designed to reduce workers' compensation claims, and the updating of the Drilling Fluids Manual and Emergency Response Plan. Alberta Labour's Oilwell Servicing Regulation and the B.C. Oil and Gas Regulations Review were the highlights in the area of regulatory and government relations. The strategic alliances signed between the PSAC and the Newfoundland Ocean Industries Association and the PSAC and the Canadian Association of Petroleum Producers demonstrated the new era of partnership and communication between petroleum producers and their suppliers. A list of PSAC publications, including special reports, was also included

  19. Petroleum Services Association of Canada 1998 annual report

    International Nuclear Information System (INIS)

    1998-01-01

    A review of the activities of the Petroleum Services Association of Canada (PSAC) for 1998 was presented. PSAC, the national trade association of the Canadian oilfield service, supply and manufacturing industry, has a mandate to protect and promote the interests of its members. Despite reduced level of activity in 1998, PSAC undertook a major strategic planning process involving a survey of the membership to determine areas of greatest need. The PSAC prepared goals, objectives and action plans. It made a submission to the BC Task Force on Business requesting a reduction of taxes and bureaucracy. It worked on the development of new regulations for Hours of Service for Truck Drivers. It participated with Alberta Labour in the 'Partners in Injury Reduction' program which is designed to reduce worksite injuries. It formed a new sectorial group to look at issues surrounding pipeline and oilfield construction. It contributed to upgrading pumping services and well testing standards. It helped to raise awareness of the Y2K problem. It participated in the General Oilfield Driver Improvement Program and operated a successful Basic Drilling Fluids Course. The Association also commissioned a long range forecast on drilling outlook past the year 2000 and carried out a compensation survey. It provided a credit information exchange and created a new shipping form for the transportation of dangerous goods. Member communications, promotions and special activities which profile the oilfield service industry to the media, the public, the oil and gas industry, government and the investment community remain the focus of activity of the Association. Increased activity in all these areas is forecast for 1998-1999

  20. 76 FR 35957 - Supplemental Standards of Ethical Conduct for Employees of the Court Services and Offender...

    Science.gov (United States)

    2011-06-21

    ...-0009-P] RIN 3209-AA15 and 3225-AA07 Supplemental Standards of Ethical Conduct for Employees of the... of the Office of Government Ethics (OGE), is adopting as final, without change, the interim CSOSA rule that supplements the executive-branch- wide Standards of Ethical Conduct (Standards) issued by OGE...

  1. Cost associated with stroke: outpatient rehabilitative services and medication.

    Science.gov (United States)

    Godwin, Kyler M; Wasserman, Joan; Ostwald, Sharon K

    2011-10-01

    This study aimed to capture direct costs of outpatient rehabilitative stroke care and medications for a 1-year period after discharge from inpatient rehabilitation. Outpatient rehabilitative services and medication costs for 1 year, during the time period of 2001 to 2005, were calculated for 54 first-time stroke survivors. Costs for services were based on Medicare reimbursement rates. Medicaid reimbursement rates and average wholesale price were used to estimate medication costs. Of the 54 stroke survivors, 40 (74.1%) were categorized as independent, 12 (22.2%) had modified dependence, and 2 (3.7%) were dependent at the time of discharge from inpatient rehabilitation. Average cost for outpatient stroke rehabilitation services and medications the first year post inpatient rehabilitation discharge was $17,081. The corresponding average yearly cost of medication was $5,392, while the average cost of yearly rehabilitation service utilization was $11,689. Cost attributed to medication remained relatively constant throughout the groups. Outpatient rehabilitation service utilization constituted a large portion of cost within each group: 69.7% (dependent), 72.5% (modified dependence), and 66.7% (independent). Stroke survivors continue to incur significant costs associated with their stroke for the first 12 months following discharge from an inpatient rehabilitation setting. Changing public policies affect the cost and availability of care. This study provides a snapshot of outpatient medication and therapy costs prior to the enactment of major changes in federal legislation and serves as a baseline for future studies.

  2. 18 CFR 284.286 - Standards of conduct for unbundled sales service.

    Science.gov (United States)

    2010-04-01

    ... ENERGY REGULATORY COMMISSION, DEPARTMENT OF ENERGY OTHER REGULATIONS UNDER THE NATURAL GAS POLICY ACT OF... POLICY ACT OF 1978 AND RELATED AUTHORITIES Blanket Certificates Authorizing Certain Natural Gas Sales by...) A pipeline that provides unbundled sales service under § 284.284 must have tariff provisions on file...

  3. Association between Parental Involvement in School and Child Conduct, Social, and Internalizing Problems: Teacher Report

    Science.gov (United States)

    Kirkhaug, Bente; Drugli, May Britt; Klockner, Christian A.; Morch, Willy-Tore

    2013-01-01

    The present study examined the factor structure of the Teacher Involvement Questionnaire (Involve-T) by means of exploratory factor analysis and examined the association between children's socio-emotional and behavioural problems and teacher-reported parental involvement in school, using structural equation modelling. The study was conducted with…

  4. Prenatal Alcohol Exposure Is Associated with Conduct Disorder in Adolescence: Findings from a Birth Cohort

    Science.gov (United States)

    Larkby, Cynthia A.; Goldschmidt, Lidush; Hanusa, Barbara H.; Day, Nancy L.

    2011-01-01

    Objective: To evaluate the association between prenatal alcohol exposure and the rate of conduct disorder in exposed compared with unexposed adolescents. Method: Data for these analyses are from a longitudinal study of prenatal substance exposures. Women were interviewed at their fourth and seventh prenatal months, and with their children, at…

  5. Skin Conductance Level Reactivity Moderates the Association between Harsh Parenting and Growth in Child Externalizing Behavior

    Science.gov (United States)

    Erath, Stephen A.; El-Sheikh, Mona; Hinnant, J. Benjamin; Cummings, E. Mark

    2011-01-01

    Skin conductance level reactivity (SCLR) was examined as a moderator of the association between harsh parenting at age 8 years and growth in child externalizing behavior from age 8 to age 10 (N = 251). Mothers and fathers provided reports of harsh parenting and their children's externalizing behavior; children also provided reports of harsh…

  6. The Association between Early Conduct Problems and Early Marijuana Use in College Students

    Science.gov (United States)

    Falls, Benjamin J.; Wish, Eric D.; Garnier, Laura M.; Caldeira, Kimberly M.; O'Grady, Kevin E.; Vincent, Kathryn B.; Arria, Amelia M.

    2011-01-01

    Early conduct problems have been linked to early marijuana use in adolescence. The present study examines this association in a sample of 1,076 college students that was divided into three groups: (1) early marijuana users (began marijuana use prior to age 15; N = 126), (2) late marijuana users (began marijuana use at or after age 15; N = 607),…

  7. Gender Differences in the Association between Conduct Disorder and Risky Sexual Behavior

    Science.gov (United States)

    Brooks Holliday, Stephanie; Ewing, Brett A.; Storholm, Erik D.; Parast, Layla; D’Amico, Elizabeth J.

    2017-01-01

    Despite suggestions that there are gender differences in the association between conduct disorder (CD) and risky sexual behavior, limited empirical research has examined this question. Youth (N = 616) were recruited from four primary care clinics and completed questions related to risky sexual behavior, alcohol and marijuana use, and CD. Results of stratified multivariate models indicated that the association between CD and having four or more lifetime partners, having two or more partners in the last 3 months, and engaging in condomless sex was stronger among female youth. However, association between CD and alcohol and other drug use before sex was stronger in male youth. This is an important contribution to our understanding of gender-specific manifestations of conduct disorder, and has the potential to inform screening and brief intervention efforts for this population. PMID:28182979

  8. Factors associated with psychosocial services in ogun state, Nigeria

    Directory of Open Access Journals (Sweden)

    Olorunfemi Emmanuel Amoran

    2013-01-01

    Full Text Available Background: Belonging to a social network group may influence a person′s decisions to engage in desired behavior. Aim: The objective of our study was to determine factors associated with utilization of psychosocial group services among people living with human immunodeficiency virus acquired immunodeficiency syndrome (PLWHAs in a Teaching Hospital in Sagamu, Southwestern Nigeria. Settings and Design: This was an analytical cross-sectional study. All consenting PLHAs who attended the anti-retroviral clinic (ART clinic during the study period were recruited into the study. Materials and Methods: A structured self-administered questionnaire was used to collect relevant information and a total of 205 PLWHAs were interviewed. Statistical Analysis Used: The data analysis focused on univariate frequency table and bivariate cross tabulations that identify important relationships between the variables. Odds ratio (OR at 95% confidence level (CI and Chi-squared and t-tests were also computed. Results: The overall point utilization of psychosocial services among the PLWHAs was 23.4%. Utilization of psychosocial services was statistically significantly associated with religion (χ2 = 11.74, P = 0.003, disclosure of human immunodeficiency virus status (χ2 = 9.18, P = 0.01 and satisfactory self-reported health-related quality-of-life (HRQOL (χ2 = 5.67, P = 0.017 while sex (χ2 = 0.02, P = 0.96, education (χ2 = 4.67, P = 0.32 tribe (χ2 = 1.46, P = 0.48 adherence to ART drugs (χ2 = 0.44, P = 0.51, mental health status (χ2 = 0.64, P = 0.42 and occupation (χ2 = 3.61, P = 0.61 were not. The only predictor of utilization of psychosocial group services was religion (OR = 0.44, CI = 0.23-0.84. Conclusion: This study shows the effectiveness of the psychosocial networks group in improving the overall HRQOL of the PLWHAs.

  9. Skin Conductance Level Reactivity Moderates the Association Between Harsh Parenting and Growth in Child Externalizing Behavior

    OpenAIRE

    Erath, Stephen A.; El-Sheikh, Mona; Hinnant, J. Benjamin; Cummings, E. Mark

    2011-01-01

    Skin conductance level reactivity (SCLR) was examined as a moderator of the association between harsh parenting at age 8 years and growth in child externalizing behavior from age 8 to age 10 (N = 251). Mothers and fathers provided reports of harsh parenting and their children’s externalizing behavior; children also provided reports of harsh parenting. SCLR was assessed in response to a socioemotional stress task and a problem-solving challenge task. Latent growth modeling revealed that boys w...

  10. Alterations of Brain Functional Architecture Associated with Psychopathic Traits in Male Adolescents with Conduct Disorder

    OpenAIRE

    Pu, Weidan; Luo, Qiang; Jiang, Yali; Gao, Yidian; Ming, Qingsen; Yao, Shuqiao

    2017-01-01

    Psychopathic traits of conduct disorder (CD) have a core callous-unemotional (CU) component and an impulsive-antisocial component. Previous task-driven fMRI studies have suggested that psychopathic traits are associated with dysfunction of several brain areas involved in different cognitive functions (e.g., empathy, reward, and response inhibition etc.), but the relationship between psychopathic traits and intrinsic brain functional architecture has not yet been explored in CD. Using a holist...

  11. Are PCI Service Volumes Associated with 30-Day Mortality? A Population-Based Study from Taiwan.

    Science.gov (United States)

    Yu, Tsung-Hsien; Chou, Ying-Yi; Wei, Chung-Jen; Tung, Yu-Chi

    2017-11-09

    The volume-outcome relationship has been discussed for over 30 years; however, the findings are inconsistent. This might be due to the heterogeneity of service volume definitions and categorization methods. This study takes percutaneous coronary intervention (PCI) as an example to examine whether the service volume was associated with PCI 30-day mortality, given different service volume definitions and categorization methods. A population-based, cross-sectional multilevel study was conducted. Two definitions of physician and hospital volume were used: (1) the cumulative PCI volume in a previous year before each PCI; (2) the cumulative PCI volume within the study period. The volume was further treated in three ways: (1) a categorical variable based on the American Heart Association's recommendation; (2) a semi-data-driven categorical variable based on k-means clustering algorithm; and (3) a data-driven categorical variable based on the Generalized Additive Model. The results showed that, after adjusting the patient-, physician-, and hospital-level covariates, physician volume was associated inversely with PCI 30-day mortality, but hospital volume was not, no matter which definitions and categorization methods of service volume were applied. Physician volume is negatively associated with PCI 30-day mortality, but the results might vary because of definition and categorization method.

  12. Adolescent Callous-Unemotional Traits Mediates the Longitudinal Association between Conduct Problems and Media Violence Exposure

    Directory of Open Access Journals (Sweden)

    Kostas. A. Fanti

    2013-09-01

    Full Text Available The current study investigates the bidirectional longitudinal association between conduct problems (CPs and media violence exposure (MVE, with callous-unemotional (CU traits as a potential mediator of this association. The sample consisted of 1,451 (49.9% boys Greek Cypriot adolescents. CPs and MVE were measured at Year 1 and Year 3 and CU traits were measured at Year 2, enabling the examination of longitudinal associations and indirect effects between these variables. A bidirectional association between CPs and MVE was identified. Further, both CPs and MVE at Year 1 were positively associated with Year 2 CU traits, and youth high on CU traits at Year 2 were more likely to exhibit CP behaviors and to be exposed to media violence at Year 3. Finally, two indirect pathways were identified, suggesting that the longitudinal bidirectional association between CPs and MVE was partially mediated by CU traits. These findings suggest that CU traits constitute an underlying mechanism explaining the longitudinal association between CPs and MVE.

  13. Nocturnal Enuresis Is Associated with Attention Deficit Hyperactivity Disorder and Conduct Problems

    Science.gov (United States)

    Park, Subin; Kim, Jae-Won; Hong, Soon-Beom; Shin, Min-Sup; Yoo, Hee Jeong; Cho, Soo-Churl

    2013-01-01

    Objective There are no published prevalence estimates of elimination disorders and their association with disruptive-behavior disorders among children in the Asian region using standardized diagnostic interviews. This study was conducted to determine the prevalence of elimination disorders and its association with disruptive-behavior disorders in a representative sample of children in Seoul, Korea. Methods The diagnosis of enuresis and encopresis was derived from parent-reported data for "enuresis and encopresis," collected using the Diagnostic Interview Schedule for Children, from a representative sample of 6- to 12-year-old children (n=1,645) who participated in the 2005 Seoul Child and Adolescent Mental Health Survey. Prevalence data for attention deficit and disruptive-behavior disorders were collected from the same sample. Results The overall 12-month prevalence of nocturnal enuresis and encopresis was 1.8% and 0.6%, respectively. Enuresis and encopresis prevalence in boys was significantly greater than that in girls. Enuresis and encopresis was most common at 7 to 9 years of age. Enuresis was significantly associated with ADHD (OR 2.6, 95% CI 1.0-6.9) and conduct disorder (CD; OR 4.7, 95% CI 1.0-22.4). Conclusion Enuresis is significantly associated with ADHD and CD, so these conditions must be assessed together during the evaluation of children with enuresis. PMID:24302948

  14. Cost of placement and complications associated with osseointegrated bone-conducting hearing prostheses: a retrospective analysis of medicare billing data.

    Science.gov (United States)

    Pross, Seth E; Layton, Andrew; Tong, Kuo; Lustig, Lawrence R

    2014-03-01

    To report the cost of placement and complications related to osseointegrated bone-conducting hearing prostheses (OBHPs) in a Medicare population. We performed a retrospective analysis of nationwide Medicare claims data for operative and nonoperative complications associated with the placement of percutaneous OBHPs between the first quarter of 2007 and the second quarter of 2009 for which there were 6 subsequent quarters of follow-up. We used Medicare Standard Analytical Files (SAF), which contain a 5% random sample of Medicare fee-for-service beneficiaries, excluding those that also were enrolled in a managed-care organization. We identified 118 patients who had OBHPs placed in the requisite period. Their complication billing data were analyzed for the six-quarters after initial placement. Seventy patients (59%) had no billing codes for complications or repeat procedures after receiving the implant, whereas 48 patients (41%) had such codes. The total adjusted mean cost with repeat/revision operations or complications was $7,812 per patient compared with $6,733 for those without these issues, an increase of $1,079 or 16%. We estimate that complications associated with the implantation of percutaneous OBHPs led to $417,616 in additional costs in the entire Medicare fee-for-service population during the study period and that the total cost of placement of these devices together with the cost of their complications totaled $6,789,248. In conclusion, the Medicare SAF database suggests that complications associated with OBHP increased the overall cost of placement by 16%. Like all surgical procedures, these complications and their associated costs should be taken into account when considering treatment options for patients who experience hearing loss.

  15. Child sex moderates the association between negative parenting and childhood conduct problems.

    Science.gov (United States)

    Tung, Irene; Li, James J; Lee, Steve S

    2012-01-01

    Although multiple dimensions of negative parenting behavior are associated with childhood conduct problems (CP), there is relatively little research on whether the association is equally robust in boys and girls. To improve the specificity of current models of negative parenting and offspring CP, we explored the potential moderating role of child sex in a sample of 179 5- to 10-year-old ethnically diverse boys and girls with and without attention-deficit/hyperactivity disorder (ADHD) who were assessed using multiple methods (i.e., rating scales, semistructured interviews) and informants (i.e., parents, teachers). Controlling for children's age, race-ethnicity, and ADHD diagnostic status (i.e., ADHD vs. non-ADHD), inconsistent discipline was positively associated with offspring aggression and rule-breaking behavior, whereas harsh punishment was positively associated with aggression, rule-breaking behavior, and oppositional defiant disorder symptoms. Furthermore, child sex significantly moderated the association of inconsistent discipline and aggression and rule-breaking behavior, such that inconsistent discipline was positively associated with CP for boys, but not for girls. Given the centrality of negative parenting to theories of and efficacious interventions for aggression and CP, we discuss these findings within a developmental psychopathology framework and consider their implications for intervention. © 2012 Wiley Periodicals, Inc.

  16. Alterations of Brain Functional Architecture Associated with Psychopathic Traits in Male Adolescents with Conduct Disorder.

    Science.gov (United States)

    Pu, Weidan; Luo, Qiang; Jiang, Yali; Gao, Yidian; Ming, Qingsen; Yao, Shuqiao

    2017-09-12

    Psychopathic traits of conduct disorder (CD) have a core callous-unemotional (CU) component and an impulsive-antisocial component. Previous task-driven fMRI studies have suggested that psychopathic traits are associated with dysfunction of several brain areas involved in different cognitive functions (e.g., empathy, reward, and response inhibition etc.), but the relationship between psychopathic traits and intrinsic brain functional architecture has not yet been explored in CD. Using a holistic brain-wide functional connectivity analysis, this study delineated the alterations in brain functional networks in patients with conduct disorder. Compared with matched healthy controls, we found decreased anti-synchronization between the fronto-parietal network (FPN) and default mode network (DMN), and increased intra-network synchronization within the frontothalamic-basal ganglia, right frontoparietal, and temporal/limbic/visual networks in CD patients. Correlation analysis showed that the weakened FPN-DMN interaction was associated with CU traits, while the heightened intra-network functional connectivity was related to impulsivity traits in CD patients. Our findings suggest that decoupling of cognitive control (FPN) with social understanding of others (DMN) is associated with the CU traits, and hyper-functions of the reward and motor inhibition systems elevate impulsiveness in CD.

  17. Protein kinase C activation induces conductance changes in Hermissenda photoreceptors like those seen in associative learning.

    Science.gov (United States)

    Farley, J; Auerbach, S

    Phosphorylation of ion channels has been suggested as one molecular mechanism responsible for learning-produced long-term changes in neuronal excitability. Persistent training-produced changes in two distinct K+ currents (IA (ref. 2), IK-Ca (refs 3,4)) and a voltage-dependent calcium current (ICa; refs 3,4) have previously been shown to occur in type B photoreceptors of Hermissenda, as a result of associative learning. But the identity of the phosphorylation pathway(s) responsible for these changes has not as yet been determined. Injections of cyclic AMP-dependent protein kinase reduce a K+ current (IK) in B cells which is different from those changed by training, but fails to reduce IA and IK-Ca. Phosphorylase b kinase (an exogenous calcium/calmodulin-dependent kinase) reduces IA, but whether IK-Ca and ICa are changed in the manner of associative training is not yet known. Another protein kinase present in high concentrations in both mammalian brain and molluscan nervous systems is protein kinase C, which is both calcium- and phospholipid-sensitive. We now present evidence that activation of protein kinase C by the tumour promoter phorbol ester (PDB) and intracellular injection of the enzyme induce conductance changes similar to those caused by associative training in Hermissenda B cells (that is a reduction of IA and IK-Ca, and enhancement of ICa). These results represent the first direct demonstration that protein kinase C affects membrane K+ ion conductance mechanisms.

  18. Organizational cultural competence in community health and social service organizations: how to conduct a self-assessment.

    Science.gov (United States)

    Olavarria, Marcela; Beaulac, Julie; Bélanger, Alexandre; Young, Marta; Aubry, Tim

    2009-01-01

    In an effort to address the significant socio-cultural changes in the population demographics of the United States (US) and Canada, organizations are increasingly seeking ways of improving their level of cultural competence. Evaluating organizational cultural competence is essential to address the needs of ethnic and cultural minorities. Yet, research related to organizational cultural competence is relatively new. The purpose of this paper is to review the extant literature with a specific focus on: (1) identifying the key standards that define culturally competent community health and social service organizations; and (2) outlining the core elements for evaluating cultural competence in a health and social service organization. Furthermore, issues related to choosing self-assessment tools and conducting an evaluation will be explored.

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

    Science.gov (United States)

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

    2010-02-01

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

  20. Sex differences in abnormal white matter development associated with conduct disorder in children.

    Science.gov (United States)

    Decety, Jean; Yoder, Keith J; Lahey, Benjamin B

    2015-08-30

    Associations between white matter pathway abnormalities and antisocial personality disorder in adults are well replicated, and there is some evidence for an association of white matter abnormalities with conduct disorder (CD) in adolescents. In this study, white matter maturation using diffusion tensor imaging (DTI) was examined in 110 children aged 10.0 ± 0.8 years selected to vary widely in their numbers of CD symptoms. The results replicated age-related increases in fractional anisotropy (FA) found in previous studies. There was not a significant association between the number of CD symptoms and FA, but CD symptoms were found to be significantly associated with greater axial and radial diffusivity in a broad range of white matter tracts, particularly in girls. In complementary analyses, there were similar significant differences in axial and radial diffusivity between children who met diagnostic criteria for CD and healthy children with no symptoms of CD, particularly in girls. Brain structural abnormalities may contribute to the emergence of CD in childhood, perhaps playing a greater role in girls. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  1. Sweating under pressure: skin conductance level reactivity moderates the association between peer victimization and externalizing behavior.

    Science.gov (United States)

    Gregson, Kim D; Tu, Kelly M; Erath, Stephen A

    2014-01-01

    This study examined whether the association between peer victimization and externalizing behavior may be illuminated by individual differences in skin conductance level reactivity (SCLR) in the context of peer stress. Participants included 123 fifth and sixth graders (Mean age = 12.03 years, 50% females; 42% ethnic minorities). SCLR was assessed in the context of an ecologically relevant, lab-based peer-evaluative stress experience in preadolescence. As hypothesized, self-reported peer victimization was linked with parent- and teacher-reported externalizing behavior, and SCLR consistently moderated these associations. Peer victimization was associated with parent- and teacher-reported externalizing behavior among preadolescents who exhibited lower SCLR, but not among preadolescents who exhibited higher SCLR. Results suggest that promoting engagement with peer stress experiences and enhancing inhibitory control are potential intervention targets that may reduce externalizing behavior in the context of peer victimization (or reduce peer victimization among preadolescents who exhibit externalizing behavior). © 2013 The Authors. Journal of Child Psychology and Psychiatry © 2013 Association for Child and Adolescent Mental Health.

  2. Compound heterozygosity for mutations (W156X and R225W) in SCN5A associated with severe cardiac conduction disturbances and degenerative changes in the conduction system

    NARCIS (Netherlands)

    Bezzina, Connie R.; Rook, Martin B.; Groenewegen, W. Antoinette; Herfst, Lucas J.; van der Wal, Allard C.; Lam, Jan; Jongsma, Habo J.; Wilde, Arthur A. M.; Mannens, Marcel M. A. M.

    2003-01-01

    Cardiac conduction defects associate with mutations in SCN5A, the gene encoding the cardiac Na+ channel. In the present study, we characterized a family in which the proband was born in severe distress with irregular wide complex tachycardia. His older sister died at 1 year of age from severe

  3. Association of attention-deficit/hyperactivity disorder and conduct disorder with early tobacco and alcohol use.

    Science.gov (United States)

    Brinkman, William B; Epstein, Jeffery N; Auinger, Peggy; Tamm, Leanne; Froehlich, Tanya E

    2015-02-01

    The association of attention-deficit/hyperactivity disorder (ADHD) and conduct disorder (CD) with tobacco and alcohol use has not been assessed in a young adolescent sample representative of the U.S. population. Data are from the 2000-2004 National Health and Nutrition Examination Survey, a cross-sectional sample representative of the U.S. population. Participants were age 12-15 years (N=2517). Exposure variables included diagnosis of ADHD and CD, and counts of ADHD and CD symptoms based on caregiver responses to the Diagnostic Interview Schedule for Children. Primary outcomes were adolescent-report of any use of tobacco or alcohol and age of initiating use. Multivariate logistic regression and Cox proportional hazard models were conducted. Adolescents with ADHD+CD diagnoses had a 3- to 5-fold increased likelihood of using tobacco and alcohol and initiated use at a younger age compared to those with neither disorder. Having ADHD alone was associated with an increased likelihood of tobacco use but not alcohol use. Hyperactive-impulsive symptom counts were not independently associated with any outcome, while every one symptom increase in inattention increased the likelihood of tobacco and alcohol use by 8-10%. Although participants with a diagnosis of CD alone (compared to those without ADHD or CD) did not have a higher likelihood of tobacco or alcohol use, for every one symptom increase in CD symptoms the odds of tobacco use increased by 31%. ADHD and CD diagnoses and symptomatology are linked to higher risk for a range of tobacco and alcohol use outcomes among young adolescents in the U.S. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  4. An epidemiological study of ADHD and conduct disorder: does family conflict moderate the association?

    Science.gov (United States)

    Sigfusdottir, Inga Dora; Asgeirsdottir, Bryndis Bjork; Hall, Hildigunnur Anna; Sigurdsson, Jon Fridrik; Young, Susan; Gudjonsson, Gisli H

    2017-04-01

    To examine the role of family conflict in the relationship between attention deficit hyperactivity disorder (ADHD) and conduct disorder (CD). A cross-sectional national population survey was carried out among 10,838 14-16 year old students in all secondary schools in Iceland. Three latent measures, financial status, ADHD and CD, and one observed measure, family structure, were included in the study. A structural equation model was used to evaluate direct effects between ADHD and CD for four different groups; females and males, experiencing family conflict and those not experiencing family conflict. ADHD was significantly and positively associated with CD for all groups. When controlling for financial status and family structure it was found that ADHD was positively and significantly associated with CD for adolescent females and males not experiencing family conflict as well as for those experiencing family conflict. The link between ADHD and CD was significantly stronger for those adolescents who had experienced family conflict compared to those who had not experienced family conflict. These results suggest that family conflict moderates the association between ADHD and CD for both girls and boys. The results of this study indicate that family environment and ADHD symptoms are important when predicting CD among adolescent youth. Most notably, family conflict exacerbates the effects of ADHD symptoms on CD among both females and males.

  5. Skilled antenatal care service utilization and its association with the ...

    African Journals Online (AJOL)

    Data were entered into EPI info version 7 statistical software and exported to STATA ... Conclusions: Skilled ANC service utilization is the joint effect of individual and ... analysis, skilled antenatal care service, women's health development team ...

  6. “... And Gladly Teach”: The American Hospital Association's Experience in Conducting Institutes on Hospital Librarianship

    Science.gov (United States)

    Yast, Helen

    1964-01-01

    As part of its overall educational program, the American Hospital Association has since 1959 conducted three institutes on hospital librarianship to meet the demand for more competent librarians in medical, nursing school, and patients' libraries. The purpose of such institutes is to teach the basic elements of library science to untrained personnel in hospital libraries. Discussed are steps in initiating an institute; factors determining length, date, and place; financing; publicity; choice and responsibility of local advisory committee; program content; qualifications of instructors; characteristics of registrants; materials for distribution; evaluations. Details of the most recent institute are outlined. A summary of problems still facing this type of educational program and suggestions for future improvements conclude the paper. PMID:14119309

  7. Patients' satisfaction towards radiological service and associated factors in Hawassa University Teaching and referral hospital, Southern Ethiopia.

    Science.gov (United States)

    Mulisa, Teshome; Tessema, Fasil; Merga, Hailu

    2017-06-26

    Patient satisfaction, one of the main components of quality of care, is a crucial phenomenon for the overall health care delivery system. Even though a number of studies have been conducted about patient satisfaction in different health services, studies in radiology services are flimsy in Ethiopia. This study aimed at assessing patient satisfaction towards radiological service and associated factors in Hawassa University Teaching and Referral hospital. An institution based cross-sectional study was conducted among 321 adult patients presented for radiological service in the study area using stratified sampling technique. Patient satisfaction was measured using SERVQUAL (Service Quality) tool that consisted of seven items: accessibility, quality of radiological service, courtesy of radiology staff, existence of good communication with service provider and desk worker, physical environment and privacy technique. Exit interviews of patients were conducted using a structured and pretested questionnaire. Data was collected by three grade ten completed trained data collectors from May 12 to May 28, 2016. Multiple logistic regressions were used to identify independent factors associated with patient satisfaction on radiological services using SPSS version 21. The overall patient satisfaction towards radiological service was 71.6%. Satisfaction to accessibility of the service was 84.5% while it was 80.6% to courtesy of the staff. Similarly, 81.6% reported satisfied with quality of the service and 59.4% and 71% of reported satisfied with physical environment and radiological service provider respectively. On the other hand, 99.7% of the respondents were dissatisfied with privacy of the service. The study revealed that patients who attended primary school (AOR = 0.317, 95% CI: 0.11-0.88), unemployed patients (AOR = 0.067, 95% CI: 0.007-0.622) and patients who had short waiting time to enter into examination room less than one hour (AOR = 4.12, 95% CI: 1.4-11.62) were

  8. Work ability among hospital food service professionals: multiple associated variables require comprehensive intervention.

    Science.gov (United States)

    Fischer, Frida Marina; Martinez, Maria Carmen

    2012-01-01

    The work of hospital food service is characterized by demands that can be associated with work ability--WA. The aim of this study was to evaluate factors associated with WA among hospital food service professionals and recommend intervention measures. This is a cross sectional study carried out in 2009, conducted in a hospital of São Paulo, Brazil. Participants were 76 (96.2%) of the eligible. They filled out a questionnaire including socio-demographic data, life styles, working conditions and WA. Multivariate linear regression analyses were performed. Factors associated with WA were age (p = 0.051), over commitment (p = 0.011), effort-reward ratio (p = 0.002) and work injuries (p work injuries is consistent with the theoretical model that demonstrated that health status is the basis to maintain the WA. The association of effort-reward imbalance shows that issues related with work organization are relevant for these workers. The association of overcommittment suggests that workers recognize their responsibility with the therapeutic processes of patients. Results showed a number of features of different nature that should be taken into account when implementing measures to improve the WA, to be applied at different levels: individual, task and institutional.

  9. Health Services Utilization Patterns Associated with Emergency Department Closure

    DEFF Research Database (Denmark)

    Hansen, Kristian Schultz; Enemark, Ulrika; Foldspang, Anders

    2011-01-01

    , 1997-2003. Data were extracted from administrative registries including information on individual use of emergency services and other hospital care, contact with GPs and socioeconomic background. Health services' use by the Morsø population was measured before reduction in emergency room opening hours...... of substitute health services. By contrast, Morsø women compared to the rest of Viborg county reduced their use of GP services in terms of face-to-face visits (β = -0.08, P = 0.020), telephone consultations (β = -0.11, P = 0.007), home visits (β = -0.48, P = 0.009), and their inpatient hospital utilization (β...... = -0.12, P = 0.022) during the period when emergeny services were only available in the daytime. CONCLUSIONS: Emergency services at neighbouring hospitals (40 kilometres distance) were able to compensate, in part, for the decreased local emergency service provision. Concurrent changes in health care...

  10. High School Sports Involvement Diminishes the Association Between Childhood Conduct Disorder and Adult Antisocial Behavior.

    Science.gov (United States)

    Samek, Diana R; Elkins, Irene J; Keyes, Margaret A; Iacono, William G; McGue, Matt

    2015-07-01

    Life course-persistent antisocial behavior manifests as a display of aggressive and antisocial behavior beginning in childhood (conduct disorder [CD]) and lasting through adulthood (adult antisocial personality disorder). This study aimed to build on prior research by evaluating whether involvement in high school sports helped attenuate the association between CD and subsequent adult antisocial behavior (AAB). A prospective sample of 967 male and female adolescents (56% adopted) was used. Structured interviews were used to assess CD (symptoms before the age of 15 years), involvement in sports during high school, and past-year adult antisocial personality disorder symptoms in young adulthood (M age = 22.4 years). As expected, the association between CD and AAB was significantly less for those involved in sports (β = .28; p antisocial behavior in the model (age, gender, adoption status), and results were consistent across males and females. Involvement in other extracurricular activities (e.g., student government, plays, clubs) did not significantly moderate the relationship between CD and AAB. Although selection effects were evident (those with more CD symptoms were less likely to be involved in sports), findings nevertheless suggest high school sports involvement may be a notable factor related to disrupting persistent antisocial behavior beginning in childhood and adolescence and lasting through young adulthood. Implications are discussed. Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  11. Incidence and factors associated with sensorineural and conductive hearing loss among survivors of congenital diaphragmatic hernia.

    Science.gov (United States)

    Partridge, Emily A; Bridge, Christina; Donaher, Joseph G; Herkert, Lisa M; Grill, Elena; Danzer, Enrico; Gerdes, Marsha; Hoffman, Casey H; D'Agostino, Jo Ann; Bernbaum, Judy C; Rintoul, Natalie E; Peranteau, William H; Flake, Alan W; Adzick, N Scott; Hedrick, Holly L

    2014-06-01

    The reported incidence of sensorineural hearing loss (SNHL) in long-term survivors of congenital diaphragmatic hernia varies widely in the literature. Conductive hearing loss (CHL) is also known to occur in CDH patients, but has been less widely studied. We sought to characterize the incidence and risk factors associated with SNHL and CHL in a large cohort of CDH patients who underwent standardized treatment and follow-up at a single institution. We retrospectively reviewed charts of all CDH patients in our pulmonary hypoplasia program from January 2004 through December 2012. Categorical variables were analyzed by Fisher's exact test and continuous variables by Mann-Whitney t-test (p≤0.05). A total of 112 patients met study inclusion criteria, with 3 (2.7%) patients diagnosed with SNHL and 38 (34.0%) diagnosed with CHL. SNHL was significantly associated with requirement for ECMO (p=0.0130), prolonged course of hospitalization (p=0.0011), duration of mechanical ventilation (p=0.0046), requirement for tracheostomy (p=0.0013), and duration of loop diuretic (p=0.0005) and aminoglycoside therapy (p=0.0003). We have identified hearing anomalies in over 30% of long-term CDH survivors. These findings illustrate the need for routine serial audiologic evaluations throughout childhood for all survivors of CDH and stress the importance of targeted interventions to optimize long-term developmental outcomes pertaining to speech and language. Copyright © 2014 Elsevier Inc. All rights reserved.

  12. IPERS guidelines for the international peer review service. Second edition. Procedures for conducting independent peer reviews of probabilistic safety assessments

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-10-01

    This publication describes the purposes and the objectives of an International Peer Review Service (IPERS) review. The main objective is first to assess whether important technological and methodological issues in the PSA are treated in an adequate manner and, second, whether specific conclusions and applications of the PSA are supported by the underlying technical analysis in an appropriate way. An important aspect for an IPERS review is the communication and exchange of views between the international experts carrying out the review and the members of the PSA team. This TECDOC is intended to give guidance on how an IPERS review is organized and conducted, it describes the steps needed to prepare the review and it highlights the PSA aspects which should be covered in detail. 30 refs, 1 fig., 2 tabs.

  13. IPERS guidelines for the international peer review service. Second edition. Procedures for conducting independent peer reviews of probabilistic safety assessments

    International Nuclear Information System (INIS)

    1995-10-01

    This publication describes the purposes and the objectives of an International Peer Review Service (IPERS) review. The main objective is first to assess whether important technological and methodological issues in the PSA are treated in an adequate manner and, second, whether specific conclusions and applications of the PSA are supported by the underlying technical analysis in an appropriate way. An important aspect for an IPERS review is the communication and exchange of views between the international experts carrying out the review and the members of the PSA team. This TECDOC is intended to give guidance on how an IPERS review is organized and conducted, it describes the steps needed to prepare the review and it highlights the PSA aspects which should be covered in detail. 30 refs, 1 fig., 2 tabs

  14. A genome-wide association study of upper aerodigestive tract cancers conducted within the INHANCE consortium.

    Directory of Open Access Journals (Sweden)

    James D McKay

    2011-03-01

    Full Text Available Genome-wide association studies (GWAS have been successful in identifying common genetic variation involved in susceptibility to etiologically complex disease. We conducted a GWAS to identify common genetic variation involved in susceptibility to upper aero-digestive tract (UADT cancers. Genome-wide genotyping was carried out using the Illumina HumanHap300 beadchips in 2,091 UADT cancer cases and 3,513 controls from two large European multi-centre UADT cancer studies, as well as 4,821 generic controls. The 19 top-ranked variants were investigated further in an additional 6,514 UADT cancer cases and 7,892 controls of European descent from an additional 13 UADT cancer studies participating in the INHANCE consortium. Five common variants presented evidence for significant association in the combined analysis (p ≤ 5 × 10⁻⁷. Two novel variants were identified, a 4q21 variant (rs1494961, p = 1×10⁻⁸ located near DNA repair related genes HEL308 and FAM175A (or Abraxas and a 12q24 variant (rs4767364, p =2 × 10⁻⁸ located in an extended linkage disequilibrium region that contains multiple genes including the aldehyde dehydrogenase 2 (ALDH2 gene. Three remaining variants are located in the ADH gene cluster and were identified previously in a candidate gene study involving some of these samples. The association between these three variants and UADT cancers was independently replicated in 5,092 UADT cancer cases and 6,794 controls non-overlapping samples presented here (rs1573496-ADH7, p = 5 × 10⁻⁸; rs1229984-ADH1B, p = 7 × 10⁻⁹; and rs698-ADH1C, p = 0.02. These results implicate two variants at 4q21 and 12q24 and further highlight three ADH variants in UADT cancer susceptibility.

  15. A genome-wide association study of upper aerodigestive tract cancers conducted within the INHANCE consortium.

    LENUS (Irish Health Repository)

    McKay, James D

    2011-03-01

    Genome-wide association studies (GWAS) have been successful in identifying common genetic variation involved in susceptibility to etiologically complex disease. We conducted a GWAS to identify common genetic variation involved in susceptibility to upper aero-digestive tract (UADT) cancers. Genome-wide genotyping was carried out using the Illumina HumanHap300 beadchips in 2,091 UADT cancer cases and 3,513 controls from two large European multi-centre UADT cancer studies, as well as 4,821 generic controls. The 19 top-ranked variants were investigated further in an additional 6,514 UADT cancer cases and 7,892 controls of European descent from an additional 13 UADT cancer studies participating in the INHANCE consortium. Five common variants presented evidence for significant association in the combined analysis (p ≤ 5 × 10⁻⁷). Two novel variants were identified, a 4q21 variant (rs1494961, p = 1×10⁻⁸) located near DNA repair related genes HEL308 and FAM175A (or Abraxas) and a 12q24 variant (rs4767364, p =2 × 10⁻⁸) located in an extended linkage disequilibrium region that contains multiple genes including the aldehyde dehydrogenase 2 (ALDH2) gene. Three remaining variants are located in the ADH gene cluster and were identified previously in a candidate gene study involving some of these samples. The association between these three variants and UADT cancers was independently replicated in 5,092 UADT cancer cases and 6,794 controls non-overlapping samples presented here (rs1573496-ADH7, p = 5 × 10⁻⁸); rs1229984-ADH1B, p = 7 × 10⁻⁹; and rs698-ADH1C, p = 0.02). These results implicate two variants at 4q21 and 12q24 and further highlight three ADH variants in UADT cancer susceptibility.

  16. 48 CFR 52.244-4 - Subcontractors and outside associates and consultants (Architect-engineer services).

    Science.gov (United States)

    2010-10-01

    ... associates and consultants (Architect-engineer services). 52.244-4 Section 52.244-4 Federal Acquisition... consultants (Architect-engineer services). As prescribed in 44.204(b), insert the following clause: Subcontractors and Outside Associates and Consultants (Architect-Engineer Services) (AUG 1998) Any subcontractors...

  17. Factors associated with the utilization of dental health services by the pediatric population: an integrative review.

    Science.gov (United States)

    Curi, Davi Silva Carvalho; Figueiredo, Andreia Cristina Leal; Jamelli, Silvia Regina

    2018-05-01

    This integrative literature review aimed to analyze studies about factors associated with the utilization of dental health services by the pediatric population between zero and 15 years old, published between 2006 and 2016 and available in Portuguese, English or Spanish. A survey of articles in the Lilacs and Medline databases was carried out, using the search strategy: ("dental care/utilization" OR "dental health services/utilization") AND ("child" OR "child, preschool") AND NOT adult. To analyze the methodological quality, the adapted Critical Appraisal Skill Programme (CASP) and the Agency for Healthcare and Research and Quality (AHRQ) were used. The following predictors of use of dental health services stood out: factors associated with children or adolescents (age, frequency of tooth brushing, chronic conditions), caregivers (schooling, perception of child's dental health, perceived oral health needs), dentists (availability at night and on the weekends) and follow up of oral health by the family health team. These are inherent factors for the planning of oral health policies or programs for the pediatric population. However, these factors vary according to the context, and therefore, a contextual analysis should be conducted.

  18. ADHD and comorbid conduct problems among adolescents: associations with self-esteem and substance use.

    Science.gov (United States)

    Glass, Kerrie; Flory, Kate; Martin, Amber; Hankin, Benjamin L

    2011-03-01

    Attention-deficit/hyperactivity disorder (ADHD) is a common child and adolescent disorder that is associated with negative outcomes (e.g., emotional and behavioral problems, substance use) and is often comorbid with Conduct Problems (CP). Research findings are mixed as to whether youth with ADHD alone or comorbid ADHD/CP suffer from low self-esteem. Research has also shown links between low self-esteem and ADHD (alone and with CP) with substance use; yet, no research has examined the links between self-esteem and substance use in adolescents with ADHD and CP. The current study examined the relation between ADHD with and without comorbid CP and self-esteem, and whether self-esteem moderated the relation between ADHD and ADHD/CP with substance use among adolescents. We hypothesized that adolescents with comorbid ADHD/CP would experience lower self-esteem than adolescents with ADHD alone or with neither disorder and that self-esteem would moderate the association between ADHD, CP, and substance use. Participants were 62 adolescents who completed the laboratory-based study with a parent. Results suggested that adolescents with comorbid ADHD and CP had significantly lower self-esteem than adolescents with ADHD alone or neither disorder. Self-esteem was not significantly different for adolescents with ADHD alone versus those in the control group. There was one marginally significant interaction between ADHD and self-esteem predicting substance use, such that individuals with comorbid ADHD/CP who also had low self-esteem tended to use more substances. Results have implications for treatments that target adolescents with ADHD and comorbid CP, as these adolescents are at risk for many deleterious outcomes.

  19. Impact of Support Services on Associate Level Nursing Programs

    Science.gov (United States)

    Busby-Parker, Michelle N.

    2014-01-01

    The goal of the research was to show the impact of the implementation of support services on admissions and graduation from nursing programs. The use of support services has been linked to higher levels of success in nursing students in the classroom and the work place. As nursing schools experience pressure to increase the student capacity to…

  20. Capability of Poultry Farmers Association for Extension Services ...

    African Journals Online (AJOL)

    dr funmi owolade

    information on poultry management techniques and marketing during in-house ... optimum human and material resources for extension services delivery to its .... vii. investigate the constraints to extension services programme in Oyo state. ..... developing countries in Agricultural Extension in Nigeria S.F. Afolayan (ed) Ilorin.

  1. Associations between Language Development and Skin Conductance Responses to Faces and Eye Gaze in Children with Autism Spectrum Disorder

    Science.gov (United States)

    Stagg, Steven D.; Davis, Robert; Heaton, Pamela

    2013-01-01

    Attention to social stimuli is associated with language development, and arousal is associated with the increased viewing of stimuli. We investigated whether skin conductance responses (SCRs) are associated with language development in autism spectrum disorder (ASD): a population that shows abnormalities in both attention to others and language…

  2. Adult antisocial syndrome with comorbid borderline pathology: association with severe childhood conduct disorder.

    Science.gov (United States)

    Howard, Rick; Huband, Nick; Duggan, Conor

    2012-05-01

    This study tested the hypothesis that adult antisocial syndrome co-concurrent with borderline personality disorder (AAS + BPD) would be associated with greater conduct disorder (CD) severity than AAS alone. Sixty-nine personality disordered individuals exhibited a sufficient number of adult antisocial traits to meet DSM-IV criterion A for antisocial personality disorder (AsPD). These were subdivided into those who did (AAS + BPD) or did not (AAS alone) meet DSM-IV criteria for a BPD diagnosis. We then compared the 2 groups on CD symptoms and historical, clinical, and self-report measures. The mean number of CD criteria met and the total number of individual CD symptoms were significantly greater in the AAS + BPD group compared with the AAS alone group. The former also were more likely to be female, to have self-harmed, to show greater personality disorder comorbidity, and to self-report greater anger. The functional link between CD and adult antisocial symptoms appears to be mediated, or at least moderated, by co-occurring borderline pathology.

  3. Associations between family characteristics and parental empowerment in the family, family service situations and the family service system.

    Science.gov (United States)

    Vuorenmaa, M; Perälä, M-L; Halme, N; Kaunonen, M; Åstedt-Kurki, P

    2016-01-01

    Parental empowerment signifies parents' sense of confidence in managing their children, interacting with services that their children use and improving child care services. High empowerment is associated with parents' resilience to demands and their confidence to make decisions and take actions that positively affect their families. Most families with children access various healthcare and education services. Professionals working in these services are therefore ideally placed to reinforce parental empowerment. However, little is known about the characteristics associated with parental empowerment within a generic sample of parents or in the context of basic child care services. The aim of this study was to assess how family characteristics are associated with maternal and paternal empowerment in the family, in service situations and in the service system. Parental empowerment was measured among 955 parents (mothers = 571; fathers = 384) of children aged 0-9 years using the Generic Family Empowerment Scale. Family characteristics were assessed through questions on children, parents and the life situation. Associations between empowerment and family characteristics were evaluated using one-way analysis of variance and t-test. Parental empowerment was predicted by multiple linear regression analysis. Parents' concerns related to their parenting, such as whether they possessed sufficient skills as a parent or losing their temper with children, as well as experiences of stress in everyday life, were negatively associated with all dimensions of maternal and paternal empowerment. Both determinants were more common and more significant in empowerment than child-related problems. Promoting parental self-confidence and providing appropriate emotional and concrete support for everyday functioning may reinforce parental empowerment, thereby enhancing families' well-being and coping, as well as improving their access to required services and timely support. Finally

  4. KBWS: an EMBOSS associated package for accessing bioinformatics web services.

    Science.gov (United States)

    Oshita, Kazuki; Arakawa, Kazuharu; Tomita, Masaru

    2011-04-29

    The availability of bioinformatics web-based services is rapidly proliferating, for their interoperability and ease of use. The next challenge is in the integration of these services in the form of workflows, and several projects are already underway, standardizing the syntax, semantics, and user interfaces. In order to deploy the advantages of web services with locally installed tools, here we describe a collection of proxy client tools for 42 major bioinformatics web services in the form of European Molecular Biology Open Software Suite (EMBOSS) UNIX command-line tools. EMBOSS provides sophisticated means for discoverability and interoperability for hundreds of tools, and our package, named the Keio Bioinformatics Web Service (KBWS), adds functionalities of local and multiple alignment of sequences, phylogenetic analyses, and prediction of cellular localization of proteins and RNA secondary structures. This software implemented in C is available under GPL from http://www.g-language.org/kbws/ and GitHub repository http://github.com/cory-ko/KBWS. Users can utilize the SOAP services implemented in Perl directly via WSDL file at http://soap.g-language.org/kbws.wsdl (RPC Encoded) and http://soap.g-language.org/kbws_dl.wsdl (Document/literal).

  5. KBWS: an EMBOSS associated package for accessing bioinformatics web services

    Directory of Open Access Journals (Sweden)

    Tomita Masaru

    2011-04-01

    Full Text Available Abstract The availability of bioinformatics web-based services is rapidly proliferating, for their interoperability and ease of use. The next challenge is in the integration of these services in the form of workflows, and several projects are already underway, standardizing the syntax, semantics, and user interfaces. In order to deploy the advantages of web services with locally installed tools, here we describe a collection of proxy client tools for 42 major bioinformatics web services in the form of European Molecular Biology Open Software Suite (EMBOSS UNIX command-line tools. EMBOSS provides sophisticated means for discoverability and interoperability for hundreds of tools, and our package, named the Keio Bioinformatics Web Service (KBWS, adds functionalities of local and multiple alignment of sequences, phylogenetic analyses, and prediction of cellular localization of proteins and RNA secondary structures. This software implemented in C is available under GPL from http://www.g-language.org/kbws/ and GitHub repository http://github.com/cory-ko/KBWS. Users can utilize the SOAP services implemented in Perl directly via WSDL file at http://soap.g-language.org/kbws.wsdl (RPC Encoded and http://soap.g-language.org/kbws_dl.wsdl (Document/literal.

  6. Association between health service utilisation of internal migrant children and parents’ acculturation in Guangdong, China: a cross-sectional study

    Science.gov (United States)

    Peng, Bo-li; Zou, Guan-yang; Chen, Wen; Lin, Yan-wei; Ling, Li

    2018-01-01

    Objectives To assess the health service utilisation of internal migrant children in Guangdong, China, and to explore the association between children’s health service utilisation and their parents’ acculturation. Design Cross-sectional survey between April and May 2016. Setting Six society-run schools of Tianhe and Baiyun districts in Guangzhou City of China. Participants We recruited all students at grade 7 or 8 and one of their parents who resided in Guangzhou over 6 months without permanent registered residence (hukou) in Guangzhou (1161 pairs completed this survey). 258 children were ill within the past 2 weeks or during the last year. Main outcome measures The main outcome was self-reported health service utilisation. Logistic regression analysis was conducted to explore the association between children’s unmet needs for outpatient or inpatient service and their parents’ acculturation (categorised into high, middle and low groups). Results In total, 216 children, or 18.6% of the total subjects, were ill within the past 2 weeks and were in need of outpatient service; 94 children, or 8.1% of the total subjects, were in need of inpatient service. Among them, 17.6% and 46.8% of the migrant children had unmet needs for outpatient and inpatient services, respectively. After controlling for enabling resources and predisposing characteristics, migrant children with parents in the middle-acculturation group (adjusted OR=3.17, 95% CIs 1.2 to 8.3, Pacculturation or low-acculturation groups, although only statistically significant when comparing with the high-acculturation group. Stratified analysis suggested that this association could be moderated by their family economic status. Conclusions Our study suggested that the association between migrant children’s health service utilisation and their parents’ acculturation was complex and could be moderated by family economic status. Increasing the service utilisation among migrant children requires

  7. Identification of heart rate-associated loci and their effects on cardiac conduction and rhythm disorders

    NARCIS (Netherlands)

    den Hoed, M.A.H.; Eijgelsheim, M.; Esko, T.; Brundel, B.J.; Peal, D.S.; Evans, D.M.; Nolte, I.M.; Segrè, A.V.; Holm, H.; Handsaker, R.E.; Westra, H.J.; Johnson, T.; Isaacs, A.; Yang, L.; Lundby, A.; Zhao, J.H.; Kim, Y.J.; Go, M.J.; Almgren, P.; Bochud, M.; Boucher, G.; Cornelis, M.C.; Gudbjartsson, D.F.; Hadley, D.; van der Harst, P.; Hayward, C.; den Heijer, M.; Igl, W.; Jackson, A.U.; Kutalik, Z.; Luan, J.; Kemp, J.P.; Kristiansson, K.; Ladenvall, C.; Lorentzon, M.; Montasser, M.E.; Njajou, O.T.; O'Reilly, P.F.; Padmanabhan, S.; St Pourcain, B.; Rankinen, T.; Salo, P.; Tanaka, T.; Timpson, N.J.; Vitart, V.; Waite, L.; Wheeler, W.; Zhang, W.; Draisma, H.H.M.; Feitosa, M.F.; Kerr, K.F.; Lind, P.A.; Mihailov, E.; Onland-Moret, N.C.; Song, C.; Weedon, M.N.; Xie, W.; Yengo, L.; Absher, D.; Albert, C.M.; Alonso, A.; Arking, D.E.; de Bakker, P.I.; Balkau, B.; Barlassina, C.; Benaglio, P.; Bis, J.C.; Bouatia-Naji, N.; Brage, S.; Chanock, S.J.; Chines, P.S.; Chung, M.; Darbar, D.; Dina, C.; Dörr, M.; Elliott, P.; Felix, S.B.; Fischer, K.; Fuchsberger, C.; de Geus, E.J.C.; Goyette, P.; Gudnason, V.; Harris, T.B.; Hartikainen, A.L.; Havulinna, A.S.; Heckbert, S.R.; Hicks, A.A.; Hofman, A.; Holewijn, S.; Hoogstra-Berends, F.; Hottenga, J.J.; Jensen, M.K.; Johansson, A.; Junttila, J.; Kääb, S.; Kanon, B.; Ketkar, S.; Khaw, K.T.; Knowles, J.W.; Kooner, A.S.; Kors, J.A.; Kumari, M.; Milani, L.; Laiho, P.; Lakatta, E.G.; Langenberg, C.; Leusink, M.; Liu, Y.; Luben, R.N.; Lunetta, K.L.; Lynch, S.N.; Markus, M.R.; Marques-Vidal, P.; Mateo Leach, I.; McArdle, W.L.; McCarroll, S.A.; Medland, S.E.; Miller, K.A.; Montgomery, G.W.; Morrison, A.C.; Müller-Nurasyid, M.; Navarro, P.; Nelis, M.; O'Connell, J.R.; O'Donnell, C.J.; Ong, K.K.; Newman, A.B.; Peters, A.; Polasek, O.; Pouta, A.; Pramstaller, P.P.; Psaty, B.M.; Rao, D.C.; Ring, S.M.; Rossin, E.J.; Rudan, D.; Sanna, S.; Scott, R.A.; Sehmi, J.S.; Sharp, S.; Shin, J.T.; Singleton, A.B.; Smith, A.V.; Soranzo, N.; Spector, T.D.; Stewart, C.; Stringham, H.M.; Tarasov, K.V.; Uitterlinden, A.G.; Vandenput, L.; Hwang, S.J.; Whitfield, J.B.; Wijmenga, C.; Wild, S.H.; Willemsen, G.; Wilson, J.F.; Witteman, J.C.; Wong, A.; Wong, Q.; Jamshidi, Y.; Zitting, P.; Boer, J.M.; Boomsma, D.I.; Borecki, I.B.; van Duijn, C.M.; Ekelund, U.; Forouhi, N.G.; Froguel, P.; Hingorani, A.D.; Ingelsson, E.; Kivimaki, M.; Kronmal, R.A.; Kuh, D; Lind, L.; Martin, N.G.; Oostra, B.A.; Pedersen, N.L.; Quertermous, T.; Rotter, J.I.; van der Schouw, Y.T.; Verschuren, W.M.; Walker, M.; Albanes, D.; Arnar, D.O.; Assimes, T.L.; Bandinelli, S.; Boehnke, M.; de Boer, R.A.; Bouchard, C.; Caulfield, W.L.; Chambers, J.C.; Curhan, G.; Cusi, D.; Eriksson, J.; Ferrucci, L.; van Gilst, W.H.; Glorioso, N.; de Graaf, J.; Groop, L.; Gyllensten, U.; Hsueh, W.C.; Hu, F.B.; Huikuri, H.V.; Hunter, D.J.; Iribarren, C.; Isomaa, B.; Järvelin, M.R.; Jula, A.; Kähönen, M.; Kiemeney, L.A.; van der Klauw, M.M.; Kooner, J.S.; Kraft, P.; Iacoviello, L.; Lehtimäki, T.; Lokki, M.L.; Mitchell, B.D.; Navis, G.; Nieminen, M.S.; Ohlsson, C.; Poulter, N.R.; Qi, L.; Raitakari, O.T.; Rimm, E.B.; Rioux, J.D.; Rizzi, F.; Rudan, I.; Salomaa, V.; Sever, P.S.; Shields, D.C.; Shuldiner, A.R.; Sinisalo, J.; Stanton, A.V.; Stolk, R.P.; Strachan, D.P.; Tardif, J.C.; Thorsteinsdottir, U.; Tuomilehto, J.; van Veldhuisen, D.J.; Virtamo, J.; Viikari, J.; Vollenweider, P.; Waeber, G.; Widen, E.; Cho, Y.S.; Olsen, J.V.; Visscher, P.M.; Willer, C.J.; Franke, L; Erdmann, J.; Thompson, J.R.; Pfeufer, A.; Sotoodehnia, N.; Newton-Cheh, C.; Ellinor, P.T.; Stricker, B.H.C.; Metspalu, A.; Perola, M.; Beckmann, J.S.; Smith, G.D.; Stefansson, K.; Wareham, N.J.; Munroe, P.B.; Sibon, O.C.M.; Milan, D.J.; Snieder, H.; Samani, N.J.; Loos, R.J.

    2013-01-01

    Elevated resting heart rate is associated with greater risk of cardiovascular disease and mortality. In a 2-stage meta-analysis of genome-wide association studies in up to 181,171 individuals, we identified 14 new loci associated with heart rate and confirmed associations with all 7 previously

  8. 26 CFR 31.3306(n)-1 - Services on American vessel whose business is conducted by general agent of Secretary of Commerce.

    Science.gov (United States)

    2010-04-01

    ... conducted by general agent of Secretary of Commerce. 31.3306(n)-1 Section 31.3306(n)-1 Internal Revenue... conducted by general agent of Secretary of Commerce. (a) Section 3306(n) and this section of the regulations... by a general agent of the Secretary of Commerce. Whether services performed by such an officer or...

  9. For a public sociology on participatory democracy. Reflexive feedback on research conducted in an association

    Directory of Open Access Journals (Sweden)

    Nez, Héloïse

    2012-12-01

    Full Text Available This paper develops a reflexive approach on the relations between research and action in works on participatory democracy; a topic in which bridges are numerous between academic, political and activist fields. It aims at analyzing the impact of the close links between sociologists and actors on the methods and results of research and, reciprocally, the role of sociology in developing participatory practices. Relying on Michael Burawoy’s reflection on “public sociology”, our own research experience in an association, and other research studies conducted in Europe, we define five ways sociologists carry out research on participatory democracy in collaboration with the actors. Beyond a reflection on the social reception of our research, the challenge is to develop a critical and committed sociology on participatory democracy with a view to contributing to the political debate and public action from a critical viewpoint.

    Este artículo desarrolla un enfoque reflexivo sobre las relaciones entre investigación y acción en los trabajos sobre democracia participativa, una temática en la que los vínculos entre los campos académicos, políticos y militantes son numerosos. El objetivo es analizar el impacto de las estrechas relaciones entre sociólogos y actores sociales en los métodos y resultados de la investigación y, al mismo tiempo, el papel de la sociología en el desarrollo de las prácticas participativas. Apoyándose en la reflexión de Michael Burawoy sobre la “sociología pública”, en nuestra propia experiencia de investigación en una asociación y en otras investigaciones en Europa, se definen cinco posturas de sociólogos que trabajan en colaboración con los actores sociales sobre la democracia participativa. Más allá de una reflexión sobre la receptividad social de nuestras investigaciones, el desafío consiste en desarrollar una sociología a la vez crítica y comprometida sobre la democracia participativa, para

  10. Identification of heart rate–associated loci and their effects on cardiac conduction and rhythm disorders

    OpenAIRE

    den Hoed, Marcel; Eijgelsheim, Mark; Esko, Tõnu; Brundel, Bianca J J M; Peal, David S; Evans, David M; Nolte, Ilja M; Segrè, Ayellet V; Holm, Hilma; Handsaker, Robert E; Westra, Harm-Jan; Johnson, Toby; Isaacs, Aaron; Yang, Jian; Lundby, Alicia

    2013-01-01

    Elevated resting heart rate is associated with greater risk of cardiovascular disease and mortality. In a 2-stage meta-analysis of genome-wide association studies in up to 181,171 individuals, we identified 14 new loci associated with heart rate and confirmed associations with all 7 previously established loci. Experimental downregulation of gene expression in Drosophila melanogaster and Danio rerio identified 20 genes at 11 loci that are relevant for heart rate regulation and highlight a rol...

  11. Association of "ADAM10" and "CAMK2A" Polymorphisms with Conduct Disorder: Evidence from Family-Based Studies

    Science.gov (United States)

    Jian, Xue-Qiu; Wang, Ke-Sheng; Wu, Tie-Jian; Hillhouse, Joel J.; Mullersman, Jerald E.

    2011-01-01

    Twin and family studies have shown that genetic factors play a role in the development of conduct disorder (CD). The purpose of this study was to identify genetic variants associated with CD using a family-based association study. We used 4,720 single nucleotide polymorphisms (SNPs) from the Illumina Panel and 11,120 SNPs from the Affymetrix 10K…

  12. Level of male involvement and associated factors in family planning services utilization among married men in Debremarkos town, Northwest Ethiopia.

    Science.gov (United States)

    Kassa, Mihretie; Abajobir, Amanuel Alemu; Gedefaw, Molla

    2014-12-02

    Men's participation is crucial to the success of family planning programs and women's empowerment and associated with better outcomes in reproductive health such as contraceptive acceptance and continuation, and safer sexual behaviors. Limited choice and access to methods, attitudes of men towards family planning, perceived fear of side-effects, poor quality of available services, cultural or religious oppositions and gender-based barriers are some of the reasons for low utilization of family planning. Hence, this study assessed the level of male involvement in family planning services utilization and its associated factors in Debremarkos town, Northwest Ethiopia. A community-based cross-sectional study was conducted from October to November, 2013. Multi-stage sampling technique was used to select 524 eligible samples. Data were collected by using semi-structured questionnaires. Epi Info and SPSS were used to enter and analyze the data; univariate, bivariate and logistic regression analyses were performed to display the outputs. Only 44 (8.4%) respondents were using or directly participating in the use of family planning services mainly male condoms. The reasons mentioned for the low participation were the desire to have more children, wife or partner refusal, fear of side effects, religious prohibition, lack of awareness about contraceptives and the thinking that it is the only issue for women. Opinion about family planning services, men approval and current use of family planning methods were associated with male involvement in the services utilization. In this study, the level of male involvement was low. Lack of information, inaccessibility to the services and the desire to have more children were found to be the reasons for low male involvement in family planning services utilization. Governmental and nongovernmental organizations, donors and relevant stakeholders should ensure availability, accessibility and sustained advocacy for use of family planning

  13. Factors associated with patient and health service delays in the ...

    African Journals Online (AJOL)

    The State Ministry of Health is responsible for. • the National Tuberculosis Programme (NTP) in. Juba town (urban). The International Medical Corps (IMC) is. • responsible for the TB services in Kajo Keji. County (rural) and a. Ministry of Health, South Sudan, Field Epidemiology and. Laboratory Training Program, Kenya. b.

  14. Management of poisoning with ethylene glycol and methanol in the UK: a prospective study conducted by the National Poisons Information Service (NPIS).

    Science.gov (United States)

    Thanacoody, Ruben H K; Gilfillan, Claire; Bradberry, Sally M; Davies, Jeremy; Jackson, Gill; Vale, Allister J; Thompson, John P; Eddleston, Michael; Thomas, Simon H L

    2016-01-01

    Poisoning with methanol and ethylene glycol can cause serious morbidity and mortality. Specific treatment involves the use of antidotes (fomepizole or ethanol) with or without extracorporeal elimination techniques. A prospective audit of patients with methanol or ethylene glycol poisoning reported by telephone to the National Poisons Information Service (NPIS) in the UK was conducted during the 2010 calendar year and repeated during the 2012 calendar year. The study was conducted to determine the frequency of clinically significant systemic toxicity and requirement for antidote use and to compare outcomes and rates of adverse reaction and other problems in use between ethanol and fomepizole. The NPIS received 1315 enquiries involving methanol or ethylene glycol, relating to 1070 individual exposures over the 2-year period. Of the 548 enquiries originating from hospitals, 329 involved systemic exposures (enteral or parenteral as opposed to topical exposure), of which 216 (66%) received an antidote (204 for ethylene glycol and 12 for methanol), and 90 (27%) extracorporeal treatment (86 for ethylene glycol and 4 for methanol). Comparing ethanol with fomepizole, adverse reactions (16/131 vs. 2/125, p methanol results in hospitalisation at least 2-3 times per week on average in the UK. No difference in outcome was detected between ethanol and fomepizole-treated patients, but ethanol was associated with more frequent adverse reactions.

  15. Associated and mediating variables related to quality of life among service users with mental disorders.

    Science.gov (United States)

    Fleury, Marie-Josée; Grenier, Guy; Bamvita, Jean-Marie

    2018-02-01

    This study aimed to identify variables associated with quality of life (QoL) and mediating variables among 338 service users with mental disorders in Quebec (Canada). Data were collected using nine standardized questionnaires and participant medical records. Quality of life was assessed with the Satisfaction with Life Domains Scale. Independent variables were organized into a six-block conceptual framework. Using structural equation modeling, associated and mediating variables related to QoL were identified. Lower seriousness of needs was the strongest variable associated with QoL, followed by recovery, greater service continuity, gender (male), adequacy of help received, not living alone, absence of substance use or mood disorders, and higher functional status, in that order. Recovery was the single mediating variable linking lower seriousness of needs, higher service continuity, and reduced alcohol use with QoL. Findings suggest that greater service continuity creates favorable conditions for recovery, reducing seriousness of needs and increasing QoL among service users. Lack of recovery-oriented services may affect QoL among alcohol users, as substance use disorders were associated directly and negatively with QoL. Decision makers and mental health professionals should promote service continuity, and closer collaboration between primary care and specialized services, while supporting recovery-oriented services that encourage service user involvement in their treatment and follow-up. Community-based organizations should aim to reduce the seriousness of needs particularly for female service users and those living alone.

