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Sample records for tertiary level public

  1. Clinical skills required of ophthalmic nurse practitioners in tertiary level public hospitals in the Western Cape Province

    Directory of Open Access Journals (Sweden)

    U. Kyriacos

    2009-09-01

    Full Text Available Background: South Africa has a 32-year history of training ophthalmic nurse practitioners (ONPs. The role and required skills and competencies of ONPs are not well documented in the international literature and are also absent from South African publications, including South African Nursing Council publications. Aim: This study aims to inform curriculum development and human resource planning by reporting on the clinical skills expected of ONPs by members of multidisciplinary ophthalmology teams. Method: A limited survey was undertaken in the ophthalmology wards and outpatient departments of three tertiary level hospitals in the Western Cape Province. A researcher-designed structured self-completion questionnaire was distributed to 30 ophthalmology practitioners: doctors, nurses and technicians. Respondents were asked to indicate the expected clinical skills of ONPs. Findings: All questionnaires were completed. All respondents favoured ONPs taking histories and performing emergency eye irrigations. There was less support for more complex procedures, such as B-scans. One-third of respondents did not expect ONPs to have skills in eight key areas, including examination of the anterior chamber angle for glaucoma. No statistically significant differences were found between responses of doctors and nurses, with one exception: more nurses (15/18 than doctors (4/10 had confidence in the ONP undertaking basic eye examinations for ocular motility (Fisher‘s exact test, P = 0 .035. Conclusion: In the study settings, ONPs are not using their specialist skills to the full. Not all practitioners were receptive to ONPs using the skills that they had acquired during their postgraduate diploma, threatening the educational effectiveness of this initiative.

  2. Anthropometric Indicators in Children Referred to a Tertiary-level Public Health Care Institution from Buenos Aires, Argentina

    International Nuclear Information System (INIS)

    Janjetic, Mariana Andrea; Mantero, Paula; Zubillaga, Marcela Beatriz; Boccio, José; Goldman, Cinthia

    2014-01-01

    Full text: Introduction: Stunting is a multifactorial phenomenon with a high prevalence in developing countries. Helicobacter pylori, a bacterium that colonizes the gastric mucosa, has been related to growth impairment due to micronutrient malabsorption. However this hypothesis remains controversial. Objective: The aim of our work was to determine anthropometric indicators in children referred to a Tertiary-level Public Health Care Institution from Buenos Aires, Argentina, for upper gastrointestinal symptoms evaluation. Methods: 525 children (4-16 y) assisting to the Gastroenterology Unit of the Hospital de Niños “Sor María Ludovica”, La Plata, Argentina, were diagnosed for H. pylori infection by the 13C-Urea Breath Test. Weight and height were measured for calculation of anthropometric indicators height for age (HAZ), weight for age (WAZ) and Body Mass Index for age (BMI) using the Anthro Plus 2007 software of the World Health Organization. Statistical analysis was performed by Student’s t Test, Mann-Whitney Test and lineal regression. Results: Prevalence of H. pylori infection was 25.1% (95% CI, 21.5-29.5), with a mean age of the children similar in both groups, 10.1y (95% CI, 9.8-10.3y). Mean HAZ and WAZ were -0.40 (95% CI, -0.57-[-0.22]) and -0.31 (95% CI, -0.51-[-0.11]) in the positive group, and -0.18 (95% CI, -0.28-[-0.09]) and -0.10 (95% CI, -0.21-0.01) in the negative group. HAZ was significantly lower in the positive group (p = 0.04), while no significant differences were found for WAZ (p = 0.07) and BMI for age (p = 0.20) between both groups. However, after adjusting for confounding factors these differences were no longer significant. Stunting was found in 4.5% (95% CI, 2.1-9.6) and 3.3% (95% CI, 1.9-5.6) of the H. pylori positive and negative children respectively, while underweight was observed in 5.3% (95% CI, 2.6-10.5) and 6.7% (95% CI, 4.6-9.6) of the above mentioned groups. Conclusions: Prevalence of stunting and underweight were low in

  3. Assessment of safety levels in operation rooms at two major tertiary care public hospitals of Karachi. Safe surgery saves life

    International Nuclear Information System (INIS)

    Minhas, M.S.; Muzzammil, M.; Effendi, J.

    2017-01-01

    The objectives of this study are to determine the knowledge and attitude towards surgical safety among the health care professionals including surgeons, anaesthetist, hospital administrators, and operation room personnel and raise awareness towards the importance of safe surgery. Method: A pilot cross- sectional study of 543 healthcare providers working in the operating rooms and the surgical intensive care units was conducted in two tertiary care hospitals, within a study period of one month. A structured questionnaire was constructed and an informed verbal consent was taken. The questionnaire was then distributed; data collected and analysed on SPSS 20.0. Results: A total of 543 respondents participated in the study out of which there were 375 (69%) men and 168 (31%) women. The ages ranged between 23-58 years, mean 40.5+-24.74. There were 110 (20.25%) surgeons, 58 (10.68%) anaesthetist, 132 (24.30%) trainees, 125 (23.02%) technicians, and were 118 (21.73%) nurses. The question regarding briefing operation room personnel is important for patient safety was agreed by 532 (98%) respondents. Amongst the respondents, 239 (44%) did not feel safe to be operated in their own setup. Team communication improvement through the check list implementation was agreed by 483 (89%) respondents. 514 (94.7%) opted for the checklist to be used while they are being operated. That operation room personnel frequently disregard established protocols was agreed by 374 (69%) respondents. 193 (35.54%) of the respondents stated that it is difficult for them to speak up in the or if they perceive a problem with patient care. Conclusion: Operation room personnel were not aware of several important areas related to briefing, communication, safety attitude, following standard protocols and use of WHO Surgical Safety check list. A pre-post intervention study should be conducted after formal introduction of the Checklist. Successful implementation will require taking all stake holders on board

  4. Diversification Management at Tertiary Education Level: A Review

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    Takwate, Kwaji Tizhe

    2016-01-01

    This paper examines the concept of management of diversification at tertiary education level in view of the growth of national secondary education system which vested high scramble for tertiary education was made in relation to question of access and expansion. This paper examines management of diversification at tertiary education level as a…

  5. Economics of Tertiary Education - Challenges and dynamics of the public tertiary education in Albania

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    Gledian Llatja

    2016-07-01

    Full Text Available The tertiary education is a critic mechanism for the socio-economic progress, for individuals who aspire a brighter future and it is also considered an important catalyzer of the economic mobility (Department of Treasury and Department of Education, 2012, 2. Based on the positive role and impact that the tertiary education has on the sustainable development, President Obama once stated that it is of damage to treat education as a luxurious public service. In line with the general considerations about the tertiary education in the U.S. the parallel comparison with Albania comes as a direct interpretation of utopia in the education policy-making. As policies are usually drafted based on data and findings, in the case of Albania there is a lack of data on expenses on tertiary education as share of GDP. This stands also for the main limitation of the paper.

  6. Public Healthcare Services - Component of Tertiary Economy

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    Mircea Bunaciu

    2016-05-01

    Full Text Available The field of public health care is a major social objective in all countries of the world. The public health care assistance reflects an effort organised to protect and promote the health of population, being achievable through political-legislative measures, programs and strategies addressed to the forums in the field of public health, as well as by establishing an organisational framework that would favour the provision of medical services requested by the population. The implementation of the objectives of health policy and strategy is done by the Ministry of Public Health as central authority in the field of public health, and local actions of public health are developed and implemented by the county authorities of public health. Public health authorities in the ascribed territory operate under the subordination of the public health authorities. Also, the county public health authorities coordinate locally the implementation of the activities arising from obligations assumed under the Treaty of Accession of Romania to the European Union and the plans for implementing the Community instruments relating to health.

  7. Challenges with Tertiary-Level Mechatronic Fluid Power

    DEFF Research Database (Denmark)

    Dransfield, Peter; Conrad, Finn

    1996-01-01

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

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

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    Velikj-Stefanovska Vesna

    2014-01-01

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

  9. Accountability of Tertiary Education at the National Level: A Chimera?

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    Lindsay, Alan; O'Byrne, Garry

    1979-01-01

    The concept of accountability and its application to Australian higher education are discussed. It is suggested that due to political, financial, and educational characteristics of tertiary education at the national system level there are fundamental and insoluble problems associated with achieving accountability. (SF)

  10. Effectiveness of Using Games in Tertiary-Level Mathematics Classrooms

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    Afari, Ernest; Aldridge, Jill M.; Fraser, Barry J.

    2012-01-01

    The primary focus of this study was to investigate the effectiveness of games when used in tertiary-level mathematics classes in the United Arab Emirates. Our study incorporated a mixed-method approach that involved surveys (to assess students' perceptions of the learning environment and attitudes towards mathematics), interviews, observations of…

  11. An Innovation Systems Perspectives on Tertiary-Level Agricultural ...

    African Journals Online (AJOL)

    This paper examines how tertiary-level agricultural education in sub-Saharan Africa can contribute to agricultural development beyond its current role as a source of technical training. The paper draws on data and information gathered from semistructured key informant interviews conducted in late 2006 in and around Addis ...

  12. Global trends in nuclear education at the tertiary level

    International Nuclear Information System (INIS)

    Kemeny, L.G.

    2001-01-01

    The public perception of nuclear science and engineering and the nuclear industry is today, primarily shaped by radical greens, nuclear-opponents, the media and socio-political opportunists. Only countries with a well diversified tertiary education system embracing all aspects of nuclear science and engineering can counter efficiently the pseudo-science and socio-political manipulation which has severely restricted nuclear energy development over the past three decades. National laboratories alone find this task extremely difficult, if not impossible

  13. Entrepreneurship Education at Tertiary Education Level: Implication to Historical Studies

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    Salahu Mohammed Lawal

    2012-07-01

    Full Text Available Nigeria is richly endowed with both human and material resources that when well utilized can make her one of the richest and developed nation in the world.  But poor utilization of the resources, corruption and dwindling fortune in her education system made her among the first twenty five poorest nations in the world.  Similarly, report shows that 26% of the employable population remained unemployed.  This called for the need for entrepreneurship education most especially at tertiary level where high level manpower is supposed to be trained.  It is on this premise that the paper attempts to examine entrepreneurship education and its implication to history students and graduates.

  14. Wage Inequalities: A Result of Different Levels and Fields of Tertiary Education?

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    Darjan Petek

    2017-03-01

    Full Text Available In this article we examine the impact of tertiary education on the amounts of wages in Slovenia for 2011. We use micro data from the statistical survey Structure of Earnings Statistics and micro data from the survey of graduates from tertiary education. We found out that there are significant differences in the amounts of wages as regards the level and field of education. Region and activity of the company where the person is employed also plays an important role in wage determination. Also the effects of gender and public/private sector are statistically significant. Using the average wage per hour as dependent variable gives similar results as the average annual wages.

  15. Tertiary Education and the Crisis of Public Finance

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    Milos Maryska

    2012-04-01

    Full Text Available Turbulent economic environment after overwhelming the last crisis period is typical for present days as well as permanent increasing dependability of all our activities on information and communication technology (ICT. Although the global economic crisis was the reason for disinvestment into ICT in 2009 there is expected that ICT will generate almost 5.8 million new jobs in Europe till year 2013 and they have to be saturated also by adequately qualified ICT specialists.This contribution presents the research in the progress focused on the tertiary education system in the Czech Republic. We are predicting trends in education and especially in ICT education in Europe and in the Czech Republic as well for next ten years. We can expect that future ten years period will be critical not only for the Czech tertiary education system, but also for the Czech Republic because number of ICT students will be decreasing and number of ICT specialist demanded by labor market will be increasing. From macroeconomic point of view we can expect that also state subventions into state governed tertiary education system will decrease in the whole Europe.Some recommendations, proposals and forecasts for further development of education system are presented at the end of this contribution.

  16. Job satisfaction in nurses working in tertiary level health care settings of Islamabad, Pakistan.

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    Bahalkani, Habib Akhtar; Kumar, Ramesh; Lakho, Abdul Rehman; Mahar, Benazir; Mazhar, Syeda Batool; Majeed, Abdul

    2011-01-01

    Job satisfaction greatly determines the productivity and efficiency of human resource for health. It literally means: 'the extent to which Health Professionals like or dislike their jobs'. Job satisfaction is said to be linked with employee's work environment, job responsibilities, and powers; and time pressure among various health professionals. As such it affects employee's organizational commitment and consequently the quality of health services. Objective of this study was to determine the level of job satisfaction and factors influencing it among nurses in a public sector hospital of Islamabad. A cross sectional study with self-administered structured questionnaire was conducted in the federal capital of Pakistan, Islamabad. Sample included 56 qualified nurses working in a tertiary care hospital. Overall 86% respondents were dissatisfied with about 26% highly dissatisfied with their job. The work environments, poor fringe benefits, dignity, responsibility given at workplace and time pressure were reason for dissatisfaction. Poor work environment, low salaries, lack of training opportunities, proper supervision, time pressure and financial rewards reported by the respondents. Our findings state a low level of overall satisfaction among workers in a public sector tertiary care health organization in Islamabad. Most of this dissatisfaction is caused by poor salaries, not given the due respect, poor work environment, unbalanced responsibilities with little overall control, time pressure, patient care and lack of opportunities for professional development.

  17. Improving listening skills of tertiary level students for effective ...

    African Journals Online (AJOL)

    Listening is essential to the leaming process. Students in tertiary institutions of learning need to acquire effective listening and note-taking skiils in order to benefit from lectures. This paper focused on factors militating against effective listening during lectures such as poor rate of presentation, poor communication skills, ...

  18. Perception of leadership among health managers working in tertiary level hospitals.

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    Shahzad, Saadia; Zareen, Humaira

    2012-01-01

    Rapid growth of medical knowledge has created major changes in technology which in turn has created greater demand of the client for better health services, and health sector is constantly under pressure of great internal and external demands. Quality of services, largely depend on to what extent managers are well versed with the concept of evidence based management, team and group approach in achieving organizational objectives. Making an effective health system, addressing the double burden of diseases coupled with resource crunch in developing countries is a big challenge for policy makers and health managers. Comprehensive concepts and application knowledge of leadership is very important for health managers in the present day in order to get best output that satisfies all the stake holders. Present anthropological study was done to assess the perception and knowledge of leadership among the health managers working in tertiary level hospitals. This qualitative study was conducted in two public sector tertiary level hospitals of Lahore chosen randomly out of a total of seven such hospitals in the same city. Convenient sampling technique was used. Observation and in- depth interviews were conducted for data collection. Open ended questionnaire on the lines of MLQ was used. One main domain of leadership was developed and categorisation of the themes was done in the two evolved categories of transformational and transactional leadership. In the domain of leadership 10 of the health managers showed positive themes for transactional leadership, 6 showed positive themes for transformational leadership, and still 1 health manager showed overall negative response for the concept of leadership; he was totally in favour of dictatorship. Health managers with degrees in management/administration had better concept about the key idea of leadership and its variables. Female health managers were more inclined towards transformational leadership behaviour.

  19. Why Do Staff of Joint-Use Libraries Sometimes Fail to Integrate? Investigating Cultures and Ethics in a Public-Tertiary Joint-Use Library

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    Calvert, Philip James

    2010-01-01

    Joint-use libraries have identified staff integration as a problem. Using focus groups, this project investigated the culture, professional ethics, and attitudes of staff in a public-tertiary joint-use library in Auckland, New Zealand. Findings show some difference in organizational cultures, but more variation at the lower level of roles and…

  20. Staff perception of relative importance of quality dimensions for patients at tertiary public services in oman.

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    Alrashdi, Ismail; Al Qasmi, Ahmed

    2012-09-01

    This research attempted to explore the public healthcare providers understanding the quality dimensions and patient priorities in Oman. It also addresses the issue of risks confronting health professionals in management without "a customer focused" approach. A descriptive study was carried out using a self-administered questionnaire distributed around two tertiary public hospitals. A total of 838 respondents from several specialties and levels of hierarchy participated in the study. The data was analyzed to compare the perception of two groups; the group of junior and frontline staff, as well as of managers and senior staff involved in management. The results showed that 61% of the junior and frontline staff, and 68.3% of the senior staff and managers think that cure or improvement in overall health is the single most important quality dimension in healthcare. Both groups perceive that technical dimensions have greater importance (to patients) over interpersonal aspects such as communication with the exception of dignity and respect. There was no significant difference between the perception of the managers and senior staff vis-à-vis the perception of junior and frontline staff on the importance of technical dimensions and the interpersonal aspects of service quality. Despite the proven contribution of empathy to patient satisfaction, it was ranked by both groups as the least important among the dimensions examined. The findings of this research are therefore informative of the need to implement strategies that deal effectively with such attitudes and create the platform and programs that reinforce the culture of good quality service amongst healthcare providers, managers in particular, and to improve patient satisfaction.

  1. Internships enhancing entrepreneurial intent and self-efficacy: Investigating tertiary-level entrepreneurship education programmes

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    Melodi Botha

    2016-09-01

    Full Text Available Background: Entrepreneurship education interventions are deemed effective when they enhance interns’ entrepreneurial intent (EI and entrepreneurial self-efficacy (ESE. Notwithstanding the emergence of internship as an experiential learning approach in entrepreneurship education, evidence about their potential to foster EI and ESE lacks systemisation. Aim: The aim of this study was to determine whether internships enhance EI and ESE. Furthermore, to what extent South African tertiary institutions include internships in their entrepreneurship and management curricula and the obstacles to such inclusion. Setting: South Africa has made a concerted effort to insert an entrepreneurship component across tertiary curricula. The evolution of this entrepreneurship component to experiential learning approaches is, however, unclear. Methods: A qualitative research approach was followed. Firstly, it reviewed empirical evidence for the positive relationship between internships and EI and ESE. Secondly, it conducted a survey of entrepreneurship and business management programmes at all 23 South African tertiary institutions and content analysed the retrieved information to determine whether such programmes include internships. Finally, 10 experts were interviewed to unveil the constraints inhibiting the inclusion of internships in tertiary curricula. Results: The results revealed empirical support for the positive influence of internships on both EI and ESE. Significant lack of inclusion of internships in tertiary curricula in South Africa emerged, owing mainly to administrative issues, curriculum re-design challenges, and lack of mentoring capacity. Conclusion: Tertiary-level entrepreneurship education programmes should include an internship component. The paper suggested that tertiary institutions pilot-test the inclusion of internships with a small number of students and a selected cohort of small business owners.

  2. A Study of the Transition Pathways of School Level Scholarship Recipients into Work and Tertiary Education

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    Hobden, Sally; Hobden, Paul

    2015-01-01

    School-level educational interventions targeting learners from low socioeconomic backgrounds often have the long-term goal of enabling access to, and successful completion of tertiary studies. This study tracked the progress of alumni of an educational intervention two or three years post school, in order to investigate their pathways to their…

  3. An Integrated Skills Approach Using Feature Movies in EFL at Tertiary Level

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    Tuncay, Hidayet

    2014-01-01

    This paper presents the results of a case study based on an integrated skills approach using feature movies (DVDs) in EFL syllabi at the tertiary level. 100 students took part in the study and the data was collected through a three - section survey questionnaire: demographic items, 18 likert scale questions and an open-ended question. The data…

  4. Level of health care and services in a tertiary health setting in Nigeria

    African Journals Online (AJOL)

    Level of health care and services in a tertiary health setting in Nigeria. ... Background: There is a growing awareness and demand for quality health care across the world; hence the ... Doctors and nurses formed 64.3% of the study population.

  5. Pregnancy outcome of women with gestational diabetes in a tertiary level hospital of North India

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    Pikee Saxena

    2011-01-01

    Full Text Available Background: Women with gestational diabetes mellitus (GDM pose an important public health problem because diabetes not only affects the maternal and fetal outcome, but these women and their fetuses are also at an increased risk of developing diabetes and related complications later in their life. Objectives: The study was conducted to determine the maternal and fetal outcomes of 50 diabetic vs 50 normoglycemic pregnancies. Materials and Methods: This was a retrospective analytical record-based study conducted in a tertiary level hospital. Detailed information regarding maternal, fetal, and labor outcome parameters was recorded in a prestructured proforma and compared in normoglycemic and diabetic pregnancies. Results: Patients with obesity, history of diabetes in the family, spontaneous abortions, and gestational diabetes in previous pregnancies had a greater incidence of GDM in current pregnancy (P<0.05 for all. Hypertension, polyhydramnios, macrosomia, fetopelvic disproportion, and cesarean sections were more (P<0.001 among diabetic pregnancies. Congenital anomalies, polycythemia, hypocalcemia, and hyperbilirubinemia were also observed to be more (P<0.05 in neonates born to diabetics, suggesting an adverse effect of hyperglycemia in utero. Conclusion: Diabetes during pregnancy is associated with higher maternal and fetal morbidity. Therefore, early screening, detection, close monitoring, and intervention is essential to reduce maternal and fetal short- and long-term adverse effects, especially in high-risk groups. Pregnancy provides an opportunity to the clinician to control the disease process and inculcate healthy lifestyle practices in these patients.

  6. Patterns of debate in tertiary level asynchronous text-based conferencing

    OpenAIRE

    Coffin, Caroline; Painter, Clare; Hewings, Ann

    2005-01-01

    Argumentation can be defined at different levels and serve different purposes, but its role in knowledge understanding and construction has given it a central place in education, particularly at tertiary level. The advent of computer-supported text-based conferences has created new sites where such educational dialogues can take place, but the quality of the interaction and whether it is serving its educational purpose is still uncertain. This paper reports on a framework of analysis that has...

  7. Ambient Noise Levels in Acute Neonatal Intensive Care Unit of a Tertiary Referral Hospital

    OpenAIRE

    Sonia R. B D'Souza; Leslie Edward Lewis; Vijay Kumar; Ramesh Bhat Y; Jayashree Purkayastha; Hari Prakash

    2017-01-01

    Background: Advances in neonatal care have resulted in improved survival of neonates admitted to the intensive care of the Neonatal Intensive Care Unit (NICU). However, the NCU may be an inappropriate milieu, with presence of overwhelming stimuli, most potent being the continuous presence of noise in the ambience of the NICU. Aim and Objectives: To determine and describe the ambient noise levels in the acute NICU of a tertiary referral hospital. Material and Methods...

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

    NARCIS (Netherlands)

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

    2009-01-01

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

  9. Self-Medication Practices with Antibiotics among Tertiary Level Students in Accra, Ghana: A Cross-Sectional Study

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    Patrick Nartey

    2012-10-01

    Full Text Available The study was carried out to estimate the prevalence of self-medication with antibiotics among tertiary level students in Accra (Ghana and evaluate factors associated with the practice. This was a descriptive cross-sectional study and involved face-to-face interviews of 600 respondents selected by convenient sampling. Prevalence of self medication was 70% (95% CI: 66.3–73.7, and the practice was significantly lower among medically inclined students (OR: 0.2, 95% CI: 0.1–0.4, p < 0.001. Among the respondents who practiced self medication, the most common frequency of antibiotic usage was at intervals of one month (30%, 95% CI: 25.6–34.4%, and the most common antibiotic used was amoxacillin (23.9%, 95% CI: 21.0–26.8%. Treatment failure were reported by 35% (95% CI: 30.5–39.6% of the respondents, and the main reasons cited for self medication were that, it was less expensive compared to medical care in the hospital and  secondly, medical care in hospitals were associated with long delays. Forty nine percent (95% CI: 44.2–53.8% of the respondents had poor knowledge about the health implications of irrational use of antibiotics, and 46% (95% CI: 41.2–50.8% did not comply with the completion of the full course of antibiotics. Self medication among tertiary students in Accra is an important public health problem and this may reflect the situation among tertiary students in the whole of Ghana.

  10. Ambient Noise Levels in Acute Neonatal Intensive Care Unit of a Tertiary Referral Hospital

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    Sonia R. B D'Souza

    2017-10-01

    Full Text Available Background: Advances in neonatal care have resulted in improved survival of neonates admitted to the intensive care of the Neonatal Intensive Care Unit (NICU. However, the NCU may be an inappropriate milieu, with presence of overwhelming stimuli, most potent being the continuous presence of noise in the ambience of the NICU. Aim and Objectives: To determine and describe the ambient noise levels in the acute NICU of a tertiary referral hospital. Material and Methods: The ambient noise, in this study was the background sound existing in the environment of the acute NICU of a tertiary referral hospital in South India. The ambient noise levels were analyzed by an audiologist and acoustical engineer using a standardized and calibrated Sound Level Meter (SLM i.e., the Hand Held Analyzer type 2250, Brüel and Kjær, Denmark on a weighted frequency A and reported as dB (A. Results: The ambient noise levels were timed measurements yielded by the SLM in terms of L eq, L as well as L exceeded the standard A 10 Aeqmax levels (Leq< 45 dB, L ≤ 50 dB, and Lmax ≤ 65 10 dB.The L eq ranged from 59.4 to 62.12 dB A. A Ventilators with alarms caused the maximum amount of ambient noise yielding a L Sound Pressure Level AF (SPL of 82.14 dB A. Conclusion: The study has found high levels of ambient noise in the acute NICU. Though there are several measures to reduce the ambient noise levels in the NICU, it is essential to raise awareness among health care personnel regarding the observed ambient noise levels and its effects on neonates admitted to the NICU.

  11. Screening of HBsAg and anti HCV from tertiary care, private and public sector hospitals

    International Nuclear Information System (INIS)

    Khan, R.A.W.; Ahmed, W.; Alam, S.E.; Arif, A

    2011-01-01

    Objectives: To find out the frequency of hepatitis B surface antigen and hepatitis C antibodies in patients referred from a tertiary care public sector hospital, other public sector and private hospitals of Karachi. Settings and duration: Pakistan Medical Research Council's Specialized Research Centre for Gastroenterology and Hepatology, at Jinnah Postgraduate Medical Centre Karachi from January to December 2009. Patients and Methods: A cross sectional study was conducted where patients were referred from different departments of Jinnah Postgraduate Medical Centre (tertiary care public sector hospital), other public sector hospitals, private hospitals and clinics for the screening of hepatitis B and C virus infection. Three ml blood was collected from each patient, serum separated and tested for HBsAg and Anti HCV using Abbott Murex fourth Generation ELISA kits. Results: A total of 2965 cases were referred in a year. Overall sero prevalence of HBsAg and Anti-HCV was 5.9% and 12.8% respectively. HBsAg positivity in patient referred from public sector hospitals was 5.8%, those from private hospitals/clinics were 7.2%, and self-referred patients was 5.6%. Anti HCV positivity rates amongst these cases were 12.5%, 16.7% and 8.5% respectively. Co-infection of hepatitis B virus and hepatitis C virus was seen in 0.9, 2.5 and 1.4% cases respectively. Breakdown of viral positivity within different departments of Jinnah Postgraduate Medical Centre Karachi showed HBsAg positivity of 7.1% in Medical department, 5.2% in Surgical department, 5.0% in Gynaecology department, 6.6% in other departments of Jinnah Postgraduate Medical Centre while, only 1.7% were positive from Pakistan Railway, hospital Anti HCV positivity was maximally (20.3%) seen in medical department followed by 14% in other departments, 10.9% in surgical department, 7.9% in gynaecology and 5.1% in railway hospital. Co-infection of HBV and HCV was seen in 2% cases referred from medical department, while rest of the

  12. Learner Inclinations to Study Computer Science or Information Systems at Tertiary Level

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    C Jacobs

    2010-07-01

    Full Text Available After the so‐called “dot‐com crash” of the Internet in the early 2000s, tertiary level student enrolments in IT‐related subjects began to experience a significant decline both in international countries and South Africa. The paper replicates research done in the Western Cape, South Africa, by Seymour et al. (2005 [20], in which grade 12 learner inclinations to study Computer Science (CS and Information Systems (IS at tertiary level were analysed and underlying factors affecting their interest in the subjects were determined. The study analyses the “misguided” perceptions that learners and students have of these subjects; the implications of the decline in enrolments on students, educational sectors and industry; and determines a set of underlying factors that influence learners in their attitudes toward further degrees in IT, starting from the secondary level of education. The research compares South African Eastern Cape learner perceptions with those from the Western Cape study and establishes three to four years later, that the reasons behind the decline in IT enrolments are still influenced by an underlying demographic and digital divide.

  13. Learner Inclinations to Study Computer Science or Information Systems at Tertiary Level

    Directory of Open Access Journals (Sweden)

    C Jacobs

    2010-08-01

    Full Text Available After the so-called “dot-com crash” of the Internet in the early 2000s, tertiary level student enrolments in IT-related subjects began to experience a significant decline both in international countries and South Africa. The paper replicates research done in the Western Cape, South Africa, by Seymour et al. (2005 [20], in which grade 12 learner inclinations to study Computer Science (CS and Information Systems (IS at tertiary level were analysed and underlying factors affecting their interest in the subjects were determined. The study analyses the “misguided” perceptions that learners and students have of these subjects; the implications of the decline in enrolments on students, educational sectors and industry; and determines a set of underlying factors that influence learners in their attitudes toward further degrees in IT, starting from the secondary level of education. The research compares South African Eastern Cape learner perceptions with those from the Western Cape study and establishes three to four years later, that the reasons behind the decline in IT enrolments are still influenced by an underlying demographic and digital divide.

  14. e-Learning for expanding distance education in tertiary level in Bangladesh: Problems and progress

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    Md. Abdullah Al-Masum

    2013-11-01

    Full Text Available E-learning has broadly become an important enabler to promote distance education (DE and lifelong learning in most of the developed countries, but in Bangladesh it is still a new successful progressive system for the learning communities. Distance education is thought to be introduced as an effective way of educating people of all sections in Bangladesh. Bangladesh Open University (BOU, the only distance education provider in Bangladesh, has been trying to adopt the use of various e-learning materials for its distance delivery. This paper has tried to describe the current progress of quality e-learning for expanding distance education, identifying the major problems of e-learning in distance education at tertiary level in Bangladesh, with special reference to BOU, and finally to put forward some valuable recommendations for solving the problems. The study is based on both primary and secondary sources. It is observed from the research that e-learning is going to ensure its bright prospect as an alternative mode of education at the tertiary level in Bangladesh. There are several problems that are identified and can be mitigated and solved through Information and Communication Technology (ICT development, greater acceptance by learners, and much research in this sector in Bangladesh to face globalization.   DOI: 10.18870/hlrc.v3i4.171

  15. Customer satisfaction survey with clinical laboratory and phlebotomy services at a tertiary care unit level.

    Science.gov (United States)

    Koh, Young Rae; Kim, Shine Young; Kim, In Suk; Chang, Chulhun L; Lee, Eun Yup; Son, Han Chul; Kim, Hyung Hoi

    2014-09-01

    We performed customer satisfaction surveys for physicians and nurses regarding clinical laboratory services, and for outpatients who used phlebotomy services at a tertiary care unit level to evaluate our clinical laboratory and phlebotomy services. Thus, we wish to share our experiences with the customer satisfaction survey for clinical laboratory and phlebotomy services. Board members of our laboratory designed a study procedure and study population, and developed two types of questionnaire. A satisfaction survey for clinical laboratory services was conducted with 370 physicians and 125 nurses by using an online or paper questionnaire. The satisfaction survey for phlebotomy services was performed with 347 outpatients who received phlebotomy services by using computer-aided interviews. Mean satisfaction scores of physicians and nurses was 58.1, while outpatients' satisfaction score was 70.5. We identified several dissatisfactions with our clinical laboratory and phlebotomy services. First, physicians and nurses were most dissatisfied with the specimen collection and delivery process. Second, physicians and nurses were dissatisfied with phlebotomy services. Third, molecular genetic and cytogenetic tests were found more expensive than other tests. This study is significant in that it describes the first reference survey that offers a survey procedure and questionnaire to assess customer satisfaction with clinical laboratory and phlebotomy services at a tertiary care unit level.

  16. Evaluation of free i-applications for tertiary level gross anatomy education

    Directory of Open Access Journals (Sweden)

    Matthew F. Pollard

    2012-04-01

    Full Text Available BackgroundThe use of electronic resources in education, including i-applications used on portable handheld devices, is increasing. Apple® handheld devices are popular, with free applications the most prevalent download form. Many gross anatomy i-applications are available, however no information on the quality of free anatomy products is available. Rating such products could therefore guide product recommendations.AimTo evaluate the quality and range of free iPod® applications that are applicable for tertiary level gross anatomy education.MethodsA search of the iTunes® Application Store with keywords anatomy, free, medical, functional, clinical, gross, and human was performed, with inclusion based on free applications containing human gross anatomy usable for tertiary education purposes. Application specification was noted; each was trialled independently and rated for usability, specification, academic level, and quality (image and programme.ResultsSixty-three applications were identified and eleven met inclusion criteria. Two provided gross anatomy of the entire body, nine examined specific regions or systems. Five were judged introductory in academic level, five intermediate, and one advanced. One application was rated low quality, and four excellent. None were considered difficult to use (six easy, five medium. Application size ranged between 1.2MB and 229MB (mean 27MB.ConclusionsThere are few free i-applications for learning gross anatomy and most concentrate on individual body systems, with the academic level and usability of all products well rated. Results suggest some free I-applications could be suitable adjuncts for gross anatomy education at both an undergraduate and graduate level.

  17. Reducing waiting time and raising outpatient satisfaction in a Chinese public tertiary general hospital-an interrupted time series study

    Directory of Open Access Journals (Sweden)

    Jing Sun

    2017-08-01

    Full Text Available Abstract Background It is globally agreed that a well-designed health system deliver timely and convenient access to health services for all patients. Many interventions aiming to reduce waiting times have been implemented in Chinese public tertiary hospitals to improve patients’ satisfaction. However, few were well-documented, and the effects were rarely measured with robust methods. Methods We conducted a longitudinal study of the length of waiting times in a public tertiary hospital in Southern China which developed comprehensive data collection systems. Around an average of 60,000 outpatients and 70,000 prescribed outpatients per month were targeted for the study during Oct 2014-February 2017. We analyzed longitudinal time series data using a segmented linear regression model to assess changes in levels and trends of waiting times before and after the introduction of waiting time reduction interventions. Pearson correlation analysis was conducted to indicate the strength of association between waiting times and patient satisfactions. The statistical significance level was set at 0.05. Results The monthly average length of waiting time decreased 3.49 min (P = 0.003 for consultations and 8.70 min (P = 0.02 for filling prescriptions in the corresponding month when respective interventions were introduced. The trend shifted from baseline slight increasing to afterwards significant decreasing for filling prescriptions (P =0.003. There was a significant negative correlation between waiting time of filling prescriptions and outpatient satisfaction towards pharmacy services (r = −0.71, P = 0.004. Conclusions The interventions aimed at reducing waiting time and raising patient satisfaction in Fujian Provincial Hospital are effective. A long-lasting reduction effect on waiting time for filling prescriptions was observed because of carefully designed continuous efforts, rather than a one-time campaign, and with appropriate incentives

  18. Reducing waiting time and raising outpatient satisfaction in a Chinese public tertiary general hospital-an interrupted time series study.

    Science.gov (United States)

    Sun, Jing; Lin, Qian; Zhao, Pengyu; Zhang, Qiongyao; Xu, Kai; Chen, Huiying; Hu, Cecile Jia; Stuntz, Mark; Li, Hong; Liu, Yuanli

    2017-08-22

    It is globally agreed that a well-designed health system deliver timely and convenient access to health services for all patients. Many interventions aiming to reduce waiting times have been implemented in Chinese public tertiary hospitals to improve patients' satisfaction. However, few were well-documented, and the effects were rarely measured with robust methods. We conducted a longitudinal study of the length of waiting times in a public tertiary hospital in Southern China which developed comprehensive data collection systems. Around an average of 60,000 outpatients and 70,000 prescribed outpatients per month were targeted for the study during Oct 2014-February 2017. We analyzed longitudinal time series data using a segmented linear regression model to assess changes in levels and trends of waiting times before and after the introduction of waiting time reduction interventions. Pearson correlation analysis was conducted to indicate the strength of association between waiting times and patient satisfactions. The statistical significance level was set at 0.05. The monthly average length of waiting time decreased 3.49 min (P = 0.003) for consultations and 8.70 min (P = 0.02) for filling prescriptions in the corresponding month when respective interventions were introduced. The trend shifted from baseline slight increasing to afterwards significant decreasing for filling prescriptions (P =0.003). There was a significant negative correlation between waiting time of filling prescriptions and outpatient satisfaction towards pharmacy services (r = -0.71, P = 0.004). The interventions aimed at reducing waiting time and raising patient satisfaction in Fujian Provincial Hospital are effective. A long-lasting reduction effect on waiting time for filling prescriptions was observed because of carefully designed continuous efforts, rather than a one-time campaign, and with appropriate incentives implemented by a taskforce authorized by the hospital managers. This

  19. Job satisfaction, work environment and intention to leave among migrant nurses working in a publicly funded tertiary hospital.

    Science.gov (United States)

    Goh, Yong-Shian; Lopez, Violeta

    2016-10-01

    This study sought to explore the job satisfaction level of migrant nurses working in a multicultural society and, more specifically, the relationship between their job satisfaction levels, work environment, their intentions to leave and the predictors of their intentions to leave. Nursing shortages have led to the increasing trend of employing migrant nurses, which necessitated studies examining nurses' migration. A cross-sectional, correlational design using a stratified random sample was conducted on 495 migrant nurses working in a tertiary public-funded hospital in Singapore. The results showed that migrant nurses were satisfied with their jobs; with job satisfaction negatively correlated with work environment. Interestingly, pre-existing groups of Chinese migrant nurses did not help newly arrived Chinese migrant nurses to assimilate better. Predictors of migrant nurses' intentions to leave included having supportive nurse managers and nursing practice environment. The presence of a supportive work environment is essential to retain migrant nurses. Health administrators need to empower nursing managers with skills to implement career development plans as part of hospitals' retention strategies for migrant nurses. Information should also be provided during recruitment campaigns to enable migrant nurses to make informed choices. © 2016 John Wiley & Sons Ltd.

  20. Role of Starting School Age in the Academic Performance at the Tertiary Level

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    Mahwish Ali Baber

    2017-11-01

    Full Text Available The purpose of this research was to find out whether starting school earlier than four years of age gave any academic benefit to the students in the long run. This research aimed to find out whether the students who started schooling earlier than four years of age are able to achieve better grades and are better at self-regulation at the tertiary level. For this purpose, a sample of 108 students from a private business school comprising both early and late school starters were made to fill in questionnaires reporting their school starting age, their CGPA and answering questions that showed their level of self-regulation. The findings of this study suggest that there is no difference in the academic performance of the two groups, both in terms of their CGPA and their self-regulation skills.

  1. Factors predicting quality of work life among nurses in tertiary-level hospitals, Bangladesh.

    Science.gov (United States)

    Akter, N; Akkadechanunt, T; Chontawan, R; Klunklin, A

    2018-06-01

    This study examined the level of quality of work life and predictability of years of education, monthly income, years of experience, job stress, organizational commitment and work environment on quality of work life among nurses in tertiary-level hospitals in the People's Republic of Bangladesh. There is an acute shortage of nurses worldwide including Bangladesh. Quality of work life is important for quality of patient care and nurse retention. Nurses in Bangladesh are fighting to provide quality care for emerging health problems for the achievement of sustainable development goals. We collected data from 288 randomly selected registered nurses, from six tertiary-level hospitals. All nurses were requested to fill questionnaire consisted of Demographic Data Sheet, Quality of Nursing Work Life Survey, Expanded Nursing Stress Scale, Questionnaire of Organizational Commitment and Practice Environment Scale of the Nursing Work Index. Data were analysed by descriptive statistics and multiple regression. The quality of work life as perceived by nurses in Bangladesh was at moderate level. Monthly income was found as the best predictor followed by work environment, organizational commitment and job stress. A higher monthly income helps nurses to fulfil their personal needs; positive work environment helps to provide quality care to the patients. Quality of work life and predictors measured by self-report only may not reflect the original picture of the quality of work life among nurses. Findings provide information for nursing and health policymakers to develop policies to improve quality of work life among nurses that can contribute to quality of nursing care. This includes the working environment, commitment to the organization and measures to reduce job stress. © 2017 International Council of Nurses.