  16. Regulatory challenges associated with conducting multicountry clinical trials in resource-limited settings.

    Science.gov (United States)

    Ndebele, Paul; Blanchard-Horan, Christina; Shahkolahi, Akbar; Sanne, Ian

    2014-01-01

    International public health and infectious diseases research has expanded to become a global enterprise transcending national and continental borders in organized networks addressing high-impact diseases. In conducting multicountry clinical trials, sponsors and investigators have to ensure that they meet regulatory requirements in all countries in which the clinical trials will be conducted. Some of these requirements include review and approval by national drug regulatory authorities and recognized research ethics committees. A limiting factor to the efficient conduct of multicountry clinical trials is the regulatory environment in each collaborating country, with significant differences determined by various factors including the laws and the procedures used in each country. The long regulatory processes in resource-limited countries may hinder the efficient implementation of multisite clinical trials, delaying research important to the health of populations in these countries and costing millions of dollars a year.

  17. The quality of insurance intermediary services: An analysis of conduct and performance in the German market of insurance intermediation

    OpenAIRE

    Eckardt, Martina

    2006-01-01

    Based on a sample of 946 German insurance intermediaries, the factors that affect the quality of the information services provided by them are studied using OLS-estimations. Applying a search theoretical approach, we analyze the impact of supply and demand side variables on service quality. Besides, the working of signaling devices (like reputation, advertising or certificates) to reduce asymmetric information with respect to the service quality of insurance intermediaries is examined. The re...

  18. Factors associated with emergency medical services scope of practice for acute cardiovascular events.

    Science.gov (United States)

    Williams, Ishmael; Valderrama, Amy L; Bolton, Patricia; Greek, April; Greer, Sophia; Patterson, Davis G; Zhang, Zefeng

    2012-01-01

    To examine prehospital emergency medical services (EMS) scope of practice for acute cardiovascular events and characteristics that may affect scope of practice; and to describe variations in EMS scope of practice for these events and the characteristics associated with that variability. In 2008, we conducted a telephone survey of 1,939 eligible EMS providers in nine states to measure EMS agency characteristics, medical director involvement, and 18 interventions authorized for prehospital care of acute cardiovascular events by three levels of emergency medical technician (EMT) personnel. A total of 1,292 providers responded to the survey, for a response rate of 67%. EMS scope of practice interventions varied by EMT personnel level, with the proportion of authorized interventions increasing as expected from EMT-Basic to EMT-Paramedic. Seven of eight statistically significant associations indicated that EMS agencies in urban settings were less likely to authorize interventions (odds ratios department-based EMS agencies were two to three times more likely to authorize interventions for EMT-Intermediate personnel. Volunteer EMS agencies were more than twice as likely as nonvolunteer agencies to authorize interventions for EMT-Basic and EMT-Intermediate personnel but were less likely to authorize any one of the 11 interventions for EMT-Paramedics. Greater medical director involvement was associated with greater likelihood of authorization of seven of the 18 interventions for EMT-Basic and EMT-Paramedic personnel but had no association with EMT-Intermediate personnel. We noted statistically significant variations in scope of practice by rural vs. urban setting, medical director involvement, and type of EMS service (fire department-based/non-fire department-based; volunteer/paid). These variations highlight local differences in the composition and capacity of EMS providers and offer important information for the transition towards the implementation of a national scope of

  19. Reproductive health service utilization and associated factors: the case of north Shewa zone youth, Amhara region, Ethiopia.

    Science.gov (United States)

    Negash, Wassie; Dessalegn, Muluken; Yitayew, Berhanu; Demsie, Mohammed; Wagnew, Maereg; Nyagero, Josephat

    2016-01-01

    Many youth are less informed, less experienced and less comfortable in utilizing reproductive health services. In the Sub-Saharan region the adolescents account for a higher proportion of new HIV infections and unmet need for reproductive health (RH) services. This study assessed reproductive health service utilization and associated factors among the youth in Amhara Region, Ethiopia. A community based cross-sectional study was conducted from June 15-July 30, 2014. Three hundred ninety one youth were selected by systematic random sampling technique and interviewed using structured questionnaire. Data were anlyzed using SPSS windows version 20. Multiple logistic regression was done to control potential confounding variables. P-values school and out-of-school youth were interviewed; 256 (65.5%) participants were in school and 209 (53.5%) were males. Almost all respondents (93.9%) had heard about reproductive health services and a third 129 (33%) had ever practiced sexual intercourse and 54.7% of them had utilized at least one reproductive health services. Never had sexual intercourse (AOR=3.693, 95%CI: 1.266, 10.775), families that asked their children about friends (parental monitoring) (AOR=1.892, 95%CI: 1.026, 3.491), know where service provided (AOR=3.273, 95%CI: 1.158, 9.247), youths who reads newspaper readers (AOR=3.787, 95%CI: 1.849were independent predictors of youth reproductive service utilization at 95 % CI and p-value <0.05%. Even though the youth have information about reproductive health services, youth reproductive health services utilization is very low. Therefore, building life skill, facilitating parent to child communication, establishing and strengthening of youth centres and increasing awareness for youth about those services are important steps to improve adolescents' reproductive health (RH) service utilization.

  20. Quality control and conduct of genome-wide association meta-analyses

    DEFF Research Database (Denmark)

    Winkler, Thomas W; Day, Felix R; Croteau-Chonka, Damien C

    2014-01-01

    Rigorous organization and quality control (QC) are necessary to facilitate successful genome-wide association meta-analyses (GWAMAs) of statistics aggregated across multiple genome-wide association studies. This protocol provides guidelines for (i) organizational aspects of GWAMAs, and for (ii) QC...

  1. Magnetoresistance effects associated with various electric conduction mechanisms in nanostructured [C/FeCo]n multilayers

    International Nuclear Information System (INIS)

    Zeng, Y.P.; Liu, Z.W.; Mikmeková, E.

    2017-01-01

    An evolution of magnetoresistance (MR) mechanism with the film structure was discovered in nanostructured [C/FeCo] n thin films fabricated by magnetron sputtering. The discontinuous multilayer nanogranular structure was confirmed by microstructure characterization. As the layer number n increased, the MR value of the film changed from positive to negative. The fitting curves of lnR−T −1/2 and lnR−T −1/4 show that there is a transition of the conduction regime in the temperature range of 2–300 K. The significant different MR effects at various conduction regimes indicated that the type of transport regime plays an important role in MR origin. - Highlights: • Nanostructured [FeCo/C]n multilayers were produced and characterized. • MR changed from positive to negative with the increase of layer number. • An ES-VRH to Mott-VRH conduction transition with temperature was found. • Significant different MR effects are closely related to various conduction regimes.

  2. Atypical Mismatch Negativity to Distressful Voices Associated with Conduct Disorder Symptoms

    Science.gov (United States)

    Hung, An-Yi; Ahveninen, Jyrki; Cheng, Yawei

    2013-01-01

    Background: Although a general consensus holds that emotional reactivity in youth with conduct disorder (CD) symptoms arises as one of the main causes of successive aggression, it remains to be determined whether automatic emotional processing is altered in this population. Methods: We measured auditory event-related potentials (ERP) in 20 young…

  3. Major Depression and Conduct Disorder in Youth: Associations with Parental Psychopathology and Parent-Child Conflict

    Science.gov (United States)

    Marmorstein, Naomi R.; Iacono, William G.

    2004-01-01

    Background: This study examined conduct disorder (CD) and major depression (MDD) in adolescents in relationship to parent-child conflict and psychopathology in their parents. Method: Participants were drawn from a population-based sample of twins and their families. Affected participants had lifetime diagnoses of CD and/or MDD; controls had no…

  4. Magnetoresistance effects associated with various electric conduction mechanisms in nanostructured [C/FeCo]n multilayers

    Czech Academy of Sciences Publication Activity Database

    Zeng, Y.P.; Liu, Z.W.; Mikmeková, Eliška

    2017-01-01

    Roč. 421, January (2017), s. 39-43 ISSN 0304-8853 Institutional support: RVO:68081731 Keywords : magnetoresistance * thin film * microstructure * conduction regime Subject RIV: JA - Electronics ; Optoelectronics, Electrical Engineering OBOR OECD: Coating and films Impact factor: 2.630, year: 2016

  5. Zinc Potentiates an Uncoupled Anion Conductance Associated with the Dopamine Transporter

    DEFF Research Database (Denmark)

    Meinild, Anne-Kristine; Sitte, Harald H; Gether, Ulrik

    2004-01-01

    but by a marked increase in the charge/DA flux coupling ratio as assessed from concomitant measurements of [(3)H]DA uptake and currents in voltage-clamped oocytes. These data suggest that Zn(2+) facilitates an uncoupled ion conductance mediated by DAT. Whereas this required substrate in the wild type (WT), we...

  6. Reducing barriers associated with delivering health care services to migratory agricultural workers.

    Science.gov (United States)

    Schmalzried, Hans D; Fallon, L Fleming

    2012-01-01

    travel an average of 29.1 km (18.1 miles) (range 0-129 km [0-80 miles]) to obtain medical services. Female heads of households had significantly less access to transportation compared with male heads of households (t=2.35; df=74; presources; and (3) healthcare clinic practices. Work environment issues relate mostly to the employers. Resources are barriers for MAWs because they are poor and have limited funds for the cost of transportation to clinics and the fees associated with accessing health care. Most of the barriers identified related to healthcare clinic practices. Some strategies to address healthcare clinic practice barriers were developed by the group conducting the study. By listening to what MAWs described as barriers to health care, providers can help improve access which can reduce the use of high cost hospital emergency room care.

  7. 29 CFR 1471.630 - May the Federal Mediation and Conciliation Service impute conduct of one person to another?

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 4 2010-07-01 2010-07-01 false May the Federal Mediation and Conciliation Service impute...) FEDERAL MEDIATION AND CONCILIATION SERVICE GOVERNMENTWIDE DEBARMENT AND SUSPENSION (NONPROCUREMENT) General Principles Relating to Suspension and Debarment Actions § 1471.630 May the Federal Mediation and...

  8. Home care clients in the last year of life: is material deprivation associated with service characteristics?

    Science.gov (United States)

    Goodridge, Donna; Buckley, Alan; Marko, Josh; Steeves, Megan; Turner, Hollie; Whitehead, Steve

    2011-09-01

    To compare demographic, social, medical, and health care characteristics of home care clients in the last year of life by quintile of deprivation and examine associations between material deprivation and service characteristics. This retrospective study used administrative data for 700 clients who died while receiving home care services. Outcome measures were the receipt of supportive or palliative home care. Associations were assessed using multiple logistic regression. Material deprivation was not associated with either the hours of home care received or the receipt of supportive home care services. Clients with dementia or stroke, those were older than 80 years and those who were single were less likely to receive palliative care services than other groups. Inequalities in allocation of home care services based on age, diagnosis, and marital status, but not material deprivation, suggest the need to carefully match service with need at the end of life.

  9. Churg-Strauss syndrome associated with rapid deterioration of left ventricular diastolic dysfunction and conduction disturbance.

    Science.gov (United States)

    Chin, Jung Yeon; Yi, Jeong Eun; Youn, Ho-Joong

    2013-10-01

    Cardiac involvement in Churg-Strauss syndrome (CSS) is a major cause of mortality. Here we report a case of a 75-year-old woman with eosinophilic endomyocarditis due to CSS. An electrocardiogram showed intraventricular conduction delay, and echocardiography showed an impaired relaxation pattern and biventricular apical thickening. Magnetic resonance imaging revealed subendocardial delayed enhancement with biventricular apical thrombi. Endomyocardial biopsy showed perivascular eosinophilic infiltration. Despite resolution of the hypereosinophilia after steroid therapy, her left ventricular (LV) diastolic function worsened into a restrictive pattern and she died with a ventricular escape rhythm on her 14th day in the hospital. This case is unusual in that there was rapid progression of the LV diastolic dysfunction and conduction disturbance due to CSS. © 2013, Wiley Periodicals, Inc.

  10. Using trajectory analyses to refine phenotype for genetic association: conduct problems and the serotonin transporter (5HTTLPR).

    Science.gov (United States)

    Sakai, Joseph T; Boardman, Jason D; Gelhorn, Heather L; Smolen, Andrew; Corley, Robin P; Huizinga, David; Menard, Scott; Hewitt, John K; Stallings, Michael C

    2010-10-01

    Conduct disorder is a serious, relatively common disorder of childhood and adolescence. Findings from genetic association studies searching for genetic determinants of the liability toward such behaviors have been inconsistent. One possible explanation for differential results is that most studies define phenotype from a single assessment; for many adolescents conduct problems decrease in severity over time, whereas for others such behaviors persist. Therefore, longitudinal datasets offer the opportunity to refine phenotype. We used Caucasians that were first assessed during adolescence from the National Youth Survey Family Study. Nine waves of data were used to create latent growth trajectories and test for associations between trajectory class and 5HTTLPR genotype. For the full sample, 5HTTLPR was not associated with conduct problem phenotypes. However, the short (s) allele was associated with chronic conduct problems in females; a nominally significant sex by 5HTTLPR genotype interaction was noted. Longitudinal studies provide unique opportunities for phenotypic refinement and such techniques, with large samples, may be useful for phenotypic definition with other study designs, such as whole genome association studies.

  11. Neighborhood disadvantage moderates associations of parenting and older sibling problem attitudes and behavior with conduct disorders in African American children.

    Science.gov (United States)

    Brody, Gene H; Ge, Xiaojia; Kim, Su Yeong; Murry, Velma McBride; Simons, Ronald L; Gibbons, Frederick X; Gerrard, Meg; Conger, Rand D

    2003-04-01

    Data from 296 sibling pairs (mean ages 10 and 13 years), their primary caregivers, and census records were used to test the hypothesis that African American children's likelihood of developing conduct problems associated with harsh parenting, a lack of nurturant-involved parenting, and exposure to an older sibling's deviance-prone attitudes and behavior would be amplified among families residing in disadvantaged neighborhoods. A latent construct representing harsh-inconsistent parenting and low levels of nurturant-involved parenting was positively associated with younger siblings' conduct disorder symptoms, as were older siblings' problematic attitudes and behavior. These associations were strongest among families residing in the most disadvantaged neighborhoods. Future research and prevention programs should focus on the specific neighborhood processes associated with increased vulnerability for behavior problems.

  12. Ecosystem-service tradeoffs associated with switching from annual to perennial energy crops in riparian zones of the US Midwest.

    Directory of Open Access Journals (Sweden)

    Timothy D Meehan

    Full Text Available Integration of energy crops into agricultural landscapes could promote sustainability if they are placed in ways that foster multiple ecosystem services and mitigate ecosystem disservices from existing crops. We conducted a modeling study to investigate how replacing annual energy crops with perennial energy crops along Wisconsin waterways could affect a variety of provisioning and regulating ecosystem services. We found that a switch from continuous corn production to perennial-grass production decreased annual income provisioning by 75%, although it increased annual energy provisioning by 33%, decreased annual phosphorous loading to surface water by 29%, increased below-ground carbon sequestration by 30%, decreased annual nitrous oxide emissions by 84%, increased an index of pollinator abundance by an average of 11%, and increased an index of biocontrol potential by an average of 6%. We expressed the tradeoffs between income provisioning and other ecosystem services as benefit-cost ratios. Benefit-cost ratios averaged 12.06 GJ of additional net energy, 0.84 kg of avoided phosphorus pollution, 18.97 Mg of sequestered carbon, and 1.99 kg of avoided nitrous oxide emissions for every $1,000 reduction in income. These ratios varied spatially, from 2- to 70-fold depending on the ecosystem service. Benefit-cost ratios for different ecosystem services were generally correlated within watersheds, suggesting the presence of hotspots--watersheds where increases in multiple ecosystem services would come at lower-than-average opportunity costs. When assessing the monetary value of ecosystem services relative to existing conservation programs and environmental markets, the overall value of enhanced services associated with adoption of perennial energy crops was far lower than the opportunity cost. However, when we monitized services using estimates for the social costs of pollution, the value of enhanced services far exceeded the opportunity cost. This

  13. Conductive hearing loss in four dogs associated with the use of ointment-based otic medications.

    Science.gov (United States)

    Cole, Lynette K; Rajala-Schultz, Päivi J; Lorch, Gwendolen

    2018-04-17

    Hearing loss (HL) is classified as conductive when sound transmission is compromised in the ear canal or middle ear, or sensorineural when there is an abnormality of the receptor cells of the cochlea or auditory pathway. Hearing in dogs is evaluated using the brainstem auditory evoked response (BAER) test. Our objective was to characterize BAER findings pre- and post-ear flushing in four dogs with acute HL following application of an ointment-based otic medication containing betamethasone, clotrimazole and gentamicin in a mineral oil-based system containing a plasticized hydrocarbon gel. Dogs, ranging from 9 to 11 years old, that had been treated with the otic medication for one to three weeks prior to hearing loss and on otoscopic examination had evidence of medication in the horizontal ear canals. Dogs were anaesthetized for an ear flush to remove the medication from the ear canals. Hearing was assessed using BAER testing, measurements were initiated with 116 decibel peak equivalent sound pressure level (dBpeSPL) click. Estimated threshold was defined as the lowest intensity in dB in which wave V was still present. Post-ear flush the estimated threshold improved in both ears of all dogs (mean 22.3 dB; range 13-41 dB), confirming conductive HL due to the otic medication. All owners noted an improvement in their dog's hearing post-ear flush, validating the BAER findings. These results emphasize the importance of an ear flush to remove otic medications in dogs that experience acute HL, to determine if the HL is conductive, and if so, to restore hearing. © 2018 ESVD and ACVD.

  14. 49 CFR Appendix to Subtitle A - United States Railway Association-Employee Responsibilities and Conduct

    Science.gov (United States)

    2010-10-01

    ... accident insurance plan or other employee welfare or benefit plan that is maintained by a business or... 49 Transportation 1 2010-10-01 2010-10-01 false United States Railway Association-Employee... Subtitle A, App. Appendix to Subtitle A—United States Railway Association—Employee Responsibilities and...

  15. Position of the American Dietetic Association, School Nutrition Association, and Society for Nutrition Education: Comprehensive School Nutrition Services

    Science.gov (United States)

    Briggs, Marilyn; Mueller, Constance G.; Fleischhacker, Sheila

    2010-01-01

    It is the position of the American Dietetic Association (ADA), School Nutrition Association (SNA), and Society for Nutrition Education (SNE) that comprehensive, integrated nutrition services in schools, kindergarten through grade 12, are an essential component of coordinated school health programs and will improve the nutritional status, health,…

  16. Risks for Conduct Disorder Symptoms Associated with Parental Alcoholism in Stepfather Families versus Intact Families from a Community Sample

    Science.gov (United States)

    Foley, Debra L.; Pickles, Andrew; Rutter, Michael; Gardner, Charles O.; Maes, Hermine H.; Silberg, Judy L.; Eaves, Lindon J.

    2004-01-01

    Background: It is not known if the prevalence of parental psychiatric disorders is higher in stepfather than intact families, or if parental alcoholism is differentially associated with risk for conduct disorder (CD) symptoms in stepfather families versus intact families. Method: The sample comprised 839 girls and 741 boys from 792 intact families…

  17. Using Satellite Technology to Increase Professional Communications Among Teachers: a Report of Experiments Conducted by the National Education Association.

    Science.gov (United States)

    National Education Association, Washington, DC. Div. of Instruction and Professional Development.

    The National Education Association (NEA) in conjunction with the National Aeronautics and Space Administration, the National Library of Medicine, The Alaska Broadcasting Commission, and the Pacific PEACESAT Network, conducted four satellite experiments designed to improve professional communication among teachers. These programs were the Satellite…

  18. What factors are associated with state performance on provision of transition services to CSHCN?

    Science.gov (United States)

    Kane, Debra J; Kasehagen, Laurin; Punyko, Judy; Carle, Adam C; Penziner, Andy; Thorson, Sarah

    2009-12-01

    To examine whether individual, condition-related, and system-related characteristics are associated with state performance (high, medium, low) on the provision of transition services to children with special health care needs (CSHCN). We conducted descriptive, bivariate, and multivariable analyses of 16876 children aged 12 to 17 years by using data from the 2005-2006 National Survey of Children With Special Health Care Needs. Polytomous logistic regression was used to compare the characteristics of CSHCN residing within high-, medium-, and low-performance states, with low-performance states serving as the reference group. Compared with non-Hispanic white CSHCN, Hispanic (adjusted odds ratio [aOR]: 0.25 [95% confidence interval (CI): 0.17-0.37]) and non-Hispanic black (aOR: 0.44 [95% CI: 0.30-0.62]) CSHCN were less likely to reside in a high-performance than in a low-performance state. Compared with CSHCN who had a medical home or adequate insurance coverage, CSHCN who did not have a medical home or adequate insurance coverage were less likely to reside in a high-performance than in a low-performance state (aOR: 0.73 [95% CI: 0.57-0.95]; aOR: 0.73 [95% CI: 0.58-0.93], respectively). Key factors found to be important in a state's performance on provision of transition services to CSHCN were race/ethnicity and having a medical home and adequate insurance coverage. Efforts to support the Maternal and Child Health Bureau's integration of system-level factors in quality-improvement activities, particularly establishing a medical home and attaining and maintaining adequate insurance, are likely to help states improve their performance on provision of transition services.

  19. Childhood bullying victimization is associated with use of mental health services over five decades: a longitudinal nationally representative cohort study.

    Science.gov (United States)

    Evans-Lacko, S; Takizawa, R; Brimblecombe, N; King, D; Knapp, M; Maughan, B; Arseneault, L

    2017-01-01

    Research supports robust associations between childhood bullying victimization and mental health problems in childhood/adolescence and emerging evidence shows that the impact can persist into adulthood. We examined the impact of bullying victimization on mental health service use from childhood to midlife. We performed secondary analysis using the National Child Development Study, the 1958 British Birth Cohort Study. We conducted analyses on 9242 participants with complete data on childhood bullying victimization and service use at midlife. We used multivariable logistic regression models to examine associations between childhood bullying victimization and mental health service use at the ages of 16, 23, 33, 42 and 50 years. We estimated incidence and persistence of mental health service use over time to the age of 50 years. Compared with participants who were not bullied in childhood, those who were frequently bullied were more likely to use mental health services in childhood and adolescence [odds ratio (OR) 2.53, 95% confidence interval (CI) 1.88-3.40] and also in midlife (OR 1.30, 95% CI 1.10-1.55). Disparity in service use associated with childhood bullying victimization was accounted for by both incident service use through to age 33 years by a subgroup of participants, and by persistent use up to midlife. Childhood bullying victimization adds to the pressure on an already stretched health care system. Policy and practice efforts providing support for victims of bullying could help contain public sector costs. Given constrained budgets and the long-term mental health impact on victims of bullying, early prevention strategies could be effective at limiting both individual distress and later costs.

  20. Provision of financial services, violation of public law conduct of business rules, and private law norm settinga Dutch, German, and European perspective

    NARCIS (Netherlands)

    Wallinga, Marnix

    2014-01-01

    Legal uncertainty exists with regards to the relationship between a violation of public law conduct of business rules and private law norm setting. In the area of financial services this uncertainty has led to the question whether private law duties of care can deviate from the norms pursuant to

  1. Factors associated with the utilization and costs of health and social services in frail elderly patients

    Directory of Open Access Journals (Sweden)

    Kehusmaa Sari

    2012-07-01

    Full Text Available Abstract Background Universal access is one of the major aims in public health and social care. Services should be provided on the basis of individual needs. However, municipal autonomy and the fragmentation of services may jeopardize universal access and lead to variation between municipalities in the delivery of services. This paper aims to identify patient-level characteristics and municipality-level service patterns that may have an influence on the use and costs of health and social services of frail elderly patients. Methods Hierarchical analysis was applied to estimate the effects of patient and municipality-level variables on services utilization. Results The variation in the use of health care services was entirely due to patient-related variables, whereas in the social services, 9% of the variation was explained by the municipality-level and 91% by the patient-level characteristics. Health-related quality of life explained a major part of variation in the costs of health care services. Those who had reported improvement in their health status during the preceding year were more frequent users of social care services. Low informal support, poor functional status and poor instrumental activities of daily living, living at a residential home, and living alone were associated with higher social services expenditure. Conclusions The results of this study showed municipality-level variation in the utilization of social services, whereas health care services provided for frail elderly people seem to be highly equitable across municipalities. Another important finding was that the utilization of social and health services were connected. Those who reported improvement in their health status during the preceding year were more frequently also using social services. This result suggests that if municipalities continue to limit the provision of support services only for those who are in the highest need, this saving in the social sector may, in

  2. Associations Between Waiting Times, Service Times, and Patient Satisfaction in an Endocrinology Outpatient Department: A Time Study and Questionnaire Survey.

    Science.gov (United States)

    Xie, Zhenzhen; Or, Calvin

    2017-01-01

    The issue of long patient waits has attracted increasing public attention due to the negative effects of waiting on patients' satisfaction with health care. The present study examined the associations between actual waiting time, perceived acceptability of waiting time, actual service time, perceived acceptability of service time, actual visit duration, and the level of patient satisfaction with care. We conducted a cross-sectional time study and questionnaire survey of endocrinology outpatients visiting a major teaching hospital in China. Our results show that actual waiting time was negatively associated with patient satisfaction regarding several aspects of the care they received. Also, patients who were less satisfied with the sociocultural atmosphere and the identity-oriented approach to their care tended to perceive the amounts of time they spent waiting and receiving care as less acceptable. It is not always possible to prevent dissatisfaction with waiting, or to actually reduce waiting times by increasing resources such as increased staffing. However, several improvements in care services can be considered. Our suggestions include providing clearer, more transparent information to keep patients informed about the health care services that they may receive, and the health care professionals who are responsible for those services. We also suggest that care providers are encouraged to continue to show empathy and respect for patients, that patients are provided with private areas where they can talk with health professionals and no one can overhear, and that hospital staff treat the family members or friends who accompany patients in a courteous and friendly way.

  3. Utilization of clean and safe delivery service package of health services extension program and associated factors in rural kebeles of Kafa Zone, Southwest Ethiopia.

    Science.gov (United States)

    Bayou, Negalign Berhanu; Gacho, Yohannes Haile Michael

    2013-07-01

    In Ethiopia, 94% of births take place at home unattended by trained persons. The government introduced an innovative strategy, Health Services Extension Program in 2003. Clean and safe delivery service is a component of maternal and child healthcare package of the program. However, little is known about the status of uptake of the service. This study thus aimed to assess utilization of clean and safe delivery service and associated factors in rural kebeles of Kafa Zone, Ethiopia. A community based cross sectional survey was conducted in rural kebeles of Kefa Zone from January 21(st) to February 25(th), 2009 using a sample of 229 mothers. Kafa Zone is located 465 kilometres away from Addis Ababa to southwest of Ethiopia. Data were collected using a structured questionnaire and analyzed using SPSS for windows version 16. OR and 95% CI were calculated. Phistory of abortion, knowledge of danger signs and antenatal care attendance. Educating women and improving their knowledge about danger signs of pregnancy and labor is recommended. Health extension workers should consider antenatal care visits as opportunities for this purpose.

  4. Association between full service and fast food restaurant density, dietary intake and overweight/obesity among adults in Delhi, India.

    Science.gov (United States)

    Patel, Opal; Shahulhameed, Safraj; Shivashankar, Roopa; Tayyab, Mohammad; Rahman, Atiqur; Prabhakaran, Dorairaj; Tandon, Nikhil; Jaacks, Lindsay M

    2017-07-19

    The food environment has been implicated as an underlying contributor to the global obesity epidemic. However, few studies have evaluated the relationship between the food environment, dietary intake, and overweight/obesity in low- and middle-income countries (LMICs). The aim of this study was to assess the association of full service and fast food restaurant density with dietary intake and overweight/obesity in Delhi, India. Data are from a cross-sectional, population-based study conducted in Delhi. Using multilevel cluster random sampling, 5364 participants were selected from 134 census enumeration blocks (CEBs). Geographic information system data were available for 131 CEBs (n = 5264) from a field survey conducted using hand-held global positioning system devices. The number of full service and fast food restaurants within a 1-km buffer of CEBs was recorded by trained staff using ArcGIS software, and participants were assigned to tertiles of full service and fast food restaurant density based on their resident CEB. Height and weight were measured using standardized procedures and overweight/obesity was defined as a BMI ≥25 kg/m 2 . The most common full service and fast food restaurants were Indian savory restaurants (57.2%) and Indian sweet shops (25.8%). Only 14.1% of full service and fast food restaurants were Western style. After adjustment for age, household income, education, and tobacco and alcohol use, participants in the highest tertile of full service and fast food restaurant density were less likely to consume fruit and more likely to consume refined grains compared to participants in the lowest tertile (both p restaurant density were significantly more likely to be overweight/obese: odds ratio (95% confidence interval), 1.44 (1.24, 1.67). After adjustment for age, household income, and education, the effect was attenuated: 1.08 (0.92, 1.26). Results were consistent with further adjustment for tobacco and alcohol use, moderate physical activity

  5. Significance, Nature, and Direction of the Association Between Child Sexual Abuse and Conduct Disorder: A Systematic Review.

    Science.gov (United States)

    Maniglio, Roberto

    2015-07-01

    To elucidate the significance, nature, and direction of the potential relationship between child sexual abuse and conduct disorder, all the pertinent studies were reviewed. Ten databases were searched. Blind assessments of study eligibility and quality were performed by two independent researchers. Thirty-six studies including 185,358 participants and meeting minimum quality criteria that were enough to ensure objectivity and to not invalidate results were analyzed. Across the majority of studies, conduct disorder was significantly and directly related to child sexual abuse, especially repeated sexual molestation and abuse involving penetration, even after controlling for various sociodemographic, family, and clinical variables. The association between child sexual abuse and conduct disorder was not confounded by other risk factors, such as gender, socioeconomic status, school achievement, substance problems, physical abuse, parental antisocial behavior or substance problems, parent-child relationships, and family disruption, conflict, or violence. Evidence for a significant interactive effect between child sexual abuse and monoamine oxidase A gene on conduct disorder was scant. Early sexual abuse might predispose to the subsequent onset of conduct disorder which, in turn, may lead to further sexual victimization through association with sexually abusive peers or involvement in dangerous situations or sexual survival strategies. © The Author(s) 2014.

  6. Studies and research concerning BNFP: shearing tests conducted at Allied-General Nuclear Services for the Consolidated Fuel Reprocessing Program

    International Nuclear Information System (INIS)

    Weil, B.; Townes, G.

    1979-09-01

    An experiment conducted to shear two dummy PWR subassemblies is described. Results pertain to the removal of end hardware by shearing, spacer grid fragmentation, the character of sheared product, product leachability, shearing force requirements, and the effects of compaction

  7. Quality of breast cancer early detection services conducted by well woman clinics in the district of Gampaha, Sri Lanka.

    Science.gov (United States)

    Vithana, Palatiyana Vithanage Sajeewanie Chiranthika; Ariyaratne, May; Jayawardana, Pl

    2013-01-01

    Breast cancer is the most common cancer diagnosed in females in Sri Lanka and early detection can lead to reduction in morbidity and mortality. To evaluate selected aspects of breast cancer early detection services implemented through well woman clinics (WWCs) in the Gampaha District. The study consisted of two components. A retrospective descriptive arm assessed clinical breast examination (CBE) coverage of target age group women (TGW) of 35-59 years in all the WWCs in Gampaha district over 2003- 2007. A cross sectional descriptive study additionally assessed quality of breast cancer early detection services. The Lot Quality Assurance Sampling (LQAS) technique was used to decide on the lot size and threshold values, which were computed as twenty and six clinics. Checklists were employed in assessing coverage, physical facilities and clinic activities. Client satisfaction on WWC services was assessed among 200 TGW attending 20 WWCs using an interviewer-administered questionnaire. CBE coverage in the Gampaha district increased only from 1.1-2.2% over 2003-2007. With regard to physical facilities, the number of clinics that were rated substandard varied between 7-18 (35- 90%). The items that were lacking included dust bins, notice boards, stationary, furniture and linen, and cleanliness of outside premises and toilets. With regard to clinic activities, punctuality of staff, late commencement of clinics, provision of health education, supervision, CBE and breast self-examination (BSE) were substandard in 7- 20 clinics (35-100%). Client satisfaction for WWC services was 45.2% (IQR: 38.7-54.8%) and only 11% had a score of ≥70%, the cut off set for satisfaction. Breast cancer early detection service coverage in the Gampaha district remained low (2.2%) in 2007, 11 years after commencing WWCs. All 20 clinics were substandard for overall CBE and BSE.

  8. Context-Specific Associations Between Harsh Parenting and Peer Rejection on Child Conduct Problems at Home and School.

    Science.gov (United States)

    Tung, Irene; Lee, Steve S

    2016-02-06

    Although harsh parenting and peer rejection are independently associated with childhood conduct problems (CP), these patterns are often informant specific, suggesting that their associations across contexts (i.e., home and school) should be considered. In a sample of 142 children with and without attention-deficit/hyperactivity disorder (ADHD; ages 5-10; 66% male), we used structural equation modeling to evaluate the structure of multi-informant (parent, teacher) and multimethod (semi-structured interview, questionnaire) rated aggressive, rule-breaking, and oppositional behavior. Next, we explored context-specific associations by modeling harsh parenting and peer rejection as simultaneous and independent predictors of home and school CP. We observed several key findings: (a) the structure of parent- and teacher-reported CP was best accounted by context-specific CP (i.e., home vs. school) and a second-order general CP factor; (b) harsh punishment and peer rejection each independently predicted the second-order general CP factor; and (c) peer rejection was uniquely associated with school CP, whereas harsh punishment was associated only with the second-order general CP factor and did not exhibit specificity with home CP. Whereas harsh parenting and peer rejection were each independently associated with generalized CP, peer rejection showed an additional, unique context-specific association with CP exclusively expressed at school. We discuss potential explanatory mechanisms underlying context-specific associations of CP, as well as address etiological and clinical implications for understanding informant-discrepancies in CP.

  9. Associations between the peer support relationship, service satisfaction and recovery-oriented outcomes: a correlational study.

    Science.gov (United States)

    Thomas, Elizabeth C; Salzer, Mark S

    2017-12-18

    The working alliance between non-peer providers and mental health consumers is associated with positive outcomes. It is hypothesized that this factor, in addition to other active support elements, is also positively related to peer support service outcomes. This study evaluates correlates of the peer-to-peer relationship and its unique association with service satisfaction and recovery-oriented outcomes. Participants were 46 adults with serious mental illnesses taking part in a peer-brokered self-directed care intervention. Pearson correlation analyses examined associations among peer relationship factors, services-related variables and recovery-oriented outcomes (i.e. empowerment, recovery and quality of life). Hierarchical multiple regression analyses evaluated associations between relationship factors and outcomes over time, controlling for other possible intervention effects. The peer relationship was not related to number of contacts. There were robust associations between the peer relationship and service satisfaction and some recovery-oriented outcomes at 24-months, but not at 12-months. These associations were not explained by other possible intervention effects. This study contributes to a better understanding of the positive, unique association between the peer-to-peer relationship and outcomes, similar to what is found in non-peer-delivered interventions. Implications for program administrators and policymakers seeking to integrate peer specialists into mental health service systems are discussed.

  10. Studies of molecular association in H2O and D2O vapors by measurement of thermal conductivity

    International Nuclear Information System (INIS)

    Curtiss, L.A.; Frurip, D.J.; Blander, M.

    1979-01-01

    The thermal conductivities of H 2 O and D 2 O vapors were measured in a modified thick hot wire cell between 358 and 386 K at pressures ranging from 100 to 1000 Torr. Analysis of the data indicates that molecular association to form a dimeric species is the main source of enhancement of the thermal conductivity of both vapors. The enthalpy and entropy of association of the H 2 O dimer are -3.59 kcal mol -1 and -18.59 cal deg -1 mol -1 , respectively. The enthalpy and entropy of association of the D 2 O dimer are -3.66 kcal mol -1 and -18.67 cal deg -1 mol -1 , respectively. The measured enthalpy of association of the H 2 O dimer is in agreement with recently reported ab initio molecular orbital calculations on the H 2 O dimer. The entropies of association of the H 2 O and D 2 O dimers are calculated theoretically and are found to be in agreement with the measured values

  11. Contextual and individual factors associated with dental services utilisation by Brazilian adults: A multilevel analysis.

    Science.gov (United States)

    Herkrath, Fernando José; Vettore, Mario Vianna; Werneck, Guilherme Loureiro

    2018-01-01

    Inequalities in the utilisation of dental services in Brazil are remarkable. The aim of this study was to evaluate the association of contextual and individual factors with the utilisation of dental services by Brazilian adults using the Andersen's behavioural model. Individual-level data from 27,017 adults residents in the State capitals who were interviewed in the 2013 Brazilian National Health Survey were pooled with contextual city-level data. The outcomes were non-utilisation of dental services and last dental visit over 12 months ago. Individual predisposing variables were age, sex, race/skin colour, schooling and social network. Individual enabling variables included income, health insurance and registration in primary health care. Individual need variables were self-perceived dental health and self-reported missing teeth. Multilevel logistic regression models were performed to estimate odds ratio (OR) and 95% confidence intervals (95% CIs) of the association of contextual and individual predisposing, enabling and need-related variables with dental services outcomes. Predisposing (OR = 0.89; 95% CI 0.81-0.97) and enabling (OR = 0.90; 95% CI 0.85-0.96) contextual factors were associated with non-utilisation of dental services. Individual predisposing (sex, race/skin colour, schooling), enabling (income, health insurance) and need (self-perceived oral health, missing teeth) were associated with non-utilisation of dental services and last dental visit over 12 months ago. The latter was also associated with other individual predisposing (age, social network) and need (eating difficulties due to oral problems) characteristics. Individual and contextual determinants influenced dental services utilisation in Brazilian adults. These factors should be on the policy agenda and considered in the organisation of health services aiming to reduce oral health inequalities related to access and utilisation of dental services.

  12. A state-space modeling approach to estimating canopy conductance and associated uncertainties from sap flux density data.

    Science.gov (United States)

    Bell, David M; Ward, Eric J; Oishi, A Christopher; Oren, Ram; Flikkema, Paul G; Clark, James S

    2015-07-01

    Uncertainties in ecophysiological responses to environment, such as the impact of atmospheric and soil moisture conditions on plant water regulation, limit our ability to estimate key inputs for ecosystem models. Advanced statistical frameworks provide coherent methodologies for relating observed data, such as stem sap flux density, to unobserved processes, such as canopy conductance and transpiration. To address this need, we developed a hierarchical Bayesian State-Space Canopy Conductance (StaCC) model linking canopy conductance and transpiration to tree sap flux density from a 4-year experiment in the North Carolina Piedmont, USA. Our model builds on existing ecophysiological knowledge, but explicitly incorporates uncertainty in canopy conductance, internal tree hydraulics and observation error to improve estimation of canopy conductance responses to atmospheric drought (i.e., vapor pressure deficit), soil drought (i.e., soil moisture) and above canopy light. Our statistical framework not only predicted sap flux observations well, but it also allowed us to simultaneously gap-fill missing data as we made inference on canopy processes, marking a substantial advance over traditional methods. The predicted and observed sap flux data were highly correlated (mean sensor-level Pearson correlation coefficient = 0.88). Variations in canopy conductance and transpiration associated with environmental variation across days to years were many times greater than the variation associated with model uncertainties. Because some variables, such as vapor pressure deficit and soil moisture, were correlated at the scale of days to weeks, canopy conductance responses to individual environmental variables were difficult to interpret in isolation. Still, our results highlight the importance of accounting for uncertainty in models of ecophysiological and ecosystem function where the process of interest, canopy conductance in this case, is not observed directly. The StaCC modeling

  13. Is there an association between Fahr′s disease and cardiac conduction system disease?: A case report

    Directory of Open Access Journals (Sweden)

    Prashanth Panduranga

    2012-01-01

    Full Text Available Background: Fahr′s disease is a rare neurodegenerative disorder of unknown cause characterized by idiopathic basal ganglia calcification that is associated with neuropsychiatric and cognitive impairment. No case of Fahr′s disease with associated cardiac conduction disease has been described in the literature to date. The objective of this case report was to describe a young female with various cardiac conduction system abnormalities and bilateral basal ganglia calcifica-tion suggestive of Fahr′s disease. Case Report: A 19-year-old female was transferred to our hospital for a pacemaker insertion. Her past medical history included cognitive impairment and asymptomatic congenital complete heart block since birth. Her manifestations in-cluded cognitive impairment, tremors, rigidity, ataxia, bilateral basal ganglia calcification without clinical manifesta-tions of mitochondrial cytopathy. She also had right bundle branch block, left anterior fascicular block, intermittent complete heart block, atrial arrhythmias with advanced atrioventricular blocks and ventricular asystole manifested by Stokes-Adams seizures, which was diagnosed as epilepsy. Conclusions: According to our knowledge, this was the first case report of a su spected association between Fahr′s disease and isolated cardiac conduction system disease. In addition, this case illustrated that in patients with heart blocks and seizures, a diagnosis of epilepsy needs to be made with caution and such patients need further evaluations by a cardiologist or electrophysiologist to consider pacing and prevent future catastrophic events.

  14. The Association between Parent-Child Conflict and Adolescent Conduct Problems over Time: Results from a Longitudinal Adoption Study

    Science.gov (United States)

    Klahr, Ashlea M.; McGue, Matt; Iacono, William G.; Burt, S. Alexandra

    2010-01-01

    A handful of prior adoption studies have confirmed that the cross-sectional relationship between child conduct problems and parent/child conflict is at least partially shared environmental in origin. However, as the direction of causation between parenting and delinquency remains unclear, this relationship could be better explained by the adolescent's propensity to elicit conflictive parenting, a phenomenon referred to as an evocative gene-environment correlation. The current study thus examined the prospective relationship between conduct problems and parent-child conflict in a sample of adoptive families. Participants included 672 adolescents in 405 adoptive families assessed at two time points roughly 4 years apart. Results indicated that parent-child conflict predicts the development of conduct problems, whereas conduct problems do not predict increases in parent-child conflict. Such findings suggest that evocative gene-environment correlations are highly unlikely as an explanation of prior shared environmental effects during adolescence. Moreover, because the adolescents in this study do not share genes with their adoptive parents, the association between conduct problems and parent-child conflict is indicative of shared environmental mediation in particular. Implications of our findings are discussed. PMID:21038930

  15. Correlates of Conduct Problems and Depression Comorbidity in Elementary School Boys and Girls Receiving Special Educational Services

    Science.gov (United States)

    Poirier, Martine; Déry, Michèle; Toupin, Jean; Verlaan, Pierrette; Lemelin, Jean-Pascal; Jagiellowicz, Jadzia

    2015-01-01

    There is limited empirical research on the correlates of conduct problems (CP) and depression comorbidity during childhood. This study investigated 479 elementary school children (48.2% girls). It compared children with comorbidity to children with CP only, depression only, and control children on individual, academic, social, and family…

  16. The nature of science and technology for pre-service chemistry teacher: A case of techno-chemistry experiment "From Stannum Metalicum to conductive glass"

    Science.gov (United States)

    Mudzakir, A.; Widhiyanti, T.; Hernani, Arifin, M.; Lestari, A. N.; Jauhariansyah, S.

    2017-08-01

    The study was conducted to address the problems related to low Indonesian students' scientific literacy as revealed in the PISA (Program for International Student Assessment) since 2000-2015. Science teachers (e.g. chemistry teacher) must recognize the nature of science (NOS) to assist their students in preparing an explanation of a phenomenon scientifically correctly. Teachers also need to understand critically about nature of technology (NOT) and it relationship with science as well as society. To integrate those two kinds of knowledge (NOS and NOT), we can conduct a techno-science activity, which integrate the technology to science course in pre-service teacher education program, so that they can improve their knowledge about nature of science and technology (NOST) and pedagogical content knowledge related to NOST. The purpose of this study was to construct an inquiry based laboratory activity worksheet for making conductive glass so that the pre-service teacher could explain how the structure of the semiconductor Fluor doped Tin Oxide (SnO2.F) affect their performance. This study we conducted, described how to design a pre-service chemistry teacher education course that can improve recognizing view of NOST by using a framework called model of educational reconstruction (MER). The scientific activities in the course were guided inquiry based techno-chemistry experiments involving "From Stannum Metallicum to Conductive Glass". Conductive glasses are interesting subject research for several reason. The application of this technology could be found on solar cell, OLED, and display panel. The doped Tin dioxide has been deposited on glass substrate using the spray pyrolysis technique at 400-550°C substrate temperature, 4-5 times, 20 cm gap between glass and sprayer and 450 angle to form a thin film which will act as electrical contact. The resistivity is about 0.5 - 15Ω. The product resulted on this study was rated by several expert to find if the worksheet could

  17. Association Between Local Bipolar Voltage and Conduction Gap Along the Left Atrial Linear Ablation Lesion in Patients With Atrial Fibrillation.

    Science.gov (United States)

    Masuda, Masaharu; Fujita, Masashi; Iida, Osamu; Okamoto, Shin; Ishihara, Takayuki; Nanto, Kiyonori; Kanda, Takashi; Sunaga, Akihiro; Tsujimura, Takuya; Matsuda, Yasuhiro; Mano, Toshiaki

    2017-08-01

    A bipolar voltage reflects a thick musculature where formation of a transmural lesion may be hard to achieve. The purpose of this study was to explore the association between local bipolar voltage and conduction gap in patients with persistent atrial fibrillation (AF) who underwent atrial roof or septal linear ablation. This prospective observational study included 42 and 36 consecutive patients with persistent AF who underwent roof or septal linear ablations, respectively. After pulmonary vein isolation, left atrial linear ablations were performed, and conduction gap sites were identified and ablated after first-touch radiofrequency application. Conduction gap(s) after the first-touch roof and septal linear ablation were observed in 13 (32%) and 19 patients (53%), respectively. Roof and septal area voltages were higher in patients with conduction gap(s) than in those without (roof, 1.23 ± 0.77 vs 0.73 ± 0.42 mV, p = 0.010; septal, 0.96 ± 0.43 vs 0.54 ± 0.18 mV, p = 0.001). Trisected regional analyses revealed that the voltage was higher at the region with a conduction gap than at the region without. Complete conduction block across the roof and septal lines was not achieved in 3 (7%) and 6 patients (17%), respectively. Patients in whom a linear conduction block could not be achieved demonstrated higher ablation area voltage than those with a successful conduction block (roof, 1.91 ± 0.74 vs 0.81 ± 0.51 mV, p = 0.001; septal, 1.15 ± 0.56 vs 0.69 ± 0.31 mV, p = 0.006). In conclusion, a high regional bipolar voltage predicts failure to achieve conduction block after left atrial roof or septal linear ablation. In addition, the conduction gap was located at the preserved voltage area. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. Child advocacy center multidisciplinary team decision and its association to child protective services outcomes.

    Science.gov (United States)

    Brink, Farah W; Thackeray, Jonathan D; Bridge, Jeffrey A; Letson, Megan M; Scribano, Philip V

    2015-08-01

    Limited studies exist evaluating the multidisciplinary team (MDT) decision-making process and its outcomes. This study evaluates the MDT determination of the likelihood of child sexual abuse (CSA) and its association to the outcome of the child protective services (CPS) disposition. A retrospective cohort study of CSA patients was conducted. The MDT utilized an a priori Likert rating scale to determine the likelihood of abuse. Subjects were dichotomized into high versus low/intermediate likelihood of CSA as determined by the MDT. Clinical and demographic characteristics were compared based upon MDT and CPS decisions. Fourteen hundred twenty-two patients were identified. A high likelihood for abuse was determined in 997 cases (70%). CPS substantiated or indicated the allegation of CSA in 789 cases (79%, Kappa 0.54). Any CSA disclosure, particularly moderate risk disclosure (AOR 59.3, 95% CI 26.50-132.80) or increasing total number of CSA disclosures (AOR 1.3, 95% CI 1.11-1.57), was independently associated with a high likelihood for abuse determination. Specific clinical features associated with discordant cases in which MDT determined high likelihood for abuse and CPS did not substantiate or indicate CSA included being white or providing a low risk CSA disclosure or other non-CSA disclosure. MDT determination regarding likelihood of abuse demonstrated moderate agreement to CPS disposition outcome. CSA disclosure is predictive of the MDT determination for high likelihood of CSA. Agreement between MDT determination and CPS protection decisions appear to be driven by the type of disclosures, highlighting the importance of the forensic interview in ensuring appropriate child protection plans. Published by Elsevier Ltd.

  19. Service Journalism in the Association Magazine: A Case Study of the "Angus Journal."

    Science.gov (United States)

    Jeffers, Dennis W.

    Examining the role of service journalism in association magazines (magazines focusing on technical and educational information relating to specific practices of association members), a case study of the "Angus Journal" (a monthly magazine devoted to the beef breeding industry) investigated the problem of determining the amount of service…

  20. 76 FR 37876 - Hours of Service (HOS) of Drivers; Renewal of American Pyrotechnics Association (APA) Exemption...

    Science.gov (United States)

    2011-06-28

    ...-28043] Hours of Service (HOS) of Drivers; Renewal of American Pyrotechnics Association (APA) Exemption... announces the renewal of the exemption of specified members of the American Pyrotechnics Association (APA... of this exemption in effect, designated APA-member motor carriers will maintain a level of safety...

  1. 77 FR 38378 - Hours of Service (HOS) of Drivers; Revision of Exemption; American Pyrotechnics Association (APA)

    Science.gov (United States)

    2012-06-27

    ...-28043] Hours of Service (HOS) of Drivers; Revision of Exemption; American Pyrotechnics Association (APA... Pyrotechnics Association (APA) that were granted an exemption from FMCSA's prohibition on driving commercial...-July 8, inclusive, in 2011 and 2012. The exemption covered renewal of 53 APA-member motor carriers and...

  2. 76 FR 37880 - Hours of Service (HOS) of Drivers; Granting of Exemption; American Pyrotechnics Association (APA)

    Science.gov (United States)

    2011-06-28

    ...-28043] Hours of Service (HOS) of Drivers; Granting of Exemption; American Pyrotechnics Association (APA... exemption from the American Pyrotechnics Association (APA) on behalf of 9 member motor carriers seeking... such exemption'' (49 U.S.C. 31315(b)(1)). The initial APA application for waiver or exemption relief...

  3. 76 FR 30232 - Hours of Service (HOS) of Drivers; Application of American Pyrotechnics Association (APA) for...

    Science.gov (United States)

    2011-05-24

    ...-28043] Hours of Service (HOS) of Drivers; Application of American Pyrotechnics Association (APA) for... American Pyrotechnics Association (APA) has applied for a limited exemption from FMCSA's regulation that... exemption would apply solely to the operation of CMVs by 9 designated APA-member motor carriers in...

  4. Boys with conduct problems and callous-unemotional traits: Neural response to reward and punishment and associations with treatment response

    Directory of Open Access Journals (Sweden)

    Amy L. Byrd

    2018-04-01

    Full Text Available Abnormalities in reward and punishment processing are implicated in the development of conduct problems (CP, particularly among youth with callous-unemotional (CU traits. However, no studies have examined whether CP children with high versus low CU traits exhibit differences in the neural response to reward and punishment. A clinic-referred sample of CP boys with high versus low CU traits (ages 8–11; n = 37 and healthy controls (HC; n = 27 completed a fMRI task assessing reward and punishment processing. CP boys also completed a randomized control trial examining the effectiveness of an empirically-supported intervention (i.e., Stop-Now-And-Plan; SNAP. Primary analyses examined pre-treatment differences in neural activation to reward and punishment, and exploratory analyses assessed whether these differences predicted treatment outcome. Results demonstrated associations between CP and reduced amygdala activation to punishment independent of age, race, IQ and co-occurring ADHD and internalizing symptoms. CU traits were not associated with reward or punishment processing after accounting for covariates and no differences were found between CP boys with high versus low CU traits. While boys assigned to SNAP showed a greater reduction in CP, differences in neural activation were not associated with treatment response. Findings suggest that reduced sensitivity to punishment is associated with early-onset CP in boys regardless of the level of CU traits. Keywords: Conduct problems, Callous-unemotional (CU traits, Reward, Punishment, fMRI

  5. Gunite and associated tanks dry well conductivity monitoring report, Oak Ridge National Laboratory, Oak Ridge, Tennessee, February 1998 - December 1998

    International Nuclear Information System (INIS)

    1999-04-01

    A waste removal program is being implemented for the Gunite and Associated Tanks Operable Unit at Oak Ridge National Laboratory, Oak Ridge, Tennessee. The waste is being removed by means of remotely operated, in-tank, confined sluicing equipment. During sluicing operations the dry wells adjacent to each of the tanks are instrumented so that potential releases can be detected by means external to the tank. The method of detection is by monitoring the electrical conductivity of the water in the dry well associated with each tank. This report documents the dry well conductivity monitoring data for the period from February 1998 through December 1998. The dry wells monitored during this period include DW-5, DW-6, DW-7, DW-8, DW-9 and DW-10. The conductivity of the water passing through Pump Station 1 (PS1) was also monitored. During this period the sluicing activities at Tank W-6 were initiated and successfully completed. In addition, flight mixers were used to remove wastes from Tank W-5, and sluicing operations were initiated on Tank W-7. Presented in this report are the dry well conductivity, rainfall, tank level, and other appropriate information relevant to the analysis and interpretation of the monitoring data for the reporting period. A thorough analysis of the monitoring results from the six dry wells in the STF and PS1 for the period between February 1998 and December 1998 indicates that no releases have occurred from the gunite tanks being monitored. Overall, the dry well conductivity monitoring continues to provide a robust and sensitive method for detecting potential releases from the gunite tanks and for monitoring seasonal and construction-related changes in the dry well and drain system

  6. Prison health service directors' views on research priorities and organizational issues in conducting research in prison: outcomes of a national deliberative roundtable.

    Science.gov (United States)

    Simpson, Paul Leslie; Guthrie, Jill; Butler, Tony

    2017-06-12

    Purpose Given that prisoners have significant health needs across most areas, the paucity of prisoner health research, and the difficulties involved in the conduct of research in this setting, there is a need to develop research priorities that align with key stakeholder groups. One such group are those responsible for health service provision in prisons - prison health service directors. The paper aims to discuss these issues. Design/methodology/approach Prison health service directors in each Australian state and territory were invited to participate in a national (deliberative) roundtable where the consensus building nominal group technique was utilized. This involved the identification of research priorities and organizational issues in conducting research with prisoners, and ranking research priorities. A thematic analysis was conducted on organizational issues. Findings In total, 13 participants attended the roundtable. Participants identified 28 research priorities and 12 organizational issues. Top ranked research priorities were mental health, cognitive and intellectual disability, post-release health maintenance, ageing prisoners, chronic health conditions and Aboriginal and Torres Strait Islander health. Themes identified from the organizational issues included prisoner access to research participation, health and research literacy of custodial staff, and institutional protectionism in response to research that may discover negative information about the custodial setting. Research limitations/implications These findings should inform future efforts to improve research infrastructures to undertake research to improve the health of people in Australian prisons, and help to align researchers' efforts with those of a key organizational stakeholder. Originality/value This is the first paper to determine the research priorities and organizational issues in conducting research in prisons of prison health service directors.

  7. [Quality management is associated with high quality services in health care].

    Science.gov (United States)

    Nielsen, Tenna Hassert; Riis, Allan; Mainz, Jan; Jensen, Anne-Louise Degn

    2013-12-09

    In these years, quality management has been the focus in order to meet high quality services for the patients in Danish health care. This article provides information on quality management and quality improvement and it evaluates its effectiveness in achieving better organizational structures, processes and results in Danish health-care organizations. Our findings generally support that quality management is associated with high quality services in health care.

  8. Distribution of conductive minerals as associated with uranium minerals at Dendang Arai sector by induced polarization method

    International Nuclear Information System (INIS)

    Nurdin, M.; Nikijuluw, N.; Subardjo; Sudarto, S.

    2000-01-01

    Based on previous investigation results, a favourable zone of 20-80 meters in wide, 80-240 meters in length and in the direction of East-West to Northwest-Southeast was found. The favourable zone is conductor, associated with sulfide. Induced polarization method has been applied to find vertical and horizontal sulfide distribution. The measurement was conducted in perpendicular to lateral direction of the conductive zone in an interval of 20 meters. Properties measured are apparent resistivity and charge ability. Measurement results indicated the presence of sulfide zone with the position and dip are sub-vertical. Sulfide zones were found on the fault cross-point with the directions being East-West to East South East-West North West by fault is North-South. This anomalies were then represented in 3 (three) dimension tomographic model. (author)

  9. Difficulties in conducting a randomized controlled trial of health service interventions in intellectual disability: implications for evidence-based practice.

    Science.gov (United States)

    Oliver, P C; Piachaud, J; Done, J; Regan, A; Cooray, S; Tyrer, P

    2002-05-01

    In an era of evidence-based medicine, practice is constantly monitored for quality in accordance with the needs of clinical governance (Oyebode et al. 1999). This is likely to lead to a dramatic change in the treatment of those with intellectual disability (ID), in which evidence for effective intervention is limited for much that happens in ordinary practice. As Fraser (2000, p. 10) has commented, the word that best explains "the transformation of learning disability practice in the past 30 years is 'enlightenment'." This is not enough to satisfy the demands of evidence, and Fraser exhorted us to embrace more research-based practice in a subject that has previously escaped randomized controlled trials (RCTs) of treatment because of ethical concerns over capacity and consent, which constitute a denial of opportunity which "is now at last regarded as disenfranchising". The present paper describes the difficulties encountered in setting up a RCT of a common intervention, i.e. assertive community treatment, and concludes that a fundamental change in attitudes to health service research in ID is needed if proper evaluation is to prosper.

  10. 13 CFR 107.900 - Management fees for services provided to a Small Business by Licensee or its Associate.

    Science.gov (United States)

    2010-01-01

    ... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Management fees for services... Licensees Management Services and Fees § 107.900 Management fees for services provided to a Small Business... apply to management services that you or your Associate provide to a Small Business that you do not...

  11. Environmental risk factors associated with the persistence of conduct difficulties in children with intellectual disabilities and autistic spectrum disorders.

    Science.gov (United States)

    Emerson, Eric; Blacher, Jan; Einfeld, Stewart; Hatton, Chris; Robertson, Janet; Stancliffe, Roger J

    2014-12-01

    We investigated the association between exposure to environmental risks in early childhood and the prevalence and persistence of conduct difficulties (CD) in children with intellectual disability (ID) who did not have autistic spectrum disorder (ASD), children with ASD and typically developing (TD) children. Results indicated that: (1) exposure to risk was associated with elevated prevalence of CD at age three and, for TD children and children with ID, increased risk of CD persisting to ages five and seven; (2) at all levels of risk, children with ASD were more likely to show persistent CD than other children; (3) children with ID were no more likely to show persistent CD than TD children at low levels of exposure to environmental risk. Copyright © 2014 Elsevier Ltd. All rights reserved.

  12. The management of heat stress for the firefighter: a review of work conducted on behalf of the Toronto Fire Service.

    Science.gov (United States)

    McLellan, Tom M; Selkirk, Glen A

    2006-07-01

    This report provides a summary of research conducted through a grant provided by the Workplace Safety Insurance Board of Ontario. The research was divided into two phases; first, to define safe work limits for firefighters wearing their protective clothing and working in warm environments; and, the second, to examine strategies to reduce the thermal burden and extend the operational effectiveness of the firefighter. For the first phase, subjects wore their protective ensemble and carried their self-contained breathing apparatus (SCBA) and performed very light, light, moderate or heavy work at 25 degrees C, 30 degrees C or 35 degrees C. Thermal and evaporative resistance coefficients were obtained from thermal manikin testing that allowed the human physiological responses to be compared with modeled data. Predicted continuous work times were then generated using a heat strain model that established limits for increases in body temperature to 38.0 degrees C, 38.5 degrees C and 39.0 degrees C. Three experiments were conducted for the second phase of the project. The first study revealed that replacing the duty uniform pants that are worn under the bunker pants with shorts reduced the thermal strain for activities that lasted longer than 60 min. The second study examined the importance of fluid replacement. The data revealed that fluid replacement equivalent to at least 65% of the sweat lost increased exposure time by 15% compared with no fluid replacement. The last experiment compared active and passive cooling. Both the use of a mister or forearm and hand submersion in cool water significantly increased exposure time compared with passive cooling that involved only removing most of the protective clothing. Forearm and hand submersion proved to be most effective and produced dramatic increases in exposure time that approximated 65% compared with the passive cooling procedure. When the condition of no fluid replacement and passive cooling was compared with fluid

  13. Skin Conductance Level Reactivity Moderates the Association Between Parental Psychological Control and Relational Aggression in Emerging Adulthood.

    Science.gov (United States)

    Wagner, Caitlin R; Abaied, Jamie L

    2016-04-01

    When studying factors that may heighten risk for relational aggression in youth, it is important to consider characteristics of both the individual and their environment. This research examined the associations between parental psychological control and reactive and proactive relational aggression in emerging adults in college. Given that sympathetic nervous system (SNS) activation may underlie differences between reactive and proactive aggression and has been shown to moderate the effects of parenting on youth development, the moderating role of SNS reactivity [indexed by skin conductance level reactivity (SCLR)] was also examined. Emerging adults (N = 180; 77.2 % female) self-reported on perceptions of parental psychological control and reactive and proactive relational aggression. SCLR was assessed in response to an interpersonal laboratory challenge task. Parental psychological control was positively associated with reactive relational aggression only for emerging adults who exhibited high SCLR. Parental psychological control was positively associated with proactive relational aggression only among emerging adults who showed low SCLR. This study extends previous research on parenting and aggression and suggests that parental psychological control is differentially associated with reactive versus proactive relational aggression, depending on emerging adults' SCLR to interpersonal stress.

  14. [Gender violence and other factors associated with emotional distress in female users of public health services in Mexico].

    Science.gov (United States)

    Valdez-Santiago, Rosario; Juárez-Ramírez, Clara; Salgado-de Snyder, V Nelly; Agoff, Carolina; Avila-Burgos, Leticia; Híjar, Martha C

    2006-01-01

    To identify and describe the factors associated with emotional distress in a national sample of women users of public health services in Mexico, such a Secretaria de Salud (SSA), Instituto Mexicano del Seguro Social (IMSS), Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (ISSSTE). This research study was conducted using the database of the National Survey of Violence against Women that consisted of the responses of a total of 26 042 female users of health care services provided by the Mexican government health agencies. The Personal Health Scale (ESP per its initials in Spanish) was used to assess emotional distress. To measure violence a 19-item scale which explores different types of violence as well as severity was used. The relationship between emotional distress and gender violence was determined through a binary logistic regression model, as were economic status and demographic variables. One of the most important findings of this study is the high prevalence of emotional distress (15.3%) among women seeking health care services from the public sector and the relationship of such emotional distress with the experience of marital physical, psychological, and sexual violence. Factors associated with emotional distress among female users of health care services were age (26 and older); activity (laborer); working hours (71 hours a week or more); alcohol intake (greater intake); abuse during childhood (frequency and types of abuse); severity of marital violence (severe violence); socioeconomic status (very low SES); and type of dwelling (urban). The principal predictor of emotional distress was intimate partner abuse, especially in severe expression. The next predictor was violence in childhood. Taking into consideration these predictors it is recommended to use screening instruments to identify emotional distress and gender violence in health setting. It is important to design and implement attention and reference programs in public

  15. Demand for long acting and permanent contraceptive methods and associated factors among family planning service users, Batu town, Central Ethiopia.

    Science.gov (United States)

    Haile, Anley; Fantahun, Mesganaw

    2012-01-01

    Evidence suggests a high unsatisfied demand for long acting and permanent contraceptive methods in sub-Saharan Africa. However, there is limited knowledge on demand for long acting and permanent contraceptive methods and associated factors in Ethiopia. The objective of this study was to assess demand for long acting and permanent contraceptive methods and associated factors among women of age group 18-49 years in Batu town, East Shoa Zone, Ethiopia. A facility based cross-sectional survey was conducted in six service delivery points from March to April 2009 on 398 women of age 18-49 years old. Thirteen (3%) were using long acting and permanent contraceptive methods and 89 (22.4%) wanted no more child in the future making the total demand of long acting and permanent contraceptive methods 24.4%. Older age group, multiparty, that the provider asked about reproductive intention, and the provider explained side effects of method selected were significantly associated with using LA and MPs (P demand and several socio demographic and family planning service quality related factors were associated with demand for long acting and permanent contraceptive methods indicating that multi-dimensional measures are needed to improve the use of long acting and permanent contraceptive methods.

  16. Frequent users of emergency services: associated factors and reasons for seeking care

    Directory of Open Access Journals (Sweden)

    Aline Marques Acosta

    2015-04-01

    Full Text Available Aim: to identify the profile of frequent users of emergency services, to verify the associated factors and to analyze the reasons for the frequent use of the services. METHOD: An explanatory sequential type mixed method was adopted. Quantitative data were collected from the electronic medical records, with a sample of 385 users attended four or more times in an emergency service, during the year 2011. Qualitative data were collected through semi-structured interviews with 18 users, intentionally selected from the results of the quantitative stage. Quantitative data were analyzed using descriptive and inferential statistics and qualitative data using thematic analysis. RESULTS: It was found that 42.9% were elderly, 84.9% had chronic diseases, 63.5% were classified as urgent, 42.1% stayed for more than 24 hours in the service and 46.5% were discharged. Scheduled follow-up appointment, risk classification, length of stay and outcome were factors associated with frequent use. The reasons for seeking the services were mainly related to the exacerbation of chronic diseases, to easier access and concentration of technology, to the bond, and to the scheduled appointments. CONCLUSIONS: The results contribute to comprehending the repeated use of emergency services and provide additional data to plan alternatives to reduce frequent use.