  2. Challenges and Perspectives for Tertiary Level Hospitals in Bolivia: The case of Santa Cruz de La Sierra Department.

    Science.gov (United States)

    Medici, André

    2015-01-01

    Current legislation transferred public tertiary hospitals in Bolivia from the Municipalities to the Regional Level. However, the Regional Governments are experiencing technical and financial constraints to reform infrastructure, modernize equipment and introduce reforms to allow better governance, management and sustainability of these hospitals. This articles summarizes the recent experience of the Government of Santa Cruz de la Sierra in Bolivia where five tertiary hospitals and blood bank (most of them in precarious working conditions) has been transferred in 2012 from the Municipal Government of Santa Cruz (the capital) to the Regional Government of Santa Cruz. To face the challenges, the Regional Government of Santa Cruz implement several improvements, such as contract new clinical and administrative personal, increases hospital budgetary autonomy, outsource hospitals' auxiliary services, take measures to eliminate waiting lists and make several new investments to modernize and equip the hospitals. The World Bank was contracted to evaluated the future financial sustainability of these investments and to advice the Government to propose changes to increase the hospitals' management performance. The article describes the remaining challenges in these hospitals and the proposals from the World Bank Study. In the area of quality of care, the main challenge is to improve client satisfaction and continuous outcomes monitoring and evaluation according quality standards. In the area of financing, the challenge is how to assure the sustainability of these hospitals with the current level of health financing and the insufficient financial transfers from the National Government. In the area of Governance, reforms to streamline and simplify internal processes need to be introduced in order to establish mechanisms to increase transparency and accountability, allowing the hospital to have a good administration and adequate participation of the main actors in the guidance of

  3. An Overview of Teaching Listening in Islamic Tertiary Level of Education

    Directory of Open Access Journals (Sweden)

    Andang Saehu

    2016-12-01

    Full Text Available The ultimate aim of this paper is to depict listening activities in teaching Basic Listening designed by lecturers in an EFL classroom observation of Islamic tertiary level of education in Indonesia. Qualitative methods, used to collect and analyze data gained from observation and interview. The result showed that the lecturer designed various activities in teaching Basic Listening in the EFL class, which they were set up in three stages: pre-listening, while-listening, and post-listening. The activities in the pre-listening were aimed at generating students’ interest, activating student’s prior knowledge, and trying to anticipate any difficult vocabularies.  The while-listening stage is to invite students to be involved at listening through various physical movements, such as story telling, dialogue, listening to songs, and drama. The post-listening stage is to internalize what they have heard with other language skills and to check students’ comprehension. 

  4. Smoke-free policies in New Zealand public tertiary education institutions.

    Science.gov (United States)

    Robertson, Lindsay A; Marsh, L

    2015-04-01

    The Framework Convention on Tobacco Control mandates the creation of smoke-free environments to protect non-smokers from second-hand smoke and reduce demand for tobacco. We aimed to examine the extent and nature of smoke-free campus policies at tertiary education institutions throughout New Zealand, and examine the policy development process. Stage one comprised an audit and content analysis of smoke-free policies. In stage two, semi-structured telephone interviews were conducted to investigate the process of developing and implementing policies. Qualitative content analysis was undertaken on interview notes. Policies were identified for most institutions (n = 26/29), though varied widely in nature. Only nine mandated 100% smoke-free campuses without exceptions and few prohibited the sale of tobacco on campus, or connections with the tobacco industry. During interviews (n = 22/29), cited barriers to developing a 100% smoke-free policy included enforcement challenges and anticipated opposition from staff and students. However, participants from institutions with 100% smoke-free policies reported having encountered few challenges. Varying levels of compliance with 100% smoke-free policies were reported yet, overall, these policies were viewed as being effective. Smoke-free campus policies could be strengthened to better reflect a completely tobacco-free organization. Other institutions and workplaces could use these findings to develop 100% smoke-free policies. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  5. Determinants of the direct cost of heart failure hospitalization in a public tertiary hospital.

    Science.gov (United States)

    Parissis, John; Athanasakis, Kostas; Farmakis, Dimitrios; Boubouchairopoulou, Nadia; Mareti, Christina; Bistola, Vasiliki; Ikonomidis, Ignatios; Kyriopoulos, John; Filippatos, Gerasimos; Lekakis, John

    2015-02-01

    Heart failure (HF) is the first reason for hospital admission in the elderly and represents a major financial burden, the greatest part of which results from hospitalization costs. We sought to analyze current HF hospitalization-related expenditure and identify predictors of cost in a public tertiary hospital in Europe. We performed a retrospective chart review of 197 consecutive patients, aged 56±16years, 80% male, with left ventricular ejection fraction (LVEF) of 30±10%, hospitalized for HF in a major university hospital in Athens, Greece. The survey involved the number of hospitalization days, laboratory investigations and medical therapies. Patients who were hospitalized in CCU/ICU or underwent interventional procedures or device implantations were excluded from analysis. Costs were estimated based on the Greek healthcare system perspective in 2013. Patients were hospitalized for a median of 7 days with a total direct cost of €3198±3260/patient. The largest part of the expenses (79%) was attributed to hospitalization (ward), while laboratory investigations and medical treatment accounted for 17% and 4%, respectively. In multivariate analysis, pre-admission New York Heart Association NYHA class (p=0.001), serum creatinine (p=0.003) and NT-proBNP (p=0.004) were significant independent predictors of hospitalization cost. Direct cost of HF hospitalization is high particularly in patients with more severe symptoms, profound neurohormonal activation and renal dysfunction. Strategies to lower hospitalization rates are warranted in the current setting of financial constraints faced by many European countries. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  6. Framework of Assessment for the Evaluation of Thinking Skills of Tertiary Level Students

    Science.gov (United States)

    Heng, Chan Swee; Ziguang, Yan

    2015-01-01

    In the 21st century, students are required to master thinking skills in order to deal with many situations that arise in the tertiary environment which later would translate into the workplace. Nowadays, thinking skills play a vital role in tertiary education. To provide an approach for teachers, this paper identifies a 4-step model that can be…

  7. [Environmental noise levels in 2 intensive care units in a tertiary care centre].

    Science.gov (United States)

    Ornelas-Aguirre, José Manuel; Zárate-Coronado, Olivia; Gaxiola-González, Fabiola; Neyoy-Sombra, Venigna

    2017-04-03

    The World Health Organisation (WHO) has established a maximum noise level of 40 decibels (dB) for an intensive care unit. The aim of this study was to compare the noise levels in 2 different intensive care units at a tertiary care centre. Using a cross-sectional design study, an analysis was made of the maximum noise level was within the intensive coronary care unit and intensive care unit using a digital meter. A measurement was made in 4 different points of each room, with 5minute intervals, for a period of 60minutes 7:30, 14:30, and 20:30. The means of the observations were compared with descriptive statistics and Mann-Whitney U. An analysis with Kruskal-Wallis test was performed to the mean noise level. The noise observed in the intensive care unit had a mean of 64.77±3.33dB (P=.08), which was similar to that in the intensive coronary care unit, with a mean of 60.20±1.58dB (P=.129). Around 25% or more of the measurements exceeded the level recommended by the WHO by up to 20 points. Noise levels measured in intensive care wards exceed the maximum recommended level for a hospital. It is necessary to design and implement actions for greater participation of health personnel in the reduction of environmental noise. Copyright © 2017 Instituto Nacional de Cardiología Ignacio Chávez. Publicado por Masson Doyma México S.A. All rights reserved.

  8. Section Level Public Land Survey - polygons

    Data.gov (United States)

    Minnesota Department of Natural Resources — Public Land Survey line delineations to the section level. Data are derived primarily from Section corner locations captured from paper USGS seven and one-half...

  9. Section Level Public Land Survey - lines

    Data.gov (United States)

    Minnesota Department of Natural Resources — Public Land Survey line delineations to the section level. Developed from manually digitized section corners captured from paper USGS seven and one-half map sources.

  10. "Digitize Me": Generating E-Learning Profiles for Media and Communication Students in a Jamaican Tertiary-Level Institution

    Science.gov (United States)

    Stewart-McKoy, Michelle A.

    2014-01-01

    The purpose of this project was to develop an e-learning profile for a group of media and communication students enrolled in a Jamaican tertiary-level institution in order to make informed decisions most the appropriate [online] learning complement for these students. The objectives sought to determine the e-learning profile of media and…

  11. Associations between Psychosocial Aspects of English Classroom Environments and Motivation Types of Chinese Tertiary-Level English Majors

    Science.gov (United States)

    Bi, Xuefei

    2015-01-01

    This study involved whether psychosocial aspects of English classroom environments had associations with the English learning motivation types of Chinese tertiary-level English majors based on a case study of approximate 1,000 English majors in their first 2 years at one of the key universities located in South China. Canonical correlation…

  12. A Changing Paradigm in Language Planning: English-Medium Instruction Policy at the Tertiary Level in Malaysia

    Science.gov (United States)

    Ali, Nor Liza

    2013-01-01

    The literature shows that English-medium instruction (EMI) programmes at the tertiary level in various parts of the world have positioned EMI as a language-planning tool to promote students' mastery of English. English proficiency is believed to be intertwined with the overall economic development of a country. In addition to internationalising…

  13. Smoke-Free Policies in New Zealand Public Tertiary Education Institutions

    Science.gov (United States)

    Robertson, Lindsay A.; Marsh, L.

    2015-01-01

    The Framework Convention on Tobacco Control mandates the creation of smoke-free environments to protect non-smokers from second-hand smoke and reduce demand for tobacco. We aimed to examine the extent and nature of smoke-free campus policies at tertiary education institutions throughout New Zealand, and examine the policy development process.…

  14. IRIS Toxicological Review of Ethyl Tertiary Butyl Ether (ETBE) (Public Comment Draft)

    Science.gov (United States)

    In September 2016, the U.S. Environmental Protection Agency's (USEPA) released the draft Integrated Risk Information System (IRIS) Toxicological Review of Ethyl Tertiary Butyl Ether (ETBE). Consistent with the 2013 IRIS Enhancements, draft IRIS assessments are released prior to e...

  15. Relationship between Vocabulary Size and Reading Comprehension Levels of Malaysian Tertiary Students

    Directory of Open Access Journals (Sweden)

    Angelina Wan Lin Tan

    2018-01-01

    Full Text Available This study investigated the relationship between vocabulary size and reading comprehension performance among students in a tertiary institution in a Malaysian context and examined the vocabulary size required for students to achieve reading comprehension at various levels of proficiency. The research questions that guided this study were: 1 What is the vocabulary size of second year diploma students studying Mass Communication?; 2 What is the reading comprehension proficiency of second year diploma students studying Mass Communication?; and 3 What vocabulary size is required for different levels of reading comprehension proficiency? This study used the quantitative approach. The participants were 53 Malaysian second-year students at a private university college in Malaysia who were reading for their Diploma in Mass Communication. The instruments used were the Vocabulary Size Test and the IELTS Reading Test (Academic Module. The findings showed that the average vocabulary size of the students was just over 6000 word families and this vocabulary size was generally insufficient for adequate reading comprehension. Students needed an average vocabulary size of about 8000 word families to achieve adequate reading comprehension and about 10000 word families to achieve proficient reading comprehension. Based on the individual student’s performance, this study did not find a linear relationship between vocabulary size and reading comprehension performance, nor was there a threshold vocabulary size for adequate reading comprehension.

  16. Needlestick and sharps injuries among health care workers at public tertiary hospitals in an urban community in Mongolia

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    Tsolmon Muugolog

    2011-06-01

    Full Text Available Abstract Background Needlestick and sharps injuries (NSSIs are one of the major risk factors for blood-borne infections at healthcare facilities. This study examines the current situation of NSSIs among health care workers at public tertiary hospitals in an urban community in Mongolia and explores strategies for the prevention of these injuries. Findings A survey of 621 health care workers was undertaken in two public tertiary hospitals in Ulaanbaatar, Mongolia, in July 2006. A semi-structured and self-administered questionnaire was distributed to study injection practices and the occurrence of NSSIs. A multiple logistic regression analysis was performed to investigate factors associated with experiencing NSSIs. Among the 435 healthcare workers who returned a completed questionnaire, the incidence of NSSIs during the previous 3 months was 38.4%. Health care workers were more likely to report NSSIs if they worked longer than 35 hours per week (odds ratio, OR: 2.47; 95% confidence interval, CI: 1.31-4.66 and administered more than 10 injections per day (OR: 4.76; 95% CI: 1.97-11.49. The likelihood of self-reporting NSSIs significantly decreased if health care workers adhered to universal precautions (OR: 0.34; 95% CI: 0.17-0.68. Conclusions NSSIs are a common public health problem at public tertiary hospitals in Mongolia. The promotion of adequate working conditions, elimination of excessive injection use, and adherence to universal precautions will be important for the future control of potential infections with blood-borne pathogens due to occupational exposures to sharps in this setting.

  17. Assessment of motivation levels and associated factors among the nursing staff of tertiary-level government hospitals.

    Science.gov (United States)

    Pandey, Rahul; Goel, Sonu; Koushal, Vipin

    2018-04-15

    The present study assessed the motivation level of nurses working in 3 highly decorated tertiary-level government hospitals of India and also underpins the factors attributing to motivation levels. A sequential mixed-method design was used in this study wherein 400 nurses working in 5 units of nursing care in the hospitals were enrolled based upon proportionate random stratified sampling techniques. A self-administered questionnaire with Likert scale was developed based upon scale used by Mbindyo et al. The attributes of motivation were then categorized into external and internal attributes. For the qualitative component, participants with varied responses in quantitative data were selected and interviewed. Overall mean motivation score of the nursing staff was found 3.57 ± 0.93, which was higher for extrinsic motivational attributes (3.67 ± 0.88) as compared with intrinsic attributes (3.47 ± 0.98). The intrinsic motivational attribute of organizational commitment was rated highest followed by general motivation, conscientiousness, and self-efficacy. Personal issues, timeliness, and burnout were prime discouraging attributes among study participants. Sociodemographic characteristics and work profile characteristics showed significant relationship with the attributes of motivation. This study underscores the significance of different attributes of motivation which needs to be considered while framing administrative strategies and policy guidelines by authorities. Copyright © 2018 John Wiley & Sons, Ltd.

  18. Approach to mathematics in textbooks at tertiary level - exploring authors' views about their texts

    Science.gov (United States)

    Randahl, Mira

    2012-10-01

    The aim of this article is to present and discuss some results from an inquiry into mathematics textbooks authors' visions about their texts and approaches they choose when new concepts are introduced. Authors' responses are discussed in relation to results about students' difficulties with approaching calculus reported by previous research. A questionnaire has been designed and sent to seven authors of the most used calculus textbooks in Norway and four authors have responded. The responses show that the authors mainly view teaching in terms of transmission so they focus mainly on getting the mathematical content correct and 'clear'. The dominant view is that the textbook is intended to help the students to learn by explaining and clarifying. The authors prefer the approach to introduce new concepts based on the traditional way of perceiving mathematics as a system of definitions, examples and exercises. The results of this study may enhance our understanding of the role of the textbook at tertiary level. They may also form a foundation for further research.

  19. PHENOMENOLOGICAL APPROACHES TO STUDY LEARNING IN THE TERTIARY LEVEL CHEMISTRY LABORATORY

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    Santiago Sandi-Urena

    Full Text Available Despite the widespread notion amongst chemistry educators that the laboratory is essential to learn chemistry, it is often a neglected area of teaching and, arguably, of educational research. Research has typically focused on secondary education, single institutions, and isolated interventions that are mostly assessed quantitatively. It has also honed in on compartmentalised features instead of searching understanding of broader aspects of learning through experimentation. This paper contends there is a gap in subject specific, tertiary level research that is comprehensive and learning-centred instead of fragmented and instruction-based. A shift in focus requires consideration of methodological approaches that can effectively tackle the challenges of researching complex learning environments. This paper reckons qualitative approaches, specifically phenomenology, are better suited for this purpose. To illustrate this potential, it summarises an exemplar phenomenological study that investigated students’ experience of change in instructional style from an expository (traditional laboratory program to one that was cooperative and project-based (reformed. The study suggests the experience was characterised by a transition from a learning environment that promoted mindless behaviour to one in which students were mindfully engaged in their learning. Thus, this work puts forth the use of Mindfulness Theory to investigate and support design of laboratory experiences.

  20. Clinical Presentation and Outcomes among Children with Sepsis Presenting to a Public Tertiary Hospital in Tanzania

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    Teresa Bleakly Kortz

    2017-12-01

    Full Text Available BackgroundPediatric sepsis causes significant global morbidity and mortality and low- and middle-income countries (LMICs bear the bulk of the burden. International sepsis guidelines may not be relevant in LMICs, especially in sub-Saharan Africa (SSA, due to resource constraints and population differences. There is a critical lack of pediatric sepsis data from SSA, without which accurate risk stratification tools and context-appropriate, evidence-based protocols cannot be developed. The study’s objectives were to characterize pediatric sepsis presentations, interventions, and outcomes in a public Emergency Medicine Department (EMD in Tanzania.MethodsProspective descriptive study of children (28 days to 14 years with sepsis [suspected infection with ≥2 clinical systemic inflammatory response syndrome (SIRS criteria] presenting to a tertiary EMD in Dar es Salaam, Tanzania (July 1 to September 30, 2016. Outcomes included: in-hospital mortality (primary, EMD mortality, and hospital length of stay. We report descriptive statistics using means and SDs, medians and interquartile ranges, and counts and percentages as appropriate. Predictive abilities of SIRS criteria, the Alert-Verbal-Painful-Unresponsive (AVPU score and the Lambaréné Organ Dysfunction Score (LODS for in-hospital, early and late mortality were tested.ResultsOf the 2,232 children screened, 433 (19.4% met inclusion criteria, and 405 were enrolled. There were 247 (61% subjects referred from an outside facility. Approximately half (54.1% received antibiotics in the EMD, and some form of microbiologic culture was collected in 35.8% (n = 145 of subjects. In-hospital and EMD mortality were 14.2 and 1.5%, respectively, median time to death was 3 days (IQR 1–6, and median length of stay was 6 days (IQR 1–12. SIRS criteria, the AVPU score, and the LODS had low positive (17–27.1, 33.3–43.9, 18.3–55.6%, respectively and high negative predictive values (88.6–89.8, 86.5

  1. A third of patients treated at a tertiary-level surgical service could be ...

    African Journals Online (AJOL)

    primary healthcare.[3,4]. The public healthcare sector in SA is overburdened at all levels of care.[5] Healthcare funding has not kept pace with inflation and the burden of disease.[6] Data are .... An example would be a skin laceration requiring sutures .... care pyramid. If skills and resources are limited, the trend is to refer to.

  2. Patient knowledge and intention to use the intrauterine contraceptive device IUCD at a tertiary level hospital

    Directory of Open Access Journals (Sweden)

    Nadia van der Westhuizen

    2016-12-01

    Full Text Available Background:  The intrauterine device (IUCD is a highly effective and safe method of contraception.  Prevention of unwanted pregnancies has made its use a matter of national priority in certain countries.Despite numerous advantages and suitability the uptake of the IUCD is poor. Patients in South Africa seem to lack knowledge regarding this contraceptive.Objectives:  The aim of this study was to determine the quantity and quality of knowledge of the IUCD, and to evaluate its acceptability for future use.Methods:  A prospective cross-sectional study was conducted at Pelonomi Tertiary Hospital.  201 consecutive patients were interviewed using structured questionnaires.Results:  Awareness of the IUCD was found in almost half (49%, n=95 of our patients. Its use was very low, with only one patient having used it before. Overall qualitative knowledge was poor, even among those that were aware of the IUCD. There was a significant association between level of education and knowledge, with patients having passed Grade 12 or higher significantly more likely to have knowledge of the IUCD than those at lower levels (RR 1.57, 95% CI 1.18-2.08. Forty-five percent (n=86 of patients indicated a desire for future IUCD use.Conclusion:  Despite the availability of the IUCD in South African clinics and hospitals, its uptake is still poor. Awareness of this method seemed to have improved over the past few years, but the qualitative knowledge still lacks considerably.  Education plays a major role in the knowledge of contraception and better educational aids in all facilities will increase its use and reduce unwanted pregnancies. 

  3. Population and colony-level determinants of tertiary sex ratio in the declining barn swallow.

    Directory of Open Access Journals (Sweden)

    Nicola Saino

    Full Text Available Sex ratio of adults (tertiary sex ratio, TSR is a major feature of animal populations with consequences for their behaviour, genetic structure and viability. Spatial and temporal variation in TSR occurs within species but the mechanisms behind it are poorly understood. In this long-term study of a declining population of a socially monogamous, colonial, migratory bird, the barn swallow (Hirundo rustica, we first analyzed population-level variation in TSR ( =  proportion of males of yearlings at sexual maturation in relation to ecological conditions as gauged by annual survival rate of adults. TSR was male-biased both among yearlings and older individuals, but male bias of yearlings was more pronounced after years with larger decline in adult survival. Thus, male offspring were less susceptible to the adverse ecological conditions that cause increased mortality. Dispersal and settling site decisions can have major consequences on fitness via the effects of local TSR on mating and sperm competition. Breeding barn swallows are highly philopatric while natal dispersal is high and, together with mortality, is the main determinant of colony TSR. We thus also investigated the mechanisms of breeding colony choice by yearlings and found that TSR of new-settlers in a given colony and year was negatively predicted by TSR of returning, early arriving older individuals in that year, but not by overall TSR at the colony in the previous year. This suggests that in our male-biased population new-settler males respond to local TSR upon arrival to choose the sites with larger breeding opportunities. Hence, variation in ecological conditions as reflected by adult survival can shift the TSR of individuals recruiting into a local population, with potentially various demographic consequences. However, breeding site choice based on TSR tends to homogenize TSR at a population level likely by facilitating settling of dispersing males in colonies with less male

  4. [A case-series analysis of tuberculosis in pediatric patients treated in a tertiary level hospital].

    Science.gov (United States)

    Vázquez Rosales, José Guillermo; Acosta Gallegos, Cynthia; Miranda Novales, María Guadalupe; Fuentes Pacheco, Yazmín Del Carmen; Labra Zamora, María Guadalupe; Pacheco Rosas, Daniel Octavio; Solórzano Santos, Fortino

    Tuberculosis (TB) remains a challenge because severe forms occur most frequently in children under 5 years of age and the diagnosis is complex. The objective of this paper was to describe the clinical presentation, frequency, diagnostic methods used and response to treatment in children with TB treated at a tertiary level hospital. The study was retrospective and descriptive of a cohort of consecutive cases treated from January 2010 to December 2013. Ninety-three medical records of children diagnosed with TB according to the definition of the NOM-006-SSA2-2013 were reviewed. Descriptive statistics were used for the analysis. From 93 children, 58% were male (mean age of 7 years), 97% with a history of BCG vaccination, and 6% had contact with a TB case. The most frequent clinical forms were pulmonary (30.1%), lymph node (24.7%), miliary/disseminated (16.1%), meningeal (13%), and osteal TB (7.5%). The most common symptoms were fever and weight loss (50% and 40%, respectively). BAAR and culture were positive in 26% and 7% of all cases, respectively. The histopathological study was conclusive in 90% of the cases. The treatment was successful in 94.6%, with not associated mortality. The association of clinical symptoms with alterations in chest radiography and positive PPD are useful in establishing the presumptive diagnosis and an early and appropriate treatment. Copyright © 2017 Hospital Infantil de México Federico Gómez. Publicado por Masson Doyma México S.A. All rights reserved.

  5. The Perception of Malaysian ESL Tertiary Level Students on the IELTS Test

    Science.gov (United States)

    Zahari, Dhiya Amalina; Dhayaalan, Jeremiah Dhayaalan Jackson

    2016-01-01

    Currently, the most acknowledged test to qualify for overseas universities is the IELTS test which is referred to as the International English Language Testing System. It is implemented as an accreditation tool and is believed to be a reputable and trustworthy tool of language competence by tertiary institutions which employ its use. Regardless of…

  6. Framework of Assessment for the Evaluation of Thinking Skills of Tertiary Level Students

    Directory of Open Access Journals (Sweden)

    Chan Swee Heng

    2015-10-01

    Full Text Available In the 21st century, students are required to master thinking skills in order to deal with many situations that arise in the tertiary environment which later would translate into the workplace. Nowadays, thinking skills play a vital role in tertiary education. To provide an approach for teachers, this paper identifies a 4-step model that can be implemented in test design with reference to Bloom’s Taxonomy for thinking skills. This model illustrates a feasible procedure of test construction built upon existing resource. The procedures can easily be applied to different fields of study. It provides an appropriate way for teachers who may want to add more ideas to their repertoire skills in addressing the learning of HOT (higher-order thinking skills. Keywords: thinking skills, Bloom’s Taxonomy, 4-step model

  7. Risk factors predicting mortality in patients with lung abscess in a public tertiary care center in Karachi, Pakistan.

    Science.gov (United States)

    Ghazal, Shaista; Kumar, Ashok; Shrestha, Binav; Sajid, Sana; Malik, Maria; Rizvi, Nadeen

    2013-01-01

    Lung abscess is a commonly encountered entity in South-East Asia but not much data regarding its outcome is available. The objective of this study was to identify the factors associated with increased mortality in patients diagnosed with lung abscess in a tertiary care center of Karachi, Pakistan. A retrospective case analysis was performed via hospital records, on patients admitted with lung abscess between January 2009 and January 2011 at the largest state-owned tertiary care centre in Karachi, Pakistan. Out of the 41 patients hospitalized, 17 could not survive and were evaluated for clinical, radiological and microbiological factors to determine association with heightened mortality. Mortality due to lung abscess stood at 41.4% (17 of 41 cases). Adult male patients were found to have higher mortality with 13 out of 17 (43%) dead patients being male. A majority (21/41, 51.2%) of the cases belonged to the 41-60 year old age group. Highest mortality was seen in patients200 mg/dL (56%) succumb to disease. Patients with a positive history of smoking, diabetes mellitus, and alcohol intake expressed mortality rates of 44%, 56%, and 50% respectively; while 29.4% of the mortalities were positive for Pseudomonas aeruginosa on sputum culture. A significant association was found with elevated mortality and low haemoglobin levels at time of admission; mortality was 58% (p=0.005) in patients with Hb less than or equal to 10 mg/dL. The risk factors involved with heightened mortality included male gender and history of smoking, diabetes and alcohol intake. High blood sugar levels and detection of Pseudomonas aeruginosa on sputum cultures were also implicated. Anemia (Hb level less than or equal to 10 mg/dl) was statistically significant predictive factor for increased mortality.

  8. Risk factors for syphilis and hiv infection in pregnant women attending a tertiary care public sector hospital

    International Nuclear Information System (INIS)

    Batool, K.; Bano, K.A.; Sherwani, M.I.K.

    2010-01-01

    Background: Syphilis, a sexually transmitted disease which seemed to have disappeared or had been controlled over the years, has now been re-emerged as a major public health problem in many communities. It can complicate the pregnancies with serious consequences. Appropriate treatment of pregnant women often prevents such complications. Aims: To study the frequency of syphilis in pregnant women attending a tertiary care public sector hospital, and see the positivity for HIV/AIDS among syphilis positive women. Patients and Methods: This cross sectional and interventional study was conducted among pregnant women attending Sir Ganga Ram hospital for antenatal care at PMRC Research Centre, Fatima Jinnah Medical College, Lahore. Blood samples from 2000 women were collected after taking consent. The blood was tested for syphilis by Treponema Pallidum Haemagglutination. History of the subjects for risks factors was also taken. Syphilis positive women were further screened for human immunodeficiency virus positivity. Results: The treponemal antibodies were detected in less than one percent (9) pregnant women. The highest positivity was observed among age group of 21-26 years. Women in third trimester were significantly more infected with syphilis. Risk factors included husband's history with frequent traveling and drug abuse. All husbands of syphilis positive women were also positive. All syphilis positive women and their husbands were negative for Human immunodeficiency virus /Acquired immune deficiency syndrome. Conclusions: Less than 1% of pregnant women were infected with syphilis, and most of the spouses of these positive women were either travelers or drug addicts.(author)

  9. Quality Computer Assisted Mobile Learning (CAML and Distance Education Leadership in Managing Technology Enhanced Learning Management System (TELMS in the Malaysian Public Tertiary Education

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    Lee Tan Luck

    2009-07-01

    Full Text Available Abstract - The success in the implementation of a quality computer assisted mobile learning and distance education in a Technology Enhanced Learning Management System is highly rely on the academic leadership in managing and application of Information and Communication Technology (ICT in the tertiary level. The effectiveness of its leadership, knowledge, application and management of ICT and learning management system is of utmost important. Successful application and management includes quality and cost effectiveness of universities administration, CAML and distance education leadership development, organizational culture, academic staffs and students’ attitude and their commitment towards teaching and learning process, support towards the usage of state of the art techno-educational facilities, availability of ICT resources, maintenance and funding of a Learning Management System. This paper will discuss the above factors, which present a comprehensive framework for the implementation of a quality CAML and distance education environment in ICT application and management in the Malaysian public universities. Selected Fifty-two respondents from two Malaysian public universities which offer e Learning and distance education with Learning Management System were acquired. A survey questionnaire is used to determine the effectiveness of ICT and mobile learning application management. Data from the questionnaires were analyzed by using non-parametric and parametric statistics testing. Results of this study show there is significant different in the CAML and distance education leadership in TELMS and the application of ICT and its management in the Malaysian public universities. The study will also address the implementation elements necessary for transforming the public universities and its CAML and distance education teaching and learning process into an effective and result oriented computer assisted mobile learning management model in public

  10. Treatment of self-poisoning at a tertiary level hospital in Bangladesh

    DEFF Research Database (Denmark)

    Verma, Vasundhara; Paul, Sujat; Ghose, Aniruddha

    2017-01-01

    OBJECTIVES: Approximately 10,000 people die from suicide annually in Bangladesh, many from pesticide poisoning. We aimed to estimate financial costs to patients and health services of treating patients with self-poisoning. METHODS: Data on direct costs to families, sources of funds for treatment...... and family wealth were collected prospectively over a one-month period in 2016 at the tertiary Chittagong Medical College Hospital, Bangladesh. Aggregate operational costs to the government were calculated using annual budget, bed occupancy and length-of-stay data. RESULTS: Agrochemicals were the most common...... as organophosphorus poisoning in 17(.) 0% of agrochemical cases resulted in increased cost to patients. Only 51(.) 9% of patients had indicators of wealth; 78(.) 1% borrowed money to cover costs. Conservatively estimated median healthcare costs (US$ 21(.) 30 per patient) were markedly lower than costs to patients...

  11. Inpatient dermatology: Characteristics of patients and admissions in a tertiary level hospital in Eastern India

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    Arpita Sen

    2016-01-01

    Full Text Available Introduction: Dermatology is primarily a non-acute, outpatient-centered clinical specialty, but substantial number of patients need indoor admission for adequate management. Over the years, the need for inpatient facilities in Dermatology has grown manifold; however, these facilities are available only in some tertiary centers. Aims and Objectives: To analyze the characteristics of the diseases and outcomes of patients admitted in the dermatology inpatient Department of a tertiary care facility in eastern India. Materials and Methods: We undertook a retrospective analysis of the admission and discharge records of all patients, collected from the medical records department, admitted to our indoor facility from 2011 to 2014. The data thus obtained was statistically analyzed with special emphasis on the patient's demographic profile, clinical diagnosis, final outcome, and duration of stay. Results and Analysis: A total of 375 patients were admitted to our indoor facility during the period. Males outnumbered females, with the median age in the 5th decade. Immunobullous disorders (91 patients, 24.27% were the most frequent reason for admissions, followed by various causes of erythroderma (80 patients, 21.33% and infective disorders (73 patients, 19.47%. Other notable causes included cutaneous adverse drug reactions, psoriasis, vasculitis, and connective tissue diseases. The mean duration of hospital stay was 22.2±15.7 days; ranging from 1 to 164 days. Majority of patients (312, 83.2% improved after hospitalization; while 29 (7.73% patients died from their illness. About 133 patients (35.64% required referral services during their stay, while 8 patients (2.13% were transferred to other departments for suitable management. Conclusion: Many dermatoses require inpatient care for their optimum management. Dermatology inpatient services should be expanded in India to cater for the large number of cases with potentially highly severe dermatoses.

  12. Short-Run Distributional Effects of Public Education Transfers to Tertiary Education Students in Seven European Countries

    Science.gov (United States)

    Callan, Tim; Smeeding, Tim; Tsakloglou, Panos

    2008-01-01

    Direct provision of public services can alter the balance of resources across income groups. We focus on the issues arising when taking account of the impact of publicly provided education services across the income distribution. We combine OECD information on spending per student in particular levels of the education system with micro data from…

  13. Job satisfaction and Job stress among various employees of tertiary care level hospital in central Uttar Pradesh, India

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    Ruchi Yadav

    2017-03-01

    Full Text Available Introduction: Job satisfaction defined as the end state of feeling, the feeling that is experienced after a task is accomplished. Job stress can be defined as the harmful physical and emotional responses that occur when the requirements of the job do not match the capabilities, resources, or need of the worker. Objectives: To study the relationship between job satisfaction and job stress among various employees of tertiary care level hospital and to find the co-relates of job stress and job satisfaction. Materials & Methods: A cross sectional study carried out for a period of 2 month among various employees working in Uttar Pradesh University of Medical Sciences, Saifai, Etawah, Uttar Pradesh, a tertiary care level hospital. A total 225 Participants 75 from each medical, paramedical and office staff were selected by purposive sampling technique. The study was conducted using pretested structured questionnaire regarding socio-demographic profile, job satisfaction and job stress. Data was analyzed using chi square test. Result: A total of 225 participants,75 from each medical, paramedical and office staff were interviewed. On doing analysis of questionnaire regarding job satisfaction and job stress it was found that majority believe that their job was well recognized and working in a good institute and were not satisfied with the management and salary and were coping well with their job stress and were having average level of satisfaction. Conclusion: The present study conclude that majority of the participants felt they are well recognized with their job, working in a good institute but not satisfied with the management and salary.

  14. Job satisfaction and Job stress among various employees of tertiary care level hospital in central Uttar Pradesh, India

    Directory of Open Access Journals (Sweden)

    Ruchi Yadav

    2017-03-01

    Full Text Available Introduction: Job satisfaction defined as the end state of feeling, the feeling that is experienced after a task is accomplished. Job stress can be defined as the harmful physical and emotional responses that occur when the requirements of the job do not match the capabilities, resources, or need of the worker. Objectives: To study the relationship between job satisfaction and job stress among various employees of tertiary care level hospital and to find the co-relates of job stress and job satisfaction. Materials & Methods: A cross sectional study carried out for a period of 2 month among various employees working in Uttar Pradesh University of Medical Sciences, Saifai, Etawah, Uttar Pradesh, a tertiary care level hospital. A total 225 Participants 75 from each medical, paramedical and office staff were selected by purposive sampling technique. The study was conducted using pretested structured questionnaire regarding socio-demographic profile, job satisfaction and job stress. Data was analyzed using chi square test. Result: A total of 225 participants,75 from each medical, paramedical and office staff were interviewed. On doing analysis of questionnaire regarding job satisfaction and job stress it was found that majority believe that their job was well recognized and working in a good institute and were not satisfied with the management and salary and were coping well with their job stress and were having average level of satisfaction. Conclusion: The present study conclude that majority of the participants felt they are well recognized with their job, working in a good institute but not satisfied with the management and salary.

  15. TERRITORIAL DISPARITIES REGARDING THE DISTRIBUTION OF HEALTH SERVICE PROVIDERS IN ROMANIA AFTER JOINING THE EUROPEAN UNION STUDY CASE: MEDICAL STAFF WITH TERTIARY LEVEL OF EDUCATION

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    Babucea Ana-Gabriela

    2017-02-01

    Full Text Available In Romania 90ˈs, there was a relatively low level of regional disparities compared with western economies in all fields, but inequalities have emerged and widened rapidly because only certain areas, especially urban areas have benefited from inflows of capital and specialized human resources. Currently, Romania has a low level of development between EU countries, five of the eight NUTS 2 regions being the most underdeveloped in Europe. The aim of this research is a comparative analysis of developments and trends manifested in the public health system in terms of distribution of health services providers at the regional level in Romania. For the analysis of regional disparities, the research seeks to highlight a comprehensive image of the level and dynamics of the Romania territorial inequalities regarding the personnel with tertiary education, which includes physicians, dentists, and pharmaceutical chemists, as professional providers of the health services. Were took into account statistical indicators that describe the distribution of such as healthcare providers, at level of the eight Romanian NUTS2 regions, highlighting inequalities in access to health services for the population. We used available data, accessed from National Institute of Statistics of Romania, regarding Romania, and itˊs eight regions. We appeal also to statistical publications at the national and European level, other data analysis, and experts' opinions expressed in recent articles in the field. In order to identify the factors that can reduce the disparities, and ensure the equity for disadvantaged population, in terms of ensuring the health system of medical services in parallel with a homogeneous distribution of resources and services in this area, we apply specific statistics for territorial analysis and comparisons.

  16. Public relations work at a regional level

    Energy Technology Data Exchange (ETDEWEB)

    Kirchhoff, H.R.

    1982-04-01

    With 'Elektrizitaets-AG Mitteldeutschland (EAM)' (power corporation central Germany) - head office in Kassel and five works maintained in Kassel, Goettingen, Marburg, Dillenburg and Hanau - public relations work has a tradition. It is seen as conscious, planned and continued effort to build up the public understanding: Public relations work is intended to present the enterprise as a community with a multitude of technical, economic and social tasks, which can be carried out with optimal success only if supported by the confidence of society.

  17. Job satisfaction among nurses working in the private and public sectors: a qualitative study in tertiary care hospitals in Pakistan

    Directory of Open Access Journals (Sweden)

    Hamid S

    2014-01-01

    Full Text Available Saima Hamid,1 Asmat Ullah Malik,2 Irum Kamran,3 Musarat Ramzan41Health Services Academy, Islamabad, Pakistan; 2Integrated Health Services, Islamabad, Pakistan; 3GIZ, Islamabad, Pakistan; 4Wah Medical College, Wah Cantt, University of Health Sciences, Wah, PakistanBackground: Many low and middle income countries lack the human resources needed to deliver essential health interventions. A health care system with a limited number of nurses cannot function effectively. Although the recommended nurse to doctor ratio is 4:1, the ratio in Pakistan is reversed, with 2.7 doctors to one nurse.Methods: A qualitative study using narrative analysis was undertaken in public and private tertiary care hospitals in Pakistan to examine and compare job satisfaction among nurses and understand the factors affecting their work climate. Interactive interviews were conducted with nurses working with inpatients and outpatients.Results: All of the respondents had joined the profession by choice and were supported by their families in their decision to pursue their career, but now indicated that they were dissatisfied with their jobs. Three types of narratives were identified, namely, “Working in the spirit of serving humanity”, “Working against all odds”, and “Working in a functional system and facing pressures of increased accountability”. Nurses working in a public sector hospital are represented in the first two narrative types, whereas the third represents those working in a private sector hospital. The first narrative represents nurses who were new in the profession and despite hard working conditions were performing their duties. The second narrative represents nurses working in the public sector with limited resources, and the third narrative is a representation of nurses who were working hard and stressed out despite a well functioning system.Conclusion: The study shows that the presence of a well trained health workforce is vital, and that certain

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

    Science.gov (United States)

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

    2013-02-01

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

  19. Evaluation of a Public Child Eye Health Tertiary Facility for Pediatric Cataract in Southern Nigeria I: Visual Acuity Outcome

    Science.gov (United States)

    Duke, Roseline E.; Adio, Adedayo; Oparah, Sidney K.; Odey, Friday; Eyo, Okon A.

    2016-01-01

    Purpose: A retrospective study of the outcome of congenital and developmental cataract surgery was conducted in a public child eye health tertiary facility in children <16 years of age in Southern Nigeria, as part of an evaluation. Materials and Method: Manual Small Incision Cataract Surgery with or without anterior vitrectomy was performed. The outcome measures were visual acuity (VA) and change (gain) in visual acuity. The age of the child at onset, duration of delay in presentation, ocular co-morbidity, non ocular co-morbidity, gender, and pre operative visual acuity were matched with postoperative visual acuity. A total of 66 children were studied for a period of six weeks following surgery. Results: Forty eight (72.7%) children had bilateral congenital cataracts and 18 (27.3%) children had bilateral developmental cataracts. There were 38(57.6%) males and 28 (42.4%) females in the study. Thirty Five (53%) children had good visual outcome (normal vision range 6/6/ -6/18) post-operatively. The number of children with blindness (vision <3/60) decreased from 61 (92.4%) pre-operatively to 4 (6.1%) post-operatively. Post operative complication occurred in 6.8% of cases six week after surgery. Delayed presentation had an inverse relationship with change (gain) in visual acuity (r = - 0.342; p-value = 0.005). Pre-operative visual acuity had a positive relationship with post operative change (gain) in visual acuity (r = 0.618; p-value = 0.000). Conclusion: Predictors of change in visual acuity in our study were; delayed presentation and pre-operative VA. Cataract surgery in children showed clinical benefit. PMID:27347247

  20. Welfare, wellness, and job satisfaction of Chinese physicians: A national survey of public tertiary hospitals in China.

    Science.gov (United States)

    Sun, Jing; Ma, Jing; Hu, Guangyu; Zhao, Qi; Yuan, Changzheng; Si, Wen; Zhang, Xinqing; Liu, Yuanli

    2017-07-01

    Little national data are available on Chinese physicians' welfare, wellness, and job satisfaction. We conducted a self-administered smartphone-based national survey in early 2016 of 17 945 physicians from 136 tertiary hospitals across 31 provinces in China. In addition to collecting the physicians' basic information, we also measured 5 domains (the ethical and working environments, welfare, wellness, and job satisfaction). Half of the physicians reported a hospital-based annual income of less than RMB 72 000 ($10 300), and 60.31% of them did not think that the current medical pricing system reflects physicians' value. More than half (58.64%) of them did not have or did not know about medical malpractice insurance. These physicians worked long hours (an average of 10 h) and slept short hours (average 6 h). Only 35.78% of them thought that they were in good health, and 51.03% were in good mental health. Approximately, a quarter of them had helped to pay medical bills for patients who could not afford care, and 1 in 7 has been penalised for seeing patients who generated bad debts. Only 33.42% of them thought that their occupation receives social recognition and respect, and 70.98% would not encourage their children to pursue a medical career. The top 3 factors that may influence physician job satisfaction as chosen by the physicians were as follows: (1) the income distribution policy (45.92%), (2) working environment safety (25.86%), and (3) public trust and respect for their job (16.10%). In conclusion, we found that Chinese physicians bear heavy physical, mental, and financial stress, and many of them lack confidence that they receive trust and respect from society. Copyright © 2017 John Wiley & Sons, Ltd.

  1. Predictive value of Borrelia burgdorferi IgG antibody levels in patients referred to a tertiary Lyme centre.

    Science.gov (United States)

    Zwerink, M; Zomer, T P; van Kooten, B; Blaauw, G; van Bemmel, T; van Hees, B C; Vermeeren, Y M; Landman, G W

    2018-03-01

    A two-step testing strategy is recommended in serological testing for Lyme borreliosis; positive and indeterminate enzyme-linked immunosorbent assay (ELISA) results are confirmed with immunoblots. Several ELISAs quantify the concentration of antibodies tested, however, no recommendation exists for an upper cut-off value at which an IgG ELISA is sufficient and the immunoblot can be omitted. The study objective was to determine at which IgG antibody level an immunoblot does not have any additional predictive value compared to ELISA results. Data of adult patients who visited a tertiary Lyme centre between 2008 and 2014 were analysed. Both an ELISA (Enzygnost Lyme link VlsE IgG) and immunoblot (recomLine blot Borrelia) were performed. Clinical data were extracted from the patient's digital medical record. Positive predictive values (PPVs) for either previous or active infection with Borrelia burgdorferi s.l. were calculated for different cut-off ELISA IgG antibody levels where the immunoblot was regarded as reference test. In total, 1454 patients were included. According to the two-step test strategy, 486 (33%), 69 (5%) and 899 (62%) patients had positive, indeterminate and negative Borrelia IgG serology, respectively. At IgG levels of 500 IU/ml and higher, all immunoblots were positive, resulting in a 100% PPV (95% CI: 97.0-100). At IgG levels of 200 IU/ml and higher, the PPV was 99.3% (95% CI: 97.4-99.8). In conclusion, at IgG levels of 200 IU/ml and higher, an ELISA was sufficient to detect antibodies to Borrelia burgdorferi s.l. At those IgG levels, a confirmatory immunoblot may be omitted in patients referred to a tertiary Lyme centre. Before these results can be implemented in routine diagnosis of Lyme borreliosis, confirmation of the results is necessary in other patient populations and using other quantitative ELISAs and immunoblots. Copyright © 2017 Elsevier GmbH. All rights reserved.

  2. Expanding the Range of the First Step to Success Intervention: Tertiary-Level Support for Children, Teachers, and Families

    Science.gov (United States)

    Frey, Andy J.; Small, Jason W.; Lee, Jon; Walker, Hill M.; Seeley, John R.; Feil, Edward G.; Golly, Annemeike

    2015-01-01

    This study presents the findings of a quasi-experimental feasibility study examining the Tertiary First Step intervention, an enhanced version of the First Step to Success early intervention program. Tertiary FirstStep was developed to engage families more effectively and influence and improve parenting practices for children having challenging…

  3. The association between estimated average glucose levels and fasting plasma glucose levels in a rural tertiary care centre

    Directory of Open Access Journals (Sweden)

    Raja Reddy P

    2013-01-01

    Full Text Available The level of hemoglobin A1c (HbA1c, also known as glycated hemoglobin, determines how well a patient’s blood glucose level has been controlled over the previous 8-12 weeks. HbA1c levels help patients and doctors understand whether a particular diabetes treatment is working and whether adjustments need to be made to the treatment. Because the HbA1c level is a marker of blood glucose for the previous 60- 90 days, average blood glucose levels can be estimated using HbA1c levels. Aim in the present study was to investigate the relationship between estimated average glucose levels, as calculated by HbA1c levels, and fasting plasma glucose levels. Methods: Type 2 diabetes patients attending medicine outpatient department of RL Jalappa hospital, Kolar between March 2010 and July 2012 were taken. The estimated glucose levels (mg/dl were calculated using the following formula: 28.7 x HbA1c-46.7. Glucose levels were determined using the hexokinase method. HbA1c levels were determined using an HPLC method. Correlation and independent t- test was the test of significance for quantitative data. Results: A strong positive correlation between fasting plasma glucose level and estimated average blood glucose levels (r=0.54, p=0.0001 was observed. The difference was statistically significant. Conclusion: Reporting the estimated average glucose level together with the HbA1c level is believed to assist patients and doctors determine the effectiveness of blood glucose control measures.

  4. Embedded and Direct Metacognitive Strategy Instruction and its Effects on the Metacognitive Awareness of Tertiary Level Malaysian ESL Listeners

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    Siew Ean Lye

    2018-01-01

    Full Text Available This small-scale quasi-experimental study compared the effects of metacognitive strategy instruction using two pedagogical approaches on the metacognitive awareness of Malaysian ESL listeners. Embedded and direct strategy instruction was delivered using the Metacognitive Pedagogical Sequence and Cognitive Academic Language Learning Approach instructional models respectively. 45 tertiary level students were randomly selected and assigned to two treatment groups to receive metacognitive instruction over a training period of five weeks. Paired-samples t-test results on participants‟ metacognitive awareness, as measured using the Metacognitive Awareness Listening Questionnaire (MALQ were inclusive despite significant improvements in their IELTS listening scores. No significant development was recorded in the overall MALQ scores but there were significant changes in three out of the five metacognitive awareness factors. Results further layered according to participants‟ listening proficiency levels (low, intermediate and high to examine if differences existed among the listening levels similarly showed no significant difference. These results suggest that ESL listeners‟ metacognitive awareness may not be easily developed with strategy instruction, regardless of the instructional approaches.

  5. Use of English Vocabulary Learning Strategies by Thai Tertiary-Level Students in Relation to Fields of Study and Language-Learning Experiences

    Science.gov (United States)

    Boonkongsaen, Nathaya; Intaraprasert, Channarong

    2014-01-01

    The present study was intended to examine the effects of 1) fields of study (arts, business and science-oriented); and 2) language-learning experiences (whether limited or non-limited to formal classroom instructions) on the use of VLSs among Thai tertiary-level students. The participants were 905 Thai EFL students studying in the Northeast of…

  6. Neonatal Resuscitation in the Delivery Room from a Tertiary Level Hospital: Risk Factors and Outcome

    OpenAIRE

    Afjeh, Seyyed-Abolfazl; Sabzehei, Mohammad-Kazem; Esmaili, Fatemeh

    2013-01-01

    Objective Timely identification and prompt resuscitation of newborns in the delivery room may cause a decline in neonatal morbidity and mortality. We try to identify risk factors in mother and fetus that result in birth of newborns needing resuscitation at birth. Methods Case notes of all deliveries and neonates born from April 2010 to March 2011 in Mahdieh Medical Center (Tehran, Iran), a Level III Neonatal Intensive Care Unit, were reviewed; relevant maternal, fetal and perinatal data was e...

  7. Patient safety in maternal healthcare at secondary and tertiary level facilities in Delhi, India

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    Chandrakant Lahariya

    2015-01-01

    Full Text Available Background: There is insufficient information on causes of unsafe care at facility levels in India. This study was conducted to understand the challenges in government hospitals in ensuring patient safety and to propose solutions to improve patient care. Materials and Methods: Desk review, in-depth interviews, and focused group discussions were conducted between January and March 2014. Healthcare providers and nodal persons for patient safety in Gynecology and Obstetrics Departments of government health facilities from Delhi state of India were included. Data were analyzed using qualitative research methods and presented adopting the "health system approach." Results: The patient safety was a major concern among healthcare providers. The key challenges identified were scarcity of resources, overcrowding at health facilities, poor communications, patient handovers, delay in referrals, and the limited continuity of care. Systematic attention on the training of care providers involved in service delivery, prescription audits, peer reviews, facility level capacity building plan, additional financial resources, leadership by institutional heads and policy makers were suggested as possible solutions. Conclusions: There is increasing awareness and understanding about challenges in patient safety. The available local information could be used for selection, designing, and implementation of measures to improve patient safety at facility levels. A systematic and sustained approach with attention on all functions of health systems could be beneficial. Patient safety could be used as an entry point to improve the quality of health care services in India.

  8. Information and communications technology facilities at the tertiary level education in some urban universities in Bangladesh

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    F. M. Shahriar

    2016-07-01

    Full Text Available With the advent of digitalization, information and communications technology facilities have become an indispensable part of education especially at the universities. This study has been undertaken with dual purposes - to find the existing scenario of information and communications technology facilities and to gauge the perception of the students onthe quality of those facilities - at the universities in Bangladesh. To that end, a survey was conducted on the undergraduate and graduate students of 9 private and public universities. To assess the quality of information and communications technology services, participants’ views on various aspects like the sufficiency of computers, availability of required software, maintenance and troubleshooting, internet and data sharing facilities, etc. were collected and analyzed. The study finds that although students are on the happier side with the information and communications technology installations and equipment, they are fairly unhappy about the maintenance services and internet facilities available at their universities. It gives some valuable insights about the information and communications technology facilities scenario at the universities that can be taken into consideration while planning future action plan and development of information and communications technology at the universities in Bangladesh.

  9. "Digitize Me": Generating E-Learning Profiles for Media and Communication Students in a Jamaican Tertiary-Level Institution

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    Michelle A. Stewart-McKoy

    2014-01-01

    Full Text Available The purpose of this project was to develop an e-learning profile for a group of media and communication students enrolled in a Jamaican tertiary-level institution in order to make informed decisions most the appropriate [online] learning complement for these students. The objectives sought to determine the e-learning profile of media and communication students but more specifically, the profile examined students’ demographic data, their technology access, usage, proficiency and comfort levels as well as their learning styles, preferences, behaviours, strategies and their preferences for specific teaching styles. The research utilised a survey research design and the participants involved in the research were ninety-eight students from all year groups in the programme. Findings reveal that the “typical” media and communication student is a young Jamaican adult with limited technology access, usage and proficiency, who stays connected with others largely by phone texts, phone calls, emails, instant messages and posts via the Facebook social network, who has a visual-learning orientation, is a sequential learner who is extrinsically motivated and who readily employs surface learning strategies.

  10. A Case Study Analysis of Clt Methods to Develop Grammar Competency for Academic Writing Purposes at Tertiary Level

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    Almodad Biduk Asmani

    2013-10-01

    Full Text Available The purpose of the research project is to find out how effective grammar teaching and learning using the Principled CLT method can improve the ability of freshman Binus University students to understand and use grammar knowledge for academic writing purposes. The research project is expected to result in computer-animated format which can be used as one of the main tools in teaching and learning grammar at tertiary level. The research project applies the descriptive quantitative approach, and thus uses numeric data. The research project involves two subject groups, which are experimental and control. The two groups are pre-tested so as to find out their level of grammar competency by their academic writing works. The experimental group receives the treatment of grammar learning by using the Principled CLT approach, while the control group receives the standard CLT approach. Then, the two groups have the post-test, and the results are compared. Through statistics, the numerical data show that there is no significant difference between the two methods’ results, and as a result, either method has its own strength and weaknesses. If one is to be implemented, it must be linked to the specific goals and purposes that each entails.  

  11. Emerging trends of nosocomial pneumonia in intensive care unit of a tertiary care public teaching hospital in Western India.

    Science.gov (United States)

    Bhadade, Rakesh; Harde, Minal; deSouza, Rosemarie; More, Ashwini; Bharmal, Ramesh

    2017-01-01

    Nosocomial pneumonia poses great challenge to an intensivist. Detailed information about hospital-acquired pneumonia (HAP) and ventilator-acquired pneumonia (VAP) is crucial for prevention and optimal management, thus improving quality Intensive Care Unit (ICU) care. Hence, we aimed to study the current trend of nosocomial pneumonia in ICU. It was a prospective observational cohort study, conducted in the ICU of a tertiary care teaching public hospital over a period of 18 months. We studied clinical profile and outcome of 120 adult patients who developed VAP/HAP during the study period. We also analyzed the causative organisms, antibiotic sensitivity, and resistance pattern in these patients. Out of 120 patients, 29 patients were HAP and 91 patients were VAP. Mortality was 60% (72), and development of VAP and requirement of mechanical ventilation showed significant association with mortality (P antibiotiques et le modèle de résistance chez ces patients. Résultats: Sur 120 patients, 29 patients étaient HAP et 91 patients étaient VAP. La mortalité était de 60% (72), et le développement du VAP et l'exigence de ventilation mécanique ont montré une association significative avec la mortalité (P antibiotique maximale a été observée chez la pipéracilline + tazobactam (58,8%), suivie de l'imipénème (49,5%) et du méropénem (41,8%), alors que la résistance antibiotique maximale a été observée à cefépime (95,1%), suivie de ceftazidime et de l'amoxicilline (91,2%) . la pneumonie nosocomiale a montré une incidence élevée (17,44%) et la mortalité (60%). Les organismes communs identifiés étaient S. aureus et K. pneumoniae. La résistance était élevée pour les antibiotiques couramment utilisés et une forte sensibilité aux antibiotiques pour la pipéracilline + le tazobactam et le carbapénème.

  12. Association of Serum LDL Cholesterol Level with Periodontitis among Patients Visiting a Tertiary-care Hospital

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    S Sharma

    2011-09-01

    Full Text Available Introduction: High low-density lipoproteins (LDL cholesterol is one of the major risk factors for cardiovascular disease. In recent years, some evidence has been presented that periodontitis,an infectious inflammatory condition of the periodontium, is associated with an increased risk of cardiovascular disease. To further elucidate this association, we have studied the levels of LDL cholesterol, a known risk marker for cardiovascular disease, in a periodontally-diseased group. Methods: The levels of serum LDL cholesterol in 47 subjects with mild to severe (clinical attachment loss equal to or greater than 1 mm chronic generalized (at least 30% of teeth affected periodontitis with the mean age of 42.21 ± 1.46 years were measured and compared with those obtained from 42 age (39.83 ± 0.94 and sex matched controls. Both groups were free from systemic illnesses. Results: The mean serum LDL cholesterol in periodontitis patients was found to be signifi cantly higher (P < 0.001 as compared to that of the controls. The mean clinical attachment loss was positively correlated with serum LDL cholesterol (P < 0.01 and gingival index (P<0.05. The frequency of persons with pathologic values of LDL cholesterol was signifi cantly higher in periodontitis patients compared with that of the controls. Conclusions: These results showed that high serum LDL cholesterol may be associated with periodontitis in healthy people. However, it is unclear whether periodontitis causes an increase in the levels of serum LDL or an increased LDL is a risk factor for both periodontitis and cardiovascular disease. Keywords: Cardiovascular disease, LDL cholesterol, periodontitis.

  13. Computer self-efficacy - is there a gender gap in tertiary level introductory computing classes?

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    Shirley Gibbs

    Full Text Available This paper explores the relationship between introductory computing students, self-efficacy, and gender. Since the use of computers has become more common there has been speculation that the confidence and ability to use them differs between genders. Self-efficacy is an important and useful concept used to describe how a student may perceive their own ability or confidence in using and learning new technology. A survey of students in an introductory computing class has been completed intermittently since the late 1990\\'s. Although some questions have been adapted to meet the changing technology the aim of the survey has remain unchanged. In this study self-efficacy is measured using two self-rating questions. Students are asked to rate their confidence using a computer and also asked to give their perception of their computing knowledge. This paper examines these two aspects of a person\\'s computer self-efficacy in order to identify any differences that may occur between genders in two introductory computing classes, one in 1999 and the other in 2012. Results from the 1999 survey are compared with those from the survey completed in 2012 and investigated to ascertain if the perception that males were more likely to display higher computer self-efficacy levels than their female classmates does or did exist in a class of this type. Results indicate that while overall there has been a general increase in self-efficacy levels in 2012 compared with 1999, there is no significant gender gap.

  14. Neonatal Resuscitation in the Delivery Room from a Tertiary Level Hospital: Risk Factors and Outcome

    Science.gov (United States)

    Afjeh, Seyyed-Abolfazl; Sabzehei, Mohammad-Kazem; Esmaili, Fatemeh

    2013-01-01

    Objective Timely identification and prompt resuscitation of newborns in the delivery room may cause a decline in neonatal morbidity and mortality. We try to identify risk factors in mother and fetus that result in birth of newborns needing resuscitation at birth. Methods Case notes of all deliveries and neonates born from April 2010 to March 2011 in Mahdieh Medical Center (Tehran, Iran), a Level III Neonatal Intensive Care Unit, were reviewed; relevant maternal, fetal and perinatal data was extracted and analyzed. Findings During the study period, 4692 neonates were delivered; 4522 (97.7%) did not require respiratory assistance. One-hundred seven (2.3%) newborns needed resuscitation with bag and mask ventilation in the delivery unit, of whom 77 (1.6%) babies responded to bag and mask ventilation while 30 (0.65%) neonates needed endotracheal intubation and 15 (0.3%) were given chest compressions. Epinephrine/volume expander was administered to 10 (0.2%) newborns. In 17 patients resuscitation was continued for >10 mins. There was a positive correlation between the need for resuscitation and following risk factors: low birth weight, preterm labor, chorioamnionitis, pre-eclampsia, prolonged rupture of membranes, abruptio placentae, prolonged labor, meconium staining of amniotic fluid, multiple pregnancy and fetal distress. On multiple regression; low birth weight, meconium stained liquor and chorioamnionitis revealed as independent risk factors that made endotracheal intubation necessary. Conclusion Accurate identification of risk factors and anticipation at the birth of a high-risk neonate would result in adequate preparation and prompt resuscitation of neonates who need some level of intervention and thus, reducing neonatal morbidity and mortality. PMID:24910747

  15. Current Trends of Using Antimicrobial Drugs in the ICU at a Tertiary Level Teaching Hospital in Mymensingh.

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    Saha, S K; Shaha, K C; Haque, M F; Khatun, S; Akhter, S M; Akhter, H

    2016-10-01

    The aim of the present study was to investigate the current trends of using antimicrobial drugs in the ICU at a tertiary level teaching hospital in Mymensingh. The study of prescribing patterns seeks to monitor, evaluate and suggest modifications in clinicians prescribing habits so as to make medical care rational. It was an observational type of descriptive study, conducted in the Mymensingh medical college hospital, Mymensingh, during the study period of June 2016 to September 2016.The study was approved by the institutional ethical committee. Most patients in the ICU belonged to the older age group >60 years. Male patients were more than the female patients in ICU. Average duration of stay in ICU was 4.35 days. Admissions in ICU were common due to respiratory system related diseases and the present study showed that 31.68% of the reported cases belong to the respiratory system. Average number of drugs per prescription was 6.46. Average number of anti-microbial drugs per prescription was 1.38. Cephalosporin group and individually ceftriaxone was the most frequently prescribed antimicrobial group and agent respectively in the ICU. Most commonly used antimicrobial combination was Cephalosporin and Metronidazole (43.33%) followed by Carbapenem (Meropenem) and Metronidazole (13.33%). Most antimicrobial agents were prescribed without bacteriological culture and sensivity testing evidence. There is a need for motivating the physicians to prescribe antimicrobial agents with supportive bacteriological evidences.

  16. Factors associated with high stress levels in adults with diabetes mellitus attending a tertiary diabetes care center, Chennai, Tamil Nadu, India.

    OpenAIRE

    Sendhilkumar, M; Tripathy, JP; Harries, AD; Dongre, AR; Deepa, M; Vidyulatha, A; Poongothai, S; Venkatesan, U; Anjana, RM; Mohan, V

    2017-01-01

    Objective: We aimed to determine perceived stress levels among adults aged >20 years with type 2 diabetes mellitus (DM) in a tertiary care diabetes center, Chennai, Tamil Nadu, India, assess their association with sociodemographic and clinical characteristics and assess the possible risk factors for stress and coping strategies. Methods: A mixed-methods (triangulation design) study with quantitative methodology (survey) and qualitative methodology (interviews) was carried out. Stress levels w...

  17. Risk Factors Predicting Mortality in Patients with Lung Abscess in a Public Tertiary Care Center in Karachi, Pakistan

    OpenAIRE

    Shaista Ghazal; Ashok Kumar; Binav Shrestha; Sana Sajid; Maria Malik; Nadeen Rizvi

    2013-01-01

    Introduction: Lung abscess is a commonly encountered entity in South-East Asia but not much data regarding its outcome is available. The objective of this study was to identify the factors associated with increased mortality in patients diagnosed with lung abscess in a tertiary care center of Karachi, Pakistan. Methods: A retrospective case analysis was performed via hospital records, on patients admitted with lung abscess between January 2009 and January 2011 at the largest state...

  18. Secondary and tertiary hyperparathyroidism.

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    Jamal, Sophie A; Miller, Paul D

    2013-01-01

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

  19. Neonatal Outcomes of Rh-Negative Pregnancies in a Tertiary Level Neonatal Intensive Care Unit: A Prospective Study

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    Chacham

    2016-07-01

    Full Text Available Background Rhesus incompatibility is a preventable cause for severe neonatal hyperbilirubinemia, hydrops fetalis and still births. The prevalence of the Rh-negative blood group among Indian woman varies from 2% - 10%. Despite declining the incidence of Rhesus incompatibility, due to availability of anti-D immunoglobulin, and improved antenatal care of the Rh-negative pregnant woman, it still accounts for a significant proportion of neonatal hyperbilirubinemia and neuro-morbidity. The prevalence of Rh-negative women having Rh-positive neonates is 60%. Objectives This study aimed to estimate the incidence of Rh iso-immunization and evaluate the outcomes of Rh iso-immunized neonates. Methods This prospective observational study was conducted in a tertiary level neonatal intensive care unit, Princess Esra hospital, Deccan college of medical sciences, Hyderabad, Telangana, India. Consecutive intramural and extramural neonates admitted to neonatal intensive care unit with the Rh-negative mother’s blood group and hyperbilirubinemia were enrolled. Neonates born to Rh+ve mothers were excluded. Neonatal gestational age, birth weight, age at admission, duration of phototherapy, duration of hospitalization, neonatal examination and investigations were recorded in a predesigned, pretested performa. Results A total of 90 neonates were born to Rh-negative mothers, of which 70% (63 had the Rh-positive blood group and 30% had the Rh-negative blood group. Of these 63 neonates, 48 (76.2% had hyperbilirubinemia and 43 neonates (68.3% had significant hyperbilirubinemia (total serum bilirubin > 15mg/dL. Among them, 2%, 75% and 23% were born to primi, multi and grandmutli, respectively. Also, 14.5% of the neonates were large for dates (LFD, 75% appropriate for dates (AFD and 10.5% were small for dates (SFD. Premature and SFD neonates had higher incidence of hyperbilirubinemia. Significantly higher incidence of jaundice occurred within 72 hours of life. The mean

  20. Level of Motivation Amongst Health Personnel Working in A Tertiary Care Government Hospital of New Delhi, India

    Science.gov (United States)

    Jaiswal, Poonam; Singhal, Ashok K.; Gadpayle, Adesh K.; Sachdeva, Sandeep; Padaria, Rabindra

    2014-01-01

    Aims: To assess the level and factors of motivation amongst permanent government employees working in a tertiary health care institution. Material and Methods: A sample of 200 health personnel (50 in each category) i.e. doctors, nurses, technician, and support staff were contacted through face to face interview. Motivation was measured as the degree to which an individual possessed various identified motivation domains like Drive, Control, Challenge, Relationship and Rewards. Each domain was represented by 4 dimensions- accordingly a closed-ended statement represented each of these dimensions and responses were assessed on a Likert based scale. Data management was done using SPSS, ver. 19. Results: The average age for different health personnel were: Doctors 48.68 (±8.53), nurses 40.72 (±7.76), technician 38.4 (±10.65) and support staff 43.24 (±9.52) years. The average year of work experience was: Doctor 19.09 (±9.77), nurses 17.2 (±8.420), technician 14.84 (±10.45), support staff 18.24 (±10.28). A comparison of overall motivation index (mean score) revealed that nurse had highest level (3.47), followed by support staff (3.46), doctor (3.45) and technician (3.43). Based on their individual mean scores, the healthcare providers were categorised into three different levels of motivation and it was found that majority of the health personnel i.e.70% of support staff, 62% nurse, 56% doctor and technician, had high to very high level of motivation index. The mean scores for all the five factors as well as their respective ranks were also found out and it was deduced that “relationship” assumed first rank for doctors (mean score: 3.71) and technician (mean score: 3.75), whereas “control” assumed greatest significance for nurses (mean score, 3.62) and support staff (mean scores, 3.61). Based upon the mean scores, “reward” assumed third rank among all the four categories. Kruskal-Wallis test was applied to test if the different categories of health

  1. Some aspects of public associations’ participation in implementing public control at municipal level

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    Roman V. Gornev

    2016-03-01

    Full Text Available Objective to clarify the status of public associations as subjects of public control and to analyze the problems of participation of citizens 39 associations in conducting public expertise and public audits. Methods the methodology of research includes general scientific methods such as dialectic method. Specific jurisprudence methods of scientific cognition have also been used. Systematic method was used for the analysis of forms of public control by citizens39 associations at the municipal level. The principle of scientific objectivity has allowed for a comprehensive and objective analysis of the factual material the totality of factors affecting the interaction of public associations with local authorities in the implementation of public control. The formallegal method allowed to analyze the normativelegal acts to reveal the signs of fixing of such public control forms as public expertise and public audit. In the present study other research methods were also applied allowing to study the theme in detail. Results the study identified the lack of legal regulation of the legal status of public associations as subjects of public control as well as some forms of public control. The additions to the list of subjects of public control by public associations were proposed as well as improvements in the implementation of public expertise and public audit by the citizens39 associations as forms of social control. Scientific novelty the author found a lack of regulation of public associationsrsquo participation in some forms of social control and justified proposals for their improvement from a scientific point of view. Practical significance the possibility to apply the research results in legislative activity aimed at improving the provisions of the Federal Laws quotOn fundamentals of public control in the Russian Federationquot and quotOn the general principles of local selfgovernment organization in the Russian Federationquot. In addition the

  2. Phenotypic and genotypic characteristics of carbapenem-resistant Enterobacteriaceae in a tertiary-level reference hospital in Turkey.

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    Baran, Irmak; Aksu, Neriman

    2016-04-06

    Enterobacteriaceae are among the most common pathogens that are responsible for serious community-acquired, hospital-acquired, and health-care associated infections. The emergence and spread of carbapenem-resistant Enterobacteriaceae (CRE) have become an increasing concern for healthcare services worldwide. Infections caused by these bacteria have been associated with significant morbidity and mortality and treatment options have been limited. The rapid and accurate detection of carbapenem resistance in these bacteria is important for infection control. The aim of this study was to investigate the phenotypic and genotypic features of CRE strains isolated in a tertiary-level reference hospital in Turkey. A total of 181 CRE strains were included in the study. Antimicrobial susceptibility rates were tested using Vitek 2 system. Modified Hodge test (MHT) was performed using meropenem and ertapenem discs. Metallo-β-lactamase antimicrobial gradient test (E-test MBL strips) were used for evaluation of metallo-β-lactamase production. A multiplex PCR was used for detection of carbapenems resistance genes (IMP, VIM, KPC, NDM-1 and OXA-48). The OXA-48 gene was detected in 86 strains, NDM-1 gene in six strains, VIM gene in one strain. IMP and KPC genes were not identified. Three strains produced both OXA-48 and NDM-1 and one strain produced both OXA-48 and VIM. In two patients more than one genus of OXA-48 positive CREs was isolated. Ninety-two of the isolates were multidrug-resistant. One hundred and ten isolates were MHT with meropenem (MEM-MHT) positive and 109 isolates were MHT with ertapenem (ERT-MHT) positive. Nine of the isolates were positive with E-test MBL strips. The sensitivity of MEM-MHT and ERT-MHT for detection of OXA-48 was 70.9 and 70.6 %, respectively. MEM-MHT was found highly discriminative for OXA-48 Escherichia coli (p Enterobacteriaceae in the hospital environment. While OXA-48 is still the most common source of carbapenem resistance in

  3. Comparison of two public sector tertiary care hospitals' management in reducing direct medical cost burden on breast carcinoma patients in Lahore, Pakistan.

    Science.gov (United States)

    Hameed Khaliq, Imran; Zahid Mahmood, Hafiz; Akhter, Naveed; Danish Sarfraz, Muhammad; Asim, Khadija; Masood Gondal, Khalid

    2018-01-01

    Breast cancer is one of the major causes of death incurring highest morbidity and mortality amongst women of Pakistan. The purpose of this study was to assess and compare the role of two public sector tertiary care hospitals' management in reducing out of pocket (OOP) expenses on direct medical costs borne by breast carcinoma patients' household from diagnosis through treatment. Moreover, the study intended to explore the reasons of opting private diagnostic facilities by the said patients during the services taken from the foresaid tertiary care centers. A purposive sample of 164 primary breast carcinoma patients was recruited for data collection of this cross-sectional study. Face to face interviews and semistructured questionnaires were adopted as method of data gathering tools. Major cost components of direct medical costs were used to compare the financial strain on the patients' households of both targeted hospitals. In addition, information was collected regarding the reasons of opting private diagnostic centers for investigations. Frequency, percentages, median and inter quartile range (IQR) were calculated for the data. Non-parametric variables were compared using the Mann-Whitney U test. It was observed that overall direct medical cost borne by the breast carcinoma patients' households in Jinnah hospital (median US$1153.93 / Rs. 118,589) was significantly higher than Mayo hospital (median US$427.93 /Rs. 43,978), pprivately opted investigations procedures was the common issue of the patients under treatment in both hospitals.

  4. Public health preparedness in Alberta: a systems-level study.

    Science.gov (United States)

    Moore, Douglas; Shiell, Alan; Noseworthy, Tom; Russell, Margaret; Predy, Gerald

    2006-12-28

    Recent international and national events have brought critical attention to the Canadian public health system and how prepared the system is to respond to various types of contemporary public health threats. This article describes the study design and methods being used to conduct a systems-level analysis of public health preparedness in the province of Alberta, Canada. The project is being funded under the Health Research Fund, Alberta Heritage Foundation for Medical Research. We use an embedded, multiple-case study design, integrating qualitative and quantitative methods to measure empirically the degree of inter-organizational coordination existing among public health agencies in Alberta, Canada. We situate our measures of inter-organizational network ties within a systems-level framework to assess the relative influence of inter-organizational ties, individual organizational attributes, and institutional environmental features on public health preparedness. The relative contribution of each component is examined for two potential public health threats: pandemic influenza and West Nile virus. The organizational dimensions of public health preparedness depend on a complex mix of individual organizational characteristics, inter-agency relationships, and institutional environmental factors. Our study is designed to discriminate among these different system components and assess the independent influence of each on the other, as well as the overall level of public health preparedness in Alberta. While all agree that competent organizations and functioning networks are important components of public health preparedness, this study is one of the first to use formal network analysis to study the role of inter-agency networks in the development of prepared public health systems.

  5. Public health preparedness in Alberta: a systems-level study

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    Noseworthy Tom

    2006-12-01

    Full Text Available Abstract Background Recent international and national events have brought critical attention to the Canadian public health system and how prepared the system is to respond to various types of contemporary public health threats. This article describes the study design and methods being used to conduct a systems-level analysis of public health preparedness in the province of Alberta, Canada. The project is being funded under the Health Research Fund, Alberta Heritage Foundation for Medical Research. Methods/Design We use an embedded, multiple-case study design, integrating qualitative and quantitative methods to measure empirically the degree of inter-organizational coordination existing among public health agencies in Alberta, Canada. We situate our measures of inter-organizational network ties within a systems-level framework to assess the relative influence of inter-organizational ties, individual organizational attributes, and institutional environmental features on public health preparedness. The relative contribution of each component is examined for two potential public health threats: pandemic influenza and West Nile virus. Discussion The organizational dimensions of public health preparedness depend on a complex mix of individual organizational characteristics, inter-agency relationships, and institutional environmental factors. Our study is designed to discriminate among these different system components and assess the independent influence of each on the other, as well as the overall level of public health preparedness in Alberta. While all agree that competent organizations and functioning networks are important components of public health preparedness, this study is one of the first to use formal network analysis to study the role of inter-agency networks in the development of prepared public health systems.

  6. 'The public is too subjective': public involvement at different levels of health-care decision making.

    Science.gov (United States)

    Litva, Andrea; Coast, Joanna; Donovan, Jenny; Eyles, John; Shepherd, Michael; Tacchi, Jo; Abelson, Julia; Morgan, Kieran

    2002-06-01

    There are a number of impulses towards public participation in health care decision making including instrumentalist, communitarian, educative and expressive impulses and the desire for increased accountability. There has, however, been little research looking systematically at the public's preferences for being involved in particular types of rationing decisions, nor indeed, has there been a critical examination of the degree of involvement desired by the public. The research reported here uses findings from focus groups and in-depth interviews to explore these questions. Eight focus groups were conducted with a total of 57 informants, four amongst randomly selected members of the public and four with informants from health and non-health related organisations. Nineteen interviews were conducted to allow the elaboration of focus group comments, to probe views more deeply and to pursue emerging themes. The findings show variations in the willingness of members of the public to be involved in health care decisions and consistency across the different forms of the public as represented by the focus groups with randomly selected citizens and pre-existing organisations. There was a strong desire in all the groups for the public to be involved both at the system and programme levels, with much less willingness to be involved at the individual level. At the system and programme levels informants generally favoured consultation, without responsibility for decisions, but with the guarantee that their contribution would be heard and that decisions taken following consultation would be explained. At the patient level informants felt that the public should participate only by setting criteria for deciding between potential beneficiaries of treatment. The public has much to contribute, particularly at the system and programme levels, to supplement the inputs of health care professionals.

  7. Growth of Business English and the Need to Teach Memo-Writing Skills to Indian Tertiary-Level Learners

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    Aruna Arputhamalar

    2015-05-01

    Full Text Available English has become an inevitable means of communication. Due to globalization and rapid growth in business communication, the need to learn the English language has also gained momentum. Employers are looking for employees who are skilled in the language skills. In India, English has become an important means of communication and learning in the education and professional setup. Though English is being taught in schools and colleges, Indian students miserably fail to produce a good quality lengthy composition. In this respect, this paper aims to focus on the need to teach memo-writing skills to tertiary students. To this end, a group of second year Indian BCA students was taken as samples for the study. The students were given a pre-test on memo writing. They lacked the essential skills in writing a memo. In order to improve their memo writing skills the students had to undergo four tasks. At the end of the tasks, they were able to write a good memo. The corporate world demands accurate business writings and our students have to be trained to meet the demands of the business world. This paper studies the growth of business English, the components of effective business writing and the need to teach business writing to tertiary students, which will enable them to be successful in the business world.

  8. Cervical cancer screening: knowledge, attitude and practices among nursing staff in a tertiary level teaching institution of rural India.

    Science.gov (United States)

    Shekhar, Shashank; Sharma, Chanderdeep; Thakur, Sita; Raina, Nidhi

    2013-01-01

    Assessment of the nursing staff knowledge, attitude and practices about cervical cancer screening in a tertiary care teaching institute of rural India. A cross sectional, descriptive, interview- based survey was conducted with a pretested questionnaire among 262 staff nurses of a tertiary care teaching and research institute. In this study 77% respondents knew that Pap smear is used for detection of cervical cancer, but less than half knew that Pap smear can detect even precancerous lesions of cervix. Only 23.4% knew human papilloma virus infection as a risk factor. Only 26.7% of the respondents were judged as having adequate knowledge based on scores allotted for questions evaluating knowledge about cervical cancer and screening. Only 17 (7%) of the staff nurses had themselves been screened by Pap smear, while 85% had never taken a Pap smear of a patient. Adequate knowledge of cervical cancer and screening, higher parity and age >30 years were significantly associated with self screening for cervical cancer. Most nurses held a view that Pap test is a doctor procedure, and nearly 90% of nurses had never referred a patient for Pap testing. The majority of nursing staff in rural India may have inadequate knowledge about cervical cancer screening, and their attitude and practices towards cervical cancer screening could not be termed positive.

  9. Efficacy, Beliefs, and Investment in Step-Level Public Goods

    NARCIS (Netherlands)

    Dijkstra, J.; Oude Mulders, J.

    2014-01-01

    behavior in terms of increasing group well-being. We report a decision and game theoretical analysis of efficacy in step-level public goods (SPGs). Previous research shows a positive relation between efficacy and contributions to SPGs and explains this relation by a purely motivational account. We

  10. Efficacy, Beliefs, and Investment in Step-Level Public Goods

    NARCIS (Netherlands)

    Dijkstra, Jacob; Mulders, Jaap Oude

    2014-01-01

    A central concept for understanding social dilemma behavior is the efficacy of an actor's cooperative behavior in terms of increasing group well-being. We report a decision and game theoretical analysis of efficacy in step-level public goods (SPGs). Previous research shows a positive relation

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

    DEFF Research Database (Denmark)

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

    2009-01-01

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

  12. Low and intermediate level waste repositories: public involvement aspects

    International Nuclear Information System (INIS)

    Ferreira, Vinicius V.M.; Mourao, Rogerio P.; Fleming, Peter M.; Soares, Wellington A.; Braga, Leticia T.P.; Santos, Rosana A.M.

    2009-01-01

    The nuclear energy acceptance creates several problems, and one of the most important is the disposal of the radioactive waste. International experiences show that not only environmental, radiological and technical questions have to be analyzed, but the public opinion about the project must be considered. The objective of this article is to summarize some public involvement aspects associated with low and intermediate level waste repositories. Experiences from USA, Canada, South Africa, Ukraine and other countries are studied and show the importance of the population in the site selection process for a repository. (author)

  13. Public perception of low-level waste technologies: Demands on research and public education programs

    International Nuclear Information System (INIS)

    Witzig, W.F.; Bord, R.J.; Vincenti, J.R.

    1986-01-01

    The complexities of our political and legal systems, along with both insufficient information and misinformation, has resulted in significant problems in the disposal of radioactive waste. Distrust of the industry and regulators by the public, along with insufficient understanding of public fear by those responsible for waste disposal, has created a delay which shows few signs of early resolution. In light of these problems, this paper will specifically cover low-level radioactive waste disposal and management issues in the Appalachian Compact state of Pennsylvania. It will focus on the public's perception of waste technologies, and related policy issues, and the necessity of research and public education to create a bridge of understanding between those responsible for disposing of this material, those who benefit (the general public) from the creation of the waste, and those who are asked to live near disposal sites

  14. THE EFFECTIVENESS OF ONLINE AND OFF LINE WORD OF MOUTH MESSAGES ON TRADITIONAL COURSE CHOICE AT TERTIARY LEVEL

    Directory of Open Access Journals (Sweden)

    N. Serdar SEVER

    2009-01-01

    Full Text Available This study aims to explain how bachelor of communications students who are enrolled to various courses at Anadolu University value word-of-mouth messages in making a course decision. Use of WOM as a marketing tool in tertiary teaching is not a common practice. As elective course numbers increase, students look for alternative avenues and types of information to be sure of making the best possible course selection. The findings of this study indicate that instructors’ previous experiences are not as important as their in-class performances. Another interesting finding of the study is although participants are prone to use internet resources as sources of information; they value the use of computer-mediated and enhanced technologies in teaching. Perhaps the most peculiar finding of the study is senior students are perceived as the most common source of information, and their experiences often seen as a point of reference in choosing a course.

  15. Accuracy of MRI diagnosis of internal derangement of the knee in a non-specialized tertiary level referral teaching hospital

    International Nuclear Information System (INIS)

    Challen, J.; Tang, Y. M.; Stuckey, S.; Hazratwala, K.

    2007-01-01

    Full text: This study was designed to assess the accuracy of knee MRl examinations carried out in a general tertiary referral hospital without a musculoskeletal fellowship trained radiologist. The study included all patients who had undergone a knee arthroscopy carried out within a 2-year period and who had had a prior MRl knee examination, where both were carried out at this institution. The accuracy of the MRl knee examination was determined by correlation to the arthroscopy report. The accuracy for diagnosis of meniscal and cartilage injuries, in this setting, was found to be similar to a published meta-analysis of previous studies correlating knee MRl and arthroscopy. The overall accuracy of this study was better than the previous similar study. However, the accuracy for diagnosing ACL injuries was lower than in the meta-analysis. The potential reasons for this and other sources of error are discussed

  16. Do pregnant women know about danger signs of pregnancy and childbirth? – A study of the level of knowledge and its associated factors from a tertiary care hospital in Southern India

    OpenAIRE

    R Nithya; Gowri Dorairajan; Palanivel Chinnakali

    2017-01-01

    Background: Awareness about danger signs during pregnancy is essential for a woman to seek prompt care. This can avert long-term morbidity and mortality. This study was aimed to find the level of knowledge and its related factors about danger signs of pregnancy and childbirth among pregnant women attending a tertiary care hospital in southern India. Patients and Methods: We conducted a cross-sectional survey of pregnant women attending a tertiary care hospital in South India. Systematic rando...