  17. A mixed-methods approach to conducting Internal Revenue Service-compliant community health needs assessments: a case example for nonprofit hospital leaders

    Directory of Open Access Journals (Sweden)

    Oglesby WH

    2014-10-01

    Full Text Available Willie H Oglesby, Ken Slenkovich Department of Health Policy and Management, College of Public Health, Kent State University, Kent, OH, USA Background: The Patient Protection and Affordable Care Act created new requirements for nonprofit hospitals to conduct a Community Health Needs Assessment (CHNA at least once every 3 years, with a significant tax penalty for noncompliance. While some resources exist to help nonprofit hospital leaders conduct various aspects of a CHNA, few reflect the new Internal Revenue Service requirements. Methods: Many different models of CHNAs have emerged over the years. Although each has its unique features, the essential elements of a CHNA include engaging stakeholders, defining the community, gathering sufficient representative data, prioritizing information, and reporting results. In this paper, we expand upon this basic approach by offering a practical step-by-step guide to conducting CHNAs that meets new Internal Revenue Service regulations. Results: We developed and tested this methodology in partnership with several nonprofit hospital systems in Northeast Ohio, USA. In this paper, we discuss our use of the methodology and identify recommendations for other nonprofit hospital leaders. Conclusion: The methodology presented in this paper is a cost-effective approach to satisfying new CHNA requirements and nonprofit hospital leaders should consider using it or modifying it to fit their unique needs. Keywords: Affordable Care Act, CHNA, community benefit, community hospital

  18. Association between full service and fast food restaurant density, dietary intake and overweight/obesity among adults in Delhi, India

    Directory of Open Access Journals (Sweden)

    Opal Patel

    2017-07-01

    Full Text Available Abstract Background The food environment has been implicated as an underlying contributor to the global obesity epidemic. However, few studies have evaluated the relationship between the food environment, dietary intake, and overweight/obesity in low- and middle-income countries (LMICs. The aim of this study was to assess the association of full service and fast food restaurant density with dietary intake and overweight/obesity in Delhi, India. Methods Data are from a cross-sectional, population-based study conducted in Delhi. Using multilevel cluster random sampling, 5364 participants were selected from 134 census enumeration blocks (CEBs. Geographic information system data were available for 131 CEBs (n = 5264 from a field survey conducted using hand-held global positioning system devices. The number of full service and fast food restaurants within a 1-km buffer of CEBs was recorded by trained staff using ArcGIS software, and participants were assigned to tertiles of full service and fast food restaurant density based on their resident CEB. Height and weight were measured using standardized procedures and overweight/obesity was defined as a BMI ≥25 kg/m2. Results The most common full service and fast food restaurants were Indian savory restaurants (57.2% and Indian sweet shops (25.8%. Only 14.1% of full service and fast food restaurants were Western style. After adjustment for age, household income, education, and tobacco and alcohol use, participants in the highest tertile of full service and fast food restaurant density were less likely to consume fruit and more likely to consume refined grains compared to participants in the lowest tertile (both p < 0.05. In unadjusted logistic regression models, participants in the highest versus lowest tertile of full service and fast food restaurant density were significantly more likely to be overweight/obese: odds ratio (95% confidence interval, 1.44 (1.24, 1.67. After adjustment for age

  19. Risk and Protective Factors Associated with Gambling Products and Services: Indigenous Gamblers in North Queensland

    Science.gov (United States)

    Breen, Helen

    2012-01-01

    As part of a larger study, this paper reports on findings into risk and protective factors associated with gambling products and services by Indigenous Australians. Both Indigenous card gambling (traditional or unregulated) and commercial gambling (regulated) were investigated. Permission was granted by Indigenous Elders and by a university ethics…

  20. National Association of School Psychologists Model for Comprehensive and Integrated School Psychological Services

    Science.gov (United States)

    School Psychology Review, 2010

    2010-01-01

    The mission of the National Association of School Psychologists (NASP) is to represent school psychology and support school psychologists to enhance the learning and mental health of all children and youth. "School psychologists" provide effective services to help children and youth succeed academically, socially, behaviorally, and emotionally.…

  1. a te atal care service utilizatio ad associated factors i metekel zo e

    African Journals Online (AJOL)

    user

    access to the service in Ethiopia in general and in Benishangul Gumuz Region in particular. ... associated with low utilization of Antenatal care in Metekel Zone are not well assed before. ... information, education and communication, promoting female education, improving .... the proposal by ethical review committee of.

  2. Predisposing, enabling, and need factors associated with high service use in a public mental health system.

    Science.gov (United States)

    Lindamer, Laurie A; Liu, Lin; Sommerfeld, David H; Folsom, David P; Hawthorne, William; Garcia, Piedad; Aarons, Gregory A; Jeste, Dilip V

    2012-05-01

    The purpose of this study was twofold: (1) To investigate the individual- and system-level characteristics associated with high utilization of acute mental health services according to a widely-used theory of service use-Andersen's Behavioral Model of Health Service Use -in individuals enrolled in a large, public-funded mental health system; and (2) To document service utilization by high use consumers prior to a transformation of the service delivery system. We analyzed data from 10,128 individuals receiving care in a large public mental health system from fiscal years 2000-2004. Subjects with information in the database for the index year (fiscal year 2000-2001) and all of the following 3 years were included in this study. Using logistic regression, we identified predisposing, enabling, and need characteristics associated with being categorized as a single-year high use consumer (HU: >3 acute care episodes in a single year) or multiple-year HU (>3 acute care episodes in more than 1 year). Thirteen percent of the sample met the criteria for being a single-year HU and an additional 8% met the definition for multiple-year HU. Although some predisposing factors were significantly associated with an increased likelihood of being classified as a HU (younger age and female gender) relative to non-HUs, the characteristics with the strongest associations with the HU definition, when controlling for all other factors, were enabling and need factors. Homelessness was associated with 115% increase in the odds of ever being classified as a HU compared to those living independently or with family and others. Having insurance was associated with increased odds of being classified as a HU by about 19% relative to non-HUs. Attending four or more outpatient visits was an enabling factor that decreased the chances of being defined as a HU. Need factors, such as having a diagnosis of schizophrenia, bipolar disorder or other psychotic disorder or having a substance use disorder

  3. CONSUMER EXPECTATION ON SERVICE QUALITY PROVIDE BY PHARMACIST IN SELF MEDICATION PRACTICES AND ITS ASSOCIATED FACTORS IN BANDUNG, INDONESIA.

    Science.gov (United States)

    Alfian, Sofa D; Sinuraya, Rano K; Kautsar, Angga P; Abdulah, Rizky

    2016-11-01

    Self-medication is the use of medicines for therapeutic intent without a clinician’s advice or prescription. The National Socioeconomic Survey for Indonesia in 2009 found the percentage of the Indonesians engaging in self-medication is increasing. The objectives of this study were to assess consumers’ expectations regarding service quality provide by pharmacist in self-medication practices and determine the factors associated with self-medication in Bandung, Indonesia. We conduct a cross-sectional survey at eight randomly selected community pharmacies during July-November 2012 and purposely sampled 1,200 costumers purchasing medication at those sites. Subjects reported they understood the information about the medicines given by the pharmacist but still wanted more information and time to consult with the pharmacist about their medicines. Factors associated with self-medication were younger age, male gender, greater education and lower income. The intervention is needed to improve appropriate self-medication.

  4. Association Between Helicopter vs Ground Emergency Medical Services and Survival for Adults With Major Trauma

    Science.gov (United States)

    Galvagno, Samuel M.; Haut, Elliott R.; Zafar, S. Nabeel; Millin, Michael G.; Efron, David T.; Koenig, George J.; Baker, Susan P.; Bowman, Stephen M.; Pronovost, Peter J.; Haider, Adil H.

    2012-01-01

    Context Helicopter emergency medical services and their possible effect on outcomes for traumatically injured patients remain a subject of debate. Because helicopter services are a limited and expensive resource, a methodologically rigorous investigation of its effectiveness compared with ground emergency medical services is warranted. Objective To assess the association between the use of helicopter vs ground services and survival among adults with serious traumatic injuries. Design, Setting, and Participants Retrospective cohort study involving 223 475 patients older than 15 years, having an injury severity score higher than 15, and sustaining blunt or penetrating trauma that required transport to US level I or II trauma centers and whose data were recorded in the 2007–2009 versions of the American College of Surgeons National Trauma Data Bank. Interventions Transport by helicopter or ground emergency services to level I or level II trauma centers. Main Outcome Measures Survival to hospital discharge and discharge disposition. Results A total of 61 909 patients were transported by helicopter and 161 566 patients were transported by ground. Overall, 7813 patients (12.6%) transported by helicopter died compared with 17 775 patients (11%) transported by ground services. Before propensity score matching, patients transported by helicopter to level I and level II trauma centers had higher Injury Severity Scores. In the propensity score–matched multivariable regression model, for patients transported to level I trauma centers, helicopter transport was associated with an improved odds of survival compared with ground transport (odds ratio [OR], 1.16; 95% CI, 1.14–1.17; P<.001; absolute risk reduction [ARR], 1.5%). For patients transported to level II trauma centers, helicopter transport was associated with an improved odds of survival (OR, 1.15; 95% CI, 1.13–1.17; P < .001; ARR, 1.4%). A greater proportion (18.2%) of those transported to level I trauma centers

  5. Factors associated with the choice of public health service among nursing students in Thailand.

    Science.gov (United States)

    Sawaengdee, Krisada; Pudpong, Nareerut; Wisaijohn, Thunthita; Suphanchaimat, Rapeepong; Putthasri, Weerasak; Lagarde, Mylene; Blaauw, Duane

    2017-01-01

    Despite the fact that public and private nursing schools have contributed significantly to the Thai health system, it is not clear whether and to what extent there was difference in job preferences between types of training institutions. This study aimed to examine attitudes towards rural practice, intention to work in public service after graduation, and factors affecting workplace selection among nursing students in both public and private institutions. A descriptive comparative cross-sectional survey was conducted among 3349 students from 36 nursing schools (26 public and 10 private) during February-March 2012, using a questionnaire to assess the association between training institution characteristics and students' attitudes, job choices, and intention to work in the public sector upon graduation. Comparisons between school types were done using ANOVA, and Bonferroni-adjusted multiple comparisons tests. Principal component analysis (PCA) was used to construct a composite rural attitude index ( 14 questions). Cronbach's alpha was used to examine the internal consistency of the scales, and ANOVA was then used to determine the differences. These relationships were further investigated through multiple regression. A higher proportion of public nursing students (86.4% from the Ministry of Public Health and 74.1% from the Ministry of Education) preferred working in the public sector, compared to 32.4% of students from the private sector ( p  = public nursing schools were less motivated by financial incentive regarding workplace choices relative to students trained by private institutions. To increase nursing workforce in the public sector, the following policy options should be promoted: 1) recruiting more students with a rural upbringing, 2) nurturing good attitudes towards working in rural areas through appropriate training at schools, 3) providing government scholarships for private students in exchange for compulsory work in rural areas, and 4) providing a

  6. Cost-effectiveness analysis on the results of screening of lung cancer using helical CT conducted by the anti-lung cancer association (ALCA)

    International Nuclear Information System (INIS)

    Iinuma, Takeshi; Kaneko, Masahiro; Moriyama, Noriyuki; Misawa, Jun

    1999-01-01

    To compare Yen/person saved in lung cancer screening using helical CT with Yen/person in the screening using conventional direct chest X-rays conducted under the Anti-lung cancer association program of the Tokyo Health Service Association. A mathematical model for cancer screening was used to estimate net number of person relieved from lung cancer by the screening and net cost required for the screening. Finally cost-effectiveness ratios in terms of Yen/person saved were calculated and compared between the two programs. Several important variables employed in the model were as follows: 5 year survival rate in chest X-ray group was 50%, and the rate in helical CT group was 75%. Cost of screening in the chest X-ray group was 15,000 Yen, and that in the helical CT group was 25,000 Yen. Cost/person screened was 14,470 Yen for chest X-ray and 21,890 Yen for helical CT. Cost/person saved was 267 x 10 5 Yen in X-ray group and 112 x 10 5 Yen in CT group. Thus the cost was higher, but cost-effectiveness ratio was better in the CT screening group. Helical CT can be adopted for lung cancer screening in stead of chest X-ray if total cost is affordable. (author)

  7. Mastery of mothering skills and satisfaction with associated health services: an ethnocultural comparison.

    Science.gov (United States)

    Whitley, Rob

    2009-09-01

    In this paper, I examine the mastery of mothering skills and satisfaction with associated health services in women who had recently given birth in Montreal (n = 33). I compare experience between women of two distinct ethnocultural groups: Anglophone Euro-Canadian and Anglophone Afro-Caribbean. The overall aim is to discern differentials in the mastery of mothering skills and associated satisfaction with maternal and child health services. The study is framed by neo-Weberian social theory suggesting that modernization and bureaucratization increasingly eviscerate everyday skills and knowledge. These processes also lead to changes regarding what is considered credible 'authoritative knowledge.' I found that older Anglophone Euro-Canadians expressed the greatest skill deficits. They attempted to redress these deficits through consultation of professionally authored books, medical Web sites and health professionals. Older Anglophone Euro-Canadians saw these resources as sources of 'authoritative knowledge.' They also expressed dissatisfaction with related health services. In contrast, Anglophone Afro-Caribbeans and younger lower-income Anglophone Euro-Canadians expressed satisfaction with their skills. This derived from widespread previous experience with children and more extensive and readily available kith and kin networks. These were considered sources of 'authoritative knowledge' in this group. This group expressed less dissatisfaction with health services, as they did not need, or expect, these services to redress skill deficits.

  8. Associations between Prenatal and Early Childhood Fish and Processed Food Intake, Conduct Problems, and Co-Occurring Difficulties.

    Science.gov (United States)

    Mesirow, Maurissa Sc; Cecil, Charlotte; Maughan, Barbara; Barker, Edward D

    2017-07-01

    Little is known about early life diet as a risk factor for early-onset persistent conduct problems (EOP CP). To investigate this, we used data from the Avon Longitudinal Study of Parents and Children, a UK-based prospective epidemiological birth cohort. 5727 mother-child pairs (49.9 % boys) monitored since pregnancy (delivery date between 1 April, 1991 and 31 December, 1992) reported intake of fish and processed foods at 32 weeks gestation and, for the child, at 3 years; EOP (n = 666) and Low conduct problem (Low CP, n = 5061) trajectories were measured from 4 to 13 years; hyperactivity and emotional difficulties were assessed in childhood (4-10 years) and early adolescence (12-13 years), in addition to potential confounding factors (family adversity, birth complications, income). Compared to Low CP, mothers of EOP children consumed less fish (p processed food (p processed food at 3 years (p processed food (vs. less than one serving/day, p processed food, and low in fish, associate with an EOP CP trajectory and co-occurring difficulties in early adolescence. As small effect size differences were found, further studies are needed to investigate the long-term impact of early unhealthy diet.

  9. On the extraction of ion association data and transference numbers from ionic diffusivity and conductivity data in polymer electrolytes

    International Nuclear Information System (INIS)

    Stolwijk, Nicolaas A.; Kösters, Johannes; Wiencierz, Manfred; Schönhoff, Monika

    2013-01-01

    The degree of ion association in polymer electrolytes is often characterized by the Nernst–Einstein deviation parameter Δ, which quantifies the relative difference between the true ionic conductivity directly measured by electrical methods and the hypothetical maximum conductivity calculated from the individual ionic self-diffusion coefficients. Despite its unambiguous definition, the parameter Δ is a global quantity with limited explanatory power. Similar is true for the cation transport number t cat * , which relies on the same ionic diffusion coefficients usually measured by nuclear magnetic resonance or radiotracer methods. Particularly in cases when neutral ion pairs dominate over higher-order aggregates, more specific information can be extracted from the same body of experimental data that is used for the calculation of Δ and t cat * . This information concerns the pair contributions to the diffusion coefficient of cations and anions. Also the true cation transference number based on charged species only can be deduced. We present the basic theoretical framework and some pertinent examples dealing with ion pairing in polymer electrolytes

  10. Factors associated with the utilization of institutional delivery services in Bangladesh.

    Science.gov (United States)

    Yaya, Sanni; Bishwajit, Ghose; Ekholuenetale, Michael

    2017-01-01

    Bangladesh has made remarkable progress towards reducing its maternal mortality rate (MMR) over the last two decades and is one of the few countries on track to achieving the MMR-related Millennium Development Goals (MDG-5A). However, the provision of universal access to reproductive healthcare (MDG-5B) and the utilization of maternal healthcare services (MHS) such as institutional delivery, which are crucial to the reduction of maternal mortality, are far behind the internationally agreed-upon target. Effective policymaking to promote the utilization of MHS can be greatly facilitated by the identification of the factors that hinder service uptake. In this study, we therefore aim to measure the prevalence of institutional delivery services and explore the factors associated with their utilization in Bangladesh. Data for this study were extracted from the 2011 Bangladesh Demographic and Health Survey (BDHS, 2011); participants were 7,313 women between the ages of 15 and 49 years, selected from both urban and rural households. Data were analyzed using Chi-square analysis, and conditional logistic regression. According to the findings, fewer than one in three women reported delivering at a health facility. The multivariable regression analysis showed that participants from rural areas were 46.9% less likely to have institutional deliveries compared to urban dwellers (OR = 0.531; pdelivery service utilization compared to those aged 15 to 29 years (OR = 1.236; p = 0.006; 95%CI: 1.062-1.437). Moreover, participants with higher educational attainment were about twice as likely to deliver at a standard health facility when compared to those without formal education (OR = 2.081; pservice utilization of institutional delivery facilities compared to those without formal education (OR = 1.709; pdelivery service use, with participants belonging to the highest economic stratum being more likely to receive skilled care compared to the lowest economic stratum (OR = 2

  11. Factors associated with non-reimbursable activity on an inpatient pediatric consultation-liaison service.

    Science.gov (United States)

    Bierenbaum, Melanie L; Katsikas, Steven; Furr, Allen; Carter, Bryan D

    2013-12-01

    The aim of this study was to identify factors contributing to clinician time spent in non-reimbursable activity on an inpatient pediatric consultation-liaison (C-L) service. A retrospective study was conducted using inpatient C-L service data on 1,246 consecutive referrals. For this patient population, the strongest predictor of level of non-reimbursable clinical activity was illness chronicity and the number of contacts with C-L service clinicians during their hospital stay. Patients with acute life-threatening illnesses required the highest mean amount of non-reimbursable service activity. On average, 28 % of total clinician time in completing a hospital consultation was spent in non-reimbursable activity. Effective C-L services require a proportion of time spent in non-reimbursable clinical activity, such as liaison and coordinating care with other providers. Identifying referral and systemic factors contributing to non-reimbursable activity can provide insight into budgeting/negotiating for institutional support for essential clinical and non-clinical functions in providing competent quality patient care.

  12. Associations of Quality of Life with Service Satisfaction in Psychotic Patients: A Meta-Analysis

    Science.gov (United States)

    Petkari, Eleni; Pietschnig, Jakob

    2015-01-01

    Background Quality of life (QoL) has gained increasing attention as a desired outcome of psychosocial treatments targeting psychotic patients. Yet, the relationship between the patients’ satisfaction with services and QoL has not been clearly established, perhaps due to the multidimensionality of the QoL concept and the variability in its assessment. Aim This is the first systematic meta-analysis of all available evidence assessing the relationship between QoL and service satisfaction. Methods: In all, 19 studies reporting data of 21 independent samples (N = 5,337) were included in the present meta-analysis. In moderator analyses, effects of age, sex, diagnoses (schizophrenia vs. other psychoses), treatment context (inpatients vs. outpatients), study design (cross-sectional vs. longitudinal), and QoL domain (subjective vs. health-related) were examined. Results Analyses revealed a highly significant medium-sized effect (r = .30, p service satisfaction. Effect sizes were significantly stronger for subjective than health-related quality of life (r = .35 vs. r = .14, respectively). Moreover, associations with subjective QoL remained largely robust when accounting for moderating variables, although there was a trend of stronger associations for outpatients compared to inpatients. In contrast, effect sizes for health-related QoL were small and only observable for samples with longitudinal designs. Conclusion Associations between QoL and service satisfaction appear to be robust but are differentiated in regard to QoL domain. Our findings suggest that agents responsible for service design and implementation need to take the patients’ perception of the service adequacy for achieving QoL enhancement into account. PMID:26275139

  13. Changes in Service and Associated Ridership Impacts near a New Light Rail Transit Line

    Directory of Open Access Journals (Sweden)

    Jeongwoo Lee

    2017-10-01

    Full Text Available Los Angeles (LA, for many years a city with limited rail transit, is substantially expanding its public transit system. This paradigm change in transportation policy and investment creates new requirements for monitoring. One area needing evaluation is whether new, high quality transit options, such as light rail, near existing transit services increase sustainable transportation mode shares and reduce car travel. Few studies have explored light rail’s role as a catalyst to increase overall transit use and achieve sustainability goals within an auto-oriented city like LA. Metro’s data show that trips taken on its bus and rail system dropped overall by 10.5% between 2009 and 2016, but its rail ridership grew 21% during the same period due to the debut of the Gold Line and Expo Line extensions. We analyze changes to bus service and associated ridership impacts that resulted from the opening of these two LRT lines in LA. The immediate effect of the city’s bus service changes along the Gold Line light rail extension appear to be associated with a net “bus plus rail” ridership decline in that corridor. In contrast, the Expo Line corridor experienced an initial increase in ridership during the two years immediately after its opening, possibly because the bus service was not reduced by the same magnitude as along the Gold Line extension. Our findings indicate that changes in bus service made to coincide with the introduction of new light rail transit (LRT can negatively affect the overall transit ridership in the corridor. Planners and policy makers should closely monitor changes in bus service and ridership associated with new rail transit to ensure investments results in an overall net increase in more sustainable travel.

  14. Services

    International Nuclear Information System (INIS)

    Hardeman, F.

    1998-01-01

    The objectives of the services section is (1) to offer complete services in health-physics measurements according to international quality standards, (2) to improve continuously these measurement techniques and to follow up international recommendations and legislation concerning the surveillance of workers, (3) to support and advise nuclear and non-nuclear industry on problems of radioactive contamination. Achievements related to gamma spectrometry, whole-body counting, beta and alpha spectrometry, dosimetry, radon measurements, calibration, instrumentation, and neutron activation analysis are described

  15. Association of antipsychotic polypharmacy with health service cost: a register-based cost analysis

    DEFF Research Database (Denmark)

    Baandrup, Lone; Sørensen, Jan; Lublin, Henrik Kai Francis

    2012-01-01

    at the two cross-sectional dates was recorded and used as proxy of polypharmacy exposure during the preceding year. A multivariate generalised linear model was fitted with total costs of primary and secondary health service use as dependent variable, and antipsychotic polypharmacy, diagnosis, age, gender......, disease duration, psychiatric inpatient admissions, and treatment site as covariates. RESULTS: The sample consisted of 736 outpatients with a diagnosis in the schizophrenia spectrum. Antipsychotic polypharmacy was associated with significantly higher total health service costs compared with monotherapy...

  16. Association between attendance at religious services and self-reported health in 22 European countries.

    Science.gov (United States)

    Nicholson, Amanda; Rose, Richard; Bobak, Martin

    2009-08-01

    There are consistent reports of protective associations between attendance at religious services and better self-rated health but existing data rarely consider the social or individual context of religious behaviour. This paper investigates whether attendance at religious services is associated with better self-rated health in diverse countries across Europe. It also explores whether the association varies with either individual-level (gender, educational, social contact) or country-level characteristics (overall level of religious practice, corruption, GDP). Cross-sectional data from round 2 of the European Social Survey were used and 18,328 men and 21,373 women from 22 European countries were included in multilevel analyses, with country as higher level. Compared to men who attended religious services at least once a week, men who never attended were almost twice as likely to describe their health as poor, with an age and education adjusted odds ratio of 1.83 [95% CI, 1.49-2.26]. A similar but weaker effect was seen in women, with an age and education adjusted odds ratio of 1.38 [1.19-1.61]. The associations were reduced only marginally in men by controlling for health status, social contact and country-level variables, but weakened in women. The relationships were stronger in people with longstanding illness, less than university education and in more affluent countries with lower levels of corruption and higher levels of religious belief. These analyses confirm that an association between less frequent attendance at religious services and poor health exists across Europe, but emphasise the importance of taking individual and contextual factors into account. It remains unclear to what extent the observed associations reflect reverse causality or are due to differing perceptions of health.

  17. Health care service utilization and associated factors among heroin users in northern Taiwan.

    Science.gov (United States)

    Chen, Yi-Chih; Chen, Chih-Ken; Lin, Shih-Ku; Chiang, Shu-Chuan; Su, Lien-Wen; Wang, Liang-Jen

    2013-11-01

    Due to the needs of medical care, the probability of using health care service from heroin users is high. This cross-sectional study investigated the frequency and correlates of health service utilization among heroin users. From June to September 2006, 124 heroin users (110 males and 14 females, mean age: 34.2 ± 8.3 years) who entered two psychiatric hospitals (N = 83) and a detention center (N = 41) in northern Taiwan received a face-to-face interview. Therefore, socio-demographic characteristics, patterns of drug use, psychiatric comorbidities, blood-borne infectious diseases and health service utilization were recorded. The behaviors of health service utilization were classified into the frequency of out-patient department visit and hospitalization, as well as the purchase of over-the-counter drugs. During 12 months prior to interview, 79.8% of the participants attended health care service at least once. The rate of having any event in out-patients service visit, hospitalization, and over-the-counter drugs were 66.1%, 29.8% and 25.8% respectively. The frequency of health service utilization was associated with numerous factors. Among these factors, patients who were recruited from hospital and having a mood disorder were conjoint predictors of out-patient department visit, hospitalization and purchase of over-the-counter drugs. According to the results of this study, social education and routine screening for mood disorders can help heroin users to obtain adequate health care service. The findings of this study are useful references for targeting the heroin users for whom a successful intervention represents the greatest cost benefit. © 2013 Elsevier Ltd. All rights reserved.

  18. Factors associated with use of maternal health services in Haiti: a multilevel analysis

    Directory of Open Access Journals (Sweden)

    Stella O. Babalola

    2014-07-01

    Full Text Available OBJECTIVE: To assess factors associated with utilization of maternal health services (MHS among women giving birth in Haiti from 2007 - 2012. METHODS: Observational data derived from the 2012 Haiti Mortality, Morbidity and Service Use Survey are analyzed. Multilevel analytic methods are used to assess factors associated with use of antenatal services and skilled birth attendance (SBA. RESULTS: The strongest adjusted predictors include child's birth rank, household poverty, and community media saturation. The odds of obtaining four antenatal care visits decrease by 53% (odds ratio (OR = 0.47; 95% confidence interval (CI: 0.37-0.57 with high birth rank and by 37% (OR = 0.63; 95% CI: 0.51-0.78 with household poverty, and increase by 38% (OR = 1.38; 95% CI: 1.01-1.88 with high community media saturation. The odds of using SBA at delivery decrease by 72% (OR = 0.28; 95% CI: 0.22-0.34 with high birth rank and by 42% (OR = 0.58; 95% CI: 0.46-0.73 with household poverty, and increase by 92% (OR = 1.92; 95% CI: 1.41-2.61 with high community media saturation. Use of antenatal services is strongly associated with SBA (OR = 2.20; 95% CI: 1.85-2.61. Significant clustering of use of MHS exists at the community level. CONCLUSIONS: Factors associated with use of MHS operate at multiple levels. Efforts to promote such services should identify and pay special attention to the needs of multiparous and uneducated women, address the distance-decay phenomenon, and improve access for the poor. Community mobilization efforts designed to change norms hindering the use of MHS are also relevant.

  19. Factors associated with use of maternal health services in Haiti: a multilevel analysis.

    Science.gov (United States)

    Babalola, Stella O

    2014-07-01

    To assess factors associated with utilization of maternal health services (MHS) among women giving birth in Haiti from 2007 - 2012. Observational data derived from the 2012 Haiti Mortality, Morbidity and Service Use Survey are analyzed. Multilevel analytic methods are used to assess factors associated with use of antenatal services and skilled birth attendance (SBA). The strongest adjusted predictors include child's birth rank, household poverty, and community media saturation. The odds of obtaining four antenatal care visits decrease by 53% (odds ratio (OR) = 0.47; 95% confidence interval (CI): 0.37-0.57) with high birth rank and by 37% (OR = 0.63; 95% CI: 0.51-0.78) with household poverty, and increase by 38% (OR = 1.38; 95% CI: 1.01-1.88) with high community media saturation. The odds of using SBA at delivery decrease by 72% (OR = 0.28; 95% CI: 0.22-0.34) with high birth rank and by 42% (OR = 0.58; 95% CI: 0.46-0.73) with household poverty, and increase by 92% (OR = 1.92; 95% CI: 1.41-2.61) with high community media saturation. Use of antenatal services is strongly associated with SBA (OR = 2.20; 95% CI: 1.85-2.61). Significant clustering of use of MHS exists at the community level. Factors associated with use of MHS operate at multiple levels. Efforts to promote such services should identify and pay special attention to the needs of multiparous and uneducated women, address the distance-decay phenomenon, and improve access for the poor. Community mobilization efforts designed to change norms hindering the use of MHS are also relevant.

  20. Anatomy of the dorsal default-mode network in conduct disorder: Association with callous-unemotional traits.

    Science.gov (United States)

    Sethi, Arjun; Sarkar, Sagari; Dell'Acqua, Flavio; Viding, Essi; Catani, Marco; Murphy, Declan G M; Craig, Michael C

    2018-04-01

    We recently reported that emotional detachment in adult psychopathy was associated with structural abnormalities in the dorsal 'default-mode' network (DMN). However, it is unclear whether these differences are present in young people at risk of psychopathy. The most widely recognised group at risk for psychopathy are children/adolescents with conduct disorder (CD) and callous-unemotional (CU) traits. We therefore examined the microstructure of the dorsal DMN in 27 CD youths (14-with/13-without CU traits) compared to 16 typically developing controls using DTI tractography. Both CD groups had significantly (p < 0.025) reduced dorsal DMN radial diffusivity compared to controls. In those with diagnostically significant CU traits, exploratory analyses (uncorrected for multiple comparisons) suggested that radial diffusivity was negatively correlated with CU severity (Left: rho = -0.68, p = 0.015). These results suggest that CD youths have microstructural abnormalities in the same network as adults with psychopathy. Further, the association with childhood/adolescent measures of emotional detachment (CU traits) resembles the relationship between emotional detachment and network microstructure in adult psychopaths. However, these changes appear to occur in opposite directions - with increased myelination in adolescent CD but reduced integrity in adult psychopathy. Collectively, these findings suggest that developmental abnormalities in dorsal DMN may play a role in the emergence of psychopathy. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

  1. Associations between high callous-unemotional traits and quality of life across youths with non-conduct disorder diagnoses.

    Science.gov (United States)

    Herpers, Pierre C M; Klip, Helen; Rommelse, Nanda N J; Greven, Corina U; Buitelaar, Jan K

    2016-05-01

    Research regarding callous-unemotional (CU) traits in non-conduct disorder (CD) diagnoses is sparse. We investigated the presence of high CU traits and their associations with quality of life (QoL) in a clinically referred sample of youths with non-CD diagnoses. Parents of 1018 children referred to a child and adolescent psychiatric clinic and rated their child's CU traits and QoL. Experienced clinicians derived DSM-IV-TR diagnoses based on systematic clinical evaluations of these children. High CU traits compared to low CU traits were present in 38.5 % of the sample, and more often in boys than girls (69.4 vs. 30.6 %, p = .004), and were associated with more police contacts (12.2 vs. 3.5 %, p disorder (odds ratio; OR = 1.61; 95 % CI 1.24-2.09; p disorder not otherwise specified/oppositional defiant disorder (OR = 4.98; 95 % CI 2.93-8.64; p disorder (OR = 1.01; 95 % CI .79-1.31; p = .94), were more likely to have high than low CU traits. Those with anxiety/mood disorders were more likely to have low than high CU traits (OR = .59; 95 % CI .42-82; p = .002). In all diagnostic groups, high CU compared to low CU traits were associated with significantly lower QoL, while controlling for gender, age, and comorbidity. As such, high CU traits significantly modify QoL in non-CD disorders.

  2. An audit of health products and services marketed on chiropractic websites in Alberta and consideration of these practices in the context of chiropractic codes of conduct and ethics.

    Science.gov (United States)

    Page, Stacey A

    2007-06-01

    Chiropractic's success as a health care profession is evidenced in part by the rising number of practitioners. Paradoxically, this success may start to cost the profession, as the number of consumers may not be increasing proportionally. Fewer patients mean less income for practitioners. Some chiropractors are responding to these pressures by marketing health products, and services. To describe the extent to which Alberta chiropractors with websites sold health products and the extent to which fee discounts/service inducements were advertised. To consider these practices in the context of chiropractic codes of conduct and ethics. Chiropractic websites in the province of Alberta were identified using the online Telus Business Finder and cross-referenced with the Yellow Pages print directories. The websites were searched and an inventory of the health products for sale was recorded. Fee discounts and service inducements were also recorded. 56 websites were identified and reviewed. Just under two-thirds of the chiropractic websites surveyed contained information on health products for sale. Orthotics were sold most often (N = 29 practices; 51.8%), followed by pillows and supports (N = 15: 26.8%), vitamins/nutritional supplements (N = 15; 26.8%) and exercise/rehabilitation products (N = 10; 17.9%). Nine practices (16.1%) offered some type of inducement to potential customers. These included discounts on treatment packages (N = 2; 3.6%), free gait/ posture analyses (N = 2; 3.6%) and free general consultations with the chiropractors (N = 3; 5.4%) The marketing of health care products and services by chiropractors in Alberta is common. Such practices raise ethical considerations for the profession. Professional guidelines vary on the acceptability of these practices. Consumer and practitioner perspectives and practices regarding retailing need to be further examined.

  3. Factors associated with the utilization of institutional and home birth services among women in Ethiopia: A scoping review

    Directory of Open Access Journals (Sweden)

    Bronwyn Lapp

    2016-12-01

    Full Text Available Objective: To examine the factors associated with the use of institutional delivery and home birth services among women in Ethiopia. Methods: Fifteen peer-reviewed, primary research articles published between 2011 and 2015 were selected for this scoping review. The articles included case-control, cross-sectional, and retrospective follow-up studies conducted in Ethiopia. Results: Findings were categorized with use of content and factorial analysis. The data in this scoping review revealed a significant inequality in skilled care use among Ethiopian women with differences in economic status, education, residence, autonomy in decision making, parity, and antenatal care attendance. Conclusion: Sociodemographic, accessibility, and obstetric factors are key determinants of skilled care utilization. Strategies and policy changes to address maternal health service use should aim to improve economic status, facilitate higher education, increase access to care, promote the empowerment of women, and enhance antenatal care initiatives. Additional research should be conducted to evaluate the influence of the media and culture on skilled care utilization, since few studies have examined these factors.

  4. Mental health services for homeless: patient profile and factors associated with suicide and homicide.

    LENUS (Irish Health Repository)

    Dunne, E

    2012-03-01

    This study aimed to establish a profile of users of the mental health service for homeless in Cork, comparing this group with those attending a General Adult Service. The homeless group were significantly more likely to be male (89% v. 46%o), unemployed (96% v. 68%), unmarried (98% v. 75%) and under 65 (94% v. 83%). Diagnostically, there was a significantly higher prevalence of schizophrenia (50% v. 34%); personality disorder (37% v. 11%) and substance dependence (74% v. 19%) in the homeless service users. They were more likely to have a history of deliberate self harm (54% v. 21%) and violence (48% v. 10%). Severe mental illness has a high prevalence in the homeless population, with particularly high levels of factors associated with suicide and homicide. Poor compliance and complexity of illness lead to a requirement for significant input from multidisciplinary mental health teams members.

  5. Association of comorbidities with home care service utilization of patients with heart failure while receiving telehealth.

    Science.gov (United States)

    Radhakrishnan, Kavita; Jacelon, Cynthia S; Bigelow, Carol; Roche, Joan P; Marquard, Jenna L; Bowles, Kathryn H

    2013-01-01

    Comorbidities adversely impact heart failure (HF) outcomes. Telehealth can assist healthcare providers, especially nurses, in guiding their patients to follow the HF regimen. However, factors, including comorbidity patterns, that act in combination with telehealth to reduce home care nursing utilization are still unclear. The purpose of this article was to examine the association of the comorbidity characteristics of HF patients with nursing utilization along with withdrawal from telehealth service during an episode of tele-home care. A descriptive, correlational study design using retrospective chart review was used. The sample comprised Medicare patients admitted to a New England home care agency who had HF as a diagnosis and had used telehealth from 2008 to 2010. The electronic documentation at the home care agency served as the data source, which included Outcome and Assessment Information Set data of patients with HF. Logistic and multiple regression analyses were used to analyze data. The sample consisted of 403 participants, of whom 70% were older than 75 years, 55% were female, and 94% were white. Comorbidities averaged 5.19 (SD, 1.92), ranging from 1 to 11, and nearly 40% of the participants had 5 or more comorbidities. The mean (SD) nursing contacts in the sample was 9.9 (4.7), ranging from 1 to 26, and 52 (12.7%) patients withdrew from telehealth service. For patients with HF on telehealth, comorbidity characteristics of anemia, anxiety, musculoskeletal, and depression were significantly associated with nursing utilization patterns, and renal failure, cancer, and depression comorbidities were significantly associated with withdrawal from telehealth service. Knowledge of the association of comorbidity characteristics with the home care service utilization patterns of patients with HF on telehealth can assist the home health nurse to develop a tailored care plan that attains optimal patient outcomes. Knowledge of such associations would also focus home

  6. Risk estimation in association with diagnostic techniques in the nuclear medicine service of the Camaguey Ciego de Avila Territory

    International Nuclear Information System (INIS)

    Barrerras, C.A.; Brigido, F.O.; Naranjo, L.A.; Lasserra, S.O.; Hernandez Garcia, J.

    1999-01-01

    The nuclear medicine service at the Maria Curie Oncological Hospital, Camaguey, has experience of over three decades in using radiofarmaceutical imaging agents for diagnosis. Although the clinical risk associated with these techniques is negligible, it is necessary to evaluate the effective dose administered to the patient due to the introduction of radioactive substances into the body. The study of the dose administered to the patient provides useful data for evaluating the detriment associated with this medical practice, its subsequently optimization and consequently, for minimizing the stochastic effects on the patient. The aim of our paper is to study the collective effective dose administered by nuclear medicine service to Camaguey and Ciego de Avila population from 1995 to 1998 and the relative contribution to the total annual effective collective dose of the different diagnostic examinations. The studies were conducted on the basis of statistics from nuclear medicine examinations given to a population of 1102353 inhabitants since 1995. The results show that the nuclear medicine techniques of neck examinations with 1168.8 Sv man (1.11 Sv/expl), thyroid explorations with 119.6 Sv man (55.5 mSv/expl) and iodide uptake with 113.7 Sv man (14.0 mSv/expl) are the main techniques implicated in the relative contribution to the total annual effective collective dose of 1419.5 Sv man. The risk estimation in association with diagnostic techniques in the nuclear medicine service studied is globally low (total detriment: 103.6 as a result of 16232 explorations), similar to other published data

  7. Critical incident exposure in South African emergency services personnel: prevalence and associated mental health issues

    Science.gov (United States)

    Ward, C L; Lombard, C J; Gwebushe, N

    2006-01-01

    Objectives To assess critical incident exposure among prehospital emergency services personnel in the developing world context of South Africa; and to assess associated mental health consequences. Methods We recruited a representative sample from emergency services in the Western Cape Province, South Africa, to participate in this cross sectional epidemiological study. Questionnaires covered critical incident exposure, general psychopathology, risky alcohol use, symptoms of post‐traumatic stress disorder (PTSD), and psychological and physical aggression between co‐workers. Open ended questions addressed additional stressors. Results Critical incident exposure and rates of general psychopathology were higher than in studies in the developed world. Exposure to critical incidents was associated with general psychopathology, symptoms of PTSD, and with aggression between co‐workers, but not with alcohol use. Ambulance, fire, and sea rescue services had lower general psychopathology scores than traffic police. The sea rescue service also scored lower than traffic police on PTSD and psychological aggression. The defence force had higher rates of exposure to physical assault, and in ambulance services, younger staff were more vulnerable to assault. Women had higher rates of general psychopathology and of exposure to psychological aggression. Other stressors identified included death notification, working conditions, and organisational problems. Conclusions Service organisations should be alert to the possibility that their personnel are experiencing work ‐related mental health and behavioural problems, and should provide appropriate support. Attention should also be given to organisational issues that may add to the stress of incidents. Workplace programmes should support vulnerable groups, and address death notification and appropriate expression of anger. PMID:16498167

  8. [Attractiveness of France for international clinical research: 8th survey conducted by Leem (French association for pharmaceutical companies)].

    Science.gov (United States)

    Galaup, Ariane; Barthélémy, Philippe; Pouletty-Lefebvre, Brigitte; Béhier, Jehan-Michel; Zetlaoui, Jean; Borel, Thomas

    2018-04-18

    The Leem (French association of pharmaceutical companies) has conducted the eighth survey on attractiveness of France for clinical research. It serves to measure France's global competitiveness for international clinical trials and assess its strengths and areas of excellence. It also highlights the potential for progress and emerging trends at a time when the regulatory environment in France and Europe is undergoing change. This survey has been updated every two years since 2002 using the same methodology. It assesses the current status of research undertaken in France by the pharmaceutical industry between January 1st 2014 and December 31st 2015. Thirty companies (62% of the French market) have participated in this 8th survey which involved 3474 centers (versus 2860 in 2014) and 16,622 patients (versus 14,634 in 2014) enrolled in France across 586 clinical trials (versus 613 in 2014). This survey shows a reduction in the number of phase I and phase II trials. It also confirms that the studies conducted in France are primarily concerned with oncology (45%). Despite improvements across hospital contracts times (due to the adoption of the sole agreement) and performance indicators in trials (such as the number of patients enrolled by center), trial setup times in France are still overly lengthy (with stable times by French authorities). Ensuring that clinical research remains a priority issue for country is crucial for patients because of rapid access to innovation but also for the vitality of the French economy. Constructive dialogue with stakeholders on the subject of clinical research is essential to enhance the attractiveness of France and to improve the continuum between research, innovation and care. Copyright © 2018 Société française de pharmacologie et de thérapeutique. Published by Elsevier Masson SAS. All rights reserved.

  9. Characteristics associated with organizational independence in consumer-operated service organizations.

    Science.gov (United States)

    Tanenbaum, Sandra J

    2011-01-01

    This research compares two types of consumer organizations in one state in order to explore the significance of organizational independence for internal structure/operations and external relationships. The first type, consumeroperated service organizations (COSOs), are independent and fully self-governing; the second are peer-support service organizations (PSSOs), which are part of larger non-consumer entities. Mail surveys were completed by COSO and PSSO directors of a geographically representative sample of organizations; telephone interviews were conducted with a sub-sample. Owing to small sample size, matched COSO-PSSO pairs were analyzed using non-parametric statistics. COSOs and PSSOs are similar in some ways, e.g., types of services provided, but significantly different on internal variables, such as budget size, and external variables, such as number of relationships with community groups. Organizational independence appears to be a significant characteristic for consumer service organizations and should be encouraged by funders and among participants. Funders might establish administrative and/or programmatic measures to support consumer organizations that are independent or moving toward independence; their participants would also benefit from the provision, by authorities or advocates, of materials to guide organizations toward, for example, 501(c)3 status.

  10. Factors associated to the imposition of types of violence against women informed in sentry services

    Directory of Open Access Journals (Sweden)

    Luiza Jane Eyre de Souza Vieira

    2013-07-01

    Full Text Available OBJECTIVE: to identify the prevalence and the factors associated to the imposition of the different types of violence against women informed in sentry services. METHOD: transversal study accomplished through 939 notification forms of cases of violence against women, referring to the three years from 2006 to 2008 in Fortaleza, Ceará. Univariate and multiple analyses by logistic regression were realized. RESULT: the results showed a positive association between the imposition of types of violence against women with a schooling varying from illiterate to basic education and the aggression which had occurred other times. CONCLUSION: this knowledge contributes to the delineation of specific actions that aim at facing this problem, as well as generates subsidies for adequate attendance proposals and guidance for the victims who call on health services.

  11. RECALMIN: The association between management of Spanish National Health Service Internal Medical Units and health outcomes.

    Science.gov (United States)

    Zapatero-Gaviria, Antonio; Javier Elola-Somoza, Francisco; Casariego-Vales, Emilio; Fernandez-Perez, Cristina; Gomez-Huelgas, Ricardo; Bernal, José Luis; Barba-Martín, Raquel

    2017-08-01

    To investigate the association between management of Internal Medical Units (IMUs) with outcomes (mortality and length of stay) within the Spanish National Health Service. Data on management were obtained from a descriptive transversal study performed among IMUs of the acute hospitals. Outcome indicators were taken from an administrative database of all hospital discharges from the IMUs. Spanish National Health Service. One hundred and twenty-four acute general hospitals with available data of management and outcomes (401 424 discharges). IMU risk standardized mortality rates were calculated using a multilevel model adjusted by Charlson Index. Risk standardized myocardial infarction and heart failure mortality rates were calculated using specific multilevel models. Length of stay was adjusted by complexity. Greater hospital complexity was associated with longer average length of stays (r: 0.42; P International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  12. Medicare Part D is associated with reducing the financial burden of health care services in Medicare beneficiaries with diagnosed diabetes.

    Science.gov (United States)

    Li, Rui; Gregg, Edward W; Barker, Lawrence E; Zhang, Ping; Zhang, Fang; Zhuo, Xiaohui; Williams, Desmond E; Soumerai, Steven B

    2013-10-01

    Medicare Part D, implemented in 2006, provided coverage for prescription drugs to all Medicare beneficiaries. To examine the effect of Part D on the financial burden of persons with diagnosed diabetes. We conducted an interrupted time-series analysis using data from the 1996 to 2008 Medical Expenditure Panel Survey (11,178 persons with diabetes who were covered by Medicare, and 8953 persons aged 45-64 y with diabetes who were not eligible for Medicare coverage). We then compared changes in 4 outcomes: (1) annual individual out-of-pocket expenditure (OOPE) for prescription drugs; (2) annual individual total OOPE for all health care services; (3) annual total family OOPE for all health care services; and (4) percentage of persons with high family financial burden (OOPE ≥10% of income). For Medicare beneficiaries with diabetes, Part D was associated with a 28% ($530) decrease in individual annual OOPE for prescription drugs, a 23% ($560) reduction in individual OOPE for all health care, a 23% ($863) reduction in family OOPE for all health care, and a 24% reduction in the percentage of families with high financial burden in 2006. There were similar reductions in 2007 and 2008. By 2008, the percentage of Medicare beneficiaries with diabetes living in high financial burden families was 37% lower than it would have been had Part D not been in place. Introduction of Part D coverage was associated with a substantial reduction in the financial burden of Medicare beneficiaries with diabetes and their families.

  13. The Association Between Gender Inequalities and Women's Utilization of Maternal Health Services: A Cross-Sectional Survey in Eight South Central Coast Provinces, Vietnam.

    Science.gov (United States)

    Bui, Ha Thi Thu; Le, Thi Minh; Van Pham, Tac; Doan, Duong Thi Thuy; Nguyen, Duy Anh; Nguyen, Canh Chuong; Duong, Duc Minh

    Gender inequalities influence the utilization of maternal health services in Vietnam, but little research has been published. This study, therefore, aimed to explore the association between gender inequalities and women's utilization of maternal health services in Vietnam. The study was conducted in 8 provinces in the South Central Coast region of Vietnam during August 2013 to May 2014. A total of 907 women who delivered a year prior to the date of interview participated in the study. A multiple logistic regression model was used to examine the association between gender inequalities (including sociodemographic determinants of health) and utilization of 4 or more antenatal care (ANC4+) services, institutional delivery, and ever used contraceptive methods. The utilization rate of maternal health services was varied, from 53.9% for ANC4+ to 87.7% for ever used a contraceptive method and 97% for institutional delivery. Ethnicity was identified as the most influential variable out of all sociodemographic determinants of health. Regarding gender inequalities, couple communication was the only variable having significant association with women's utilization of maternal health services. Women's equal role within context of their daily life and relations with their husbands (discussing maternal care with husband and having equal income to husband) supported their use of maternal health services. Therefore, there should be concerted efforts from all relevant stakeholders including the health system to focus on disadvantaged women in planning and delivery of maternal health services, especially to ethnic minority women. Male involvement strategy should be implemented to promote maternal health care, especially during the prenatal and postpartum period. To provide more culturally sensitive and right-based approaches in delivery of maternal health services to disadvantaged women in Vietnam, interventions are recommended that promote male involvement, that is, to engage men in

  14. Association between fee-for-service expenditures and morbidity burden in primary care

    DEFF Research Database (Denmark)

    Kristensen, Troels; Olsen, Kim Rose; Schroll, Henrik

    2014-01-01

    BACKGROUND: In primary care, fee-for-services (FFS) tariffs are often based on political negotiation rather than costing systems. The potential for comprehensive measures of patient morbidity to explain variation in negotiated FFS expenditures has not previously been examined. OBJECTIVES...... fees are based on average costing. However, our results indicate that there may be room for improvement of the association between politically negotiated FFS expenditures and morbidity in primary care....

  15. Childhood ADHD Symptoms: Association with Parental Social Networks and Mental Health Service Use during Adolescence

    OpenAIRE

    Bussing, Regina; Meyer, Johanna; Zima, Bonnie T.; Mason, Dana M.; Gary, Faye A.; Garvan, Cynthia Wilson

    2015-01-01

    Objective: This study examines the associations of childhood attention-deficit/hyperactivity disorder (ADHD) risk status with subsequent parental social network characteristics and caregiver strain in adolescence; and examines predictors of adolescent mental health service use. Methods: Baseline ADHD screening identified children at high risk (n = 207) and low risk (n = 167) for ADHD. At eight-year follow-up, parents reported their social network characteristics, caregiver strain, adolescent...

  16. Structural brain alterations associated with schizophrenia preceded by conduct disorder: a common and distinct subtype of schizophrenia?

    Science.gov (United States)

    Schiffer, Boris; Leygraf, Norbert; Müller, Bernhard W; Scherbaum, Norbert; Forsting, Michael; Wiltfang, Jens; Gizewski, Elke R; Hodgins, Sheilagh

    2013-09-01

    Conduct disorder (CD) prior to age 15 is a precursor of schizophrenia in a minority of cases and is associated with violent behavior through adulthood, after taking account of substance misuse. The present study used structural magnetic imaging to examine gray matter (GM) volumes among 27 men with schizophrenia preceded by CD (SZ+CD), 23 men with schizophrenia but without CD (SZ-CD), 27 men with CD only (CD), and 25 healthy (H) men. The groups with schizophrenia were similar in terms of age of onset and duration of illness, levels of psychotic symptoms, and medication. The 2 groups with CD were similar as to number of CD symptoms, lifelong aggressive behavior, and number of criminal convictions. Men with SZ+CD, relative to those with SZ-CD, displayed (1) increased GM volumes in the hypothalamus, the left putamen, the right cuneus/precuneus, and the right inferior parietal cortex after controlling for age, alcohol, and drug misuse and (2) decreased GM volumes in the inferior frontal region. Men with SZ+CD (relative to the SZ-CD group) and CD (relative to the H group) displayed increased GM volumes of the hypothalamus and the inferior and superior parietal lobes, which were not associated with substance misuse. Aggressive behavior, both prior to age 15 and lifetime tendency, was positively correlated with the GM volume of the hypothalamus. Thus, among males, SZ+CD represents a distinct subtype of schizophrenia. Although differences in behavior emerge in childhood and remain stable through adulthood, further research is needed to determine whether the differences in GM volumes result from abnormal neural development distinct from that of other males developing schizophrenia.

  17. Asthma-Like Symptoms in Homeless Children in the Greater Paris Area in 2013: Prevalence, Associated Factors and Utilization of Healthcare Services in the ENFAMS Survey.

    Directory of Open Access Journals (Sweden)

    Delphine Lefeuvre

    Full Text Available Asthma remains poorly studied in homeless children. We sought to estimate the prevalence of asthma-like symptoms (ALS and to identify the factors associated with ALS and healthcare service utilisation.A cross-sectional survey of a random sample of sheltered homeless families was conducted by interviewing 801 parents of children (0-12 years in 17 languages. ALS were defined as wheezing or night cough without fever during the previous year. Poisson regression models with robust error variance were used to compute prevalence ratios (PR for factors associated with ALS and healthcare service utilisation for ALS.The prevalence of ALS among the children was 19.9%. Poor housing sanitation was significantly associated with ALS, as being born in the European Union. Most of the children with ALS had used healthcare services (85.4%. The main barriers to accessing such services were having lived in France for less than 49 months, having difficulties in French and living in poor housing conditions.ALS prevalence seemed lower than in the general child population, possibly because of the children's origins. Environmental factors associated with ALS point to the need to improve the indoor environment of family shelters. The relatively high rate of healthcare service utilisation should not overshadow existing barriers.

  18. Introduction of electronic referral from community associated with more timely review by secondary services.

    Science.gov (United States)

    Warren, J; White, S; Day, K J; Gu, Y; Pollock, M

    2011-01-01

    Electronic referral (eReferral) from community into public secondary healthcare services was introduced to 30 referring general medical practices and 28 hospital based services in late 2007. To measure the extent of uptake of eReferral and its association with changes in referral processing. Analysis of transactional data from the eReferral message service and the patient information management system of the affected hospital; interview of clinical, operational and management stakeholders. eReferral use rose steadily to 1000 transactions per month in 2008, thereafter showing moderate growth to 1200 per month in 2010. Rate of eReferral from the community in 2010 is estimated at 56% of total referrals to the hospital from general practice, and as 71% of referrals from those having done at least one referral electronically. Referral latency from letter date to hospital triage improves significantly from 2007 to 2009 (psystem usability issues. With eReferrals, a referral's status can be checked, and its content read, by any authorized user at any time. The period of eReferral uptake was associated with significant speed-up in referral processing without changes in staffing levels. The eReferral system provides a foundation for further innovation in the community-secondary interface, such as electronic decision support and shared care planning systems. We observed substantial rapid voluntary uptake of eReferrals associated with faster, more reliable and more transparent referral processing.

  19. 78 FR 17652 - Tri-State Generation and Transmission Association, Inc. v. Public Service Company of New Mexico...

    Science.gov (United States)

    2013-03-22

    ... Generation and Transmission Association, Inc. v. Public Service Company of New Mexico; Notice of Complaint... CFR 385.206 and 18 CFR 385.212, Tri-State Generation and Transmission Association, Inc. (Complainant), filed a complaint against the Public Service Company of New Mexico (Respondent or PNM) alleging that...

  20. ESRS guidelines for software safety reviews. Reference document for the organization and conduct of Engineering Safety Review Services (ESRS) on software important to safety in nuclear power plants

    International Nuclear Information System (INIS)

    2000-01-01

    The IAEA provides safety review services to assist Member States in the application of safety standards and, in particular, to evaluate and facilitate improvements in nuclear power plant safety performance. Complementary to the Operational Safety Review Team (OSART) and the International Regulatory Review Team (IRRT) services are the Engineering Safety Review Services (ESRS), which include reviews of siting, external events and structural safety, design safety, fire safety, ageing management and software safety. Software is of increasing importance to safety in nuclear power plants as the use of computer based equipment and systems, controlled by software, is increasing in new and older plants. Computer based devices are used in both safety related applications (such as process control and monitoring) and safety critical applications (such as reactor protection). Their dependability can only be ensured if a systematic, fully documented and reviewable engineering process is used. The ESRS on software safety are designed to assist a nuclear power plant or a regulatory body of a Member State in the review of documentation relating to the development, application and safety assessment of software embedded in computer based systems important to safety in nuclear power plants. The software safety reviews can be tailored to the specific needs of the requesting organization. Examples of such reviews are: project planning reviews, reviews of specific issues and reviews prior final acceptance. This report gives information on the possible scope of ESRS software safety reviews and guidance on the organization and conduct of the reviews. It is aimed at Member States considering these reviews and IAEA staff and external experts performing the reviews. The ESRS software safety reviews evaluate the degree to which software documents show that the development process and the final product conform to international standards, guidelines and current practices. Recommendations are

  1. A Behavioral Test of Accepting Benefits that Cost Others: Associations with Conduct Problems and Callous-Unemotionality

    Science.gov (United States)

    Sakai, Joseph T.; Dalwani, Manish S.; Gelhorn, Heather L.; Mikulich-Gilbertson, Susan K.; Crowley, Thomas J.

    2012-01-01

    Background Youth with conduct problems (CP) often make decisions which value self-interest over the interests of others. Self-benefiting behavior despite loss to others is especially common among youth with CP and callous-unemotional traits (CU). Such behavioral tendencies are generally measured using self- or observer-report. We are unaware of attempts to measure this tendency with a behavioral paradigm. Methods/Principal Findings In our AlAn's (altruism-antisocial) game a computer program presents subjects with a series of offers in which they will receive money but a planned actual charity donation will be reduced; subjects decide to accept or reject each offer. We tested (1) whether adolescent patients with CP (n = 20) compared with adolescent controls (n = 19) differed on AlAn's game outcomes, (2) whether youths with CP and CU differed significantly from controls without CP or CU, and (3) whether AlAn's game outcomes correlated significantly with CP and separately, CU severity. Patients with CP and CU compared with controls without these problems took significantly more money for themselves and left significantly less money in the charity donation; AlAn's game outcomes were significantly correlated with CU, but not CP. Conclusions/Significance In the AlAn's game adolescents with conduct problems and CU traits, compared with controls without CP/CU, are disposed to benefit themselves while costing others even in a novel situation, devoid of peer influences, where anonymity is assured, reciprocity or retribution are impossible, intoxication is absent and when the “other” to be harmed is considered beneficent. AlAn's game outcomes are associated with measures of CU. Results suggest that the AlAn's game provides an objective means of capturing information about CU traits. The AlAn's game, which was designed for future use in the MRI environment, may be used in studies attempting to identify the neural correlates of self-benefiting decision-making. PMID

  2. Associations between perceptions of drinking water service delivery and measured drinking water quality in rural Alabama.

    Science.gov (United States)

    Wedgworth, Jessica C; Brown, Joe; Johnson, Pauline; Olson, Julie B; Elliott, Mark; Forehand, Rick; Stauber, Christine E

    2014-07-18

    Although small, rural water supplies may present elevated microbial risks to consumers in some settings, characterizing exposures through representative point-of-consumption sampling is logistically challenging. In order to evaluate the usefulness of consumer self-reported data in predicting measured water quality and risk factors for contamination, we compared matched consumer interview data with point-of-survey, household water quality and pressure data for 910 households served by 14 small water systems in rural Alabama. Participating households completed one survey that included detailed feedback on two key areas of water service conditions: delivery conditions (intermittent service and low water pressure) and general aesthetic characteristics (taste, odor and color), providing five condition values. Microbial water samples were taken at the point-of-use (from kitchen faucets) and as-delivered from the distribution network (from outside flame-sterilized taps, if available), where pressure was also measured. Water samples were analyzed for free and total chlorine, pH, turbidity, and presence of total coliforms and Escherichia coli. Of the 910 households surveyed, 35% of participants reported experiencing low water pressure, 15% reported intermittent service, and almost 20% reported aesthetic problems (taste, odor or color). Consumer-reported low pressure was associated with lower gauge-measured pressure at taps. While total coliforms (TC) were detected in 17% of outside tap samples and 12% of samples from kitchen faucets, no reported water service conditions or aesthetic characteristics were associated with presence of TC. We conclude that consumer-reported data were of limited utility in predicting potential microbial risks associated with small water supplies in this setting, although consumer feedback on low pressure-a risk factor for contamination-may be relatively reliable and therefore useful in future monitoring efforts.

  3. Associations between Perceptions of Drinking Water Service Delivery and Measured Drinking Water Quality in Rural Alabama

    Directory of Open Access Journals (Sweden)

    Jessica C. Wedgworth

    2014-07-01

    Full Text Available Although small, rural water supplies may present elevated microbial risks to consumers in some settings, characterizing exposures through representative point-of-consumption sampling is logistically challenging. In order to evaluate the usefulness of consumer self-reported data in predicting measured water quality and risk factors for contamination, we compared matched consumer interview data with point-of-survey, household water quality and pressure data for 910 households served by 14 small water systems in rural Alabama. Participating households completed one survey that included detailed feedback on two key areas of water service conditions: delivery conditions (intermittent service and low water pressure and general aesthetic characteristics (taste, odor and color, providing five condition values. Microbial water samples were taken at the point-of-use (from kitchen faucets and as-delivered from the distribution network (from outside flame-sterilized taps, if available, where pressure was also measured. Water samples were analyzed for free and total chlorine, pH, turbidity, and presence of total coliforms and Escherichia coli. Of the 910 households surveyed, 35% of participants reported experiencing low water pressure, 15% reported intermittent service, and almost 20% reported aesthetic problems (taste, odor or color. Consumer-reported low pressure was associated with lower gauge-measured pressure at taps. While total coliforms (TC were detected in 17% of outside tap samples and 12% of samples from kitchen faucets, no reported water service conditions or aesthetic characteristics were associated with presence of TC. We conclude that consumer-reported data were of limited utility in predicting potential microbial risks associated with small water supplies in this setting, although consumer feedback on low pressure—a risk factor for contamination—may be relatively reliable and therefore useful in future monitoring efforts.

  4. Associations between Perceptions of Drinking Water Service Delivery and Measured Drinking Water Quality in Rural Alabama

    Science.gov (United States)

    Wedgworth, Jessica C.; Brown, Joe; Johnson, Pauline; Olson, Julie B.; Elliott, Mark; Forehand, Rick; Stauber, Christine E.

    2014-01-01

    Although small, rural water supplies may present elevated microbial risks to consumers in some settings, characterizing exposures through representative point-of-consumption sampling is logistically challenging. In order to evaluate the usefulness of consumer self-reported data in predicting measured water quality and risk factors for contamination, we compared matched consumer interview data with point-of-survey, household water quality and pressure data for 910 households served by 14 small water systems in rural Alabama. Participating households completed one survey that included detailed feedback on two key areas of water service conditions: delivery conditions (intermittent service and low water pressure) and general aesthetic characteristics (taste, odor and color), providing five condition values. Microbial water samples were taken at the point-of-use (from kitchen faucets) and as-delivered from the distribution network (from outside flame-sterilized taps, if available), where pressure was also measured. Water samples were analyzed for free and total chlorine, pH, turbidity, and presence of total coliforms and Escherichia coli. Of the 910 households surveyed, 35% of participants reported experiencing low water pressure, 15% reported intermittent service, and almost 20% reported aesthetic problems (taste, odor or color). Consumer-reported low pressure was associated with lower gauge-measured pressure at taps. While total coliforms (TC) were detected in 17% of outside tap samples and 12% of samples from kitchen faucets, no reported water service conditions or aesthetic characteristics were associated with presence of TC. We conclude that consumer-reported data were of limited utility in predicting potential microbial risks associated with small water supplies in this setting, although consumer feedback on low pressure—a risk factor for contamination—may be relatively reliable and therefore useful in future monitoring efforts. PMID:25046635

  5. Factors associated with the utilization of institutional delivery services in Bangladesh.

    Directory of Open Access Journals (Sweden)

    Sanni Yaya

    Full Text Available Bangladesh has made remarkable progress towards reducing its maternal mortality rate (MMR over the last two decades and is one of the few countries on track to achieving the MMR-related Millennium Development Goals (MDG-5A. However, the provision of universal access to reproductive healthcare (MDG-5B and the utilization of maternal healthcare services (MHS such as institutional delivery, which are crucial to the reduction of maternal mortality, are far behind the internationally agreed-upon target. Effective policymaking to promote the utilization of MHS can be greatly facilitated by the identification of the factors that hinder service uptake. In this study, we therefore aim to measure the prevalence of institutional delivery services and explore the factors associated with their utilization in Bangladesh.Data for this study were extracted from the 2011 Bangladesh Demographic and Health Survey (BDHS, 2011; participants were 7,313 women between the ages of 15 and 49 years, selected from both urban and rural households. Data were analyzed using Chi-square analysis, and conditional logistic regression.According to the findings, fewer than one in three women reported delivering at a health facility. The multivariable regression analysis showed that participants from rural areas were 46.9% less likely to have institutional deliveries compared to urban dwellers (OR = 0.531; p<0.001; 95%CI: 0.467-0.604, and participants aged between 30 and 49 years had a 23.6% higher prevalence of institutional delivery service utilization compared to those aged 15 to 29 years (OR = 1.236; p = 0.006; 95%CI: 1.062-1.437. Moreover, participants with higher educational attainment were about twice as likely to deliver at a standard health facility when compared to those without formal education (OR = 2.081; p<0.001; 95%CI: 1.650-2.624, and similarly, husbands with higher educational attainment exhibited an approximately 71% higher service utilization of institutional

  6. Phosphorylation of connexin43 on S279/282 may contribute to laminopathy-associated conduction defects

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Steven C., E-mail: bug@uw.edu [Fred Hutchinson Cancer Research Center (FHCRC), Public Health Sciences Division, 1100 Fairview Ave. N., Seattle, WA 98109 (United States); University of Washington Department of Biochemistry, 1959 NE Pacific St., Seattle, WA 98195 (United States); Kennedy, Brian K., E-mail: bkennedy@buckinstitute.org [University of Washington Department of Biochemistry, 1959 NE Pacific St., Seattle, WA 98195 (United States); Buck Institute for Research on Aging, 8001 Redwood Boulevard, Novato, CA 94945 (United States); Lampe, Paul D., E-mail: plampe@fhcrc.org [Fred Hutchinson Cancer Research Center (FHCRC), Public Health Sciences Division, 1100 Fairview Ave. N., Seattle, WA 98109 (United States)

    2013-04-01

    An understanding of the molecular mechanism behind the arrhythmic phenotype associated with laminopathies has yet to emerge. A-type lamins have been shown to interact and sequester activated phospho-ERK1/2(pERK1/2) at the nucleus. The gap junction protein connexin43 (Cx43) can be phosphorylated by pERK1/2 on S279/282 (pS279/282), inhibiting intercellular communication. We hypothesized that without A-type lamins, pS279/282 Cx43 will increase due to inappropriate phosphorylation by pERK1/2, resulting in decreased gap junction function. We observed a 1.6-fold increase in pS279/282 Cx43 levels in Lmna{sup −/−} mouse embryonic fibroblasts (MEFs) compared to Lmna{sup +/+}, and 1.8-fold more pERK1/2 co-precipitated from Lmna{sup −/−} MEFs with Cx43 antibodies. We found a 3-fold increase in the fraction of non-nuclear pERK1/2 and a concomitant 2-fold increase in the fraction of pS279/282 Cx43 in Lmna{sup −/−} MEFs by immunofluorescence. In an assay of gap junctional function, Lmna{sup −/−} MEFs transferred dye to 60% fewer partners compared to Lmna{sup +/+} controls. These results are mirrored in 5–6 week-old Lmna{sup −/−} mice compared to their Lmna{sup +/+} littermates as we detect increased pS279/282 Cx43 in gap junctions by immunofluorescence and 1.7-fold increased levels by immunoblot. We conclude that increased pS279/282 Cx43 in the Lmna{sup −/−} background results in decreased cell communication and may contribute to the arrhythmic pathology in vivo. - Highlights: ► Connexin43 phosphorylation plays a role in laminopathy-associated conduction defects. ► Loss of A-type lamin activity results in release of pERK1/2 from the nucleus. ► Increased cytoplasmic localization of pERK1/2 acts to phosphorylate S279/282 of Cx43. ► Phosphorylation of S279/282 on Cx43 decreases gap junction activity in cell culture. ► Mice lacking A-type lamins have increased phosphorylation on S279/282 of Cx43.