  17. How to integrate street-level bureaucracies into public management?

    DEFF Research Database (Denmark)

    Aagaard, Peter; Pedersen, John Storm

    the professionals in the public sector at the street-level such as social-workers, teachers, doctors, and other professionals have maintained autonomy regarding the provision, production and delivery of the specific core welfare services to the citizens as end users. By definition hard budget constraint...... and professionals´ autonomy do not fit well. To explore both theoretically and empirically the conflicts between hard budget constraint and professionals´ autonomy, the professionals´ provision, production and delivery of the services to the citizens with disability and socially disadvantaged people and the public...... management of the public spending on the services in Denmark is used as a case. Surprisingly, we find that the managers have been able to resolve the conflicts between the hard budget constraint and the professionals´ autonomy to a rather high degree. The managers have integrated the street...

  18. Anxiety Level in Students of Public Speaking: Causes and Remedies

    Directory of Open Access Journals (Sweden)

    Farhan Uddin Raja

    2017-06-01

    Full Text Available Despite being competent in their field of work, professional’s worldwide struggle due to lack of good public speaking skills. Their assessments and appraisals are often not depictive of their professional competitiveness; therefore, it is important for students to overcome public speaking anxiety before they transit from academic life to professional life. The purpose of this study is to analyze the reasons behind the anxiety level in undergraduate students of a public speaking class and recommend strategies to overcome this fear. This study was entailed quantitative research paradigm on a sample of 50 students using convenience sampling technique from a reputable private sector business school in Karachi. The findings showed that students who fear public speaking can perform well if they use certain strategies to fight their fears. 75% participants admitted their fear of public speaking and 95% participants agreed that if proper counseling, instruction and coaching is provided, this fear can be overcome. Research revealed that exposure to virtual environment can facilitate student confidence and enables themto face audience irrespective of the size.

  19. Nuclear Accidents Intervention Levels for Protection of the Public

    International Nuclear Information System (INIS)

    1989-01-01

    The impact of the 1986 Chernobyl accident called attention to the need to improve international harmonization of the principles and criteria for the protection of the public in the event of a nuclear accident. This report provides observations and guidance related to the harmonization of radiological protection criteria, and is intended to be of use to national authorities and international organizations examining the issue of emergency response planning and intervention levels

  20. Hospital-associated methicillin-resistant Staphylococcus aureus: A cross-sectional analysis of risk factors in South African tertiary public hospitals.

    Directory of Open Access Journals (Sweden)

    Liliwe L Shuping

    Full Text Available Hospital-associated methicillin-resistant S. aureus (HA-MRSA remains a significant cause of morbidity and mortality worldwide. We conducted a study to determine risk factors for HA-MRSA in order to inform control strategies in South Africa.We used surveillance data collected from five tertiary hospitals in Gauteng and Western Cape provinces during 2014 for analysis. A case of HA-MRSA was defined as isolation of MRSA from a blood culture 48 hours after admission and/or if the patient was hospitalised in the six months prior to the current culture. Multivariable logistic regression modelling was used to determine risk factors for HA-MRSA.Of the 9971 patients with positive blood cultures, 7.7% (772 had S. aureus bacteraemia (SAB. The overall prevalence of MRSA among those with SAB was 30.9% (231/747; 95% confidence interval [CI] 27.6%- 34.3%. HA-MRSA infections accounted for 28.3% of patients with SAB (207/731; 95% CI 25.1%- 31.7%. Burns (adjusted odds ratio [aOR] 12.7; 95% CI 4.7-34.4, age ≤1 month (aOR 8.7; 95% CI 3.0-24.6, residency at a long-term care facility (aOR 5.2; 95% CI, 1.5-17.4, antibiotic use within two months of the current SAB episode (aOR 5.1; 95% CI 2.8-9.1, hospital stay of 13 days or more (aOR 2.8; 95% CI 1.3-5.6 and mechanical ventilation (aOR 2.2; 95% CI 1.07-4.6, were independent risk factors for HA-MRSA infection.The prevalence of MRSA remains high in South African tertiary public hospitals. Several identified risk factors of HA-MRSA infections should be considered when instituting infection and prevention strategies in public-sector hospitals, including intensifying the implementation of antimicrobial stewardship programmes. There is an urgent need to strengthen infection prevention and control in burn wards, neonatal wards, and intensive care units which house mechanically ventilated patients.

  1. Hospital-associated methicillin-resistant Staphylococcus aureus: A cross-sectional analysis of risk factors in South African tertiary public hospitals

    Science.gov (United States)

    Kuonza, Lazarus; Musekiwa, Alfred; Iyaloo, Samantha; Perovic, Olga

    2017-01-01

    Introduction Hospital-associated methicillin-resistant S. aureus (HA-MRSA) remains a significant cause of morbidity and mortality worldwide. We conducted a study to determine risk factors for HA-MRSA in order to inform control strategies in South Africa. Methods We used surveillance data collected from five tertiary hospitals in Gauteng and Western Cape provinces during 2014 for analysis. A case of HA-MRSA was defined as isolation of MRSA from a blood culture 48 hours after admission and/or if the patient was hospitalised in the six months prior to the current culture. Multivariable logistic regression modelling was used to determine risk factors for HA-MRSA. Results Of the 9971 patients with positive blood cultures, 7.7% (772) had S. aureus bacteraemia (SAB). The overall prevalence of MRSA among those with SAB was 30.9% (231/747; 95% confidence interval [CI] 27.6%– 34.3%). HA-MRSA infections accounted for 28.3% of patients with SAB (207/731; 95% CI 25.1%– 31.7%). Burns (adjusted odds ratio [aOR] 12.7; 95% CI 4.7–34.4), age ≤1 month (aOR 8.7; 95% CI 3.0–24.6), residency at a long-term care facility (aOR 5.2; 95% CI, 1.5–17.4), antibiotic use within two months of the current SAB episode (aOR 5.1; 95% CI 2.8–9.1), hospital stay of 13 days or more (aOR 2.8; 95% CI 1.3–5.6) and mechanical ventilation (aOR 2.2; 95% CI 1.07–4.6), were independent risk factors for HA-MRSA infection. Conclusion The prevalence of MRSA remains high in South African tertiary public hospitals. Several identified risk factors of HA-MRSA infections should be considered when instituting infection and prevention strategies in public-sector hospitals, including intensifying the implementation of antimicrobial stewardship programmes. There is an urgent need to strengthen infection prevention and control in burn wards, neonatal wards, and intensive care units which house mechanically ventilated patients. PMID:29145465

  2. Arrival time pattern and waiting time distribution of patients in the emergency outpatient department of a tertiary level health care institution of North India

    Directory of Open Access Journals (Sweden)

    Yogesh Tiwari

    2014-01-01

    Full Text Available Background: Emergency Department (ED of tertiary health care institute in India is mostly overcrowded, over utilized and inappropriately staffed. The challenges of overcrowded EDs and ill-managed patient flow and admission processes result in excessively long waits for patients. Aim: The objective of the present study was to analyze the patient flow system by assessing the arrival and waiting time distribution of patients in an Emergency out Patient Department (EOPD. Materials and Methods: This short cross-sectional descriptive study was conducted in the EOPD of a Tertiary level health care Institution in North India in the month of May, 2011. The data was obtained from 591 patients, who were present in the EOPD during the month of May, 2011. The waiting time, inter arrival time between two consecutive patients were calculated in addition to the daily census data (discharge rate, admission rate and transfer out rates etc. of the emergency. Results: Arrival time pattern of patients in the EOPD was highly stochastic with the peak arrival hours to be "9.00-12.00 h" in which around 26.3% patients arrived in the EOPD. The primary waiting areas of patients included patients "under observation" (29.6%; "waiting for routine diagnostic tests" (16.4% and "waiting for discharge" (14.6%. Around 71% patients were waiting due to reasons within emergency complex. Conclusion: The patient flow of the ED could only be addressed by multifaceted, multidisciplinary and hospital wide approach.

  3. Treatment of self-poisoning at a tertiary-level hospital in Bangladesh: cost to patients and government.

    Science.gov (United States)

    Verma, Vasundhara; Paul, Sujat; Ghose, Aniruddha; Eddleston, Michael; Konradsen, Flemming

    2017-12-01

    Approximately 10 000 people die from suicide annually in Bangladesh, many from pesticide poisoning. We aimed to estimate financial costs to patients and health services of treating patients with self-poisoning. Data on direct costs to families, sources of funds for treatment and family wealth were collected prospectively over a one-month period in 2016 at the tertiary Chittagong Medical College Hospital, Bangladesh. Aggregate operational costs to the government were calculated using annual budget, bed occupancy and length-of-stay data. Agrochemicals were the most common substances ingested (58.8%). Median duration of stay and of illness was 2 and 5 days, respectively. Median total cost to patients was conservatively estimated at US$ 98.40, highest in agrochemical poisoning (US$ 179.50), with the greatest cost due to medicines and equipment. Misdiagnosis as organophosphorus poisoning in 17.0% of agrochemical cases resulted in increased cost to patients. Only 51.9% of patients had indicators of wealth; 78.1% borrowed money to cover costs. Conservatively estimated median healthcare costs (US$ 21.30 per patient) were markedly lower than costs to patients. Cost to patients of treating a case of agrochemical poisoning was approximately three times the cost of one month's essential items basket. Incorrect diagnosis at admission costs families substantial sums of money and increased length of stay; it costs the national government an estimated US$ 80 428.80 annually. Widespread access to a list of pesticides used in self-poisoning plus greater focus on training doctors to better manage different forms of agrochemical poisoning should reduce the financial burden to patients and healthcare systems. © 2017 John Wiley & Sons Ltd.

  4. Exploiting the potential of intranet for managing drug spectrum a web base publication in a Tertiary Care Hospital in Mumbai

    Directory of Open Access Journals (Sweden)

    Yashashri Chandrakant Shetty

    2015-01-01

    Full Text Available Objective: The study surveyed the availability of the intranet in campus and also the knowledge related to drug spectrum an intranet publication. Materials and Methods: Institutional ethics committee permission was obtained. Verbal consent was taken from the faculty and resident doctors of departments where all the facilities were available. Universal sampling method was used for recruitment. Pre-validated questionnaires were given to approximately 100 faculty and 500 resident doctors in the year 2012-2013. The questionnaire contained 15 items. Content analysis was done. The study questionnaire focused on a survey to obtain participants feedback on the use of the intranet and to evaluate the use of intranet as a source of knowledge. It also dealt on the relevance of the drug spectrum in the context of their subject. The responses were taken after giving the participants sufficient time. Data was entered into an Excel 2003 spread sheet and analyzed by using descriptive statistics. Results: The total number of respondents who participated in our study was 134 including faculty and residents from various departments. A total of 117 (89.66% respondents stated that their departments have access to the internet. Departments having access to intranet was 103 (76.29%. 67 (49.62% respondents have accessed. 67 (49.62% did not have the time to visit intranet site whereas 67 (49.62% have not accessed intranet. 89 (65.92% respondents were not aware of the drug spectrum. 101 (74.81% respondents felt that drug spectrum is a useful activity on intranet. 45 (33.33% knew about the intranet periodical drug spectrum, but most of the respondents (33.33% explained the meaning of the word drug spectrum according to their understanding, but never knew about the online intranet journal drug spectrum. Conclusion: The study found that the intranet is available in the campus, but it is not being utilized. The awareness and knowledge regarding drug spectrum is lacking, but

  5. Estimating the Direct Medical Economic Burden of Health Care-Associated Infections in Public Tertiary Hospitals in Hubei Province, China.

    Science.gov (United States)

    Li, Hao; Liu, Xinliang; Cui, Dan; Wang, Quan; Mao, Zongfu; Fang, Liang; Zhang, Furong; Yang, Ping; Wu, Huiling; Ren, Nili; He, Jianyun; Sun, Jing

    2017-07-01

    This study estimated the attributable direct medical economic burden of health care-associated infections (HAIs) in China. Data were extracted from hospitals' information systems. Inpatient cases with HAIs and non-HAIs were grouped by the propensity score matching (PSM) method. Attributable hospitalization expenditures and length of hospital stay were measured to estimate the direct medical economic burden of HAIs. STATA 12.0 was used to conduct descriptive analysis, bivariate χ 2 test, paired Z test, PSM ( r = 0.25σ, nearest neighbor 1:1 matching), and logistic regress analysis. The statistically significant level was set at .05. The HAIs group had statistically significant higher expenditures and longer hospitalization stay than the non-HAIs group during 2013 to 2015 ( P economic burden of HAIs calls for more effective HAI surveillance and better control with appropriate incentives.

  6. Levels of violence among nurses in Cape Town public hospitals.

    Science.gov (United States)

    Khalil, Doris

    2009-01-01

    The paper presents findings from a study examining violence in nursing. A combined ethno-phenomenology was identified as the most appropriate approach. Ethnography is to understand the culture of nursing that permits violence to occur within the profession. Phenomenology is to explore and capture nurse-on-nurse experiences of violence. The population is all nurses registered with the South African Nursing Council. The research participants are nurses employed in eight public hospitals in Cape Town during 2005. METHOD OF DATA COLLECTION: The first stage of data collection was the distributions of confidential questionnaires to nurses employed in eight hospitals and willing to participate in the study. Responses to close-ended questions were analyzed using Microsoft Excel. Responses to open-ended questions were grouped per question. The qualitative data were then compared for similarities and differences in information provided. Six levels of violence exist among nurses. The highest forms of violence among nurses occurred at the psychological level, with the least at the physical level of interaction. The other four levels of violence among nurses were vertical, horizontal, covert, and overt. All categories of nurses in the study had resorted to one or more levels of violence against other nurses during their nursing career. Professional nurses and senior nurse managers were identified as the main category of nurses that frequently resort to mistreating other nurses. However, auxiliary nurses were identified as the main perpetrators of physical violence against other nurses.

  7. Factors associated with high stress levels in adults with diabetes mellitus attending a tertiary diabetes care center, Chennai, Tamil Nadu, India

    Science.gov (United States)

    Sendhilkumar, Muthappan; Tripathy, Jaya Prasad; Harries, Anthony D.; Dongre, Amol R.; Deepa, Mohan; Vidyulatha, Ashok; Poongothai, Subramanian; Venkatesan, Ulaganathan; Anjana, Ranjit Mohan; Mohan, Viswanathan

    2017-01-01

    Objective: We aimed to determine perceived stress levels among adults aged >20 years with type 2 diabetes mellitus (DM) in a tertiary care diabetes center, Chennai, Tamil Nadu, India, assess their association with sociodemographic and clinical characteristics and assess the possible risk factors for stress and coping strategies. Methods: A mixed-methods (triangulation design) study with quantitative methodology (survey) and qualitative methodology (interviews) was carried out. Stress levels were assessed among type 2 DM patients attending a diabetes clinic using a 5-point perceived stress scale-10. One-on-one interviews were carried out with 376 participants with DM having high/very high stress levels to understand the reasons for perceived stress and explore their coping mechanisms. Results: The prevalence of high/very high stress was 35% among DM patients. Age 30–40 years, working in professional jobs, and lack of physical activity were factors significantly associated with stress. The perceived major stress inducers were related to family, work, financial issues, and the disease itself. Conclusions: This study showed high levels of stress in more than one-third of DM patients. Potential solutions include regular, formal assessment of stress levels in the clinic, providing integrated counseling and psychological care for DM patients, and promoting physical activity. PMID:28217499

  8. Factors associated with high stress levels in adults with diabetes mellitus attending a tertiary diabetes care center, Chennai, Tamil Nadu, India

    Directory of Open Access Journals (Sweden)

    Muthappan Sendhilkumar

    2017-01-01

    Full Text Available Objective: We aimed to determine perceived stress levels among adults aged >20 years with type 2 diabetes mellitus (DM in a tertiary care diabetes center, Chennai, Tamil Nadu, India, assess their association with sociodemographic and clinical characteristics and assess the possible risk factors for stress and coping strategies. Methods: A mixed-methods (triangulation design study with quantitative methodology (survey and qualitative methodology (interviews was carried out. Stress levels were assessed among type 2 DM patients attending a diabetes clinic using a 5-point perceived stress scale-10. One-on-one interviews were carried out with 376 participants with DM having high/very high stress levels to understand the reasons for perceived stress and explore their coping mechanisms. Results: The prevalence of high/very high stress was 35% among DM patients. Age 30–40 years, working in professional jobs, and lack of physical activity were factors significantly associated with stress. The perceived major stress inducers were related to family, work, financial issues, and the disease itself. Conclusions: This study showed high levels of stress in more than one-third of DM patients. Potential solutions include regular, formal assessment of stress levels in the clinic, providing integrated counseling and psychological care for DM patients, and promoting physical activity.

  9. Factors associated with high stress levels in adults with diabetes mellitus attending a tertiary diabetes care center, Chennai, Tamil Nadu, India.

    Science.gov (United States)

    Sendhilkumar, Muthappan; Tripathy, Jaya Prasad; Harries, Anthony D; Dongre, Amol R; Deepa, Mohan; Vidyulatha, Ashok; Poongothai, Subramanian; Venkatesan, Ulaganathan; Anjana, Ranjit Mohan; Mohan, Viswanathan

    2017-01-01

    We aimed to determine perceived stress levels among adults aged >20 years with type 2 diabetes mellitus (DM) in a tertiary care diabetes center, Chennai, Tamil Nadu, India, assess their association with sociodemographic and clinical characteristics and assess the possible risk factors for stress and coping strategies. A mixed-methods (triangulation design) study with quantitative methodology (survey) and qualitative methodology (interviews) was carried out. Stress levels were assessed among type 2 DM patients attending a diabetes clinic using a 5-point perceived stress scale-10. One-on-one interviews were carried out with 376 participants with DM having high/very high stress levels to understand the reasons for perceived stress and explore their coping mechanisms. The prevalence of high/very high stress was 35% among DM patients. Age 30-40 years, working in professional jobs, and lack of physical activity were factors significantly associated with stress. The perceived major stress inducers were related to family, work, financial issues, and the disease itself. This study showed high levels of stress in more than one-third of DM patients. Potential solutions include regular, formal assessment of stress levels in the clinic, providing integrated counseling and psychological care for DM patients, and promoting physical activity.

  10. Hydrogeology, groundwater levels, and generalized potentiometric-surface map of the Green River Basin lower Tertiary aquifer system, 2010–14, in the northern Green River structural basin

    Science.gov (United States)

    Bartos, Timothy T.; Hallberg, Laura L.; Eddy-Miller, Cheryl

    2015-07-14

    In cooperation with the Bureau of Land Management, groundwater levels in wells located in the northern Green River Basin in Wyoming, an area of ongoing energy development, were measured by the U.S. Geological Survey from 2010 to 2014. The wells were completed in the uppermost aquifers of the Green River Basin lower Tertiary aquifer system, which is a complex regional aquifer system that provides water to most wells in the area. Except for near perennial streams, groundwater-level altitudes in most aquifers generally decreased with increasing depth, indicating a general downward potential for groundwater movement in the study area. Drilled depth of the wells was observed as a useful indicator of depth to groundwater such that deeper wells typically had a greater depth to groundwater. Comparison of a subset of wells included in this study that had historical groundwater levels that were measured during the 1960s and 1970s and again between 2012 and 2014 indicated that, overall, most of the wells showed a net decline in groundwater levels.

  11. Species distribution and antifungal susceptibility patterns of Candida isolates from a public tertiary teaching hospital in the Eastern Cape Province, South Africa.

    Science.gov (United States)

    Mnge, P; Okeleye, B I; Vasaikar, S D; Apalata, T

    2017-05-15

    Candida species are the leading cause of invasive fungal infections, and over the past decade there has been an increased isolation of drug resistant Candida species. This study aimed to identify the species distribution of Candida isolates and to determine their unique antifungal susceptibility and resistance patterns. During a cross-sectional study, 209 Candida isolates (recovered from 206 clinical samples) were collected and their species distribution was determined using ChromAgar Candida. The Vitek-2 system (Biomerieux, South Africa) was used to determine minimum inhibitory concentrations (MICs) to azoles (fluconazole, voriconazole), echinocandins (caspofungin, micafungin), polyenes (amphotericin B) and flucytosine. Four species of Candida were isolated, of which C. albicans was the most frequent, isolated in 45.4% (95/209) of the isolates, followed by C. glabrata: 31.1% (65/209). The MICs of the different antifungal drugs varied amongst the species of Candida. From the 130 isolates tested for MICs, 90.77% (112/130) were susceptible to all antifungal drugs and 6.9% (9/130) of the isolates were multi-drug resistant. C. dubliniensis (n=2) isolates were susceptible to all the above mentioned antifungal drugs. There was no significant difference in species distribution amongst clinical specimens and between patients' genders (P>0.05). An increase in MIC values for fluconazole and flucytosine towards the resistance range was observed. To our knowledge, this is the first report on surveillance of Candida species distribution and antifungal susceptibility at a public tertiary teaching hospital in Eastern Cape, South Africa.

  12. [Evaluation of strategies aimed at reducing the level of noise in different areas of neonatal care in a tertiary hospital].

    Science.gov (United States)

    Nieto-Sanjuanero, Adriana; Quero-Jiménez, José; Cantú-Moreno, Daniel; Rodríguez-Balderrama, Isaías; Montes-Tapia, Fernando; Rubio-Pérez, Nadina; Treviño-Garza, Consuelo; de la O-Cavazos, Manuel

    2015-01-01

    To determine the noise levels of different areas responsible for newborn care, develop intervention strategies to decrease the noise, and evaluate its effectiveness. Prospective, observational and longitudinal study carried out using a sonometer, measuring sound levels for three weeks in the neonatal intensive care unit (NICU), neonatal intermediate care unit (UCIREN), delivery (TOCO QX) and nursery (CUNERO) units. We implemented an intervention program and subsequent measurements were performed under the same initial conditions. When comparing the decibel levels in different areas during the three weeks, pre- and post-intervention, we found at the neonatal intensive care unit 59.9±4.8 vs. 56.4±4.7 dB (pTOCO QX, so the intervention program was effective in these areas; however, the decibel levels registered continue above those recommended by international standards.

  13. Evaluation of prevalence of low and high level mupirocin resistance in methicillin resistant staphylococcus aureus isolates at a tertiary care hospital

    International Nuclear Information System (INIS)

    Nizamuddin, S.; Irfan, S.; Zafar, A.

    2011-01-01

    To evaluate the trend of mupirocin resistance in MRSA, isolated at the Clinical Microbiology Laboratory of a tertiary care hospital. Methods: A total of 200 MRSA strains recovered over a 2 year period from various body sites were tested using the 5 and 200 mu g discs of mupirocin to detect its resistance. Results: High level and low level mupirocin resistance were detected in zero and 1 % of MRSA strains, respectively. Resistance to other non beta lactam antibiotics was also high. No MRSA strains were found to be resistant to vancomycin and tegicycline. Conclusion: Mupirocin resistance was found to be very low among local clinical isolates of MRSA. Its judicious use to decolonize nasal carriers should be promoted among hospitalized patients to avoid further transmission and infections due to prevalent endemic MRSA strains in any health care setting. Concomitantly, regular surveillance and effective infection control initiatives are desirable to reduce the incidence of health care associated infections due to MRSA and also of mupirocin resistance. (author)

  14. STUDY OF LIPOPROTEIN (A LEVELS AS A RISK FACTOR IN PATIENTS WITH ESSENTIAL HYPERTENSION IN A TERTIARY CARE HOSPITAL

    Directory of Open Access Journals (Sweden)

    Arun S. Menon

    2016-06-01

    Full Text Available BACKGROUND Lipoprotein (a has been identified as an important, independent, causal risk factor for various cardiovascular diseases, but its association with hypertension has shown differing results. The studies regarding this association are limited. AIMS AND OBJECTIVES In the present study, the levels of Lp (a and other lipid parameters like Serum Total Cholesterol, Serum LDL Cholesterol, Serum HDL Cholesterol, serum triglycerides have been studied in hypertensive and non-hypertensive patients to investigate any significant relationship between the same. MATERIALS AND METHODS 30 essential hypertensive patients were selected and were compared with 30 controls matched in terms of age and sex. Lipid profile including Total cholesterol, LDL- Cholesterol, HDL- Cholesterol, Triglycerides and Lp (a were studied in both groups. RESULTS Hypertensive patients were observed to have higher levels of Serum Total Cholesterol, Serum Triglycerides, Serum LDL cholesterol, but it was not found to be significant. But lipoprotein (a was found to be significantly higher (p<0.01 in cases than in controls.

  15. EVALUATION OF SERUM VITAMIN B12 LEVELS IN TYPE 2 DIABETES PATIENTS ON METFORMIN THERAPY ATTENDING A TERTIARY CARE HOSPITAL

    Directory of Open Access Journals (Sweden)

    Anand Kalakappa Koppad

    2017-11-01

    Full Text Available BACKGROUND Type 2 Diabetes Mellitus (T2DM is an endocrine disorder and a heterogeneous group of syndromes characterised by an elevation of fasting blood glucose that is caused by a relative or absolute deficiency in insulin. Serum vitamin B12 levels have been reported to be inversely associated with the dose and duration of metformin use. Vitamin B12 deficiency is a treatable condition. However, there is insufficient data regarding prevalence of vitamin B12 deficiency in the South Indian population. Hence, the study was undertaken to evaluate serum vitamin B12 levels in T2DM on metformin therapy. MATERIALS AND METHODS A total of 100 T2DM patients attending Outpatient Department (OPD or admitted under Department of General Medicine of KIMS, Hubli, during the time period of 2 years were taken for study considering the inclusion and exclusion criteria. Qualifying patients underwent detailed history, clinical examination, routine investigation and vitamin B12 estimation. RESULTS Majority were in the age group of 45-59 years making 42% of the total. The age group in most patients having vitamin B12 deficiency was >60 years. Males had more vitamin B12 deficiency forming 54.5%. Vitamin B12 deficiency was more in hypertensive group accounting for 71.4%, which was statistically significant. Most of the vitamin B12 deficiency patients had diabetes duration >10 years. Most of the vitamin B12 deficient patients were taking metformin therapy for longer years (≥10 years and in higher dose (>2 g/day. Most of the vitamin B12 deficient diabetes patients were overweight forming 52.5% of the total. CONCLUSION Longer duration of diabetes increases the risk of developing vitamin B12 deficiency on metformin therapy. The higher dose of metformin intake had inverse relation with vitamin B12 levels. Longer duration of metformin intake causes vitamin B12 deficiency and hence should be screened for vitamin B12 deficiency and can be supplemented with vitamin B12.

  16. 45 CFR 400.66 - Eligibility and payment levels in a publicly-administered RCA program.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 2 2010-10-01 2010-10-01 false Eligibility and payment levels in a publicly... REFUGEE RESETTLEMENT PROGRAM Refugee Cash Assistance § 400.66 Eligibility and payment levels in a publicly-administered RCA program. (a) In administering a publicly-administered refugee cash assistance program, the...

  17. Low and Intermediate Level Waste Repository: Radiation and Public

    International Nuclear Information System (INIS)

    Cerskov Klika, M.

    1998-01-01

    Some of basic elements related to public participation in radioactive waste management in Croatia are underlined in the paper. Most of them are created or led by the APO-Hazardous Waste Management Agency. Present efforts in improvement of public participation in the field radioactive waste management are important in particular due to negligible role of public in environmentally related issues during former Yugoslav political system. For this reason it is possible to understand the public fearing to be deceived or neglected again. Special attention is paid to the current APO editions related to public information and education in the field of radioactive waste management. It is important because only the well-informed public can present an active and respectful factor in hazardous and radioactive waste management process. (author)

  18. Results of level-ii oncoplasty in breast cancer patients: an early experience from a tertiary care hospital in pakistan

    International Nuclear Information System (INIS)

    Qureshi, S.; Ghazanfar, S.; Quraishy, S.; Iqbal, S.

    2014-01-01

    Objective: To assess the oncologic and cosmetic outcomes for breast cancer patients who underwent breast conservation therapy using Level II oncoplasty techniques. Methods: The prospective, non-randomised and descriptive study was conducted at the Department of Surgery, Unit IV of Civil Hospital, Karachi, from December 2009 to November 2011 in which 21 consecutive women with breast carcinoma who underwent wide local excision with remodeling mammoplasty were enrolled. All patients were reviewed by the surgeon and medical oncologist every 3 months for the first year. A grading system of 5-1 (excellent to poor) was employed and those with 3 or more were considered to have acceptable results. Results: The mean patient age was 45.38+-10.09 years (range: 26-70); 11 (52.3%) were premenopausal and 10 (47.7%) were postmenopausal; and 5 (27.8%) had family history of breast cancer. The mean size of the tumour determined by histology was 59.9+-3.18 mm (range: 25-150). Eight (30%) patients received preoperative chemotherapy to downsize the tumour. Three (14.2%) patients received preoperative radiotherapy. Mean operative time was 1.59+-0.52 hours (range: 1-2.5 hours). Mean volume of breast tissue excised from the breast containing the tumour was 545.27+-412.06 cm3 (range: 43.70-1456). Assessment of excision margins showed no tumour at the margins of 19 (90.4%) patients. Two (9.5%) patients had close but negative margins. The mean hospital stay was 7.10+-3.30 days (range: 4-15). There were early complications in 4 (19%) patients. One (4.76%) patient had late complications. Two (9.5%) patients developed tumour recurrence; both had an ipsilateral tumour recurrence. None of the patients developed metastases and one died of cardiac problem. Twenty (95.2%) patients had an acceptable post-surgical cosmetic result. Conclusion: Level II oncoplasty was a safe option in breast conservation allowing large sized and difficult-location tumour excision with good cosmetic outcome in the study

  19. New public diplomacy and its effects on international level

    OpenAIRE

    Elena Gurgu; Aristide Dumitru Cociuban

    2016-01-01

    Abstract. The purpose of this article is to make known the new type of public diplomacy and the effects this new diplomacy can have internationally. The objectives of our article refer to the context of change, the role of the media in public diplomacy, new approaches and elements of public diplomacy, current diplomacy in scientific and technical way and the use of scientific cooperation to improve bilateral relations between countries.

  20. New public diplomacy and its effects on international level

    Directory of Open Access Journals (Sweden)

    Elena Gurgu

    2016-09-01

    Full Text Available Abstract. The purpose of this article is to make known the new type of public diplomacy and the effects this new diplomacy can have internationally. The objectives of our article refer to the context of change, the role of the media in public diplomacy, new approaches and elements of public diplomacy, current diplomacy in scientific and technical way and the use of scientific cooperation to improve bilateral relations between countries.

  1. Noninvasive Mechanical Ventilation Knowledge Level of the Nurses: A Questionnaire Survey in a Tertiary Care Training and Research Hospital

    Directory of Open Access Journals (Sweden)

    Merve Tarhan

    2015-12-01

    Full Text Available Objective: The correct use of necessary equipment is the key for a successful noninvasive mechanical ventilation (NIMV practice. Trained health care personnel are important part of the practice. The current study was conducted to that end, with the aim of determining the level of knowledge about NIMV of nurses working in a training and research hospital as descriptive. Methods: The study was conducted with 147 nurses who are working at Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital in İstanbul. Questionnaire form of 36 questions prepared by investigators was used to collect data. For the analysis of the results, numerical, percentages, Mann-Whitney U and Kruskal Wallis tests were used.’ Results: 40.8% nurses had received training about NIMV. By contrast, 24.5% stated that they had learned NIMV practices on their own. The lowest rate (26.5% of correct answered question was “disadvantages of oronasal mask”. The most answered statement as true was “Face masks should be established to the patient’s face with no gaps for prevention of leaks and the mask should be worn not to pressure on nasal bridge” (78.9%. Female and postgraduate nurses‘ total scores obtained from NIMV questions were higher than others and were statistically significant (p<0.05. Conclusion: The effective NIMV practices requires trained personnel. Nurses who have active role in NIMV practices should receive basic training in this topic. How will be started treatment, indications, who will be responsible for follow-up and points to take into consideration are mentioned clearly in the training program. This training programme should include processing of clinical experience as well as theoretical information.

  2. Anxiety Level in Students of Public Speaking: Causes and Remedies

    Science.gov (United States)

    Raja, Farhan

    2017-01-01

    Despite being competent in their field of work, professional's worldwide struggle due to lack of good public speaking skills. Their assessments and appraisals are often not depictive of their professional competitiveness; therefore, it is important for students to overcome public speaking anxiety before they transit from academic life to…

  3. Hospitalized Patients' Awareness Of Their Rights-A Cross Sectional Survey In A Public And Private Tertiary Care Hospitals Of Punjab, Pakistan.

    Science.gov (United States)

    Tabassum, Tahirah; Ashraf, Mariam; Thaver, Inayat

    2016-01-01

    The awareness of patient's rights is negligible in developing countries where no legal framework is present to protect these rights and Pakistan is no exception. Not only is there an absence of legal structure for protection of patients' rights, but the enforcement and implementation for existing law is also questionable. Pakistan has an Islamic Charter of Medical and Health Ethics which includes the medical behaviour and physician's rights and duties towards the patients. Despite all these charters on patients' rights, there is little to no awareness regarding these rights and their practice remains low in healthcare system of Pakistan. This assessment of awareness among patients about their rights will guide in formulating recommendations to improve the existing system of healthcare delivery in the country. This descriptive cross-sectional comparative study was conducted in two hospitals in Lahore, each belonging to public and private sector. A structured questionnaire was used to collect data from patients. A total of 220 patients were selected to participate in the study, 110 belonging to each private and public hospital. The findings indicate that most of the patients (64%) were not aware of their rights. The awareness level was better in patients seeking care from private hospital than those from public hospital. Education, monthly income and type of hospital utilized were found to be positively associated with the level of awareness. Most of the patients were not satisfied with the practices of their rights, especially in public hospitals. The lack of awareness regarding the rights of a patient was more common in patients of public/government hospitals compared to private hospitals. A nation-wide healthcare education program is needed to increase awareness and practice of patients' rights in the country.

  4. Rethinking the Tertiary Mathematics Curriculum

    Science.gov (United States)

    Petocz, Peter; Reid, Anna

    2005-01-01

    Mathematics curriculum at the tertiary level is located within a range of social and cultural theories, and is often constructed by academics seeking to promulgate a particular view of mathematics. We argue that such a curriculum should incorporate a real acknowledgement of the different ways in which students understand the nature of mathematics…

  5. Knowledge, attitude and practice of cervical cancer screening among women attending gynecology clinics in a tertiary level medical care center in southeastern Nigeria.

    Science.gov (United States)

    Mbamara, Sunday U; Ikpeze, Okechukwu C; Okonkwo, John E N; Onyiaorah, Igwebuike V; Ukah, Cornelius O

    2011-01-01

    To describe the knowledge, attitudes and practices of gynecology clinic attendees in a tertiary level healthcare center in Nigeria. This is a descriptive, cross-sectional, questionnaire-based study conducted at Nnamdi Azikwe University Teaching Hospital in Nigeria in December 2007. A total of 200 questionnaires were distributed, and 198 were properly completed. The 198 completely and properly filled questionnaires formed the basis of the analysis. Twenty-five (12.6%) of the women were aware of the cervical cancer screening test, while 173 (87.4%) had never heard of the test before. Only 8% of the respondents had knowledge of the prevention of cervical cancer, but none of them were aware of the introduction of the human papillomavirus vaccine. Twenty-one (84.0%) of those women who were aware of the cervical cancer screening test got their information from healthcare providers, 3 (12.0%) from television and 2 (8.0%) from radio. Of the 25 respondents who were aware of the cervical cancer screening test, 15 (60.0%) had received at least a Pap smear test. All of the screening was done as an opportunistic screening exercise. A total of 119 (85.0%) of the women were not able to be screened because they were not aware of the cervical cancer smear screening, while 4 (3.2%) felt that it was unnecessary. There is a significant association between the educational status and the knowledge of the cervical smear Pap test (chi2 = 10.14, p value = 0.001). Eighty (57.1%) of the women agreed that they would like to undertake cervical cancer screening, while 60 (42.9%) would decline the cervical cancer screening test. The knowledge about cervical cancer in this study was very low. This poor knowledge may limit the utilization of cervical cancer prevention programs. This study underscores the need to establish an intensive and sustainable awareness campaign on the prevention of cancer of the cervix.

  6. Can delayed time to referral to a tertiary level urologist with an abnormal PSA level affect subsequent Gleason grade in the opportunistically screened population?

    LENUS (Irish Health Repository)

    O'Kelly, Fardod

    2013-09-01

    There is growing conflict in the literature describing the effect of delayed treatment on outcomes following radical prostatectomy. There is also evidence to suggest progression of low-risk prostate cancer to develop higher grades and volumes of prostate cancer during active surveillance. It is unknown as to what affect a delay in referral of those men with abnormal screened-PSA levels have on subsequent Gleason grade.

  7. Radiological safety for the public during nuclear emergencies: application of intervention levels and derived intervention levels

    International Nuclear Information System (INIS)

    Thomas, G.; Kumar, K.S.

    2006-01-01

    Control of radiation exposures to the public following a major nuclear accident can be achieved through intervention by implementing countermeasures such as sheltering, iodine prophylaxis, evacuation, control of foodstuff, etc. Intervention levels (I.L.) are formulated such that exposure to individuals from all exposure pathways is well below the thresholds for deterministic effects, and risk of stochastic health effects to individuals and overall incidence of stochastic effects in the exposed population are minimized. It is also necessary to translate such I.L. into quantities, called derived intervention levels (D.I.L.) that can be measured. The I.L. followed in various countries for the recommended countermeasures cater to the exposure range of 1-50 mSv for sheltering, 10-500 mSv for evacuation, 30- 1000 mSv for iodine prophylaxis and 1-10 mSv for food control. The models used for these are based on conservative estimations assuming maximum dose delivered to the critical group for the pathway assumed. While the concept of upper dose level above which countermeasures is always justified to avoid deterministic effects, the lower range of dose levels have to be optimised based on various parameters as discussed in this paper. While arriving at the I.L., the question to be addressed is: How much (dose) risk should be averted by the intervention planned? Implementation of any countermeasure will result in some inconvenience/ limitation of resource/ disruption and consequently, a positive net benefit will justify the intervention. Sheltering may result in substantially less disruption than evacuation, but if the type of sheltering is not offering enough radiation shielding or ventilation protection, this may not result in significant reduction of exposure. It is to be ensured that deterministic effects are totally avoided and it is possible to define a safe threshold exposure and above which balancing risks and benefits is not applicable. While the dose limit for the

  8. Leveling up? An inter-neighborhood experiment on parochialism and the efficiency of multi-level public goods provision

    OpenAIRE

    Gallier, Carlo; Goeschl, Timo; Kesternich, Martin; Lohse, Johannes; Reif, Christiane; Römer, Daniel

    2017-01-01

    Many public goods can be provided at different spatial levels. Evidence from social identity theory and in-group favoritism raises the possibility that where higher-level provision is more efficient, subjects’ narrow concern for local outcomes (parochialism) could harm efficiency. Building on the experimental paradigm of multi-level public good games and the ‘neighborhood attachment’ concept, we conduct an artefactual field experiment with 600 participants in a setting conducive to parochial...

  9. A public health framework to translate risk factors related to political violence and war into multi-level preventive interventions.

    Science.gov (United States)

    De Jong, Joop T V M

    2010-01-01

    Political violence, armed conflicts and human rights violations are produced by a variety of political, economic and socio-cultural factors. Conflicts can be analyzed with an interdisciplinary approach to obtain a global understanding of the relative contribution of risk and protective factors. A public health framework was designed to address these risk factors and protective factors. The framework resulted in a matrix that combined primary, secondary and tertiary interventions with their implementation on the levels of the society-at-large, the community, and the family and individual. Subsequently, the risk and protective factors were translated into multi-sectoral, multi-modal and multi-level preventive interventions involving the economy, governance, diplomacy, the military, human rights, agriculture, health, and education. Then the interventions were slotted in their appropriate place in the matrix. The interventions can be applied in an integrative form by international agencies, governments and non-governmental organizations, and molded to meet the requirements of the historic, political-economic and socio-cultural context. The framework maps the complementary fit among the different actors while engaging themselves in preventive, rehabilitative and reconstructive interventions. The framework shows how the economic, diplomatic, political, criminal justice, human rights, military, health and rural development sectors can collaborate to promote peace or prevent the aggravation or continuation of violence. A deeper understanding of the association between risk and protective factors and the developmental pathways of generic, country-specific and culture-specific factors leading to political violence is needed.

  10. Motivating green public procurement in China: an individual level perspective.

    Science.gov (United States)

    Zhu, Qinghua; Geng, Yong; Sarkis, Joseph

    2013-09-15

    Green public procurement (GPP) practices have been recognized as an effective policy tool for sustainable production and consumption. However, GPP practices adoption, especially in developing countries, is still an issue. Seeking to help understand these adoption issues, we develop a conceptual model which hypothesizes moderation effects of GPP knowledge on the relationships between GPP drivers and practices. Using primary data collected from 193 Chinese government officials, we find that regulations, rewards & incentive gains, and stakeholders exert pressure to motivate adoption of GPP practices. Knowledge of GPP regulations, responsibilities and experiences in developed countries is found to be limited. The study also found that voluntary regulations may actually be demotivating GPP practices. This study contributes to further theoretical and practical understanding of GPP practices. The findings can be helpful for policy makers, especially those in developing countries, to establish promotion and diffusion mechanisms for GPP practices as an important sustainable development tool. Copyright © 2013 Elsevier Ltd. All rights reserved.

  11. Prognostic Implications of Level-of-Care at Tertiary Heart Centers Compared With Other Hospitals After Resuscitation From Out-of-Hospital Cardiac Arrest

    DEFF Research Database (Denmark)

    Søholm, Helle; Kjaergaard, Jesper; Bro-Jeppesen, John

    2015-01-01

    (OR, 10 [5.3-22] and 3.8 [2.5-5.7]), neurophysiological examination (OR, 1.8 [1.3-2.6]), and brain computed tomography (OR, 1.9 [1.4-2.6]), whereas no difference in therapeutic hypothermia was noted. Patients at tertiary centers were more often consulted by a cardiologist (OR, 8.6 [5.0-15]), had...

  12. The public sector nursing workforce in Kenya: a county-level analysis.

    Science.gov (United States)

    Wakaba, Mabel; Mbindyo, Patrick; Ochieng, Jacob; Kiriinya, Rose; Todd, Jim; Waudo, Agnes; Noor, Abdisalan; Rakuom, Chris; Rogers, Martha; English, Mike

    2014-01-27

    Kenya's human resources for health shortage is well documented, yet in line with the new constitution, responsibility for health service delivery will be devolved to 47 new county administrations. This work describes the public sector nursing workforce likely to be inherited by the counties, and examines the relationships between nursing workforce density and key indicators. National nursing deployment data linked to nursing supply data were used and analyzed using statistical and geographical analysis software. Data on nurses deployed in national referral hospitals and on nurses deployed in non-public sector facilities were excluded from main analyses. The densities and characteristics of the public sector nurses across the counties were obtained and examined against an index of county remoteness, and the nursing densities were correlated with five key indicators. Of the 16,371 nurses in the public non-tertiary sector, 76% are women and 53% are registered nurses, with 35% of the nurses aged 40 to 49 years. The nursing densities across counties range from 1.2 to 0.08 per 1,000 population. There are statistically significant associations of the nursing densities with a measure of health spending per capita (P value = 0.0028) and immunization rates (P value = 0.0018). A higher county remoteness index is associated with explaining lower female to male ratio of public sector nurses across counties (P value public sector countrywide is complicated by mal-distribution and varying workforce characteristics (for example, age profile) across counties. All stakeholders should support improvements in human resources information systems and help address personnel shortages and mal-distribution if equitable, quality health-care delivery in the counties is to be achieved.

  13. Analysis of Management Practices in Lagos State Tertiary Institutions through Total Quality Management Structural Framework

    Science.gov (United States)

    AbdulAzeez, Abbas Tunde

    2016-01-01

    This research investigated total quality management practices and quality teacher education in public tertiary institutions in Lagos State. The study was therefore designed to analyse management practices in Lagos state tertiary institutions through total quality management structural framework. The selected public tertiary institutions in Lagos…

  14. A critically educated public explores high level radioactive waste management

    International Nuclear Information System (INIS)

    Blum, J.E.

    1994-01-01

    It is vital to the citizens of Nevada that they and their children are given an opportunity to explore all sides of the characterization of Yucca Mountain as a potential repository site for spent nuclear fuel. The state-wide, national and international implications demand a reasoned and complete approach to this issue, which has become emotionally and irrationally charged and fueled by incomplete perception and information. The purpose of this paper is to provide curriculum suggestions and recommend concomitant policy developments that will lead to the implementation of a Critical Thinking (CT) approach to High Level Radioactive Waste Management

  15. 76 FR 9004 - Public Comment on Setting Achievement Levels in Writing

    Science.gov (United States)

    2011-02-16

    ... DEPARTMENT OF EDUCATION Public Comment on Setting Achievement Levels in Writing AGENCY: U.S... Achievement Levels in Writing. SUMMARY: The National Assessment Governing Board (Governing Board) is... for NAEP in writing. This notice provides opportunity for public comment and submitting...

  16. Parathyroid carcinoma in tertiary hyperparathyroidism.

    Science.gov (United States)

    Kim, Byung Seup; Ryu, Han Suk; Kang, Kyung Ho; Park, Sung Jun

    2016-10-01

    Parathyroid carcinoma is a rare disease of unknown etiology. This study presents a case of parathyroid carcinoma in a patient with tertiary hyperparathyroidism. Despite a successful kidney transplantation, the intact parathyroid hormone (iPTH) level of the patient was elevated consistently and could not be controlled by medical therapy. Due to the development of tertiary hyperparathyroidism with bone pain and osteoporosis, subtotal parathyroidectomy was performed 4 months after the kidney transplantation. Histological evaluation revealed that one of four parathyroid lesions was a parathyroid carcinoma, while the others were diffuse hyperplasia. Postoperative laboratory studies indicated a decreased level of iPTH. A positron emission tomography-computed tomography performed 6 months after the operation revealed no evidence of local recurrence or distant metastasis. Copyright © 2013. Published by Elsevier Taiwan.

  17. A decentralised model of psychiatric care: Profile, length of stay and outcome of mental healthcare users admitted to a district-level public hospital in the Western Cape

    Directory of Open Access Journals (Sweden)

    Eileen Thomas

    2015-02-01

    Full Text Available Background. There is a lack of studies assessing the profile and outcome of psychiatric patients at entry-level public hospitals that are prescribed by the Mental Health Care Act to provide a decentralised model of psychiatric care. Objective. To assess the demographic and clinical profile as well as length of stay and outcomes of mental healthcare users admitted to a district-level public hospital in the Western Cape.  Method. Demographic data, clinical diagnosis, length of stay, referral profile and outcomes of patients (N=487 admitted to Helderberg Hospital during the period 1 January 2011 - 31 December 2011 were collected.  Results. Psychotic disorders were the most prevalent (n=287, 59% diagnoses, while 228 (47% of admission episodes had comorbid/secondary diagnoses. Substance use disorders were present in 184 (38% of admission episodes, 37 (57% of readmissions and 19 (61% of abscondments. Most admission episodes (n=372, 76% were discharged without referral to specialist/tertiary care.  Conclusion. Methamphetamine use places a significant burden on the provision of mental healthcare services at entry-level care. Recommendations for improving service delivery at this district-level public hospital are provided.

  18. Stress Level of Measurement of Public Employees A Research on Public Officials in Eskisehir

    OpenAIRE

    Hüseyin GÜRBÜZ; Rüveyda DOĞAN; Elif GÖRMÜŞ; Gamze Pelin TOKYAY; Dilara ÖZTEKİN; Gökhan ENGİZ

    2014-01-01

    Stress emerges as a concept which negatively affects the efficiency and the productivity of an individual. In addition to the negative and productivity lessening effects of stress, some researchers cited various positive effects of it. A stress level that affects an increase in productivity and that doesn’t cause a deterioration of health is accepted as a positive one and the studies about stress in work life mostly focus on the productivity of the employees.. This study was focused on the fa...

  19. Comparison of cardiovascular disease patterns in two data sets of patients admitted at a tertiary care public hospital in Karachi five years apart

    International Nuclear Information System (INIS)

    Kazim, S.F.; Itrat, A.; Butt, N.W.; Ishaq, M.

    2009-01-01

    To compare the disease patterns in two data sets of patients, five years apart, at the National Institute of Cardiovascular Diseases (NICVD), a tertiary care cardiac hospital in Karachi. The underlying objective was to determine any changes in cardiovascular disease patterns at an acute cardiac unit over a period of five years. A retrospective descriptive study was conducted on patients admitted in West Ward, National Institute of Cardiovascular Diseases (NICVD), Karachi in September, 2000 and September, 2005. Patient's record files were reviewed and the relevant information was recorded on a proforma designed for the purpose. In September, 2000, a total of 414 patients were admitted. Of these 71.25% were males. Majority of patients (72.92%) were in the fifth decade of life or beyond. Acute coronary syndrome (ACS) was the commonest presentation, present in 39.8% of the patients. 27.3% had myocardial infarction (MI) while 10.34% were diagnosed with heart muscle diseases. The overall mortality was 3.4%. In September, 2005, a total of 446 patients were admitted. Of these, 63% were males. 71.29% were in the fifth, sixth, and seventh decades of life. 43.04% patients were admitted with acute coronary syndromes (ACS), 26% with myocardial infarction (MI) and 13.45% with heart muscle diseases. The overall mortality was 1.34%. The almost similar results in two data sets of patients five years apart suggests that the cardiovascular disease burden and pattern has not changed significantly at this center. There is a preponderance of cardiovascular illnesses in males and older age groups. ACS and MI account for majority of admissions. (author)

  20. 77 FR 75491 - Entry-Level Driver Training; Public Listening Session

    Science.gov (United States)

    2012-12-20

    ... identified are supported by research and data analyses, including cost/benefit considerations. The session...-27748] Entry-Level Driver Training; Public Listening Session AGENCY: Federal Motor Carrier Safety Administration (FMCSA), DOT. ACTION: Notice of public listening session. SUMMARY: FMCSA announces that it will...

  1. Public health leadership competency level among health professionals in a South Eastern European country

    NARCIS (Netherlands)

    Pampuri, O.; Czabanowska, K.; Hysa, B.; Roshi, E.; Burazeri, G.

    2015-01-01

    Pampuri O, Czabanowska K, Hysa B, Roshi E, Burazeri G. Public health leadership competency level among health professionals in a South Eastern European country (Original research). SEEJPH 2015, posted: 10 February 2015. DOI 10.12908/SEEJPH-2014-40

  2. Co-existing institutional logics and agency among top-level public servants

    DEFF Research Database (Denmark)

    Bjerregaard, Toke

    2011-01-01

    to address parts of this void. This study examines the agency exerted by top-level public servants through their everyday strategy and policy work in face of co-existing logics of public administration. The findings illustrate how their action strategies span from more passive strategies of coping...... with coexisting logics of administration to more skilled agency of combining logics aimed at enhancing their opportunity and action space. The study suggests that the interplay between co-existing institutional logics, action strategies and the practical skills of top-level public servants provides the basis...... for both coping and more proactive strategies in pluralistic public administrations. Findings illustrate the role of public servants' practical sense of realizable opportunities that inform such strategies of handling co-existing institutional logics. Implications for institutional studies of organizations...

  3. Level of satisfaction and issues with procurement systems used in the Malaysian public sector

    Directory of Open Access Journals (Sweden)

    Mastura Jaafar

    2013-03-01

    Full Text Available Since the declaration of Malaysian independence, the public sector has significantly contributed to the country’s development. In the 1990s, a new procurement system was developed due to CIBD various changes in the construction industry. Since that period, the poor quality of public sector projects has started to attract public attention. This paper describes a study that was conducted to identify the dominant public procurement systems in place, the problems associated with these systems, and the satisfaction level of the industry players in the Malaysian construction industry. The results were drawn from 84 survey responses and interviews with industry players. The public sector is using a traditional system inherited from the British, with an intention to adopt new procurement systems. Aside from the disputes that are present in most systems, the public sector seems to encounter particular problems in relation to capabilities, time, and cost of the major procurement systems used. Traditional work culture and the industry environment influence public sector practice, which accounts for the modifications of each procurement system used. Thus, the full advantages of using an alternative procurement system may not be realised in public sector organizations. This produces an average level of satisfaction gained from the procurement system adopted. As a developing country, Malaysia needs to exert significant efforts to improve the public procurement system. 

  4. Level of satisfaction and issues with procurement systems used in the Malaysian public sector

    Directory of Open Access Journals (Sweden)

    Mastura Jaafar

    2013-03-01

    Full Text Available Since the declaration of Malaysian independence, the public sector has significantly contributed to the country’s development. In the 1990s, a new procurement system was developed due to CIBD various changes in the construction industry. Since that period, the poor quality of public sector projects has started to attract public attention. This paper describes a study that was conducted to identify the dominant public procurement systems in place, the problems associated with these systems, and the satisfaction level of the industry players in the Malaysian construction industry. The results were drawn from 84 survey responses and interviews with industry players. The public sector is using a traditional system inherited from the British, with an intention to adopt new procurement systems. Aside from the disputes that are present in most systems, the public sector seems to encounter particular problems in relation to capabilities, time, and cost of the major procurement systems used. Traditional work culture and the industry environment influence public sector practice, which accounts for the modifications of each procurement system used. Thus, the full advantages of using an alternative procurement system may not be realised in public sector organizations. This produces an average level of satisfaction gained from the procurement system adopted. As a developing country, Malaysia needs to exert significant efforts to improve the public procurement system.

  5. Evaluating public involvement in the National Low-Level Radioactive Waste Management Program

    International Nuclear Information System (INIS)

    1982-09-01

    The Department of Energy contracted with the Keystone Center to evaluate the effectiveness of the National Low-Level Radioactive Waste Management Program's public-involvement efforts. The Center chose six evaluators with diverse training and experience related to low-level waste management and public-participation programs. Keystone's evaluation was based on (a) observations by the evaluators who attended the National Program-sponsored strategy review meetings and fairs; (b) interviews with low-level waste generators, local government officials, state legislators, public-interest groups, and members of the general public; and (c) observations of the final National Program strategy task force meeting. The evaluators concluded that, overall, the public-participation processes yielded some very positive results - for policy development and for DOE and the EG and G staff. They judged the strategy document to be complete, concise, and helpful to public dialogue on low-level waste issues. They also made specific recommendations for improvements to the public-participation program

  6. Public health and health promotion capacity at national and regional level: a review of conceptual frameworks

    Directory of Open Access Journals (Sweden)

    Christoph Aluttis

    2014-04-01

    Full Text Available The concept of capacity building for public health has gained much attention during the last decade. National as well as international organizations increasingly focus their efforts on capacity building to improve performance in the health sector. During the past two decades, a variety of conceptual frameworks have been developed which describe relevant dimensions for public health capacity. Notably, these frameworks differ in design and conceptualization. This paper therefore reviews the existing conceptual frameworks and integrates them into one framework, which contains the most relevant dimensions for public health capacity at the country or regional level. A comprehensive literature search was performed to identify frameworks addressing public health capacity building at the national or regional level. We content-analysed these frameworks to identify the core dimensions of public health capacity. The dimensions were subsequently synthesized into a set of thematic areas to construct a conceptual framework which describes the most relevant dimensions for capacities at the national or regional level. The systematic review resulted in the identification of seven core domains for public health capacity: resources, organizational structures, workforce, partnerships, leadership and governance, knowledge development and country specific context. Accordingly, these dimensions were used to construct a framework, which describes these core domains more in detail. Our research shows that although there is no generally agreed upon model of public health capacity, a number of key domains for public health and health promotion capacity are consistently recurring in existing frameworks, regardless of their geographical location or thematic area. As only little work on the core concepts of public health capacities has yet taken place, this study adds value to the discourse by identifying these consistencies across existing frameworks and by synthesising

  7. 76 FR 10810 - Public Workshop to Discuss Low-Level Radioactive Waste Management

    Science.gov (United States)

    2011-02-28

    ... Radioactive Waste Management AGENCY: Nuclear Regulatory Commission. ACTION: Public Workshop and Request for... regulatory framework for the management of commercial low-level radioactive waste (LLW). The purpose of this...-level radioactive wastes that did not exist at the time part 61 was promulgated. The developments...

  8. Assessing the Readability of College Textbooks in Public Speaking: Attending to Entry Level Instruction

    Science.gov (United States)

    Schneider, David E.

    2011-01-01

    More research is needed that examines textbooks intended for the entry level college classroom. This study offers valuable information to academics that adopt a public speaking textbook for instruction as well as objective feedback to the collective authors. Readability levels of 22 nationally published textbooks, based on McGlaughlin's (1969)…

  9. Grade-Level Retention in Texas Public Schools, 2015-16

    Science.gov (United States)

    Texas Education Agency, 2017

    2017-01-01

    This annual report provides information for the 2015-16 school year on grade-level retention in the Texas public school system. Data on retention are provided by student characteristics, including grade level; race/ethnicity; gender; degree of English proficiency; and economic, at-risk, immigrant, migrant, and overage statuses. Data also are…

  10. Theoretical Aspects of Optimizing the Allocation of Public Financial Resources at Local Level

    OpenAIRE

    Eugen DOGARIU

    2010-01-01

    The allocation of financial resources at local, but also at central level, is an issue especially since in times of crisis, finding the optimum way to spend public funds concerns all authorities. This paper aims to identify the ways in which, by leaving from the division of powers based on the allocation of resources and tools available, the local authorities can identify an optimal level of public expenditure so as to achieve a maximum level of using them. Also, the paper seeks to identify t...

  11. Equalization of opportunities in the tertiary level of education of students with special needs in the Czech Republic – innovation programme of services at the University of Hradec Kralove

    Directory of Open Access Journals (Sweden)

    Ruzickova Kamila

    2016-01-01

    Full Text Available The specialized text describes the standard rules of the equalization of opportunities at the tertiary level of the education of students with special needs in the Czech Republic. National standard recommendations for support services at Czech universities and colleges are presented in the first part of the article. The next part concentrates specifically on the innovative programme of services for students with special needs at the University of Hradec Kralove. The final part of the article provides the selected results of research study into the level of support services at the University of Hradec Kralove. Data were obtained from 52 respondents - kye workers for equalization of opportunities for students with special needs. A set of questionnaire was analysed using descriptive statistic. The first selected data demonstrate the status of readiness the innovated service system at the University of Hradec Kralove

  12. THE FACTORS AFFECTING SATISFACTION LEVELS IN HOSPITALIZED PATIENTS: AN APPLICATION IN PUBLIC HOSPITAL

    Directory of Open Access Journals (Sweden)

    Neşe ACAR

    2017-09-01

    Full Text Available This study was conducted to determine the factors that affect the level of satisfaction of services provided by public hospitals. Patients' satisfaction levels were measured by interviewing 156 patients in a public hospital. Factor analysis of the data obtained from the research resulted in five factors called nurses 'behaviors, physical conditions, doctors' behavior, technical staff behaviors, food and beverage. MANOVA analysis was conducted to determine the differences in the perception of factors with respect to the demographic characteristics of the patients and differences were found in terms of profession. It has been seen that it is important that public hospitals have specialist doctors and modern equipment and that they have qualities such as the quality of the health personnel in preferring patients to public hospitals.

  13. Dietary habits and physical activity levels in Jordanian adolescents attending private versus public schools.

    Science.gov (United States)

    Tayyem, R F; Al-Hazzaa, H M; Abu-Mweis, S S; Bawadi, H A; Hammad, S S; Musaiger, A O

    2014-07-08

    The present study examined differences in dietary habits and physical activity levels between students attending private and public high schools in Jordan. A total of 386 secondary-school males and 349 females aged 14-18 years were randomly recruited using a multistage, stratified, cluster sampling technique. Dietary habits and physical activity level were self-reported in a validated questionnaire. The prevalence of obesity was significantly higher among adolescents in private (26.0%) than in public schools (16.7%). The frequency of breakfast intake was significantly higher among adolescents in private schools, whereas French fries and sweets intake was significantly higher in public schools. Television viewing showed a significant interaction with school type by sex. A higher rate of inactivity was found among students attending private schools. Despite a slightly better overall dietary profile for students in private schools, they had a higher rate of overweight and obesity compared with those in public schools.

  14. Low-level radioactive waste disposal technology development through a public process

    International Nuclear Information System (INIS)

    Murphy, M.P.; Hysong, R.J.; Edwards, C.W.

    1989-01-01

    When Pennsylvania's legislature ratified the Appalachian States Low-Level Radioactive Waste Compact in 1985, the Commonwealth of Pennsylvania became the host state designee for the compact's low-level radioactive waste (LLWR) disposal facility. Programs necessary for the establishment of this facility became the responsibility of the Department of Environmental Resources' (DER), Bureau of Radiation Protection's, Division of Nuclear Safety (DNS). It was realized early in the process that the technical aspects of this program, while challenging, probably were not the largest obstacle to completing the facility on schedule. The largest obstacle was likely to be public acceptance. Recognizing this, the DNS set out to develop a program that would maximize public involvement in all aspects of site and facility development. To facilitate public involvement in the process, the DNS established a LLRW advisory committee and a strategy for holding public meetings throughout Pennsylvania. As a result of the significant public involvement generated by these efforts, Pennsylvania passed, in February of 1988, one of the most stringent and technically demanding LLRW disposal laws in the nation. Hopefully, increased public confidence will reduce to a minimum public opposition to the facility

  15. Pediatric dental care in a tertiary public hospital. Four years of experience in the Service of Stomatology of Valencia University General Hospital (Valencia, Spain).

    Science.gov (United States)

    Poveda, Rafael; Jiménez, Yolanda; Gavaldá, Carmen; Sanchís, José María; Carbonell, Enrique; Margaix, María; Sarrión, Gracia

    2008-05-01

    A study is made of the experience gained with the Child Oral Care Program (Plan de Atención Dental Infantil, PADI) in the Service of Stomatology of Valencia University General Hospital (Valencia, Spain) after four years in operation (July 2003 - July 2007). The sample comprised 2626 children between 5-14 years of age, pertaining to department 9 of the Valencian public health system. A clinical history was compiled in each case, a radiological study was made, and a treatment plan was elaborated including fillings, extractions, and control visits. Of the 2626 designated children, 2369 visited our Service - mostly referred from the Preventive Dental Care Units. A total of 5784 fillings were carried out (93.3% with silver amalgam, 5.6% with composites and the rest as provisional fillings). The permanent first molars were the teeth with the largest number of fillings (70.2% of the total). These were followed in order of frequency by the second molars (19.1%). As regards composite resin fillings, most involved the upper central incisors, followed by the upper lateral incisors. A total of 644 extractions were performed, corresponding to 110 permanent teeth and 534 temporary teeth. In the case of the permanent dentition, the first molars were the most commonly removed teeth. In the temporary dentition, the most frequently removed teeth were the second molars. The response of the population to this program has been very good, and reinforces the preventive measures already in place, with the provision of restorative treatments to improve the oral and dental health of the pediatric population, and yielding good results in terms of the program quality indicators. The Service of Stomatology (Valencia University General Hospital) is able to address the demand and offers the public health network integrated and continuous patient care.

  16. Public acceptance for centralized storage and repositories of low-level waste session (Panel)

    Energy Technology Data Exchange (ETDEWEB)

    Lutz, H.R.

    1995-12-31

    Participants from various parts of the world will provide a summary of their particular country`s approach to low-level waste management and the cost of public acceptance for low-level waste management facilities. Participants will discuss the number, geographic location, and type of low-level waste repositories and centralized storage facilities located in their countries. Each will discuss the amount, distribution, and duration of funds to gain public acceptance of these facilities. Participants will provide an estimated $/meter for centralized storage facilities and repositories. The panel will include a brief discussion about the ethical aspects of public acceptance costs, approaches for negotiating acceptance, and lessons learned in each country. The audience is invited to participate in the discussion.

  17. Text mining analysis of public comments regarding high-level radioactive waste disposal

    International Nuclear Information System (INIS)

    Kugo, Akihide; Yoshikawa, Hidekazu; Shimoda, Hiroshi; Wakabayashi, Yasunaga

    2005-01-01

    In order to narrow the risk perception gap as seen in social investigations between the general public and people who are involved in nuclear industry, public comments on high-level radioactive waste (HLW) disposal have been conducted to find the significant talking points with the general public for constructing an effective risk communication model of social risk information regarding HLW disposal. Text mining was introduced to examine public comments to identify the core public interest underlying the comments. The utilized test mining method is to cluster specific groups of words with negative meanings and then to analyze public understanding by employing text structural analysis to extract words from subjective expressions. Using these procedures, it was found that the public does not trust the nuclear fuel cycle promotion policy and shows signs of anxiety about the long-lasting technological reliability of waste storage. To develop effective social risk communication of HLW issues, these findings are expected to help experts in the nuclear industry to communicate with the general public more effectively to obtain their trust. (author)

  18. 2. Tertiary Foraminifera

    NARCIS (Netherlands)

    Umbgrove, J.H.F.

    1931-01-01

    In his review of the palaeozoology of Java, K. Martin could in 1919, record 49 foraminifera from tertiary strata of Java, on the strength of a critical study of the existant literature, and especially on the strength of his own studies and knowledge of the above mentioned fossils (Bibl. 49). In

  19. Derivation of Intervention levels for Protection of the Public in a Radiological Emergency in Korea

    International Nuclear Information System (INIS)

    Lee, Jong Tai; Lee, Goan Yup; Khang, Byung Oui; Oh, Ki Hoon; Kim, Chang Kyu

    2001-01-01

    Intervention levels for protection of the public in a radiological emergency are theoretically derived by the cost-benefit approach with the concept of justification and optimization. Intervention levels on the sheltering, evacuation, temporary relocation and permanent resettlement for protection of the public are estimated with the cost to protective countermeasures and the value from dose averted which are the site specific parameters. As a result, it is confirmed that IAEA guidelines for intervention levels are applicable to the radiological emergency in Korea. Optimum ranges of 5 - 10 mSv/2days for sheltering, 25 - 130 mSv/week for evacuation, 15 - 90 mSv/month for temporary relocation and 600 - 3,500 mSv/lifetime for permanent resettlement for intervention levels are also provided. The result can be applied as useful data to update intervention levels under the theoretical background in Korea

  20. Public Acceptance of Low-Level Waste Disposal Critical to the Nuclear Renaissance

    International Nuclear Information System (INIS)

    Sonny Goldston, W.T.

    2009-01-01

    The disposal of various Low-Level Waste (LLW) forms projected to result from the operation of a pilot or large scale Advanced Fuel Cycle Initiative Programs' (formally known as Global Nuclear Energy Partnership (GNEP)) reprocessing and vitrification plants requires the DOE LLW program and regulatory structure to be utilized in its present form due to the limited availability of Nuclear Regulatory Commission licensed commercial LLW disposal facilities to handle wastes with radionuclide concentrations that are greater than Nuclear Regulatory Commission (NRC) Class A limits. This paper will describe the LLW forms and the regulatory structures and facilities available to dispose of this waste. Then the paper discusses the necessity of an excellent public involvement program to ensure the success of an effective technical solution. All of the decisions associated with the management of these wastes are of interest to the public and successful program implementation would be impossible without including the public up-front in the program formulation. Serious problems can result if program decisions are made without public involvement, and if the public is informed after key decisions are made. This paper will describe the regulatory and public involvement program and their effects on the decisions concerning the disposal of Low-Level Radioactive Waste (LLW) at the Savannah River Site (SRS). An extensive public communications effort resulted in endorsement of changes in disposal practices by the SRS Citizens Advisory Board that was critical to the success of the program. A recommendation will be made to install a public involvement program that is similar to the SRS Citizens Advisory Board in order to ensure the success of the AFCI programs in view of the limited availability to handle the wastes from the program and the public acceptance of change that will be required. (authors)

  1. Is the low level of physical activity a public policy issue?

    Directory of Open Access Journals (Sweden)

    Kalman Michal

    2013-03-01

    Full Text Available BACKGROUND: Many studies and scientific evidence confirm a positive effect of physical activity on the quality of life and human health. Physical activity, which is also one of the key factors preventing mass non-communicable diseases, is decreasing in Europe, including the Czech Republic, both in children and adults. Serious health consequences for the population and economy of the countries are a reason for a discussion about including the low level of physical activity among public policy issues and a higher allocation of public sources into the area of physical activity promotion. OBJECTIVES: The main objective of the paper is to determine whether the low level of physical activity is a public policy issue. An issue that should by systematically addressed by national, regional as well as local policy. METHODS: Through the policy analysis approach we conducted a content analysis of 25 systematically selected foreign national strategies aimed at the issue of physical activity promotion. The data source was an internal database of the World Health Organization - the International Inventory of Documents on Physical Activity Promotion. The content analysis of the strategies was performed using the Atlas.ti software tool. RESULTS: During a content analysis of 25 foreign strategies a total of 411 text segments (quotations relating to the low level of physical activity were selected. These text segments showed five basic features of a public policy issue according to a conceptual framework developed by Bardach (2000 and Patton and Sawicky (1993 - 1 affects the lives of a significant number of people of a society; 2 is analysable; 3 can be solved through public policy tools; 4 the primary cause or problem can be defined; 5 cannot be solved easily and quickly. CONCLUSIONS: The results indicate that the low level of physical activity is a public policy issue that must be systematically addressed at national level.

  2. Evaluation of the clinical risk index in very low birth weight newborns at a public tertiary maternity in the city of São Paulo, Brazil

    Directory of Open Access Journals (Sweden)

    Pedro Alexandre Breuel

    2007-12-01

    Full Text Available Objective: To evaluate the clinical risk index in very low birthweight newborns at a public maternity hospital, its associationwith mortality, some selected neonatal respiratory diseases andsurfactant therapy. Methods: A cohort prospective study carriedout at the Hospital Municipal Vila Nova Cachoeirinha e MaternidadeEscola, in São Paulo, Brazil. All newborns with gestational age< 31 weeks and birth weight < 1500 g were evaluated for theapplication of the clinical risk index for babies (CRIB. Newbornswho died in the first 12 hours of life or were referred from othermaternities were excluded from this study. Statistical analysesused logistic regression, Spearman correlation test and Student’st test. Results: Seventy-one cases were studied. The meangestational age was 27.30 ± 2.61 weeks; the mean weight was1032.61 ± 280.62 g. Birth weight and gestational age showedbetter predictive values for neonatal mortality than the clinicalrisk index for babies (80.30%, 76.10%, 73.20%. Twins showed nosignificant index differences (t = 0.601; p = 0.748. The scorewas inversely related to Apgar scores at 1 and 5 minutes and wasassociated with the respiratory distress syndrome, pneumothoraxand the use of surfactants. There was no significant correlation withchronic lung disease. Conclusion: The clinical risk index for babieswas not the best predictor for neonatal mortality as compared toweight and gestational age, but showed a significant associationwith 1 and 5-minute Apgar scores, respiratory distress syndrome,extrapulmonary air and the use of surfactants. It was not predictivefor chronic lung disease. Twins were not associated with CRIB.

  3. Do pregnant women know about danger signs of pregnancy and childbirth? – A study of the level of knowledge and its associated factors from a tertiary care hospital in Southern India

    Directory of Open Access Journals (Sweden)

    R Nithya

    2017-01-01

    Full Text Available Background: Awareness about danger signs during pregnancy is essential for a woman to seek prompt care. This can avert long-term morbidity and mortality. This study was aimed to find the level of knowledge and its related factors about danger signs of pregnancy and childbirth among pregnant women attending a tertiary care hospital in southern India. Patients and Methods: We conducted a cross-sectional survey of pregnant women attending a tertiary care hospital in South India. Systematic random sampling of every 10th woman exiting the antenatal clinic was done. Results: We studied 382 pregnant women. Of them, 188 (49.2% [95% confidence interval (CI: 44%–54%], 104 (27.2% [95% CI: 23%–32%], and 81 (21.2% [95% CI: 17%–26%] women had sufficient knowledge about danger signs during pregnancy, labor, and childbirth, respectively. On multivariable analysis, lack of exposure to formal awareness raising health counseling classes was the only factor found to be significantly associated with a lack of knowledge about danger signs of pregnancy (adjusted prevalence ratio, 95% CI: 1.8 [1.2–2.7] and after childbirth (1.4 [1.1–1.7]. Lower education level was significantly associated with a lack of knowledge about danger signs of labor (1.2 [1.1–1.4]. Conclusion: We found that lack of exposure to formal awareness raising health counseling classes is a modifiable risk factor to improve knowledge about danger signs. We recommend structured mandatory health awareness sessions addressing the danger signs of pregnancy and child health to all pregnant women.

  4. State-level public policy as a predictor of individual and family well-being.

    Science.gov (United States)

    Zimmerman, S L

    1987-01-01

    This exploratory study examines the relationship between state-level public policy and individual and family well-being and factors that affect it. The inquiry, based on exchange and choice theories, assumes that state-level public policy reflects states' awareness of the needs of individuals and families, their ability to predict the future in failing to meet them, and the extent to which the norm of reciprocity prevails in the 50 states. Measures of states' collective choices were states' per capita expenditures for public welfare, education, and health, and per capita taxes in 1980; measures of states' individual and well- or ill-being, or social malaise, were states' teenage birthrates, infant death rates, and suicide rates. Taken into account as antecedent and intervening variables were age, gender, and racial composition, income distribution, marital, socioeconomic, and employment status of states' populations, and attitudes toward public spending. The findings show that higher state expenditures for public welfare and for education indeed contribute to individual and family well-being as measured by lower state rates of suicide and teenage births. States per capita spending for education, which together with state per capita spending for public welfare was a positive predictor of school completion rates and positively associated with states' income level, accounted for almost all of the variance in states' per capita taxes. State spending for public welfare was not a predictor of state per capita taxes. These findings are cause for considerable concern given the reduced role of the federal government in human affairs, particularly in states whose choices violate the assumptions underlying exchange and choice theories and the norm of reciprocity which says that people should help, not hurt, others.

  5. Mapping of radio frequency electromagnetic field exposure levels in outdoor environment and comparing with reference levels for general public health.

    Science.gov (United States)

    Cansiz, Mustafa; Abbasov, Teymuraz; Kurt, M Bahattin; Celik, A Recai

    2018-03-01

    In this study, radio frequency electromagnetic field exposure levels were measured on the main streets in the city center of Diyarbakır, Turkey. Measured electric field levels were plotted on satellite imagery of Diyarbakır and were compared with exposure guidelines published by the International Commission on Non-Ionizing Radiation Protection (ICNIRP). Exposure measurements were performed in dense urban, urban and suburban areas each day for 7 consecutive days. The measurement system consisted of high precision and portable spectrum analyzer, three-axis electric field antenna, connection cable and a laptop which was used to record the measurement samples as a data logger. The highest exposure levels were detected for two places, which are called Diclekent and Batıkent. It was observed that the highest instantaneous electric field strength value for Batıkent was 7.18 V/m and for Diclekent was 5.81 V/m. It was statistically determined that the main contributor band to the total exposure levels was Universal Mobile Telecommunications System band. Finally, it was concluded that all measured exposure levels were lower than the reference levels recommended by ICNIRP for general public health.

  6. Uncovering High-Level Corruption: Cross-National Objective Corruption Risk Indicators Using Public Procurement Data

    OpenAIRE

    Fazekas, Mihaly; Kocsis, G

    2017-01-01

    Measuring high-level corruption is subject to extensive scholarly and policy interest, which has achieved moderate progress in the last decade. This article develops two objective proxy measures of high-level corruption in public procurement: single bidding in competitive markets and a composite score of tendering ‘red flags’. Using official government data on 2.8 million contracts in twenty-eight European countries in 2009–14, we directly operationalize a common definition of corruption: unj...

  7. Gender Differences in Public and Private Drinking Contexts: A Multi-Level GENACIS Analysis

    Directory of Open Access Journals (Sweden)

    Jason C. Bond

    2010-05-01

    Full Text Available This multi-national study hypothesized that higher levels of country-level gender equality would predict smaller differences in the frequency of women’s compared to men’s drinking in public (like bars and restaurants settings and possibly private (home or party settings. GENACIS project survey data with drinking contexts included 22 countries in Europe (8; the Americas (7; Asia (3; Australasia (2, and Africa (2, analyzed using hierarchical linear models (individuals nested within country. Age, gender and marital status were individual predictors; country-level gender equality as well as equality in economic participation, education, and political participation, and reproductive autonomy and context of violence against women measures were country-level variables. In separate models, more reproductive autonomy, economic participation, and educational attainment and less violence against women predicted smaller differences in drinking in public settings. Once controlling for country-level economic status, only equality in economic participation predicted the size of the gender difference. Most country-level variables did not explain the gender difference in frequency of drinking in private settings. Where gender equality predicted this difference, the direction of the findings was opposite from the direction in public settings, with more equality predicting a larger gender difference, although this relationship was no longer significant after controlling for country-level economic status. Findings suggest that country-level gender equality may influence gender differences in drinking. However, the effects of gender equality on drinking may depend on the specific alcohol measure, in this case drinking context, as well as on the aspect of gender equality considered. Similar studies that use only global measures of gender equality may miss key relationships. We consider potential implications for alcohol related consequences, policy and public

  8. Gender differences in public and private drinking contexts: a multi-level GENACIS analysis.

    Science.gov (United States)

    Bond, Jason C; Roberts, Sarah C M; Greenfield, Thomas K; Korcha, Rachael; Ye, Yu; Nayak, Madhabika B

    2010-05-01

    This multi-national study hypothesized that higher levels of country-level gender equality would predict smaller differences in the frequency of women's compared to men's drinking in public (like bars and restaurants) settings and possibly private (home or party) settings. GENACIS project survey data with drinking contexts included 22 countries in Europe (8); the Americas (7); Asia (3); Australasia (2), and Africa (2), analyzed using hierarchical linear models (individuals nested within country). Age, gender and marital status were individual predictors; country-level gender equality as well as equality in economic participation, education, and political participation, and reproductive autonomy and context of violence against women measures were country-level variables. In separate models, more reproductive autonomy, economic participation, and educational attainment and less violence against women predicted smaller differences in drinking in public settings. Once controlling for country-level economic status, only equality in economic participation predicted the size of the gender difference. Most country-level variables did not explain the gender difference in frequency of drinking in private settings. Where gender equality predicted this difference, the direction of the findings was opposite from the direction in public settings, with more equality predicting a larger gender difference, although this relationship was no longer significant after controlling for country-level economic status. Findings suggest that country-level gender equality may influence gender differences in drinking. However, the effects of gender equality on drinking may depend on the specific alcohol measure, in this case drinking context, as well as on the aspect of gender equality considered. Similar studies that use only global measures of gender equality may miss key relationships. We consider potential implications for alcohol related consequences, policy and public health.

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

    NARCIS (Netherlands)

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

    2018-01-01

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

  10. Networking and Managers' Career Success in the Malaysian Public Sector: The Moderating Effect of Managerial Level

    Science.gov (United States)

    Rasdi, Roziah Mohd; Garavan, Thomas N.; Ismail, Maimunah

    2012-01-01

    Purpose: The purpose of this paper is to investigate how managerial level moderates the relationships between networking behaviours and career success (objective and subjective) in the context of a public sector organisation in Malaysia. Design/methodology/approach: The study utilised a cross-sectional design and investigated these relationships…

  11. The dark sides of public service motivation: A multi-level theoretical framework

    NARCIS (Netherlands)

    Schott, C.; Ritz, Adrian

    2017-01-01

    Over the past decade, research on public service motivation (PSM) has made substantial progress in terms of explaining the desired work outcomes of the concept such as individual performance and satisfaction. In light of Perry and Wise’s warning, already voiced in 1990, that high levels of PSM may

  12. Most Common Publication Types in Radiology Journals:: What is the Level of Evidence?

    Science.gov (United States)

    Rosenkrantz, Andrew B; Pinnamaneni, Niveditha; Babb, James S; Doshi, Ankur M

    2016-05-01

    This study aimed to assess the most common publication types in radiology journals, as well as temporal trends and association with citation frequency. PubMed was searched to extract all published articles having the following "Publication Type" indices: "validation studies," "meta-analysis," "clinical trial," "comparative study," "evaluation study," "guideline," "multicenter study," "randomized study," "review," "editorial," "case report," and "technical report." The percentage of articles within each category published within clinical radiology journals was computed. Normalized percentages for each category were also computed on an annual basis. Citation counts within a 2-year window following publication were obtained using Web of Science. Overall trends were assessed. Publication types with the highest fraction in radiology journals were technical reports, evaluation studies, and case reports (4.8% to 5.8%). Publication types with the lowest fraction in radiology journals were randomized trials, multicenter studies, and meta-analyses (0.8% to 1.5%). Case reports showed a significant decrease since 1999, with accelerating decline since 2007 (P = 0.002). Publication types with highest citation counts were meta-analyses, guidelines, and multicenter studies (8.1 ± 10.7 to 12.9 ± 5.1). Publication types with lowest citation counts were case reports, editorials, and technical reports (1.4 ± 2.4 to 2.9 ± 4.3). The representation in radiology journals and citation frequency of the publication types showed weak inverse correlation (r = -0.372). Radiology journals have historically had relatively greater representation of less frequently cited publication types. Various strategies, including methodological training, multidisciplinary collaboration, national support networks, as well as encouragement of higher level of evidence by funding agencies and radiology journals themselves, are warranted to improve the impact of radiological research

  13. 41 CFR 102-79.65 - May Executive agencies outlease space on major public access levels, courtyards and rooftops of...

    Science.gov (United States)

    2010-07-01

    ... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false May Executive agencies outlease space on major public access levels, courtyards and rooftops of public buildings? 102-79.65... Utilization of Space Outleasing § 102-79.65 May Executive agencies outlease space on major public access...