  7. The role of the State Security Service (Stasi) in the context of international clinical trials conducted by western pharmaceutical companies in Eastern Germany (1961-1990).

    Science.gov (United States)

    Erices, Rainer; Frewer, Andreas; Gumz, Antje

    2018-01-01

    After the building of the Berlin Wall in the 1960s, a number of international pharmaceutical manufacturers from the West had their drugs tested in Eastern Germany (GDR). So far, the extensive collection of documents on the subject stored in the archives of the GDR State Security Service (Stasi, MfS) has not been systematically analysed. Until now, the role of the Stasi with respect to the surveillance of the trials has been unclear. A keyword search within the database of the Stasi files was conducted. All available files were screened in order to identify institutions, companies and personnel involved in the clinical trials. On this basis, further files were requested. A total of 259 files were available for analysis. Relevant data was derived from 160 of these files. A contextualised approach was applied, which critically explored the origin, content, and impact of the data. In addition, an approach guided by the central steps of document analysis was applied. At least 400 clinical trials were conducted during the GDR period. The exact number remains speculative. According to references found in the Stasi files, it might have been considerably higher. Initially, the main goal of the trials was for the GDR authorities to decide whether to import certain Western drugs. By 1983, this intention had changed. Now, the primary aim of the trials was the procurement of foreign currency. The Stasi feared that the pharmaceutical companies could have a significant influence on GDR Health System. Stasi spies were holding positions in the responsible medical committees, universities, and hospitals. Constant surveillance by the Stasi served the purpose of monitoring any contact between people from the West and the East. Unknowingly, representatives of Western companies were surveilled by the Stasi. The studied documents also point to the fact that a number of clinical trials conducted during the GDR period did not comply with GDR regulations, and were therefore deemed illegal

  8. The Modernization and Associated Restructuring of the National Weather Service: An Overview.

    Science.gov (United States)

    Friday, Elbert W., Jr.

    1994-01-01

    The scientific understanding of the atmosphere and the ability to forecast large-and small-scale hydrometeorological phenomena have increased dramatically over the last two decades. As a result, the National Oceanic and Atmospheric Administration has set an ambitious goal: to modernize the National Weather Service (NWS)through the deployment of proven observational, information processing, and communications technologies, and to establish an associated cost-effective operational structure. The modernization and associated restructuring of the NWS will assure that the major advances that have been made in our ability to observe and understand the atmosphere are applied to the practical problems of providing atmospheric and hydrologic services to the nation. Implementation and practice of the new science will improve forecasts, provide more reliable detection of and warnings for severe weather and flooding, achieve more uniform hydrometeorological services across the nation, permit a more cost-effective NWS, and increase productivity among NWS employees. The changes proposed by the NWS will allow increased productivity and efficiency for any entity dependent on weather information, including local, state, and federal government agencies; researchers; private-sector meteorologists; private industry; and resource management organizations. This is the first in a series of articles intended to highlight these changes.

  9. Healthcare workers' behaviors and personal determinants associated with providing adequate sexual and reproductive healthcare services in sub-Saharan Africa: a systematic review.

    Science.gov (United States)

    Jonas, Kim; Crutzen, Rik; van den Borne, Bart; Reddy, Priscilla

    2017-03-13

    Healthcare workers may affect the utilization of sexual and reproductive healthcare (SRH) services, and quality of care thereof, for example by their behaviours or attitudes they hold. This can become a hindrance to accessing and utilizing SRH services, particularly by young people, and thus a better understanding of these behaviours and associated factors is needed to improve access to and utilization of SRH services. A systematic review of literature was conducted to identify studies focusing on healthcare workers' behaviors and personal determinants associated with providing adequate SRH services in sub-Saharan Africa (January 1990 - October 2015). Five databases were searched until 30th October 2015, using a search strategy that was adapted based on the technical requirements of each specific database. Articles were independently screened for eligibility by two researchers. Of the 125-screened full-text articles, 35 studies met all the inclusion criteria. Negative behaviours and attitudes of healthcare workers, as well as other personal determinants, such as poor knowledge and skills of SRH services, and related factors, like availability of essential drugs and equipment are associated with provision of inadequate SRH services. Some healthcare workers still have negative attitudes towards young people using contraceptives and are more likely to limit access to and utilization of SRH by adolescents especially. Knowledge of and implementation of specific SRH components are below optimum levels according to the WHO recommended guidelines. Healthcare workers' negative behaviours and attitudes are unlikely to encourage women in general to access and utilize SRH services, but more specifically young women. Knowledge of SRH services, including basic emergency obstetric care (EmOC) is insufficient among healthcare workers in SSA. A protocol for this systematic review was registered with PROSPERO and the registration number is: CRD42015017509 .

  10. Reversible acute axonal polyneuropathy associated with Wernicke-Korsakoff syndrome: impaired physiological nerve conduction due to thiamine deficiency?

    Science.gov (United States)

    Ishibashi, S; Yokota, T; Shiojiri, T; Matunaga, T; Tanaka, H; Nishina, K; Hirota, H; Inaba, A; Yamada, M; Kanda, T; Mizusawa, H

    2003-05-01

    Acute axonal polyneuropathy and Wernicke-Korsakoff encephalopathy developed simultaneously in three patients. Nerve conduction studies (NCS) detected markedly decreased compound muscle action potentials (CMAPs) and sensory nerve action potentials (SNAPs) with minimal conduction slowing; sympathetic skin responses (SSRs) were also notably decreased. Sural nerve biopsies showed only mild axonal degeneration with scattered myelin ovoid formation. The symptoms of neuropathy lessened within two weeks after an intravenous thiamine infusion. CMAPs, SNAPs, and SSRs also increased considerably. We suggest that this is a new type of peripheral nerve impairment: physiological conduction failure with minimal conduction delay due to thiamine deficiency.

  11. Association of Cost Sharing With Use of Home Health Services Among Medicare Advantage Enrollees.

    Science.gov (United States)

    Li, Qijuan; Keohane, Laura M; Thomas, Kali; Lee, Yoojin; Trivedi, Amal N

    2017-07-01

    Several policy proposals advocate introducing copayments for home health care in the Medicare program. To our knowledge, no prior studies have assessed this cost-containment strategy. To determine the association of home health copayments with use of home health services. A difference-in-differences case-control study of 18 Medicare Advantage (MA) plans that introduced copayments for home health care between 2007 and 2011 and 18 concurrent control MA plans. The study included 135 302 enrollees in plans that introduced copayment and 155 892 enrollees in matched control plans. Introduction of copayments for home health care between 2007 and 2011. Proportion of enrollees receiving home health care, annual numbers of home health episodes, and days receiving home health care. Copayments for home health visits ranged from $5 to $20 per visit, which were estimated to be associated with $165 (interquartile range [IQR], $45-$180) to $660 (IQR, $180-$720) in out-of-pocket spending for the average user of home health care. The increased copayment for home health care was not associated with the proportion of enrollees receiving home health care (adjusted difference-in-differences, -0.15 percentage points; 95% CI, -0.38 to 0.09), the number of home health episodes per user (adjusted difference-in-differences, 0.01; 95% CI, -0.01 to 0.03), and home health days per user (adjusted difference-in-differences, -0.19; 95% CI, -3.02 to 2.64). In both intervention and control plans and across all levels of copayments, we observed higher disenrollment rates among enrollees with greater baseline use of home health care. We found no evidence that imposing copayments reduced the use of home health services among older adults. More intensive use of home health services was associated with increased rates of disenrollment in MA plans. The findings raise questions about the potential effectiveness of this cost-containment strategy.

  12. Health Trajectories of Family Caregivers: Associations With Care Transitions and Adult Day Service Use

    Science.gov (United States)

    Liu, Yin; Kim, Kyungmin; Zarit, Steven H.

    2017-01-01

    Objective The study examines family caregivers’ health changes over 1 year on four health dimensions and explores the association of differential health trajectories with adult day service (ADS) use and caregiving transitions. Method The participants were 153 primary caregivers of individuals with dementia (IWDs) who provided information on care situations and their own health at baseline, 6-month, and 12-month interviews. Results Caregivers showed increasing functional limitations and decreasing bodily pain over time, whereas role limitation and general health perception remained stable. Furthermore, caregivers’ trajectories of functional limitation were associated with their extent of ADS use at baseline and their relatives’ placement. Discussion Health is multidimensional; all dimensions of caregiver health do not change in a uniform manner. The findings underscore the importance of the association of caregiving transitions and caregiver health and the potential health benefits of ADS use for family caregivers. PMID:25348275

  13. Assessing Health Outcomes After Environmental Exposures Associated With Open Pit Burning in Deployed US Service Members.

    Science.gov (United States)

    Rohrbeck, Patricia; Hu, Zheng; Mallon, Col Timothy M

    2016-08-01

    This study assessed the long-term health impact of environmental exposures associated with open pit burning in deployed US service members. Two hundred individuals deployed to Balad, Iraq, and Bagram, Afghanistan, with known exposure to open pits, were matched to 200 non-deployed service members. Both cohorts were observed for adverse health outcomes after returning from deployment. Slight increased risks were observed for respiratory diseases in the Bagram cohort (adj RR: 1.259), and for cardiovascular disease in the Balad cohort (adj RR: 1.072), but the findings were not significant. The combined deployed cohort showed lower risks for adverse health outcomes, suggesting a healthy deployer effect. In conclusion, this study did not find significantly increased risks for selected health outcomes after burn pit exposure during deployment among two deployed cohorts compared with a non-deployed cohort.

  14. Risk for Suicidal Ideation and Suicide Attempts Associated with Co-Occurring Depression and Conduct Problems in Early Adolescence

    Science.gov (United States)

    Vander Stoep, Ann; Adrian, Molly; Mc Cauley, Elizabeth; Crowell, Sheila E.; Stone, Andrea; Flynn, Cynthia

    2011-01-01

    This study investigates the early manifestation of co-occurring depression and conduct problems as a predictor of heightened risk for later suicidal ideation and behavior in a community sample of 521 adolescents. Self-reported symptoms of depression and conduct problems were evaluated in early 6th grade. Suicidal thoughts and behaviors were…

  15. Opportunities of Trade in Services between the EU and Ukraine: the Case of Telecommunications Services under the GATS and the Association Agreement

    DEFF Research Database (Denmark)

    Batura, Olga; Kretova, Olga A.

    This working paper studies the legal and regulatory conditions for trade in ser- vices between the European Union (EU) and Ukraine on the example of tele- communications services that are important carrier services for various busi- ness activities in the cross-border trade. The paper outlines...... the general frame- work for trade in services under the GATS as expressed in the commitments undertaken by Ukraine and examines the detailed provisions of the EU- Ukraine Association Agreement on trade liberalisation and regulatory approx- imation that is a WTO-extra agreement. It also provides an overview...... – the internal mar- ket treatment – is difficult to reach due to unclear and complicated rules on regulatory approximation. Key words: EU, Ukraine, trade in services, telecommunications services, liber- alisation, regulatory approximation...

  16. Retrospective chart review for obesity and associated interventions among rural Mexican-American adolescents accessing healthcare services.

    Science.gov (United States)

    Champion, Jane Dimmitt; Collins, Jennifer L

    2013-11-01

    To report a retrospective analysis of data routinely collected in the course of healthcare services at a rural health clinic and to assess obesity incidence and associated interventions among rural Mexican-American adolescents. Two hundred and twelve charts reviewed; 98 (46.2%) males and 114 (53.8%) females. Data extracted included Medicaid exams conducted at the clinic within 5 years. Equal overweight or obese (n = 105, 49.5%), versus normal BMI categorizations (n = 107, 50.5%) documented overall and by gender. Female obesity higher (25.4%) than national norms (17.4%); male rates (25.5%) were within national norm. Interventions provided by nurse practitioners (94%) for 34.8%-80% of overweight/obese had limited follow-up (4%). Obesity incidence markedly increased between 13 and 18 years of age without associated interventions; 51.4%-75.6% without interventions. Obesity is a healthcare problem among rural Mexican-American adolescents accessing care at the rural health clinic. Obesity intervention and follow-up was suboptimal within this setting. Rural and ethnic minority adolescents experience health disparities concerning obesity prevalence and remote healthcare access. Obesity prevention and treatment during adolescence is a national health priority given physiologic and psychological tolls on health and potential for obesity into adulthood. Obesity assessment and translation of evidence-based interventions for rural Mexican-American adolescents at rural health clinics is implicated. ©2013 The Author(s) ©2013 American Association of Nurse Practitioners.

  17. The role of conduct disorder in the association between ADHD and alcohol use (disorder). Results from the Netherlands Mental Health Survey and Incidence Study-2

    NARCIS (Netherlands)

    Tuithof, Marlous; ten Have, Margreet; van den Brink, Wim; Vollebergh, Wilma; de Graaf, Ron

    2012-01-01

    Much is unclear about the association between attention-deficit/hyperactivity disorder (ADHD) and alcohol use (disorder). Research on this subject is hindered by the role of conduct disorder (CD). We investigate whether (1) childhood ADHD is associated with higher prevalence and earlier onset of

  18. Bidirectional Associations between Parenting Practices and Conduct Problems in Boys from Childhood to Adolescence: The Moderating Effect of Age and African-American Ethnicity

    Science.gov (United States)

    Pardini, Dustin A.; Fite, Paula J.; Burke, Jeffrey D.

    2008-01-01

    This study examined the bidirectional relationship between parent and teacher reported conduct problems in youth and parenting practices using a longitudinal sample of boys assessed from 6 to 16 years of age. Analyses tested whether these bidirectional associations changed across development and whether the nature of these associations varied…

  19. Interaction matters: quantifying conduct problem × depressive symptoms interaction and its association with adolescent alcohol, cigarette, and marijuana use in a national sample.

    Science.gov (United States)

    Maslowsky, Julie; Schulenberg, John E

    2013-11-01

    Substance use is a major contributor to morbidity and mortality among American adolescents. Conduct problems and depressive symptoms have each been found to be associated with adolescent substance use. Although they are highly comorbid, the role of the interaction of conduct problems and depressive symptoms in substance use is not clear. In national samples of 8th-, 10th-, and 12th-grade students from the Monitoring the Future study, latent moderated structural equation modeling was used to estimate the association of conduct problems, depressive symptoms, and their interaction to the use of alcohol (including binge drinking), cigarettes, and marijuana. Moderation by age and sex was tested. The interaction of conduct problems with depressive symptoms was a strong predictor of substance use, particularly among younger adolescents. With few exceptions, adolescents with high levels of both conduct problems and depressive symptoms used substances most frequently. Conduct problems were a strong positive predictor of substance use, and depressive symptoms were a weak positive predictor. Whereas conduct problems are often thought to be a primary predictor of substance use, this study revealed that depressive symptoms potentiate the relation of conduct problems to substance use. Therefore, substance use prevention efforts should target both depressive symptoms and conduct problems.

  20. Operational challenges in conducting a community-based technology-enabled mental health services delivery model for rural India: Experiences from the SMART Mental Health Project.

    Science.gov (United States)

    Maulik, Pallab K; Kallakuri, Sudha; Devarapalli, Siddhardha

    2018-01-01

    Background: There are large gaps in the delivery of mental health care in low- and middle-income countries such as India, and the problems are even more acute in rural settings due to lack of resources, remoteness, and lack of infrastructure, amongst other factors. The Systematic Medical Appraisal Referral and Treatment (SMART) Mental Health Project was conceived as a mental health services delivery model using technology-based solutions for rural India. This paper reports on the operational strategies used to facilitate the implementation of the intervention. Method: Key components of the SMART Mental Health Project included delivering an anti-stigma campaign, training of primary health workers in screening, diagnosing and managing stress, depression and increased suicide risk and task sharing of responsibilities in delivering care; and using mobile technology based electronic decision support systems to support delivery of algorithm based care for such disorders. The intervention was conducted in 42 villages across two sites in the state of Andhra Pradesh in south India. A pre-post mixed methods evaluation was done, and in this paper operational challenges are reported. Results: Both quantitative and qualitative results from the evaluation from one site covering about 5000 adults showed that the intervention was feasible and acceptable, and initial results indicated that it was beneficial in increasing access to mental health care and reducing depression and anxiety symptoms. A number of strategies were initiated in response to operational challenges to ensure smoother conduct of the project and facilitated the project to be delivered as envisaged. Conclusions: The operational strategies initiated for this project were successful in ensuring the delivery of the intervention. Those, coupled with other more systematic processes have informed the researchers to understand key processes that need to be in place to develop a more robust study, that could eventually be

  1. Factors associated with utilization of dental services in a long-term care facility: a descriptive cross-sectional study.

    Science.gov (United States)

    Scannapieco, Frank A; Amin, Summar; Salme, Marc; Tezal, Mine

    2017-03-01

    To describe factors associated with the utilization of dental services in a long-term care facility (LTCF) in Western New York. A descriptive cross-sectional study reviewed the dental and medical records of residents of an LTCF discharged between January 1, 2008 and December 30, 2012. Information on demographic and health variables at admission was extracted from electronic health records. Information on oral health variables was extracted from patient charts. A total of 2,516 residents were discharged between 2008 and 2012. From those, 259 (10.3%) utilized dental services at least once during their stay. Those who utilized dental services were significantly older at admission (78.5 vs. 82.0 years, p dental services. Dental services appear to be underutilized by residents of LTCF. Significant differences exist in demographic and health variables between residents who utilize these services compared to those who do not. © 2016 Special Care Dentistry Association and Wiley Periodicals, Inc.

  2. Association between psychological distress and cancer type in patients referred to a psycho-oncology service

    LENUS (Irish Health Repository)

    Lavelle, C

    2017-06-01

    Psychological distress is common in patients with cancer and psychological well-being is increasingly seen as an important component of cancer care. The aim of this study was to examine the relationship between cancer type and subjective distress. The following data were collected from a database of consecutive psycho-oncology referrals to the Liaison Psychiatry service in Cork University Hospital from 2006 to 2015: demographics, cancer diagnosis, Distress Thermometer (DT) score. 2102 out of 2384 referrals were assessed. Of those assessed, the most common cancer diagnoses were breast (23%, n=486) followed by haematological (21%, n=445). There were significant difference in DT score between the different cancer types, (χ2(13)=33.685, p=0.001, Kruskal–Wallis test). When adjusted for age, gender and whether or not the cancer was recently diagnosed, there was no significant association between cancer type and psychological distress. In conclusion, cancer type is not associated with level of distress in cancer.

  3. Factors associated with early childhood education and care service implementation of healthy eating and physical activity policies and practices in Australia: a cross-sectional study.

    Science.gov (United States)

    Wolfenden, Luke; Finch, Meghan; Nathan, Nicole; Weaver, Natasha; Wiggers, John; Yoong, Sze Lin; Jones, Jannah; Dodds, Pennie; Wyse, Rebecca; Sutherland, Rachel; Gillham, Karen

    2015-09-01

    Many early childhood education and care (ECEC) services fail to implement recommended policies and practices supportive of healthy eating and physical activity. The purpose of this study was to assess whether certain theoretically-based factors are associated with implementation of healthy eating and physical activity policies and practices in a sample of ECEC services. A cross-sectional survey was conducted with Service Managers of ECEC services. The survey assessed the operational characteristics, policy, and practice implementation, and 13 factors were suggested by Damschroder's Consolidated Framework for Implementation Research to impede or promote implementation. Logistic regression analyses found a significant association between implementation factor score and full implementation (OR 1.38; 95% CI 1.18-1.61; p = <0.01), indicating that for every one point increase in implementation score, ECEC services were 38 % more likely to be fully implementing the policies and practices. The findings highlight the opportunities for improving implementation of obesity prevention interventions in this setting by developing interventions that address such factors.

  4. Preterm birth-associated cost of early intervention services: an analysis by gestational age.

    Science.gov (United States)

    Clements, Karen M; Barfield, Wanda D; Ayadi, M Femi; Wilber, Nancy

    2007-04-01

    Characterizing the cost of preterm birth is important in assessing the impact of increasing prematurity rates and evaluating the cost-effectiveness of therapies to prevent preterm delivery. To assess early intervention costs that are associated with preterm births, we estimated the program cost of early intervention services for children who were born in Massachusetts, by gestational age at birth. Using the Pregnancy to Early Life Longitudinal Data Set, birth certificates for infants who were born in Massachusetts between July 1999 and June 2000 were linked to early intervention claims through 2003. We determined total program costs, in 2003 dollars, of early intervention and mean cost per surviving infant by gestational age. Costs by plurality, eligibility criteria, provider discipline, and annual costs for children's first 3 years also were examined. Overall, 14,033 of 76,901 surviving infants received early intervention services. Program costs totaled almost $66 million, with mean cost per surviving infant of $857. Mean cost per infant was highest for children who were 24 to 31 weeks' gestational age ($5393) and higher for infants who were 32 to 36 weeks' gestational age ($1578) compared with those who were born at term ($725). Cost per surviving infant generally decreased with increasing gestational age. Among children in early intervention, mean cost per child was higher for preterm infants than for term infants. At each gestational age, mean cost per surviving infant was higher for multiples than for singletons, and annual early intervention costs were higher for toddlers than for infants. Compared with their term counterparts, preterm infants incurred higher early intervention costs. This information along with data on birth trends will inform budget forecasting for early intervention programs. Costs that are associated with early childhood developmental services must be included when considering the long-term costs of prematurity.

  5. 7 CFR 4290.900 - Management fees for services provided to an Enterprise by RBIC or its Associate.

    Science.gov (United States)

    2010-01-01

    ... AGRICULTURE RURAL BUSINESS INVESTMENT COMPANY (âRBICâ) PROGRAM Financing of Enterprises by RBICs Limitations on Disposition of Assets § 4290.900 Management fees for services provided to an Enterprise by RBIC or... management services that you or your Associate provide to an Enterprise that you do not finance. (b) The...

  6. Medicaid Reimbursement for School Nursing Services: A Position Paper of the National Association of State School Nurse Consultants.

    Science.gov (United States)

    Journal of School Health, 1996

    1996-01-01

    This statement of the National Association of State School Nurse Consultants lists those school nursing services and procedures the organization believes should be reimbursable by Medicaid to school districts. Identified services are in the areas of case finding, nursing care procedures, care coordination, patient/student counseling, and emergency…

  7. Associations between neck musculoskeletal complaints and work related factors among public service computer workers in Kaunas

    Directory of Open Access Journals (Sweden)

    Gintaré Kaliniene

    2013-10-01

    Full Text Available Objectives:Information technologies have been developing very rapidly, also in the case of occupational activities. Epidemiological studies have shown that employees, who work with computers, are more likely to complain of musculoskeletal disorders (MSD. The aim of this study was to evaluate associations between neck MSD and individual and work related factors. Materials and Methods: The investigation which consisted of two parts - a questionnaire study (using Nordic Musculoskeletal questionnaire and Copenhagen Psychosocial Questionnaire and a direct observation (to evaluate ergonomic work environment using RULA method was carried out in three randomly selected public sector companies of Kaunas. The study population consisted of 513 public service office workers. Results: The survey showed that neck MSDs were very common in the investigated population. The prevalence rate amounted to 65.7%. According to our survey neck MSDs were significantly associated with older age, bigger work experience, high quantitative and cognitive job demands, working for longer than 2 h without taking a break as well as with higher ergonomic risk score. The fully adjusted model working for longer than 2 h without taking a break had the strongest associations with neck complaints. Conclusion: It was confirmed, that neck MSDs were significantly associated with individual factors as well as conditions of work, therefore, preventive acions against neck complaints should be oriented at psychosocial and ergonomic work environment as well as at individual factors.

  8. Magnetoresistance effects associated with various electric conduction mechanisms in nanostructured [C/FeCo]{sub n} multilayers

    Energy Technology Data Exchange (ETDEWEB)

    Zeng, Y.P. [School of Materials Science and Engineering, South China University of Technology, Guangzhou, 510640 China (China); Liu, Z.W., E-mail: zwliu@scut.edu.cn [School of Materials Science and Engineering, South China University of Technology, Guangzhou, 510640 China (China); Mikmeková, E. [Institute of Scientific Instruments of the ASCR, v.v.i., Kralovopolska 147, Brno, 61264 Czech Republic (Czech Republic)

    2017-01-01

    An evolution of magnetoresistance (MR) mechanism with the film structure was discovered in nanostructured [C/FeCo]{sub n} thin films fabricated by magnetron sputtering. The discontinuous multilayer nanogranular structure was confirmed by microstructure characterization. As the layer number n increased, the MR value of the film changed from positive to negative. The fitting curves of lnR−T{sup −1/2} and lnR−T{sup −1/4} show that there is a transition of the conduction regime in the temperature range of 2–300 K. The significant different MR effects at various conduction regimes indicated that the type of transport regime plays an important role in MR origin. - Highlights: • Nanostructured [FeCo/C]n multilayers were produced and characterized. • MR changed from positive to negative with the increase of layer number. • An ES-VRH to Mott-VRH conduction transition with temperature was found. • Significant different MR effects are closely related to various conduction regimes.

  9. Adversity and Resilience Are Associated with Outcome after Mild Traumatic Brain Injury in Military Service Members.

    Science.gov (United States)

    Reid, Matthew W; Cooper, Douglas B; Lu, Lisa H; Iverson, Grant L; Kennedy, Jan E

    2018-05-15

    The objective of this study was to assess the associations between resilience, adversity, post-concussion symptoms, and post-traumatic stress symptom reporting after mild traumatic brain injury (mTBI). We hypothesized that resilience would be associated with less symptom reporting, and adversity would be associated with greater symptom reporting. This was a cross-sectional study of retrospective data collected for an ongoing TBI repository. United States military service members who screened positive for mTBI during a primary care visit completed the Trauma History Screen (THS), Connor-Davidson Resilience Scale (CD-RISC), Neurobehavioral Symptom Inventory (NSI), and post-traumatic stress disorder (PTSD) Checklist-Civilian Version (PCL-C). Data collected from February 2015 to August 2016 were used for the present study. Only participants with complete data for the above measures were included, yielding a sample size of 165 participants. Adversity (THS) and resilience (CD-RISC) scores were each correlated significantly with post-concussion (NSI) and traumatic stress (PCL-C) total and subscale scores in the hypothesized direction. Interactions between adversity and resilience were absent for all measures except the NSI sensory subscale. Four traumatic event types were significantly associated positively with most NSI and PCL-C total and subscale scores, but the age at which traumatic events were first experienced showed few and mixed significant associations. In conclusion, resilience and adversity were significantly associated with symptom endorsement after mTBI. Screening for cumulative adversity may identify individuals at greater risk of developing persistent post-concussion symptoms and/or PTSD, and interventions that increase resilience may reduce symptom severity.

  10. Factors associated with hospital service satisfaction in a sample of Arab subjects with schizophrenia

    Directory of Open Access Journals (Sweden)

    Al-Zayed Adel A

    2010-10-01

    Full Text Available Abstract Background Assessment of patients' satisfaction with health care services could help to identify the strengths and weaknesses of the system and provide guidance for further development. The study's objectives were to: (i assess the pattern of satisfaction with hospital care for a sample of people with schizophrenia in Kuwait, using the Verona Service Satisfaction Scale (VSSS-EU; ii compare the pattern of satisfaction with those of similar studies; and iii assess the association of VSSS seven domains with a number of variables representing met and unmet needs for care, family caregiver burden, severity of psychopathology, level of psychosocial functioning, socio-demographic characteristics, psychological well-being and objective quality of life. Methods Consecutive outpatients in stable condition and their family caregivers were interviewed with the VSSS-EU and measures of needs for care, caregiver burden, quality of life and psychopathology. Results There were 130 patients (66.1%m, mean age 36.8. While over two-thirds expressed satisfaction with the domains of "overall satisfaction", "professionals' skills", "access", "efficacy", and "relatives' involvement", only about one-third were satisfied with the domains of "information" and "types of intervention". The later two domains were the areas in which European patients had better satisfaction than our patients, while our patients expressed better satisfaction than the Europeans in the domain of "relatives' involvement". In multiple regression analyses, self-esteem, positive and negative affect were the most important correlates of the domains of service satisfaction, while clinical severity, caregiver burden and health unmet needs for care played relatively minor roles. Conclusion The noted differences and similarities with the international data, as well as the predictive power of self-esteem and affective state, support the impression that patients' attitudes towards psychiatric care

  11. A conductance study of guanidinium chloride, thiocyanate, sulfate, and carbonate in dilute aqueous solutions: ion-association and carbonate hydrolysis effects.

    Science.gov (United States)

    Hunger, Johannes; Neueder, Roland; Buchner, Richard; Apelblat, Alexander

    2013-01-17

    We study the conductance of dilute aqueous solutions for a series of guandinium salts at 298.15 K. The experimental molar conductivities were analyzed within the framework of the Quint-Viallard theory in combination with Debye-Hückel activity coefficients. From this analysis, we find no evidence for significant ion association in aqueous solutions of guanidinium chloride (GdmCl) and guanidinium thiocyanate (GdmSCN), and the molar conductivity of these electrolytes can be modeled assuming a complete dissociation. The limiting ionic conductivity of the guanidinium ion (Gdm(+)) is accurately determined to λ(Gdm(+)) = 51.45 ± 0.10 S cm(2) mol(-1). For the bivalent salts guanidinium sulfate (Gdm(2)SO(4)) and guanidinium carbonate (Gdm(2)CO(3)), the molar conductivities show small deviations from ideal (fully dissociated electrolyte) behavior, which are related to weak ion association in solution. Furthermore, for solutions of Gdm(2)CO(3), the hydrolysis of the carbonate anion leads to distinctively increased molar conductivities at high dilutions. The observed ion association is rather weak for all studied electrolytes and cannot explain the different protein denaturing activities of the studied guanidinium salts, as has been proposed previously.

  12. Phytophthora ramorum infects tanoak sapwood and is associated with reduced sap flux and specific conductivity of xylem

    Science.gov (United States)

    Jennifer Parke; Eunsung Oh; Steve Voelker; Everett Hansen; Gerri Buckles; Barb Lachenbruch

    2008-01-01

    Culture, detection with diagnostic PCR, and microscopy demonstrated the presence of Phytophthora ramorum in the sapwood of mature, naturally infected tanoak (Lithocarpus densiflorus) trees in Curry County, Oregon. The pathogen was strongly associated with discolored sapwood (P

  13. Research Problems Associated with Limiting the Applied Force in Vibration Tests and Conducting Base-Drive Modal Vibration Tests

    Science.gov (United States)

    Scharton, Terry D.

    1995-01-01

    The intent of this paper is to make a case for developing and conducting vibration tests which are both realistic and practical (a question of tailoring versus standards). Tests are essential for finding things overlooked in the analyses. The best test is often the most realistic test which can be conducted within the cost and budget constraints. Some standards are essential, but the author believes more in the individual's ingenuity to solve a specific problem than in the application of standards which reduce problems (and technology) to their lowest common denominator. Force limited vibration tests and base-drive modal tests are two examples of realistic, but practical testing approaches. Since both of these approaches are relatively new, a number of interesting research problems exist, and these are emphasized herein.

  14. Thermal conductivity and expansion enhancement associated with formation of the superionic state in SrCl2

    International Nuclear Information System (INIS)

    Moore, J.P.; Weaver, F.J.; Graves, R.S.; McElroy, D.L.

    1983-01-01

    A second-order phase transition in SrCl 2 near 1000 K produces superionic conduction and is often called the Bredig transition. Fine-grained, 99% dense, SrCl 2 samples containing three volume percent TiO 2 to reduce radiant transport were used to measure the differential thermal expansion coefficient (α) by push-rod dilatometry and the thermal conductivity (lambda) by a radial heat flow method. Both properties show maxima near the Bredig transition. The peak α-value is over 75 x 10 -6 K -1 . The data obtained from the radial heat flow method show good agreement with earlier tests at low temperatures, and the high temperature results show a local enhancement of lambda if about 0.06 W/m.K. This enhancement cannot be attributed to electronic or radiant transport, but is due to a new mechanism of thermal diffusion of vacancy-anion interstitial pairs in the superionic state

  15. Differential Association of Stigma with Perceived Need and Mental Health Service Use.

    Science.gov (United States)

    Wong, Eunice C; Collins, Rebecca L; Breslau, Joshua; Burnam, M Audrey; Cefalu, Matthew; Roth, Elizabeth A

    2018-06-01

    This study examined the role of stigma at two stages of the treatment-seeking process by assessing associations between various types of stigma and perceived need for mental health treatment as well as actual treatment use. We analyzed cross-sectional data from the 2014 and 2016 California Well-Being Survey, a telephone survey with a representative sample of 1954 California residents with probable mental illness. Multivariable logistic regression indicated that perceived need was associated with less negative beliefs about mental illness (odds ratio [OR] = 0.72; 95% confidence interval [CI] = 0.54, 0.95) and greater intentions to conceal a mental illness (OR = 1.47; 95% CI = 1.12-1.92). Among respondents with perceived need, treatment use was associated with greater mental health knowledge/advocacy (OR = 1.63; 95% CI = 1.03-2.56) and less negative treatment attitudes (OR = 0.66; 95% CI = 0.43-1.00). Understanding which aspects of stigma are related to different stages of the help-seeking process is essential to guiding policy and program initiatives aimed at ensuring individuals with mental illness obtain needed mental health services.

  16. Association between neighbourhood fast-food and full-service restaurant density and body mass index: a cross-sectional study of Canadian adults.

    Science.gov (United States)

    Hollands, Simon; Campbell, M Karen; Gilliland, Jason; Sarma, Sisira

    2014-05-07

    Frequent fast-food consumption is a well-known risk factor for obesity. This study sought to determine whether the availability of fast-food restaurants has an influence on body mass index (BMI). BMI and individual-level confounding variables were obtained from the 2007-08 Canadian Community Health Survey. Neighbourhood socio-demographic variables were acquired from the 2006 Canadian Census. The geographic locations of all restaurants in Canada were assembled from a validated business registry database. The density of fast-food, full-service and non-chain restaurants per 10,000 individuals was calculated for respondents' forward sortation area. Multivariable regression analyses were conducted to analyze the association between restaurant density and BMI. Fast-food, full-service and non-chain restaurant density variables were statistically significantly associated with BMI. Fast-food density had a positive association whereas full-service and non-chain restaurant density had a negative association with BMI (additional 10 fast-food restaurants per capita corresponded to a weight increase of 1 kilogram; p<0.001). These associations were primarily found in Canada's major urban jurisdictions. This research was the first to investigate the influence of fast-food and full-service restaurant density on BMI using individual-level data from a nationally representative Canadian survey. The finding of a positive association between fast-food restaurant density and BMI suggests that interventions aiming to restrict the availability of fast-food restaurants in local neighbourhoods may be a useful obesity prevention strategy.

  17. Organizational characteristics associated with cultural and linguistic service provision within Alabama hospitals.

    Science.gov (United States)

    Davis, Jullet A; Whitman, Marilyn V

    2008-01-01

    Like several states in the Southeast, Alabama is in the nascent stages of an increase in the population of foreign-born individuals for whom English is a second language. These individuals are also culturally different from the traditional southern population. Given the impact of culture and language on a person's service utilization, the introduction of new cultures may pose significant challenges for Alabama's health care providers if they are not prepared. The purpose of this project is to examine the organizational characteristics associated with the provision of culturally and linguistically appropriate services by Alabama hospitals. The data for the project come from a survey of all medical/surgical hospitals (N = 101). Fifty-nine surveys were returned, giving us a 58% response rate. The data were analyzed using correlations, analysis of variance, and logistic regression. Approximately 47% of the sample hospitals reported having a staff interpreter. Furthermore, hospitals that had staff interpreters did seem to be more aware of their community, which was reflected in their mission statements. In addition, directors who viewed their role as fulfilling the strategic plan accepted the task of providing staff interpreters. Thus, several hospitals in Alabama seemed to be ready to meet the cultural and language needs of their markets.

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

    Science.gov (United States)

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

    2015-12-15

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

  19. Factors associated with regulatory action involving investigation of illnesses associated with Shiga toxin-producing Escherichia coli in products regulated by the Food Safety and Inspection Service.

    Science.gov (United States)

    Green, Alice L; Seys, Scott; Douris, Aphrodite; Levine, Jeoff; Robertson, Kis

    2014-07-01

    We described characteristics of the Escherichia coli O157 and Escherichia coli non-O157 illness investigations conducted by the United States Department of Agriculture's Food Safety and Inspection Service (FSIS) during the 5-year period from 2006 through 2010. We created a multivariable logistic regression model to determine characteristics of these investigations that were associated with FSIS regulatory action, which was defined as having occurred if a product recall occurred or if FSIS personnel performed an environmental health assessment (Food Safety Assessment) at the implicated establishment. During this period, FSIS took regulatory action in 38 of 88 (43%) investigations. Illness investigations in which FoodNet states were involved were more likely to result in regulatory action. Illness investigations in which state and local traceback, or FSIS traceback occurred were more likely to result in regulatory action. Reasons for lack of action included evidence of cross-contamination after the product left a regulated establishment, delayed notification, lack of epidemiological information, and insufficient product information.

  20. Association of British Clinical Diabetologists (ABCD): survey of specialist diabetes care services in the UK, 2000. 3. Podiatry services and related foot care issues.

    Science.gov (United States)

    Winocour, P H; Morgan, J; Ainsworth, A; Williams, D R R

    2002-07-01

    To examine the provision of, and variations in, podiatry and other services for diabetic foot care in the UK. A postal survey of secondary care providers of diabetes services in the UK in 2000. Following two reminders a 77% response rate was achieved. The responses indicated that 97% had a state-registered podiatrist attached to the service, providing three (median) sessions each week for diabetes care, although only 44% had availability at all diabetic clinics, and only 3% had availability at paediatric diabetic services. Podiatry access at all diabetic clinics increased the likelihood of associated preventative as opposed to reactive ('trouble shooting') care (P podiatry input to patient education was common (84%), only 6% had received formal training in education. Guidelines and strategies for management of active foot problems were available in 50-74% of cases. Orthotic input was highly variable, and absent in 15% of responses. Podiatrist fitting and application of foot protective apparatus was only recorded in 22-61% of responses. Access to isotopic and/or MR foot imaging and peripheral angiography and angioplasty was recorded in 75-83% of responses. Separate specialist foot clinics were available in 49%, and where this was the case the use of newer foot ulcer healing applications was higher (P podiatry support to diabetes care over the last 10 years, the level of access and the nature of the services provided is much less than recommended in many advisory documents. The strategy of a co-ordinated 'team' approach to foot care still takes place in less than 50% of centres. There are clear regional differences in diabetes foot care services. Both providers and purchasers of diabetes services may not have given sufficient attention to this area, given the relatively small number of documented bids for service improvements in this area, and the very low success rate of such bids.

  1. Is video gaming, or video game addiction, associated with depression, academic achievement, heavy episodic drinking, or conduct problems?

    Science.gov (United States)

    Brunborg, Geir Scott; Mentzoni, Rune Aune; Frøyland, Lars Roar

    2014-03-01

    While the relationships between video game use and negative consequences are debated, the relationships between video game addiction and negative consequences are fairly well established. However, previous studies suffer from methodological weaknesses that may have caused biased results. There is need for further investigation that benefits from the use of methods that avoid omitted variable bias. Two wave panel data was used from two surveys of 1,928 Norwegian adolescents aged 13 to 17 years. The surveys included measures of video game use, video game addiction, depression, heavy episodic drinking, academic achievement, and conduct problems. The data was analyzed using first-differencing, a regression method that is unbiased by time invariant individual factors. Video game addiction was related to depression, lower academic achievement, and conduct problems, but time spent on video games was not related to any of the studied negative outcomes. The findings were in line with a growing number of studies that have failed to find relationships between time spent on video games and negative outcomes. The current study is also consistent with previous studies in that video game addiction was related to other negative outcomes, but it made the added contribution that the relationships are unbiased by time invariant individual effects. However, future research should aim at establishing the temporal order of the supposed causal effects. Spending time playing video games does not involve negative consequences, but adolescents who experience problems related to video games are likely to also experience problems in other facets of life.

  2. Predisposing, enabling, and need factors associated with utilization of institutional delivery services: A community-based cross-sectional study in far-western Nepal.

    Science.gov (United States)

    Freidoony, Leila; Ranabhat, Chhabi Lal; Kim, Chun-Bae; Kim, Chang-Soo; Ahn, Dong-Won; Doh, Young Ah

    2018-01-01

    Use of institutional delivery services can be effective in reducing maternal and infant mortality. In Nepal, however, the majority of women deliver at home. Using Andersen's behavioral model of use of health care services, this cross-sectional study aimed to identify factors associated with use of institutional delivery services in four villages and one municipality in Kailali district, Nepal. Mothers (N = 500) who had given birth in the 5 years preceding the survey (conducted between January and February 2015) were randomly selected by cluster sampling and interviewed using a semi-structured questionnaire. Bivariate analyses and multivariate hierarchical logistic regression analyses were performed. Among the women surveyed, 65.6% had used institutional delivery services for their last delivery, a higher proportion than the national average. Primiparity, having a secondary or higher education level, living in the Durgauli village, having husbands with occupations other than agriculture or professional/technical jobs, and having attended four or more antenatal care (ANC) visits had significantly increased use of institutional deliveries. Also, belonging to the richest 20% of the community and having experienced pregnancy complications were marginally significantly associated. These findings demonstrate the need for improving mother's education, encouraging them to attend ANC visits and addressing disparities between different regions.

  3. The Public's Attitude Toward Public Library Services in Essex County, New Jersey; A Research Study Conducted for the Essex County Library Directors Group Public Relations Committee.

    Science.gov (United States)

    Market Dynamics, Inc., Princeton, NJ.

    In order to structure an effective campaign aimed at increasing the usage of the public libraries in Essex County, New Jersey, this research project was undertaken to determine the consumer attitudes toward various aspects of public library services. These aspects include: extent of public library usage; awareness of library services offered,…

  4. Patient satisfaction with the perioperative surgical services and associated factors at a University Referral and Teaching Hospital, 2014: a cross-sectional study.

    Science.gov (United States)

    Gebremedhn, Endale Gebreegziabher; Lemma, Girmay Fitiwi

    2017-01-01

    Globally, increasing consideration has been given to the assessment of patient satisfaction as a method of monitor of the quality of health care provision in the health institutions. Perioperative patient satisfaction has been contemplated to be related with the level of postoperative pain intensity, patients' expectation of the outcome, patient health provider relationship, inpatient services, hospital facilities, access to care, waiting time, cost and helpfulness of treatments received. The study aimed to assess the level of patient satisfaction with perioperative surgical services and associated factors. Hospital based quantitative cross-sectional study was conducted in University of Gondar teaching hospital from April1-30, 2014. Structured Amharic version questionnaire and checklist used for data collection. All patients who operated upon during the study period were included. Both bivariate and multivariate logistic regression model used to identify the variables which had association with the dependent variable. P-values patient satisfaction with perioperative surgical services was 98.1%. The variables that had association with the outcome variable from the multivariate analysis were patient admission status (AOR=0.073, CI=0.007-0.765, P=0.029), information about the disease and operation (AOR=0.010, CI=0.001-0.140, P=0.001) and operation theatre staff attention to the patients complains (AOR=0.028, CI=0.002-0.390, P=0.008) respectively. The level of patient satisfaction with perioperative surgical services was high compared with previous studies conducted in the country and other countries in the world. Health professionals need to give emphasis for information on care provision processes, patients' health progress and patients' complaints.

  5. Association between diabetes type 1 and DQB1 alleles in a case-control study conducted in Montevideo, Uruguay.

    Science.gov (United States)

    Mimbacas, Adriana; Pérez-Bravo, Francisco; Hidalgo, Pedro C; Javiel, Gerardo; Pisciottano, Carmen; Grignola, Rosario; Jorge, Ana María; Gallino, Juan Pablo; Gasagoite, Jackeline; Cardoso, Horacio

    2003-03-31

    We studied HLA DQB1 allele frequencies and the relative risk (RR) of various genotypes in 72 type 1 diabetic patients and 40 control individuals in Uruguay. This is a tri-racial (Caucasian, Black and Indo-American) mixed population. The products of the polymerase chain reaction amplifications were hybridized with oligonucleotides by allele-specific oligonucleotide reverse or dot blot methods. Significant differences between these two groups were observed only for allele DQB1*0302 (35%, RR = 7.34, P<0.001). The frequency of the alleles carrying a non-aspartic acid residue at position 57 was significantly higher in the diabetic patients (85 vs 53%, P<0.001). In contrast, the frequency of Asp alleles was negatively associated with type 1 diabetes (RR = 0.20, P<0.001). The genotype DQB1*0302/DQB1*0201 (33%, RR = 5.41, P<0.05) was positively associated with this disease. The genotype frequencies associated with type 1 diabetes in our population were significantly different from what is known for Caucasian and Black populations as well as compared with another admixed population, from Chile.

  6. Is video gaming, or video game addiction, associated with depression, academic achievement, heavy episodic drinking, or conduct problems?

    Science.gov (United States)

    Brunborg, Geir Scott; Mentzoni, Rune Aune; Frøyland, Lars Roar

    2014-01-01

    Background and aims: While the relationships between video game use and negative consequences are debated, the relationships between video game addiction and negative consequences are fairly well established. However, previous studies suffer from methodological weaknesses that may have caused biased results. There is need for further investigation that benefits from the use of methods that avoid omitted variable bias. Methods: Two wave panel data was used from two surveys of 1,928 Norwegian adolescents aged 13 to 17 years. The surveys included measures of video game use, video game addiction, depression, heavy episodic drinking, academic achievement, and conduct problems. The data was analyzed using first-differencing, a regression method that is unbiased by time invariant individual factors. Results: Video game addiction was related to depression, lower academic achievement, and conduct problems, but time spent on video games was not related to any of the studied negative outcomes. Discussion: The findings were in line with a growing number of studies that have failed to find relationships between time spent on video games and negative outcomes. The current study is also consistent with previous studies in that video game addiction was related to other negative outcomes, but it made the added contribution that the relationships are unbiased by time invariant individual effects. However, future research should aim at establishing the temporal order of the supposed causal effects. Conclusions: Spending time playing video games does not involve negative consequences, but adolescents who experience problems related to video games are likely to also experience problems in other facets of life. PMID:25215212

  7. Factors associated with emergency services use in Taiwanese advanced cancer patients receiving palliative home care services during out-of-hours periods: a retrospective medical record study.

    Science.gov (United States)

    Kao, Yee-Hsin; Liu, Yao-Ting; Koo, Malcolm; Chiang, Jui-Kun

    2018-03-12

    For patients receiving palliative home care, the need to visit the emergency department is considered to be an indicator of poor quality care. The situation can be particularly distressing when it occurs outside of normal hours of palliative home care service. The aim of this study was to investigate the factors for emergency department use during out-of-hours periods of palliative home care service among advanced cancer patients in Taiwan. This case-control study was based on a retrospective medical chart review (January 2010 to December 2012) of advanced cancer patients who were receiving palliative home care in a community hospital in south Taiwan. The use of emergency medical services by these patients was dichotomized into either normal hours (8 a.m. to midnight, Monday to Friday, excluding public holidays) of palliative home care or outside normal hours. Logistic regression analyses were performed to evaluate factors associated with emergency services use during out-of-hours period of palliative home care. Of the 94 patients receiving palliative home care, 65 had used emergency services at least once during the 3-year study period. Of these 65 patients, 40% used emergency services during out-of-hours of palliative home care. Patients with distressing conditions (defined as the occurrence of any two conditions of dyspnea, change of consciousness, or gastrointestinal bleeding) were significantly more likely to use emergency services during out-of-hours of palliative home care. Patients at risk of developing dyspnea, change of consciousness, or gastrointestinal bleeding should be provided with relevant information regarding these symptoms and signs.

  8. Patterns of the utilization of prenatal diagnosis services among pregnant women, their satisfaction and its associated factors in Viet Nam.

    Science.gov (United States)

    Doan, Duong Thi Thuy; Nguyen, Huong Thi Thu; Bui, Ha Thi Thu

    2017-02-01

    This study aimed at understanding the patterns of the utilization of prenatal diagnostic (PND) services among pregnant women, their satisfaction and its associated factors at three regional prenatal diagnostic centres in Viet Nam. A cross-sectional design was used, with a consecutive sampling method to recruit pregnant women who used PND services at the three biggest regional PND services centres in Viet Nam between January and June, 2014. A total of 298 participants, about 100 participants per centre were interviewed and included in data analysis. Descriptive analyses and logistic regression methods were applied to identify association between satisfaction of women and their socio-economic characteristics. 80% of pregnant women received counselling on PND services, whilst 90% received ultrasonography services; 65.4% were satisfied with the PND services they used. Pregnant women, who were in a lower income group and received counselling but did not receive ultrasonography, were more likely to have higher satisfaction levels of PND services. A process to ensure that every pregnant woman receives sufficient PND counselling before and after receiving PND testing must be given careful and thorough consideration.

  9. Enhanced biogeochemical cycling and subsequent reduction of hydraulic conductivity associated with soil-layer interfaces in the vadose zone

    Science.gov (United States)

    Hansen, David J.; McGuire, Jennifer T.; Mohanty, Binayak P.

    2013-01-01

    Biogeochemical dynamics in the vadose zone are poorly understood due to the transient nature of chemical and hydrologic conditions, but are nonetheless critical to understanding chemical fate and transport. This study explored the effects of a soil layer on linked geochemical, hydrological, and microbiological processes. Three laboratory soil columns were constructed: a homogenized medium-grained sand, a homogenized organic-rich loam, and a sand-over-loam layered column. Upward and downward infiltration of water was evaluated during experiments to simulate rising water table and rainfall events respectively. In-situ collocated probes measured soil water content, matric potential, and Eh while water samples collected from the same locations were analyzed for Br−, Cl−, NO3−, SO42−, NH4+, Fe2+, and total sulfide. Compared to homogenous columns, the presence of a soil layer altered the biogeochemistry and water flow of the system considerably. Enhanced biogeochemical cycling was observed in the layered column over the texturally homogeneous soil columns. Enumerations of iron and sulfate reducing bacteria showed 1-2 orders of magnitude greater community numbers in the layered column. Mineral and soil aggregate composites were most abundant near the soil-layer interface; the presence of which, likely contributed to an observed order-of-magnitude decrease in hydraulic conductivity. These findings show that quantifying coupled hydrologic-biogeochemical processes occurring at small-scale soil interfaces is critical to accurately describing and predicting chemical changes at the larger system scale. Findings also provide justification for considering soil layering in contaminant fate and transport models because of its potential to increase biodegradation and/or slow the rate of transport of contaminants. PMID:22031578

  10. Individual, social, and behavioral factors associated with co-occurring conduct problems and callous-unemotional traits.

    Science.gov (United States)

    Fanti, Kostas A

    2013-07-01

    Conduct problems (CP) and callous-unemotional (CU) traits can have a long-lasting negative impact into adulthood. Importantly, among youth with CP, those high on CU traits engage in a more severe, aggressive, and persistent pattern of antisocial behavior. The current study investigates the co-occurrence between CP and CU traits among a large sample of Greek-Cypriot adolescents (N = 1,674; 50.1 % girls). Five distinct groups were identified with Latent Profile Analysis: low risk (48.7 %), average risk (33.8 %), co-occurring high CP-high CU (5.4 %), high CP-low CU (5.2 %), and low CP-high CU (6.9 %). Although more boys were identified in the higher risk groups, boys and girls within each group were not differentiated on levels of CP or CU traits during early adolescence. Youth in the identified groups were compared on early (Mean age = 12.12) and middle (Mean age = 14.02) adolescence individual and contextual factors. Youth with high CP-high CU were at higher risk for behavioral (bullying and substance use), individual (inattention, impulsivity, narcissism), and contextual (low family-support) problems compared to youth in the high CP-low CU and low CP-high CU groups, providing evidence that the combination of CP and CU traits might constitute a pathological group. These findings demonstrate the usefulness of sub-typing CP based on CU traits for the forthcoming fifth edition of the Diagnostic and Statistical Manual. Additional novel findings suggested that adolescents scoring high on CP, irrespective of CU, were not differentiated on hyperactivity, victimization, and anxiety/depression, and adolescents scoring high on CU traits, with or without CP, reported similar low levels of self-esteem and peer and family social-support.

  11. Combined Bicarbonate Conductance-Impairing Variants in CFTR and SPINK1 Are Associated with Chronic Pancreatitis in Patients without Cystic Fibrosis

    Science.gov (United States)

    Schneider, Alexander; LaRusch, Jessica; Sun, Xiumei; Aloe, Amy; Lamb, Janette; Hawes, Robert; Cotton, Peter; Brand, Randall E.; Anderson, Michelle A.; Money, Mary E.; Banks, Peter A.; Lewis, Michele D.; Baillie, John; Sherman, Stuart; DiSario, James; Burton, Frank R.; Gardner, Timothy B.; Amann, Stephen T.; Gelrud, Andres; George, Ryan; Kassabian, Sirvart; Martinson, Jeremy; Slivka, Adam; Yadav, Dhiraj; Oruc, Nevin; Barmada, M. Michael; Frizzell, Raymond; Whitcomb, David C.

    2010-01-01

    Background & Aims Idiopathic chronic pancreatitis (ICP) is a complex inflammatory disorder associated with multiple genetic and environmental factors. In individuals without cystic fibrosis (CF), variants of CFTR that inhibit bicarbonate conductance but maintain chloride conductance might selectively impair secretion of pancreatic juice, leading to trypsin activation and pancreatitis. We investigated whether sequence variants in the gene encoding the pancreatic secretory trypsin inhibitor, SPINK1, further increase the risk of pancreatitis in these patients. Methods We screened patients with ICP (sporadic or familial) and controls for variants in SPINK1 associated with chronic pancreatitis (CP) risk (in exon 3) and in all 27 exons of CFTR. The final study group included 53 patients with sporadic ICP, 27 probands with familial ICP, and 150 unrelated controls, plus 503 controls for limited genotyping. CFTR wild-type (wt) and p.R75Q were cloned and expressed in HEK293 cells and relative conductances of HCO3− and Cl− were measured. Results SPINK1 variants were identified in 36% of subjects and 3% controls (odds ratio [OR]=16.5). One variant of CFTR that has not been associated with CF, p.R75Q, was found in 16% of subjects and 5.4% controls (OR=3.4). Co-inheritance of CFTR p.R75Q and SPINK1 variants occurred in 8.75% of patients and 0.15% controls (OR=62.5). Patch-clamp recordings of cells that expressed CFTR p.R75Q demonstrated normal chloride currents but significantly reduced bicarbonate currents (P=0.0001). Conclusions The CFTR variant p.R75Q causes a selective defect in bicarbonate conductance and increases risk for pancreatitis. Co-inheritance of CF-associated, and some not associated, CFTR variants with SPINK1 variants significantly increase risk of ICP. PMID:20977904

  12. Skilled delivery service utilization and its association with the establishment of Women's Health Development Army in Yeky district, South West Ethiopia: a multilevel analysis.

    Science.gov (United States)

    Negero, Melese Girmaye; Mitike, Yifru Berhan; Worku, Abebaw Gebeyehu; Abota, Tafesse Lamaro

    2018-01-30

    Because of the unacceptably high maternal and perinatal morbidity and mortality, the government of Ethiopia has established health extension program with a community-based network involving health extension workers (HEWs) and a community level women organization which is known as "Women's Health Development Army" (WHDA). Currently, the HEWs and WHDA network is the approach preferred by the government to register pregnant women and encourage them to link in the healthcare system. However, its association with skilled delivery service utilization is not well known. A community-based cross-sectional study was conducted from January to February 2015. Within 380 clusters of WHDA, a total of 748 reproductive-age women who gave birth in 1 year preceding the study, were included using multistage sampling technique. The data were entered into EPI info version 7 statistical software and exported to STATA version 11 for analysis. Multilevel analysis technique was applied to check for an association of selected variables with a utilization of skilled delivery service. About 45% of women have received skilled delivery care. A significant heterogeneity was observed between "Women's Health Development Teams (clusters)" for skilled delivery care service utilization which explains about 62% of the total variation. Individual-level predictors including urban residence [AOR (95% CI) 35.10 (4.62, 266.52)], previous exposure of complications [AOR (95% CI) 3.81 (1.60, 9.08)], at least four ANC visits [AOR (95% CI) 7.44 (1.48, 37.42)] and preference of skilled personnel [AOR (95% CI) 8.11 (2.61, 25.15)] were significantly associated with skilled delivery service use. Among cluster level variables, the distance of clusters within 2 km radius from the nearest health facility was significantly associated [AOR (95% CI) 6.03 (1.92, 18.93)] with skilled delivery service utilization. In this study, significant variation among clusters of WHDA was observed. Both individual and cluster level

  13. Interleukin-1 antagonism moderates the inflammatory state associated with Type 1 diabetes during clinical trials conducted at disease onset.

    Science.gov (United States)

    Cabrera, Susanne M; Wang, Xujing; Chen, Yi-Guang; Jia, Shuang; Kaldunski, Mary L; Greenbaum, Carla J; Mandrup-Poulsen, Thomas; Hessner, Martin J

    2016-04-01

    It was hypothesized that IL-1 antagonism would preserve β-cell function in new onset Type 1 diabetes (T1D). However, the Anti-Interleukin-1 in Diabetes Action (AIDA) and TrialNet Canakinumab (TN-14) trials failed to show efficacy of IL-1 receptor antagonist (IL-1Ra) or canakinumab, as measured by stimulated C-peptide response. Additional measures are needed to define immune state changes associated with therapeutic responses. Here, we studied these trial participants with plasma-induced transcriptional analysis. In blinded analyses, 70.2% of AIDA and 68.9% of TN-14 participants were correctly called to their treatment arm. While the transcriptional signatures from the two trials were distinct, both therapies achieved varying immunomodulation consistent with IL-1 inhibition. On average, IL-1 antagonism resulted in modest normalization relative to healthy controls. At endpoint, signatures were quantified using a gene ontology-based inflammatory index, and an inverse relationship was observed between measured inflammation and stimulated C-peptide response in IL-1Ra- and canakinumab-treated patients. Cytokine neutralization studies showed that IL-1α and IL-1β additively contribute to the T1D inflammatory state. Finally, analyses of baseline signatures were indicative of later therapeutic response. Despite the absence of clinical efficacy by IL-1 antagonist therapy, transcriptional analysis detected immunomodulation and may yield new insight when applied to other clinical trials. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  14. Conducting Polymers

    Indian Academy of Sciences (India)

    would exhibit electronic conductivity, their conductivities (of compressed pellets) were indeed measured by others, and were found to be .... Polyaniline. Polyphenylene. Polypheny lene- vinylene. Table 1. G!NeRAl I ARTICl! structure. Maximum conductivity Stem Stability. Processability. ~. 1.5 x 105. Reacts with Film not n air.

  15. 13 CFR 108.900 - Fees for management services provided to a Small Business by a NMVC Company or its Associate.

    Science.gov (United States)

    2010-01-01

    ... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Fees for management services... Small Businesses by NMVC Companies Management Services and Fees § 108.900 Fees for management services... management services that you or your Associate provide to a Small Business during the term of a Financing or...

  16. Nursing Unit Environment Associated with Provision of Language Services in Pediatric Hospices.

    Science.gov (United States)

    Lindley, Lisa C; Held, Mary L; Henley, Kristen M; Miller, Kathryn A; Pedziwol, Katherine E; Rumley, Laurie E

    2017-04-01

    Provision of language services in pediatric hospice enables nurses to communicate effectively with patients who have limited English proficiency. Language barriers contribute to ethnic disparities in health care. While language service use corresponds with improved patient comprehension of illness and care options, we lack an understanding of how the nurse work environment affects the provision of these services. Data were obtained from the 2007 National Home and Hospice Care Survey and included a study sample of 1251 pediatric hospice agencies. Variable selection was guided by structural contingency theory, which posits that organizational effectiveness is dependent upon how well an organization's structure relates to its context. Using multivariate logistic regression, we analyzed the extent to which nursing unit environment predicted provision of translation services and interpreter services. The majority of hospices provided translation services (74.9 %) and interpreter services (87.1 %). Four variables predicted translation services: registered nurse (RN) unit size, RN leadership, RN medical expertise, and for-profit status. RN medical expertise and having a safety climate within the hospice corresponded with provision of interpreter services. Findings indicate that nursing unit environment predicts provision of language services. Hospices with more specialized RNs and a stronger safety climate might include staffs who are dedicated to best care provision, including language services. This study provides valuable data on the nurse work environment as a predictor of language services provision, which can better serve patients with limited English proficiency and ultimately reduce ethnic disparities in end-of-life care for children and their families.

  17. Implementation of Brazil's "family health strategy": factors associated with community health workers', nurses', and physicians' delivery of drug use services.

    Science.gov (United States)

    Spector, Anya Y; Pinto, Rogério M; Rahman, Rahbel; da Fonseca, Aline

    2015-05-01

    Brazil's "family health strategy" (ESF), provides primary care, mostly to individuals in impoverished communities through teams of physicians, nurses, and community health workers (CHWs). ESF workers are called upon to offer drug use services (e.g., referrals, counseling) as drug use represents an urgent public health crisis. New federal initiatives are being implemented to build capacity in this workforce to deliver drug use services, yet little is known about whether ESF workers are providing drug use services already. Guided by social cognitive theory, this study examines factors associated with ESF workers' provision of drug use services. Cross-sectional surveys were collected from 262 ESF workers (168 CHWs, 62 nurses, and 32 physicians) in Mesquita, Rio de Janeiro State and Santa Luzia, Minas Gerais State. provision of drug-use services. capacity to engage in evidence-based practice (EBP), resource constraints, peer support, knowledge of EBP, and job title. Logistic regression was used to determine relative influence of each predictor upon the outcome. Thirty-nine percent reported providing drug use services. Younger workers, CHWs, workers with knowledge about EBP and workers that report peer support were more likely to offer drug use services. Workers that reported resource constraints and more capacity to implement EBP were less likely to offer drug use services. ESF workers require education in locating, assessing and evaluating the latest research. Mentorship from physicians and peer support through team meetings may enhance workers' delivery of drug use services, across professional disciplines. Educational initiatives aimed at ESF teams should consider these factors as potentially enhancing implementation of drug use services. Building ESF workers' capacity to collaborate across disciplines and to gain access to tools for providing assessment and treatment of drug use issues may improve uptake of new initiatives. Copyright © 2014 Elsevier B.V. All

  18. Prevalence of mental disorders in a population requesting health services at a primary health care center and its association with suicidal ideation and perceived disability

    Directory of Open Access Journals (Sweden)

    Mérida R. Rodríguez

    2012-10-01

    Full Text Available Objective: this study’s goal was to determine the most prevalent mental disorders and the impact on the perception of disability and suicidal ideation among the population from a primary health care center in the city of Cali. Methodology: a cross sectional study was conducted on 254 patients who were screened with the prime-md instrument. Descriptive statistics was used in the analysis to determine the most frequent disorders. Similarly, a multiple analysis with logistic and Poisson regressions using robust variance was conducted to determine the influence of mental disorders on disability and suicidal ideation. Results: most patients were female, young, and mature adults. Depression was present in 66.8% of all cases, followed by somatization disorder and anxiety. Half of the patients had had suicidal ideations at some point in their lives, and three out of four patients claimed to suffer from some kind of disability. Upon adjusting for the covariables, depression and anxiety disorders had a strong association with suicidal ideation and perceived disability that was overestimated by the logistic regression. Conclusion: depression and anxiety were the most common disorders and showed a strong association with suicidal ideation and disability. This is why it is necessary to screen for those disorders among adults using primary health care services. Likewise, we suggest considering Poisson regression with robust variance in cross-sectional studies in health services.

  19. Are doctors and nurses associated with coverage of essential health services in developing countries? A cross-sectional study

    Directory of Open Access Journals (Sweden)

    de Pinho Helen

    2009-03-01

    Full Text Available Abstract Background There is broad policy consensus that a shortage of doctors and nurses is a key constraint to increasing utilization of essential health services important for achieving the health Millennium Development Goals. However there is limited research on the quantitative links between health workers and service coverage rates. We examined the relationship between doctor and nurse concentrations and utilization rates of five essential health services in developing countries. Methods We performed cross-national analyses of low- and middle-income countries by means of ordinary least squares regression with coverage rates of antenatal care, attended delivery, caesarean section, measles immunization, tuberculosis case diagnosis and care for acute respiratory infection as outcomes. Doctor, nurse and aggregate health worker (sum of doctors and nurses concentrations were the main explanatory variables. Results Nurses were associated with utilization of skilled birth attendants (P = 0.02 and doctors were associated with measles immunization rates (P = 0.01 in separate adjusted analyses. Aggregate health workers were associated with the utilization of skilled birth attendants (P Conclusion A range of health system and population-level factors aside from health workers influences coverage of health services in developing countries. However, it is also plausible that health workers who are neither doctors nor nurses, such as clinical officers and community health workers, may be providing a substantial proportion of health services. The human resources for health research agenda should be expanded beyond doctors and nurses.

  20. Scaling up postabortion contraceptive service--results from a study conducted among women having unwanted pregnancies in urban and rural Tanzania

    DEFF Research Database (Denmark)

    Rasch, Vibeke; Yambesi, Fortunata; Kipingili, Rose

    2005-01-01

    Tanzania and 42% in rural Tanzania stated that their pregnancy was unwanted. Contraceptive acceptance among women with unwanted pregnancies was high; 93% in urban Tanzania and 71% in rural Tanzania left with a contraceptive method. CONCLUSION: The high proportion of women with unwanted pregnancies in urban...... and rural Tanzania underlines the need of scaling up postabortion contraceptive service....

  1. Patterns of smoking and its association with psychosocial work conditions among blue-collar and service employees of hospitality venues in Shenyang, PR China.

    Science.gov (United States)

    Li, Xun; Liang, Huiying; Li, Xuelian; Guan, Peng; Yin, Zhihua; Zhou, Baosen

    2010-01-27

    To characterize the smoking patterns of hospitality employees in blue-collar and service occupations, and to examine its relations with psychosocial work conditions. The Shenyang Hospitality Industry Employees Survey-a face-to-face cross-sectional study of representative hospitality industry employees-was conducted between March and July 2008. A total of 4,213 workers were selected using stratified random cluster sampling designs, and final analyses were performed on 2,508 blue-collar and service subjects. Multilevel-logistic regression models were used to estimate the contribution of psychosocial work conditions to smoking status. Blue-collar and service employees smoked at a rate 1.4 times that of the general population (49.4% vs. 35.8%), more particularly for females (12.9% vs. 3.08%). Strain jobs had significantly higher odds ratio of daily smoking (OR 2.09, 95%CI: 1.28-3.41) compared to the relaxed category. The passive jobs (OR 2.01, 95%CI 1.27 to 3.17), highest job demands (OR 1.72, 95%CI: 1.13-2.61), and lowest job control (OR 2.56, 95%CI: 1.57-4.16) were also associated with a significantly higher daily smoking ratio. The negative relationship between job stability and smoking behavior was slightly stronger among daily than occasional smokers. However, neither job strain nor any of its components was found to be significantly associated with occasional smoking. Smoking in hospitality blue-collar and service employees is certainly a major occupational health problem in Shenyang. This evidence also suggests an association between psychosocial-work conditions and smoking status, and implies that more intervention studies where changes in work environment are carried out in combination with health promotion interventions should be performed.