  14. Evolution of global contribution in multi-level threshold public goods games with insurance compensation

    Science.gov (United States)

    Du, Jinming; Tang, Lixin

    2018-01-01

    Understanding voluntary contribution in threshold public goods games has important practical implications. To improve contributions and provision frequency, free-rider problem and assurance problem should be solved. Insurance could play a significant, but largely unrecognized, role in facilitating a contribution to provision of public goods through providing insurance compensation against the losses. In this paper, we study how insurance compensation mechanism affects individuals’ decision-making under risk environments. We propose a multi-level threshold public goods game model where two kinds of public goods games (local and global) are considered. Particularly, the global public goods game involves a threshold, which is related to the safety of all the players. We theoretically probe the evolution of contributions of different levels and free-riders, and focus on the influence of the insurance on the global contribution. We explore, in both the cases, the scenarios that only global contributors could buy insurance and all the players could. It is found that with greater insurance compensation, especially under high collective risks, players are more likely to contribute globally when only global contributors are insured. On the other hand, global contribution could be promoted if a premium discount is given to global contributors when everyone buys insurance.

  15. Evaluating public involvement in the national low-level radioactive-waste-management program. Final report

    International Nuclear Information System (INIS)

    1982-01-01

    An extensive public involvement approach has been developed to obtain the views and assistance of state and local governments, citizen groups, industry, professional societies and other organizations in the preparation and review of a national strategy document on low-level radioactive wastes. Six evaluators who have a wide diversity of backgrounds were selected to evaluate the effectiveness of this approach. This final report presents findings discussed under the headings: Introduction to the Recent History of Low-level Waste Policy Development (LLWMP) and the Role of Public Participation; Public Participation Mechanisms Employed in Preparing the National Strategy Document; the Keystone's Evaluation Process; and Findings. The overall evaluation of the process was very positive. It was clear that the LLWMP staff was seriously committed to building a credible public participation process. The evaluation team was provided rough cost figures for the various components of the LLWMP effort and concluded that, in its opinion, the public participation process provided benefits to the federal government that exceeded its costs. Moreover, the costs of the individual components were not out of line with each one's usefulness and contribution to the overall effort

  16. Lithium levels in the public drinking water supply and risk of suicide: A pilot study.

    Science.gov (United States)

    Liaugaudaite, Vilma; Mickuviene, Narseta; Raskauskiene, Nijole; Naginiene, Rima; Sher, Leo

    2017-09-01

    Suicide is a major public health concern affecting both the society and family life. There are data indicating that higher level lithium intake with drinking water is associated with lower suicide rate. This pilot study examined the relationship between lithium levels in drinking water and suicide rates in Lithuania. Twenty-two samples from public drinking water systems were taken in 9 cities of Lithuania. The lithium concentration in these samples was determined by inductively coupled plasma mass spectrometry (ICP-MS). The suicide data were obtained from the Lithuania Database of Health Indicators, and comprised all registered suicides across all ages and gender within the 5-year period from 2009 to 2013. The study demonstrated an inverse correlation between levels of lithium (log natural transformed), number of women for 1000 men and standardized mortality rate for suicide among total study population. After adjusting for confounder (the number of women for 1000 men), the lithium level remained statistically significant in men, but not in women. Our study suggested that higher levels of lithium in public drinking water are associated with lower suicide rates in men. It might have a protective effect on the risk of suicide in men. Copyright © 2017 The Authors. Published by Elsevier GmbH.. All rights reserved.

  17. Siting a low-level radioactive waste incinerator in North Carolina: the impacts of public opposition

    International Nuclear Information System (INIS)

    Miller, E.M.

    1987-01-01

    Establishing low-level radioactive waste (LLRW) facilities has become increasingly difficult due to public opposition to siting proposals. Widespread opposition to siting new waste management facilities of all types has focused sharp attention on the technical, political, and socioeconomic problems associated with siting controversial, but necessary facilities. This paper reviews a recent private sector initiative to site a LLRW incinerator in Bladen County, NC. Public reactions to the proposed facility are documents, as well as reasons for public opposition to the facility. The impacts of public opposition on the siting process, regulatory agencies, the media, industry, the general public, and elected officials are examined. The paper points out how public opposition to proposed waste management facilities may have both positive and negative impacts on the long-term management of LLRW. In doing so, the paper addresses policy questions, processes, and perceptions that will shape the debate over the development and location of new treatment and disposal facilities for managing LLRW. 14 references

  18. Necessidade de cuidados intensivos em maternidade pública terciária Necessity of intensive care in a tertiary public maternity hospital

    Directory of Open Access Journals (Sweden)

    Marcello Braga Viggiano

    2004-05-01

    mortalidade materna e duração da internação (48 horas nas UTI's (p=0,08. A RMI encontrada foi de 18,8/1.000 partos. CONCLUSÕES: a necessidade de cuidados intensivos estimada pela RMI foi de 18,8/1.000 partos, sendo que as síndromes hipertensivas induzidas pela gestação foram responsáveis pela maioria das indicações para as transferências maternas.OBJECTIVE: to evaluate the epidemiological and parturitional aspects of obstetric patients admitted to intensive care units (ICU, and analyze the frequency of intensive support needed by them. METHODS: observational and descriptive study of all obstetric patients' transfers to ICU from the Hospital Materno Infantil of Goiânia-Go, from January 1999 to December 2001. The analysis has included variables as maternal age, parity, obstetric and non-obstetric indications for ICU admissions, moment of transfer, mode of delivery, maternal death, and the frequency of ICU utilization per 1,000 deliveries (IDR - imminent death ratio. The statistical analysis was performed by the chi2 test or the Fisher exact test and a significant difference was set at a level of 5%. RESULTS: over the 36-month period analyzed, 86 pregnancy-associated ICU admissions were identified (among 4,560 deliveries. Of the 86 patients, 52.33% (n=45 were nulliparae and 63 (73.26% were between 19 and 35 years old. Hypertensive disorders accounted for 41 (57.75% of the admissions and hemorrhage for 14 (19.72%. Eclampsia (n=23, HELLP syndrome (n=13 and premature abruptio placentae (n=5 were the most common obstetric indications for ICU admissions. Maternal cardiac disorders accounted for 4 cases of non-obstetric indications. There was a predominance of postpartum transfers (82.35%. Fifty-five (72.37% patients needed delivery by caesarian section. The average time spent in the UCI by those patients was 5.1 days. Maternal mortality found in this study was 24.29%, hypertensive disorders being responsible for 52.94% (9/17 of all obstetric-associated deaths. There were

  19. Low and intermediate level waste repositories: Socioeconomic aspects and public involvement. Proceedings of a workshop

    International Nuclear Information System (INIS)

    2007-06-01

    Waste management facilities are needed to protect the environment and improve public health for the long term future. One significant challenge is to inform the public on the relative hazards of radioactive waste compared to other hazards in our modern society and to get the acceptance of the appropriate members of the public for these necessary facilities. Over the entire life cycle of these facilities, the projects must be managed without expending a disproportionate share of the collective resources. Public involvement plays a key role and the sophisticated and extensive public education systems that exist provide a vital service to gain public acceptance. There is a full range of compensation and benefit programmes used as incentives for hosting a LILW facility. Even if exemptions exist the experience in most countries indicate the direct/indirect incentives as a necessary part of gaining public acceptance. The countries, regions and local communities have their own established processes to make public decisions. Each organization developing a site must select and implement the methods that are acceptable within their framework of laws and regulations. A three day workshop on socio-economic issues and public involvement practices and approaches for developing and operating repositories for low and intermediate level waste took place in the IAEA headquarters on 9-11 November 2005. The workshop provided a forum where experts from Member States shared their experiences in non-technical aspects of planning, licensing and operating LILW disposal facilities. Description of both principles and practices applied in particular countries provides a useful overview of potential approaches in application of non-technical issues during a repository lifecycle. Participants presented approaches and practices applied in their countries, established new contacts and were able to take advantage of activities and experiences from abroad. There were 25 interesting presentations

  20. Comprehensive analysis of changes in clinically significant divalent serum cation levels during automated plateletpheresis in healthy donors in a tertiary care center in North India

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    Archana Solanki

    2015-01-01

    Full Text Available Background: Adverse effects due to apheresis are unusual. The most common apheresis-specific reaction is hypocalcemia due to citrate anticoagulation and induces ionized hypocalcemia and hypomagnesemia by chelating effect during the plateletpheresis; generally transient and self-limiting but has the potential of severely injuring donor. We have investigated total calcium (tCa ++ and magnesium (tMg ++ levels in sixty healthy plateletpheresis donors at different intervals during the procedure and 30 min post-procedure. Materials and Methods: A total of 60 procedures were performed on healthy donors. Blood samples were obtained from sterile diversion pouch placed on apheresis circuit. 5 ml sample in plain vials was obtained at different intervals during each procedure and 30 min after the end of the procedure. Samples were used for measurement of tCa ++ and tMg ++ levels. Results: There is continuous decrease in mean tCa ++ from baseline levels (9.83 ± 0.64 mg/dl till end of procedure (8.33 ± 0.78 mg/dl, but after 30 min, levels again reached near their respective baseline values (9.42 ± 0.54 mg/dl. Similarly, mean tMg ++ fell from baseline levels (2.36 ± 0.3 mg/dl till the end of procedure (1.39 ± 0.40 mg/dl. After 30 min, levels were again increased, their respective baseline values (2.25 ± 0.25 mg/dl. Conclusion: There is continuous, gradual, and significant fall (P < 0.05 in mean tCa ++ and mean tMg ++ from baseline levels to till the end of procedure but after 30 min of completion of procedure, levels again reached near their respective baseline values.

  1. Public administration of quality of education at the local level on the foundation of the competence approach

    Directory of Open Access Journals (Sweden)

    O. I. Popova

    2014-04-01

    Full Text Available The article deals with the essence of the phenomenon of management, reveals the meaning of science categories of public administration, of public administration of education and public administration of quality of education at the local level. Personnel factor identifies priority in improving of public administration of quality of education at the local level, the importance of the implementation of the competence approach to management education sector as a necessary condition to ensure the quality of education.

  2. Study on generic intervention levels for protecting the public in a nuclear accident or radiological emergency

    International Nuclear Information System (INIS)

    Suzuki, Fabio Fumio

    2003-01-01

    After a nuclear accident or radiological emergency, several social and economical factors shall be considered for the actions to protect the public and to recover the environment. The application of the radiological protection principles on practices in intervention situations may lead to adoption of protective measures disproportional to the involved risk, compromising the resources available to more effective actions. This causes a negative impact on the population and may conduct to discredit about the protective measures and the lost of confidence on the authorities. In this context, the principles of radiological protection for interventions should be studied and analyzed for being adequately applied in accident situations or radiological emergencies that involves the country. These principles are constantly improved and the concept of generic intervention level plays an important role in the decision-making to protect the public. The costs involved to the protective measures for the public in Brazil were studied and cost benefit analysis techniques were applied to estimate the generic intervention levels for public protection applicable in the country. These results were compared to those values internationally recommended, as well to values obtained in a similar study accomplished for Japan. It was also performed a sensibility analysis of the results regarding a value and a simple analysis of the results considering the costs of the several protective measures. (author)

  3. What evidence and support do state-level public health practitioners need to address obesity prevention.

    Science.gov (United States)

    Leeman, Jennifer; Teal, Randall; Jernigan, Jan; Reed, Jenica Huddleston; Farris, Rosanne; Ammerman, Alice

    2014-01-01

    Obesity has reached epidemic proportions. Public health practitioners are distinctly positioned to promote the environmental changes essential to addressing obesity. The Centers for Disease Control and Prevention (CDC) and other entities provide evidence and technical assistance to support this work, yet little is known about how practitioners use evidence and support as they intervene to prevent obesity. The study's purpose was to describe how practitioners and CDC project officers characterized the obesity prevention task, where practitioners accessed support and evidence, and what approaches to support and evidence they found most useful. APPROACH OR DESIGN: Mixed-methods, cross-sectional interviews, and survey. State-level public health obesity prevention programs. Public health practitioners and CDC project officers. We conducted 10 in-depth interviews with public health practitioners (n = 7) and project officers (n = 3) followed by an online survey completed by 62 practitioners (50% response rate). We applied content analysis to interview data and descriptive statistics to survey data. Practitioners characterized obesity prevention as uncertain and complex, involving interdependence among actors, multiple levels of activity, an excess of information, and a paucity of evidence. Survey findings provide further detail on the types of evidence and support practitioners used and valued. We recommend approaches to tailoring evidence and support to the needs of practitioners working on obesity prevention and other complex health problems.

  4. Is Level of Injury a Determinant of Quality of Life Among Individuals with Spinal Cord Injury? A Tertiary Rehabilitation Center Report

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    Seyed Amir Hossein Tavakoli

    2016-03-01

    Full Text Available Objectives: The role of injury-related variables in determining health-related quality of life (HRQOL among Iranian persons with spinal cord injury (SCI has not yet been fully described. In this study, we compared HRQOL between individuals with injury at cervical level and those with injury at thoracolumbar sections and evaluated the discriminating value of injury level as a determinant of HRQOL among Iranian people with SCI. Methods: Individuals with SCI, who were referred to Brain and Spinal Cord Injury Research Center, were invited to participate in this investigation. HRQOL was assessed using the Short Form (SF-36 questionnaire to determine the quality of life (QOL in eight domains: physical functioning (PF, role limitation due to physical problems (RP, bodily pain (BP, general health (GH, vitality (VT, social functioning (SF, role limitation due to emotional problems (RE, and mental health (MH. Results: Ninety patients with paraplegia and 94 quadriplegic patients participated in this investigation. The mean score of PF domain was significantly lower in patients with injury at cervical level (p < 0.0001. There was no significant difference in other domains of SF-36 between subjects with paraplegia and quadriplegia (p = 0.670, 0.700, 0.910, 0.710, 0.730, 0.290 and 0.850 for RP, RE, VT, MH, SF, BP and GH, respectively. Similarly, the mean physical component summary (PCS score was significantly higher among individuals with injury at thoracolumbar sections (p < 0.0001. The mean mental component summary (MCS score did not differ between the two groups (p = 0.720. Conclusions: Patients with SCI at the cervical level have similar mental health compared to those with injury at thoracolumbar sections, which shows proper mental adaptability in quadriplegic individuals. Injury level can be used as a major determinant of the physical component of QOL among people with SCI.

  5. Serum ferritin levels, socio-demographic factors and desferrioxamine therapy in multi-transfused thalassemia major patients at a government tertiary care hospital of Karachi, Pakistan

    Directory of Open Access Journals (Sweden)

    Rehman Anis

    2011-08-01

    Full Text Available Abstract Background Beta thalassemia is the most frequent genetic disorder of haemoglobin synthesis in Pakistan. Recurrent transfusions lead to iron-overload manifested by increased serum Ferritin levels, for which chelation therapy is required. Findings The study was conducted in the Pediatric Emergency unit of Civil Hospital Karachi after ethical approval by the Institutional Review Board of Dow University of Health Sciences. Seventy nine cases of beta thalassemia major were included after a written consent. The care takers were interviewed for the socio-demographic variables and the use of Desferrioxamine therapy, after which a blood sample was drawn to assess the serum Ferritin level. SPSS 15.0 was employed for data entry and analysis. Of the seventy-nine patients included in the study, 46 (58.2% were males while 33 (41.8% were females. The mean age was 10.8 (± 4.5 years with the dominant age group (46.2% being 10 to 14 years. In 62 (78.8% cases, the care taker education was below the tenth grade. The mean serum Ferritin level in our study were 4236.5 ng/ml and showed a directly proportional relationship with age. Desferrioxamine was used by patients in 46 (58.2% cases with monthly house hold income significant factor to the use of therapy. Conclusions The mean serum Ferritin levels are approximately ten times higher than the normal recommended levels for normal individuals, with two-fifths of the patients not receiving iron chelation therapy at all. Use of iron chelation therapy and titrating the dose according to the need can significantly lower the iron load reducing the risk of iron-overload related complications leading to a better quality of life and improving survival in Pakistani beta thalassemia major patients. Conflicts of Interest: None

  6. Remuneração nos serviços no Brasil: o contraste entre funcionários públicos e privados Earnings in the tertiary sector in Brazil: the contrast between public and private workers

    Directory of Open Access Journals (Sweden)

    Daniela Verzola Vaz

    2007-08-01

    Full Text Available Utilizando dados da PNAD, o trabalho investiga o comportamento do hiato de rendimentos entre funcionários públicos e empregados do setor privado com carteira assinada, ocupados no setor terciário, de 1992 a 2005. São ajustadas, em separado, equações de rendimento, a fim de apontar as diferenças no efeito de vários fatores (idade, sexo, escolaridade, etc. sobre o salário de cada categoria. Mediante o emprego da metodologia de Blinder-Oaxaca identifica-se quanto do diferencial de rendimentos entre os dois grupos se deve a diferenças na capacitação individual dos trabalhadores e quanto está associado a outros fatores, analisando como essa decomposição evoluiu ao longo do período 1992-2005. Um resultado importante é o crescimento do hiato de rendimentos entre os dois grupos, especialmente da parcela não explicada pelas diferenças na capacitação dos empregados.ABSTRACT Using data from an annual household survey (PNAD, this study analyses the behavior of the wage gap between public and private formal workers from the tertiary sector in Brazil from 1992 to 2005. Earnings equations are estimated separately for these two groups. Such equations allow us to evaluate the effect of age, gender, schooling, color (race, position in the occupation, weekly working time and other factors on earnings of each category. Blinder-Oaxaca methodology reveals how much of the wage gap between the workers of both sectors is due to differences in productive endowments and how much is due to other factors, such as the existence of segmentation between the public and the private labor market in Brazil. An important result is the increase of the wage gap between the two groups of workers, mainly of the part that can not be explained by workers' productive endowments.

  7. Sociology, Street-Level Bureaucracy, and the Management of the Public Sector

    OpenAIRE

    Piore, Michael J.

    2011-01-01

    This article extends the concept of street-level bureaucracy to address the problem of the inflexibility and rigidity of governmental rules and regulations, a problem at the heart of the standard economic argument against an active government role in the management of the economy. In so doing, it seeks to create a conceptual bridge over which a range of social science disciplines can be drawn into the debate about public sector management and thereby expand the repertoire of policy tools. The...

  8. The level of knowledge of, attitude toward and emphasis given to HBV and HCV infections among healthcare professionals: Data from a tertiary hospital in Turkey

    Directory of Open Access Journals (Sweden)

    Ayhan Hilmi Cekin

    2013-02-01

    Full Text Available Objectives: To evaluate the level of knowledge of, to investigate the attitudes toward, and to determine the emphasis given to the national prevalence of HBV/HCV infections among healthcare professionals. Materials and Methods: A total of 206 healthcare professionals (mean (SD age: 37.0 (6.3 years; 86.9% – females including medical laboratory technicians (N = 54 and nurses (N = 152 employed in the Antalya Training and Research Hospital, Antalya, Turkey. Laboratory (N = 53, operating room (N = 41 and in-patient clinic (N = 112 staff were included in this descriptive study. A 33-questionnaire composed of questions related to their level of knowledge and attitudes toward HBV/HCV infections, the sources of their knowledge of HBV/HCV infections and the emphasis given to the national and global importance of the diseases was administered via a face–to-face interview method with each subject; participation was volunteer based. Results: The participants working in the in-patient clinic (18.0 (3.2 had the highest mean (SD knowledge level compared to the laboratory (16.4 (3.1, p < 0.05 and operating room (17.0 (2.8, p < 0.05 staff. The participants from the in-patient clinic (44.6% had a more advanced level of knowledge compared to the participants working in the laboratory (27.8%, p < 0.05 and the operating room (30.0%, p < 0.05. Most of the subjects (60.7% had education concerning HBV/HCV infections in the past. There was no signifi cant difference between the hospital units in terms of the attitudes of healthcare workers (HCWs toward HBV/HCV infections and the level of education concerning them. Conclusions: Our fi ndings revealed a moderate level of knowledge in most HCWs, regardless of their exposure to risk. While the highest knowledge scores and vaccination rates were noted among the in-patient clinic staff, there was no signifi cant difference between the hospital units in terms of the attitudes of HCWs towards a patient or a colleague with an

  9. New hospital structure in the twenty-first century: the position of level III (tertiary) neurological and stroke care in a changing healthcare system.

    Science.gov (United States)

    Szentes, Tamás; Kovács, László; Óváry, Csaba

    2016-01-01

    The determination of the necessary capacity and number of neurology wards of level III progressivity that can be defined in the system of criteria detailed in this article and which possess optimal operating conditions in Hungarian terms. We used the National Health Insurance Company's database to calculate case numbers and capacity for different levels of neurological and stroke care. We also revised the allocation of advanced diagnostic and therapeutic technologies, and proposed changes, based on health insurance data. We also discussed these propositions with clinical experts to test their viability. We determined the adequate number of organisational units capable of providing special neurological healthcare services on the basis of the basic data of the Hungarian healthcare system, specifying this number as 6 instead of the current 11. In our study, we have identified significant bias in the nationwide level of neurological and stroke care organisation, which needs revised allocation of healthcare resources. Naturally, this can only be carried out through the restructuring of the emergency care system and the expansion of pre-hospital care.

  10. Correlation between preoperative serum alpha-fetoprotein levels and survival with respect to the surgical treatment of hepatocellular carcinoma at a tertiary care hospital in Veracruz, Mexico

    Directory of Open Access Journals (Sweden)

    G. Martínez-Mier

    2017-10-01

    Full Text Available Introduction: Preoperative serum alpha-fetoprotein levels can have predictive value for hepatocellular carcinoma survival. Aim: Our aim was to analyze the correlation between preoperative serum alpha-fetoprotein levels and survival, following the surgical treatment of hepatocellular carcinoma. Methods: Nineteen patients were prospectively followed (07/2005-01/2016. An ROC curve was created to determine the sensitivity and specificity of alpha-fetoprotein in relation to survival (Kaplan-Meier. Results: Of the 19 patients evaluated, 57.9% were men. The mean patient age was 68.1 ± 8.5 years and survival at 1, 3, and 5 years was 89.4, 55.9, and 55.9%. The alpha-fetoprotein cutoff point was 15.1 ng/ml (sensitivity 100%, specificity 99.23%. Preoperative alpha-fetoprotein levels below 15.1, 200, 400, and 463 ng/ml correlated with better 1 and 5-year survival rates than levels above 15.1, 200, 400, and 463 ng/ml (P<.05. Conclusions: Elevated preoperative serum alpha-fetoprotein levels have predictive value for hepatocellular carcinoma survival. Resumen: Introducción: Los niveles séricos de alfafetoproteína (AFP preoperatoria pueden tener valor predictivo para la sobrevida del hepatocarcinoma (HCC. Objetivo: Analizar la correlación entre los niveles séricos de AFP preoperatoria y la sobrevida posterior al tratamiento quirúrgico del HCC. Métodos: Diecinueve pacientes fueron seguidos prospectivamente (julio del 2005-enero del 2016. Se realizó una curva ROC para determinar la sensibilidad y la especificidad de la AFP con relación con la sobrevida (Kaplan-Meier. Resultados: Se evaluó a 19 pacientes, 57.9% hombres, edad media 68.1 ± 8.5 años con sobrevida a 1, 3 y 5 años del 89.4, el 55.9 y el 55.9%. El punto de corte de AFP fue 15.1 ng/ml (sensibilidad 100%, especificidad 99.23%. Los niveles preoperatorios de AFP menores de 15.1, 200, 400 y 463 ng/ml correlacionaron con mejor sobrevida a 1 y 5 años que niveles mayores de AFP (p < 0

  11. DO PUBLIC AND PRIVATE DEBT LEVELS AFFECT THE SIZE OF FISCAL MULTIPLIERS?

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    Chairul Adi

    2017-09-01

    Full Text Available This paper investigates the effectiveness of fiscal policies – as measured by the impact and cumulative multipliers – and how they interact with public and private debt. Harnessing the moderated panel regression approach, based on the yearly data set of several economies during the period from 1996 to 2012, the analysis is focused on the impact of spending-and-revenue-based fiscal policies on economic growth and how these fiscal instruments interact with public and private indebtedness. The result of spending stimuli advocates the basic Keynesian theory. An increase in public expenditures contemporaneously generates a positive multiplier, of around 0.29 – 0.44 and around 0.45 – 0.58 during two years. Decomposing the expenditures into their elements, this paper documents a stronger impact from public investment than that from government purchases. On the other hand, the revenue stimuli seem to follow the Ricardian Equivalence Hypothesis (REH, arguing that current tax cuts are inconsequential. The impact and cumulative multipliers for this fiscal instrument have mixed results, ranging from -0.21 to 0.05 and -0.26 to 0.06, respectively. Moreover, no robust evidence is found to support the argument that government debt moderates the effectiveness of fiscal policies. The size of the multipliers for both spending and revenue policies remain constant with the level of public debt. On the other hand, private debt appears to show a statistically significant moderating effect on spending stimuli. Its impact on spending multipliers, however, is economically insignificant. The moderation effect of private debt on the revenue stimuli does not seem to exist. Finally, this paper documents that both public and private debt exhibit a negative and statistically significant estimation for economic output.

  12. Mangrove associated lignite beds of Malvan, Konkan: Evidence for higher sea-level during the Late Tertiary (Neogene) along the west coast of India

    Energy Technology Data Exchange (ETDEWEB)

    Kumaran, K.P.N.; Shindikar, M.; Limaye, R.B. [Agharkar Research Inst., Pune (India)

    2004-01-25

    Fossil pneumatophores (breathing roots) of Avicennia are recovered and reported from the lignite beds exposed in Kolamb well-section near Malvan, Konkan area of western Maharashtra. The accrued palynoflora is dominated by mangroves (Avicennia, Aegialitis, Excoecaria, Rhizophora and Sonneratia). The spores of mangrove fern (Acrostichum aureum) an estuarine fungus Cirrenalia indicate that these lignites are autochthonous and deposited in a near-shore environment. Presence of foraminiferal linings (= microforaminifera), dinoflagellate cysts, a few calcareous nannofossils and scolecodonts is an irrefutable proof of marine and brackish water influence during the deposition of lignites under intertidal/tidal swampy condition (mangrove influenced) with fair input from freshwater swamps and hinterland. Freshwater-related forms, viz. Ceratopteris thalictroides, Nymphaeaceae, Ctenolophonaceae and hinterland taxa (Cullenia/Durio) of Bombacaceae along with abundance of microthyriaceous fungi in the palynoflora imply a warm humid tropical climate with high precipitation during the depositional period. The presence of Ctenolophon englerianus (= Ctenolophonidites costatus) in Kolamb lignites suggests the Late Neogene (Late Miocene-Early Pliocene) age. The occurrence of pneumatophores and associated lignite deposits about 37 m above the present mean sea-level, and much inland, clearly indicates the higher sea-level strand during Late Neogene along the west coast of India.

  13. Turning point: the Robert Wood Johnson Foundation's effort to revitalize public health at the state level.

    Science.gov (United States)

    Hassmiller, Susan

    2002-01-01

    The Robert Wood Johnson (RWJ) Foundation initiated Turning Point in collaboration with the W.K. Kellogg Foundation (Kellogg) in 1997. The purpose of this major national initiative was to strengthen the public health infrastructure in the United States so that states, local communities, and their public health agencies might respond to the challenge to protect and improve the public's health in the 21st century. RWJ funded 21 states and Kellogg funded 43 communities to work together to create a new way of thinking about how health could be improved and who should be involved. Although the ultimate outcome was to improve health, both foundations expected diverse partnerships to work together to create strategic health improvement plans at both the community and state levels. The foundations funded a variety of strategies within those health improvement plans during an implementation phase. The premise in funding partnerships, as opposed to a single entity, was that effective public health systems would be developed best through a shared responsibility (including the private sector) for the health of a community.

  14. The effects of media on the level of accountability of public organization

    Directory of Open Access Journals (Sweden)

    Mehrdad Matani

    2014-09-01

    Full Text Available One of the features of democratic political systems is the accountability against their own performances. Media, one of the powerful elements of civil society and effectual on public thought, plays an important role in making the government responsive. To achieve this goal, the present study tries to investigate the effect of media on the improvement of the accountability level of the government agencies. The statistical society of this research includes all male students of Azad Ghaemshahr University where 320 students were selected through purposive sampling method based on Kerjesy and Morgan table. Applied research method is used in this survey. A researcher-made questionnaire was used to collect the required data. In order to validate the instrument, appropriate questions related to each variable were extracted from valid sources and finally approved by authorities. In order to calculate the reliability of the questionnaire, Cronbach’s alpha was calculated to be 89. Since the distribution of the data was normal, parametric statistical tests were used to testify the hypotheses. The findings of the study show that the media could be effective in terms of making public organizations responsive, through leading and training the public, unifying demands, and monitoring and broadcasting. However, the findings reveal that if the media were free and independent, they would better perform their responsibilities. Finally, the study at hand concludes that in comparison to other media, television is much more powerful in terms of pushing the public sector to be responsive.

  15. Visible-light-induced photocatalysis of low-level methyl-tertiary butyl ether (MTBE) and trichloroethylene (TCE) using element-doped titanium dioxide

    Energy Technology Data Exchange (ETDEWEB)

    Jo, Wan-Kuen; Yang, Chang-Hee [Department of Environmental Engineering, Kyungpook National University, Sankeokdong, Bukgu, Daegu 702-701 (Korea)

    2010-04-15

    While the photocatalytic degradation of various volatile organic compounds in conjunction with UV light has been widely reported, visible-light-induced photocatalytic degradation of low-levels of the pollutants MTBE and TCE, which have been linked to potential adverse health effects, is rarely reported. The present study examined whether visible-light-activated S- or N-doped TiO{sub 2} photocatalytic technology can be used to control indoor concentrations of MTBE and TCE. This study consists of the characterization of the doped TiO{sub 2} powders, as well as an investigation of their photocatalytic activities. In regards to both powders, a shift of the absorbance spectrum towards the visible light region was observed. An activity test suggested that these photocatalysts exhibited reasonably high degradation efficiencies towards MTBE and TCE under visible light irradiation. The degradation efficiencies of MTBE and TCE by S- and N-doped photocatalysts exceeded 75 and 80%, respectively, at input concentrations (IC) of 0.1 ppm. Degradation efficiency was dependent on both IC and relative humidity. TCE could enhance the degradation efficiency of MTBE even under visible-light irradiation. The estimated mineralization efficiencies (MEs) were comparable to those of previous studies conducted with UV/TiO{sub 2} systems. Similar to the relative degradation efficiencies, the ME of TCE was higher in comparison to that of MTBE. The CO production measured during the photocatalytic processes represented a negligible addition to indoor CO levels. These results suggest that visible-light-activated S- and N-doped TiO{sub 2} photocatalysts may prove a useful tool in the effort to improve indoor air quality. (author)

  16. Publicity.

    Science.gov (United States)

    Chisholm, Joan

    Publicity for preschool cooperatives is described. Publicity helps produce financial support for preschool cooperatives. It may take the form of posters, brochures, newsletters, open house, newspaper coverage, and radio and television. Word of mouth and general good will in the community are the best avenues of publicity that a cooperative nursery…

  17. A non-clinical randomised controlled trial to assess the impact of pharmaceutical care intervention on satisfaction level of newly diagnosed diabetes mellitus patients in a tertiary care teaching hospital in Nepal.

    Science.gov (United States)

    Upadhyay, Dinesh Kumar; Mohamed Ibrahim, Mohamed Izham; Mishra, Pranaya; Alurkar, Vijay M

    2015-02-12

    Patient satisfaction is the ultimate goal of healthcare system which can be achieved from good patient-healthcare professional relationship and quality of healthcare services provided. Study was conducted to determine the baseline satisfaction level of newly diagnosed diabetics and to explore the impact of pharmaceutical care intervention on patients' satisfaction during their follow-ups in a tertiary care teaching hospital in Nepal. An interventional, pre-post non-clinical randomised controlled study was designed among randomly distributed 162 [control group (n = 54), test 1 group (n = 54) and test 2 group (n = 54)] newly diagnosed diabetes mellitus patients by consecutive sampling method for 18 months. Diabetes Patient Satisfaction Questionnaire was used to evaluate patient's satisfaction scores at baseline, three, six, nine and, twelve months' follow-ups. Test groups patients were provided pharmaceutical care whereas control group patients only received their usual care from physician/nurses. The responses were entered in SPSS version 16. Data distribution was not normal on Kolmogorov-Smirnov test. Non-parametric tests i.e. Friedman test, Mann-Whitney U test and Wilcoxon signed rank test were used to find the differences among the groups before and after the intervention (p ≤0.05). There were significant (p patients' satisfaction scores in the test groups on Friedman test. Mann-Whitney U test identified the significant differences in satisfaction scores between test 1 and test 2 groups, control and test 1 groups and, control and test 2 groups at 3-months (p = 0.008), (p satisfaction level of diabetics in the test groups compare to the control group. Diabetic kit demonstration strengthened the satisfaction level among the test 2 group patients. Therefore, pharmacist can act as a counsellor through pharmaceutical care program and assist the patients in managing their disease. This will not only modify the patients' related outcomes and their

  18. A structural model analysis of public opposition to a high-level radioactive waste facility

    International Nuclear Information System (INIS)

    Flynn, J.; Mertz, C.K.; Slovic, P.; Burns, W.

    1991-09-01

    Studies show that most Nevada residents and almost all state officials oppose the proposed high-level radioactive waste repository project at Yucca Mountain. Surveys of the public show that individual citizens view the Yucca Mountain repository as having high risk; nuclear experts, in contrast, believe the risks are very low. Policy analysts have suggested that public risk perceptions may be reduced by better program management, increased trust in the federal government, and increased economic benefits for accepting a repository. The model developed in this study is designed to examine the relationship between public perceptions of risk, trust in risk management, and potential economic impacts of the current repository program using a confirmatory multivariate method known as covariance structure analysis. The results indicate that perceptions of potential economic gains have little relationship to opposition to the repository. On the other hand, risk perceptions and the level of trust in repository management are closely related to each other and to opposition. The impacts of risk perception and trust in management on opposition to the repository result from a combination of their direct influences as well as their indirect influences operating through perceptions that the repository would have serious negative impacts on the state's economy due to stigmatization and reduced tourism

  19. Public involvement in multi-objective water level regulation development projects-evaluating the applicability of public involvement methods

    International Nuclear Information System (INIS)

    Vaentaenen, Ari; Marttunen, Mika

    2005-01-01

    Public involvement is a process that involves the public in the decision making of an organization, for example a municipality or a corporation. It has developed into a widely accepted and recommended policy in environment altering projects. The EU Water Framework Directive (WFD) took force in 2000 and stresses the importance of public involvement in composing river basin management plans. Therefore, the need to develop public involvement methods for different situations and circumstances is evident. This paper describes how various public involvement methods have been applied in a development project involving the most heavily regulated lake in Finland. The objective of the project was to assess the positive and negative impacts of regulation and to find possibilities for alleviating the adverse impacts on recreational use and the aquatic ecosystem. An exceptional effort was made towards public involvement, which was closely connected to planning and decision making. The applied methods were (1) steering group work, (2) survey, (3) dialogue, (4) theme interviews, (5) public meeting and (6) workshops. The information gathered using these methods was utilized in different stages of the project, e.g., in identifying the regulation impacts, comparing alternatives and compiling the recommendations for regulation development. After describing our case and the results from the applied public involvement methods, we will discuss our experiences and the feedback from the public. We will also critically evaluate our own success in coping with public involvement challenges. In addition to that, we present general recommendations for dealing with these problematic issues based on our experiences, which provide new insights for applying various public involvement methods in multi-objective decision making projects

  20. OCRWM [Office of Civilian Radioactive Waste Management] publications catalog on high-level radioactive waste management

    International Nuclear Information System (INIS)

    1987-07-01

    The US Department of Energy's (DOE's) Office of Civilian Radioactive Waste Management (OCRWM) is publishing this catalog to provide citations of selected technical and public information on the subject of high-level radioactive waste management. The catalog is a resource and reference tool. It will be updated and printed annually. The online catalog will be available for review through OCRWM's Product Record System (PRS) and can eventually be made available to the public. The printed catalog version is suitable for libraries and those individuals needing either a broad base of information or a particular source; the computerized catalog version provides the most current information resources available, since updates to citations will be made as they are received. The number of documents suitable for listing in this catalog is expected to grow significantly each year

  1. Colombia - National Level Public Financial Management and Procurement Report : Status of the Public Financial Management and Procurement System

    OpenAIRE

    World Bank; Inter-American Development Bank

    2009-01-01

    This Public Financial Management Performance Report (PFMPR) analyzes the performance of Colombia's public financial management (PFM) institutions, systems and processes. It documents areas where performance is close to or follows international good practice, as well as opportunities to further enhance PFM contribution to the goals of strengthening fiscal discipline, enabling more efficient...

  2. Colombia - National Level Public Financial Management and Procurement Report : Status of the Colombian Public procurement System - OECD Methodology

    OpenAIRE

    World Bank

    2009-01-01

    This Public Financial Management Performance Report (PFMPR) analyzes the performance of Colombia's public financial management (PFM) institutions, systems and processes. It documents areas where performance is close to or follows international good practice, as well as opportunities to further enhance PFM contribution to the goals of strengthening fiscal discipline, enabling more efficient...

  3. Effect of public transport strikes on air pollution levels in Barcelona (Spain).

    Science.gov (United States)

    Basagaña, Xavier; Triguero-Mas, Margarita; Agis, David; Pérez, Noemí; Reche, Cristina; Alastuey, Andrés; Querol, Xavier

    2018-01-01

    Public transport strikes can lead to an increase of the number of private vehicle trips, which in turn can increase air pollution levels. We aimed to estimate the change in air pollution concentrations during public transport strikes in the city of Barcelona (Spain). Data on strikes of the metro, train or bus systems were collected from government records (2005-2016). We collected daily concentrations of NOx; particulate matter with an aerodynamic diameter smaller than 10μm (PM10), 2.5μm (PM2.5), and 1μm (PM1); particle number concentration (N); black carbon (BC) and CO from research and official monitoring stations. We fitted linear regression models for each pollutant with the strike indicator as an independent variable, and models were adjusted for day of the week, month, year, and holiday periods. During the study period, there were 208days affected by a strike of the metro (28), train (106) or bus (91) systems. Half of the strikes were partial, most of them were single-day strikes, there was little overlap between strikes of the different transport systems, and all strikes had to comply with mandatory minimal services. When pooling all types of strikes, NOx and BC showed higher levels during strike days in comparison with non-strike days (increase between 4.1% and 7.7%, with higher increases for NO). The increases in these concentrations were more evident during full day and multiday metro strikes. In conclusion, alterations in public transport have consequences on air quality. This highlights the importance of public transport in reducing air pollution concentrations in cities. Copyright © 2017 Elsevier B.V. All rights reserved.

  4. Performance of the Public Expenditure Management at Local Level in Romania

    Directory of Open Access Journals (Sweden)

    Ani MATEI

    2008-06-01

    Full Text Available The current paper aims to analyze the performance of the public expenditure management based on the decrease of the administrative costs. The paper is grounded on the following premises: (1 Romania as an EU Member State is under a continuous process to harmonize its legislation with the EU legislation. (2 The integration of Romania in EU in 2007 has determined a significant change in the administrative expenditure amount. (3 Strengthening local autonomy through the decentralization and the devolution processes emphasizes clearer the need for improving the performance of the expenditure management at local level. (4 Internal order, flows of communication and transfer, synergy of the governance system assume administrative expenditure that can be determined. (5 The performance of public organizations in managing local governance issues depends directly also on the administrative expenditure level**. [** Paper accepted to be presented at the Fourth TransAtlantic Dialogue “The Status of Inter-Governmental Relations and Multi-Level Governance in Europe and the US”, Workshop 5: “Performance measurement and accountability in IGR-MLG”.

  5. Comparing Canadian and American cybersecurity awareness levels: Educational strategies to increase public awareness

    Science.gov (United States)

    Hoggard, Amy

    Cybersecurity awareness is an important issue that affects everyone who uses a computer or a mobile device. Canada and the United States both recognize the value of mitigating cybersecurity risks in terms of national safety, economic stability and protection of their citizens. The research performed compared the levels of cybersecurity awareness in Canadian and American Internet users. Canadian and American users were equally aware of cybersecurity measures, but were not implementing best practices to keep themselves safe. The research suggested users needed to understand why a cybersecurity measure was important before being motivated to implement it. Educational strategies were reviewed in both Canada and the United States and it was determined that although there were significant resources available, they were not being utilized by both the educators and the public. In order to increase cybersecurity awareness levels, nations should focus on increasing the public's awareness by using various types of messaging, such as cartoons, in media. One possible consideration is a compulsory awareness model before accessing the Internet. Cybersecurity topics should be included in the curriculum for students at all levels of education and a focus on providing training and resources to teachers will help increase the cybersecurity knowledge of children and youth.