  2. Family planning utilization and factors associated among women receiving abortion services in health facilities of central zone towns of Tigray, Northern Ethiopia: a cross sectional Study.

    Science.gov (United States)

    Hagos, Goshu; Tura, Gurmesa; Kahsay, Gizienesh; Haile, Kebede; Grum, Teklit; Araya, Tsige

    2018-06-05

    Abortion remains among the leading causes of maternal death worldwide. Post-abortion contraception is significantly effective in preventing unintended pregnancy and abortion if provided before women leave the health facilty. However, the status of post-abortion family planning (PAFP) utilization and the contributing factors are not well studied in Tigray region. So, we conduct study aimed on family planning utilization and factors associated with it among women receiving abortion services. A facility based cross-sectional study design was conducted among women receiving abortion services in central zone of Tigray from December 2015to February 2016 using a total of 416 sample size. Women who came for abortion services were selected using systematic random sampling technique.. The data were collected using a pre-tested interviewer administered questionnair. Data were coded and entered in to Epi info 7 and then exported to SPSS for analysis. Descriptive statisticslike frequencies and mean were computed to display the results. Both Bivariable and multivariable logistic regression was used in the analysis. Variables statistically significant at p < 0.05 in the bivariable analysis were checked in multivariable logistic regration to identify independently associated factors. Then variables which were significantly associated with post abortion family planning utilization at p-value < 0.05 in the multivariable analysis were declared as significantly associated factors. A total of 409 abortion clients were interviewed in this study with 98.3% of response rate. Majority 290 (70.9%) of study participants utilized contracepives after abortion. Type of health facility, the decision maker on timing of having child, knowledge that pregnancy can happen soon after abortion and husband's opposition towards contraceptives were significantly associated with Post-abortion family planning ustilization. About one-third of abortion women failed to receive contraceptive before

  3. Association of ionic liquids in solution: a combined dielectric and conductivity study of [bmim][Cl] in water and in acetonitrile.

    Science.gov (United States)

    Bešter-Rogač, Marija; Stoppa, Alexander; Hunger, Johannes; Hefter, Glenn; Buchner, Richard

    2011-10-21

    Ion association of the ionic liquid [bmim][Cl] in acetonitrile and in water was studied by dielectric spectroscopy for salt concentrations c ≤ 1.3 M at 298.15 K and by measurement of molar electrical conductivities, Λ, of dilute solutions (c ≤ 0.006 M) in the temperature range 273.15 ≲ T/K ≤ 313.15. Whilst acetonitrile solutions of [bmim][Cl] exhibit moderate ion pairing, with an association constant of K°(A) ≈ 60 M(-1) and increasing with temperature, [bmim][Cl] is only weakly associated in water (K°(A) ≈ 6 M(-1)) and ion pairing decreases with rising temperature. Only contact ion pairs were detected in both solvents. Standard-state enthalpy, entropy and heat capacity changes of ion association were derived, as well as the activation enthalpy of charge transport and the limiting conductivity of the cation, λ(∞) ([bmim](+)). These data, in conjunction with effective solvation numbers obtained from the dielectric spectra, suggest that the solvation of [bmim](+) is much weaker in water than in acetonitrile. This journal is © the Owner Societies 2011

  4. Factors Associated with Mental Health Service Utilization among Korean American Immigrants

    Science.gov (United States)

    Park, So-Youn; Cho, Sunhee; Park, Yeddi; Bernstein, Kunsook S.; Shin, Jinah K.

    2014-01-01

    This study adapted Andersen's Health Belief Model to examine the predictors of mental health services utilization among Korean American (KA) immigrants. A cross-sectional survey was used to gather data on 363 KA immigrants 18 years and older residing in New York City. Predisposing factors included gender, age, marital status, education, length of stay in the US, and religion; the need factor was depression; and enabling factors included health insurance, English proficiency, income, and perceived need for help. Approximately 8.5 % of participants reported having utilized mental health services, while 23 % reported having depressive symptoms. Shorter duration of residence in the US, lower income, and the presence of perceived need for help were significantly related to use of mental health services. The perceived need for help mediated the relationship between depression and mental health service utilization. Failure to perceive the need for psychological help continues to be a major reason that KA immigrants do not use mental health services. PMID:23417654

  5. Association between obesity, quality of life, physical activity and health service utilization in primary care patients with osteoarthritis.

    NARCIS (Netherlands)

    Rosemann, T.J.; Grol, R.P.T.M.; Herman, K.; Wensing, M.J.P.; Szecsenyi, J.

    2008-01-01

    ABSTRACT: OBJECTIVE: To assess the association of obesity with quality of life, health service utilization and physical activity in a large sample of primary care patients with osteoarthritis (OA). METHODS: Data were retrieved from the PraxArt project, representing a cohort of 1021 primary care

  6. Beliefs Associated with Support for Child-Centred Learning Environment among Hong Kong Pre-Service Early Childhood Teachers

    Science.gov (United States)

    Cheung, Sum Kwing; Ling, Elsa Ka-wei; Leung, Suzannie Kit Ying

    2017-01-01

    The physical, social and temporal dimensions of the classroom environment have an important role in children's learning. This study examines the level of support for child-centred learning, and its associated beliefs, that is provided by Hong Kong's pre-service early childhood teachers. Two hundred and seventy-five students from a pre-service…

  7. The association between income source and met need among community mental health service users in Ontario, Canada.

    Science.gov (United States)

    Durbin, Anna; Bondy, Susan J; Durbin, Janet

    2012-10-01

    We examined income source and match between recommended and received care among users of community mental health services. We conducted a secondary analysis of needs-based planning data on adults in Ontario community mental health programs from 2000 to 2002. The outcome was whether clients were severely underserved (yes/no) based on the match between level of care recommended and received. A logistic regression model investigated if income source predicted this outcome. 13% of clients were severely underserved. Over 40% were on public assistance and they had a higher risk of being severely undeserved than the others. Men were at greater risk. One aim of mental health reform is to increase access to care for vulnerable individuals. The finding that among users of community mental health services, individuals with public assistance income support are most vulnerable to being severely underserved should be considered by service planners and providers.

  8. The Associations Between Pre- and Postnatal Maternal Symptoms of Distress and Preschooler's Symptoms of ADHD, Oppositional Defiant Disorder, Conduct Disorder, and Anxiety

    DEFF Research Database (Denmark)

    Bendiksen, Bothild; Aase, Heidi; Diep, Lien My

    2015-01-01

    ,195), recruited from the Norwegian Mother and Child Cohort Study, were assessed with a semistructured parental psychiatric interview. Perinatal maternal symptoms of distress were assessed by Symptom Checklist (SCL-5); Poisson regression was used to examine the associations. RESULTS: Mid-gestational maternal......OBJECTIVE: The objective of this article is to examine the associations between pre- and postnatal maternal distress and preschooler's symptoms of ADHD, Oppositional Defiant Disorder (ODD), Conduct Disorder (CD), and anxiety, by timing and gender. METHOD: Children, aged 3.5 years (N = 1...... distress significantly increased the average number of child symptoms, ranging between 3.8% for ADHD hyperactive-impulsive (ADHD-HI) and 8.7% for anxiety. The combination of high maternal scores of distress both pre- and postnatally were associated with increased risk of child symptoms of anxiety (relative...

  9. Associations between dairy cow inter-service interval and probability of conception.

    Science.gov (United States)

    Remnant, J G; Green, M J; Huxley, J N; Hudson, C D

    2018-07-01

    Recent research has indicated that the interval between inseminations in modern dairy cattle is often longer than the commonly accepted cycle length of 18-24 days. This study analysed 257,396 inseminations in 75,745 cows from 312 herds in England and Wales. The interval between subsequent inseminations in the same cow in the same lactation (inter-service interval, ISI) were calculated and inseminations categorised as successful or unsuccessful depending on whether there was a corresponding calving event. Conception risk was calculated for each individual ISI between 16 and 28 days. A random effects logistic regression model was fitted to the data with pregnancy as the outcome variable and ISI (in days) included in the model as a categorical variable. The modal ISI was 22 days and the peak conception risk was 44% for ISIs of 21 days rising from 27% at 16 days. The logistic regression model revealed significant associations of conception risk with ISI as well as 305 day milk yield, insemination number, parity and days in milk. Predicted conception risk was lower for ISIs of 16, 17 and 18 days and higher for ISIs of 20, 21 and 22 days compared to 25 day ISIs. A mixture model was specified to identify clusters in insemination frequency and conception risk for ISIs between 3 and 50 days. A "high conception risk, high insemination frequency" cluster was identified between 19 and 26 days which indicated that this time period was the true latent distribution for ISI with optimal reproductive outcome. These findings suggest that the period of increased numbers of inseminations around 22 days identified in existing work coincides with the period of increased probability of conception and therefore likely represents true return estrus events. Copyright © 2018 Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

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

    2012-06-01

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

  11. Association between infrastructure and observed quality of care in 4 healthcare services: A cross-sectional study of 4,300 facilities in 8 countries.

    Directory of Open Access Journals (Sweden)

    Hannah H Leslie

    2017-12-01

    Full Text Available It is increasingly apparent that access to healthcare without adequate quality of care is insufficient to improve population health outcomes. We assess whether the most commonly measured attribute of health facilities in low- and middle-income countries (LMICs-the structural inputs to care-predicts the clinical quality of care provided to patients.Service Provision Assessments are nationally representative health facility surveys conducted by the Demographic and Health Survey Program with support from the US Agency for International Development. These surveys assess health system capacity in LMICs. We drew data from assessments conducted in 8 countries between 2007 and 2015: Haiti, Kenya, Malawi, Namibia, Rwanda, Senegal, Tanzania, and Uganda. The surveys included an audit of facility infrastructure and direct observation of family planning, antenatal care (ANC, sick-child care, and (in 2 countries labor and delivery. To measure structural inputs, we constructed indices that measured World Health Organization-recommended amenities, equipment, and medications in each service. For clinical quality, we used data from direct observations of care to calculate providers' adherence to evidence-based care guidelines. We assessed the correlation between these metrics and used spline models to test for the presence of a minimum input threshold associated with good clinical quality. Inclusion criteria were met by 32,531 observations of care in 4,354 facilities. Facilities demonstrated moderate levels of infrastructure, ranging from 0.63 of 1 in sick-child care to 0.75 of 1 for family planning on average. Adherence to evidence-based guidelines was low, with an average of 37% adherence in sick-child care, 46% in family planning, 60% in labor and delivery, and 61% in ANC. Correlation between infrastructure and evidence-based care was low (median 0.20, range from -0.03 for family planning in Senegal to 0.40 for ANC in Tanzania. Facilities with similar

  12. Association between infrastructure and observed quality of care in 4 healthcare services: A cross-sectional study of 4,300 facilities in 8 countries.

    Science.gov (United States)

    Leslie, Hannah H; Sun, Zeye; Kruk, Margaret E

    2017-12-01

    It is increasingly apparent that access to healthcare without adequate quality of care is insufficient to improve population health outcomes. We assess whether the most commonly measured attribute of health facilities in low- and middle-income countries (LMICs)-the structural inputs to care-predicts the clinical quality of care provided to patients. Service Provision Assessments are nationally representative health facility surveys conducted by the Demographic and Health Survey Program with support from the US Agency for International Development. These surveys assess health system capacity in LMICs. We drew data from assessments conducted in 8 countries between 2007 and 2015: Haiti, Kenya, Malawi, Namibia, Rwanda, Senegal, Tanzania, and Uganda. The surveys included an audit of facility infrastructure and direct observation of family planning, antenatal care (ANC), sick-child care, and (in 2 countries) labor and delivery. To measure structural inputs, we constructed indices that measured World Health Organization-recommended amenities, equipment, and medications in each service. For clinical quality, we used data from direct observations of care to calculate providers' adherence to evidence-based care guidelines. We assessed the correlation between these metrics and used spline models to test for the presence of a minimum input threshold associated with good clinical quality. Inclusion criteria were met by 32,531 observations of care in 4,354 facilities. Facilities demonstrated moderate levels of infrastructure, ranging from 0.63 of 1 in sick-child care to 0.75 of 1 for family planning on average. Adherence to evidence-based guidelines was low, with an average of 37% adherence in sick-child care, 46% in family planning, 60% in labor and delivery, and 61% in ANC. Correlation between infrastructure and evidence-based care was low (median 0.20, range from -0.03 for family planning in Senegal to 0.40 for ANC in Tanzania). Facilities with similar infrastructure scores

  13. Evaluation of diabetic polyneuropathy in Type 2 diabetes mellitus by nerve conduction study and association of severity of neuropathy with serum sFasL level

    Directory of Open Access Journals (Sweden)

    Avijit Mondal

    2012-01-01

    Full Text Available Introduction: Diabetes mellitus (DM, a growing health problem globally, has reached epidemic proportions in India. Recently, Fas-mediated apoptosis has been proposed as a causative factor responsible for neuronal degeneration in diabetic polyneuropathy (DPN, but there are very few studies to show association of serum soluble Fas ligand (sFasL level with severity of neuropathy. Aim and Objective: The aim of this study was to investigate whether serum sFasL, a transmembrane glycoprotein involved in apoptosis, has any association with severity of peripheral neuropathy in Type 2 DM. Materials and Methods: The study was conducted in Department of Physiology in collaboration with Department of Endocrinology, IPGME&R. sFasL levels in serum were assessed using ELISA method in healthy individuals (n = 16, newly diagnosed diabetic controls (n = 16 without any complications, and in DPN cases (n = 33 with predominant neuropathy only. All subjects underwent both electrodiagnostic procedures and vibration perception threshold (VPT for quantitative assessment of the severity of neuropathy. Using nerve conduction studies, amplitudes, velocities, and latencies of both sensory and motor nerves were recorded. Results: In DPN patients, concentration of sFasL levels (87.53 ± 3.49 was significantly decreased (P < 0.0001 not only when compared with normal controls (225.30 ± 2.97 but also when compared with diabetic patients without any complication (161 ± 3.63. Moreover, the concentration of sFasL is significantly (P < 0.0001 associated with the severity of neuropathy both by VPT and nerve conduction velocity (NCV. Conclusion: Fas-mediated apoptosis is involved in Type 2 DM and might be associated with the severity of polyneuropathy.

  14. Association between perceived stress, multimorbidity and primary care health services: a Danish population-based cohort study.

    Science.gov (United States)

    Prior, Anders; Vestergaard, Mogens; Larsen, Karen Kjær; Fenger-Grøn, Morten

    2018-02-24

    Mental stress is common in the general population. Mounting evidence suggests that mental stress is associated with multimorbidity, suboptimal care and increased mortality. Delivering healthcare in a biopsychosocial context is key for general practitioners (GPs), but it remains unclear how persons with high levels of perceived stress are managed in primary care. We aimed to describe the association between perceived stress and primary care services by focusing on mental health-related activities and markers of elective/acute care while accounting for mental-physical multimorbidity. Population-based cohort study. Primary healthcare in Denmark. 118 410 participants from the Danish National Health Survey 2010 followed for 1 year. Information on perceived stress and lifestyle was obtained from a survey questionnaire. Information on multimorbidity was obtained from health registers. General daytime consultations, out-of-hours services, mental health-related services and chronic care services in primary care obtained from health registers. Perceived stress levels were associated with primary care activity in a dose-response relation when adjusted for underlying conditions, lifestyle and socioeconomic factors. In the highest stress quintile, 6.8% attended GP talk therapy (highest vs lowest quintile, adjusted incidence rate ratios (IRR): 4.96, 95% CI 4.20 to 5.86), 3.3% consulted a psychologist (IRR: 6.49, 95% CI 4.90 to 8.58), 21.5% redeemed an antidepressant prescription (IRR: 4.62, 95% CI 4.03 to 5.31), 23.8% attended annual chronic care consultations (IRR: 1.22, 95% CI 1.16 to 1.29) and 26.1% used out-of-hours services (IRR: 1.47, 95% CI 1.51 to 1.68). For those with multimorbidity, stress was associated with more out-of-hours services, but not with more chronic care services. Persons with high stress levels generally had higher use of primary healthcare, 4-6 times higher use of mental health-related services (most often in the form of psychotropic drug

  15. Associations of alcohol use disorder, alcohol use, housing, and service use in a homeless sample of 255 individuals followed over two years.

    Science.gov (United States)

    Asana, Olubunmi O; Ayvaci, Emine R; Pollio, David E; Hong, Barry A; North, Carol S

    2018-03-29

    Homeless individuals with alcohol use disorders have multiple comorbidities and therefore various service needs. Despite need for services, homeless individuals face numerous barriers to treatment. Little is known about the associations of specific services in relation to homelessness in the context of alcohol problems. The current study analyzed 2-year prospective longitudinal data on a homeless sample, examining relationships between alcohol use disorder, alcohol use, housing status, and service use over time. 255 of 400 individuals recruited systematically from shelters and street locations completed 3 annual assessments (69% completion). Data on lifetime and current psychiatric disorders, housing status, and past year service use were obtained and merged with service use data gathered from local agencies. GEE models were created to predict dependent outcome variables of stable housing, alcohol use, and service use in both follow-up years. Lifetime alcohol use disorder was positively associated with substance and medical service use. Alcohol problems did not hinder attainment of stable housing, and placement in housing did not necessarily increase risk for alcohol use. Stable housing was negatively associated with psychiatric and substance service use. In the second year, when alcohol use was finally associated with receiving substance services, it appears that these services provided a gateway to psychiatric services. The psychiatric services in turn appeared to provide a gateway to medical services. Alcohol use acted differently compared to lifetime alcohol use disorder in relation to service use. Lack of association between alcohol use and housing supports Housing First policy. Obtaining housing may have ameliorative effects on mental health, diminishing perceived need for psychiatric services. Services may also be more accessible during homelessness. Obtaining substance treatment may provide a gateway for those who use alcohol after becoming homeless to

  16. Heat conduction

    International Nuclear Information System (INIS)

    Grigull, U.; Sandner, H.

    1984-01-01

    Included are discussions of rates of heat transfer by conduction, the effects of varying and changing properties, thermal explosions, distributed heat sources, moving heat sources, and non-steady three-dimensional conduction processes. Throughout, the importance of thinking both numerically and symbolically is stressed, as this is essential to the development of the intuitive understanding of numerical values needed for successful designing. Extensive tables of thermophysical properties, including thermal conductivity and diffusivity, are presented. Also included are exact and approximate solutions to many of the problems that arise in practical situations

  17. Association between time of pay-for-performance for patients and community health services use by chronic patients.

    Directory of Open Access Journals (Sweden)

    Xi Sun

    Full Text Available BACKGROUND: Pay-for-performance for patients is a cost-effective means of improving health behaviours. This study examined the association between the pay time for performance for patients and CHS use by chronic patients. METHODS: A cross-sectional study was undertaken to estimate distribution characteristics of CHS use in 2011 and collect data of socio-demographic characteristics (sex, age, education level, occupation, disposable personal income in 2011, distance between home and community health agency, chronic disease number, and time of pay-for-performance for patients. Participants were 889 rural adults with hypertension or type II diabetes aged 35 and above. Standardized CHS use means chronic patients use CHS at least once per quarter. RESULTS: Patients who received incentives prior to services had 2.724 times greater odds of using standardized CHS than those who received incentives after services (95%CI, 1.986-3.736, P<0.001. For all subgroups (socio-demographic characteristics and chronic disease number, patients who received incentives prior to services were more likely to use standardized CHS than those receiving incentives after services. CONCLUSIONS: Pay time for performance for patients was associated with CHS use by chronic patients. Patients receiving incentive prior to services were more likely to use standardized CHS. And pay time should not be ignored when the policy on pay-for-performance for patients is designed.

  18. Implementation of Integrated Service Networks under the Quebec Mental Health Reform: Facilitators and Barriers associated with Different Territorial Profiles.

    Science.gov (United States)

    Fleury, Marie-Josée; Grenier, Guy; Vallée, Catherine; Aubé, Denise; Farand, Lambert

    2017-03-10

    This study evaluates implementation of the Quebec Mental Health Reform (2005-2015), which promoted the development of integrated service networks, in 11 local service networks organized into four territorial groups according to socio-demographic characteristics and mental health services offered. Data were collected from documents concerning networks; structured questionnaires completed by 90 managers and by 16 respondent-psychiatrists; and semi-structured interviews with 102 network stakeholders. Factors associated with implementation and integration were organized according to: 1) reform characteristics; 2) implementation context; 3) organizational characteristics; and 4) integration strategies. While local networks were in a process of development and expansion, none were fully integrated at the time of the study. Facilitators and barriers to implementation and integration were primarily associated with organizational characteristics. Integration was best achieved in larger networks including a general hospital with a psychiatric department, followed by networks with a psychiatric hospital. Formalized integration strategies such as service agreements, liaison officers, and joint training reduced some barriers to implementation in networks experiencing less favourable conditions. Strategies for the implementation of healthcare reform and integrated service networks should include sustained support and training in best-practices, adequate performance indicators and resources, formalized integration strategies to improve network coordination and suitable initiatives to promote staff retention.

  19. National Collegiate Athletic Association Division I Certified Athletic Trainers' Perceptions of the Benefits of Sport Psychology Services

    Science.gov (United States)

    Zakrajsek, Rebecca A.; Martin, Scott B.; Wrisberg, Craig A.

    2016-01-01

    Context:  Certified athletic trainers (ATs) are responsible for integrating relevant professionals into the rehabilitation team to assist with the holistic care of injured athletes. Objective:  To explore National Collegiate Athletic Association Division I (DI) ATs' experience with sport psychology consultants (SPCs), willingness to encourage athletes to use SPCs for injury rehabilitation, and perceptions of the benefits of sport psychology services. Design:  Quantitative study. Setting:  A Web-based survey was administered to a national sample of DI ATs. Patients or Other Participants:  A total of 659 (341 men, 318 women) ATs completed the survey. Main Outcome Measure(s):  Athletic trainers' experience with SPCs, willingness to encourage athletes to seek sport psychology services, and perceptions of the benefits of those services in injury-rehabilitation settings were self-reported using a rating scale that ranged from 1 (never or not at all) to 5 (definitely or extremely). Results:  Logistic regression revealed that the availability of SPCs, previous encouragement to athletes to seek sport psychology services, and previous positive interactions with SPCs predicted the ATs' willingness to encourage athletes to use these services (P psychology services might call on SPCs to complement their work with injured athletes. PMID:27159188

  20. Magnitude and factors associated with institutional delivery service utilization among childbearing mothers in Cheha district, Gurage zone, SNNPR, Ethiopia: a community based cross sectional study.

    Science.gov (United States)

    Habte, Feleke; Demissie, Meaza

    2015-11-17

    Ethiopia is one of the six countries that contributes' to more than 50 % of worldwide maternal deaths. While it is revealed that delivery attended by skilled provider at health facility reduced maternal deaths, more than half of all births in Ethiopia takes place at home. According to EDHS 2011 report nine women in every ten deliver at home in Ethiopia. The situation is much worse in southern region. The aim of our study is to measure the prevalence and to identify factors associated with institutional delivery service utilization among childbearing mothers in Cheha District, SNNPR, Ethiopia. A community based cross sectional survey was conducted in Cheha District from Dec 22, 2012 to Jan 11, 2013. Multistage sampling method was employed and 816 women who gave birth within the past 2 years and lived in Cheha district for minimum of one year prior to the survey were involved in the study. Data was entered and analyzed using Epi Info Version 7 and SPSS Version 16. Frequencies and binary logistic regression were done. Factors affecting institutional delivery were determined using multivariate logistic regression. A total of 31 % of women gave birth to their last child at health facility. Place of residence, ability to afford for the whole process to get delivery service at health facility, traveling time that takes to reach to health institution which provides delivery service, husband's attitude towards institutional delivery, counseling about where to deliver during ANC visit and place of birth of the 2(nd) youngest child were found to have statistically significant association with institutional delivery. Institutional delivery is low in the study area. Access to health service was found to be the most important predictor of institutional delivery among others. Accessing health facility within reasonable travel time; providing health education and BCC services to husbands and the community at large on importance of using health institution for delivery service

  1. Electrical Conductivity.

    Science.gov (United States)

    Hershey, David R.; Sand, Susan

    1993-01-01

    Explains how electrical conductivity (EC) can be used to measure ion concentration in solutions. Describes instrumentation for the measurement, temperature dependence and EC, and the EC of common substances. (PR)

  2. Conduct Disorder

    Science.gov (United States)

    ... objections runs away from home often truant from school Children who exhibit these behaviors should receive a comprehensive evaluation by an experience mental health professional. Many children with a conduct disorder may ...

  3. The Associations Between Pre- and Postnatal Maternal Symptoms of Distress and Preschooler's Symptoms of ADHD, Oppositional Defiant Disorder, Conduct Disorder, and Anxiety.

    Science.gov (United States)

    Bendiksen, Bothild; Aase, Heidi; Diep, Lien My; Svensson, Elisabeth; Friis, Svein; Zeiner, Pål

    2015-12-07

    The objective of this article is to examine the associations between pre- and postnatal maternal distress and preschooler's symptoms of ADHD, Oppositional Defiant Disorder (ODD), Conduct Disorder (CD), and anxiety, by timing and gender. Children, aged 3.5 years (N = 1,195), recruited from the Norwegian Mother and Child Cohort Study, were assessed with a semistructured parental psychiatric interview. Perinatal maternal symptoms of distress were assessed by Symptom Checklist (SCL-5); Poisson regression was used to examine the associations. Mid-gestational maternal distress significantly increased the average number of child symptoms, ranging between 3.8% for ADHD hyperactive-impulsive (ADHD-HI) and 8.7% for anxiety. The combination of high maternal scores of distress both pre- and postnatally were associated with increased risk of child symptoms of anxiety (relative risk [RR] = 2.10; 95% confidence interval [CI] = [1.43, 3.07]), CD (RR = 1.83; 95% CI = [1.33, 2.51]), and ODD (RR = 1.30; 95% CI = [1.03, 1.64]), with minor sex differences. Maternal distress during mid-gestation was associated with ADHD, behavioral, and emotional symptoms in preschool children. Continued exposure into the postnatal period may further increase these risk associations . © The Author(s) 2015.

  4. Development of a service organization. CHA (Catholic Hospital Association) from post-World War II through Vatican II.

    Science.gov (United States)

    Kauffman, C J

    1990-06-01

    Having weathered the Depression and war years, CHA in the late 1940s looked forward to a new era in Catholic healthcare. The third and fourth articles of Health Progress's six-part history of CHA described how Rev. Alphonse M. Schwitalla, SJ, led the association through one of the most difficult periods in U.S. history. This article follows CHA's development into a modern service organization under the leadership of Rev. John J. Flanagan, SJ. The series' final installment, which will appear in the July-August issue, describes how CHA has modernized its services and structure in the past two decades to help its members adjust to a turbulent environment.

  5. National Collegiate Athletic Association Division I Certified Athletic Trainers' Perceptions of the Benefits of Sport Psychology Services.

    Science.gov (United States)

    Zakrajsek, Rebecca A; Martin, Scott B; Wrisberg, Craig A

    2016-05-01

    Certified athletic trainers (ATs) are responsible for integrating relevant professionals into the rehabilitation team to assist with the holistic care of injured athletes. To explore National Collegiate Athletic Association Division I (DI) ATs' experience with sport psychology consultants (SPCs), willingness to encourage athletes to use SPCs for injury rehabilitation, and perceptions of the benefits of sport psychology services. Quantitative study. A Web-based survey was administered to a national sample of DI ATs. A total of 659 (341 men, 318 women) ATs completed the survey. Athletic trainers' experience with SPCs, willingness to encourage athletes to seek sport psychology services, and perceptions of the benefits of those services in injury-rehabilitation settings were self-reported using a rating scale that ranged from 1 (never or not at all) to 5 (definitely or extremely). Logistic regression revealed that the availability of SPCs, previous encouragement to athletes to seek sport psychology services, and previous positive interactions with SPCs predicted the ATs' willingness to encourage athletes to use these services (P sport and building confidence). Chi-square analyses indicated that female ATs' ratings of perceived benefits were higher (P ≤ .001) than those of male ATs, and the ratings of ATs who were likely to encourage the use of SPCs were higher (P ≤ .001) than those who were unlikely to encourage SPC service use. Athletic trainers in our study who had previous positive SPC experiences were most likely to use SPCs and their services during the injury-rehabilitation process. Possible implications are offered for how ATs interested in sport psychology services might call on SPCs to complement their work with injured athletes.

  6. Callous-unemotional, impulsive-irresponsible, and grandiose-manipulative traits: Distinct associations with heart rate, skin conductance, and startle responses to violent and erotic scenes.

    Science.gov (United States)

    Fanti, Kostas A; Kyranides, Melina N; Georgiou, Giorgos; Petridou, Maria; Colins, Olivier F; Tuvblad, Catherine; Andershed, Henrik

    2017-05-01

    The present study aimed to examine whether callous-unemotional, grandiose-manipulative, and impulsive-irresponsible dimensions of psychopathy are differentially related to various affective and physiological measures, assessed at baseline and in response to violent and erotic movie scenes. Data were collected from young adults (N = 101) at differential risk for psychopathic traits. Findings from regression analyses revealed a unique predictive contribution of grandiose-manipulative traits in particular to higher ratings of positive valence for violent scenes. Callous-unemotional traits were uniquely associated with lower levels of sympathy toward victims and lower ratings of fear and sadness during violent scenes. All three psychopathy dimensions and the total psychopathy scale showed negative zero-order correlations with heart rate at baseline, but regression analyses revealed that only grandiose manipulation was uniquely predictive of lower baseline heart rate. Grandiose manipulation was also significantly associated with lower baseline skin conductance. Regarding autonomic activity, findings resulted in a unique negative association between grandiose manipulation and heart rate activity in response to violent scenes. In contrast, the impulsive-irresponsible dimension was positively related with heart rate activity to violent scenes. Finally, findings revealed that only callous-unemotional traits were negatively associated with startle potentiation in response to violent scenes. No associations during erotic scenes were identified. These findings point to unique associations between the three assessed dimensions of psychopathy with physiological measures, indicating that grandiose manipulation is associated with hypoarousal, impulsive irresponsibility with hyperarousal, and callous-unemotional traits with low emotional and fear responses to violent scenes. © 2017 Society for Psychophysiological Research.

  7. Should a doctor stop rendering medical services? Part II – Analysis of medico-legal conduct in cases of uncertainties regarding informed consent in minors. The Polish perspective

    Directory of Open Access Journals (Sweden)

    Justyna Zajdel

    2014-06-01

    Full Text Available introduction. The doctor’s decision whether to save the life of a minor who has attempted to commit suicide depends on the decision of the person who, under legal regulations, is responsible for the minor. In everyday medical practice doctors are often placed in difficult situations and often cannot make any decision. Such doubts arise when it is impossible to contact the person(s responsible for the minor. The doctor encounters similar issues when the parents of a minor under 16 years of age express different opinions on the recommended procedures, and are against the doctor’s decision and do not want their child to be hospitalized. materials and methods. The current legislation and doctrine was analyzed and an attempt was made to determine the way of conduct with regard to suicidal minors, and algorithmize the way of conduct towards such suicidal minors. The conduct was discussed on the two examples, based on real clinical cases. results. With regard to minors in a clinical state demanding urgent procedures, who have of the decision made by the guardian, and regardless of the fact there is no contact with the guardian. If the status is stable, the physician’s modus operandi depends on various accompanying circumstances. However, he is still obliged to provide medical help. discussion. A practical algorithm is presented and all the possible legal variations discussed and clarified.

  8. [Accessibility and quality to health social services in Italy for the patients with rare diseases: the opinion of associations].

    Science.gov (United States)

    Agazio, E; Salerno, P; Mirabella, F; Gnessi, F; Mastroiacovo, P; Morosini, P; Tarsitani, G; Taruscio, D

    2005-01-01

    This paper concerns the first phase of a study about the perception of social and health needs of people with rare diseases. The study was performed by the National Center for Rare Diseases at the Italian National Institute of Health (Istituto Superiore di Sanità - ISS). The project wants to be an example of collaboration between the research and the association worlds. Responsible of Associations of Patients and their relatives were asked their opinion about the accessibility and quality of important features of health and social services (accessibility and quality of diagnostic, pharmacological, psychological and rehabilitative interventions, social support, school and vocational training, information that was given to relatives). An ad hoc questionnaire was developed through focus groups. The questionnaire was completed by 108 associations (26,5% of the associations thar are recorded in the ISS database). Average scores showed satisfaction only for some variables and a negative gradient north-south was observed. The most frequent complaints were about information, quality of school and job training services and availability of psychological support. The study showed an high level of dissatisfaction with availability, quality and integration health and social services.

  9. Should a doctor stop rendering medical services? Principles of conduct towards patients attempting to commit suicide. Part 1 -- the Polish perspective.

    Science.gov (United States)

    Zajdel, Justyna; Zajdel, Radoslaw; Krakowiak, Anna

    2013-01-01

    According to the general idea a doctor can start the medical management process in an adult and not legally incapacitated patient after the patient has given consent to initiate such a process. The patient's refusal makes rendering medical services impossible, irrespective of their scope and kind. It should be emphasized that such a refusal is respected if it is expressed fully, clearly and consciously. Cases in which such a refusal is expressed by an intoxicated suicidal patient, remaining under the influence of narcotics, drugs or medicaments which characterize with a similar activity should be particularly analysed. Although such a person is able to verbally declare his objection, his ability to process the information given by the doctor before initiating medical procedures is limited, or even non-existant. The refusal therefore cannot be regarded as reliable, which results in rendering medical services to the patient. An analysis was made of Acts of Law and the opinions of the judiciar by comparing and excluding contradictory and incoherent elements. Despite the lack of clear regulations of a patient rejecting procedures aimed at saving the patient's life, or the prevention of serious health impairment or sustaining injury, it should be assumed that the objection expressed by the patient who does not demonstrate the ability to process the information provided by the doctor is not reliable, and the doctor is therefore still obliged to render medical services. External factors, such as consumption of alcohol, narcotics and drugs, which characterize with a similar activity impair perception and make the taking of a conscious decision impossible. Not providing medical help and introducing direct compulsion would mean neglecting provision of due diligence in the process of treatment and, as a consequence, placing the patient's health at risk, and suffering from negative implications for the patient's life and/or health in the future. Current provisions should

  10. Trade-Offs in Values Assigned to Ecological Goods and Services Associated with Different Coral Reef Management Strategies

    Directory of Open Access Journals (Sweden)

    Christina C. Hicks

    2009-06-01

    Full Text Available Societies value ecosystems and the services they provide in a number of ways. These values can help inform the management of ecosystems such as coral reefs. However, the trade-offs in ecosystem goods and services associated with different social and management conditions are poorly understood. Consequently, we examined values assigned to the goods and services identified across three types of management on the Kenyan coast: (1 a government-imposed no-take area in the Mombasa Marine National Park; (2 co-management of gear between fishing communities and the government's fisheries department; and (3 community-initiated no-take area management, where a community independently initiated and controlled a small closed area. We compared the ecosystem goods and services and the broader total economic value to explore how the history of these sites, their social conditions, and different management choices were associated with these values. The highest total economic values were associated with government management interventions and were probably due to the government's priority to be involved in the high-value beach tourism destinations. This is, however, associated with losses in a range of local community-level values and the social capital of the resource-user community. For example, resource users near the government marine protected area had the lowest value for measures of biological knowledge. Sites displaying greater community-level values were characterized by high social capital, and users had the most confidence in their ability to manage the resource. This study suggests that trade-offs occur in values associated with the interests and responsibilities of the management. The ability to cope with disturbance and change will depend on these values and responsibilities, and local communities are less likely to respond when government management and interests are strong.

  11. Regional grey matter volume and concentration in at-risk adolescents: Untangling associations with callous-unemotional traits and conduct disorder symptoms.

    Science.gov (United States)

    Cohn, Moran D; Viding, Essi; McCrory, Eamon; Pape, Louise; van den Brink, Wim; Doreleijers, Theo A H; Veltman, Dick J; Popma, Arne

    2016-08-30

    Structural Magnetic Resonance Imaging studies have reported volume reductions in several brain regions implicated in social cognition and emotion recognition in juvenile antisocial populations. However, it is unclear whether these structural abnormalities are specifically related to antisocial features, or to co-occurring callous-unemotional (CU) traits. The present study employed voxel-based morphometry to assess both grey matter volume (GMV) and grey matter concentration (GMC) in a large representative at-risk sample of adolescents (n=134; mean age 17.7yr), characterized by a broad range of CU trait and conduct disorder (CD) symptom scores. There was a significant interaction between CD symptom and CU trait scores in the prediction of GMV in the anterior insula, with a significant positive association between CU traits and GMV in youth low on CD symptoms only. In addition, we found a significant unique positive association between CD symptoms and GMC in the amygdala, and unique negative associations between CU traits and GMC in the amygdala and insula. These findings are in line with accumulating evidence of distinct associations of CD symptoms and CU traits with amygdala and insula GMC in juvenile antisocial populations. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  12. Bullying and victimisation are common in four-year-old children and are associated with somatic symptoms and conduct and peer problems.

    Science.gov (United States)

    Ilola, Anna-Marja; Lempinen, Lotta; Huttunen, Jukka; Ristkari, Terja; Sourander, Andre

    2016-05-01

    There are few population-based studies on bullying behaviour among preschool children. The aims of the study were to investigate the prevalence of bullying behaviour among four-year-old children, as reported by their parents, the prevalence of types of bullying behaviour and the associations between bullying behaviour and psychosocial factors. This study was based on a population-based study sample of 931 children who attended their check-up at a child health clinic at four years of age. Parents completed the questionnaire about their child's bullying behaviour and risk factors during the check-up. Bullying behaviour, especially being both a bully and a victim, was a common phenomenon among four-year-old children. Being a bully or both a bully and victim were most strongly associated with conduct problems, while being a victim was associated with somatic symptoms and peer problems. Bullying behaviour was frequently found in preschool children and associated with a wide range of other problems, which indicate that routine checking of bullying behaviour should be included in child health clinic check-ups. Bullying prevention programmes are usually targeted at school-aged children, but this study highlights the importance of focusing already on preschool children. ©2016 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  13. Association Between Employee Dental Claims, Health Risks, Workplace Productivity, and Preventive Services Compliance.

    Science.gov (United States)

    Burton, Wayne N; Chen, Chin-Yu; Li, Xingquan; Schultz, Alyssa B

    2017-08-01

    This study examined differences in health risks and workplace outcomes among employees who utilized preventive dental services compared with other employees. A retrospective observational study of employees of a large financial services corporation, with data from health risk appraisal questionnaires, medical claims, pharmacy claims, and dental claims. Employees with no dental claims were significantly more likely to have a variety of health risk factors (such as obesity and tobacco use), health conditions (such as diabetes), absenteeism, and lost on-the-job productivity, and were significantly less likely to be compliant with clinical preventive services compared with those with preventive dental claims. Employees with preventive dental claims had fewer health risks and medical conditions and better health and productivity measures. Study employees underutilized free dental care; employers should incorporate preventive dental care awareness into their worksite wellness programs.

  14. Intimate partner violence among pregnant women in Rwanda, its associated risk factors and relationship to ANC services attendance: a population-based study.

    Science.gov (United States)

    Rurangirwa, Akashi Andrew; Mogren, Ingrid; Ntaganira, Joseph; Krantz, Gunilla

    2017-02-22

    To investigate the prevalence of four forms of intimate partner violence during pregnancy in Rwandan women, associated sociodemographic and psychosocial factors and relationship to antenatal care service usage. This was a cross-sectional population-based study conducted in the Northern province of Rwanda and in Kigali city. A total of 921 women who gave birth within the past 13 months were included. Villages in the study area were selected using a multistage random sampling technique and community health workers helped in identifying eligible participants. Clinical psychologists, nurses or midwives carried out face-to-face interviews using a structured questionnaire. Bivariable and multivariable logistic regression were used to assess associations. The prevalence rates of physical, sexual, psychological violence and controlling behaviour during pregnancy were 10.2% (95% CI 8.3 to 12.2), 9.7% (95% CI 7.8 to 11.6), 17.0% (95% CI 14.6 to 19.4) and 20.0% (95% CI 17.4 to 22.6), respectively. Usage of antenatal care services was less common among women who reported controlling behaviour (OR) 1.93 (95% CI 1.34 to 2.79). No statistically significant associations between physical, psychological and sexual violence and antenatal care usage were found. Low socioeconomic status was associated with physical violence exposure (OR) 2.27 (95% CI 1.29 to 3.98). Also, young age, living in urban areas and poor social support were statistically significant in their associations with violence exposure during pregnancy. Intimate partner violence inquiry should be included in the standard antenatal care services package and professionals should be trained in giving support, advice and care to those exposed. Gender-based violence is criminalised behaviour in Rwanda; existing policies and laws must be followed and awareness raised in society for preventive purposes. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go

  15. Conduct disorders

    NARCIS (Netherlands)

    Buitelaar, J.K.; Smeets, K.C.; Herpers, P.; Scheepers, F.; Glennon, J.; Rommelse, N.N.J.

    2013-01-01

    Conduct disorder (CD) is a frequently occurring psychiatric disorder characterized by a persistent pattern of aggressive and non-aggressive rule breaking antisocial behaviours that lead to considerable burden for the patients themselves, their family and society. This review paper updates diagnostic

  16. An examination of the prospective association between religious service attendance and suicide: Explanatory factors and period effects.

    Science.gov (United States)

    Kleiman, Evan M; Liu, Richard T

    2018-01-01

    We addressed two unanswered questions from prior research, demonstrating a prospective association between frequent religious service attendance and decreased risk for suicide. First, we assessed whether religious service attendance conferred protection from suicide even after accounting for strength of religious affiliation. Second, we evaluated whether the relationship between religious service attendance and suicide was subject to period effects. Data were drawn from the 1978-2010 General Social Survey, a nationally representative study of 30,650 non-institutionalized, English-speaking American residents age 18 or older. Data were linked with the National Death Index through the end of 2014. We analyzed these data using moderated Cox proportional hazard analyses. Religious affiliation had no relationship with suicide. Religious service attendance only had a protective effect against suicide death among those in later (2000-2010) rather than earlier (1998 and earlier) data collection periods. Secondary analysis of data limited the types of variables that were available. The protective nature of religion is due more to participating in religious activities, such as attending religious services, than to having a strong religious affiliation, and this effect exists primarily in more recent data collection periods. Copyright © 2017 Elsevier B.V. All rights reserved.

  17. [Association between sense of coherence and occupational stress of workers in modern service industry in Shanghai, China].

    Science.gov (United States)

    Lu, X Y; Dai, J M; Wu, N; Shu, C; Gao, J L; Fu, H

    2016-10-20

    Objective: To investigate understand the current status of the sense of coherence and occupational stress in modern service workers, and to analyze the association between occupational stress and the sense of coherence. Methods: From March to April, 2016, 834 modern service workers from 3 companies in Shanghai, China (in air transportation industry, marketing industry, and travel industry) were surveyed by non-ran-dom sampling. The self-completion questionnaires were filled out anonymously given the informed consent of the workers. The occupational stress questionnaire was used to evaluate occupational stress, and the Chinese version of the Sense of Coherence Scale (SOC-13) was used to assess the mental health. Results: The mean score for the sense of coherence of the respondents was 61.54±10.46, and 50.1% of them were self-rated as having occupational stress. There were significant differences in SOC score between groups with different ages, marital status, positions, lengths of service, family per capita monthly income, and weekly work hours ( P occupational stress score differed significantly across groups with different marital status, lengths of service, and weekly work hours ( P occupational stress differed significantly between groups with different SOC levels ( Poccupational stress. High SOC is a protective factor for occupational stress ( OR =0.39, 95% CI 0.26~ 0.59). Conclusion: Modern service workers in Shanghai have high SOC and moderate occupational stress. Therefore, improving SOC may reduce occupational stress.

  18. Association Between Parental Barriers to Accessing a Usual Source of Care and Children's Receipt of Preventive Services.

    Science.gov (United States)

    Bellettiere, John; Chuang, Emmeline; Hughes, Suzanne C; Quintanilla, Isaac; Hofstetter, C Richard; Hovell, Melbourne F

    Preventive health services are important for child development, and parents play a key role in facilitating access to services. This study examined how parents' reasons for not having a usual source of care were associated with their children's receipt of preventive services. We used pooled data from the 2011-2014 National Health Interview Survey (n = 34 843 participants). Parents' reasons for not having a usual source of care were framed within the Penchansky and Thomas model of access and measured through 3 dichotomous indicators: financial barriers (affordability), attitudes and beliefs about health care (acceptability), and all other nonfinancial barriers (accessibility, accommodation, and availability). We used multivariable logistic regression models to test associations between parental barriers and children's receipt of past-year well-child care visits and influenza vaccinations, controlling for other child, family, and contextual factors. In 2014, 14.3% (weighted percentage) of children had at least 1 parent without a usual source of care. Children of parents without a usual source of care because they "don't need a doctor and/or haven't had any problems" or they "don't like, trust, or believe in doctors" had 35% lower odds of receiving well-child care (adjusted odds ratio = 0.65; 95% CI, 0.56-0.74) and 23% lower odds of receiving influenza vaccination (adjusted odds ratio = 0.77; 95% CI, 0.69-0.86) than children of parents without those attitudes and beliefs about health care. Financial and other nonfinancial parental barriers were not associated with children's receipt of preventive services. Results were independent of several factors relevant to children's access to preventive health care, including whether the child had a usual source of care. Parents' attitudes and beliefs about having a usual source of care were strongly associated with their children's receipt of recommended preventive health services. Rates of receipt of child preventive

  19. Learning by Helping? Undergraduate Communication Outcomes Associated with Training or Service-Learning Experiences

    Science.gov (United States)

    Katz, Jennifer; DuBois, Melinda; Wigderson, Sara

    2014-01-01

    This study investigated communication outcomes after training or applied service-learning experiences. Pre-practicum trainees learned active listening skills over 10 weeks. Practicum students were successful trainees who staffed a helpline. Community interns were trained and supervised at community agencies. Undergraduate students in psychology…

  20. 78 FR 76196 - Secondary Service Connection for Diagnosable Illnesses Associated With Traumatic Brain Injury

    Science.gov (United States)

    2013-12-17

    ... questions of causation and service connection in individual cases. Even if medical studies indicate that TBI... 7, 2004. We wrote this in relation to the use of presumptions in the case of prisoners of war who...-pituitary changes if manifest within 12 months of moderate or severe TBI. We provided a 60-day public...

  1. Effects of light reduction on food webs and associated ecosystem services of Yaquina Bay

    Science.gov (United States)

    Reduced water clarity can affect estuarine primary production but little is known of its subsequent effects to consumer guilds or ecosystem services. We investigated those effects using inverse analysis of modeled food webs of the lower (polyhaline) and upper (mesohaline) reache...

  2. The Effects of Ride Hailing Services on Travel and Associated Greenhouse Gas Emissions

    Science.gov (United States)

    2018-04-01

    Towards the close of the first decade of the 21st Century, ride-hailing services began to enter the transportation market through smart phone applications that allowed consumers to hail and pay for a ride from drivers using their own vehicle. The inf...

  3. Pharmacy Characteristics Associated with the Provision of Drug Therapy Services in Nonmetropolitan Community Pharmacies

    Science.gov (United States)

    Gadkari, Abhijit S.; Mott, David A.; Kreling, David H.; Bonnarens, Joseph K.

    2009-01-01

    Context: Higher prevalence of chronic diseases and reduced access to other health professionals in rural areas suggest that rural Medicare enrollees will benefit from pharmacist-provided drug therapy services (DTS). Purpose: The purpose of this study was to describe non-metropolitan community pharmacy sites in Wisconsin, the provision of DTS at…

  4. 78 FR 74222 - Hours of Service of Drivers: Oregon Trucking Associations; Application for Exemption

    Science.gov (United States)

    2013-12-10

    ... a limited exemption from the 30-minute rest-break requirement of the Agency's hours-of-service... including the specific section of this document to which each comment applies, and provide a reason for each... decision of the Agency must be published in the Federal Register (49 CFR 381.315(b)) with the reasons for...

  5. ASTRID In Service Inspection and Repair: Review of R&D program and associated results

    International Nuclear Information System (INIS)

    Baqué, François; Jadot, Françoise; Bourdais, Florian le; Sibilo, Julien; Augem, Jean-Michel; Gastaldi, Olivier

    2013-01-01

    In Service Inspection & Repair (ISI&R): → range of provisions enabling to verify that the equipments state is in compliance with design criteria; → other range of provisions allowing to characterize an abnormal situation (failure, operation mistake) and to perform necessary actions to reach again an achievable plant configuration

  6. 12 CFR 362.12 - Service corporations of insured State savings associations.

    Science.gov (United States)

    2010-01-01

    .... (B) Equity securities of a company that acquires and retains adjustable-rate and money market...) Acquiring and retaining adjustable-rate and money market preferred stock. A service corporation may engage... instruments held under this paragraph (b)(2)(ii)(B), paragraph (b)(2)(iv) of this section, and § 362.11(b)(2...

  7. Update of computer applications associated to measuring equipment of the services of internal dosimetry of NPPS and Tecnatom

    International Nuclear Information System (INIS)

    Bravo, B.; Sollet, E.; Serrano, E.

    2014-01-01

    Within the continuous improvement processes that take place in all the activities taking place in the Spanish nuclear power plants, and as a result of implementation of ISO Standards for Internal Dosimetry, has undertaken a review, improvement and updating INDAC ALEDIN and applications associated with measuring equipment and DIYs Quicky kind Personal Internal Dosimetry Services of the Spanish nuclear power plants and Tecnatom This paper presents updates capacities both tools. (Author)

  8. Reductions in access to HIV prevention and care services are associated with arrest and convictions in a global survey of men who have sex with men.

    Science.gov (United States)

    Santos, Glenn-Milo; Makofane, Keletso; Arreola, Sonya; Do, Tri; Ayala, George

    2017-02-01

    Men who have sex with men (MSM) are disproportionately impacted by HIV. Criminalisation of homosexuality may impede access to HIV services. We evaluated the effect of the enforcement of laws criminalising homosexuality on access to services. Using data from a 2012 global online survey that was published in a prior paper, we conducted a secondary analysis evaluating differences in perceived accessibility to health services (ie, 'how accessible are ____' services) between MSM who responded 'yes'/'no' to: 'have you ever been arrested or convicted for being gay/MSM?' Of the 4020 participants who completed the study and were included in the analysis, 8% reported ever being arrested or convicted under laws relevant to being MSM. Arrests and convictions were most common in sub-Saharan Africa (23.6% (58/246)), Eastern Europe/Central Asia (18.1% (123/680)), the Caribbean (15% (15/100)), Middle East/North Africa (13.2% (10/76)) and Latin America (9.7% (58/599)). Those arrested or convicted had significantly lower access to sexually transmitted infection treatment (adjusted OR (aOR)=0.81; 95% CI 0.67 to 0.97), condoms (aOR=0.77; 95% CI 0.61 to 0.99) and medical care (aOR=0.70; 95% CI 0.54 to 0.90), compared with other MSM, while accounting for clustering by country and adjusting for age, HIV status, education and country-level income. Arrests and convictions under laws relevant to being MSM have a strong negative association with access to HIV prevention and care services. Creating an enabling legal and policy environment, and increasing efforts to mitigate antihomosexuality stigma to ensure equitable access to HIV services are needed, along with decriminalisation of homosexuality, to effectively address the public health needs of this population. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  9. Contextual factors associated with health care service utilization for children with acute childhood illnesses in Nigeria.

    Directory of Open Access Journals (Sweden)

    Sulaimon T Adedokun

    Full Text Available To examine the independent contribution of individual, community and state-level factors to health care service utilization for children with acute childhood illnesses in Nigeria.The study was based on secondary analyses of cross-sectional population-based data from the 2013 Nigeria Demographic and Health Survey (DHS. Multilevel logistic regression models were applied to the data on 6,427 under-five children who used or did not use health care service when they were sick (level 1, nested within 896 communities (level 2 from 37 states (level 3.About one-quarter of the mothers were between 15 and 24 years old and almost half of them did not have formal education (47%. While only 30% of the children utilized health service when they were sick, close to 67% lived in the rural area. In the fully adjusted model, mothers with higher education attainment (Adjusted odds ratio [aOR] = 1.63; 95% credible interval [CrI] = 1.31-2.03, from rich households (aOR = 1.76; 95% CrI = 1.35-2.25, with access to media (radio, television or magazine (aOR = 1.18; 95% CrI = 1.08-1.29, and engaging in employment (aOR = 1.18; 95% CrI = 1.02-1.37 were significantly more likely to have used healthcare services for acute childhood illnesses. On the other hand, women who experienced difficulty getting to health facilities (aOR = 0.87; 95% CrI = 0.75-0.99 were less likely to have used health service for their children.Our findings highlight that utilization of healthcare service for acute childhood illnesses was influenced by not only maternal factors but also community-level factors, suggesting that public health strategies should recognise this complex web of individual composition and contextual composition factors to guide provision of healthcare services. Such interventions could include: increase in female school enrolment, provision of interest-free loans for small and medium scale enterprises, introduction of mobile clinics and establishment of more primary health care

  10. Factors associated with no dental treatment in preschoolers with toothache: a cross-sectional study in outpatient public emergency services.

    Science.gov (United States)

    Machado, Geovanna C M; Daher, Anelise; Costa, Luciane R

    2014-08-08

    Many parents rely on emergency services to deal with their children's dental problems, mostly pain and infection associated with dental caries. This cross-sectional study analyzed the factors associated with not doing an oral procedure in preschoolers with toothache attending public dental emergency services. Data were obtained from the clinical files of preschoolers treated at all nine dental emergency centers in Goiania, Brazil, in 2011. Data were children's age and sex, involved teeth, oral procedures, radiography request, medications prescribed and referrals. A total of 531 files of children under 6 years old with toothache out of 1,108 examined were selected. Children's mean age was 4.1 (SD 1.0) years (range 1-5 years) and 51.6% were girls. No oral procedures were performed in 49.2% of cases; in the other 50.8%, most of the oral procedures reported were endodontic intervention and temporary restorations. Primary molars were involved in 48.4% of cases. With the exception of "sex", the independent variables tested in the regression analysis significantly associated with non-performance of oral procedures: age (OR 0.7; 95% CI 0.5-0.8), radiography request (OR 3.8; 95% CI 1.7-8.2), medication prescribed (OR 7.5; 95% CI 4.9-11.5) and patient referred to another service (OR 5.7; 3.0-10.9). Many children with toothache received no oral procedure for pain relief.

  11. Fall Risk and Its Associated Factors among Older Adults without Home-Help Services in a Swedish Municipality.

    Science.gov (United States)

    Hammarlund, Catharina Sjödahl; Hagell, Peter; Westergren, Albert

    2016-01-01

    During preventive home visits, the purpose of this study was to identify the prevalence of fall risk and any associated factors. Participants (n = 1471) were cognitively sound community-dwelling older adults (≥ 70 years) without home-help service, living in a Swedish municipality. The Downton Fall Risk Index and nine single items were used. Tiredness/fatigue, age ≥ 80, inability to walk 1 hr, inability to climb stairs and worrying were significantly associated with fall risk. Preventive home visits incorporating fall-risk screening proved valuable, providing information for interventions aimed at preventing falls, maintaining independence, and facilitating health among community dwelling participants.

  12. Adult antisocial syndrome co-morbid with borderline personality disorder is associated with severe conduct disorder, substance dependence and violent antisociality.

    Science.gov (United States)

    Freestone, Mark; Howard, Rick; Coid, Jeremy W; Ullrich, Simone

    2013-01-01

    This study tested the hypothesis that syndromal adult antisocial behaviour (AABS) co-morbid with borderline personality disorder (BPD) is a syndrome that emerges from severe conduct disorder (CD) in childhood and adolescence and is strongly associated, in adulthood, with both violence and substance dependence. In a sample of 8 580 community-resident adults screened for the presence of personality disorders, the following predictions arising from this hypothesis were tested: first, that those with AABS co-morbid with BPD would, in comparison with those showing AABS or BPD only, show a high level of antisocial outcomes, including violence; second, that adjusting for co-morbid alcohol dependence would attenuate group differences in many of the antisocial outcomes, and violence in particular; and third, that the AABS/BPD group would show both a high prevalence and a high severity of CD, and that adjusting for co-morbid CD would attenuate any association found between AABS/BPD co-morbidity and violence. Results confirmed these predictions, suggesting that AABS/BPD co-morbidity mediates the relationship between childhood CD and a predisposition to adult violence. The triad of AABS/BPD co-morbidity, alcohol dependence and severe CD is likely associated with the risk of criminal recidivism in offenders with personality disorder following release into the community. Copyright © 2012 John Wiley & Sons, Ltd.

  13. Service Modularity

    DEFF Research Database (Denmark)

    Avlonitis, Viktor; Hsuan, Juliana

    2015-01-01

    The purpose of this research is to investigate the studies on service modularity with a goal of informing service science and advancing contemporary service systems research. Modularity, a general systems property, can add theoretical underpinnings to the conceptual development of service science...... in general and service systems in particular. Our research is guided by the following question: how can modularity theory inform service system design? We present a review of the modularity literature and associated concepts. We then introduce the contemporary service science and service system discourse...

  14. Cervical Cancer Screening Service Uptake and Associated Factors among Age Eligible Women in Mekelle Zone, Northern Ethiopia, 2015: A Community Based Study Using Health Belief Model.

    Directory of Open Access Journals (Sweden)

    Hinsermu Bayu

    Full Text Available Cervical cancer is the third most common cancer among women worldwide, with about 500,000 new patients diagnosed and over 250,000 deaths every year. Cervical cancer screening offers protective benefits and is associated with a reduction in the incidence of invasive cervical cancer and cervical cancer mortality. But there is very low participation rate in screening for cervical cancer among low and middle-income countries.This study aimed to determine cervical cancer screening service uptake and its associated factor among age eligible women in Mekelle zone, northern Ethiopia, 2015.A community based cross-sectional study was conducted in Mekelle zone among age eligible women from February to June 2015. Systematic sampling technique was used to select 1286 women in to the study. A pre-tested structured questionnaire was used to collect relevant data. Data was entered and cleaned using EPINFO and analyzed using SPSS version 20 software package. Bivariate and Multivariate logistic regression was performed to assess association between dependent and independent variables with 95% CI and p-value less than 0.05 was set for association.The study revealed that among 1186 age eligible women, only 235(19.8% have been screened for cervical cancer. Age (AOR = 1.799, 95%CI = 1.182-2.739, history of multiple sexual partners (AOR = 1.635, 95%CI = 1.094-2.443, history of sexually transmitted disease (AOR = 1.635,95%CI = 1.094-2.443, HIV sero status (AOR = 5.614, 95%CI = 2.595-12.144, perceived susceptibility to cervical cancer (AOR = 2.225, 95%CI = 1.308-3.783, perceived barriers to premalignant cervical lesions screening (AOR = 2.256, 95%CI = 1.447-3.517 and knowledge on cervical cancer and screening (AOR = 2.355, 95%CI = 1.155-4.802 were significant predictors of cervical cancer screening service uptake.Magnitude of cervical cancer screening service uptake among age eligible women is still unacceptably low. Age of the women, history of multiple sexual partners

  15. Method and associated apparatus for capturing, servicing, and de-orbiting earth satellites using robotics

    Science.gov (United States)

    Cepollina, Frank J. (Inventor); Burns, Richard D. (Inventor); Holz, Jill M. (Inventor); Corbo, James E. (Inventor); Jedhrich, Nicholas M. (Inventor)

    2009-01-01

    This invention is a method and supporting apparatus for autonomously capturing, servicing and de-orbiting a free-flying spacecraft, such as a satellite, using robotics. The capture of the spacecraft includes the steps of optically seeking and ranging the satellite using LIDAR; and matching tumble rates, rendezvousing and berthing with the satellite. Servicing of the spacecraft may be done using supervised autonomy, which is allowing a robot to execute a sequence of instructions without intervention from a remote human-occupied location. These instructions may be packaged at the remote station in a script and uplinked to the robot for execution upon remote command giving authority to proceed. Alternately, the instructions may be generated by Artificial Intelligence (AI) logic onboard the robot. In either case, the remote operator maintains the ability to abort an instruction or script at any time, as well as the ability to intervene using manual override to teleoperate the robot.In one embodiment, a vehicle used for carrying out the method of this invention comprises an ejection module, which includes the robot, and a de-orbit module. Once servicing is completed by the robot, the ejection module separates from the de-orbit module, leaving the de-orbit module attached to the satellite for de-orbiting the same at a future time. Upon separation, the ejection module can either de-orbit itself or rendezvous with another satellite for servicing. The ability to de-orbit a spacecraft further allows the opportunity to direct the landing of the spent satellite in a safe location away from population centers, such as the ocean.

  16. Conductivity Probe

    Science.gov (United States)

    2008-01-01

    The Thermal and Electrical Conductivity Probe (TECP) for NASA's Phoenix Mars Lander took measurements in Martian soil and in the air. The needles on the end of the instrument were inserted into the Martian soil, allowing TECP to measure the propagation of both thermal and electrical energy. TECP also measured the humidity in the surrounding air. The needles on the probe are 15 millimeters (0.6 inch) long. The Phoenix Mission is led by the University of Arizona, Tucson, on behalf of NASA. Project management of the mission is by NASA's Jet Propulsion Laboratory, Pasadena, Calif. Spacecraft development is by Lockheed Martin Space Systems, Denver.

  17. Expression of ABA synthesis and metabolism genes under different irrigation strategies and atmospheric VPDs is associated with stomatal conductance in grapevine (Vitis vinifera L. cv Cabernet Sauvignon).

    Science.gov (United States)

    Speirs, Jim; Binney, Allan; Collins, Marisa; Edwards, Everard; Loveys, Brian

    2013-04-01

    The influence of different levels of irrigation and of variation in atmospheric vapour pressure deficit (VPD) on the synthesis, metabolism, and transport of abscisic acid (ABA) and the effects on stomatal conductance were examined in field-grown Cabernet Sauvignon grapevines. Xylem sap, leaf tissue, and root tissue were collected at regular intervals during two seasons in conjunction with measurements of leaf water potential (Ψleaf) and stomatal conductance (gs). The different irrigation levels significantly altered the Ψleaf and gs of the vines across both seasons. ABA abundance in the xylem sap was correlated with gs. The expression of genes associated with ABA synthesis, NCED1 and NCED2, was higher in the roots than in the leaves throughout and highest in the roots in mid January, a time when soil moisture declined and VPD was at its highest. Their expression in roots was also inversely related to the levels of irrigation and correlated with ABA abundance in the roots, xylem sap, and leaves. Three genes encoding ABA 8'-hydroxylases were isolated and their identities confirmed by expression in yeast cells. The expression of one of these, Hyd1, was elevated in leaves when VPD was below 2.0-2.5 kPa and minimal at higher VPD levels. The results provide evidence that ABA plays an important role in linking stomatal response to soil moisture status and that changes in ABA catabolism at or near its site of action allows optimization of gas exchange to current environmental conditions.

  18. Pathophysiological mechanisms of sino-atrial dysfunction and ventricular conduction disease associated with SCN5A deficiency: insights from mouse models

    Directory of Open Access Journals (Sweden)

    Christopher L-H Huang

    2012-07-01

    Full Text Available Genetically modified mice provide a number of models for studying cardiac channelopathies related to cardiac Na+ channel (SCN5A abnormalities. We review key pathophysiological features in these murine models that may underlie clinical features observed in sinus node dysfunction and progressive cardiac conduction disease, thereby providing insights into their pathophysiological mechanisms. We describe loss of Na+ channel function and fibrotic changes associated with both loss and gain-of-function Na+ channel mutations. Recent reports further relate the progressive fibrotic changes to upregulation of TGF-β1 production and the transcription factors, Atf3, a stress-inducible gene, and Egr1, to the presence of heterozygous Scn5a inactivation. Both changes are thus directly implicated in the clinically observed disruptions in sino-atrial node pacemaker function, and sino-atrial and ventricular conduction, and their progression with age. Murine systems with genetic modifications in Scn5a thus prove a useful tool to address questions concerning roles of genetic and environmental modifiers on human SCN5A disease phenotypes.

  19. Neurogenic detrusor overactivity is associated with decreased expression and function of the large conductance voltage- and Ca(2+-activated K(+ channels.

    Directory of Open Access Journals (Sweden)

    Kiril L Hristov

    Full Text Available Patients suffering from a variety of neurological diseases such as spinal cord injury, Parkinson's disease, and multiple sclerosis often develop neurogenic detrusor overactivity (NDO, which currently lacks a universally effective therapy. Here, we tested the hypothesis that NDO is associated with changes in detrusor smooth muscle (DSM large conductance Ca(2+-activated K(+ (BK channel expression and function. DSM tissue samples from 33 patients were obtained during open bladder surgeries. NDO patients were clinically characterized preoperatively with pressure-flow urodynamics demonstrating detrusor overactivity, in the setting of a clinically relevant neurological condition. Control patients did not have overactive bladder and did not have a clinically relevant neurological disease. We conducted quantitative polymerase chain reactions (qPCR, perforated patch-clamp electrophysiology on freshly-isolated DSM cells, and functional studies on DSM contractility. qPCR experiments revealed that DSM samples from NDO patients showed decreased BK channel mRNA expression in comparison to controls. Patch-clamp experiments demonstrated reduced whole cell and transient BK currents (TBKCs in freshly-isolated DSM cells from NDO patients. Functional studies on DSM contractility showed that spontaneous phasic contractions had a decreased sensitivity to iberiotoxin, a selective BK channel inhibitor, in DSM strips isolated from NDO patients. These results reveal the novel finding that NDO is associated with decreased DSM BK channel expression and function leading to increased DSM excitability and contractility. BK channel openers or BK channel gene transfer could be an alternative strategy to control NDO. Future clinical trials are needed to evaluate the value of BK channel opening drugs or gene therapies for NDO treatment and to identify any possible adverse effects.

  20. Factors associated with utilization of skilled service delivery among women in rural Northern Ghana: a cross sectional study.