  6. Screening-Level Safety Assessment of Personal Care Product Constituents Using Publicly Available Data

    Directory of Open Access Journals (Sweden)

    Ernest S. Fung

    2018-06-01

    Full Text Available Organizations recommend evaluating individual ingredients when assessing the safety of personal care or cosmetic products. The goal of this study was to present a screening-level safety assessment methodology to evaluate the safety of a product by identifying individual ingredients, determining their frequency of use in on-market products, and examining published safe-level-of-use information for each ingredient. As a case study, we evaluated WEN by Chaz Dean (WCD cleansing conditioners since there have been claims of adverse health effects associated with product use. We evaluated 30 ingredients in three on-market WCD cleansing conditioners. We then analyzed the National Library of Medicine’s Household Products Database and the Environmental Working Group’s (EWG Skin Deep Cosmetic Database, two of the largest publicly available databases, for other on-market personal care and cosmetic products that contained these ingredients. Safe-level-of-use information for each ingredient was obtained by reviewing peer-reviewed literature, the Food and Drug Administration’s (FDA generally recognized as safe (GRAS database, available Cosmetic Ingredient Review (CIR publications, and available product safety publications. The results of this analysis showed that more than 20,000 personal care and cosmetic products contained one or more of the evaluated ingredients used in WCD cleaning conditioners. Published safety information was available for 21 of the 30 evaluated ingredients: seven identified ingredients were designated as GRAS by the FDA and 16 ingredients had safe-level-of-use information available from the CIR. This study presents a screening-level safety assessment methodology that can serve as an initial screening tool to evaluate the safety of an ingredient intended for use in personal care and cosmetic products before a product is launched onto the market. This study provides evidence that the evaluated WCD cleansing conditioner ingredients

  7. Examining public open spaces by neighborhood-level walkability and deprivation.

    Science.gov (United States)

    Badland, Hannah M; Keam, Rosanna; Witten, Karen; Kearns, Robin

    2010-11-01

    Public open spaces (POS) are recognized as important to promote physical activity engagement. However, it is unclear how POS attributes, such as activities available, environmental quality, amenities present, and safety, are associated with neighborhood-level walkability and deprivation. Twelve neighborhoods were selected within 1 constituent city of Auckland, New Zealand based on higher (n = 6) or lower (n = 6) walkability characteristics. Neighborhoods were dichotomized as more (n = 7) or less (n = 5) socioeconomically deprived. POS (n = 69) were identified within these neighborhoods and audited using the New Zealand-Public Open Space Tool. Unpaired 1-way analysis of variance tests were applied to compare differences in attributes and overall score of POS by neighborhood walkability and deprivation. POS located in more walkable neighborhoods have significantly higher overall scores when compared with less walkable neighborhoods. Deprivation comparisons identified POS located in less deprived communities have better quality environments, but fewer activities and safety features present when compared with more deprived neighborhoods. A positive relationship existed between presence of POS attributes and neighborhood walkability, but the relationship between POS and neighborhood-level deprivation was less clear. Variation in neighborhood POS quality alone is unlikely to explain poorer health outcomes for residents in more deprived areas.

  8. Development of the Teacher Candidates’ Level of being Affected from Public Personnel Selection Examination Scale

    Directory of Open Access Journals (Sweden)

    Fatma SUSAR KIRMIZI

    2016-07-01

    Full Text Available This study aimed to develop a scale to evaluate teacher candidates' level of being affected from the public personnel selection examination. The participants of the study consisted of the final year students at Pamukkale University Education Faculty. The participants were 207 teacher candidates, of whom 143 were female and 64 were male. The validity and reliability study of the scale was conducted on the data gathered from teacher candidates studying at Art Teaching, Music Teaching, Turkish Language Teaching, Social Studies Education, Science Teaching, Psychological Counseling and Guidance Education, Elementary Education and Preschool Education departments of Pamukkale University Education Faculty. The Lawshe technique was used in the evaluation of the scale by experts. To determine the construct validity, factor analysis was performed on the data, and two sub-scales were identified. The factor loading values of the items in the first sub-scale ranged between 0,65 and 0,35, and those in the second sub-scale between 0,75 and 0,39. As a result of the analyses, the "Teacher Candidates' Level of Being Affected From Public Personnel Selection Examination Scale" (TCLBAPPSES including 33 items, 23 negative and 10 positive, and two sub-scales was produced. The Cronbach's Alpha reliability coefficient was found as 0,86 for the first sub-dimension, 0,73 for the second sub-dimension, and 0,91 for the whole scale. As a result, it can be argued that the scale is reliable

  9. Preconception healthcare delivery at a population level: construction of public health models of preconception care.

    Science.gov (United States)

    Shannon, Geordan D; Alberg, Corinna; Nacul, Luis; Pashayan, Nora

    2014-08-01

    A key challenge of preconception healthcare is identifying how it can best be delivered at a population level. To review current strategies of preconception healthcare, explore methods of preconception healthcare delivery, and develop public health models which reflect different preconception healthcare pathways. Preconception care strategies, programmes and evaluations were identified through a review of Medline and Embase databases. Search terms included: preconception, pre-pregnancy, intervention, primary care, healthcare, model, delivery, program, prevention, trial, effectiveness, congenital disorders OR abnormalities, evaluation, assessment, impact. Inclusion criteria for review articles were: (1) English, (2) human subjects, (3) women of childbearing age, (4) 1980–current data, (5) all countries, (6) both high risk and universal approaches, (7) guidelines or recommendations, (8) opinion articles, (9) experimental studies. Exclusion criteria were: (1) non-human subjects, (2) non-English, (3) outside of the specified timeframe, (4) articles on male healthcare. The results of the literature review were synthesised into public health models of care: (1) primary care; (2) hospital-based and inter-conception care; (3) specific preconception care clinics; and, (4) community outreach. Fifteen evaluations of preconception care were identified. Community programmes demonstrated a significant impact on substance use, folic acid supplementation, diabetes optimization, and hyperphenylalaninemia. An ideal preconception visits entail risk screening, education, and intervention if indicated. Subsequently, four public health models were developed synthesizing preconception care delivery at a population level. Heterogeneity of risk factors, health systems and strategies of care reflect the lack of consensus about the best way to deliver preconception care. The proposed models aim to reflect differing aspects of preconception healthcare delivery.

  10. Directions of improvement for public administration institutional structure in field of ecology at regional level

    Directory of Open Access Journals (Sweden)

    O. I. Matyushenko

    2017-06-01

    Full Text Available Based on the analysis of the organizational structure of public authorities at national and regional level involved in the process of governance in the environmental field as well as their legal security it was found that at the regional level, in regions there are different units (departments, management authorities, divisions, sectors that coordinate the process of public administration in the environmental field. In order to offer its own structure unit of state administration, to deal with environmental issues it is analyzed the organizational structures of central executive authority in the field of ecology - the Ministry of Ecology and Natural Resources of Ukraine at the national level and the organizational structures of departments / offices of Ecology and Natural Resources regional administrations respectively, at the regional level. As it is determined there is no typical structure of the regional state administration unit in Ukraine. Recognized that departments and sectors uniting at the high level is chaotic, unsystematic and apparently dictated by different reasons (financial, personal and psychological, corruption etc., not the content of (the logic of and structural accountability to senior management level. It is offered the author organizational structure for the Ecology and Natural Resources Department of Regional State Administration. It is suggested that this Department consists of three units: Department of Ecology (Department of environmental monitoring and audit department of environmental security department of planning and coordination of international projects in the environmental field; Department of Natural Resources (Department of Conservation of Natural Resources, Department of Protected Areas and Ecological Network Development, Department of Environmental Economics; Management support of the Department (Legal, Financial and Economic Division, Department of Administration Department, a department of scientific and

  11. Regionalised tertiary psychiatric residential facilities.

    Science.gov (United States)

    Lesage, Alain; Groden, David; Goldner, Elliot M; Gelinas, Daniel; Arnold, Leslie M

    2008-01-01

    Psychiatric hospitals remain the main venue for long-term mental health care and, despite widespread closures and downsizing, no country that built asylums in the last century has done away with them entirely--with the recent exception of Italy. Differentiated community-based residential alternatives have been developed over the past decades, with staffing levels that range from full-time professional, to daytime only, to part-time/on-call. This paper reviews the characteristics of community-based psychiatric residential care facilities as an alternative to long-term care in psychiatric hospitals. It describes five factors decision makers should consider: 1. number of residential places needed; 2. staffing levels; 3. physical setting; 4. programming; and 5. governance and financing. In Italy, facilities with full-time professional staff have been developed since the mid-1990s to accommodate the last cohorts of patients discharged from psychiatric hospitals. In the United Kingdom, experiments with hostel wards since the 1980s have shown that home-like, small-scale facilities with intensive treatment and rehabilitation programming can be effective for the most difficult-to-place patients. More recently in Australia, Community Care Units (CCUs) have been applying this concept. In the Canadian province of British Columbia (BC), Tertiary Psychiatric Residential Facilities (TPRFs) have been developed as part of an effort to regionalise health and social services and downsize and ultimately close its only psychiatric hospital. This type of service must be further developed in addition to the need for forensic, acute-care and intermediate-level beds, as well as for community-based care such as assertive community treatment and intensive case management. All these types of services, together with long-term community-based residential care, constitute the elements of a balanced mental health care system. As part of a region's balanced mental health care plan, these Tertiary

  12. MKEM: a Multi-level Knowledge Emergence Model for mining undiscovered public knowledge

    Directory of Open Access Journals (Sweden)

    Song Min

    2010-04-01

    Full Text Available Abstract Background Since Swanson proposed the Undiscovered Public Knowledge (UPK model, there have been many approaches to uncover UPK by mining the biomedical literature. These earlier works, however, required substantial manual intervention to reduce the number of possible connections and are mainly applied to disease-effect relation. With the advancement in biomedical science, it has become imperative to extract and combine information from multiple disjoint researches, studies and articles to infer new hypotheses and expand knowledge. Methods We propose MKEM, a Multi-level Knowledge Emergence Model, to discover implicit relationships using Natural Language Processing techniques such as Link Grammar and Ontologies such as Unified Medical Language System (UMLS MetaMap. The contribution of MKEM is as follows: First, we propose a flexible knowledge emergence model to extract implicit relationships across different levels such as molecular level for gene and protein and Phenomic level for disease and treatment. Second, we employ MetaMap for tagging biological concepts. Third, we provide an empirical and systematic approach to discover novel relationships. Results We applied our system on 5000 abstracts downloaded from PubMed database. We performed the performance evaluation as a gold standard is not yet available. Our system performed with a good precision and recall and we generated 24 hypotheses. Conclusions Our experiments show that MKEM is a powerful tool to discover hidden relationships residing in extracted entities that were represented by our Substance-Effect-Process-Disease-Body Part (SEPDB model.

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

    Science.gov (United States)

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

    2018-06-01

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

  14. Quality of research and level of evidence in foot and ankle publications.

    Science.gov (United States)

    Barske, Heather L; Baumhauer, Judith

    2012-01-01

    The quality of research and evidence to support medical treatments is under scrutiny from the medical profession and the public. This study examined the current quality of research and level of evidence (LOE) of foot and ankle surgery papers published in orthopedic and podiatric medical journals. Two independent evaluators performed a blinded assessment of all foot and ankle clinical research articles (January 2010 to June 2010) from seven North American orthopedic and podiatric journals. JBJS-A grading system was used for LOE. Articles were assessed for indicators of study quality. The data was stratified by journal and medical credentials. A total of 245 articles were published, 128 were excluded based on study design, leaving 117 clinical research articles. Seven (6%) were Level I, 14 (12%) Level II, 18 (15%) Level III, and 78 (67%) Level IV. The orthopedic journals published 78 studies on foot and ankle topics. Of the podiatric journals, the Journal of the American Podiatric Medical Association (JAPMA) published 12 clinical studies and the Journal of Foot and Ankle Surgery (JFAS) published 27, 21 (78%) of which were Level IV studies. When the quality of research was examined, few therapeutic studies used validated outcome measures and only 38 of 96 (40%) gathered data prospectively. Thirty (31%) studies used a comparison group. Eighty-seven articles (74%) were authored by a MD and 22 (19%) by a DPM. Foot & Ankle International (FAI) published higher quality studies with a higher LOE as compared to podiatry journals. Regardless of the journal, MDs produced the majority of published clinical foot and ankle research. Although improvements have been made in the quality of some clinical research, this study highlights the need for continued improvement in methodology within foot and ankle literature.

  15. An analysis of orthopaedic theses in Turkey: Evidence levels and publication rates.

    Science.gov (United States)

    Koca, Kenan; Ekinci, Safak; Akpancar, Serkan; Gemci, Muhammed Hanifi; Erşen, Ömer; Akyıldız, Faruk

    2016-10-01

    The aim of this study was to present characteristics and publication patterns of studies arise from orthopedic theses obtained from National Thesis Center; database in terms of publication years, study types, topics, level of evidence between 1974 and 2014. Firstly, National Thesis Center database was searched for orthopedics and Traumatology theses. The theses, which their summary or full text were available were included in the study. The topics, study types and quality of study designs were reviewed. Then theses were searched in the PubMed database. Journals of published theses were classified according to category, scope and impact factors of the year 2014. 1508 theses were included into the study. Clinical studies comprised 71,7% of the theses, while 25,6% of the theses were non-clinical experimental and 2,7% of the theses were observational studies. Clinical studies were Level I in 8,6% (n = 93) and Level II in 5,8% of the theses (n = 63). A total of 224 theses (14,9%) were published in the journals indexed in PubMed database from 1974 to 2012. Fifty-two (23,2%) were published in SCI; 136 theses (60,7%) were published in SCI-E journals and 36 theses (16%) were published in other Journals indexed in PubMed. The quantity and quality of published theses need to be improved and effective measures should be taken to promote quality of theses. Theses from universities and Training hospitals which did not allow open access, and; incomplete records of the National Thesis Center database were major limitations of this study. Copyright © 2016 Turkish Association of Orthopaedics and Traumatology. Production and hosting by Elsevier B.V. All rights reserved.

  16. [Level of job satisfaction among employees working at healthcare facilities in Nisava and Toplica district].

    Science.gov (United States)

    Marković, Roberta Teofilo; Ilić, Marina Deljanin; Milosević, Zoran; Vasić, Milena; Bogdanović, Dragan; Sagrić, Cedomir

    2013-01-01

    The product of health system and its employees is health service whose quality is related to the satisfaction and motivation of people working in health system. The objective of this study was to assess and compare satisfaction with different aspects of work among different categories of employees in healthcare facilities on primary, secondary and tertiary level of health care in Nisava and Toplica districts. The study was conducted as a one-day study in 15 healthcare facilities on primary level, in two public hospitals and 27 clinics of Clinical Centre of Nis, using anonymous questionnaire. Out of 3,892 employees, who took part in this study, 2,227 were from primary and 1,665 were from secondary and tertiary level. All employees on primary level are more satisfied with the majority of aspects of job comparing with employees on secondary and tertiary level of health care. Administrative staff is in general more satisfied with all aspects of job comparing with other categories of employees. All employees on secondary and tertiary level are more physically and psychically exhausted than employees on primary level of health care. Health workers on secondary and tertiary level are most psychically exhausted. There is a difference in satisfaction with different aspects ofjob in different categories of employees, and on different levels of health, in healthcare facilities in Nisava and Toplica districts. Employees of healthcare facilities on primary level of health care are in general more satisfied than employees on se-condary and tertiary level of health care.

  17. A comparison of the Web of Science with publication-level classification systems of science

    Energy Technology Data Exchange (ETDEWEB)

    Perianes-Rodriguez, A.; Ruiz-Castillo, J.

    2016-07-01

    In this paper we propose a new criterion for choosing between a pair of classification systems of science that assign publications (or journals) to a set of scientific fields. Consider the standard normalization procedure in which field mean citations are used as normalization factors. We recommend system A over system B whenever the standard normalization procedure based on A performs better than the when it is based on B. Since the evaluation can be made in terms of either system, the performance assessment requires a double test. In addition, since the assessment of two normalization procedures would be generally biased in favor of the one based on the classification system used for evaluation purposes, ideally a pair of classification systems must be compared using a third, independent classification system for evaluation purposes. We illustrate this strategy by comparing a Web of Science journal-level classification system, consisting of 236 journal subject categories, with two publication-level algorithmically constructed classification systems consisting of 1,363 (G6) and 5,119 (G8) clusters. There are two main findings. (1) The G8 system is found to dominate the G6 system. Therefore, when we have a choice between two classification systems at different granularity levels, we should use the system at the higher level because it typically exhibits a better standard normalization performance. (2) The G8 system and the Web of Science (WoS) journal-level system are found to be non-comparable. Nevertheless, the G8-normalization procedure performs better using the WoS system for evaluation purposes than the WoS-normalization procedure using the G8 system for evaluation purposes. Furthermore, when we use the G6 system for evaluation purposes, the G8-normalization procedure performs better than the WoS-normalization procedure. We conclude that algorithmically constructed classification systems constitute a credible alternative to the WoS system and, by extension, to

  18. Study of dose levels absorbed by members of the public in the nuclear medicine departments

    International Nuclear Information System (INIS)

    Cabral, Geovanna Oliveira de Mello

    2001-03-01

    In nuclear Medicine, radioisotopes are bound to various compounds (called radiopharmaceuticals) for use in various diagnostic and therapeutic applications. These unsealed sources are administered in various forms to patients, who remain radioactive for hours or days, and represent a source of potential radiation exposure for others. Thus, in nuclear medicine departments, radiation protection of workers and members of the public, especially persons accompanying patients, must consider, this exposure. In Brazil, the Comissao Nacional de Energia Nuclear (CNEN) establishes that, in nuclear medicine departments, the patients and persons accompanying should be separated each other. However, this rule is not always followed due to many factors such as physical and emotional conditions of patients. In this context, the aim of this study was the investigation of dose levels, which the persons accompanying patients are exposed to. For monitoring, thermoluminescent dosimeters were employed. The dosimeters were given to 380 persons who were accompanying patients in nuclear medicine departments. Exposure results were lower than 1 mSv. On the basis of CNEN rules, issues regarding stay conditions for members of the public in these departments are discussed. (author)

  19. Which type of leader do I support in step-level public good dilemmas? The roles of level of threshold and trust.

    Science.gov (United States)

    De Cremer, David

    2007-02-01

    The present research examined the moderating effect of the level of threshold on people's preferences for different leader types in step-level public good dilemmas. It was assumed that the primary focus of people in step-level public good dilemmas is to make sure that the group surpasses the threshold. Consequently, when the level of threshold is difficult to reach people are expected to provide more support for and cooperate with a leader that monitors and controls the contributions made toward the public good. However, if the threshold is easy to surpass people will focus more on whether the obtained public good or bonus will be distributed according to agreements, suggesting that people will provide more support to and cooperate with a leader that monitors and controls the distribution of the bonus. These predictions were confirmed across two experiments using a step-level public good paradigm with a dichotomous (Study 1) and a continuous (Study 2) contribution choice. Moreover, the results also revealed that perceptions of trust accounted, in part, for the effect of level of threshold on people's leadership preferences.

  20. Sickness absence and workplace levels of satisfaction with psychosocial work conditions at public service workplaces

    DEFF Research Database (Denmark)

    Munch-Hansen, Torsten; Wieclaw, Joanna; Agerbo, Esben

    2009-01-01

    BACKGROUND: The objective of this study was to examine the impact of psychosocial work conditions on sickness absence while addressing methodological weaknesses in earlier studies. METHODS: The participants were 13,437 employees from 698 public service workplace units in Aarhus County, Denmark....... Satisfaction with psychosocial work conditions was rated on a scale from 0 (low) to 10 (high). Individual ratings were aggregated to workplace scores. Analysis of variance was used to compare the average number of days of yearly sickness absence in three groups with different levels of satisfaction...... with psychosocial work conditions. RESULTS: Sickness absence was 30.8% lower in the most satisfied group (11.7 days/year (CI 95%: 10.2; 13.1)) than in the least satisfied group (16.9 days/year (CI 95%: 15.3; 18.6)) adjusted for the covariates included. CONCLUSIONS: Satisfaction with psychosocial work conditions has...

  1. A Collaborative Governance Approach to Improving Tertiary Education in Papua New Guinea

    Science.gov (United States)

    Eldridge, Kaye; Larry, Lisa; Baird, Jeanette; Kavanamur, David

    2018-01-01

    Tertiary education in Papua New Guinea (PNG) is in a critical state, as the sector struggles to address increased demand for student places with severely curtailed capacity. Recent thinking about improving public services in PNG has emphasized "whole of sector" or collaborative governance. Such an approach in tertiary education has the…

  2. A retrospective review of snake bite victims admitted in a tertiary ...

    African Journals Online (AJOL)

    Objective: Snake bite remains major public health problem worldwide. We present our experience with cases of snake bites managed in our tertiary care teaching center of South India. Materials and Methods: The details of all patients with snake bite admitted to a tertiary teaching care hospital from 2010 to 2012 were ...

  3. Barriers and Facilitators to Career Advancement by Top-Level, Entry-Level and Non-Administrative Women in Public School Districts: A Mixed Methods Study

    Science.gov (United States)

    Ahmed, Eman Ibrahim El-Desouki

    2011-01-01

    The purpose of this study was to investigate the barriers and facilitators to career advancement among women administrators occupying top-level positions, those occupying entry-level positions and those in non-administrative positions in both rural and urban public school districts in central Pennsylvania. The need to increase the awareness of the…

  4. Cost of delivering secondary-level health care services through public sector district hospitals in India

    Science.gov (United States)

    Prinja, Shankar; Balasubramanian, Deepak; Jeet, Gursimer; Verma, Ramesh; Kumar, Dinesh; Bahuguna, Pankaj; Kaur, Manmeet; Kumar, Rajesh

    2017-01-01

    Background & objectives: Despite an impetus for strengthening public sector district hospitals for provision of secondary health care in India, there is lack of robust evidence on cost of services provided through these district hospitals. In this study, an attempt was made to determine the unit cost of an outpatient visit consultation, inpatient bed-day of hospitalization, surgical procedure and overall per-capita cost of providing secondary care through district hospitals. Methods: Economic costing of five randomly selected district hospitals in two north Indian States - Haryana and Punjab, was undertaken. Cost analysis was done using a health system perspective and employing bottom-up costing methodology. Quantity of all resources - capital or recurrent, used for delivering services was measured and valued. Median unit costs were estimated along with their 95 per cent confidence intervals. Sensitivity analysis was undertaken to assess the effect of uncertainties in prices and other assumptions; and to generalize the findings for Indian set-up. Results: The overall annual cost of delivering secondary-level health care services through a public sector district hospital in north India was 11,44,13,282 [US Dollars (USD) 2,103,185]. Human resources accounted for 53 per cent of the overall cost. The unit cost of an inpatient bed-day, surgical procedure and outpatient consultation was 844 (USD 15.5), i; 3481 (USD 64) and 170 (USD 3.1), respectively. With the current set of resource allocation, per-capita cost of providing health care through district hospitals in north India was 139 (USD 2.5). Interpretation & conclusions: The estimates obtained in our study can be used for Fiscal planning of scaling up secondary-level health services. Further, these may be particularly useful for future research such as benefit-incidence analysis, cost-effectiveness analysis and national health accounts including disease-specific accounts in India. PMID:29355142

  5. Analysis of the user satisfaction level in a public physical therapy service

    Directory of Open Access Journals (Sweden)

    Renato S. Almeida

    2013-08-01

    Full Text Available BACKGROUND: The concepts of quality management have increasingly been introduced into the health sector. Methods to measure satisfaction and quality are examples of this trend. OBJECTIVE: This study aimed to identify the level of customer satisfaction in a physical therapy department involved in the public area and to analyze the key variables that impact the usersâ€(tm perceived quality. METHOD: A cross-sectional observational study was conducted, and 95 patients from the physical therapy department of the Hospital Universitário Gaffrée e Guinle - Universidade Federal do Estado do Rio de Janeiro (HUGG/UNIRIO - Rio de Janeiro, Brazil, were evaluated by the SERVQUAL questionnaire. A brief questionnaire to identify the sociocultural profile of the patients was also performed. RESULTS: Patients from this health service presented a satisfied status with the treatment, and the population final average value in the questionnaire was 0.057 (a positive value indicates satisfaction. There was an influence of the educational level on the satisfaction status (χ‡Â²=17,149; p=0.002. A correlation was found between satisfaction and the dimensions of tangibility (rho=0.56, p=0.05 and empathy (rho=0.46, p=0.01 for the Unsatisfied group. Among the Satisfied group, the dimension that was correlated with the final value of the SERVQUAL was responsiveness (rho=0.44, p=0.01. CONCLUSIONS: The final values of the GGUH physical therapy department showed that patients can be satisfied even in a public health service. Satisfaction measures must have a multidimensional approach, and we found that people with more years of study showed lower values of satisfaction.

  6. Analysis of the user satisfaction level in a public physical therapy service.

    Science.gov (United States)

    Almeida, Renato S; Nogueira, Leandro A C; Bourliataux-Lajoine, Stéphane

    2013-01-01

    The concepts of quality management have increasingly been introduced into the health sector. Methods to measure satisfaction and quality are examples of this trend. This study aimed to identify the level of customer satisfaction in a physical therapy department involved in the public area and to analyze the key variables that impact the usersâ€(tm) perceived quality. A cross-sectional observational study was conducted, and 95 patients from the physical therapy department of the Hospital Universitário Gaffrée e Guinle - Universidade Federal do Estado do Rio de Janeiro (HUGG/UNIRIO) - Rio de Janeiro, Brazil, were evaluated by the SERVQUAL questionnaire. A brief questionnaire to identify the sociocultural profile of the patients was also performed. Patients from this health service presented a satisfied status with the treatment, and the population final average value in the questionnaire was 0.057 (a positive value indicates satisfaction). There was an influence of the educational level on the satisfaction status (χ²=17,149; p=0.002). A correlation was found between satisfaction and the dimensions of tangibility (rho=0.56, p=0.05) and empathy (rho=0.46, p=0.01) for the Unsatisfied group. Among the Satisfied group, the dimension that was correlated with the final value of the SERVQUAL was responsiveness (rho=0.44, p=0.01). The final values of the GGUH physical therapy department showed that patients can be satisfied even in a public health service. Satisfaction measures must have a multidimensional approach, and we found that people with more years of study showed lower values of satisfaction.

  7. Cost of delivering secondary-level health care services through public sector district hospitals in India.

    Science.gov (United States)

    Prinja, Shankar; Balasubramanian, Deepak; Jeet, Gursimer; Verma, Ramesh; Kumar, Dinesh; Bahuguna, Pankaj; Kaur, Manmeet; Kumar, Rajesh

    2017-09-01

    Despite an impetus for strengthening public sector district hospitals for provision of secondary health care in India, there is lack of robust evidence on cost of services provided through these district hospitals. In this study, an attempt was made to determine the unit cost of an outpatient visit consultation, inpatient bed-day of hospitalization, surgical procedure and overall per-capita cost of providing secondary care through district hospitals. Economic costing of five randomly selected district hospitals in two north Indian States - Haryana and Punjab, was undertaken. Cost analysis was done using a health system perspective and employing bottom-up costing methodology. Quantity of all resources - capital or recurrent, used for delivering services was measured and valued. Median unit costs were estimated along with their 95 per cent confidence intervals. Sensitivity analysis was undertaken to assess the effect of uncertainties in prices and other assumptions; and to generalize the findings for Indian set-up. The overall annual cost of delivering secondary-level health care services through a public sector district hospital in north India was ' 11,44,13,282 [US Dollars (USD) 2,103,185]. Human resources accounted for 53 per cent of the overall cost. The unit cost of an inpatient bed-day, surgical procedure and outpatient consultation was ' 844 (USD 15.5), ' 3481 (USD 64) and ' 170 (USD 3.1), respectively. With the current set of resource allocation, per-capita cost of providing health care through district hospitals in north India was ' 139 (USD 2.5). The estimates obtained in our study can be used for Fiscal planning of scaling up secondary-level health services. Further, these may be particularly useful for future research such as benefit-incidence analysis, cost-effectiveness analysis and national health accounts including disease-specific accounts in India.

  8. Policing low-level disorder:police use of section 5 of the Public Order Act 1986

    OpenAIRE

    Brown, David; Ellis, Tom

    1996-01-01

    Following a Government review of public disorder law, the Public Order act 1986 introduced a structured series of offences to deal with disorder at all levels. At the lower end of the range, section 5 covers various forms of offensive conduct likely to cause harassment, alarm, or distress to vulnerable members of society.

  9. [Effectiveness of a nutritional education program in lowering blood cholesterol levels in a public health center].

    Science.gov (United States)

    Seki, M; Yamaguchi, T

    1993-06-01

    An educational program for persons found to have high blood cholesterol during health examinations at the Nerima Public Health Center was begun in April, 1989. This program was differed from the usual program in two areas. First, new educational material was developed consisting of a check list of 30 items to assess eating patterns. By checking these items, participants could gain an understanding of what they should change in their eating behavior. Secondly, the table of restricted foods was not used. Participants were advised to achieve healthy eating patterns and followed up with a nutritional consultation that was held after three months, at which time they were interviewed regarding compliance and had their blood cholesterol levels measured. The effectiveness of the new educational program and the relationship between achievement of healthy eating patterns and reduction in blood cholesterol levels were analyzed. The main results were as follows: 1) In subjects (n = 79) who received the new education program in 1989-1990, serum cholesterol levels showed significant reduction, as compared with controls (n = 38) who received the usual education program in 1988-1989. 2) Subjects were divided into three groups according to their changes in serum cholesterol levels,--normalized, improved and unimproved--and the number of items complied with were counted for analysis. The mean score of compliance was highest in the normalized group with significant difference between the normalized and the unimproved groups. 3) The items of the high compliance score in the normalized group were in order of high score "to decrease high-fat meats", "to decrease cakes", "to choose lean meats and poultry without skin" and "to eat vegetables at every meal".

  10. The impact of later trading hours for Australian public houses (hotels) on levels of violence.

    Science.gov (United States)

    Chikritzhs, Tanya; Stockwell, Tim

    2002-09-01

    To examine the impact of later trading hours for licensed hotels (Australian public houses are usually known as "hotels") in Perth, Western Australia, on levels of violent assault on or near these premises. Data on assault offenses reported to police between July 1, 1991, and June 30, 1997, were examined to identify those offenses that occurred on or close to hotels. During this period, 45 (24%) of the 188 hotels meeting study criteria were granted an extended trading permit for 1AM closing ("ETP hotels"), whereas the rest continued to close at midnight ("non-ETP hotels"). A time-series analysis employing linear regression was used to test whether there was a relationship between the introduction of extended trading and monthly rates of assaults associated with ETP hotels, while controlling for the general trend in assault rates among normally trading hotels. Possible confounders and other variables of interest (e.g., levels of alcohol purchases) were also examined. After controlling for the general trend in assaults occurring throughout Perth hotels, there was a significant increase in monthly assault rates for hotels with late trading following the introduction of extended trading permits. This relationship was largely accounted for by higher volumes of high alcohol content beer, wine and distilled spirits purchased by late trading hotels. Late trading was associated with both increased violence in and around Perth hotels and increased levels of alcohol consumption during the study period. It is suggested that greater numbers of patrons and increased levels of intoxication contributed to the observed increase in violence and that systematic planning and evaluation of late trading licenses is required.

  11. Variations in levels of care between nursing home patients in a public health care system.

    Science.gov (United States)

    Døhl, Øystein; Garåsen, Helge; Kalseth, Jorid; Magnussen, Jon

    2014-03-05

    Within the setting of a public health service we analyse the distribution of resources between individuals in nursing homes funded by global budgets. Three questions are pursued. Firstly, whether there are systematic variations between nursing homes in the level of care given to patients. Secondly, whether such variations can be explained by nursing home characteristics. And thirdly, how individual need-related variables are associated with differences in the level of care given. The study included 1204 residents in 35 nursing homes and extra care sheltered housing facilities. Direct time spent with patients was recorded. In average each patient received 14.8 hours direct care each week. Multilevel regression analysis is used to analyse the relationship between individual characteristics, nursing home characteristics and time spent with patients in nursing homes. The study setting is the city of Trondheim, with a population of approximately 180 000. There are large variations between nursing homes in the total amount of individual care given to patients. As much as 24 percent of the variation of individual care between patients could be explained by variation between nursing homes. Adjusting for structural nursing home characteristics did not substantially reduce the variation between nursing homes. As expected a negative association was found between individual care and case-mix, implying that at nursing home level a more resource demanding case-mix is compensated by lowering the average amount of care. At individual level ADL-disability is the strongest predictor for use of resources in nursing homes. For the average user one point increase in ADL-disability increases the use of resources with 27 percent. In a financial reimbursement model for nursing homes with no adjustment for case-mix, the amount of care patients receive does not solely depend on the patients' own needs, but also on the needs of all the other residents.

  12. RAISING ESP STUDENTS’ AWARENESS OF THE GENERIC STRUCTURES AND LINGUISTIC FEATURES OF JOB APPLICATION LETTERS THROUGH THE APPLICATION OF GENRE-BASED INSTRUCTION AT THE TERTIARY LEVEL: THE CASE OF 3 rd YEAR MANAGEMENT STUDENTS DJILLALI LIABES UNIVERSITY, SIDI BEL ABBES

    OpenAIRE

    SEKKAL, Faiza

    2012-01-01

    The current study is an attempt to investigate the genre of job application letter using genre-based analysis as a powerful educational tool, in order to improve the teaching of business writing at the tertiary level with reference to third- year management students by raising their awareness of the generic structures and linguistic features of the target genre. In this regard, this research work is based on the theory of genre analysis in ESP; it aims to help future graduates ...

  13. Maternal and reproductive health financing in Burundi: public-sector contribution levels and trends from 2010 to 2012.

    Science.gov (United States)

    Chaumont, Claire; Muhorane, Carmen; Moreira-Burgos, Isabelle; Juma, Ndereye; Avila-Burgos, Leticia

    2015-10-01

    An understanding of public financial flows to reproductive health (RH) at the country level is key to assessing the extent to which they correspond to political commitments. This is especially relevant for low-income countries facing important challenges in the area of RH. To this end, the present study analyzes public expenditure levels and trends with regards to RH in Burundi between the years 2010 to 2012, looking specifically at financing agents, health providers, and health functions. The analysis was performed using standard RH sub-account methodology. Information regarding public expenditures was gathered from national budgets, the Burundi Ministry of Public Health information system, and from other relevant public institutions. Public RH expenditures in Burundi accounted for $41.163 million international dollars in 2012, which represents an increase of 16 % from 2010. In 2012, this sum represented 0.57 % of the national GDP. The share of total public health spending allocated to RH increased from 15 % in 2010 to 19 % in 2012. In terms of public agents involved in RH financing, the Ministry of Public Health proved to play the most important role. Half of all public RH spending went to primary health care clinics, while more than 70 % of this money was used for maternal health; average public RH spending per woman of childbearing age stagnated during the study period. The flow patterns and levels of public funds to RH in Burundi suggest that RH funding correctly reflects governmental priorities for the period between 2010 and 2012. In a context of general shrinking donor commitment, local governments have come to play a key role in ensuring the efficient use of available resources and the mobilizing of additional domestic funding. A strong and transparent financial tracking system is key to carrying out this role and making progress towards the MDG Goals and development beyond 2015.

  14. The Need for a Study into Stakeholders Needs and Expectations of Schools Graduates English Language Level and Skills for Entry into the Tertiary Education Level in the Sultanate of Oman

    OpenAIRE

    Khalid Salim Al-Jardani

    2014-01-01

    During the last forty years, the Sultanate of Oman has undergone rapid economic growth and development. As a result, the country is facing the challenge of preparing its youth for life and work in the modern global economy. It is essential that young people are provided with a high level of knowledge and skills in Maths, Science, Technology and Languages to deal with the changes in society, life style, technology and international business (Ministry of Education, 2010). High levels of knowled...

  15. Balancing public health and resource limitations: A role for ethical low-level risk communication

    International Nuclear Information System (INIS)

    McGinn, R.E.

    1991-01-01

    Recognition of the pervasiveness of risk in everyday life in modern industrial society has elicited calls for greater efforts to protect individual and public health. Yet, it is increasingly clear that decisions to do so must often be made in the context of significant limits in the amounts of financial resources available for achieving that protection. Achieving risk-free work, residential, and community environments may be so expensive as to render a private business unit uncompetitive or as to divert resources from or prelude commencing with other governmental projects with equal or greater health benefit potential. Ethical low-level risk communication (LLRC) is something risk-generating entities are morally obligated to do. However, such communication also offers important opportunities for such entities to move toward achieving better balances between health and the costs of protecting it. In this paper, the authors elaborate on several features of an ethically ideal LLRC process, focusing on those with aspects they hope are not obvious or common knowledge. In discussing these features, they provide examples of conflicts between health risks and resource limits at the level of the individual private firm, the local community, or the national government, such that LLRC with the feature in question provides an opportunity for mitigating or at least clarifying the conflict in question

  16. Public budgets for energy RD&D and the effects on energy intensity and pollution levels.

    Science.gov (United States)

    Balsalobre, Daniel; Álvarez, Agustín; Cantos, José María

    2015-04-01

    This study, based on the N-shaped cubic model of the environmental Kuznets curve, analyzes the evolution of per capita greenhouse gas emissions (GHGpc) using not just economic growth but also public budgets dedicated to energy-oriented research development and demonstration (RD&D) and energy intensity. The empirical evidence, obtained from an econometric model of fixed effects for 28 OECD countries during 1994-2010, suggests that energy innovations help reduce GHGpc levels and mitigate the negative impact of energy intensity on environmental quality. When countries develop active energy RD&D policies, they can reduce both the rates of energy intensity and the level of GHGpc emissions. This paper incorporates a moderating variable to the econometric model that emphasizes the effect that GDP has on energy intensity. It also adds a variable that reflects the difference between countries that have made a greater economic effort in energy RD&D, which in turn corrects the GHG emissions resulting from the energy intensity of each country.

  17. Sexual harassment in tertiary institutions: A comparative perspective

    OpenAIRE

    Joseph Janice

    2015-01-01

    Sexual harassment is not a new phenomenon in tertiary institutions. It has been receiving considerable attention in research and the media and public awareness has increased dramatically. However, the term sexual harassment is not used uniformly across the globe because countries have defined it differently. Consequently, prevalence of sexual harassment in education varies across cultures. This paper examines sexual harassment from a comparative perspective...

  18. Leadership and innovation in the public sector: studying the organizational, team and individual level

    NARCIS (Netherlands)

    S.J. Dorsman (Stephan)

    2017-01-01

    markdownabstractPublic sector organizations throughout the world are facing unprecedented challenges. Given these challenges and demands, fostering innovation could obviously be a very useful strategy for public organizations. As proposed by scholars, increased innovativeness is of key importance

  19. (De)Centralization of Public Procurement at the Local Level in the EU

    OpenAIRE

    Boštjan BREZOVNIK; Žan Jan OPLOTNIK; Borut VOJINOVIĆ

    2015-01-01

    The so-called decentralization of public procurement in EU Member States is accepted as the most suitable design of the public procurement system, often justifi ed by greater economic effi ciency and by the possibility of boosting the development of small and medium-sized enterprises, which act on the public procurement market as providers of goods, services and works. Despite the existence of highly decentralized public procurement systems which refl ect the decentralization of administrativ...

  20. The Efficacy of PCI's Reading Program--Level One: A Report of a Randomized Experiment in Brevard Public Schools and Miami-Dade County Public Schools. Research Summary

    Science.gov (United States)

    Empirical Education Inc., 2008

    2008-01-01

    PCI Education sought scientifically based evidence on the effectiveness of the "PCI Reading Program--Level One" for students with severe disabilities. During the 2007-2008 academic year. Empirical Education conducted a randomized control trial (RCT) in two Florida districts, Brevard and Miami-Dade County Public Schools. For this…

  1. The Efficacy of PCI's "Reading Program--Level One": A Report of a Randomized Experiment in Brevard Public Schools and Miami-Dade County Public Schools. Research Report

    Science.gov (United States)

    Toby, Megan; Ma, Boya; Jaciw, Andrew; Cabalo, Jessica

    2008-01-01

    PCI Education sought scientifically based evidence on the effectiveness of the "PCI Reading Program--Level One" for students with severe disabilities. During the 2007-2008 academic year. Empirical Education conducted a randomized control trial (RCT) in two Florida districts, Brevard and Miami-Dade County Public Schools. For this…

  2. Study on Generic Intervention Levels for Protecting the Public in a Nuclear Accident or Radiological Emergency

    International Nuclear Information System (INIS)

    Suzuki, E. F.; Sordi, G. M. A. A.; Rodrigues, D. L.

    2004-01-01

    Large amounts of radioactive material can be released to the environment in a nuclear accident or radiological emergency. In these cases, social and economical factors should be considered in the actions for protecting the public and to recover the environment, as these actions may affect not only the exposed individuals but also the society as a whole, because of the social impact and high costs. In 1994, the International Atomic Energy Agency, IAEA, published the radiological protection principles for intervention criteria in accident situations involving radioactive materials, as well as numeric values for the generic intervention levels, GIL, for the main countermeasures for protecting the public. These GIL values were selected to achieve broadly the maximum net benefit in many accident situations and, nowadays, those principles still represent the international consensus about this matter. On the other hand, the economic differences between countries can lead the optimization process to get GIL values that are quite different from those recommended. In this context, the monetary value of unit collective averted dose, called alpha-value, is a key element for the determination of the GIL. In this work, the method recommended by the IAEA, based on the human capital approach, was used to estimate the alpha-value for Brazil and the value of US$ 3268 per person-sievert was obtained, considering the year 2000 prices. The per capita costs of the countermeasures for protecting the public, as sheltering, evacuation, temporary relocation and permanent resettlement, were estimated and the cost-benefit analysis technique was applied to estimate the respective GIL applicable in the country. Some of the results for the GILs were smaller than those internationally recommended, even the alpha-value being about six times lower than the alpha-value considered by the IAEA. These results were discussed and they were also compared to values estimated by a similar study accomplished

  3. 78 FR 13607 - Minimum Training Requirements for Entry-Level Commercial Motor Vehicle Operators; Public...