    Science.gov (United States)

    Gudu, William; Addo, Bright

    2017-05-31

    Ghana's current Maternal Mortality Ratio (MMR) of 319 per 100,000 live births makes achievement of the Sustainable Development Goal of 70 maternal deaths per 100,000 live births or less by 2030 appear to be illusory. Skilled assistance during childbirth is a critical strategy to reducing maternal mortality, yet the proportion of deliveries taking place within health facilities where such assistance is provided is very low in Ghana, with huge disparity between urban and rural women. To address the gap in skilled attendance in rural Upper East Region, the Ghana Health Service (GHS) in 2005 piloted a program that involved training of Community Health Officers (CHOs) as midwives. This study explored factors associated with skilled delivery services utilization in a predominantly rural district in Ghana. A cross-sectional study, data was collected from a sample of 400 women between the ages of 15 and 49 years who had given birth a year prior to the study. We used frequencies and percentages for descriptive analysis and chi-square (χ 2 ) test for relationship between independents factors and utilization of skilled delivery services. Of the 400 women included in the analysis, 93.3% of them delivered in a health facility. Almost all of the mothers (97.3%) attended or received antenatal care at their last pregnancy with 75.0% of them having four or more ANC visits. The proportion of women who received ANC and utilized skilled delivery services was high (91.5%). Mother's educational attainment, ANC attendance, frequency of ANC visits, satisfaction with ANC services and possession of valid NHIS card significantly associated with utilisation of skilled delivery services. For a predominantly rural district, the percentage of women who deliver within health facilities where skilled assistance is available is very encouraging and a significant stride towards reducing Ghana's overall MMR. Having four or more ANC visits and improving on the quality of care provided has a great

  1. Are You Covered? Associations Between Patient Protection and Affordable Care Act Knowledge and Preventive Reproductive Service Use.

    Science.gov (United States)

    Sawyer, Ashlee N; Kwitowski, Melissa A; Benotsch, Eric G

    2018-05-01

    Sexual and reproductive health conditions (eg, infections, cancers) represent public health concerns for American women. The present study examined how knowledge of the Patient Protection and Affordable Care Act (PPACA) relates to receipt of preventive reproductive health services among women. Cross-sectional online survey. Online questionnaires were completed via Amazon Mechanical Turk, a crowdsourcing website where individuals complete web-based tasks for compensation. Cisgendered women aged 18 to 44 years (N = 1083) from across the United States. Participants completed online questionnaires assessing demographics, insurance status, preventive service use, and knowledge of PPACA provisions. Chi-squares showed that receipt of well-woman, pelvic, and breast examinations, as well as pap smears, was related to insurance coverage, with those not having coverage at all during the previous year having significantly lower rates of use. Hierarchical logistic regressions determined the independent relationship between PPACA knowledge and use of health services after controlling for demographic factors and insurance status. Knowledge of PPACA provisions was associated with receiving well-woman, pelvic, and breast examinations, human papillomavirus vaccination, and sexually transmitted infections testing, after controlling for these factors. Results indicate that expanding knowledge about health-care legislation may be beneficial in increasing preventive reproductive health service use among women. Current findings provide support for increasing resources for outreach and education of the general population about the provisions and benefits of health-care legislation, as well as personal health coverage plans.

  2. Postnatal Care Service Utilization and Associated Factors among Women Who Gave Birth in the Last 12 Months prior to the Study in Debre Markos Town, Northwestern Ethiopia: A Community-Based Cross-Sectional Study

    Directory of Open Access Journals (Sweden)

    Miteku Andualem Limenih

    2016-01-01

    Full Text Available Improving maternal and newborn health through proper postnatal care services under the care of skilled health personnel is the key strategy to reduce maternal and neonatal mortality. However, there were limited evidences on utilization of postnatal care services in Ethiopia. A community based cross-sectional study was conducted in Debremarkos town, Northwest Ethiopia. Cluster sampling technique was used to select 588 study participants. Bivariate and multivariable logistic regression model was fitted to identify factors associated with postnatal care utilization. Odds ratio with 95% confidence interval was computed to determine the level of significance. Postnatal care service utilization was found to be 33.5%. Awareness about maternal complication (AOR: 2.72, 95% CI (1.71, 4.34, place of delivery of last child (AOR: 1.68, 95% CI: (1.01, 2.79, outcome of birth (AOR: 2.71, 95% CI (1.19, 6.19, delivery by cesarean section (AOR: 4.82, 95% CI (1.86, 12.54, and delivery complication that occurred during birth (AOR: 2.58, 95% CI (1.56, 4.28 were factors associated with postnatal care service utilization. Postnatal care service utilization was found to be low. Increasing awareness about postnatal care, preventing maternal and neonatal complication, and scheduling mothers based on the national postnatal care follow-up protocol would increase postnatal care service utilization.

  3. Postnatal Care Service Utilization and Associated Factors among Women Who Gave Birth in the Last 12 Months prior to the Study in Debre Markos Town, Northwestern Ethiopia: A Community-Based Cross-Sectional Study.

    Science.gov (United States)

    Limenih, Miteku Andualem; Endale, Zerfu Mulaw; Dachew, Berihun Assefa

    2016-01-01

    Improving maternal and newborn health through proper postnatal care services under the care of skilled health personnel is the key strategy to reduce maternal and neonatal mortality. However, there were limited evidences on utilization of postnatal care services in Ethiopia. A community based cross-sectional study was conducted in Debremarkos town, Northwest Ethiopia. Cluster sampling technique was used to select 588 study participants. Bivariate and multivariable logistic regression model was fitted to identify factors associated with postnatal care utilization. Odds ratio with 95% confidence interval was computed to determine the level of significance. Postnatal care service utilization was found to be 33.5%. Awareness about maternal complication (AOR: 2.72, 95% CI (1.71, 4.34)), place of delivery of last child (AOR: 1.68, 95% CI: (1.01, 2.79)), outcome of birth (AOR: 2.71, 95% CI (1.19, 6.19)), delivery by cesarean section (AOR: 4.82, 95% CI (1.86, 12.54)), and delivery complication that occurred during birth (AOR: 2.58, 95% CI (1.56, 4.28)) were factors associated with postnatal care service utilization. Postnatal care service utilization was found to be low. Increasing awareness about postnatal care, preventing maternal and neonatal complication, and scheduling mothers based on the national postnatal care follow-up protocol would increase postnatal care service utilization.

  4. The barriers associated with emergency medical service use for acute coronary syndrome: the awareness and influence of an Australian public mass media campaign.

    Science.gov (United States)

    Cartledge, Susie; Finn, Judith; Straney, Lahn; Ngu, Phillip; Stub, Dion; Patsamanis, Harry; Shaw, James; Bray, Janet

    2017-07-01

    Emergency medical services (EMS) transport to hospital is recommended in acute coronary syndrome (ACS) guidelines, but only half of patients with ACS currently use EMS. The recent Australian Warning Signs campaign conducted by the Heart Foundation addressed some of the known barriers against using EMS. Our aim was to examine the influence of awareness of the campaign on these barriers in patients with ACS. Interviews were conducted with patients admitted to an Australian tertiary hospital between July 2013 and April 2014 with a diagnosis of ACS. Patient selection criteria included: aged 35-75 years, competent to provide consent, English speaking, not in residential care and medically stable. Multivariable logistic regression was used to examine factors associated with EMS use. Only 54% of the 199 patients with ACS interviewed used EMS for transport to hospital. Overall 64% of patients recalled seeing the campaign advertising, but this was not associated with increased EMS use (52.0%vs56.9%, p=0.49) or in the barriers against using EMS. A large proportion of patients (43%) using other transport thought it would be faster. Factors associated with EMS use for ACS were: age >65 years, ST-elevation myocardial infarction, a sudden onset of pain and experiencing vomiting. In medically stable patients with ACS, awareness of the Australian Warning Signs campaign was not associated with increased use of EMS or a change in the barriers for EMS use. Future education strategies could emphasise the clinical role that EMS provide in ACS. © 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.

  5. The association between question type and the outcomes of a Dermatology eConsult service.

    Science.gov (United States)

    O'Toole, Ashley; Joo, Jiyeh; DesGroseilliers, Jean-Pierre; Liddy, Clare; Glassman, Steven; Afkham, Amir; Keely, Erin

    2017-08-01

    eConsult is a web based service that facilitates communication between primary care providers (PCPs) and specialists, which can reduce the need for face-to-face consultations with specialists. One example is the Champlain BASE (Building Access to Specialist through eConsultation) service with dermatology being the largest specialty consulted. Dermatology eConsults submitted from July 2011 to January 2015 were reviewed. Post eConsult surveys for PCPs were analyzed to determine the number of traditional consults avoided and perceived value of eConsults. The time it took the PCP to receive a reply and the amount of time reported by the specialist to answer eConsult were proactively recorded and analyzed. A subset of 154 most recent eConsults was categorized for dermatology content and question type (e.g. diagnosis or management) using a validated taxonomy. A total of 965 eConsults were directed to dermatology from 217 unique PCPs. The majority of eConsults (64%) took the specialist between 10 and 15 minutes to answer. The overall value of this service to the provider was rated as very good or excellent in 95% of cases. In 49%, traditional in-person assessments were avoided. In the subset of the most recent cases, diagnosis was the most common question type asked (65.2%) followed by management (29%) and drug treatment (10.6%). The top five subject areas (40%) were: Dermatitis, Infections, Neoplasm, Nevi, and Pruritus. eConsults was feasible and well received by PCPs, which improves access to dermatology care with a potential to reduce wait times for traditional consultation. © 2017 The International Society of Dermatology.

  6. Proceedings of the Petroleum Services Association of Canada 2008 spring conference

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2008-07-01

    This annual conference focused on workplace safety and personnel management with particular reference to current training and safety issues affecting the petroleum services industry. Presentations given at the conference discussed issues related to transportation operations, transportation management, and asset management. New methods of reviewing critical incidents were presented along with recent updates to the National Safety Code. Issues related to contractor safety were also discussed. Improved methods of managing personnel were presented and issues related to disability management were examined. Employment standards were also reviewed along with methods of improving supervisory skills. One of the 24 presentations featured at this conference has been catalogued separately for inclusion in this database. tabs., figs.

  7. For Distinguished Public Service: Medical Library Association Honors FNLM and NIH MedlinePlus Magazine | NIH ...

    Science.gov (United States)

    ... Medical Library Association Honors FNLM and NIH MedlinePlus Magazine Past Issues / Summer 2011 Table of Contents MLA ... From You We want your feedback on the magazine and ideas for future issues, as well as ...

  8. Restoring Forests and Associated Ecosystem Services on Appalachian Coal Surface Mines

    Science.gov (United States)

    Zipper, Carl E.; Burger, James A.; Skousen, Jeffrey G.; Angel, Patrick N.; Barton, Christopher D.; Davis, Victor; Franklin, Jennifer A.

    2011-05-01

    Surface coal mining in Appalachia has caused extensive replacement of forest with non-forested land cover, much of which is unmanaged and unproductive. Although forested ecosystems are valued by society for both marketable products and ecosystem services, forests have not been restored on most Appalachian mined lands because traditional reclamation practices, encouraged by regulatory policies, created conditions poorly suited for reforestation. Reclamation scientists have studied productive forests growing on older mine sites, established forest vegetation experimentally on recent mines, and identified mine reclamation practices that encourage forest vegetation re-establishment. Based on these findings, they developed a Forestry Reclamation Approach (FRA) that can be employed by coal mining firms to restore forest vegetation. Scientists and mine regulators, working collaboratively, have communicated the FRA to the coal industry and to regulatory enforcement personnel. Today, the FRA is used routinely by many coal mining firms, and thousands of mined hectares have been reclaimed to restore productive mine soils and planted with native forest trees. Reclamation of coal mines using the FRA is expected to restore these lands' capabilities to provide forest-based ecosystem services, such as wood production, atmospheric carbon sequestration, wildlife habitat, watershed protection, and water quality protection to a greater extent than conventional reclamation practices.

  9. Health service cost associated with percutaneous vertebroplasty in patients with spinal metastases.

    Science.gov (United States)

    Chew, C; O'Dwyer, P J; Edwards, R

    2013-08-01

    To ascertain prospectively the health service cost of vertebroplasty in a cohort of consecutive patients with spinal metastases. Percutaneous vertebroplasty was performed under conscious sedation and local anaesthetic in the Interventional Suite with fluoroscopic guidance. Data were collected prospectively on standard forms. Quality of life questionnaires (EQ-5D) were filled out pre-, 6 weeks, and at 6 months post-vertebroplasty. The majority of the procedures were performed on an outpatient basis (8/11). The median duration of the procedure was 60 min (range 40-80 min) with a further 60 min spent in the recovery room (range 10-230 min). Personnel involved included a consultant radiologist, a radiology registrar, four nurses, and two radiographers. The average cost of vertebroplasty per patient, including consumables, capital equipment, hotel/clinic costs, and staffing, was £2213.25 (95% CI £729.95). The mean EQ-5D utility scores increased from 0.421 pre-treatment to 0.5979 post-treatment (p = 0.047). The visual analogue scale (VAS) of perceived health improved from a mean of 41.88 to 63.75 (p = 0.00537). Health service costs for percutaneous vertebroplasty in patients with spinal metastases is significantly lower than previously estimated and is in keeping with that of other palliative radiological procedures. Copyright © 2013 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  10. Health service cost associated with percutaneous vertebroplasty in patients with spinal metastases

    International Nuclear Information System (INIS)

    Chew, C.; O'Dwyer, P.J.; Edwards, R.

    2013-01-01

    Aims: To ascertain prospectively the health service cost of vertebroplasty in a cohort of consecutive patients with spinal metastases. Materials and methods: Percutaneous vertebroplasty was performed under conscious sedation and local anaesthetic in the Interventional Suite with fluoroscopic guidance. Data were collected prospectively on standard forms. Quality of life questionnaires (EQ-5D) were filled out pre-, 6 weeks, and at 6 months post-vertebroplasty. Results: The majority of the procedures were performed on an outpatient basis (8/11). The median duration of the procedure was 60 min (range 40–80 min) with a further 60 min spent in the recovery room (range 10–230 min). Personnel involved included a consultant radiologist, a radiology registrar, four nurses, and two radiographers. The average cost of vertebroplasty per patient, including consumables, capital equipment, hotel/clinic costs, and staffing, was £2213.25 (95% CI £729.95). The mean EQ-5D utility scores increased from 0.421 pre-treatment to 0.5979 post-treatment (p = 0.047). The visual analogue scale (VAS) of perceived health improved from a mean of 41.88 to 63.75 (p = 0.00537). Conclusion: Health service costs for percutaneous vertebroplasty in patients with spinal metastases is significantly lower than previously estimated and is in keeping with that of other palliative radiological procedures

  11. Bilingual children referred for psychiatric services: associations of language disorders, language skills, and psychopathology.

    Science.gov (United States)

    Toppelberg, Claudio O; Medrano, Laura; Peña Morgens, Liana; Nieto-Castañon, Alfonso

    2002-06-01

    To investigate (1) the prevalence of language deficits and disorders and (2) the relationship of bilingual language skills and psychopathology, in Spanish-English bilingual children referred for child and adolescent psychiatry services. Bilingual language skills, emotional/behavioral problems, sociodemographics, immigration variables, and nonverbal IQ were studied in 50 consecutively referred children. Estimated prevalence was high for language deficits (48%) and disorders (41%), with most cases (>79%) being of the mixed receptive-expressive type. In children with clinically significant emotional/behavioral problems, bilingual language skills were strongly and inversely correlated with problem scores, particularly global problems (r = -0.67, p or = -0.54; p language disorders and delays and (2) the close tie between poor language skills and emotional/behavioral problems. The data strongly suggest the clinical importance and feasibility of language assessment and the significance of receptive problems in bilingual children referred for psychiatric services. A safe approach is to fully assess language skills, rather than misattributing these children's language delays to normal bilingual acquisition processes.

  12. The Association between Sexually Transmitted Infections, Length of Service and Other Demographic Factors in the U.S. Military.

    Directory of Open Access Journals (Sweden)

    Robert Deiss

    Full Text Available Numerous studies have found higher rates of sexually transmitted infections (STIs among military personnel than the general population, but the cumulative risk of acquiring STIs throughout an individual's military career has not been described.Using ICD-9 diagnosis codes, we analyzed the medical records of 100,005 individuals from all service branches, divided in equal cohorts (n = 6,667 between 1997 and 2011. As women receive frequent STI screening compared to men, these groups were analyzed separately. Incidence rates were calculated for pathogen-specific STIs along with syndromic diagnoses. Descriptive statistics were used to characterize the individuals within each accession year cohort; repeat infections were censored.The total sample included 29,010 females and 70,995 males. The STI incidence rates (per 100 person-years for women and men, respectively, were as follows: chlamydia (3.5 and 0.7, gonorrhea (1.1 and 0.4, HIV (0.04 and 0.07 and syphilis (0.14 and 0.15. During the study period, 22% of women and 3.3% of men received a pathogen-specific STI diagnosis; inclusion of syndromic diagnoses increased STI prevalence to 41% and 5.5%, respectively. In multivariate analyses, factors associated with etiologic and syndromic STIs among women included African American race, younger age and fewer years of education. In the overall sample, increasing number of years of service was associated with an increased likelihood of an STI diagnosis (p<0.001 for trend.In this survey of military personnel, we found very high rates of STI acquisition throughout military service, especially among women, demonstrating that STI-related risk is significant and ongoing throughout military service. Lower STI incidence rates among men may represent under-diagnosis and demonstrate a need for enhancing male-directed screening and diagnostic interventions.

  13. The Association between Sexually Transmitted Infections, Length of Service and Other Demographic Factors in the U.S. Military

    Science.gov (United States)

    Deiss, Robert; Bower, Richard J.; Co, Edgie; Mesner, Octavio; Sanchez, Jose L.; Masel, Jennifer; Ganesan, Anuradha; Macalino, Grace E.; Agan, Brian K.

    2016-01-01

    Background Numerous studies have found higher rates of sexually transmitted infections (STIs) among military personnel than the general population, but the cumulative risk of acquiring STIs throughout an individual’s military career has not been described. Methods Using ICD-9 diagnosis codes, we analyzed the medical records of 100,005 individuals from all service branches, divided in equal cohorts (n = 6,667) between 1997 and 2011. As women receive frequent STI screening compared to men, these groups were analyzed separately. Incidence rates were calculated for pathogen-specific STIs along with syndromic diagnoses. Descriptive statistics were used to characterize the individuals within each accession year cohort; repeat infections were censored. Results The total sample included 29,010 females and 70,995 males. The STI incidence rates (per 100 person-years) for women and men, respectively, were as follows: chlamydia (3.5 and 0.7), gonorrhea (1.1 and 0.4), HIV (0.04 and 0.07) and syphilis (0.14 and 0.15). During the study period, 22% of women and 3.3% of men received a pathogen-specific STI diagnosis; inclusion of syndromic diagnoses increased STI prevalence to 41% and 5.5%, respectively. In multivariate analyses, factors associated with etiologic and syndromic STIs among women included African American race, younger age and fewer years of education. In the overall sample, increasing number of years of service was associated with an increased likelihood of an STI diagnosis (pmilitary personnel, we found very high rates of STI acquisition throughout military service, especially among women, demonstrating that STI-related risk is significant and ongoing throughout military service. Lower STI incidence rates among men may represent under-diagnosis and demonstrate a need for enhancing male-directed screening and diagnostic interventions. PMID:27936092

  14. What Are Women Told When Requesting Family Planning Services at Clinics Associated with Catholic Hospitals? A Mystery Caller Study.

    Science.gov (United States)

    Guiahi, Maryam; Teal, Stephanie B; Swartz, Maryke; Huynh, Sandy; Schiller, Georgia; Sheeder, Jeanelle

    2017-12-01

    Catholic Church directives restrict family planning service provision at Catholic health care institutions. It is unclear whether obstetrics and gynecology clinics that are owned by or have business affiliations with Catholic hospitals offer family planning appointments. Mystery callers phoned 144 clinics nationwide that were found on Catholic hospital websites between December 2014 and February 2016, and requested appointments for birth control generally, copper IUD services specifically, tubal ligation and abortion. Chi-square and Fisher's exact tests assessed potential correlates of appointment availability, and multivariable logistic regressions were computed if bivariate testing suggested multiple correlates. Although 95% of clinics would schedule birth control appointments, smaller proportions would schedule appointments for copper IUDs (68%) or tubal ligation (58%); only 2% would schedule an abortion. Smaller proportions of Catholic-owned than of Catholic-affiliated clinics would schedule appointments for birth control (84% vs. 100%), copper IUDs (4% vs. 97%) and tubal ligation (29% vs. 72%); for birth control and copper IUD services, no other clinic characteristics were related to appointment availability. Multivariable analysis confirmed that tubal ligation appointments were less likely to be offered at Catholic-owned than at Catholic-affiliated clinics (odds ratio. 0.1); location and association with one of the top 10 Catholic health care systems also were significant. Adherence to church directives is inconsistent at Catholic-associated clinics. Women visiting such clinics who want highly effective methods may need to rely on less effective methods or delay method uptake while seeking services elsewhere. Copyright © 2017 by the Guttmacher Institute.

  15. The association of generalized anxiety disorder and Somatic Symptoms with frequent attendance to health care services: A cross-sectional study from the Northern Finland Birth Cohort 1966.

    Science.gov (United States)

    Kujanpää, Tero S; Jokelainen, Jari; Auvinen, Juha P; Timonen, Markku J

    2017-03-01

    Objective Generalized anxiety disorder is associated with higher rate of physical comorbities, unexplained symptoms, and health care utilization. However, the role of somatic symptoms in determining health care utilization is unclear. The present study aims to assess the association of frequent attendance of health care services between generalized anxiety disorder symptoms and somatic symptoms. Method This study was conducted cross-sectionally using the material of the 46-year follow-up survey of the Northern Finland Birth Cohort 1966. Altogether, 5585 cohort members responded to the questionnaires concerning health care utilization, illness history, physical symptoms, and generalized anxiety disorder-7 screening tool. Odds ratios belonging to the highest decile in health care utilization were calculated for generalized anxiety disorder symptoms and all (n = 4) somatic symptoms of Hopkins Symptom Checklist-25 controlled for confounding factors. Results Adjusted Odds ratios for being frequent attender of health care services were 2.29 (95% CI 1.58-3.31) for generalized anxiety disorder symptoms and 1.28 (95% CI 0.99-1.64), 1.94 (95% CI 1.46-2.58), 2.33 (95% CI 1.65-3.28), and 3.64 (95% CI 2.15-6.18) for 1, 2, 3, and 4 somatic symptoms, respectively. People with generalized anxiety disorder symptoms had on average a higher number of somatic symptoms (1.8) than other cohort members (0.9). Moreover, 1.6% of people without somatic symptoms tested positive for generalized anxiety disorder, meanwhile 22.6% of people with four somatic symptoms tested positive for generalized anxiety disorder. Conclusions Both generalized anxiety disorder symptoms and somatic symptoms are associated with a higher risk for being a health care frequent attender.

  16. Within-unit relationship quality mediates the association between military sexual trauma and posttraumatic stress symptoms in veterans separating from military service.

    Science.gov (United States)

    Laws, Holly; Mazure, Carolyn M; McKee, Sherry A; Park, Crystal L; Hoff, Rani

    2016-09-01

    Few studies have examined the impact of military sexual trauma (MST) on social functioning during deployment. Yet consideration of unit relationships during deployment may be important, given that military unit cohesion and support can provide protective effects against the stress of combat, and reduce the likelihood of developing posttraumatic stress disorder. Although prior research has posited that depleted social resources are one pathway through which MST is associated with posttraumatic stress symptoms (PTSS), no studies have statistically tested this theory. This study examined the association of MST and PTSS and evaluated the potential mediating role of decreased unit relationship quality. Mediational analyses were conducted on a sample of veterans following discharge from military service (N = 818; 328 women, 490 men). Women were significantly more likely to experience MST than men. As hypothesized, experiences of MST during deployment were associated with higher PTSS. MST experiences were associated with less trust in and support from one's military unit, which partially mediated the association between MST and PTSS. The indirect effect of MST on PTSS through lower unit relationship quality accounted for 20.4% of the total effect of MST on PTSS. While the retrospective study design precludes tests of causality, mediational findings provided statistical evidence that lower unit relationship quality partially explains the association between MST and PTSS. This finding is consistent with interpersonal theories of trauma response suggesting that the deleterious effects of MST may be in part due to its erosion of social resources during deployment. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  17. Institutional capacity to provide psychosocial oncology support services: A report from the Association of Oncology Social Work.

    Science.gov (United States)

    Zebrack, Brad; Kayser, Karen; Padgett, Lynne; Sundstrom, Laura; Jobin, Chad; Nelson, Krista; Fineberg, Iris C

    2016-06-15

    This study reports cancer-treating institutions' capacity to deliver comprehensive psychosocial support services. Oncology care providers at 60 cancer-treating institutions completed surveys assessing the capacity of their institutions to provide psychosocial care. Capacity was assessed with the Cancer Psychosocial Care Matrix (CPCM) from the National Cancer Institute (NCI). Scores represented individuals' perceptions of their cancer program's performance with respect to 10 fundamental elements of psychosocial care. Among 2134 respondents, 62% reported a mid-level capacity for ≥5 of 10 CPCM items. In comparison with other types of cancer programs (eg, NCI-designated, academic, or comprehensive centers), providers at community cancer programs reported a significantly greater capacity with respect to patient-provider communication, psychosocial needs assessment, and continuity in the delivery of psychosocial care over time. Nurses and primary medical providers reported a significantly lower capacity for linking patients and families with needed psychosocial services within their respective cancer programs. They also reported a significantly higher capacity for conducting follow-up, re-evaluations, and adjustments of psychosocial treatment plans. Cancer programs are performing moderately well in terms of communicating to patients the importance of psychosocial care, identifying patient psychosocial needs, and referring patients and families to psychosocial services. They are doing less well with respect to the provision of that care over time. Findings suggest that gaps in psychosocial service capacity are a function of patient, provider, and system characteristics. These results may be useful in formulating strategies to enhance psychosocial care delivery. Cancer 2016;122:1937-45. © 2016 American Cancer Society. © 2016 American Cancer Society.

  18. Conduct disorders.

    Science.gov (United States)

    Buitelaar, Jan K; Smeets, Kirsten C; Herpers, Pierre; Scheepers, Floor; Glennon, Jeffrey; Rommelse, Nanda N J

    2013-02-01

    Conduct disorder (CD) is a frequently occurring psychiatric disorder characterized by a persistent pattern of aggressive and non-aggressive rule breaking antisocial behaviours that lead to considerable burden for the patients themselves, their family and society. This review paper updates diagnostic and therapeutic approaches to CD in the light of the forthcoming DSM-5 definition. The diagnostic criteria for CD will remain unchanged in DSM-5, but the introduction of a specifier of CD with a callous-unemotional (CU) presentation is new. Linked to this, we discuss the pros and cons of various other ways to subtype aggression/CD symptoms. Existing guidelines for CD are, with few exceptions, already of a relatively older date and emphasize that clinical assessment should be systematic and comprehensive and based on a multi-informant approach. Non-medical psychosocial interventions are recommended as the first option for the treatment of CD. There is a role for medication in the treatment of comorbid syndromes and/or in case of insufficient response to psychosocial interventions and severe and dangerous aggressive and violent behaviours.

  19. Supervisor vs. employee safety perceptions and association with future injury in US limited-service restaurant workers.

    Science.gov (United States)

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

    2012-07-01

    Many studies have found management commitment to safety to be an important construct of safety climate. This study examined the association between supervisor and employee (shared and individual) perceptions of management commitment to safety and the rate of future injuries in limited-service restaurant workers. A total of 453 participants (34 supervisors/managers and 419 employees) from 34 limited-service restaurants participated in a prospective cohort study. Employees' and managers' perceptions of management commitment to safety and demographic variables were collected at the baseline. The survey questions were made available in three languages: English, Spanish, and Portuguese. For the following 12 weeks, participants reported their injury experience and weekly work hours. A multivariate negative binomial generalized estimating equation model with compound symmetry covariance structure was used to assess the association between the rate of self-reported injuries and measures of safety perceptions. There were no significant relationships between supervisor and either individual or shared employee perceptions of management commitment to safety. Only individual employee perceptions were significantly associated with future employee injury experience but not supervisor safety perceptions or shared employee perceptions. Individual employee perception of management commitment to safety is a significant predictor for future injuries in restaurant environments. A study focusing on employee perceptions would be more predictive of injury outcomes than supervisor/manager perceptions. Copyright © 2012 Elsevier Ltd. All rights reserved.

  20. Factors associated with inadequate receipt of components and use of antenatal care services in Nigeria: a population-based study.

    Science.gov (United States)

    Agho, Kingsley E; Ezeh, Osita K; Ogbo, Felix A; Enoma, Anthony I; Raynes-Greenow, Camille

    2018-05-01

    Antenatal care (ANC) is an essential intervention to improve maternal and child health. In Nigeria, no population-based studies have investigated predictors of poor receipt of components and uptake of ANC at the national level to inform targeted maternal health initiatives. This study aimed to examine factors associated with inadequate receipt of components and use of ANC in Nigeria. The study used information on 20 405 singleton live-born infants of the mothers from the 2013 Nigeria Demographic and Health Survey. Multivariable logistic regression analyses that adjusted for cluster and survey weights were used to determine potential factors associated with inadequate receipt of components and use of ANC. The prevalence of underutilization and inadequate components of ANC were 47.5% (95% CI: 45.2 to 49.9) and 92.6% (95% CI: 91.8 to 93.2), respectively. Common risk factors for underutilization and inadequate components of ANC in Nigeria included residence in rural areas, no maternal education, maternal unemployment, long distance to health facilities and less maternal exposure to the media. Other risk factors for underutilization of ANC were home births and low household wealth. The study suggests that underutilization and inadequate receipt of the components of ANC were associated with amenable factors in Nigeria. Subsidized maternal services and well-guided health educational messages or financial support from the government will help to improve uptake of ANC services.

  1. Association of post-traumatic stress disorder and work performance: A survey from an emergency medical service, Karachi, Pakistan.

    Science.gov (United States)

    Kerai, Salima; Pasha, Omrana; Khan, Uzma; Islam, Muhammad; Asad, Nargis; Razzak, Junaid

    2017-01-01

    The purpose of the study was to explore the association between post-traumatic stress disorder (PTSD) and work performance of emergency medical services personnel in Karachi, Pakistan. Emergency medical service personnel were screened for potential PTSD using Impact of Event Scale-Revised (IES-R). Work performance was assessed on the basis of five variables: number of late arrivals to work, number of days absent, number of days sick, adherence to protocol, and patient satisfaction over a period of 3 months. In order to model outcomes like the number of late arrivals to work, days absent and days late, negative binomial regression was applied, whereas logistic regression was applied for adherence to protocol and linear for patient satisfaction scores. Mean scores of PTSD were 24.0±12.2. No association was found between PTSD and work performance measures: number of late arrivals to work ( RR adj 0.99; 0.98-1.00), days absent ( RR adj 0.98; 0.96-0.99), days sick ( RR adj 0.99; 0.98-1.00), adherence to protocol ( OR adj 1.01; 0.99-1.04) and patient satisfaction ( β 0.001%-0.03%) after adjusting for years of formal schooling, living status, coping mechanism, social support, working hours, years of experience and anxiety or depression. No statistically significant association was found between PTSD and work performance amongst EMS personnel in Karachi, Pakistan.

  2. Modeling the Association Between Home Care Service Use and Entry Into Residential Aged Care: A Cohort Study Using Routinely Collected Data.

    Science.gov (United States)

    Jorgensen, Mikaela; Siette, Joyce; Georgiou, Andrew; Warland, Andrew; Westbrook, Johanna

    2018-02-01

    To examine home care service-related and person-based factors associated with time to entry into permanent residential aged care. Longitudinal cohort study using routinely collected client management data. A large aged care service provider in New South Wales and the Australian Capital Territory, Australia. A total of 1116 people aged 60 years and older who commenced home care services for higher-level needs between July 1, 2015 and June 30, 2016. Survival analysis methods were used to examine service-related and person-based factors that were associated with time between first home care service and entry into permanent residential aged care. Predictors included service hours per week, combination of service types, demographics, needs, hospital leave, and change in care level. Cluster analysis was used to determine patterns of types of services used. By December 31, 2016, 21.1% of people using home care services had entered into permanent residential care (n = 235). After adjusting for significant factors such as age and care needs, each hour of service received per week was associated with a 6% lower risk of entry into residential care (hazard ratio = 0.94, 95% confidence interval 0.90-0.98). People who were predominant users of social support services, those with an identified carer, and those born in a non-main English-speaking country also remained in their own homes for longer. Greater volume of home care services was associated with significantly delayed entry into permanent residential care. This study provides much-needed evidence about service outcomes that could be used to inform older adults' care choices. Crown Copyright © 2017. Published by Elsevier Inc. All rights reserved.

  3. Prevalence and Factors Associated with the Utilization of Dental Care Services among Factory Workers in Nava Nakorn Industrial Estate, Pathumthani Province, Thailand.

    Science.gov (United States)

    Jaidee, Jeeratip; Ratanasiri, Amornrat; Chatrchaiwiwatana, Supaporn; Soonthon, Surasak

    2015-07-01

    The present study aimed to find out the utilization prevalence of dental care services among factory workers over a period of one year and factors associated with utilization of dental care services. This was a cross-sectional analytic study. The study population was factory workers in Nava Nakorn Industrial Estate randomly sampled using Probability Proportion to Size Cluster Sampling Method. The tool was a questionnaire about utilization of dental care services. Among the sample group of 1,500 workers from 16 factories, almost 2/3 (63.9%) had never used any dental care services in the previous year while only 36.1% did. A multivariable logistic regression analysis showed that workplace, accommodation, tooth decay, toothache history, transportation, experience in using social security fund for dental care services, availability and accessibility of dental care services, brushing teeth regularly after meals, using dental care services regularly in a dental clinic, and agreement with the idea that a tooth extraction and medication by a dentist could reduce the risk of progression of disease, statistical significance (p-value < 0.05), were factors associated with the utilization of dental care services at R2 (The Nagelkerke R Square) 0.38. That the prevalence of the factory workers who did not use dental care services during the last one year was 63.9 percent. This study identified three groups of factors associated with the utilization of dental care services as: 1) Predisposing factors, 2) Enabling factors, and 3) Need factors.

  4. Social workers and unemployment: Factors associated with using employment-promoting practices in Israeli Municipal Departments of Social Services.

    Science.gov (United States)

    Levin, Lia; Sefati, Noga

    2018-04-23

    Unemployment is a harsh social phenomenon with far reaching negative implications. Unemployed individuals often seek assistance from social workers working in Municipal Departments of Social Services around the world. However, little to no research exists on the factors involved in social workers' choice to engage in employment-promoting practices (EPP). The current study aimed to tackle this gap of knowledge, providing initial conclusions about the relationship between social workers' attitudes towards unemployment, their knowledge regarding EPP, the extent to which they perceive their organisations as endorsing EPP and their actual implementation. The main research question dealt with the extent to which each of the examined factors, in itself or in combination with others, would be the best predictor of social workers' utilisation of EPP. The study sample consisted of 163 social workers in Israel with varied experience in working with the unemployed, all working in public sector social services. Structural equation modelling performed on the attained data revealed that knowledge, skills and perceived organisational endorsement of EPP were positively associated with implementation of EPP. Contrary to the hypothesised, attitudes towards unemployment were not associated with the implementation of such practices. At the same time, professional training and seniority were associated with EPP only through the mediation of perceived organisational endorsement. Ultimately, perceived organisational endorsement of EPP emerged as the most influential factor involved in social workers' decision to carry out EPP with their service-users. Consequences of these findings for social work education, supervision, research and policy making are discussed, referring to the local Israeli context as well as its possible international inferences. © 2018 John Wiley & Sons Ltd.

  5. Associations Between County Wealth, Health and Social Services Spending, and Health Outcomes.

    Science.gov (United States)

    McCullough, J Mac; Leider, Jonathon P

    2017-11-01

    Each year, the County Health Rankings rate the health outcomes of each county in the U.S. A common refrain is that poor counties perform worse than wealthier ones. This article examines that assumption and specifically analyzes characteristics of counties that have performed better in terms of health outcomes than their wealth alone would suggest. Data from the 2013 County Health Rankings were used, as were 2012 financial and demographic information collected by the U.S. Census Bureau. A logistic model was constructed to examine the odds of a county "overperforming" in the rankings relative to community wealth. Analyses were performed in 2016. Communities that were wealthier performed better on the rankings. However, more than 800 of 3,141 counties overperformed by ranking in a better health outcomes quartile than their county's wealth alone would suggest. Regression analyses found that for each additional percentage point of total public spending that was allocated toward community health care and public health, the odds of being an overperformer increased by 3.7%. Community wealth correlates with health, but not always. Population health outcomes in hundreds of counties overperform what would be expected given community wealth alone. These counties tend to invest more in community health care and public health spending and other social services. Although the level of a community's wealth is outside the control of practitioners, shifting the proportion of spending to certain social services may positively impact population health. Copyright © 2017 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  6. Congenital heart diseases in a reference service: clinical evolution and associated illnesses.

    Science.gov (United States)

    Huber, Janaína; Peres, Vivian Catarino; Santos, Tiago Jeronimo dos; Beltrão, Lauro da Fontoura; Baumont, Angélica Cerveira de; Cañedo, Andrés Delgado; Schaan, Beatriz D'Agord; Pellanda, Lucia Campos

    2010-03-01

    Several factors, which include prenatal diagnosis and availability of new therapeutic procedures, have contributed to change the profile of patients with congenital heart disease (CHD). Knowing these changes is important to a better health care. Description of profile of patients with CHD in a reference service in the State of Rio Grande do Sul, Brazil. It is a cross-sectional study including 684 patients with CHD in a service of pediatric cardiology from January 2007 to May 2008. We interviewed the patients (and/or their parents) and examined these patients (congenital malformations, anthropometric measures). Moreover, their charts were reviewed in order to detail heart diseases, procedures and echocardiography. Patients were from 16 days to 66 years old, 51.8% were female, and 93.7% were Caucasian. The mean age at diagnosis was 15.8 +/- 46.8 months. Ventricular septal defect, patent ductus arteriosus and Tetralogy of Fallot were the most prevalent CHD. 59.1% of examined patients, whose average age was 44.3 +/- 71.2 months, have been undergoing therapeutic procedures; 30.4% had congenital extracardiac malformations; and 12 patients had genetic syndrome. Regarding development, 46.6% had low weight and height gain, and 13.7% had neuropsychomotor delay. Furthermore, 18.4% had family history of congenital heart disease. Neuropsychomotor delay and low weight and height gain may be related to CHD. Establishing a profile of patients with CHD, who were treated at an institution of reference, may function as a basis in which health care of this population can be planed appropriately.

  7. 77 FR 73366 - Secondary Service Connection for Diagnosable Illnesses Associated With Traumatic Brain Injury

    Science.gov (United States)

    2012-12-10

    ... mental ``disabilities'' for VA compensation purposes. However, the behavioral, social, and occupational... Diagnosable Illnesses Associated With Traumatic Brain Injury AGENCY: Department of Veterans Affairs. ACTION... Sciences, Institute of Medicine (IOM), Gulf War and Health, Volume 7: Long-Term Consequences of Traumatic...

  8. Library Service to Industry at USC: The Industrial Associates of the School of Engineering.

    Science.gov (United States)

    Frohmberg, Katherine A.

    Special libraries in Southern California and the San Francisco Bay Area who were members of the University of Southern California (USC) School of Engineering Industrial Associate program were surveyed on their use of the USC program and other similar programs. The questionnaire was designed to discover the attitudes and needs of the Industrial…

  9. Housing Equity Withdrawal : Perceptions of Obstacles among Older Australian Home Owners and associated Service Providers

    NARCIS (Netherlands)

    Jefferson, T; Austen, S; Ong, R; Haffner, M.E.A.; Wood, G.A.

    2017-01-01

    Housing wealth dominates the asset portfolios of the older population in Australia and many other countries. Given the anticipated spike in fiscal costs associated with population ageing, there is growing policy interest in housing equity withdrawal (HEW) to finance living needs in retirement.

  10. 78 FR 28546 - Secondary Service Connection for Diagnosable Illnesses Associated With Traumatic Brain Injury

    Science.gov (United States)

    2013-05-15

    ... Diagnosable Illnesses Associated With Traumatic Brain Injury Correction In proposed rule document 2012-29709...: The factors considered are: Structural imaging of the brain. LOC--Loss of consciousness. AOC--Alteration of consciousness/mental state. PTA--Post-traumatic amnesia. GCS--Glasgow Coma Scale. (For purposes...

  11. 78 FR 51267 - Hours of Service of Drivers: National Ready Mixed Concrete Association; Application for Exemption

    Science.gov (United States)

    2013-08-20

    ... Mixed Concrete Association (NRMCA) for an exemption from the 30-minute rest break provision of the.... Due to the nature of their operation, NRMCA believes that compliance with the 30-minute rest break... reasons for denying or granting the application and, if granted, the name of the person or class of...

  12. Epidemiology of Epilepsy in Older Adults with an Intellectual Disability in Ireland: Associations and Service Implications

    Science.gov (United States)

    McCarron, Mary; O'Dwyer, Marie; Burke, Eilish; McGlinchey, Eimear; McCallion, Philip

    2014-01-01

    There are limited studies on the prevalence of epilepsy and co-morbid conditions in older adults with an ID. To begin to address this prevalence of epilepsy was estimated for participants in the Intellectual Disability Supplement to the Irish Longitudinal Study on Ageing. Associations with demographic variables and co morbid health conditions were…

  13. Delivery Practices and Associated Factors among Mothers Seeking Child Welfare Services in Selected Health Facilities in Nyandarua South District, Kenya

    Directory of Open Access Journals (Sweden)

    Wanjira Carol

    2011-05-01

    Full Text Available Abstract Background A measure of the proportion of deliveries assisted by skilled attendants is one of the indicators of progress towards achieving Millennium Development Goal (MDG 5, which aims at improving maternal health. This study aimed at establishing delivery practices and associated factors among mothers seeking child welfare services at selected health facilities in Nyandarua South district, Kenya to determine whether mothers were receiving appropriate delivery care. Methods A hospital-based cross-sectional survey among women who had recently delivered while in the study area was carried out between August and October 2009. Binary Logistic regression was used to identify factors that predicted mothers' delivery practice. Results Among the 409 mothers who participated in the study, 1170 deliveries were reported. Of all the deliveries reported, 51.8% were attended by unskilled birth attendants. Among the deliveries attended by unskilled birth attendants, 38.6% (452/1170 were by neighbors and/or relatives. Traditional Birth Attendants attended 1.5% (17/1170 of the deliveries while in 11.7% (137/1170 of the deliveries were self administered. Mothers who had unskilled birth attendance were more likely to have Conclusion Among the mothers interviewed, utilization of skilled delivery attendance services was still low with a high number of deliveries being attended by unqualified lay persons. There is need to implement cost effective and sustainable measures to improve the quality of maternal health services with an aim of promoting safe delivery and hence reducing maternal mortality.

  14. Towards Improved Satellite-In Situ Oceanographic Data Interoperability and Associated Value Added Services at the Podaac

    Science.gov (United States)

    Tsontos, V. M.; Huang, T.; Holt, B.

    2015-12-01

    The earth science enterprise increasingly relies on the integration and synthesis of multivariate datasets from diverse observational platforms. NASA's ocean salinity missions, that include Aquarius/SAC-D and the SPURS (Salinity Processes in the Upper Ocean Regional Study) field campaign, illustrate the value of integrated observations in support of studies on ocean circulation, the water cycle, and climate. However, the inherent heterogeneity of resulting data and the disparate, distributed systems that serve them complicates their effective utilization for both earth science research and applications. Key technical interoperability challenges include adherence to metadata and data format standards that are particularly acute for in-situ data and the lack of a unified metadata model facilitating archival and integration of both satellite and oceanographic field datasets. Here we report on efforts at the PO.DAAC, NASA's physical oceanographic data center, to extend our data management and distribution support capabilities for field campaign datasets such as those from SPURS. We also discuss value-added services, based on the integration of satellite and in-situ datasets, which are under development with a particular focus on DOMS. The distributed oceanographic matchup service (DOMS) implements a portable technical infrastructure and associated web services that will be broadly accessible via the PO.DAAC for the dynamic collocation of satellite and in-situ data, hosted by distributed data providers, in support of mission cal/val, science and operational applications.

  15. Position of the American Dietetic Association: Providing nutrition services for people with developmental disabilities and special health care needs.

    Science.gov (United States)

    Van Riper, Cynthia L; Wallace, Lee Shelly

    2010-02-01

    It is the position of the American Dietetic Association that nutrition services provided by registered dietitians (RDs) and dietetic technicians, registered (DTRs), are essential components of comprehensive care for all people with developmental disabilities and special health care needs. Nutrition services should be provided throughout life in a manner that is interdisciplinary, family-centered, community-based, and culturally competent. People with developmental disabilities and special health care needs frequently have nutrition concerns, including growth alterations (failure to thrive, obesity, or growth retardation), metabolic disorders, poor feeding skills, medication-nutrient interactions, and sometimes partial or total dependence on enteral or parenteral nutrition. Individuals with special needs are also more likely to develop comorbid conditions such as obesity or endocrine disorders that require nutrition interventions. Poor health habits, limited access to services, and long-term use of multiple medications are considered health risk factors. Health maintenance and avoidance of complications can be promoted by timely and cost-effective nutrition interventions. Public policy for individuals with special needs has evolved over time, resulting in a transition from institutional facilities and programs to community living. The expansion of public access to technology and health information on the Internet challenges RDs and DTRs to provide accurate scientific information for those with developmental disabilities and special health care needs. Nationally credentialed RDs and DTRs are best prepared to provide appropriate nutrition information for wellness and quality of life.

  16. Survival analysis of increases in care needs associated with dementia and living alone among older long-term care service users in Japan.

    Science.gov (United States)

    Lin, Huei-Ru; Otsubo, Tetsuya; Imanaka, Yuichi

    2017-08-15

    Japan is known for its long life expectancy and rapidly aging society that there are various demands of older adults need to be fulfilled with, and one of them is long-term care needs. Therefore, Japan implemented the Long-Term Care Insurance in year 2000 for citizens who are above 65-year old and citizens who are above 40-year old in needs of long-term care services. This study was undertaken to longitudinally examine the influence of dementia and living alone on care needs increases among older long-term care insurance service users in Japan. Long-term care insurance claims data were used to identify enrollees who applied for long-term care services between October 2010 and September 2011, and subjects were tracked until March 2015. A Kaplan-Meier survival analysis was conducted to examine increases in care needs over time in months. Cox regression models were used to examine the effects of dementia and living alone on care needs increases. The cumulative survival rates before care needs increased over the 4.5-year observation period were 17.6% in the dementia group and 31.9% in the non-dementia group. After adjusting for age, sex, care needs level, and status of living alone, the risk of care needs increases was found to be 1.5 times higher in the dementia group. Living alone was not a significant risk factor of care needs increases, but people with dementia who lived alone had a higher risk of care needs increases than those without dementia. Dementia, older age, the female sex, and lower care needs levels were associated with a higher risk of care needs increases over the study period. Among these variables, dementia had the strongest impact on care needs increases, especially in persons who lived alone.

  17. Mental status of the elderly receiving home health services and the associated stress of home helpers.

    Science.gov (United States)

    Nagatomo, I; Takigawa, M

    1998-01-01

    One hundred and ninety elderly people receiving home health service were investigated. The intellectual levels, depressive state evaluated by the Cornell scale for depression in dementia (CSDD) scale, abnormal behaviors evaluated by the dementia behavior disturbance (DBD) scale, and activities of daily living (ADL) were examined. These assessments were performed by 72 skilled home helpers who also assessed the severity of their own level of stress using the Burnout scale. The intellectual level and mood-related signs, based on the CSDD scale, of the elderly living with families or with a spouse were diminished significantly as compared to the elderly living alone. The elderly living with families also performed worse on all ADL categories except for visual acuity as compared to the elderly living with a spouse or living alone. There was no significant correlation between the Burnout scale score and age or frequency of working as a home helper. These results suggest that elderly people living with families as compared to the elderly living with a spouse or living alone have greater mental health needs as well as more profound physical limitations.

  18. Maintenance requirements associated with mandibular implant overdentures: clinical results after first year of service.

    Science.gov (United States)

    Bilhan, Hakan; Geckili, Onur; Mumcu, Emre; Bilmenoglu, Caglar

    2011-12-01

    The aim of this clinical study was to evaluate the prosthodontic maintenance requirements during the first year of service of mandibular overdentures supported by interforaminal implants and to assess the influence of attachment type, implant number, and bite force on these requirements. Fifty-nine patients treated with mandibular implant overdentures between the years 2004 and 2009 and appearing in the 12th-month recall were included in this study. The overdentures constituted 4 groups: 2 single interforaminal implants (1 group with locator and 1 group with ball attachments), 3 single interforaminal implants, 3 splinted interforaminal implants (bar), and 4 splinted interforaminal implants (bar). During the examination, prosthetic parameters such as occlusion, tissue adaptation, condition of the retentive mechanism (matrice and patrice), and the condition of the denture-bearing tissues were evaluated and recorded. No statistically significant relation was found between attachment type, bite force values, implant number, and the occurring complications except the need for relining, which was found significantly more in the ball attachments than in other attachment groups (P  =  .03). After 12 months following the overdenture insertion, there seems to be no relation between occurring complications and patient-related factors, such as maximum bite force, age, and gender, as well as factors related to the overdentures such as number and type of attachments.

  19. Enusa, Internationalized Enterprise in Nuclear Fuel Manufacture and Associated Engineering Services

    International Nuclear Information System (INIS)

    Garcia-Calderon, G.

    2000-01-01

    Since the beginning of its activities, in 1972, ENUSA has been providing an important contribution to Spanish nuclear energy development, performing activities in the first part of the nuclear fuel cycle. Few years after starting the production at the juzbado manufacturing plant, ENUSA realised that, in order to be competitive, needed to expand its activities beyond the Spanish border and took the decision of being present in the Nuclear fuel market in Europe internationalizing its activities. ENUSA reached Strategic Alliance with of the most important technology owners, General Electric and Westinghouse. These alliances have allowed the Company to be one of the players in the very competitive European fuel market, and have also been, important to position ENUSA in an industry in process of consolidation. In parallel to these activities, ENUSA has been present in different international R and D projects, being member of the NFIR of EPRI and Halden projects, and promoting other international R and D programs with companies from USA, Japan, etc. This R and D efforts, together with those Alliance, will allow ENUSA to have an advanced product in this new deregulated market, creating value to the service of our customers. (Author)

  20. Institutional violence and quality of service in obstetrics are associated with postpartum depression.

    Science.gov (United States)

    Souza, Karina Junqueira de; Rattner, Daphne; Gubert, Muriel Bauermann

    2017-07-20

    To investigate the association between institutional violence in obstetrics and postpartum depression (PP depression) and the potential effect of race, age, and educational level in this outcome. This is a cross-sectional study about the health care conditions for the maternal and child population of the Federal District, Brazil, carried out in 2011. The study has used a probabilistic sample of 432 women, whose children were aged up to three months, stratified by clusters. Indicators of institutional violence and demographic characteristics have been used in a logistic regression model to estimate the probability of occurrence of postpartum depression. The model has identified a high prevalence of postpartum depression, being it higher among non-white women and adolescent females, besides having a strong positive association between the several indicators of obstetric violence and postpartum depression. Positive interactions on a multiplicative scale have also been observed between: violence by negligence by health care professionals and race and age; physical violence from health care professionals and age; and, verbal violence from health care professionals and race. The indicators adopted to reflect institutional violence in obstetric care are positively associated with postpartum depression, which calls for a reflection on the need to make the health care protocols adequate to the precepts of the Brazilian humanization of childbirth care policies and changes in the obstetric care model.

  1. Institutional violence and quality of service in obstetrics are associated with postpartum depression

    Directory of Open Access Journals (Sweden)

    Karina Junqueira de Souza

    Full Text Available ABSTRACT OBJECTIVE To investigate the association between institutional violence in obstetrics and postpartum depression (PP depression and the potential effect of race, age, and educational level in this outcome. METHODS This is a cross-sectional study about the health care conditions for the maternal and child population of the Federal District, Brazil, carried out in 2011. The study has used a probabilistic sample of 432 women, whose children were aged up to three months, stratified by clusters. Indicators of institutional violence and demographic characteristics have been used in a logistic regression model to estimate the probability of occurrence of postpartum depression. RESULTS The model has identified a high prevalence of postpartum depression, being it higher among non-white women and adolescent females, besides having a strong positive association between the several indicators of obstetric violence and postpartum depression. Positive interactions on a multiplicative scale have also been observed between: violence by negligence by health care professionals and race and age; physical violence from health care professionals and age; and, verbal violence from health care professionals and race. CONCLUSIONS The indicators adopted to reflect institutional violence in obstetric care are positively associated with postpartum depression, which calls for a reflection on the need to make the health care protocols adequate to the precepts of the Brazilian humanization of childbirth care policies and changes in the obstetric care model.

  2. Association of socio-economic status with diabetes prevalence and utilization of diabetes care services

    Directory of Open Access Journals (Sweden)

    Svenson Lawrence W

    2006-10-01

    Full Text Available Abstract Background Low income appears to be associated with a higher prevalence of diabetes and diabetes related complications, however, little is known about how income influences access to diabetes care. The objective of the present study was to determine whether income is associated with referral to a diabetes centre within a universal health care system. Methods Data on referral for diabetes care, diabetes prevalence and median household income were obtained from a regional Diabetes Education Centre (DEC database, the Canadian National Diabetes Surveillance System (NDSS and the 2001 Canadian Census respectively. Diabetes rate per capita, referral rate per capita and proportion with diabetes referred was determined for census dissemination areas. We used Chi square analyses to determine if diabetes prevalence or population rates of referral differed across income quintiles, and Poisson regression to model diabetes rate and referral rate in relation to income while controlling for education and age. Results There was a significant gradient in both diabetes prevalence (χ2 = 743.72, p 2 = 168.435, p Conclusion Low income is associated with a higher prevalence of diabetes and a higher population rate of referral to this regional DEC. After accounting for diabetes prevalence, however, the equal proportions referred to the DEC across income groups suggest that there is no access bias based on income.

  3. The association between psychological well-being and problematic use of Internet communicative services among young people.

    Science.gov (United States)

    Casale, Silvia; Lecchi, Stefano; Fioravanti, Giulia

    2015-01-01

    Previous studies on problematic Internet use have focused almost exclusively on the fact that presence of negative functioning, such as social anxiety, depressive symptoms, or loneliness, represents a risk factor for unhealthy use of the web. For this reason the aim of the present study was to investigate the association between psychological well-being dimensions and problematic use of Internet communicative services. In the current study 495 undergraduate students were recruited. The Italian adaptations of the Psychological Well-being Scales and the Generalized Problematic Internet Use Scale 2 (GPIUS2) were used to assess psychological well-being dimensions and generalized problematic Internet use, respectively. Psychological well-being dimensions explained a significant portion of variance for the GPIUS2 total score levels, after controlling for sex, age, and occupational status. The levels of Autonomy, Environmental Mastery, and Positive Relations with Others acted as significant negative predictors of the tendency to use the web for regulating negative feelings, compulsive use of the web, and the negative outcomes that can arise as a result. The overall findings of the present study provide preliminary evidence that low psychological well-being is associated with problematic use of Internet communicative services.

  4. The association of state per capita income and military service deaths in the Vietnam and Iraq wars

    Directory of Open Access Journals (Sweden)

    Maynard Charles

    2009-01-01

    Full Text Available Abstract Background In the United States, social burdens including war casualties are often distributed unequally across groups of individuals, communities, and states. The purpose of this report was to examine the association between war deaths and per capita income in the 50 states and District of Columbia during the Vietnam and Iraq wars. Methods The numbers of deaths by the home state of record for each conflict were obtained from Department of Defense records on the Internet as were key variables including age at death, gender, race, branch of service, rank, circumstances of death, home state of record and the ratio of wounded to dead. In addition, we obtained state per capita income and state population for the relevant times. Results Characteristics of decedents in the 2 conflicts were very similar with young, white enlisted men accounting for the majority of deaths. However, in the Iraq war, women accounted for a 2.4% of casualties. Also of note was the higher ratio of wounded to dead in Iraq. At the level of the state, the correlation between the ratio of deaths per 100,000 and per capita income was -0.51 (p Conclusion For military service members serving in the Vietnam and Iraq conflicts, there were many more women who died in the latter war. Whether war deaths resulted in lower per capita income cannot be determined from these cross sectional data; we simply note a strong association between per capita income and war casualty rates for both wars.

  5. Pregnancy attitudes, contraceptive service utilization, and other factors associated with Los Angeles homeless youths' use of effective contraception and withdrawal.

    Science.gov (United States)

    Winetrobe, H; Rhoades, H; Barman-Adhikari, A; Cederbaum, J; Rice, E; Milburn, N

    2013-12-01

    This study aims to understand the associations of contraceptive service utilization (ie, accessing condoms or birth control), pregnancy attitudes, and lifetime pregnancy history among male and female homeless youth in relation to use of effective contraception and withdrawal. Between October 2011 and February 2012, homeless youth (14-27 years old) from 2 drop-in centers in Los Angeles (N = 380) were recruited and completed a questionnaire. The data in this paper are restricted to those who reported vaginal sex at last sex (N = 283). Analyses examined history of foster care, sexual abuse, exchange sex, pregnancy, lifetime homelessness duration, current living situation, contraceptive service utilization, and pregnancy attitudes in predicting use of effective contraception and withdrawal at last sex. Over 62% of females and 43% of males report having ever been pregnant or impregnating someone. There are no gender-based differences in pregnancy attitudes; 21% agree they would like to become pregnant within the year. Additionally, there are no gender-based differences in reported contraceptive use at last vaginal sex. In the multivariable model, high school education, contraceptive service utilization (Relative Risk Ratio [RRR]: 4.0), and anti-pregnancy attitudes (RRR: 1.3) are significant positive predictors of using effective contraception; anti-pregnancy attitudes (RRR: 1.2) and gender (RRR: 0.3) are significantly associated with using withdrawal. Health professionals should acknowledge that some homeless youth desire pregnancy; for those that do not, access to effective contraception is important. Programs must continue to promote pregnancy prevention, and include discussions of healthy pregnancy habits for pregnancy-desiring youth. Copyright © 2013 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

  6. A blueprint for community benefit. A CHA-AAHA (Catholic Health Association-American Association of Homes for the Aging) document helps long-term care providers plan for and implement needed services.

    Science.gov (United States)

    Forschner, B; Trocchio, J

    1993-05-01

    A collaborative effort of the Catholic Health Association (CHA) and the American Association of Homes for the Aging, The Social Accountability Program: Continuing the Community Benefit Tradition of Not-for-Profit Homes and Services for the Aging helps long-term care organizations plan and report community benefit activities. The program takes long-term care providers through five sequential tasks: reaffirming commitment to the elderly and others in the community; developing a community service plan; developing and providing community services; reporting community services; and evaluating the community service role. To help organizations reaffirm commitment, the Social Accountability Program presents a process facilities can use to review their historical roots and purposes and evaluate whether current policies and procedures are consistent with the organizational philosophy. Once this step is completed, providers can develop a community service plan by identifying target populations and the services they need. For facilities developing and implementing such services, the program suggests ways of measuring and monitoring them for budgetary purposes. Once they have implemented services, not-for-profit healthcare organizations must account for their impact on the community. The Social Accountability Program lists elements to be included in community service reports. It also provides guidelines for evaluating these services' effectiveness and the organization's overall community benefit role.

  7. Matrix Metalloproteinase-2 Activity is Associated with Divergent Regulation of Calponin-1 in Conductance and Resistance Arteries in Hypertension-induced Early Vascular Dysfunction and Remodelling.

    Science.gov (United States)

    Parente, Juliana M; Pereira, Camila A; Oliveira-Paula, Gustavo H; Tanus-Santos, José E; Tostes, Rita C; Castro, Michele M

    2017-10-01

    Matrix metalloproteinase (MMP)-2 participates in hypertension-induced maladaptive vascular remodelling by degrading extra- and intracellular proteins. The consequent extracellular matrix rearrangement and phenotype switch of vascular smooth muscle cells (VSMCs) lead to increased cellular migration and proliferation. As calponin-1 degradation by MMP-2 may lead to VSMC proliferation during hypertension, the hypothesis of this study is that increased MMP-2 activity contributes to early hypertension-induced maladaptive remodelling in conductance and resistance arteries via regulation of calponin-1. The main objective was to analyse whether MMP-2 exerts similar effects on the structure and function of the resistance and conductance arteries during early hypertension. Two-kidney, one-clip (2K-1C) hypertensive male rats and corresponding controls were treated with doxycycline (30 mg/kg/day) or water until reaching one week of hypertension. Systolic blood pressure was increased in 2K-1C rats, and doxycycline did not reduce it. Aortas and mesenteric arteries were analysed. MMP-2 activity and expression were increased in both arteries, and doxycycline reduced it. Significant hypertrophic remodelling and VSMC proliferation were observed in aortas but not in mesenteric arteries of 2K-1C rats. The contractility of mesenteric arteries to phenylephrine was increased in 2K-1C rats, and doxycycline prevented this alteration. The potency of phenylephrine to contract aortas of 2K-1C rats was increased, and doxycycline decreased it. Whereas calponin-1 expression was increased in 2K-1C mesenteric arteries, calponin-1 was reduced in aortas. Doxycycline treatment reverted changes in calponin-1 expression. MMP-2 contributes to hypertrophic remodelling in aortas by decreasing calponin-1 levels, which may result in VSMC proliferation. On the other hand, MMP-2-dependent increased calponin-1 in mesenteric arteries may contribute to vascular hypercontractility in 2K-1C rats. Divergent

  8. Decision in the matter of a generic hearing in respect to market issues and conduct related to the sale of gas and customer services in the natural gas industry in New Brunswick

    International Nuclear Information System (INIS)

    2003-01-01

    In response to changes in the Gas Distribution Act and the Gas Distributor Marketing Regulation, the New Brunswick Board of Commissioners of Public Utilities (Board), issued an order in June 2003 for a generic hearing regarding the sale of gas and customer services in the natural gas industry in New Brunswick. The purpose of the hearing was to have an open discussion among intervenors regarding several issues, such as whether the Code of Conduct provides fair and adequate rules for marketers; should Enbridge Gas New Brunswick (EGNB) be required to follow rules similar to the Code of Conduct; the requirements surrounding letters of credit; the Board's decision on Rules and Regulations regarding the billing conduct of gas distributors and marketers; the information that should be provided by a gas marketer or a distributor to the customer before the customer enters into an agreement for the supply of gas; the need for information on price volatility; the need for EGNB to notify potential customers of all possible suppliers of gas; the removal of automatic renewal clauses from gas retailers' contracts; how the Board should determine if prices are reasonably and sufficiently competitive; financial reporting requirements; the role of the Board in response to customer complaints regarding the sale of gas by a distributor; and, the Board's action regarding Enbridge Atlantic's plan to exit the New Brunswick market. This report provided the response to these issues by 10 intervenors

  9. Demand for long acting contraceptive methods and associated factors among family planning service users, Northwest Ethiopia: a health facility based cross sectional study.

    Science.gov (United States)

    Yalew, Saleamlak Adbaru; Zeleke, Berihun Megabiaw; Teferra, Alemayehu Shimeka

    2015-02-04

    Demand for long acting contraceptive methods is one of the key factors for total fertility rate and reproductive health issues. Increased demand for these methods can decline fertility rate through spacing and limiting family size in turn improving maternal and family health and socioeconomic development of a country. The aim of this study was to assess demand for long acting contraceptives and associated factors among family planning users in Debre-Tabor Town, Northwest Ethiopia. Facility based cross-sectional study was conducted from July to August 2013. Data was collected on 487 current family planning users through face to face interview using structured questionnaire. Study participants were selected by systematic sampling method. Data were entered in to Epi Info and analyzed by using SPSS version 20. Bi-variable and multi-variable regression analyses were done to identify factors associated with demand for long acting contraceptive methods. Odds ratio with 95% CI was used to assess the association between the independent variables and demand for long acting family planning methods. The study showed that, demand for long acting contraceptives was 17%. Only 9.2% of the women were using long acting contraceptive methods (met need). About 7.8% of women were using short acting methods while they actually want to use long acting methods (unmet need). Demand for LACMs was positively associated 3 with being a daily labour (AOR = 3.87, 95% CI = [1.06, 14.20]), being a student (AOR = 2.64, 95% CI = [1.27, 5.47]), no future birth intensions (AOR = 2.17, 95% CI = [1.12, 4.23]), having five or more children (AOR = 1.67, 95% CI = [1.58, 4.83]), deciding together with husbands for using the methods (AOR = 2.73, 95% CI = [1.40, 5.32]) and often having discussion with husband (AOR = 3.89, 95% CI = [1.98, 7.65]). Clients treated poorly by the health care providers during taking the services was negatively associated with demand for LACMs (AOR = 0.42, 95% CI = [0.24, 0

  10. Exiting the Emergency Medical Services Profession and Characteristics Associated with Intent to Return to Practice.

    Science.gov (United States)

    Cash, Rebecca E; Crowe, Remle P; Agarwal, Riddhima; Rodriguez, Severo A; Panchal, Ashish R

    2018-01-01

    Inadequate staffing of agencies, increasing attrition rates, and frequent turnover of personnel make employee retention an ongoing concern for Emergency Medical Services (EMS). Faced with increasing demand for EMS, understanding the causes underlying turnover is critical. The objectives of this study were to describe the proportion of individuals that left EMS, likelihood of returning to the profession, and key factors contributing to the decision to leave EMS. This was a cross-sectional study of nationally-certified EMS professionals who left EMS. Respondents to a census survey who reported not practicing EMS were directed to a subsection of items regarding their choice to leave EMS. Demographic and employment characteristics, likelihood of returning to EMS, and factors influencing the decision to leave EMS were assessed. Descriptive and comparative statistics (Chi-square and nonparametric test of trend [p-trend]) and univariable odds ratios were calculated. The overall response rate for the full survey was 10% (n = 32,114). A total of 1247 (4%) respondents reported leaving the profession and completed the exit survey. The majority (72%) reported that they will likely return to EMS. A stepwise decrease in the reported likelihood of returning was seen with increasing years of EMS experience (e.g., 2 or less years of experience: 83%; 16 or more years: 52%; p-trend benefits (65%), decision to pursue further education (60%), dissatisfaction with organization's management (54.7%), and desire for career change (54.1%). This cross-sectional study found an attrition rate of approximately 4% among nationally certified EMS professionals; however, the majority reported that they intended to return to the EMS profession. Intention to return to EMS decreased as years of experience and months away from the profession increased. Important factors in the decision to leave EMS included a desire for better pay and benefits and the decision to pursue further education. Targeting the

  11. Investigation of ULF magnetic pulsations, air conductivity changes, and infra red signatures associated with the 30 October Alum Rock M5.4 earthquake

    Directory of Open Access Journals (Sweden)

    T. Bleier

    2009-04-01

    ionization reported to be associated with radon emission from the ground (Ouzounov, 2007, and a series of laboratory rock stressing experiments (Freund, 2006, 2007a, b, c to determine if field data was consistent either of these accounts. We could not find a data set with pre-earthquake radon measurements taken near the Alum Rock epicenter to compare against our field data. However, based on the Alum Rock data set example and another data set at Parkfield, the field tests are at least consistent with the lab experiments showing currents, magnetic field disturbances, air conductivity changes, and IR signatures. This is encouraging, but more instrumented earthquake examples are needed to prove a repeating pattern for these types of pre-earthquake EM signatures.

  12. Is violence associated with increased risk behavior among MSM? Evidence from a population-based survey conducted across nine cities in Central America.

    Science.gov (United States)

    Wheeler, Jennifer; Anfinson, Katherine; Valvert, Dennis; Lungo, Susana

    2014-01-01

    There is a dearth of research examining the linkages between violence and HIV risk behavior among men who have sex with men (MSM), including those who identify as transgender women (TW), particularly in Central America where violence is widespread. In this paper, we use population-based survey results to independently examine the correlations between physical, emotional and sexual violence and HIV risk behavior among MSM populations in five countries in Central America. As part of USAID's Combination Prevention for HIV program in Central America, PASMO conducted population based surveys using respondent-driven sampling (RDS) in nine cities in Guatemala, El Salvador, Nicaragua, Costa Rica, and Panama. Initial seeds were recruited using the following criteria: individuals who represented subgroups of MSM by self-identification (homosexual vs. heterosexual or bisexual vs. transgender), social economic strata, and by sex work practices. This study examines the association between violence and 1) HIV risk behaviors relevant to the study populations; 2) protective behaviors; and 3) reported STIs. Individualized RDS estimator weights for each outcome variable were calculated using RDSAT software, and logistic regression analysis was used to determine associations between different forms of violence and the outcome variables. MSM who experienced physical violence were more likely to be engaged in transactional sex (OR: 1.76 [1.42-2.18]), have multiple partners in the past 30 days (OR: 1.37 [1.09-1.71]), and have engaged in sex under the influence of alcohol or drugs (OR: 1.51 [1.24-1.83]). Both physical violence and psychological/verbal violence were also associated with reporting STI symptoms or diagnosis within the past 12 months (OR: 1.72 [1.34-2.21] and 1.80 [1.45-2.23]). The effects of violence on the outcomes were observed after controlling for other risk factors. Transgender women were 3.9 times more likely to report engaging in transactional sex. Respondents who

  13. Is violence associated with increased risk behavior among MSM? Evidence from a population-based survey conducted across nine cities in Central America

    Directory of Open Access Journals (Sweden)

    Jennifer Wheeler

    2014-10-01

    Full Text Available Background/Objective: There is a dearth of research examining the linkages between violence and HIV risk behavior among men who have sex with men (MSM, including those who identify as transgender women (TW, particularly in Central America where violence is widespread. In this paper, we use population-based survey results to independently examine the correlations between physical, emotional and sexual violence and HIV risk behavior among MSM populations in five countries in Central America. Design: As part of USAID's Combination Prevention for HIV program in Central America, PASMO conducted population based surveys using respondent-driven sampling (RDS in nine cities in Guatemala, El Salvador, Nicaragua, Costa Rica, and Panama. Initial seeds were recruited using the following criteria: individuals who represented subgroups of MSM by self-identification (homosexual vs. heterosexual or bisexual vs. transgender, social economic strata, and by sex work practices. This study examines the association between violence and 1 HIV risk behaviors relevant to the study populations; 2 protective behaviors; and 3 reported STIs. Individualized RDS estimator weights for each outcome variable were calculated using RDSAT software, and logistic regression analysis was used to determine associations between different forms of violence and the outcome variables. Results: MSM who experienced physical violence were more likely to be engaged in transactional sex (OR: 1.76 [1.42–2.18], have multiple partners in the past 30 days (OR: 1.37 [1.09–1.71], and have engaged in sex under the influence of alcohol or drugs (OR: 1.51 [1.24–1.83]. Both physical violence and psychological/verbal violence were also associated with reporting STI symptoms or diagnosis within the past 12 months (OR: 1.72 [1.34–2.21] and 1.80 [1.45–2.23]. The effects of violence on the outcomes were observed after controlling for other risk factors. Transgender women were 3.9 times more likely

  14. Integrated services

    International Nuclear Information System (INIS)

    Chafcouloff, S.; Michel, G.; Trice, M.; Clark, G.; Cosad, C.; Forbes, K.

    1995-01-01

    Integrated services is the name given to several services grouped together under a single contract. Four key factors determine the success of integrated services projects: teamwork, common objectives, technology, and shared benefits. For oil companies, integration means smoother, more efficient operations by bringing service companies on board as part of the team. For the service industry, it means a radical change in the way business is conducted, taking on more responsibility in return for greater incentives. This article reviews the need for change and the approach Schlumberger has adopted to meet this challenge. 20 figs., 20 refs

  15. Integrated services

    Energy Technology Data Exchange (ETDEWEB)

    Chafcouloff, S.; Michel, G.; Trice, M. [Schlumberger Integrated Project Management Group, Montrouge (France); Clark, G. [Schlumberger Testing Services, Aberdeen (United Kingdom); Cosad, C.; Forbes, K. [Schlumberger Integrated Project Management Group, Aberdeen (United Kingdom)

    1995-12-31

    Integrated services is the name given to several services grouped together under a single contract. Four key factors determine the success of integrated services projects: teamwork, common objectives, technology, and shared benefits. For oil companies, integration means smoother, more efficient operations by bringing service companies on board as part of the team. For the service industry, it means a radical change in the way business is conducted, taking on more responsibility in return for greater incentives. This article reviews the need for change and the approach Schlumberger has adopted to meet this challenge. 20 figs., 20 refs

  16. [Profiles of high-frequency users of primary care services and associations with depressive anxiety disorders in Cali, Colombia].

    Science.gov (United States)

    Rodriguez-Lopez, Mérida; Arrivillaga, Marcela; Holguín, Jorge; León, Hoover; Ávila, Alfonso; Hernández, Carlos; Rincón-Hoyos, Hernán G

    2016-01-01

    To determine the profiles of highly frequent users of primary care services and the associations of these profiles with depressive anxiety disorders in Cali, Colombia. A case-control study, high-frequency cases were defined as those involving patients with a percentile >75 with regard to the frequency of spontaneous use of outpatient facilities in the last 12 months; controls were defined as those with a percentile depression and anxiety on frequent attendance was determined via logistic regression. Among the 780 participating patients, differences in the profiles among frequent users and controls were related to predisposing factors such as sex, age, and education, capacity factors such as the time required to visit the institution and the means of transport used, and need factors such as health perceptions, social support, family function, and the presence of anxiety or depressive disorders. A depression or anxiety disorder was found to associate positively with frequent attendance (adjusted odds ratio [aOR]: 1.99, 95% confidence interval [CI]: 1.19-3.31) and a referral system (aOR: 1.61, 95% CI: 1.01-2.76), but negatively with mild or no family dysfunction (aOR: 0.79; 95% CI: 0.48-0.88) after adjusting for age, sex, ethnicity, and health service-providing institutions. The profiles of high-frequency patients differ from control patients with respect to factors related to capacity, need, and willingness; in particular, the latter were independently associated with frequent attendance. Notably, the presence of an anxious or depressive disorder doubled the risk of highfrequency attendance at a primary care facility.

  17. Validity of Medical Student Questionnaire Data in Prediction of Rural Practice Choice and Its Association With Service Orientation.

    Science.gov (United States)

    Shannon, C Ken; Jackson, Jodie

    2015-01-01

    The validity of medical student projection of, and predictors for, rural practice and the association of a measure of service orientation, projected practice accessibility to the indigent, were investigated. West Virginia (WV) medical student online pre- and postrural rotation questionnaire data were collected during the time period 2001-2009. Of the 1,517 respondent students, submissions by 1,271 met the time interval criterion for inclusion in analyses. Subsequent WV licensing data were available for 461 in 2013. These 2 databases were used to assess for validity of projection of rural practice, for predictors of rural practice, and for student projected accessibility of the future practice to indigent patients. There were statistically significant associations between both pre- and postrotation projections of rural practice and subsequent rural practice. The most significant independent predictors of rural practice were student rural background, reported primary care intent, prediction of rural practice and projection of greater accessibility of the future practice to indigent patients. For scoring of practice access, there were trends for higher scoring by rural students and rural practitioners, with greater pre-post increases for those with urban hometowns. This study demonstrates the utility of medical student questionnaires for projections of numbers of future rural physicians. It suggests that students with a rural background, rural practice intent, or greater service orientation are more likely to enter rural practice. It also suggests that students, particularly those with urban hometowns, are influenced by rural rotation experiences in forecasting greater practice accessibility and in entering rural practice. © 2015 National Rural Health Association.

  18. Modular Approach to Therapy for Anxiety, Depression, Trauma, or Conduct Problems in outpatient child and adolescent mental health services in New Zealand: study protocol for a randomized controlled trial.

    Science.gov (United States)

    Lucassen, Mathijs F G; Stasiak, Karolina; Crengle, Sue; Weisz, John R; Frampton, Christopher M A; Bearman, Sarah Kate; Ugueto, Ana M; Herren, Jennifer; Cribb-Su'a, Ainsleigh; Faleafa, Monique; Kingi-'Ulu'ave, Denise; Loy, Jik; Scott, Rebecca M; Hartdegen, Morgyn; Merry, Sally N

    2015-10-12

    Mental health disorders are common and disabling for young people because of the potential to disrupt key developmental tasks. Implementation of evidence-based psychosocial therapies in New Zealand is limited, owing to the inaccessibility, length, and cost of training in these therapies. Furthermore, most therapies address one problem area at a time, although comorbidity and changing clinical needs commonly occur in practice. A more flexible approach is needed. The Modular Approach to Therapy for Children with Anxiety, Depression, Trauma, or Conduct Problems (MATCH-ADTC) is designed to overcome these challenges; it provides a range of treatment modules addressing different problems, within a single training program. A clinical trial of MATCH-ADTC in the USA showed that MATCH-ADTC outperformed usual care and standard evidence-based treatment on several clinical measures. We aim to replicate these findings and evaluate the impact of providing training and supervision in MATCH-ADTC to: (1) improve clinical outcomes for youth attending mental health services; (2) increase the amount of evidence-based therapy content; (3) increase the efficiency of service delivery. This is an assessor-blinded multi-site effectiveness randomized controlled trial. Randomization occurs at two levels: (1) clinicians (≥60) are randomized to intervention or usual care; (2) youth participants (7-14 years old) accepted for treatment in child and adolescent mental health services (with a primary disorder that includes anxiety, depression, trauma-related symptoms, or disruptive behavior) are randomly allocated to receive MATCH-ADTC or usual care. Youth participants are recruited from 'mainstream', Māori-specific, and Pacific-specific child and adolescent mental health services. We originally planned to recruit 400 youth participants, but this has been revised to 200 participants. Centralized computer randomization ensures allocation concealment. The primary outcome measures are: (i) the

  19. Associations between the organisation of stroke services, process of care, and mortality in England: prospective cohort study.

    Science.gov (United States)

    Bray, Benjamin D; Ayis, Salma; Campbell, James; Hoffman, Alex; Roughton, Michael; Tyrrell, Pippa J; Wolfe, Charles D A; Rudd, Anthony G

    2013-05-10

    To estimate the relations between the organisation of stroke services, process measures of care quality, and 30 day mortality in patients admitted with acute ischaemic stroke. Prospective cohort study. Hospitals (n=106) admitting patients with acute stroke in England and participating in the Stroke Improvement National Audit Programme and 2010 Sentinel Stroke Audit. 36,197 adults admitted with acute ischaemic stroke to a participating hospital from 1 April 2010 to 30 November 2011. Associations between process of care (the assessments, interventions, and treatments that patients receive) and 30 day all cause mortality, adjusting for patient level characteristics. Process of care was measured using six individual measures of stroke care and summarised into an overall quality score. Of 36,197 patients admitted with acute ischaemic stroke, 25,904 (71.6%) were eligible to receive all six care processes. Patients admitted to stroke services with high organisational scores were more likely to receive most (5 or 6) of the six care processes. Three of the individual processes were associated with reduced mortality, including two care bundles: review by a stroke consultant within 24 hours of admission (adjusted odds ratio 0.86, 95%confidence interval 0.78 to 0.96), nutrition screening and formal swallow assessment within 72 hours (0.83, 0.72 to 0.96), and antiplatelet therapy and adequate fluid and nutrition for first the 72 hours (0.55, 0.49 to 0.61). Receipt of five or six care processes was associated with lower mortality compared with receipt of 0-4 in both multilevel (0.74, 0.66 to 0.83) and instrumental variable analyses (0.62, 0.46 to 0.83). Patients admitted to stroke services with higher levels of organisation are more likely to receive high quality care as measured by audited process measures of acute stroke care. Those patients receiving high quality care have a reduced risk of death in the 30 days after stroke, adjusting for patient characteristics and

  20. [Nutritional factors associated with dyslipidemia in users of service in primary health care].

    Science.gov (United States)

    Ferreira, Nathália Luíza; Rodrigues, Maria Tereza; Abreu, Mery Natali; Lopes, Aline Cristine

    2011-12-01

    Dyslipidemias are relevant to public health because are one of the major risk factors for Non-Communicable Diseases and Disorders, especially cardiovascular diseases. Identify factors associated with dyslipidemias on users of Primary Health Care Center. Users were assessed through the nutritional anamnesis (demographic data, consumption of foods and nutrients and morbidity) and anthropometry. Was performed descriptive analysis, t-Student, Chi-Square and Mann Whitney tests (ppercentage of adequacy monounsaturated fatty acids (MUFA) (p=0.007). In contrast, had higher proportion of adequacy of lipid (p=0.017), lower mean weight (p=0.044) and lower inadequate intake of fatty meat (p=0.005). Multivariate analysis showed that insufficient consumption of MUFA (p=0.005) and inadequate intake of lard (p=0.021) were the main variables which influenced the presence of dyslipidemia. The results show that important dietary changes for the prevention and control of dyslipidemia have not been implemented, demonstrating the importance of nutritional interventions aimed at to clarify new dietary strategies, such as reduce consumption of sugar and to maintain an adequate consumption of lipid fractions.

  1. Longitudinal associations between case management and supportive services use among black and Latina HIV-positive women in New York City.

    Science.gov (United States)

    Halkitis, Perry N; Kupprat, Sandra A; Mukherjee, Preetika Pandey

    2010-01-01

    The literature analyzing the relationship between case management and supportive service use longitudinally among African American and Latina HIV-positive women is limited. This retrospective analysis of participant case management, supportive service, and medical charts sought to examine both descriptive and relational data on use of case management and supportive services over a 2-year period from 2002 to 2005 and to analyze moderating person- level or institution-level factors. The analyzed case management, supportive service, and medical charts revealed that participants interacted with their case manager four times and received 3.6 supportive services per month. Transportation, primary healthcare/medical specialists, and support groups were the services most used, with rates ranging from 70% to 80%. Using hierarchical linear modeling (HLM), the unconditional growth models showed that case management and supportive service use patterns remained constant over the 24-month period. Additionally, the multivariate unconditional model suggests a significant positive relationship between case management and supportive services. No moderation was indicated in the association between case management and supportive service use by person-level (e.g., mental illness, substance use) and institution-level (i.e., service delivery model) factors. Participants use supportive and case management services in a similar manner based on individual need. This synergistic relationship suggests that increases in either may result in retaining women in care. Implications for service delivery point to the need for skills building training for case managers, outreach workers, or system navigators to assist with short-term goals of establishing rapport and maintaining the client relationship, as this may lead to HIV-positive women accessing services. Additionally, outreach and engagement strategies need to be developed for those who typically underuse these services.

  2. [Prevalence and factors associated with intimate partner abuse in female users of public health services in Mexico: a comparative analyses].

    Science.gov (United States)

    Ávila-Burgos, Leticia; Valdez-Santiagob, Rosario; Barroso-Quiab, Abigail; Híjar, Martha; Rojas, Rosalba; Del Río-Zolezzi, Aurora

    2014-01-01

    To analyze the evolution of the prevalence in intimate partner violence during the years 2003 and 2006 in Mexico, identifying factors associated with its severity, comparing our results with findings from 2003. Data from the Encuesta Nacional de Violencia contra las Mujeres (ENVIM 2006) was used; it has urban-rural national representation of female users of Mexican public health services. A total of 22,318 women above 14 years of age were interviewed. A multinomial logistic regression model was adjusted. The dependent variable was the Index of Intimate Partner Abuse. Intimate partner abuse increased 17% in comparison to the year 2003. Women's personal history of childhood abuse (ORA= 5.12, 95% CI4.15-6.30) and rape (ORA = 3.5, 95% CI = 2.66-4.62) were the most important women's factors that were found associated with severe violence. Male partner's daily alcohol consumption increased eleven fold the possibility of severe violence; higher disagreement with traditional female gender roles and higher education of both partners were protective factors. Factors associated with violence and their severities were consistent with findings reported in 2003. Intimate partner violence is a highly prevalent social problem which requires comprehensive strategies supporting empowerment of women through higher education, early detection and care of those battered, as well as structured interventions to prevent violence in future generations.

  3. Quality of Interhospital Transfer Communication Practices and Association With Adverse Events on an Internal Medicine Hospitalist Service.

    Science.gov (United States)

    Borofsky, Jennifer S; Bartsch, Jason C; Howard, Alan B; Repp, Allen B

    Communication practices around interhospital transfer have not been rigorously assessed in adult medicine patients. Furthermore, the clinical implications of such practices have not been reported. This case-control study was designed to assess the quality of communication between clinicians during interhospital transfer and to determine if posttransfer adverse events (PTAEs) are associated with suboptimal communication. Cases included patients transferred to a Medicine Hospitalist Service from an outside hospital who subsequently experienced a PTAE, defined as unplanned transfer to an intensive care unit or death within 24 hours of transfer. Control patients also underwent interhospital transfer but did not experience a PTAE. A blinded investigator retrospectively reviewed the recorded pretransfer phone conversations between sending and receiving clinicians for adherence to a set of 13 empiric best practice communication elements. The primary outcome was the mean communication score, on a scale of 0-13. Mean scores between PTAE (8.3; 95% confidence interval [CI], 7.6-8.9) and control groups (7.9; 95% CI, 7.1-8.8) did not differ significantly (p = .50), although suboptimal communication on a subset of these elements was associated with increased PTAEs. Communication around interhospital transfer appears suboptimal compared with an empiric set of standard communication elements. Posttransfer adverse events were not associated with aggregate adherence to these standards.

  4. [Certification of an ambulatory gastroenterologic service fulfilling ISO Law 9001--criteria and national guidelines of the Gastroenterologic Association].

    Science.gov (United States)

    Birkner, B

    2000-09-01

    The objectives of certification and accreditation are the deployment and examination of quality improvement measures in health care services. The quality management system of the ISO 9001 is created to install measures and tools leading to assured and improved quality in health care. Only some experiences with certification fulfilling ISO 9001 criteria exist in the German health care system. Evidence-based clinical guidelines can serve as references for the development of standards in quality measurement. Only little data exists on the implementation strategy of guidelines and evaluation, respectively. A pilot quality management system in consistence with ISO 9001 criteria was developed for ambulatory, gastroenterological services. National guidelines of the German Society of Gastroenterology and Metabolism and the recommendations of the German Association of Physicians for quality assurance of gastrointestinal endoscopy were included in the documentation and internal auditing. This pilot quality management system is suitable for the first steps in the introduction of quality management in ambulatory health care. This system shows validity for accreditation and certification of gastrointestinal health care units as well.

  5. Analysis of changes in the association of income and the utilization of curative health services in Mexico between 2000 and 2006.

    Science.gov (United States)

    Danese-Dlsantos, Laura G; Sosa-Rubí, Sandra G; Valencia-Mendoza, Atanacio

    2011-10-07

    A common characteristic of health systems in most developing countries is unequal access to health services. As a result, members of the poorest population groups often do not receive formal attention for health services, because they cannot afford it. In 2001 in Mexico, to address income-related differences in the use of health services, the government launched a major healthcare reform, which includes a health insurance program called Seguro Popular, aimed at improving healthcare access among poor, uninsured residents. This paper analyzes the before and after changes in the demand for curative ambulatory health services focusing on the association of income-related characteristics and the utilization of formal healthcare providers vs. no healthcare service utilization. By using two nationally representative health surveys (ENSA-2000 and ENSANUT-2006), we modeled an individual's decision when experiencing an illness to use services provided by the (1) Ministry of Health (MoH), (2) social security, (3) private entities, or (4) to not use formal services (no healthcare service utilization). Poorer individuals were more likely in 2006 than in 2000 to respond to an illness by using formal healthcare providers. Trends in provider selection differed, however. The probability of using public services from the MoH increased among the poorest population, while the findings indicated an increase in utilization of private health services among members of low- and middle-income groups. No significant change was seen among formal workers -covered by social security services-, regardless of socioeconomic status. Overall, for 2006 the Mexican population appears less differentiated in using healthcare across economic groups than in 2000. This may be related, in part, to the implementation of Seguro Popular, which seems to be stimulating healthcare demand among the poorest and previously uninsured segment of the population. Still, public health authorities need to address the

  6. What Health Service Provider Factors Are Associated with Low Delivery of HIV Testing to Children with Acute Malnutrition in Dowa District of Malawi?

    Science.gov (United States)

    Chitete, Lusungu; Puoane, Thandi

    2015-01-01

    The Community-based Management of Acute Malnutrition is the national program for treating acute malnutrition in Malawi. Under this program's guidelines all children enrolled should undergo an HIV test, so that those infected can receive appropriate treatment and care. However, the national data of 2012 shows a low delivery of testing. Prior studies have investigated client-related factors affecting uptake of HIV testing in Community-based Management of Acute Malnutrition program. Lacking is the information on the service provider factors that are associated with the delivery of testing. This study investigated service provider factors that affect delivery of HIV testing among children enrolled in the program and explored ways in which this could be improved. A descriptive study that used qualitative methods of data collection. Client registers were reviewed to obtain the number of children enrolled in Community-based Management of Acute Malnutrition and the number of children who were tested for HIV over a 12-month period. In-depth interviews were conducted with Community-based Management of Acute Malnutrition and HIV Testing and Counselling focal persons to investigate factors affecting HIV test delivery. Descriptive statistics were used to analyze data from client registers. Information from interviews was analyzed using a thematic approach. Quantitative data revealed that 1738 (58%) of 2981 children enrolled in Community-based Management of Acute Malnutrition were tested for HIV. From in-depth interviews four themes emerged, that is, lack of resources for HIV tests; shortage of staff skilled in HIV testing and counseling; lack of commitment among staff in referring children for HIV testing; and inadequately trained staff. There is a need for a functioning health system to help reduce child mortality resulting from HIV related conditions.

  7. Health service use and costs associated with aggressiveness or agitation and containment in adult psychiatric care: a systematic review of the evidence.

    Science.gov (United States)

    Rubio-Valera, Maria; Luciano, Juan V; Ortiz, José Miguel; Salvador-Carulla, Luis; Gracia, Alfredo; Serrano-Blanco, Antoni

    2015-03-04

    Agitation and containment are frequent in psychiatric care but little is known about their costs. The aim was to evaluate the use of services and costs related to agitation and containment of adult patients admitted to a psychiatric hospital or emergency service. Systematic searches of four electronic databases covering the period January 1998-January 2014 were conducted. Manual searches were also performed. Paper selection and data extraction were performed in duplicate. Cost data were converted to euros in 2014. Ten studies met inclusion criteria and were included in the analysis (retrospective cohorts, prospective cohorts and cost-of-illness studies). Evaluated in these studies were length of stay, readmission rates and medication. Eight studies assessed the impact of agitation on the length of stay and six showed that it was associated with longer stays. Four studies examined the impact of agitation on readmission and a statistically significant increase in the probability of readmission of agitated patients was observed. Two studies evaluated medication. One study showed that the mean medication dose was higher in agitated patients and the other found higher costs of treatment compared with non-agitated patients in the unadjusted analysis. One study estimated the costs of conflict and containment incurred in acute inpatient psychiatric care in the UK. The estimation for the year 2014 of total annual cost per ward for all conflict was €182,616 and €267,069 for containment based on updated costs from 2005. Agitation has an effect on healthcare use and costs in terms of longer length of stay, more readmissions and higher drug use. Evidence is scarce and further research is needed to estimate the burden of agitation and containment from the perspective of hospitals and the healthcare system.

  8. Examining the association between suicidal behaviors and referral for mental health services among children involved in the child welfare system in Ontario, Canada.

    Science.gov (United States)

    Baiden, Philip; Fallon, Barbara

    2018-05-01

    Although various studies have investigated factors associated with mental health service utilization, few studies have examined factors associated with referral for mental health services among maltreated children. The objective of this study was to examine the association between suicidal thoughts and self-harming behavior and referral for mental health services among children involved in the Child Welfare System in Ontario, Canada. Data for this study were obtained from the Ontario Incidence Study of Reported Child Abuse and Neglect 2013. An estimate 57,798 child maltreatment investigations was analyzed using binary logistic regression with referral for mental health service as the outcome variable. Of the 57,798 cases, 4709 (8.1%), were referred for mental health services. More than seven out of ten maltreated children who engaged in self-harming behavior and two out of three maltreated children who expressed suicidal thoughts were not referred for mental health services. In the multivariate logistic regression model, children who expressed suicidal thoughts had 2.39 times higher odds of being referred for mental health services compared to children with no suicidal thoughts (AOR = 2.39, 99% C.I. 2.05-2.77) and children who engaged in self-harming behavior had 1.44 times higher odds of being referred for mental health services compared to children who did not engage in self-harming behavior (AOR = 1.44, 99% C.I. 1.24-1.67), both after controlling for child demographic characteristics, maltreatment characteristics, and child functioning concerns. Given that referral is the initial step towards mental health service utilization, it is important that child welfare workers receive the necessary training so as to carefully assess and refer children in care who expressed suicidal thoughts or engaged in self-harming behavior for appropriate mental health services. The paper discusses the results and their implications for child welfare policy and practice

  9. HIV Case Management Support Service Is Associated with Improved CD4 Counts of Patients Receiving Care at the Antiretroviral Clinic of Pantang Hospital, Ghana

    Directory of Open Access Journals (Sweden)

    Bismark Sarfo

    2017-01-01

    Full Text Available Background. Factors associated with individual patient-level management of HIV have received minimal attention in sub-Saharan Africa. This study determined the association between support services and cluster of differentiation 4 (CD4 counts among HIV patients attending ART clinic in Ghana. Methodology. This was a cross-sectional study involving adults with HIV recruited between 1 August 2014 and 31 January 2015. Data on support services were obtained through a closed-ended personal interview while the CD4 counts data were collected from their medical records. Data were entered into EpiData and analyzed using Stata software. Results. Of the 201 patients who participated in the study, 67% (129/191 received case management support service. Counseling about how to prevent the spread of HIV (crude odds ratio (cOR (95% confidence interval (CI (2.79 (1.17–6.68, mental health services (0.2 (0.04–1.00, and case management support service (2.80 (1.34–5.82 was associated with improved CD4 counts of 350 cells/mm3 or more. After adjusting for counseling about how to prevent the spread of HIV and mental health services, case management support service was significantly associated with CD4 counts of 350 cells/mm3 or more (aOR = 2.36 (CI = 1.01–5.49. Conclusion. Case management support service for HIV patients receiving ART improves their CD4 counts above 350 cells/mm3. Incorporating HIV case management services in ART regimen should be a priority in sub-Saharan Africa.

  10. Factors associated with linkage to HIV care and TB treatment at community-based HIV testing services in Cape Town, South Africa.

    Science.gov (United States)

    Meehan, Sue-Ann; Sloot, Rosa; Draper, Heather R; Naidoo, Pren; Burger, Ronelle; Beyers, Nulda

    2018-01-01

    Diagnosing HIV and/or TB is not sufficient; linkage to care and treatment is conditional to reduce the burden of disease. This study aimed to determine factors associated with linkage to HIV care and TB treatment at community-based services in Cape Town, South Africa. This retrospective cohort study utilized routinely collected data from clients who utilized stand-alone (fixed site not attached to a health facility) and mobile HIV testing services in eight communities in the City of Cape Town Metropolitan district, between January 2008 and June 2012. Clients were included in the analysis if they were ≥12 years and had a known HIV status. Generalized estimating equations (GEE) logistic regression models were used to assess the association between determinants (sex, age, HIV testing service and co-infection status) and self-reported linkage to HIV care and/or TB treatment. Linkage to HIV care was 3 738/5 929 (63.1%). Linkage to HIV care was associated with the type of HIV testing service. Clients diagnosed with HIV at mobile services had a significantly reduced odds of linking to HIV care (aOR 0.7 (CI 95%: 0.6-0.8), p<0.001. Linkage to TB treatment was 210/275 (76.4%). Linkage to TB treatment was not associated with sex and service type, but was associated with age. Clients in older age groups were less likely to link to TB treatment compared to clients in the age group 12-24 years (all, p-value<0.05). A large proportion of clients diagnosed with HIV at mobile services did not link to care. Almost a quarter of clients diagnosed with TB did not link to treatment. Integrated community-based HIV and TB testing services are efficient in diagnosing HIV and TB, but strategies to improve linkage to care are required to control these epidemics.

  11. Factors associated with underutilization of antenatal care services in Indonesia: results of Indonesia Demographic and Health Survey 2002/2003 and 2007

    Directory of Open Access Journals (Sweden)

    Titaley Christiana R

    2010-08-01

    Full Text Available Abstract Background Antenatal care aims to prevent maternal and perinatal mortality and morbidity. In Indonesia, at least four antenatal visits are recommended during pregnancy. However, this service has been underutilized. This study aimed to examine factors associated with underutilization of antenatal care services in Indonesia. Methods We used data from Indonesia Demographic and Health Survey (IDHS 2002/2003 and 2007. Information of 26,591 singleton live-born infants of the mothers' most recent birth within five years preceding each survey was examined. Twenty-three potential risk factors were identified and categorized into four main groups, external environment, predisposing, enabling, and need factors. Logistic regression models were used to examine the association between all potential risk factors and underutilization of antenatal services. The Population Attributable Risk (PAR was calculated for selected significant factors associated with the outcome. Results Factors strongly associated with underutilization of antenatal care services were infants from rural areas and from outer Java-Bali region, infants from low household wealth index and with low maternal education level, and high birth rank infants with short birth interval of less than two years. Other associated factors identified included mothers reporting distance to health facilities as a major problem, mothers less exposed to mass media, and mothers reporting no obstetric complications during pregnancy. The PAR showed that 55% of the total risks for underutilization of antenatal care services were attributable to the combined low household wealth index and low maternal education level. Conclusions Strategies to increase the accessibility and availability of health care services are important particularly for communities in rural areas. Financial support that enables mothers from poor households to use health services will be beneficial. Health promotion programs targeting

  12. Measurement of thermal conductance

    International Nuclear Information System (INIS)

    Kuchnir, M.

    1977-01-01

    The 6-m long, 45-kG, warm-iron superconducting magnets envisioned for the Energy Doubler stage of the Fermilab accelerator require stiff supports with minimized thermal conductances in order to keep the refrigeration power reasonable. The large number of supports involved in the system required a careful study of their heat conduction from the room temperature wall to the intercepting refrigeration at 20 0 K and to the liquid helium. For this purpose the thermal conductance of this support was measured by comparing it with the thermal conductance of a copper strap of known geometry. An association of steady-state thermal analysis and experimental thermal conductivity techniques forms the basis of this method. An important advantage is the automatic simulation of the 20 0 K refrigeration intercept by the copper strap, which simplifies the apparatus considerably. This relative resistance technique, which uses electrical analogy as a guideline, is applicable with no restrictions for materials with temperature-independent thermal conductivity. For other materials the results obtained are functions of the specific temperature interval involved in the measurements. A comprehensive review of the literature on thermal conductivity indicates that this approach has not been used before. A demonstration of its self-consistency is stressed here rather than results obtained for different supports

  13. [Trends in the use of medical and dental services and associations with educational level and private health plan coverage in Brazil, 1998-2013].

    Science.gov (United States)

    Pilotto, Luciane Maria; Celeste, Roger Keller

    2018-03-29

    The public-private mix in the Brazilian health system favors double coverage of health services for individuals with private health plans and may aggravate inequities in the use of services. The aim of this study was to describe trends in the use of medical and dental services and associations with schooling and private health coverage. Data were obtained from a national household survey with representative samples in the years 1998, 2003, 2008, and 2013. The study described trends in the use of health services by adults, adjusted by private health coverage, years of schooling, sex, and age. There was an upward trend in the use of health services in adults without a private plan and among adults with a private plan the trend in use varied in a non-linear way. The medical service presented alternation in use over the years and the dental service showed a tendency to decline after 2003. It is necessary to monitor trends in private health coverage and the use of health services to assist government in regulating private plans and avoid increasing inequities among citizens in access to and use of health services.

  14. Association between parental access to paid sick leave and children's access to and use of healthcare services.

    Science.gov (United States)

    Asfaw, Abay; Colopy, Maria

    2017-03-01

    We examined the association between parental access to paid sick leave (PPSL) and children's use of preventive care and reduced likelihood of delayed medical care and emergency room (ER) visits. We used the child sample of the National Health Interview Survey data (linked to the adult and family samples) from 2011 through 2015 and logistic and negative binomial regression models. Controlling for covariates, the odds of children with PPSL receiving flu vaccination were 12.5% [95%CI: 1.06-1.19] higher and receiving annual medical checkups were 13.2% [95%CI: 1.04-1.23] higher than those of children without PPSL. With PPSL, the odds of children receiving delayed medical care because of time mismatch were 13.3% [95%CI: 0.76-0.98] lower, and being taken to ER were 53.6% [95%CI: 0.27-0.81] lower than those of children without PPSL. PPSL was associated with 11% [95%CI: 0.82-0.97] fewer ER visits per year. PPSL may improve children's access and use of healthcare services and reduce the number of ER visits. Am. J. Ind. Med. 60:276-284, 2017. © 2017 Wiley Periodicals, Inc. © Published 2017. This article is a U.S. Government work and is in the public domain in the USA.

  15. Canadian military personnel's population attributable fractions of mental disorders and mental health service use associated with combat and peacekeeping operations.

    Science.gov (United States)

    Sareen, Jitender; Belik, Shay-Lee; Afifi, Tracie O; Asmundson, Gordon J G; Cox, Brian J; Stein, Murray B

    2008-12-01

    We investigated mental disorders, suicidal ideation, self-perceived need for treatment, and mental health service utilization attributable to exposure to peacekeeping and combat operations among Canadian military personnel. With data from the Canadian Community Health Survey Cycle 1.2 Canadian Forces Supplement, a cross-sectional population-based survey of active Canadian military personnel (N = 8441), we estimated population attributable fractions (PAFs) of adverse mental health outcomes. Exposure to either combat or peacekeeping operations was associated with posttraumatic stress disorder (men: PAF = 46.6%; 95% confidence interval [CI] = 27.3, 62.7; women: PAF = 23.6%; 95% CI = 9.2, 40.1), 1 or more mental disorder assessed in the survey (men: PAF = 9.3%; 95% CI = 0.4, 18.1; women: PAF = 6.1%; 95% CI = 0.0, 13.4), and a perceived need for information (men: PAF = 12.3%; 95% CI = 4.1, 20.6; women: PAF = 7.9%; 95% CI = 1.3, 15.5). A substantial proportion, but not the majority, of mental health-related outcomes were attributable to combat or peacekeeping deployment. Future studies should assess traumatic events and their association with physical injury during deployment, premilitary factors, and postdeployment psychosocial factors that may influence soldiers' mental health.

  16. Spending on social and public health services and its association with homicide in the USA: an ecological study.

    Science.gov (United States)

    Sipsma, Heather L; Canavan, Maureen E; Rogan, Erika; Taylor, Lauren A; Talbert-Slagle, Kristina M; Bradley, Elizabeth H

    2017-10-12

    To examine whether state-level spending on social and public health services is associated with lower rates of homicide in the USA. Ecological study. USA. All states in the USA and the District of Columbia for which data were available (n=42). Homicide rates for each state were abstracted from the US Department of Justice Federal Bureau of Investigation's Uniform Crime Reporting. After adjusting for potential confounding variables, we found that every $10 000 increase in spending per person living in poverty was associated with 0.87 fewer homicides per 100 000 population or approximately a 16% decrease in the average homicide rate (estimate=-0.87, SE=0.15, phomicide rates at the state level. Although we cannot infer causality from this research, such spending may provide promising avenues for homicide reduction in the USA, particularly among states with lower levels of poverty. © 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.

  17. Context-Aware HCI Service Selection

    Directory of Open Access Journals (Sweden)

    Yao Shen

    2012-01-01

    Full Text Available Context-awareness has become a key issue in Human-Computer Interaction(HCI to provide better user experience under multi-device and multi-modal environment. With this intuition, we have proposed a web service based framework, which associates interactions with services, and provided service selection mechanism using context knowledge to achieve smart interaction migration [1]. A fundamental problem of such a service-oriented framework for interaction migration is to design an effective while scalable algorithm for service selection. In this paper, we propose a service selection algorithm considering not only context information and user preferences but also inter-service relations such as relative location. Our algorithm detects interaction hot spots within user active scope and presents the best service combination based on evaluation of interaction effectiveness. We also conduct simulation and the results illustrate that our algorithm is effective and scalable for interaction service selection.

  18. Utilization of institutional delivery service and associated factors in Bench Maji zone, Southwest Ethiopia: community based, cross sectional study.

    Science.gov (United States)

    Tadele, Niguse; Lamaro, Tafesse

    2017-02-01

    At the end of Millennium development goals, Ethiopia was included among 10 countries which constitutes about 59% of maternal deaths due to complications of pregnancy and/or childbirth every year globally. Institutional delivery, which is believed to contribute in reduction of maternal mortality is still low. Hence this study was conducted in order to assess utilization of institutional delivery and related factors in Bench Maji zone, Southwest Ethiopia. Cross sectional study was employed from September 1st - 30th, 2015 in Bench Maji Zone, Southwest Ethiopia where 765 mothers who deliver 2 years preceding the study provided data for this research. Data were collected by enumerators who were trained. In addition to descriptive statistics, binary and multivariate logistic regression analyses were performed. Statistical significance was considered at a p-value delivery which was significant. In Bench Maji Zone institutional delivery was shown to be comparatively good compared to other studies in the region and in Ethiopia in general even though it is below the health sector transformation plan of Ethiopia which aimed to increase deliveries attended by skilled health personnel to 95%. Empowering women, increasing awareness about institutional delivery and proper scaling up of antenatal care services which is an entry point for institutional delivery are recommended.

  19. Working relationships of infection prevention and control programs and environmental services and associations with antibiotic-resistant organisms in Canadian acute care hospitals.

    Science.gov (United States)

    Zoutman, Dick E; Ford, B Douglas; Sopha, Keith

    2014-04-01

    Environmental contamination in hospitals with antibiotic-resistant organisms (AROs) is associated with patient contraction of AROs. This study examined the working relationship of Infection Prevention and Control (IPAC) and Environmental Services and the impact of that relationship on ARO rates. Lead infection control professionals completed an online survey that assessed the IPAC and Environmental Services working relationship in their acute care hospital in 2011. The survey assessed cleaning collaborations, staff training, hospital cleanliness, and nosocomial methicillin-resistant Staphylococcus aureus (MRSA) infection, vancomycin-resistant Enterococcus (VRE) infection, and Clostridium difficile infection (CDI). The survey was completed by 58.3% of hospitals (119 of 204). Two-thirds (65.8%; 77 of 117) of the respondents reported that their cleaners were adequately trained, and 62.4% (73 of 117) reported that their hospital was sufficiently clean. Greater cooperation between IPAC and Environmental Services was associated with lower rates of MRSA infection (r = -0.22; P = .02), and frequent collaboration regarding cleaning protocols was associated with lower rates of VRE infection (r = -0.20; P = .03) and CDI (r = -0.31; P Environmental Services, and this was associated with lower rates of ARO. Deficits in the adequacy of cleaning staff training and hospital cleanliness were identified. The promotion of collaborative working relationships and additional training for Environmental Services workers would be expected to lower ARO rates. Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

  20. The readiness of German GPs to recommend and conduct cancer screening is associated with patient-physician gender concordance. Results of a survey.

    Science.gov (United States)

    Engler, Jennifer; Dahlhaus, Anne; Güthlin, Corina

    2017-12-01

    Cancer screening participation rates in Germany differ depending on patients' gender. International studies have found that patient-physician gender concordance fosters recommendation and conducting of cancer screening, and especially cancer screening for women. We aimed to ascertain whether gender concordance influences general practitioners' (GPs') rating of the usefulness of cancer screening, as well as their recommendations and readiness to conduct cancer screening in general practice in Germany. For an exploratory cross-sectional survey, 500 randomly selected GPs from all over Germany were asked to fill in a questionnaire on cancer screening in general practice between March and June 2015. We asked them to rate the usefulness of each cancer screening examination, how frequently they recommended and conducted them and whether they viewed GPs or specialists as responsible for carrying them out. We used multiple logistic regression to analyse gender effect size by calculating odds ratios. Our study sample consisted of 139 GPs of which 65% were male. Male and female GPs did not differ significantly in their rating of the general usefulness of any of the specified cancer screening examinations. Male GPs were 2.9 to 6.8 times as likely to consider GPs responsible for recommending and conducting PSA testing and digital rectal examinations and were 3.7 to 7.9 times as likely to recommend and conduct these examinations on a regular basis. Patient-physician gender concordance made it more likely that male-specific cancer screenings would be recommended and conducted, but not female-specific screenings. [Box: see text].

  1. Place of origin associated with depressive symptoms in health professionals performing social health service in Ancash, Peru, 2015.

    Science.gov (United States)

    Montesinos-Segura, Renee; Maticorena-Quevedo, Jesus; Chung-Delgado, Kocfa; Pereyra-Elías, Reneé; Taype-Rondan, Alvaro; Mayta-Tristán, Percy

    2018-05-01

    Health professionals performing their social health service (SHS) in rural communities could be at risk of developing depression. Moreover, those who migrate from farther places to perform their SHS could have an increased risk. The objective of this study was to evaluate the association between place of origin and the presence of depressive symptoms, in health professionals performing rural social health service (SHS) in Ancash, Peru. This was a cross-sectional study. During April 2015, a survey was applied to health professionals performing SHS in the Peruvian Ministry of Health (MINSA) facilities in Ancash. The main outcome was the presence of depressive symptoms, defined as a score ≥2 points in the Patient Health Questionnaire-2. The main exposure was the place of origin, defined as the place where the subjects completed their undergraduate professional studies (Ancash, Lima city or others). Poisson regressions with robust variance were performed to calculate crude and adjusted prevalence ratios (PR and aPR) and their 95% confidence interval (95%CI). From 573 health professionals performing their SHS in MINSA in Ancash, 347 were included in the study. The mean age was 27.2±4.5 years, 78.7% were women, and 14.7% scored positive for depressive symptoms. Those who had completed their undergraduate professional studies in Lima city had a higher prevalence of presence of depressive symptoms compared to those who did in Ancash (aPR=2.59, 95%CI=1.23-5.45). Those who completed their undergraduate professional studies in Lima had a higher prevalence of depressive symptoms than those who did in Ancash. Possible explanations include the difficulty in visiting family and friends, acculturation, and lack of Quechua language proficiency.

  2. Introduction of Renal Key Performance Indicators Associated with Increased Uptake of Peritoneal Dialysis in a Publicly Funded Health Service.

    Science.gov (United States)

    Toussaint, Nigel D; McMahon, Lawrence P; Dowling, Gregory; Holt, Stephen G; Smith, Gillian; Safe, Maria; Knight, Richard; Fair, Kathleen; Linehan, Leanne; Walker, Rowan G; Power, David A

    2017-01-01

    was associated with an increased uptake of PD but not home HD. This change in clinical practice restricted growth of SHD and reduced pressure on satellite services. The effect was offset by a modest PD technique survival. Many patients in whom PD was unsuccessful were subsequently transferred to SHD rather than home HD. Copyright © 2017 International Society for Peritoneal Dialysis.

  3. Factors associated with reported service use for mental health problems by residents of rural and remote communities: cross-sectional findings from a baseline survey

    Science.gov (United States)

    2013-01-01

    Background The patterns of health service use by rural and remote residents are poorly understood and under-represented in national surveys. This paper examines professional and non-professional service use for mental health problems in rural and remote communities in Australia. Methods A stratified random sample of adults was drawn from non-metropolitan regions of New South Wales, Australia as part of a longitudinal population-based cohort. One-quarter (27.7%) of the respondents were from remote or very remote regions. The socio-demographic, health status and service utilization (professional and non-professional) characteristics of 2150 community dwelling residents are described. Hierarchical logistic regressions were used to identify cross-sectional associations between socio-demographic, health status and professional and non-professional health service utilization variables. Results The overall rate of professional contacts for mental health problems during the previous 12 months (17%) in this rural population exceeded the national rate (11.9%). Rates for psychologists and psychiatrists were similar but rates for GPs were higher (12% vs. 8.1%). Non-professional contact rates were 12%. Higher levels of help seeking were associated with the absence of a partner, poorer finances, severity of mental health problems, and higher levels of adversity. Remoteness was associated with lower utilization of non-professional support. A Provisional Service Need Index was devised, and it demonstrated a broad dose–response relationship between severity of mental health problems and the likelihood of seeking any professional or non-professional help. Nevertheless, 47% of those with estimated high service need had no contact with professional services. Conclusions An examination of self-reported patterns of professional and non-professional service use for mental health problems in a rural community cohort revealed relatively higher rates of general practitioner attendance for

  4. Factors associated with reported service use for mental health problems by residents of rural and remote communities: cross-sectional findings from a baseline survey.

    Science.gov (United States)

    Perkins, David; Fuller, Jeffrey; Kelly, Brian J; Lewin, Terry J; Fitzgerald, Michael; Coleman, Clare; Inder, Kerry J; Allan, John; Arya, Dinesh; Roberts, Russell; Buss, Richard

    2013-04-30

    The patterns of health service use by rural and remote residents are poorly understood and under-represented in national surveys. This paper examines professional and non-professional service use for mental health problems in rural and remote communities in Australia. A stratified random sample of adults was drawn from non-metropolitan regions of New South Wales, Australia as part of a longitudinal population-based cohort. One-quarter (27.7%) of the respondents were from remote or very remote regions. The socio-demographic, health status and service utilization (professional and non-professional) characteristics of 2150 community dwelling residents are described. Hierarchical logistic regressions were used to identify cross-sectional associations between socio-demographic, health status and professional and non-professional health service utilization variables. The overall rate of professional contacts for mental health problems during the previous 12 months (17%) in this rural population exceeded the national rate (11.9%). Rates for psychologists and psychiatrists were similar but rates for GPs were higher (12% vs. 8.1%). Non-professional contact rates were 12%. Higher levels of help seeking were associated with the absence of a partner, poorer finances, severity of mental health problems, and higher levels of adversity. Remoteness was associated with lower utilization of non-professional support. A Provisional Service Need Index was devised, and it demonstrated a broad dose-response relationship between severity of mental health problems and the likelihood of seeking any professional or non-professional help. Nevertheless, 47% of those with estimated high service need had no contact with professional services. An examination of self-reported patterns of professional and non-professional service use for mental health problems in a rural community cohort revealed relatively higher rates of general practitioner attendance for such problems compared with data from

  5. A Cross-Sectional Study to Examine Factors Associated with Primary Health Care Service Utilization among Older Adults in the Irbid Governorate of Jordan

    Directory of Open Access Journals (Sweden)

    Abdullah Alkhawaldeh

    2014-01-01

    Full Text Available Background. Recently, the percentage of older adults in developing countries has increased significantly. Objective. This study examined patterns and factors associated with primary health care services utilization in the past 1, 6, and 12 months. Method. A cross-sectional study design was used to collect data from 190 older adults in the Irbid governorate of Jordan. Results. Primary health care services were used by less than half of the participants in the past 1 month, by 68.4% in the past 6 months, and by 73.8% in the past 12 months. Primary health care (PHC services use was associated with age, education level, tobacco use, chronic illnesses, perceived general health status today, a physical component summary score, employment, and perceived general health status in the past 6 and 12 months. The primary predictor of PHC services use at 1, 6, and 12 months was chronic illnesses (OR=13.32, (OR=19.63, and (OR=17.91, respectively. Conclusion. Although many factors were associated with PHC service utilization, the strongest predictor of PHC service utilization was chronic illnesses.

  6. Clima organizacional: un modo eficaz para dirigir los servicios de salud Climas organizacional: um modo eficaz para dirigir os serviços de saúde Organizational climate: an efficient way to conduct health services

    Directory of Open Access Journals (Sweden)

    Arturo Alexánder Segura Massó

    2012-01-01

    desenvolvimento de quatro elementos fundamentais dentro de qualquer organização do setor: a auto-eficácia do trabalhador, a satisfação do paciente, a qualidade do serviço fornecido, e a formação de recursos humanos no subsistema de pós-graduação. Conclui-se que o estudo do clima organizacional dentro duma instituição ou serviço de saúde deve contribuir para o estabelecimento de relações harmoniosas entre seus trabalhadores e como consequência se deve produzir um aumento da auto-eficácia deles na satisfação da população que garanta a qualidade do serviço de saúde fornecido. Por tanto, assevera-se que a análise e estudo do clima organizacional de um serviço de saúde são os modos mais eficazes para administrálo.We see the way health organizations, institutions and/ or services are conducted in Cuba as a major challenge in the health service, starting from the concept of an appropriate organizational climate to obtain the maximum level of commitment from its workers in tasks being developed. Purpose: To formulate considerations about the way in which organizational climate analysis and study constitute an efficient organizational way of health management for the constant pursue of excellence. Studying and implementing an appropriate organizational climate in health services favors the development of four core elements within any organization in the sector: worker's self-efficacy, patient satisfaction, quality of services provided, and training of human resources in the post-graduate subsystem. In conclusion, studying organizational climate within a health institution or service should contribute to establish harmonious relations among workers and, consequently, it should increase self-efficacy in the satisfaction of the population, ensuring the quality of services provided. Therefore, it is hereby stated that analyzing and studying the organizational climate of a health service is the most efficient way to conduct it.

  7. Thermal conductivity of fully dense unirradiated UO2: A new formulation from experimental results between 100 deg. C and 2500 deg. C, and associated fundamental properties

    International Nuclear Information System (INIS)

    Delette, G.; Charles, M.

    1997-01-01

    The various contributions to the thermal conductivity of UO 2 are first reviewed: contribution from phonons is preponderant up to 1600 deg. C; radiative contribution is negligible in the case of a polycrystalline sample, and is unable to account for the increase in conductivity observed above 1600 deg. C; electronic contribution, which seems patently to be responsible for this increase, is efficient from 1400 deg. C (electron-hole pairs treated as small polarons). Given the lack of decisive arguments on their actual efficiency, it was decided that, for temperatures above 2400 deg. C, neither a possible decrease in the electronic contribution due to vacancies, nor an additional possible contribution from Frenkel pairs would be described. We do not go therefore beyond the above-mentioned electronic contribution. In the light of these considerations, the law established by CEA for the thermal conductivity of unirradiated UO 2 , on the basis of a homogeneous set of measurements between 100 deg. C and 2500 deg. C, has been revised. A least-square method applied to the above measurements was used to derive simultaneously the four adjustable constants of the law which is henceforth proposed: λ = 1/A + BT+C/T 2 exp(-W/kT). The values of A, B, C, and W obtained, have the advantage of giving a better account of the high temperature results compared to the Martin recommendations (which has, by the way, the same physical form as above). Furthermore, this new law allows an extrapolation towards the melting point which is better founded than the earlier CEA law, while still respecting the value of the integrated thermal conductivity up to melting. Finally, various burnup effects (impurities, stoichiometry, etc.) can be formulated in physical terms. Moreover, the values of various fundamental properties connected with the derived constants have been determined: Debye temperature, Grueneisen parameter, Mott-Hubbard energy, electrical conductivity. These values are discussed and

  8. Institutional delivery service utilization and associated factors among mothers who gave birth in the last 12 months in Sekela District, north west of Ethiopia: a community-based cross sectional study.

    Science.gov (United States)

    Teferra, Alemayehu Shimeka; Alemu, Fekadu Mazengia; Woldeyohannes, Solomon Meseret

    2012-07-31

    Reduction of maternal mortality is a global priority particularly in developing countries including Ethiopia where maternal mortality ratio is one of the highest in the world. The key to reducing maternal mortality ratio and improving maternal health is increasing attendance by skilled health personnel throughout pregnancy and delivery. However, delivery service is significantly lower in Amhara Regional State, Ethiopia. Therefore, this study aimed to assess factors affecting institutional delivery service utilization among mothers who gave birth in the last 12 months in Sekela District, Amhara Region, Ethiopia. Community-based cross-sectional study was conducted among mothers with birth in the last 12 months during August, 2010. Multistage sampling technique was used to select 371 participants. A pre tested and structured questionnaire was used to collect data. Bivariate and multivariate data analysis was performed using SPSS version 16.0 software. The study indicated that 12.1% of the mothers delivered in health facilities. Of 87.9% mothers who gave birth at home, 80.0% of them were assisted by family members and relatives. The common reasons for home delivery were closer attention from family members and relatives (60.9%), home delivery is usual practice (57.7%), unexpected labour (33.4%), not being sick or no problem at the time of delivery (21.6%) and family influence (14.4%). Being urban resident (AOR [95% CI] = 4.6 [1.91, 10.9]), ANC visit during last pregnancy (AOR [95% CI] = 4.26 [1.1, 16.4]), maternal education level (AOR [95%CI] =11.98 [3.36, 41.4]) and knowledge of mothers on pregnancy and delivery services (AOR [95% CI] = 2.97[1.1, 8.6]) had significant associations with institutional delivery service utilization. Very low institutional delivery service utilization was observed in the study area. Majority of the births at home were assisted by family members and relatives. ANC visit and lack of knowledge on pregnancy and delivery services were found to

  9. Institutional delivery service utilization and associated factors among mothers who gave birth in the last 12 months in Sekela District, North West of Ethiopia: A community - based cross sectional study

    Directory of Open Access Journals (Sweden)

    Teferra Alemayehu

    2012-07-01

    Full Text Available Abstract Background Reduction of maternal mortality is a global priority particularly in developing countries including Ethiopia where maternal mortality ratio is one of the highest in the world. The key to reducing maternal mortality ratio and improving maternal health is increasing attendance by skilled health personnel throughout pregnancy and delivery. However, delivery service is significantly lower in Amhara Regional State, Ethiopia. Therefore, this study aimed to assess factors affecting institutional delivery service utilization among mothers who gave birth in the last 12 months in Sekela District, Amhara Region, Ethiopia. Methods Community-based cross-sectional study was conducted among mothers with birth in the last 12 months during August, 2010. Multistage sampling technique was used to select 371 participants. A pre tested and structured questionnaire was used to collect data. Bivariate and multivariate data analysis was performed using SPSS version 16.0 software. Results The study indicated that 12.1% of the mothers delivered in health facilities. Of 87.9% mothers who gave birth at home, 80.0% of them were assisted by family members and relatives. The common reasons for home delivery were closer attention from family members and relatives (60.9%, home delivery is usual practice (57.7%, unexpected labour (33.4%, not being sick or no problem at the time of delivery (21.6% and family influence (14.4%. Being urban resident (AOR [95% CI] = 4.6 [1.91, 10.9], ANC visit during last pregnancy (AOR [95% CI] = 4.26 [1.1, 16.4], maternal education level (AOR [95%CI] =11.98 [3.36, 41.4] and knowledge of mothers on pregnancy and delivery services (AOR [95% CI] = 2.97[1.1, 8.6] had significant associations with institutional delivery service utilization. Conclusions Very low institutional delivery service utilization was observed in the study area. Majority of the births at home were assisted by family members and relatives. ANC visit and lack of

  10. Operational challenges in conducting a community-based technology-enabled mental health services delivery model for rural India: Experiences from the SMART Mental Health Project [version 1; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    Pallab K. Maulik

    2018-04-01

    Full Text Available Background: There are large gaps in the delivery of mental health care in low- and middle-income countries such as India, and the problems are even more acute in rural settings due to lack of resources, remoteness, and lack of infrastructure, amongst other factors. The Systematic Medical Appraisal Referral and Treatment (SMART Mental Health Project was conceived as a mental health services delivery model using technology-based solutions for rural India. This paper reports on the operational strategies used to facilitate the implementation of the intervention. Method: Key components of the SMART Mental Health Project included delivering an anti-stigma campaign, training of primary health workers in screening, diagnosing and managing stress, depression and increased suicide risk and task sharing of responsibilities in delivering care; and using mobile technology based electronic decision support systems to support delivery of algorithm based care for such disorders. The intervention was conducted in 42 villages across two sites in the state of Andhra Pradesh in south India. A pre-post mixed methods evaluation was done, and in this paper operational challenges are reported. Results: Both quantitative and qualitative results from the evaluation from one site covering about 5000 adults showed that the intervention was feasible and acceptable, and initial results indicated that it was beneficial in increasing access to mental health care and reducing depression and anxiety symptoms. A number of strategies were initiated in response to operational challenges to ensure smoother conduct of the project and facilitated the project to be delivered as envisaged. Conclusions: The operational strategies initiated for this project were successful in ensuring the delivery of the intervention. Those, coupled with other more systematic processes have informed the researchers to understand key processes that need to be in place to develop a more robust study, that

  11. The American Psychological Association Task Force assessment of violent video games: Science in the service of public interest.

    Science.gov (United States)

    Calvert, Sandra L; Appelbaum, Mark; Dodge, Kenneth A; Graham, Sandra; Nagayama Hall, Gordon C; Hamby, Sherry; Fasig-Caldwell, Lauren G; Citkowicz, Martyna; Galloway, Daniel P; Hedges, Larry V

    2017-01-01

    A task force of experts was convened by the American Psychological Association (APA) to update the knowledge and policy about the impact of violent video game use on potential adverse outcomes. This APA Task Force on Media Violence examined the existing literature, including the meta-analyses in the field, since the last APA report on media violence in 2005. Because the most recent meta-analyses were published in 2010 and reflected work through 2009, the task force conducted a search of the published studies from 2009-2013. These recently published articles were scored and assessed by a systematic evidentiary review, followed by a meta-analysis of the high utility studies, as documented in the evidentiary review. Consistent with the literature that we reviewed, we found that violent video game exposure was associated with: an increased composite aggression score; increased aggressive behavior; increased aggressive cognitions; increased aggressive affect, increased desensitization, and decreased empathy; and increased physiological arousal. The size of the effects was similar to that in prior meta-analyses, suggesting a stable result. Our task force concluded that violent video game use is a risk factor for adverse outcomes, but found insufficient studies to examine any potential link between violent video game use and delinquency or criminal behavior. Our technical report is the basis of this article. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  12. [The association between diabetes mellitus and lower urinary tract dysfunctions in women assisted in a reference service].

    Science.gov (United States)

    de Oliveira, Eneida Gonçalves; Marinheiro, Lizanka Paola Figueiredo; da Silva, Kátia Silveira

    2011-12-01

    to describe lower urinary tract dysfunctions and clinical demographic characteristics of patients with urinary symptoms. This study assessed the prevalence of diabetes mellitus and urodynamic changes in these women. We conducted a cross-sectional, retrospective study on 578 women. The prevalence of diabetes mellitus and urodynamic diagnoses was assessed in patients with lower urinary tract dysfunctions, with their respective 95% confidence intervals. The prevalence ratios of urodynamic alterations were calculated according to the diabetes mellitus diagnoses. Seventy-seven patients (13.3%) had diabetes and type 2 diabetes was predominant (96.1%). Stress urinary incontinence was the most frequent urodynamic diagnosis (39%) in diabetic patients, followed by detrusor overactivity (23.4%). The prevalence of urodynamic alterations was associated with diabetes (PR=1.31; 95%CI=1.17-1.48). Changes in detrusor contractility (over- or underactivity) were diagnosed in 42.8% diabetic patients and in 31.5% non-diabetic patients. Diabetic women had a greater prevalence of urodynamic alterations than the non-diabetic ones. There was no association between diabetes mellitus and detrusor contractility alterations (p=0.80).

  13. The association between women's self-rated health and satisfaction with environmental services in an underserved community in Lebanon.

    Science.gov (United States)

    Habib, Rima R; Elzein, Kareem; Hojeij, Safa

    2013-01-01

    This research evaluated the association between women's self-rated health and a number of socioeconomic and environmental health indicators relating to drinking water services in an underserved Lebanese community. A population-based, cross-sectional survey using interviews was adopted to obtain information from female homemakers of 2,223 households in the town of Bebnine, Lebanon. The questionnaire included indicators on self-rated health, satisfaction with water quality, source of drinking water, occurrence of diarrhea, and socioeconomic variables, such as education, occupation, and perceived economic status. Self-rated health was categorized as poor, fair, and good. Odds ratios for poor and fair compared to good self-rated health values were calculated using multinomial logistic regression. A total of 712 women (32%) reported poor self-rated health. Women who perceived their household income to be worse than others in town were four times as likely to report poor health. Compared to women who were satisfied with drinking water quality, dissatisfied women were 42% more likely to report poor health. Women living in households reporting recent episodes of diarrheal illness had poorer health ratings than those without. The findings suggest a positive relationship between individual perceptions of water quality and self-rated health. Community concerns over their surrounding environment serve as a primary guide for infrastructural development and government policy.

  14. Guidelines from the Canadian Association of Pathologists for establishing a telepathology service for anatomic pathology using whole-slide imaging

    Directory of Open Access Journals (Sweden)

    Chantal Bernard

    2014-01-01

    Full Text Available The use of telepathology for clinical applications in Canada has steadily become more attractive over the last 10 years, driven largely by its potential to provide rapid pathology consulting services throughout the country regardless of the location of a particular institution. Based on this trend, the president of the Canadian Association of Pathologists asked a working group consisting of pathologists, technologists, and healthcare administrators from across Canada to oversee the development of guidelines to provide Canadian pathologists with basic information on how to implement and use this technology. The guidelines were systematically developed, based on available medical literature and the clinical experience of early adopters of telepathology in Canada. While there are many different modalities and applications of telepathology, this document focuses specifically on whole-slide imaging as applied to intraoperative pathology consultation (frozen section, primary diagnosis, expert or second opinions and quality assurance activities. Applications such as hematopathology, microbiology, tumour boards, education, research and technical and/or standard-related issues are not covered.

  15. A large outbreak of salmonellosis associated with sandwiches contaminated with multiple bacterial pathogens purchased via an online shopping service.

    Science.gov (United States)

    Wei, Sung-Hsi; Huang, Angela S; Liao, Ying-Shu; Liu, Yu-Lun; Chiou, Chien-Shun

    2014-03-01

    Food sold over the internet is an emerging business that also presents a concern with regard to food safety. A nationwide foodborne disease outbreak associated with sandwiches purchased from an online shop in July 2010 is reported. Consumers were telephone interviewed with a structured questionnaire and specimens were collected for etiological examination. A total of 886 consumers were successfully contacted and completed the questionnaires; 36.6% had become ill, with a median incubation period of 18 h (range, 6-66 h). The major symptoms included diarrhea (89.2%), abdominal pain (69.8%), fever (47.5%), headache (32.7%), and vomiting (17.3%). Microbiological laboratories isolated Salmonella enterica serovar Enteritidis, Salmonella Virchow, Staphylococcus aureus, Bacillus cereus, and enterotoxigenic Escherichia coli from the contaminated sandwiches, Salmonella Enteritidis and Salmonella Virchow from the patients, and Salmonella Enteritidis and Staphylococcus aureus from food handlers. Pulsed-field gel electrophoresis genotyping suggested a common origin of Salmonella bacteria recovered from the patients, food, and a food handler. Among the pathogens detected, the symptoms and incubation period indicated that Salmonella, likely of egg origin, was the probable causative agent of the outbreak. This outbreak illustrates the importance of meticulous hygiene practices during food preparation and temperature control during food shipment and the food safety challenges posed by online food-shopping services.

  16. A Large Outbreak of Salmonellosis Associated with Sandwiches Contaminated with Multiple Bacterial Pathogens Purchased via an Online Shopping Service

    Science.gov (United States)

    Wei, Sung-Hsi; Huang, Angela S.; Liao, Ying-Shu; Liu, Yu-Lun

    2014-01-01

    Abstract Food sold over the internet is an emerging business that also presents a concern with regard to food safety. A nationwide foodborne disease outbreak associated with sandwiches purchased from an online shop in July 2010 is reported. Consumers were telephone interviewed with a structured questionnaire and specimens were collected for etiological examination. A total of 886 consumers were successfully contacted and completed the questionnaires; 36.6% had become ill, with a median incubation period of 18 h (range, 6–66 h). The major symptoms included diarrhea (89.2%), abdominal pain (69.8%), fever (47.5%), headache (32.7%), and vomiting (17.3%). Microbiological laboratories isolated Salmonella enterica serovar Enteritidis, Salmonella Virchow, Staphylococcus aureus, Bacillus cereus, and enterotoxigenic Escherichia coli from the contaminated sandwiches, Salmonella Enteritidis and Salmonella Virchow from the patients, and Salmonella Enteritidis and Staphylococcus aureus from food handlers. Pulsed-field gel electrophoresis genotyping suggested a common origin of Salmonella bacteria recovered from the patients, food, and a food handler. Among the pathogens detected, the symptoms and incubation period indicated that Salmonella, likely of egg origin, was the probable causative agent of the outbreak. This outbreak illustrates the importance of meticulous hygiene practices during food preparation and temperature control during food shipment and the food safety challenges posed by online food–shopping services. PMID:24313786

  17. Thermal conductivity of fully dense unirradiated UO{sub 2}: A new formulation from experimental results between 100 deg. C and 2500 deg. C, and associated fundamental properties

    Energy Technology Data Exchange (ETDEWEB)

    Delette, G; Charles, M [Commissariat a l` Energie Atomique, Grenoble (France)

    1997-08-01

    The various contributions to the thermal conductivity of UO{sub 2} are first reviewed: contribution from phonons is preponderant up to 1600 deg. C; radiative contribution is negligible in the case of a polycrystalline sample, and is unable to account for the increase in conductivity observed above 1600 deg. C; electronic contribution, which seems patently to be responsible for this increase, is efficient from 1400 deg. C (electron-hole pairs treated as small polarons). Given the lack of decisive arguments on their actual efficiency, it was decided that, for temperatures above 2400 deg. C, neither a possible decrease in the electronic contribution due to vacancies, nor an additional possible contribution from Frenkel pairs would be described. We do not go therefore beyond the above-mentioned electronic contribution. In the light of these considerations, the law established by CEA for the thermal conductivity of unirradiated UO{sub 2}, on the basis of a homogeneous set of measurements between 100 deg. C and 2500 deg. C, has been revised. A least-square method applied to the above measurements was used to derive simultaneously the four adjustable constants of the law which is henceforth proposed: {lambda} = 1/A + BT+C/T{sup 2}exp(-W/kT). The values of A, B, C, and W obtained, have the advantage of giving a better account of the high temperature results compared to the Martin recommendations (which has, by the way, the same physical form as above). Furthermore, this new law allows an extrapolation towards the melting point which is better founded than the earlier CEA law, while still respecting the value of the integrated thermal conductivity up to melting. Finally, various burnup effects (impurities, stoichiometry, etc.) can be formulated in physical terms. Moreover, the values of various fundamental properties connected with the derived constants have been determined: Debye temperature, Grueneisen parameter, Mott-Hubbard energy, electrical conductivity. These values

  18. The dilemma of service productivity and service innovation : An empirical exploration in financial services

    NARCIS (Netherlands)

    Aspara, Jaakko; Klein, Jan; Luo, Xueming; Tikkanen, Henrikki

    2017-01-01

    We conduct a systematic exploratory investigation of the effects of firms’ existing service productivity on the success of their new service innovations. Although previous research extensively addresses service productivity and service innovation, respectively, this is the first empirical study that

  19. Low thermal conductivity skutterudites

    Energy Technology Data Exchange (ETDEWEB)

    Fleurial, J P; Caillat, T; Borshchevsky, A

    1997-07-01

    Recent experimental results on semiconductors with the skutterudite crystal structure show that these materials possess attractive transport properties and have a good potential for achieving ZT values substantially larger than for state-of-the-art thermoelectric materials. Both n-type and p-type conductivity samples have been obtained, using several preparation techniques. Associated with a low hole effective mass, very high carrier mobilities, low electrical resistivities and moderate Seebeck coefficients are obtained in p-type skutterudites. For a comparable doping level, the carrier mobilities of n-type samples are about an order of magnitude lower than the values achieved on p-type samples. However, the much larger electron effective masses and Seebeck coefficients on p-type samples. However, the much larger electron effective masses and Seebeck coefficients make n-type skutterudite promising candidates as well. Unfortunately, the thermal conductivities of the binary skutterudites compounds are too large, particularly at low temperatures, to be useful for thermoelectric applications. Several approaches to the reduction of the lattice thermal conductivity in skutterudites are being pursued: heavy doping, formation of solid solutions and alloys, study of novel ternary and filled skutterudite compounds. All those approaches have already resulted in skutterudite compositions with substantially lower thermal conductivity values in these materials. Recently, superior thermoelectric properties in the moderate to high temperature range were achieved for compositions combining alloying and filling of the skutterudite structure. Experimental results and mechanisms responsible for low thermal conductivity in skutterudites are discussed.

  20. Demographic, health services and socio-economic factors associated with pulmonary tuberculosis mortality in Los Altos Region of Chiapas, Mexico.

    Science.gov (United States)

    Nájera-Ortiz, J C; Sánchez-Pérez, H J; Ochoa-Díaz, H; Arana-Cedeño, M; Lezama, Ma Salazar; Mateo, M Martín

    2008-08-01

    Chiapas is one of the Mexican states having the highest rates of Pulmonary Tuberculosis (PTB), due to the numerous factors impeding its management and control (poverty, poor housing and nutrition, shortage of health resources, among others). To analyse the PTB mortality of a cohort of patients in Los Altos Region of Chiapas, who had been diagnosed with PTB from January 1, 1998 to December 31, 2002; and, to identify demographic, socioeconomic and health services utilization factors, associated with death from PTB. Analysis of a cohort of patients aged over 14 years diagnosed with PTB in the above mentioned period (n = 431) in Los Altos region of Chiapas. The records of the Tuberculosis Programme were reviewed, and patients were located through a search attempting to locate them in their homes. Those found alive were interviewed and asked to provide sputum samples. In the case of deceased patients, a verbal autopsy was obtained from a member of their family. The records of the PTB Programme in the area were incomplete and erroneous in many cases. The results of the home follow-up visits were: 208 (48%) patients located alive, five of whom were still PTB positive (three with multi-drug resistance); 145 (34%) could not be located and 78 (18%) had already died. Apparently, in at least 40 cases, the deaths were associated with PTB. Of these forty, 33 (83%) died without having received any medical care. The factors associated with dying from PTB were: 45 and over years of age (OR = 1.3; 95% CI = 0.98-1.3), 0-3 schooling years (OR = 3.3; 95% CI = 1.1-9.6), engaged in agriculture (OR = 2.2; 95% CI = 1.1-4.4), not living in main villages of their municipality (OR = 1.2; 95% CI = 1.0-1.3), living in a rural community (OR = 2.7; 95% CI = 1.1-6.8), not having been treated in DOTS (OR = 1.2; 95% CI = 1.0-1.3) and having defaulted from treatment (OR = 11.5; 95% CI = 5.3-24.8). The high rate of mortality due to PTB observed constitutes a serious public health problem deserving

  1. Characteristics of service users and provider organisations associated with experience of out of hours general practitioner care in England: population based cross sectional postal questionnaire survey.

    Science.gov (United States)

    Warren, Fiona C; Abel, Gary; Lyratzopoulos, Georgios; Elliott, Marc N; Richards, Suzanne; Barry, Heather E; Roland, Martin; Campbell, John L

    2015-04-29

    To investigate the experience of users of out of hours general practitioner services in England, UK. Population based cross sectional postal questionnaire survey. General Practice Patient Survey 2012-13. Potential associations between sociodemographic factors (including ethnicity and ability to take time away from work during working hours to attend a healthcare consultation) and provider organisation type (not for profit, NHS, or commercial) and service users' experience of out of hours care (timeliness, confidence and trust in the out of hours clinician, and overall experience of the service), rated on a scale of 0-100. Which sociodemographic/provider characteristics were associated with service users' experience, the extent to which any observed differences could be because of clustering of service users of a particular sociodemographic group within poorer scoring providers, and the extent to which observed differences in experience varied across types of provider. The overall response rate was 35%; 971,232/2,750,000 patients returned surveys. Data from 902,170 individual service users were mapped through their registered practice to one of 86 providers of out of hours GP care with known organisation type. Commercial providers of out of hours GP care were associated with poorer reports of overall experience of care, with a mean difference of -3.13 (95% confidence interval -4.96 to -1.30) compared with not for profit providers. Asian service users reported lower scores for all three experience outcomes than white service users (mean difference for overall experience of care -3.62, -4.36 to -2.89), as did service users who were unable to take time away from work compared with service users who did not work (mean difference for overall experience of care -4.73, -5.29 to -4.17). Commercial providers of out of hours GP care were associated with poorer experience of care. Targeted interventions aimed at improving experience for patients from ethnic minorities and

  2. Facilitating Fresh: State Laws Supporting School Gardens Are Associated With Use of Garden-Grown Produce in School Nutrition Services Programs.

    Science.gov (United States)

    Turner, Lindsey; Leider, Julien; Piekarz, Elizabeth; Schermbeck, Rebecca M; Merlo, Caitlin; Brener, Nancy; Chriqui, Jamie F

    2017-06-01

    To examine whether state laws are associated with the presence of school gardens and the use of garden-grown produce in school nutrition services programs. Nationally representative data from the School Health Policies and Practices Study 2014 were combined with objectively coded state law data regarding school gardens. Outcomes were: (1) the presence of a school garden at each school (n = 419 schools), and (2) the use of garden-grown items in the school nutrition services program. Multivariate logistic regression was used to examine each outcome. Contextual covariates included school level, size, locale, US Census region, student race/ethnic composition, and percentage of students eligible for free and reduced-priced meals. State law was not significantly associated with whether schools had a garden, but it was associated with whether schools used garden-grown items in nutrition services programs (odds ratio, 4.21; P garden-grown items in nutrition services programs was 15.4% among schools in states with a supportive law, vs 4.4% among schools in states with no law. State laws that support school gardens may facilitate the use of garden-grown items in school nutrition service programs. Additional research is needed regarding the types of messaging that might be most effective for motivating school administrators to appreciate the value of school gardens. In addition, another area for further research pertains to scaling garden programs for broader reach. Copyright © 2017 Society for Nutrition Education and Behavior. All rights reserved.

  3. Integrating Apparent Conductance in Resistivity Sounding to Constrain 2D Gravity Modeling for Subsurface Structure Associated with Uranium Mineralization across South Purulia Shear Zone, West Bengal, India

    Directory of Open Access Journals (Sweden)

    Arkoprovo Biswas

    2014-01-01

    Full Text Available South Purulia Shear Zone (SPSZ is an important area for the prospect of uranium mineralization and no detailed geophysical investigations have been carried out in this region. To delineate the subsurface structure in the present area, vertical electrical soundings using Schlumberger array and gravity survey were carried out along a profile perpendicular to the SPSZ. Apparent conductance in the subsurface revealed a possible connection from SPSZ to Raghunathpur. The gravity model reveals the presence of a northerly dipping low density zone (most likely the shear zone extending up to Raghunathpur under a thin cover of granitic schist of Chotanagpur Granite Gneissic Complex (CGGC. The gravity model also depicts the depth of the zone of density low within this shear zone at ~400 m near Raghunathpur village and this zone truncates with a steep slope. Integration of resistivity and gravity study revealed two possible contact zones within this low density zone in the subsurface at depth of 40 m and 200 m. Our study reveals a good correlation with previous studies in Raghunathpur area characterized by medium to high hydro-uranium anomaly. Thus the conducting zone coinciding with the low gravity anomaly is inferred to be a possible uranium mineralized zone.

  4. Psychotic relapse and associated factors among patients attending health services in Southwest Ethiopia: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Mahlet Fikreyesus

    2016-10-01

    Full Text Available Abstract Background Psychotic relapse leads to repeated hospitalization and negatively affects the clinical prognosis of the patients. Information on prevalence of relapse among patients with psychotic disorders in Ethiopian setting is scarce. This study aimed to assess the prevalence of relapse among patients with psychotic disorders attending services in Jimma University Specialized Hospital (JUSH. Methods Data were collected using interviewer administered questionnaire. We used medication adherence rating scale (MARS to assess compliance to medication and abnormal involuntary movement scale (AIMS to detect medication side effects. Logistic regression analysis was used to identify independent predictors of psychotic relapse. All variables with P-value <0.25 in the bivariate analyses were entered into multivariate logistic regression and variables with P-value < 0.05 in the final model were declared to be significantly associated with the outcome variable. Results The prevalence of relapse among patients with psychotic disorder was 24.6 % (n = 95. Of this, 25.4 and 22.4 % were males and females respectively. The odds of developing psychotic relapse among patients living with family was 72 % lower than that of patients living alone (aOR = 0.28, 95 % CI = 0.08, 0.93. The odds of developing psychotic relapse among patients compliant to medication was 69 % lower than that of patients who were not compliant to medications (aOR = 0.31, 95 % CI = 0.12, 0.80. The odds of developing psychotic relapse among patients having high score on social support score was 48 % lower than that of patients who were compliant to medications (aOR = 0.52, 95 % CI = 0.28, 0.95. The odds of developing psychotic relapse among patients reporting to have sought religious support was 45 % lower than that of patients who have not sought religious support (aOR = 0.55, 95 % CI = 0.31, 0.96. On the other hand, the odds of developing

  5. The association of financial difficulties with clinical outcomes in cancer patients: secondary analysis of 16 academic prospective clinical trials conducted in Italy.

    Science.gov (United States)

    Perrone, F; Jommi, C; Di Maio, M; Gimigliano, A; Gridelli, C; Pignata, S; Ciardiello, F; Nuzzo, F; de Matteis, A; Del Mastro, L; Bryce, J; Daniele, G; Morabito, A; Piccirillo, M C; Rocco, G; Guizzaro, L; Gallo, C

    2016-12-01

    Cancer may cause financial difficulties, but its impact in countries with public health systems is unknown. We evaluated the association of financial difficulties with clinical outcomes of cancer patients enrolled in academic clinical trials performed within the Italian public health system. Data were pooled from 16 prospective multicentre trials in lung, breast or ovarian cancer, using the EORTC quality of life (QOL) C30 questionnaire. Question 28 scores financial difficulties related to disease or treatment in four categories from 'not at all' to 'very much'. We defined financial burden (FB) as any financial difficulty reported at baseline questionnaire, and financial toxicity (FT) as score worsening in a subsequent questionnaire. We investigated (i) the association of FB with clinical outcomes (survival, global QOL response [questions 29/30] and severe toxicity), and (ii) the association of FT with survival. Multivariable analyses were performed using logistic regression models or the Cox model adjusting for trial, gender, age, region and period of enrolment, baseline global QOL and, where appropriate, FB and global QOL response. Results are reported as odds ratio (OR) or hazard ratio (HR) with 95% confidence intervals (CI). At baseline 26% of the 3670 study patients reported FB, significantly correlated with worse baseline global QOL. FB was not associated with risks of death (HR 0.94, 95% CI 0.85-1.04, P = 0.23) and severe toxicity (OR 0.90, 95% CI 0.76-1.06, P = 0.19) but was predictive of a higher chance of worse global QOL response (OR 1.35, 95% CI 1.08-1.70, P = 0.009). During treatment, 2735 (74.5%) patients filled in subsequent questionnaires and 616 (22.5%) developed FT that was significantly associated with an increased risk of death (HR 1.20, 95% CI 1.05-1.37, P = 0.007). Several sensitivity analyses confirmed these findings. Even in a public health system, financial difficulties are associated with relevant cancer patients outcomes like QOL and

  6. Associations of Participation in Service Activities with Academic, Behavioral, and Civic Outcomes of Adolescents at Varying Risk Levels

    Science.gov (United States)

    Schmidt, Jennifer A.; Shumow, Lee; Kackar, Hayal Z.

    2012-01-01

    Youth who participate in service activities differ from those who do not on a number of key demographic characteristics like socio-economic status and other indicators of risk; and most studies demonstrating positive outcomes among service participants employ small non-representative samples. Thus, there is little evidence as to whether the…

  7. The Relationship between Sun Protection Policy and Associated Practices in a National Sample of Early Childhood Services in Australia

    Science.gov (United States)

    Ettridge, Kerry A.; Bowden, Jacqueline A.; Rayner, Joanne M.; Wilson, Carlene J.

    2011-01-01

    Limiting exposure to sunlight during childhood can significantly reduce the risk of skin cancer. This was the first national study to assess the sun protection policies and practices of early childhood services across Australia. It also examined the key predictors of services' sun protection practices. In 2007, 1017 respondents completed a…

  8. A Conceptual Model to Assess Stress-Associated Health Effects of Multiple Ecosystem Services Degraded by Disaster Events in the Gulf of Mexico and Elsewhere

    Science.gov (United States)

    Few conceptual frameworks attempt to connect disaster-associated environmental injuries to impacts on ecosystem services (the benefits humans derive from nature) and thence to both psychological and physiological human health effects. To our knowledge, this study is one of the fi...

  9. Analysis of changes in the association of income and the utilization of curative health services in Mexico between 2000 and 2006

    Directory of Open Access Journals (Sweden)

    Valencia-Mendoza Atanacio

    2011-10-01

    Full Text Available Abstract Background A common characteristic of health systems in most developing countries is unequal access to health services. As a result, members of the poorest population groups often do not receive formal attention for health services, because they cannot afford it. In 2001 in Mexico, to address income-related differences in the use of health services, the government launched a major healthcare reform, which includes a health insurance program called Seguro Popular, aimed at improving healthcare access among poor, uninsured residents. This paper analyzes the before and after changes in the demand for curative ambulatory health services focusing on the association of income-related characteristics and the utilization of formal healthcare providers vs. no healthcare service utilization. Methods By using two nationally representative health surveys (ENSA-2000 and ENSANUT-2006, we modeled an individual's decision when experiencing an illness to use services provided by the (1 Ministry of Health (MoH, (2 social security, (3 private entities, or (4 to not use formal services (no healthcare service utilization. Results Poorer individuals were more likely in 2006 than in 2000 to respond to an illness by using formal healthcare providers. Trends in provider selection differed, however. The probability of using public services from the MoH increased among the poorest population, while the findings indicated an increase in utilization of private health services among members of low- and middle-income groups. No significant change was seen among formal workers -covered by social security services-, regardless of socioeconomic status. Conclusions Overall, for 2006 the Mexican population appears less differentiated in using healthcare across economic groups than in 2000. This may be related, in part, to the implementation of Seguro Popular, which seems to be stimulating healthcare demand among the poorest and previously uninsured segment of the

  10. Higher densities of fast-food and full-service restaurants are not associated with obesity prevalence.

    Science.gov (United States)

    Mazidi, Mohsen; Speakman, John R

    2017-08-01

    Background: The obesity epidemic in the United States has been mirrored by an increase in calories consumed outside of the home and by expansions in the numbers of, and portion sizes at, both fast-food restaurants (FFRs) and full-service restaurants (FSRs), leading some to blame the epidemic on the restaurant industry. If this were indeed true, one would predict that greater per capita densities of FFRs and FSRs would lead to greater obesity prevalence. Objective: We evaluated the population-level association between both FSRs and FFRs and the prevalence of obesity and calculated the proportion of calories consumed in these establishments. Design: In this ecological cross-sectional study, we used county-level data (aggregate-level data) for obesity prevalence across the mainland United States in 2012 and matched these data to county-level per capita densities of FFRs and FSRs in the same year. Multiple linear regression was used to determine the relation between the prevalence of obesity and the densities of FFRs and FSRs after adjustment for confounding factors. Results: Contrary to expectations, obesity prevalence was highly significantly negatively related to the densities of both FFRs and FSRs (combined-effect R 2 = 0.195). This was principally because greater numbers of both FFRs and FSRs were located in areas in which individuals were on average wealthier and more educated. When we normalized for these factors (and additional socioeconomic variables), the associations between restaurant densities and obesity effectively disappeared (pooled R 2 = 0.008). Our calculations showed that the percentage of total calories consumed in FFRs and FSRs is a mean of only 15.9% of the total intake (maximum: 22.6%). Conclusions: Variations in the densities of FFRs and FSRs are not linked to the prevalence of obesity in the United States, and food consumed in these establishments is responsible for <20% of total energy intake. This finding has implications for policy

  11. Understanding school food service characteristics associated with higher competitive food revenues can help focus efforts to improve school food environments.

    Science.gov (United States)

    Guthrie, Joanne F; Newman, Constance; Ralston, Katherine; Prell, Mark; Ollinger, Michael

    2012-08-01

    Many school food services sell extra foods and beverages, popularly referred to as “competitive foods,” in addition to USDA school meals. On the basis of national survey data, most competitive foods and beverages selected by students are of low nutritional value. Recent federal legislation will allow schools that participate in USDA school meal programs to sell competitive foods only if the food items they sell meet nutrition standards based on the Dietary Guidelines for Americans. Concerns have been raised about the potential effects of limiting competitive foods on local school food service finances. However, national data indicate that only in a subset of schools do food services receive large amounts of revenues from competitive foods. These food services are typically located in secondary schools in more affluent districts, serving higher proportions of students who do not receive free or reduced price meals. Compared to other food services, these food services couple higher competitive food revenues with lower school meal participation. Increasing school meal participation could increase meal revenues to offset any loss of competitive food revenues. Replacing less-healthful competitive items with healthier options could also help maintain school food service revenues while improving the school food environment. Nationally consistent nutrition standards for competitive foods may encourage development and marketing of healthful products.

  12. The reliability, concurrent validity and association with salivary oxytocin of the self-report version of the Inventory of Callous-Unemotional Traits in adolescents with conduct disorder.

    Science.gov (United States)

    Levy, Tomer; Apter, Alan; Djalovski, Amir; Peskin, Miriam; Fennig, Silvana; Gat-Yablonski, Galia; Bar-Maisels, Meytal; Borodkin, Katy; Bloch, Yuval

    2017-10-01

    The present study evaluated the self-report version of the Inventory of Callous-Unemotional Traits (ICU-SR) in terms of reliability, concurrent validity, and correlation with salivary oxytocin levels, a potential biomarker of CU traits. 67 socially at-risk male adolescents (mean 16.2 years) completed the ICU-SR, ICU teacher-version (ICU-TR), Strengths and Difficulties Questionnaire, and their medical files were coded for previous antisocial acts using Brown-Goodwin Lifetime Aggression Scale. Salivary samples were assayed for oxytocin. The reliability of ICU-SR was lower (α = 0.71) than ICU-TR (α = 0.86). ICU-SR mean score was significantly lower than ICU-TR (M = 25.29, SD = 8.02; M = 33.14, SD = 9.47). ICU-TR but not ICU-SR, significantly correlated with history of antisocial acts (r = 0.40). Two-way analysis of variance showed a significant effect of conduct disorder and oxytocin on ICU-TR but not ICU-SR [F(1,59) = 6.53; F(1,59) = 6.08], and a significant interaction only for ICU-TR [F(1,59) = 2.89]. Subjective self-reports of CU traits may be less reliable and valid than teachers' reports. Copyright © 2017 Elsevier B.V. All rights reserved.

  13. Service co-innovation

    DEFF Research Database (Denmark)

    Henten, Anders; Sundbo, Jon; Sundbo, Donna

    of studies of the degree of satisfaction of the users with the services in the service encounters and studies that examine service innovation processes. The paper is based on research conducted in 21 service delivery situations in as many service companies. Drivers of and barriers to encounterbased service......This paper examines the factors affecting the innovativeness of service encounters. The assumption is that a considerable share of innovations in service industries is initiated in the service encounters. The theoretical foundation of this paper builds on a combination of research tradition...

  14. Contraceptive use following spontaneous and induced abortion and its association with family planning services in primary health care: results from a Brazilian longitudinal study.

    Science.gov (United States)

    Borges, Ana Luiza Vilela; OlaOlorun, Funmilola; Fujimori, Elizabeth; Hoga, Luiza Akiko Komura; Tsui, Amy Ong

    2015-10-15

    Although it is well known that post-abortion contraceptive use is high when family planning services are provided following spontaneous or induced abortions, this relationship remains unclear in Brazil and similar settings with restrictive abortion laws. Our study aims to assess whether contraceptive use is associated with access to family planning services in the six-month period post-abortion, in a setting where laws towards abortion are highly restrictive. This prospective cohort study recruited 147 women hospitalized for emergency treatment following spontaneous or induced abortion in Brazil. These women were then followed up for six months (761 observations). Women responded to monthly telephone interviews about contraceptive use and the utilization of family planning services (measured by the utilization of medical consultation and receipt of contraceptive counseling). Generalized Estimating Equations were used to analyze the effect of family planning services and other covariates on contraceptive use over the six-month period post-abortion. Women who reported utilization of both medical consultation and contraceptive counseling in the same month had higher odds of reporting contraceptive use during the six-month period post-abortion, when compared with those who did not use these family planning services [adjusted aOR = 1.93, 95 % Confidence Interval: 1.13-3.30]. Accessing either service alone did not contribute to contraceptive use. Age (25-34 vs. 15-24 years) was also statistically associated with contraceptive use. Pregnancy planning status, desire to have more children and education did not contribute to contraceptive use. In restrictive abortion settings, family planning services offered in the six-month post-abortion period contribute to contraceptive use, if not restricted to simple counseling. Medical consultation, in the absence of contraceptive counseling, makes no difference. Immediate initiation of a contraceptive that suits women's pregnancy

  15. The association between in-service sexual harassment and post-traumatic stress disorder among Department of Veterans Affairs disability applicants.

    Science.gov (United States)

    Murdoch, Maureen; Polusny, Melissa A; Hodges, James; Cowper, Diane

    2006-02-01

    The goal was to describe the association between post-traumatic stress disorder (PTSD) and in-service sexual harassment in a nationally representative sample of Department of Veterans Affairs PTSD disability applicants. The study was a cross-sectional survey. Of 4,918 eligible veterans, 3,337 (68%) returned surveys. Nonresponse bias appeared to be minimal. After adjustment for other reported traumas, women's reported in-service sexual harassment severity was significantly associated with PTSD symptom severity (p men and for in-service sexual assault among the women. Men showed no association between in-service sexual harassment and PTSD (p = 0.33), although power was low for this test. Sexual harassment significantly contributed to female veterans' PTSD symptoms; its contribution to men's symptoms was unclear. We discuss mechanisms through which sexual harassment might affect PTSD symptom severity, including the possibility that sexual harassment sometimes meets the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, definition of a criterion A stressor.

  16. Factors associated with diarrhea in children under five years old in the state of Pernambuco, according to surveys conducted in 1997 and 2006.

    Science.gov (United States)

    Vasconcelos, Maria Josemere de Oliveira Borba; Rissin, Anete; Figueiroa, José Natal; Lira, Pedro Israel Cabral de; Batista Filho, Malaquias

    2018-01-01

    OBJECTIVE Describe and compare variations of the factors associated with the prevalence of diarrhea in children under five years old in the state of Pernambuco. METHODS We used the databases of two population-based surveys from the years 1997 and 2006, with 2,078 and 1,650 children, respectively, evaluated in 18 municipalities of Pernambuco (Metropolitan Region of Recife, urban and rural interior). The variables, allocated at hierarchical levels, were analyzed using prevalence and Poisson regression ratios. RESULTS Only four variables were independently associated and were included in the final hierarchical model: geographical area, number of people per room, maternal age and the age of the child. In 1997: urban interior = 1.33 (95%CI 1.06-1.66), rural interior = 1.22 (95%CI 0.97-1.53) and in 2006: urban interior = 1.87 (95%CI 1.31-2.66), rural interior = 2.07 (95%CI 1.50-2.85); number of persons per room (1997): 1 to less than 2 = 1.29 (95%CI 0.98-1.68), two or more = 1.47 (95%CI 1.11-1.95) and in 2006: 1 to less than 2 = 0.86 (95%CI 0.68-1.09), two or more = 1.29 (95%CI 0.94-1.75); maternal age (1997): 10 to 19 years = 1.48 (95%CI 1.05-2.08), 20 to 24 years = 1.23 (95%CI 0.94-1.60), 25 to 34 years = 1.01 (95%CI 0.78-1.30) and in 2006: 10 to 19 years old = 1.70 (95%CI 1.08-2.66), 20 to 24 years old = 1.64 (95%CI 1.16-2.32), 25 to 34 years = 1.20 (95%CI 0.89-1.62); and age of the child (1997): 0-11 months = 1.57 (95%CI 1.27-1.94), 12-23 months = 1.73 (95%CI 1.41-2.12) and in 2006: 0-11 months = 1.04 (95%CI 0.76-1.41), 12-23 months = 1.77 (95%CI 1.41-2.23). CONCLUSIONS There was a great variability of the conditioners of diarrhea in children between the two periods analyzed. At the public policy level, despite changes in terms of people, time sequences, and geographic spaces, diarrhea remains on an important scale in the ranking of government power.

  17. Comparison of asbestos-associated respiratory disease by medical examination between shipyard retiree and workers of active service with asbestos exposure

    International Nuclear Information System (INIS)

    Ikeda, Tooru; Yoshida, Toshiaki; Fujisawa, Hiroyuki; Tanaka, Ayako; Ikeda, Hideki; Kawano, Hiroaki

    2009-01-01

    We examined 407 shipyard workers with asbestos exposure (406 men and one woman; mean age, 60.4 years) for asbestos-associated respiratory disease using the multi-slice chest CT in addition to the regular examinations. After the examination, workers with suspicion of malignancy by the multi-slice CT, other examinations including biopsy were performed to make the final diagnosis. We divided these people into two groups as follows; retiree (133 cases, 132 men and one woman; mean age, 65.9 years) and workers of shipyard active service (274 cases, all men, mean age, 57.6 years). We compared the incidence of asbestos-associated respiratory disease, age, incubation time and work period at asbestos exposure in these two groups. 97 of 133 (72.9%) retired workers and 94 of 274 (34.4%) active service had asbestos-associated respiratory disease as follows: pleural plaque without calcification, 25 cases (18.8%) (retired) and 35 (12.8%) (active service); pleural plaque with calcification, 65 (48.7%) and 51 (18.6%); diffuse pleural thickening, 0 (0%) and 0 (0%); asbestosis, 5 (3.8%) and 6 (2.2%); lung cancer, 1 case (0.8%) and 2 cases (0.7%) and malignant pleural mesothelioma 1 case (0.8%) and none (0%). The rate of workers with total asbestos-associated respiratory disease in the retired group was significantly higher than that in active service (P<0.01). Especially pleural plaque with calcification were detected more in shipyard retired workers than active service workers. The incidence of pleural plaque is related to age and incubation time but not to work period at asbestos exposure. (author)

  18. Changes in ecosystem services associated with planting structures of cropland: A case study in Minle County in China

    Science.gov (United States)

    Liu, Yaqun; Song, Wei; Mu, Fengyun

    2017-12-01

    The cropland ecosystem provides essential direct and indirect products and services to mankind such as food, fiber, biodiversity and soil conservation. A change of crop planting structure can change the ecosystem services of cropland by affecting land use type. In recent years, under the influence of regional comparative advantage and consumer demand changes, the crop planting structure in China has changed rapidly. However, there is still a lack of deep understanding on the effect of such a change in planting structure on the ecosystem services of cropland. Therefore, this research selected Minle County in the Heihe River Basin, which has small scattered croplands and a complex planting structure, as a study area. Based on the key time phase and optimal threshold of the normalized difference vegetation index (NDVI) data of the Thematic Mapper and Enhanced Thematic Mapper Plus (TM/ETM+) images, this study used the decision tree algorithm to classify and extract the crop planting structure in Minle County in 2007 and 2012 and to analyze the changes in its temporal and spatial patterns. Then, the market value method was adopted to estimate the effect of the change in crop planting structure on the ecosystem services of the cropland. From 2007 to 2012, the planting area of corn and rapeseed in Minle County increased by 5.86 × 103 ha and 5.10 × 103 ha, respectively. Conversely, the planting area of wheat and barley was reduced by 3.26 × 103 ha and 6.34 × 103 ha, respectively. These changes directly caused the increase of the ecosystem services value of corn and rapeseed by 1062.82 × 104 USD and 842.54 × 104 USD, respectively. The resulting reduction in the ecosystem services value of wheat and barley was 488.24 × 104 USD and 828.29 × 104 USD, respectively. Besides, the total ecosystem services value of cropland increased by 1564.98 × 104 USD. Further analysis found that the change in the crop planting structure caused an increase in the ecosystem services

  19. The association of personal importance of religion and religious service attendance with suicidal ideation by age group in the National Survey on Drug Use and Health.

    Science.gov (United States)

    Nishi, Daisuke; Susukida, Ryoko; Kuroda, Naoaki; Wilcox, Holly C

    2017-09-01

    Religiosity has been shown to be inversely associated with suicidal ideation, but few studies have examined associations by age group. This study aimed to examine the association between religiosity with suicidal ideation by age group. This study used a large nationally representative sample of 260,816 study participants from the National Survey on Drug Use and Health. Religiosity was defined as self-reported importance of religious beliefs and frequency of religious service attendance. The association between religiosity and suicidal ideation was assessed by multivariable logistic regression analysis stratified by age group (18-25, 26-34, 35-49, 50-64, 65 or older). The importance of religious beliefs was inversely associated with suicidal ideation in all age groups. The association was the strongest in people aged 65 or older, followed by people aged 18-25. Religious service attendance was also inversely associated with suicidal ideation in people aged 65 or more when attendance was more than 25 times per year. These findings may be helpful to understand age in relation to the relationship between religiosity and suicidal ideation. Particular attention to religiosity among older adults as a protective factor for suicidal ideation may be helpful in clinical settings. Copyright © 2017. Published by Elsevier B.V.

  20. Behavior change techniques used in group-based behavioral support by the English stop-smoking services and preliminary assessment of association with short-term quit outcomes.

    Science.gov (United States)

    West, Robert; Evans, Adam; Michie, Susan

    2011-12-01

    To develop a reliable coding scheme for components of group-based behavioral support for smoking cessation, to establish the frequency of inclusion in English Stop-Smoking Service (SSS) treatment manuals of specific components, and to investigate the associations between inclusion of behavior change techniques (BCTs) and service success rates. A taxonomy of BCTs specific to group-based behavioral support was developed and reliability of use assessed. All English SSSs (n = 145) were contacted to request their group-support treatment manuals. BCTs included in the manuals were identified using this taxonomy. Associations between inclusion of specific BCTs and short-term (4-week) self-reported quit outcomes were assessed. Fourteen group-support BCTs were identified with >90% agreement between coders. One hundred and seven services responded to the request for group-support manuals of which 30 had suitable documents. On average, 7 BCTs were included in each manual. Two were positively associated with 4-week quit rates: "communicate group member identities" and a "betting game" (a financial deposit that is lost if a stop-smoking "buddy" relapses). It is possible to reliably code group-specific BCTs for smoking cessation. Fourteen such techniques are present in guideline documents of which 2 appear to be associated with higher short-term self-reported quit rates when included in treatment manuals of English SSSs.

  1. Residents examine factors associated with 30-day, same-cause hospital readmissions on an internal medicine service.

    Science.gov (United States)

    Moran, Jennifer; Colbert, Colleen Y; Song, Juhee; Hull, Joshua; Rajan, Sabitha; Varghees, Sunita; Arroliga, Alejandro C; Reddy, Santosh P

    2013-01-01

    In recent years, there has been increased interest in stemming the tide of hospital readmissions in an attempt to improve quality of care. This study presents the Phase I results of a resident-led quality improvement initiative to determine the percentage of and risk factors for same-cause readmissions (SCRs; defined as hospital readmission within 30 days of hospital discharge for treatment of the same condition) to the internal medicine service of a multispecialty teaching hospital in central Texas. Results indicate that patients diagnosed with chronic obstructive pulmonary disease/asthma or anemia may be at increased risk for SCRs. Those patients who are insured by Medicaid and those who require assistance from social services also demonstrated an increased risk for SCRs. This study appears to be the first resident-led initiative in the field to examine 30-day SCRs to an internal medicine service for demographic and clinical risk factors.

  2. Association between pain severity, depression severity, and use of health care services in Japan: results of a nationwide survey

    Directory of Open Access Journals (Sweden)

    Vietri J

    2015-03-01

    Full Text Available Jeffrey Vietri,1 Tempei Otsubo,2 William Montgomery,3 Toshinaga Tsuji,4 Eiji Harada5 1Health Outcomes Practice, Kantar Health, Milan, Italy; 2Tokyo Shinjuku Medical Center, Tokyo, Japan; 3Eli Lilly Australia Pty Ltd., West Ryde, Australia; 4Medical Affairs, Shionogi & Co., Ltd., Osaka, Japan; 5Eli Lilly Japan KK, Kobe, Japan Background: Depression is often associated with painful physical symptoms. Previous research has seldom assessed the relationship between the severity of physical symptoms and the severity of mental and emotional symptoms of depression or other health outcomes, and no such studies have been conducted previously among individuals with depression in Japan. The aim of this study was to assess the relationship between the severity of physical pain and depression and other outcomes among individuals in Japan diagnosed with depression.Methods: Data for individuals aged 18 and older in Japan who reported being diagnosed with depression and also reported physical pain were obtained from the Japan National Health and Wellness Survey. These respondents were characterized on sociodemographics and health characteristics, and the relationship between ratings of severity on pain in the last week and health outcomes were assessed using bivariate correlations and generalized linear models. Measures included the Patient Health Questionnaire for depression severity, Medical Outcomes Study 12-Item Short Form Survey Instrument for health-related quality of life, the Work Productivity and Activity Impairment for work and activity impairment, and 6-month report of health care use.Results: More severe physical pain in the past week was correlated with more severe depression, worse health-related quality of life, lower health utility, greater impairment at work, and more health care provider visits. These relationships remained significant after incorporating sociodemographics and health characteristics in the statistical models

  3. Organizing to Coordinate Child Care Services. (With an Appendix) The Greater Minneapolis Day Care Association: Early History.

    Science.gov (United States)

    Ratliff, Patricia; Berryman, Pauline

    Systems of coordinating child care services are analyzed as a guide to organizing. Federal Community Child Care (4-C) are the focus of the analysis. In Part I, evolution of coordination, an initial steering committee is followed through its various phases of expansion--initial impetus, visibility, staffing patterns, parent involvement, community…

  4. Changes in Children's Behavior and Costs for Service Use Associated with Parents' Response to Treatment for Dysthymia

    Science.gov (United States)

    Byrne, Carolyn; Browne, Gina; Roberts, Jacqueline; Mills, Michael; Bell, Barbara; Gafni, Amiram; Jamieson, Ellen; Webb, Michelle

    2006-01-01

    Objective: This study examined differences in children's behavior and expenditures for health and social services used when their parents with dysthymia did or did not respond to antidepressant therapy. Method: Children ages 4 to 16 years of consenting parents enrolled in a treatment trial for dysthymia who did and did not respond to treatment…

  5. Are HPV vaccination services accessible to high-risk communities? A spatial analysis of HPV-associated cancer and Chlamydia rates and safety-net clinics.

    Science.gov (United States)

    Tsui, Jennifer; Rodriguez, Hector P; Gee, Gilbert C; Escobedo, Loraine A; Kominski, Gerald F; Bastani, Roshan

    2013-12-01

    While HPV vaccines can greatly benefit adolescents and young women from high-risk areas, little is known about whether safety-net immunization services are geographically accessible to communities at greatest risk for HPV-associated diseases. We explore the spatial relationship between areas with high HPV risk and proximity to safety-net clinics from an ecologic perspective. We used cancer registry data and Chlamydia surveillance data to identify neighborhoods within Los Angeles County with high risk for HPV-associated cancers. We examined proximity to safety-net clinics among neighborhoods with the highest risk. Proximity was measured as the shortest distance between each neighborhood center and the nearest clinic and having a clinic within 3 miles of each neighborhood center. The average 5-year non-age-adjusted rates were 1,940 cases per 100,000 for Chlamydia and 60 per 100,000 for HPV-associated cancers. A large majority, 349 of 386 neighborhoods with high HPV-associated cancer rates and 532 of 537 neighborhoods with high Chlamydia rates, had a clinic within 3 miles of the neighborhood center. Clinics were more likely to be located within close proximity to high-risk neighborhoods in the inner city. High-risk neighborhoods outside of this urban core area were less likely to be near accessible clinics. The majority of high-risk neighborhoods were geographically near safety-net clinics with HPV vaccination services. Due to low rates of vaccination, these findings suggest that while services are geographically accessible, additional efforts are needed to improve uptake. Programs aimed to increase awareness about the vaccine and to link underserved groups to vaccination services are warranted.

  6. Characteristics of service users and provider organisations associated with experience of out of hours general practitioner care in England: population based cross sectional postal questionnaire survey

    OpenAIRE

    Warren, Fiona C; Abel, Gary; Lyratzopoulos, Georgios; Elliott, Marc N; Richards, Suzanne; Barry, Heather E; Roland, Martin; Campbell, John L

    2015-01-01

    Objective: To investigate the experience of users of out of hours general practitioner services in England, UK. Design: Population based cross sectional postal questionnaire survey. Setting: General Practice Patient Survey 2012-13. Main outcome measures: Potential associations between sociodemographic factors (including ethnicity and ability to take time away from work during working hours to attend a healthcare consultation) and provider organisation type (not for profit, NHS, or commercial)...

  7. Ecosystem services provided by bats.

    Science.gov (United States)

    Kunz, Thomas H; Braun de Torrez, Elizabeth; Bauer, Dana; Lobova, Tatyana; Fleming, Theodore H

    2011-03-01

    Ecosystem services are the benefits obtained from the environment that increase human well-being. Economic valuation is conducted by measuring the human welfare gains or losses that result from changes in the provision of ecosystem services. Bats have long been postulated to play important roles in arthropod suppression, seed dispersal, and pollination; however, only recently have these ecosystem services begun to be thoroughly evaluated. Here, we review the available literature on the ecological and economic impact of ecosystem services provided by bats. We describe dietary preferences, foraging behaviors, adaptations, and phylogenetic histories of insectivorous, frugivorous, and nectarivorous bats worldwide in the context of their respective ecosystem services. For each trophic ensemble, we discuss the consequences of these ecological interactions on both natural and agricultural systems. Throughout this review, we highlight the research needed to fully determine the ecosystem services in question. Finally, we provide a comprehensive overview of economic valuation of ecosystem services. Unfortunately, few studies estimating the economic value of ecosystem services provided by bats have been conducted to date; however, we outline a framework that could be used in future studies to more fully address this question. Consumptive goods provided by bats, such as food and guano, are often exchanged in markets where the market price indicates an economic value. Nonmarket valuation methods can be used to estimate the economic value of nonconsumptive services, including inputs to agricultural production and recreational activities. Information on the ecological and economic value of ecosystem services provided by bats can be used to inform decisions regarding where and when to protect or restore bat populations and associated habitats, as well as to improve public perception of bats. © 2011 New York Academy of Sciences.

  8. Association between perceived social stigma against mental disorders and use of health services for psychological distress symptoms in the older adult population: validity of the STIG scale.

    Science.gov (United States)

    Préville, Michel; Mechakra Tahiri, Samia Djemaa; Vasiliadis, Helen-Maria; Quesnel, Louise; Gontijo-Guerra, Samantha; Lamoureux-Lamarche, Catherine; Berbiche, Djamal

    2015-01-01

    To document the reliability, construct and nomological validity of the perceived Social Stigmatisation (STIG) scale in the older adult population. Cross-sectional survey. Primary medical health services clinics. Probabilistic sample of older adults aged 65 years and over waiting for medical services in the general medical sector (n = 1765). Perceived social stigma against people with a mental health problem was measured using the STIG scale composed of seven indicators. A second-order measurement model of perceived social stigma fitted adequately the observed data. The reliability of the STIG scale was 0.83. According to our results, 39.6% of older adults had a significant level of perceived social stigma against people with a mental health problem. RESULTS showed that the perception of social stigma against mental health problems was not significantly associated with a respondent gender and age. RESULTS also showed that the perception of social stigma against the mental health problems was directly associated with the respondents' need for improved mental health (b = -0.10) and indirectly associated with their use of primary medical health services for psychological distress symptoms (b = -0.07). RESULTS lead us to conclude that social stigma against mental disorders perceived by older adults may limit help-seeking behaviours and warrants greater public health and public policy attention. Also, results lead us to conclude that physicians should pay greater attention to their patients' attitudes against mental disorders in order to identify possible hidden mental health problems.

  9. Online Reviews as Health Data: Examining the Association Between Availability of Health Care Services and Patient Star Ratings Exemplified by the Yelp Academic Dataset.

    Science.gov (United States)

    Tran, Nam N; Lee, Joon

    2017-07-12

    There have been public health interventions that aim to reduce barriers to health care access by extending opening hours of health care facilities. However, the impact of opening hours from the patient's perspective is not well understood. This study aims to investigate the relationship between temporal accessibility of health care services and how patients rate the providers on Yelp, an online review website that is popular in the United States. Using crowdsourced open Internet data, such as Yelp, can help circumvent the traditional survey method. From Yelp's limited academic dataset, this study examined the pattern of visits to health care providers and performed a secondary analysis to examine the association between patient rating (measured by Yelp's rating) and temporal accessibility of health care services (measured by opening hours) using ordinal logistic regression models. Other covariates included were whether an appointment was required, the type of health care service, the region of the health care service provider, the number of reviews the health care service provider received in the past, the number of nearby competitors, the mean rating of competitors, and the standard deviation of competitors' ratings. From the 2085 health care service providers identified, opening hours during certain periods, the type of health care service, and the variability of competitors' ratings showed an association with patient rating. Most of the visits to health care service providers took place between normal working hours (9 AM-5 PM) from Sunday to Thursday, and the least on Saturday. A model fitted to the entire sample showed that increasing hours during normal working hours on Monday (OR 0.926, 95% CI 0.880-0.973, P=0.03), Saturday (OR 0.897, 95% CI 0.860-0.935, P<0.001), Sunday (OR 0.904, 95% CI 0.841-0.970, P=0.005), and outside normal working hours on Friday (OR 0.872, 95% CI 0.760-0.998, P=0.048) was associated with receiving lower ratings. But increasing hours

  10. Cost of treating ventilator-associated pneumonia post cardiac surgery in the National Health Service: Results from a propensity-matched cohort study.

    Science.gov (United States)

    Luckraz, Heyman; Manga, Na'ngono; Senanayake, Eshan L; Abdelaziz, Mahmoud; Gopal, Shameer; Charman, Susan C; Giri, Ramesh; Oppong, Raymond; Andronis, Lazaros

    2018-05-01

    Ventilator-associated pneumonia is associated with significant morbidity, mortality and healthcare costs. Most of the cost data that are available relate to general intensive care patients in privately remunerated institutions. This study assessed the cost of managing ventilator-associated pneumonia in a cardiac intensive care unit in the National Health Service in the United Kingdom. Propensity-matched study of prospectively collected data from the cardiac surgical database between April 2011 and December 2014 in all patients undergoing cardiac surgery (n = 3416). Patients who were diagnosed as developing ventilator-associated pneumonia, as per the surveillance definition for ventilator-associated pneumonia (n = 338), were propensity score matched with those who did not (n = 338). Costs of treating post-op cardiac surgery patients in intensive care and cost difference if ventilator-associated pneumonia occurred based on Healthcare Resource Group categories were assessed. Secondary outcomes included differences in morbidity, mortality and cardiac intensive care unit and in-hospital length of stay. There were no significant differences in the pre-operative characteristics or procedures between the groups. Ventilator-associated pneumonia developed in 10% of post-cardiac surgery patients. Post-operatively, the ventilator-associated pneumonia group required longer ventilation (p < 0.01), more respiratory support, longer cardiac intensive care unit (8 vs 3, p < 0.001) and in-hospital stay (16 vs 9) days. The overall cost for post-operative recovery after cardiac surgery for ventilator-associated pneumonia patients was £15,124 compared to £6295 for non-ventilator-associated pneumonia (p < 0.01). The additional cost of treating patients with ventilator-associated pneumonia was £8829. Ventilator-associated pneumonia was associated with significant morbidity to the patients, generating significant costs. This cost was nearer to the lower end for

  11. Multimedia applications in differential services

    International Nuclear Information System (INIS)

    Mahfooz, S.; Merabti, M.; Pereira, R.

    2003-01-01

    In this paper we present a mechanism to provide Quality of Service (QoS) guarantees to different multimedia applications that share link bandwidth in IP-based differential services domain. In this mechanism weights are associated with each and to individual users according to their priorities. In order to evaluate the performance of our scheme we conducted simulations. The test data used portray different multimedia applications i.e. MPEG-2, IP telephony. The simulation results obtained show the effectiveness of our scheme for multimedia applications by allocating link share to each multimedia application and minimising end-to-end transmission delay 9Y bringing them in line with the recommended standard acceptable transmission delay for multimedia applications. This paper also presents extension to our proposed Relative Bandwidth Sharing (RES) scheme for differential services. We have identified and highlighted the role of border routers and core routers in differential services domain. Exploring features of Internet Protocol IPv6 in our architecture. (author)

  12. Association between the perspective of adult inpatients with digestive cancer regarding the nursing service and their quality of recovery on postoperative day 3.

    Science.gov (United States)

    Sasaki, Kumiko; Tamakoshi, Koji

    2018-02-01

    Although qualitative research that focuses on inpatients' experience immediately after surgery has continued to elucidate the efficacy of the nursing service for postoperative recovery, there has been little quantitative research. Our aim was to quantitatively clarify the association between inpatients' perception of the nursing service and the quality of postoperative recovery. Seventy-one digestive cancer patients who underwent surgery were recruited. Participants completed two self-administered questionnaires, including the Japanese version of the 40-item postoperative Quality of Recovery scale (QoR-40J) and the Nursing Service Quality Scale for Japan (NURSERV-J) which has 22 items and five dimensions (tangibles, reliability, responsiveness, assurance, and empathy) on postoperative day 3. There were significant positive associations between the global scores of the NURSERV-J and the QoR-40J. The global score of the QoR-40J was compared between patients who gave full marks for each dimension of the NURSERV-J (the entirely satisfied group) and those who did not (the not entirely satisfied group). The entirely satisfied groups regarding tangibles, reliability and responsiveness had a significantly higher global score for the QoR-40J than the respective not entirely satisfied groups. Adjusted for age, gender, operative procedure, and duration of surgery, the entirely satisfied groups regarding tangibles and responsiveness had a significant higher global score for the QoR-40J than the respective not entirely satisfied groups. Patients who perceived that they had received a nursing service of high quality were likely to attain a high quality of postoperative recovery. Nursing services related to tangibles, reliability, and responsiveness especially contributed to postoperative recovery.

  13. Perinatal and psychosocial circumstances associated with risk of attempted suicide, non-suicidal self-injury and psychiatric service use. A longitudinal study of young people.

    LENUS (Irish Health Repository)

    Young, Robert

    2011-11-18

    Abstract Background Past studies using large population based datasets link certain perinatal circumstances (birth weight, parity, etc) with mental health outcomes such as suicide, self-harm and psychiatric problems. Problematically, population datasets omit a number of social confounds. The aim of this study is to replicate past research linking perinatal circumstances and mental health (suicidality and use of psychiatric services) and to determine if such associations remain after adjusting for social circumstances. Methods A longitudinal school-based survey of 2157 young people (surveyed at age 11, 13, 15) followed up in early adulthood (age 19). At age 11 parents of participants provided information about perinatal circumstances (birth weight, birth complications, etc.) and psychiatric service use. Participants provided data about their mental health at age 15 (attempted suicide, suicidal thoughts) and at ages 19 (self-harm, psychiatric service use). In addition, data were collected about their social and psychosocial circumstances (gender, deprivation, religion, sexual behaviour, etc.). Results Predictably, social factors were linked to mental health outcomes. For example, those with same sex partners were more likely (OR 4.84) to self-harm than those without a same sex partner. With a single exception, in both unadjusted and adjusted models, perinatal circumstances were not or only marginally associated with mental health outcomes. The exception was the number of birth complications; young people with two or more complications were approximately 2-3 times more likely than those without complications to use psychiatric services. Conclusions While we failed to replicate results found using large population based datasets, some of our results are compatible with prior research findings. Further, evidence from this study supports the influence of perinatal circumstances (birth complications) on later psychiatric problems, or at least higher than expected contact

  14. Multidimensional Heat Conduction

    DEFF Research Database (Denmark)

    Rode, Carsten

    1998-01-01

    Analytical theory of multidimensional heat conduction. General heat conduction equation in three dimensions. Steay state, analytical solutions. The Laplace equation. Method of separation of variables. Principle of superposition. Shape factors. Transient, multidimensional heat conduction....

  15. Psychotic relapse and associated factors among patients attending health services in Southwest Ethiopia: a cross-sectional study.

    Science.gov (United States)

    Fikreyesus, Mahlet; Soboka, Matiwos; Feyissa, Garumma Tolu

    2016-10-20

    Psychotic relapse leads to repeated hospitalization and negatively affects the clinical prognosis of the patients. Information on prevalence of relapse among patients with psychotic disorders in Ethiopian setting is scarce. This study aimed to assess the prevalence of relapse among patients with psychotic disorders attending services in Jimma University Specialized Hospital (JUSH). Data were collected using interviewer administered questionnaire. We used medication adherence rating scale (MARS) to assess compliance to medication and abnormal involuntary movement scale (AIMS) to detect medication side effects. Logistic regression analysis was used to identify independent predictors of psychotic relapse. All variables with P-value value higher when compared to those who have never experienced medication side effects (aOR = 1.83, 95 % CI = 1.01, 3.31). The high prevalence of relapse among patients with psychotic disorder needs special attention. Clinicians need to pay attention to medication side effects the patient faces. Intervening noncompliance to medication and appropriately managing medication side effects may help in preventing psychotic relapse that may result because of non-compliance. The provision of counseling, psycho education, psycho social support may help patients in improving compliance to medication and reducing psychotic relapse. Developing and strengthening community based rehabilitation services should be emphasized as part of mental healthcare services.

  16. The Association Between Home Palliative Care Services and Quality of End-of-Life Care Indicators in the Province of Québec.

    Science.gov (United States)

    Gagnon, Bruno; Nadeau, Lyne; Scott, Susan; Dumont, Serge; MacDonald, Neil; Aubin, Michèle; Mayo, Nancy

    2015-07-01

    In Canada, governments have increased spending on home care to promote better end-of-life care. In the province of Québec, Canada, home palliative care (PC) services (HPCS) are provided by Public Local Community-Based Health Care Service providers (Centres Locaux de Services Communautaires [CLSC]) with universal coverage. Accordingly, there should be no regional variations of these services and their effect on quality of end-of-life PC (QEoLPC) indicators. To test if all the CLSCs provided the same level of HPCS to cancer patients in the province of Québec, Canada, and the association between level of HPCS and QEoLPC indicators. Characteristics of 52,316 decedents with cancer were extracted from administrative databases between 2003 and 2006. Two gender-specific "adjusted performance of CLSCs in delivering HPCS" models were created using gender-specific hierarchical regression adjusted for patient and CLSC neighborhood characteristics. Using the same approach, the strength of the association between the adjusted performance of CLSCs in delivering HPCS and the QEoLPC indicators was estimated. Overall, 27,255 (52.1%) decedents had at least one HPCS. Significant variations in the adjusted performance of CLSC in delivering HPCS were found. Higher performance led to a lower proportion of men having more than one emergency room visit during the last month of life (risk ratio [RR] 0.924; 95% CI 0.867-0.985), and for women, a higher proportion dying at home (RR 2.255; 95% CI 1.703-2.984) and spending less time in hospital (RR 0.765; 95% CI 0.692-0.845). Provision of HPCS remained limited in Québec, but when present, they were associated with improved QEoLPC indicators. Copyright © 2015 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  17. Uncovering ecosystem service bundles through social preferences.

    Directory of Open Access Journals (Sweden)

    Berta Martín-López

    Full Text Available Ecosystem service assessments have increasingly been used to support environmental management policies, mainly based on biophysical and economic indicators. However, few studies have coped with the social-cultural dimension of ecosystem services, despite being considered a research priority. We examined how ecosystem service bundles and trade-offs emerge from diverging social preferences toward ecosystem services delivered by various types of ecosystems in Spain. We conducted 3,379 direct face-to-face questionnaires in eight different case study sites from 2007 to 2011. Overall, 90.5% of the sampled population recognized the ecosystem's capacity to deliver services. Formal studies, environmental behavior, and gender variables influenced the probability of people recognizing the ecosystem's capacity to provide services. The ecosystem services most frequently perceived by people were regulating services; of those, air purification held the greatest importance. However, statistical analysis showed that socio-cultural factors and the conservation management strategy of ecosystems (i.e., National Park, Natural Park, or a non-protected area have an effect on social preferences toward ecosystem services. Ecosystem service trade-offs and bundles were identified by analyzing social preferences through multivariate analysis (redundancy analysis and hierarchical cluster analysis. We found a clear trade-off among provisioning services (and recreational hunting versus regulating services and almost all cultural services. We identified three ecosystem service bundles associated with the conservation management strategy and the rural-urban gradient. We conclude that socio-cultural preferences toward ecosystem services can serve as a tool to identify relevant services for people, the factors underlying these social preferences, and emerging ecosystem service bundles and trade-offs.

  18. Uncovering Ecosystem Service Bundles through Social Preferences

    Science.gov (United States)

    Martín-López, Berta; Iniesta-Arandia, Irene; García-Llorente, Marina; Palomo, Ignacio; Casado-Arzuaga, Izaskun; Amo, David García Del; Gómez-Baggethun, Erik; Oteros-Rozas, Elisa; Palacios-Agundez, Igone; Willaarts, Bárbara; González, José A.; Santos-Martín, Fernando; Onaindia, Miren; López-Santiago, Cesar; Montes, Carlos

    2012-01-01

    Ecosystem service assessments have increasingly been used to support environmental management policies, mainly based on biophysical and economic indicators. However, few studies have coped with the social-cultural dimension of ecosystem services, despite being considered a research priority. We examined how ecosystem service bundles and trade-offs emerge from diverging social preferences toward ecosystem services delivered by various types of ecosystems in Spain. We conducted 3,379 direct face-to-face questionnaires in eight different case study sites from 2007 to 2011. Overall, 90.5% of the sampled population recognized the ecosystem’s capacity to deliver services. Formal studies, environmental behavior, and gender variables influenced the probability of people recognizing the ecosystem’s capacity to provide services. The ecosystem services most frequently perceived by people were regulating services; of those, air purification held the greatest importance. However, statistical analysis showed that socio-cultural factors and the conservation management strategy of ecosystems (i.e., National Park, Natural Park, or a non-protected area) have an effect on social preferences toward ecosystem services. Ecosystem service trade-offs and bundles were identified by analyzing social preferences through multivariate analysis (redundancy analysis and hierarchical cluster analysis). We found a clear trade-off among provisioning services (and recreational hunting) versus regulating services and almost all cultural services. We identified three ecosystem service bundles associated with the conservation management strategy and the rural-urban gradient. We conclude that socio-cultural preferences toward ecosystem services can serve as a tool to identify relevant services for people, the factors underlying these social preferences, and emerging ecosystem service bundles and trade-offs. PMID:22720006

  19. Family Caregivers of Adults with Intellectual and Developmental Disabilities: Outcomes Associated with U.S. Services and Supports

    Science.gov (United States)

    Williamson, Heather J.; Perkins, Elizabeth A.

    2014-01-01

    Individuals with intellectual and developmental disabilities (IDD) in the U.S. predominantly live with their family caregivers. As care delivery and support systems vary widely globally, consideration of caregiver outcomes specifically in the U.S. context is needed. A systematic literature review was conducted to identify U.S. family caregiver…

  20. Inner Ear Conductive Hearing Loss and Unilateral Pulsatile Tinnitus Associated with a Dural Arteriovenous Fistula: Case Based Review and Analysis of Relationship between Intracranial Vascular Abnormalities and Inner Ear Fluids

    Directory of Open Access Journals (Sweden)

    Ettore Cassandro

    2015-01-01

    Full Text Available While pulsatile tinnitus (PT and dural arteriovenous fistula (DAVF are not rarely associated, the finding of a conductive hearing loss (CHL in this clinical picture is unusual. Starting from a case of CHL and PT, diagnosed to be due to a DAVF, we analyzed relationship between intracranial vascular abnormalities and inner ear fluids. DAVF was treated with endovascular embolization. Following this, there was a dramatic recovery of PT and of CHL, confirming their cause-effect link with DAVF. We critically evaluated the papers reporting this association. This is the first case of CHL associated with PT and DAVF. We describe the most significant experiences and theories reported in literature, with a personal analysis about the possible relationship between vascular intracranial system and labyrinthine fluids. In conclusion, we believe that this association may be a challenge for otolaryngologists. So we suggest to consider the possibility of a DAVF or other AVMs when PT is associated with CHL, without alterations of tympanic membrane and middle ear tests.

  1. 7 CFR 97.157 - Professional conduct.

    Science.gov (United States)

    2010-01-01

    ... Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE (CONTINUED) COMMODITY LABORATORY TESTING PROGRAMS... appearing before the Office shall conform to the standards of ethical and professional conduct, generally...

  2. NOAA NOS SOS, EXPERIMENTAL, 1902-present, Conductivity

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The NOAA NOS SOS server is part of the IOOS DIF SOS Project. The stations in this dataset have conductivity data. *These services are for testing and evaluation use...

  3. The sensitivity of the electron transport within bulk zinc-blende gallium nitride to variations in the crystal temperature, the doping concentration, and the non-parabolicity coefficient associated with the lowest energy conduction band valley

    Energy Technology Data Exchange (ETDEWEB)

    Siddiqua, Poppy; O' Leary, Stephen K., E-mail: stephen.oleary@ubc.ca [School of Engineering, The University of British Columbia, 3333 University Way, Kelowna, British Columbia V1V 1V7 (Canada)

    2016-09-07

    Within the framework of a semi-classical three-valley Monte Carlo simulation approach, we analyze the steady-state and transient electron transport that occurs within bulk zinc-blende gallium nitride. In particular, we examine how the steady-state and transient electron transport that occurs within this material changes in response to variations in the crystal temperature, the doping concentration, and the non-parabolicity coefficient associated with the lowest energy conduction band valley. These results are then contrasted with those corresponding to a number of other compound semiconductors of interest.

  4. Conducting compositions of matter

    Science.gov (United States)

    Viswanathan, Tito (Inventor)

    2000-01-01

    The invention provides conductive compositions of matter, as well as methods for the preparation of the conductive compositions of matter, solutions comprising the conductive compositions of matter, and methods of preparing fibers or fabrics having improved anti-static properties employing the conductive compositions of matter.

  5. CSAIO – a progressive tool at the service of staff associations of international organizations and European agencies

    CERN Multimedia

    Staff Association

    2016-01-01

    Every year in autumn, a two-day CSAIO (Conference of Staff Associations of International Organizations) conference is organized for staff associations of international organizations based mainly in Europe, as well as European agencies. Creation, objectives and progress CSAIO, created by the staff associations of CERN and OECD in 2000, invites about 30 staff associations to share their experiences and ideas to better identify the expectations and aspirations of a personnel evolving at the heart of international and European organizations. Over time, the preparation of the conference has evolved to better accommodate the requests of the staff representatives coming from different horizons. For two years, there has been an initiative to institutionalize the informal follow-up, during the first half-day of the conference, of themes discussed the previous year. This follow-up allows participants to share their experience on the implementation and impacts of certain propositions as reflected in their organizations ...

  6. Protective associations of importance of religion and frequency of service attendance with depression risk, suicidal behaviours and substance use in adolescents in Nova Scotia, Canada.

    Science.gov (United States)

    Rasic, Daniel; Kisely, Steve; Langille, Donald B

    2011-08-01

    We examined relationships of measures of personal importance of religion and frequency of attendance at religious services with risk of depression and risk behaviours in high school students in Cape Breton, Canada. We examined the impact of confounding and explanatory factors on these relationships. Data were drawn from self-report surveys of adolescents aged 15-19 (N=1615) at three high schools in May, 2006. We used logistic regression to assess associations of religious importance and religious service attendance with risk of depression, suicidal behaviour, binge drinking and frequent marijuana use, controlling in multivariate models for sociodemographic factors, family structure and social capital. Among females, higher personal importance of religion was associated with decreased odds of depression, suicidal ideation, drinking and marijuana use, while more religious attendance was protective for substance use behaviours and suicidal ideation. In males, both measures of religiosity were associated with decreased substance use. In multivariate models, religious importance had weak protective effects for depression and suicidal thinking in females, which were respectively modified by social trust and substance use. Attendance was protective for suicidal thinking in females, and was modified by depression. These associations were not seen in males. Attendance was consistently associated with less substance use in females, while importance was not. Importance was consistently protective for marijuana use and attendance was protective for binge drinking in males. This was a cross-sectional self-report survey and causality cannot be inferred. Protective associations of measures of religiosity are seen in Canadian adolescents, as they are elsewhere. Copyright © 2011 Elsevier B.V. All rights reserved.

  7. Association of Fast-Food and Full-Service Restaurant Densities With Mortality From Cardiovascular Disease and Stroke, and the Prevalence of Diabetes Mellitus.

    Science.gov (United States)

    Mazidi, Mohsen; Speakman, John R

    2018-05-25

    We explored whether higher densities of fast-food restaurants (FFRs) and full-service restaurants are associated with mortality from cardiovascular disease (CVD) and stroke and the prevalence of type 2 diabetes mellitus (T2D) across the mainland United States. In this cross-sectional study county-level data for CVD and stroke mortality, and prevalence of T2D, were combined with per capita densities of FFRs and full-service restaurants and analyzed using regression. Mortality and diabetes mellitus prevalence were corrected for poverty, ethnicity, education, physical inactivity, and smoking. After adjustment, FFR density was positively associated with CVD (β=1.104, R 2 =2.3%), stroke (β=0.841, R 2 =1.4%), and T2D (β=0.578, R 2 =0.6%) and full-service restaurant density was positively associated with CVD mortality (β=0.19, R 2 =0.1%) and negatively related to T2D prevalence (β=-0.25, R 2 =0.3%). In a multiple regression analysis (FFRs and full-service restaurants together in same model), only the densities of FFRs were significant (and positive). If we assume these relationships are causal, an impact analysis suggested that opening 10 new FFRs in a county would lead to 1 extra death from CVD every 42 years and 1 extra death from stroke every 55 years. Repeated nationally across all counties, that would be an extra 748 CVD deaths and 567 stroke deaths (and 390 new cases of T2D) over the next 10 years. These results suggest that an increased density of FFRs is associated with increased risk of death from CVD and stroke and increased T2D prevalence, but the maximal impact (assuming the correlations reflect causality) of each individual FFR is small. URL: http://www.clinicaltrials.gov. Unique identifier: NCT03243253. © 2018 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

  8. Implementing a multifaceted intervention to decrease central line-associated bloodstream infections in SEHA (Abu Dhabi Health Services Company) intensive care units: the Abu Dhabi experience.

    Science.gov (United States)

    Latif, Asad; Kelly, Bernadette; Edrees, Hanan; Kent, Paula S; Weaver, Sallie J; Jovanovic, Branislava; Attallah, Hadeel; de Grouchy, Kristin K; Al-Obaidli, Ali; Goeschel, Christine A; Berenholtz, Sean M

    2015-07-01

    OBJECTIVE To determine whether implementation of a multifaceted intervention would significantly reduce the incidence of central line-associated bloodstream infections. DESIGN Prospective cohort collaborative. SETTING AND PARTICIPANTS Intensive care units of the Abu Dhabi Health Services Company hospitals in the Emirate of Abu Dhabi. INTERVENTIONS A bundled intervention consisting of 3 components was implemented as part of the program. It consisted of a multifaceted approach that targeted clinician use of evidence-based infection prevention recommendations, tools that supported the identification of local barriers to these practices, and implementation ideas to help ensure patients received the practices. Comprehensive unit-based safety teams were created to improve safety culture and teamwork. Finally, the measurement and feedback of monthly infection rate data to safety teams, senior leaders, and staff in participating intensive care units was encouraged. The main outcome measure was the quarterly rate of central line-