    Science.gov (United States)

    2013-02-28

    ... analyses, including cost/benefit considerations. The entire day's proceedings will be webcast. DATES: The... Vehicle Operators; Public Listening Session AGENCY: Federal Motor Carrier Safety Administration (FMCSA), DOT. ACTION: Notice of public listening session. SUMMARY: FMCSA announces that it will hold a public...

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

    Science.gov (United States)

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

    2016-02-01

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

  5. The Ability of Posters to Enhance the Comfort Level with Breastfeeding in a Public Venue in Rural Newfoundland and Labrador.

    Science.gov (United States)

    Vieth, Alissa; Woodrow, Janine; Murphy-Goodridge, Janet; O'Neil, Courtney; Roebothan, Barbara

    2016-02-01

    The acceptance and support of breastfeeding in public venues can influence breastfeeding practices and, ultimately, the health of the population. The primary aim of this study was to investigate whether posters targeted at the general public could improve acceptability of breastfeeding in public places. A convenience sample of 255 participants was surveyed at shopping centers in 2 rural communities of Newfoundland and Labrador. Experimentally, questions were posed to 117 participants pre- and post-exposure to 2 specific posters designed to promote public acceptance of breastfeeding in public. Initially, we surveyed that only 51.9% of participants indicated that they were comfortable with a woman breastfeeding anywhere in public. However, context played a role, whereby a doctor's office (84.5%) or park (81.4%) were the most acceptable public places for breastfeeding, but least acceptable was a business office environment (66.7%). Of participants, 35.4% indicated previously viewing specific posters. We used a visual analog scale to test poster viewing on the acceptability of public breastfeeding in the context of a doctor's office and a restaurant. Results of pre- versus post-viewing of the promotional posters indicated significant improvements in both scenarios: in a doctor's office (P = .035) and in a restaurant (P = .021). Nearly 50% of the surveyed population indicated discomfort with a mother breastfeeding in public. Both cross-sectional and interventional evidence showed that posters significantly improved the reported level of comfort toward seeing breastfeeding in public. © The Author(s) 2015.

  6. Sexual harassment in tertiary institutions: A comparative perspective

    Directory of Open Access Journals (Sweden)

    Joseph Janice

    2015-01-01

    Full Text Available Sexual harassment is not a new phenomenon in tertiary institutions. It has been receiving considerable attention in research and the media and public awareness has increased dramatically. However, the term sexual harassment is not used uniformly across the globe because countries have defined it differently. Consequently, prevalence of sexual harassment in education varies across cultures. This paper examines sexual harassment from a comparative perspective. It specifically focuses on the definition of sexual harassment, incidence of sexual harassment of students in tertiary institutions, effects of sexual harassment on victims; and victims’ responses to sexual harassment. It also offers suggestions for curtailing sexual harassment in these institutions.

  7. Generic versus specific competencies of entry-level public health graduates: employers' perceptions in Poland, the UK, and the Netherlands.

    Science.gov (United States)

    Biesma, Regien G; Pavlova, Milena; Vaatstra, Rina; van Merode, Godefridus G; Czabanowska, Katarzyna; Smith, Tony; Groot, Wim

    2008-08-01

    Constant changes in society and the public health domain force public health professionals into new roles and the development of new competencies. Public health professionals will need to be trained to respond to this challenge. The aim of this comparative study among Poland, the UK and the Netherlands is to identify competence needs for Master of Public Health graduates entering the labour market from a European perspective. A self-administered questionnaire was sent to employers in the three countries, rating the importance of competency in public health on a master's level. In all three countries, interpersonal competencies, like team working and communication skills, are rated as highly important. However, employers in the UK and Poland generally rate public health specific competencies as much more important than their Dutch colleagues. It is concluded that while public health specific knowledge is providing a useful starting point for entry-level public health professionals, employers increasingly recognise the value of generic competencies such as communication and team working skills. The results suggest a stronger emphasis on teaching methods that encourage active learning and the integration of skills, which is crucial for enhancing graduates' employability, and foster an open attitude to multidisciplinary working, which is essential in modern health care.

  8. Tertiary climatic fluctuations and methods of analysis of tertiary floras

    Science.gov (United States)

    Wolfe, J.A.

    1971-01-01

    On theoretical grounds, an analysis of the physiognomy of a Tertiary leaf assemblage is more direct and reliable than a circuitous floristic analysis in assigning thermal regimes to fossil assemblages. Using primarily foliar physiognomy and secondarily floristic composition, it can be shown that: (1) some middle latitude Tertiary assemblages probably lived under meteoroligically tropical climates; (2) a major and rapid climatic deterioration occurred in the Oligocene; and (3) a major climatic fluctuation probably occurred in the Late Eocene. These analyses thus substantiate the conclusions of several other paleobotanists regarding climatic fluctuations. Recent criticisms of these analyses are shown to be invalid and to be based largely on misinterpretations. ?? 1971.

  9. (DeCentralization of Public Procurement at the Local Level in the EU

    Directory of Open Access Journals (Sweden)

    Boštjan BREZOVNIK

    2015-10-01

    Full Text Available The so-called decentralization of public procurement in EU Member States is accepted as the most suitable design of the public procurement system, often justifi ed by greater economic effi ciency and by the possibility of boosting the development of small and medium-sized enterprises, which act on the public procurement market as providers of goods, services and works. Despite the existence of highly decentralized public procurement systems which refl ect the decentralization of administrative systems, especially after the recession, there is a stronger tendency for centralization of public procurement in the EU. The so-called aggregation of demand by contracting authorities can be done in order to achieve economies of scale, including lower prices and transaction costs as well as to improve and professionalize the management of procurement procedures (as highlighted in the Directive 2014/24/EU by the European Parliament and the EU Council. However, even in the context of public procurement centralization, local contracting authorities (i.e., public administration authorities and organizations in Member States should be provided with a suffi ciently wide range of possible (centralized organizational structures and contractual (vertical and horizontal public-public partnerships which will allow them to select the most suitable and most economically effective organizational structure for the execution of public procurement.

  10. Level of infertility in regions according to Ministry of Public Health data

    Directory of Open Access Journals (Sweden)

    Tymchenko O.I.

    2014-09-01

    Full Text Available The aim of the research: estimation of morbidity and prevalence, risks of female and male infertility among the different regions of Ukraine. Materials and methods. The Morbidity and prevalence of female and male infertility were calculated according to Ministry of Public Health official statistics (2002-2012 per 1 000 of population of reproductive age (15-44. Relative risk including 95% confidence interval was calculated for each region in comparison with whole Ukraine. Results. In Ukraine infertility level grows. Over the years interrelation of female infertility prevalence to male decreases. In 2002-2012 prevalence of infertility was 400,1±0,59 per 100 000 of women and 87,41±0,28 per 100 000 of men aged 15-44 years, including infertility morbidity - 122,8±0,33 and 33,63±0,17 per 100 000 accordingly. It was detected the increased risk of female and male infertility deve¬lopment in Odessa, Dnipropetrovsk and Zaporozhzhye regions, and decreased risk in Lviv, Rivne, Kyiv, Cherkassy, Kirovograd, Mykolaiv, Sumy, Kharkiv, Lugansk and Donetsk regions.

  11. Exposure to non-ionizing electromagnetic radiation and public health : review of safety levels

    International Nuclear Information System (INIS)

    Ubeda, A.; Trillo, M. A.

    2005-01-01

    The potential health effects of the exposure to non-ionizing electromagnetic radiation are a source of increasing interest on the part of the public and the authorities. This article summarizes the theoretical-experimental basis supporting the safety levels proposed by international committees, and reviews the recent scientific literature on non-ionizing radiation's bioeffects that are relevant to the validation or modification of the present exposure limits. Because of its social interest, special consideration is given to power frequency fields (50-60Hz) and to the radio communication signals of mobile telephony. The paper also describes how interpretations of the scientific evidence, other than those of the international committees, have generated some controversy and have provided a basis for more restrictive limits, like those adopted in Europe by Switzerland and Italy. The article also identifies some gaps in the present scientific knowledge on the bioelectromagnetics discipline and proposes that additional research is needed to complete our present knowledge on the biological responses to non-ionizing radiation. (Author) 80 refs

  12. Population-level assessments should be emphasized over community/ecosystem-level assessments. Environmental Sciences Division Publication No. 1535

    International Nuclear Information System (INIS)

    Van Winkle, W.

    1980-01-01

    Arguments are presented in favor of emphasizing population-level assessments over community/ecosystem-level assessments. The two approaches are compared on each of four issues: (1) the nature of entrainment/impingement impacts; (2) the ability to forecast reliably for a single fish population as contrasted to the ability to forecast for an aquatic community or ecosystem; (3) practical considerations involving money, manpower, time, and the need to make decisions; and (4) the nature of societal and economic concerns. The conclusion on each of these four issues is that population-level assessments provide the optimal approach for evaluating the effects of entrainment and impingement mortality

  13. Improvement of the organizational support of public water management in Ukraine at the national level

    OpenAIRE

    N. V. Vostrikova; V. P. Vostrikov

    2015-01-01

    The article revealed the theoretical and methodological provision of public water management system by formulating the generalized system model and mechanism of state water management. Due to the classical definition of governance and existing approaches to environmental management the interpretation of the term «public water management» is proposed. Using a systematic approach summarizes the system of public water management and considered its main components: control subsystem, controlled s...

  14. Achieving recommended daily physical activity levels through commuting by public transportation: unpacking individual and contextual influences.

    Science.gov (United States)

    Wasfi, Rania A; Ross, Nancy A; El-Geneidy, Ahmed M

    2013-09-01

    This paper estimates the amount of daily walking associated with using public transportation in a large metropolitan area and examines individual and contextual characteristics associated with walking distances. Total walking distance to and from transit was calculated from a travel diary survey for 6913 individuals. Multilevel regression modelling was used to examine the underlying factors associated with walking to public transportation. The physical activity benefits of public transportation varied along gender and socio-economic lines. Recommended minutes of daily physical activity can be achieved for public transportation users, especially train users living in affluent suburbs. Copyright © 2013 Elsevier Ltd. All rights reserved.

  15. Factors affecting public prejudice and social distance on mental illness: analysis of contextual effect by multi-level analysis.

    Science.gov (United States)

    Jang, Hyeongap; Lim, Jun-Tae; Oh, Juhwan; Lee, Seon-Young; Kim, Yong-Ik; Lee, Jin-Seok

    2012-03-01

    While there have been many quantitative studies on the public's attitude towards mental illnesses, it is hard to find quantitative study which focused on the contextual effect on the public's attitude. The purpose of this study was to identify factors that affect the public's beliefs and attitudes including contextual effects. We analyzed survey on the public's beliefs and attitudes towards mental illness in Korea with multi-level analysis. We analyzed the public's beliefs and attitudes in terms of prejudice as an intermediate outcome and social distance as a final outcome. Then, we focused on the associations of factors, which were individual and regional socio-economic factors, familiarity, and knowledge based on the comparison of the intermediate and final outcomes. Prejudice was not explained by regional variables but was only correlated with individual factors. Prejudice increased with age and decreased by high education level. However, social distance controlling for prejudice increased in females, in people with a high education level, and in regions with a high education level and a high proportion of the old. Therefore, social distance without controlling for prejudice increased in females, in the elderly, in highly educated people, and in regions with a high education and aged community. The result of the multi-level analysis for the regional variables suggests that social distance for mental illness are not only determined by individual factors but also influenced by the surroundings so that it could be tackled sufficiently with appropriate considering of the relevant regional context with individual characteristics.

  16. Differences between users of six public parks in Barcelona depending on the level of perceived safety in the neighborhood

    Directory of Open Access Journals (Sweden)

    Félix Pérez Tejera

    2012-03-01

    Full Text Available Research on the relation between fear of crime and public space has been often limited to psychosocial processes (place attachment, social cohesion, collective efficacy and the effect of environmental variables (brightness, graffitis, cleaness. Most of the behavioral aspects involved, however, have been neglected. In this work we carried out a systematic observational study of the types of users (gender, age, ethnicity, signs of poverty of six public parks in Barcelona. We examined whether there would be differences between users of three parks in the neighbourhood with the highest level of fear of crime and the users of three public parks in the neighbourhoods with the highest levels of perceived safety. The analysis showed significant differences in the spatial occupancy patterns between the two neighbourhoods. The differences highlighted processes of avoidance of public space by women, children and the elderly, and processes of spatial segregation depending on ethnicity and the presence of signs of poverty.

  17. The effectiveness of the Danish Organic Action Plan 2020 to increase the level of organic public procurement in Danish public kitchens

    DEFF Research Database (Denmark)

    Sørensen, Nina Nørgaard; Tetens, Inge; Løje, Hanne

    2016-01-01

    and after kitchen employees participated in conversion projects. Public kitchens participating in the nine organic food conversion projects under the Danish Organic Action Plan 2020, initiated during autumn 2012 and spring 2013 and completed in summer 2015. A total of 622 public kitchens. The average...... (median) increase in organic food percentage from baseline to follow-up was 24 percentage points (Pincrease remained significant for seven out of eight kitchens. Furthermore......’, ‘menu planning’, ‘network’ and ‘Organic Cuisine Label method’ to ensure successful implementation. The study reports significant increases in the level of organic food procurement among public kitchens participating in the Danish Organic Action Plan 2020. Recommendations for future organic conversion...

  18. The University of Illinois at Chicago School of Public Health Doctor of Public Health program: an innovative approach to doctoral-level practice leadership development.

    Science.gov (United States)

    Lenihan, Patrick; Welter, Christina; Brandt-Rauf, Paul; Neuberger, Babette; Pinsker, Eve; Petros, Michael; Risley, Kristine

    2015-03-01

    The University of Illinois at Chicago, School of Public Health, Doctor of Public Health degree is designed to build leadership skills and an ability to contribute to the evidence base of practice. The competency-based, distance-format, doctoral-level program for midcareer professionals features an action learning approach in which students apply leadership principles from the virtual classroom to real-world problems at their work sites. Students demonstrate mastery of the competencies and readiness to advance to the dissertation stage through completing a portfolio by using a process of systematic reflection. The practice-oriented dissertation demonstrates the ability to contribute to the evidence base of public health practice in an area of emphasis. Preliminary evaluation data indicate that the program is meeting its intended purposes.

  19. Radioguided parathyroidectomy for tertiary hyperparathyroidism.

    Science.gov (United States)

    Somnay, Yash R; Weinlander, Eric; Alfhefdi, Amal; Schneider, David; Sippel, Rebecca S; Chen, Herbert

    2015-05-15

    Tertiary hyperparathyroidism (3HPT) is defined as the persistent hyperproduction of parathyroid hormone and resulting hypercalcemia after renal transplantation. Here, we examine the utility of radioguided parathyroidectomy (RGP) in patients with 3HPT. We reviewed a prospective surgery database containing 80 3HPT patients who underwent RGP from January 2001-July 2014 at our institution. We evaluated patient demographics, operative management, radioguided neoprobe utilization, and operative outcomes. Data are reported as mean ± standard error of the mean. The mean age of the patients was 52 ± 1 y, and 46% were male. A total of 69 patients had hyperplasia and received subtotal parathyroidectomy, whereas 5 patients had double adenomas and 6 patients had single adenomas. The average calcium level among 3HPT patients was 10.8 ± 0.1 mg/dL preoperatively and 8.7 ± 0.1 mg/dL postoperatively. In vivo radioguided counts normalized to background counts averaged 145 ± 4%, whereas ex vivo counts normalized to background counts averaged 69 ± 5%. All but one ex vivo count was >20%. Ectopically located glands were successfully localized in 38 patients using the gamma probe. Ex vivo percentage did not correlate with parathyroid gland weight, preoperative parathyroid hormone, or preoperative calcium. Our radioguided approach achieved normocalcemia in 96% of 3HPT patients undergoing RGP; two patients developed recurrent disease. In this series, all enlarged parathyroid glands were localized and resected using the gamma probe. Thus, RGP reliably localizes adenomatous, hyperplastic, and ectopically located glands in patients with 3HPT, resulting in high cure rate after resection. Copyright © 2015 Elsevier Inc. All rights reserved.

  20. KNOWLEDGE AND ATTITUDE TOWARDS HUMAN PAPILLOMA VIRUS AND ITS VACCINE AMONG PHARMACY STUDENTS OF TERTIARY TEACHING UNIVERSITY HOSPITAL IN SOUTH INDIA

    OpenAIRE

    Raghupathi Mahitha; T. S. Arunprasath

    2016-01-01

    BACKGROUND Cervical cancer in women can be effectively prevented by HPV vaccine. Healthcare professionals including pharmacists have a role in creating awareness about this vaccine to public. In this context, it was decided to study awareness level about HPV among pharmacy students. The aim of the study is to study the knowledge and attitude towards human papilloma virus and it’s vaccine among pharmacy students of tertiary teaching university hospital in South India. MATERIA...

  1. The level playing field - things the public knows all too little about

    International Nuclear Information System (INIS)

    Grimston, M.C.

    1996-01-01

    Over half a century on from the dawn of nuclear fission, the public has yet to make its peace with nuclear power. Early, irrational, promises of unbelievably cheap power, which could never be realized, together with an inherent fear of the nuclear process (tied up with the dread of the atom bomb), have contributed to a lingering mistrust in the minds of the public. This public perception has been little influenced by the industry's attempts at improved public relations. The reasons for this are diverse and complex and have more to do with psychology than with factual reasoning. This report explores these problems and attempts to find the way forward in educating a sceptical public that knows all too little about the field of nuclear power. (Author)

  2. Policy considerations of low-level and intermediate-level radioactive wastes from a public interest perspective

    International Nuclear Information System (INIS)

    Rodgers, S.

    1977-01-01

    A critical, environmentalist view is taken of the problem of low-level radioactive waste disposal. Policy questions and needs for additional data are listed. The lack of a requirement for environmental impact statements prior to site licensing is pointed out. Some of New Mexico's experiences are briefly recounted. The need for definitions for radioactive wastes is pointed out

  3. Power distribution, the environment, and public health. A state-level analysis

    International Nuclear Information System (INIS)

    Boyce, James K.; Klemer, Andrew R.; Templet, Paul H.; Willis, Cleve E.

    1999-01-01

    This paper examines relationships among power distribution, the environment, and public health by means of a cross-sectional analysis of the 50 US states. A measure of inter-state variations in power distribution is derived from data on voter participation, tax fairness, Medicaid access, and educational attainment. We develop and estimate a recursive model linking the distribution of power to environmental policy, environmental stress, and public health. The results support the hypothesis that greater power inequality leads to weaker environmental policies, which in turn lead to greater environmental degradation and to adverse public health outcomes

  4. Power distribution, the environment, and public health. A state-level analysis

    Energy Technology Data Exchange (ETDEWEB)

    Boyce, James K. [Department of Economics, University of Massachusetts, Amherst, MA 01003 (United States); Klemer, Andrew R. [Department of Biology, University of Minnesota, Duluth, MN (United States); Templet, Paul H. [Institute of Environmental Studies, Louisiana State University, Baton Rouge, LA (United States); Willis, Cleve E. [Department of Resource Economics, University of Massachusetts, Amherst, MA 01003 (United States)

    1999-04-15

    This paper examines relationships among power distribution, the environment, and public health by means of a cross-sectional analysis of the 50 US states. A measure of inter-state variations in power distribution is derived from data on voter participation, tax fairness, Medicaid access, and educational attainment. We develop and estimate a recursive model linking the distribution of power to environmental policy, environmental stress, and public health. The results support the hypothesis that greater power inequality leads to weaker environmental policies, which in turn lead to greater environmental degradation and to adverse public health outcomes.

  5. Power distribution, the environment, and public health. A state-level analysis

    Energy Technology Data Exchange (ETDEWEB)

    Boyce, James K. [Department of Economics, University of Massachusetts, Amherst, MA 01003 (United States); Klemer, Andrew R. [Department of Biology, University of Minnesota, Duluth, MN (United States); Templet, Paul H. [Institute of Environmental Studies, Louisiana State University, Baton Rouge, LA (United States); Willis, Cleve E. [Department of Resource Economics, University of Massachusetts, Amherst, MA 01003 (United States)

    1999-04-15

    This paper examines relationships among power distribution, the environment, and public health by means of a cross-sectional analysis of the 50 US states. A measure of inter-state variations in power distribution is derived from data on voter participation, tax fairness, Medicaid access, and educational attainment. We develop and estimate a recursive model linking the distribution of power to environmental policy, environmental stress, and public health. The results support the hypothesis that greater power inequality leads to weaker environmental policies, which in turn lead to greater environmental degradation and to adverse public health outcomes

  6. Acquisition of public lands for disposal of low-level radioactive waste

    International Nuclear Information System (INIS)

    Dawson, J.H.

    1983-09-01

    It is clear that the Federal Land Policy Management Act (FLPMA) gives broadly extended statutory authority to the Bureau of Land Management (BLM) to effect public land transactions. For the purposes of this study, the focus will be on an examination of the boundaries of BLM's powers to effect the exchange and sale of public lands. In the course of examining these powers, consideration will be given also to certain limitations inherent in the statutes which may delay implementation of BLM powers and the consequent effective transfer of public lands. The principal reason for possible delay is the FLPMA requirement for land use planning. Other delay sources could be the requirement for fair market value and the increased prospect of third party judicial challenge. Finally, some consideration will be given to alternative approaches such as the Federal Asset Management Program, the Recreation and Public Purposes Act and State selection of lands

  7. Goals, communication, participation, and feedback : mid-level management and traditional public administration

    NARCIS (Netherlands)

    Favero, N.; Meier, K.J.; O'Toole, Laurence J.

    2012-01-01

    Much recent work in the study of public administration has emphasized new challenges, and relatively unusual aspects of management, such as managerial networking and interorganizational collaboration, cross-sectoral partnerships, the centrality of information technology in contemporary management,

  8. What Use Patterns Were Observed for PEV Drivers at Publicly Accessible AC Level 2 EVSE Sites?

    Energy Technology Data Exchange (ETDEWEB)

    Francfort, James Edward [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2015-12-01

    The EV Project deployed over 4,000 ACL2 EVSE for drivers to charge their plug-in electric vehicle (PEV) when away-from-home. The vast majority of these EVSE stations were installed to be available to all PEV drivers at publicly accessible locations. Some were also deployed for use at workplaces and fleets. This paper examines only the use patterns of PEV drivers using the EVSE intended to be publicly accessible.

  9. Problems in siting low level radioactive wastes: A focus on public participation

    International Nuclear Information System (INIS)

    Bord, R.J.

    1985-01-01

    Public participation programs must develop a means to enlist meaningful public feedback. Besides the traditional public meetings, which generally mobilize the opposition, careful surveys can be done of a representative spectrum of the public getting their judgments about specific criteria. These judgments can be used to shape siting policy. Such an approach would help avoid the criticism that public input is not taken into account. While the suggestions included in this paper go far in dealing with public fear and distrust they cannot guarantee siting success. There are a number of uncontrollable contingencies that can affect any siting program. Another energy crises, for example, may increase the prestige of the nuclear industry and make LLRW siting less onerous. Or, new broadcasts of waste site failures or of nuclear accidents could make LLRW siting more problematic. The problems of waste siting will not disappear nor are the solutions easy ones. They demand serious consideration by talented scientists of all kinds. Waste siting difficulties certainly rank near the top of challenges facing advanced industrial societies. Attempts to site wastes of all kinds have foundered because of strong public opposition. LLRW siting attempts are certain to meet similar problems. Local communities tend to see little or no benefits but high costs in hosting waste sites. Fear of pollution, the unknown aspects of radiation risks, a lack of confidence in governmental agencies, are all factors promoting public resistance. Compounding these problems has been the failure of citizen participation programs to fulfill the functions for which they were designed. Instead of fostering more open communication, regulating conflict, and generating better ideas, participation programs dealing with waste siting tend to generate more conflict and mobilize determined opposition

  10. An analysis of public debt levels in both developed and developing countries

    Directory of Open Access Journals (Sweden)

    Arsić Sonja

    2015-01-01

    Full Text Available The main objective of this paper is pointing out the importance of high public debt problem as well as the underlying causes that have led to rise in public debt in selected countries. The following methods were used in this research: historical method, deduction, generalization methods and statistical methods. By observing data on ten year trend of public debt in selected countries, we have concluded that there is a trend of increase in public debt, as a percentage of the gross domestic product of a country. Each of the analyzed countries (Canada, United Kingdom, Greece, Argentina and Serbia has specific causes that have led to rise in public debt, but the main cause that is common to all countries is the excessive consumption of state organs and reduction of tax revenues that has arisen as a result of reduced economic activity due to the global economic crisis in recent years. By analyzing the data on the trend of public debt in the observed countries in the period from 2003. to 2014., we have concluded that the problem can be solved by increasing gross domestic product, or reducing government spending.

  11. Public funding of health at the district level in Indonesia after decentralization-sources, flows and contradictions.

    Science.gov (United States)

    Heywood, Peter; Harahap, Nida P

    2009-04-16

    During the Suharto era public funding of health in Indonesia was low and the health services were tightly controlled by the central government; district health staff had practically no discretion over expenditure. Following the downfall of President Suharto there was a radical political, administrative and fiscal decentralization with delivery of services becoming the responsibility of district governments. In addition, public funding for health services more than doubled between 2001 and 2006. It was widely expected that services would improve as district governments now had both more adequate funds and the responsibility for services. To date there has been little improvement in services. Understanding why services have not improved requires careful study of what is happening at the district level. We collected information on public expenditure on health services for the fiscal year 2006 in 15 districts in Java, Indonesia from the district health offices and district hospitals. Data obtained in the districts were collected by three teams, one for each province. Information on district government revenues were obtained from district public expenditure databases maintained by the World Bank using data from the Ministry of Finance. The public expenditure information collected in 15 districts as part of this study indicates district governments are reliant on the central government for as much as 90% of their revenue; that approximately half public expenditure on health is at the district level; that at least 40% of district level public expenditure on health is for personnel, almost all of them permanent civil servants; and that districts may have discretion over less than one-third of district public expenditure on health; the extent of discretion over spending is much higher in district hospitals than in the district health office and health centers. There is considerable variation between districts. In contrast to the promise of decentralization there has been

  12. Conflict and coordination in the provision of public goods: a conceptual analysis of continuous and step-level games.

    Science.gov (United States)

    Abele, Susanne; Stasser, Garold; Chartier, Christopher

    2010-11-01

    Conflicts between individual and collective interests are ubiquitous in social life. Experimental studies have investigated the resolution of such conflicts using public goods games with either continuous or step-level payoff functions. Game theory and social interdependence theory identify consequential differences between these two types of games. Continuous function games are prime examples of social dilemmas because they always contain a conflict between individual and collective interests, whereas step-level games can be construed as social coordination games. Step-level games often provide opportunities for coordinated solutions that benefit both the collective and the individuals. For this and other reasons, the authors conclude that one cannot safely generalize results obtained from step-level to continuous-form games (or vice versa). Finally, the authors identify specific characteristics of the payoff function in public goods games that conceptually mark the transition from a pure dilemma to a coordination problem nested within a dilemma.

  13. Tertiary Journalism Education: Its Value in Cadet Selection at Metropolitan Media.

    Science.gov (United States)

    Alysen, Barbara

    2001-01-01

    Notes tertiary study in journalism has been a feature of the education of Australian journalists for decades, yet many industry representatives remain skeptical of its value. Finds applicants for entry-level jobs with a tertiary journalism qualification can expect to secure, on average, at least half the available positions in any cadet or trainee…

  14. Development of the Teacher Candidates’ Level of being Affected from Public Personnel Selection Examination Scale

    Directory of Open Access Journals (Sweden)

    Fatma SUSAR KIRMIZI

    2015-07-01

    Full Text Available This study aimed to develop a scale to evaluate teacher candidates' level of being affected from the public personnel selection examination. The participants of the study consisted of the final year students at Pamukkale University Education Faculty. The participants were 207 teacher candidates, of whom 143 were female and 64 were male. The validity and reliability study of the scale was conducted on the data gathered from teacher candidates studying at Art Teaching, Music Teaching, Turkish Language Teaching, Social Studies Education, Science Teaching, Psychological Counseling and Guidance Education, Elementary Education and Preschool Education departments of Pamukkale University Education Faculty. The Lawshe technique was used in the evaluation of the scale by experts. To determine the construct validity, factor analysis was performed on the data, and two sub-scales were identified. The factor loading values of the items in the first sub-scale ranged between 0,65 and 0,35, and those in the second sub-scale between 0,75 and 0,39. As a result of the analyses, the "Teacher Candidates' Level of Being Affected From Public Personnel Selection Examination Scale" (TCLBAPPSES including 33 items, 23 negative and 10 positive, and two sub-scales was produced. The Cronbach's Alpha reliability coefficient was found as 0,86 for the first sub-dimension, 0,73 for the second sub-dimension, and 0,91 for the whole scale. As a result, it can be argued that the scale is reliable.-------------Öğretmen Adaylarının Kamu Personeli Seçme Sınavından Etkilenme Düzeyi Ölçeğinin GeliştirilmesiÖzet:Bu çalışmada, öğretmen adaylarının kamu personeli seçme sınavından etkilenme düzeylerini değerlendirmek için bir ölçek geliştirilmesi amaçlanmıştır. Araştırmanın çalışma grubunu Pamukkale Üniversitesi Eğitim Fakültesi son sınıf öğrencileri oluşturmuştur. Araştırmada 143 kız, 64 erkek olmak üzere toplam 207 öğretmen adayına ula

  15. How Multi-Levels of Individual and Team Learning Interact in a Public Healthcare Organisation: A Conceptual Framework

    Science.gov (United States)

    Doyle, Louise; Kelliher, Felicity; Harrington, Denis

    2016-01-01

    The aim of this paper is to review the relevant literature on organisational learning and offer a preliminary conceptual framework as a basis to explore how the multi-levels of individual learning and team learning interact in a public healthcare organisation. The organisational learning literature highlights a need for further understanding of…

  16. Enhancing public access to legal information : A proposal for a new official legal information generic top-level domain

    NARCIS (Netherlands)

    Mitee, Leesi Ebenezer

    2017-01-01

    Abstract: This article examines the use of a new legal information generic Top-Level Domain (gTLD) as a viable tool for easy identification of official legal information websites (OLIWs) and enhancing global public access to their resources. This intervention is necessary because of the existence of

  17. Annual limits on intake for members of the public and derived reference levels of radionuclide concentrations in the environment

    International Nuclear Information System (INIS)

    Mason, G.C.

    1983-01-01

    A proposal is presented recommending the introduction in Australia of Annual Limits on Intake of radionuclides for members of the public and of corresponding reference levels of radionuclide concentrations in the environment. The proposal is related to recent recommendations of the International Commission on Radiological Protection and draft recommendations under consideration by the International Atomic Energy Agency

  18. Segregation Levels in Cleveland Public Schools and the Cleveland Voucher Program. School Choice Issues in the State

    Science.gov (United States)

    Forster, Greg

    2006-01-01

    Examining the widespread claims that private schools have high segregation levels and vouchers will lead to greater segregation, this study finds that both assertions are empirically unsupportable. Private schools participating in Cleveland's voucher program are much less segregated than Cleveland's public schools. This means that students using…

  19. Segregation Levels in Milwaukee Public Schools and the Milwaukee Voucher Program. School Choice Issues in the State

    Science.gov (United States)

    Forster, Greg

    2006-01-01

    This study compares segregation levels in Milwaukee public schools and in private schools participating in the Milwaukee voucher program. Using a segregation index that measures the difference between the percent of students in a school who are white and the percentage of school-age children in the greater metro area who are white, it finds that…

  20. Usability of cerebrospinal fluid biomarkers in a tertiary memory clinic

    DEFF Research Database (Denmark)

    Brandt, C.; Bahl, J.C.; Heegaard, N.H.

    2008-01-01

    AIM: Assays for cerebrospinal fluid (CSF) levels of total tau, phospho-tau protein and beta-amyloid 1-42 have been available for some years. The aim of the study was to assess the usability of these biomarkers in a mixed population of tertiary dementia referral patients in a university-based memory......, the sensitivity of a single abnormal value was between 33 and 66%. The specificity was high except when discriminating AD from amnestic mild cognitive impairment. Two or more abnormal markers further increased the specificity and decreased the sensitivity. CONCLUSION: In a tertiary setting, abnormal CSF biomarker...

  1. A Comparison of the Industriousness Levels of KEEP and Public School Students. Technical Report #55.

    Science.gov (United States)

    Antill, Ellen; Tharp, Roland G.

    This report compares the on-task behavior (industriousness) of K-3 students in the demonstration school of the Kamehameha Early Education Program (KEEP) with that of children from classes in four public schools. Industriousness was measured by tallying the occurrence of such behaviors as working on an appropriate task, attending to the teacher, or…

  2. Exploring Levels of Job Satisfaction among Teachers in Public Secondary Schools in Tanzania

    Science.gov (United States)

    Msuya, Ombeni William

    2016-01-01

    A case study on the role of extrinsic factors (hygiene factors) and socio-demographic factors in determining job satisfaction among teachers in public secondary schools in Tanzania was undertaken. Biographical variables pertaining to teachers' age, sex, marital status and work experience were investigated to determine whether they had any…

  3. Health Care Public Sector Share and the U.S. Life Expectancy Lag: A Country-level Longitudinal Study.

    Science.gov (United States)

    Reynolds, Megan M

    2018-04-01

    Growing research on the political economy of health has begun to emphasize sociopolitical influences on cross-national differences in population health above and beyond economic growth. While this research investigates the impact of overall public health spending as a share of GDP ("health care effort"), it has for the most part overlooked the distribution of health care spending across the public and private spheres ("public sector share"). I evaluate the relative contributions of health care effort, public sector share, and GDP to the large and growing disadvantage in U.S. life expectancy at birth relative to peer nations. I do so using fixed effects models with data from 16 wealthy democratic nations between 1960 and 2010. Results indicate that public sector share has a beneficial effect on longevity net of the effect of health care effort and that this effect is nonlinear, decreasing in magnitude as levels rise. Moreover, public sector share is a more powerful predictor of life expectancy at birth than GDP per capita. This study contributes to discussions around the political economy of health, the growth consensus, and the American lag in life expectancy. Policy implications vis-à-vis the U.S. Affordable Care Act are discussed.

  4. Study of Some Demographic Properties Influencing the Burnout Levels of Nurses in Public Hospitals by CHAID Analysis

    Directory of Open Access Journals (Sweden)

    Zübeyir BAĞCI

    2015-12-01

    Full Text Available In this study, it is aimed to identify the burnout levels of nurses which prevent them from doing their business more efficiently and to examine the effects of various demographic variables on burnout. The data necessary for the research have been gathered from 256 nurses working in public hospitals within borders of central district of Denizli province using “Maslach Burnout Inventory”. They were analyzed by SPSS and CHAID was used as the analysis method. In consequence it has been determined that nurses experience low-level emotional exhaustion, average-level depersonalization and high-level decrease in personal accomplishment. It has also been concluded that burnout levels are affected by demographic properties such as age, marital status, tenure of office, daily workload, education and income level

  5. Generic intervention levels for protecting the public in the event of a nuclear accident or radiological emergency

    International Nuclear Information System (INIS)

    1993-04-01

    Many international organizations are in the process of developing common safety standards for protection against ionizing radiation and for the safety of radiation sources. This document is intended to provide input to the final specification of intervention levels, at which actions of various kinds to protect members oft the public after an accident are advised. It provides the radiation protection principles underlying such intervention levels and proposes numerical values for these levels based on an analysis of some of the more directly quantifiable factors involved. Factors such as social disruption, psychological factors and political considerations are discussed, but are explicitly excluded from the derivation. Refs, figs and tabs

  6. Utilization of Antihypertensive Drugs: A Comparison of Tertiary and ...

    African Journals Online (AJOL)

    To compare the quality of antihypertensive prescriptions at 2 different health care levels in a hypertensive Nigerian population.We carried out a retrospective comparative analysis of the quality and pattern of antihypertensive and low-dose aspirin prescription in a tertiary and two secondary health care institutions providing ...

  7. Counselling for Sustainable Peace in Tertiary Institutions in Nigeria

    Science.gov (United States)

    Nduka-Ozo, Stella Ngozi

    2016-01-01

    This study reviewed the nature of peace in Tertiary Institutions in Nigeria using Ebonyi State University as a case study. The purpose of the study was to review the various factors responsible for lack of peace. The sample was drawn from the three hundred level students of the Faculty of Education. Thirty students were selected from each of the…

  8. Tertiary Institutions, Entrepreneurship Education and Youth Empowerment in Nigeria

    Science.gov (United States)

    Olasunkanmi, Abari Ayodeji; Olufunke, Oyetola Idowu; Adetayo, Okunuga Adedapo

    2013-01-01

    Entrepreneurship Education has recently become a global phenomenon in the development of world youths for self employment and self-reliance. The Nigerian nation cannot afford to be left out and left behind in this new trend in education both at the secondary and tertiary levels. However, while the Universal Basic Education (UBE) curriculum has…

  9. An Examination of Tertiary Students' Desire to Found an Enterprise

    Science.gov (United States)

    Birdthistle, Naomi

    2008-01-01

    Purpose: The purpose of this paper is twofold. First, the paper aims to identify and explain the behaviour and intentions of students in their decision to start entrepreneurial activities and establish an enterprise. Second, the paper aims to identify whether students in tertiary level institutions in Ireland display the personality traits of an…

  10. Public health leadership competency level among health professionals in a South Eastern European country

    Directory of Open Access Journals (Sweden)

    Orjola Pampuri

    2015-12-01

    the overall scores and the subscale scores of the current and the required level of leadership competencies among health professionals. Results: Mean value of the overall summary score for the 52 items of the instrument was significantly lower for the current leadership competency level compared with the required leadership competency level (138.4±11.2 vs. 159.7±25.3, respectively; P<0.001. Most of the subscales’ scores were significantly higher for the required than for the current leadership competency level. Conclusion: Our study provides useful evidence about the current and the required level of leadership competencies among health professionals in transitional Albania. Findings of this study may help policymakers in Albania to identify the gap between the required and the current level of leadership competencies among health  professionals. Furthermore, findings of this study should be expanded in the neighbouring countries of the South Eastern European region and beyond.

  11. Datasets will not be made accessible to the public due to the fact that they include household level data with PII.

    Data.gov (United States)

    U.S. Environmental Protection Agency — Datasets will not be made accessible to the public due to the fact that they include household level data with PII. This dataset is not publicly accessible because:...

  12. Level of infertility in regions according to Ministry of Public Health data.

    OpenAIRE

    Tymchenko, O. I.; Mykytenko, D. O.; Koba, O. P.; Lynchak, O. V.

    2014-01-01

    The aim of the research: estimation of morbidity and prevalence, risks of female and male infertility among the different regions of Ukraine. Materials and methods. The Morbidity and prevalence of female and male infertility were calculated according to Ministry of Public Health official statistics (2002-2012) per 1 000 of population of reproductive age (15-44). Relative risk including 95% confidence interval was calculated for each region in comparison with whole Ukraine. Results. In Ukrain...

  13. Public-private collaboration and scientific impact: an analysis at the level of the individual researcher

    Energy Technology Data Exchange (ETDEWEB)

    Bloch, C.; Ryan, T.K.; Andersen, J.P.

    2016-07-01

    This paper examines whether citation impact for individual researchers differs when collaborating with industry compared to work only involving academic researchers. To do this, we have identified a group of corresponding authors with addresses in Denmark with articles involving public-private collaboration for 2008-2010 and thereafter constructed a list of all articles authored by these researchers during the period 2006-2012. (Author)

  14. Use of Treated Municipal Wastewater as Power Plant Cooling System Makeup Water: Tertiary Treatment versus Expanded Chemical Regimen for Recirculating Water Quality Management

    Energy Technology Data Exchange (ETDEWEB)

    David Dzombak; Radisav Vidic; Amy Landis

    2012-06-30

    nitrification helped to reduce the corrosivity and biocide demand. Also, the lower pH and alkalinity resulting from nitrification reduced the scaling to an acceptable level, without the addition of anti-scalant chemicals. Additional GAC adsorption treatment, MWW_NFG, yielded no net benefit. Removal of organic matter resulted in pitting corrosion in copper and cupronickel alloys. Negligible improvement was observed in scaling control and biofouling control. For all of the tertiary treatments, biofouling control was achievable, and most effectively with pre-formed monochloramine (2-3 ppm) in comparison with NaOCl and ClO2. Life cycle cost (LCC) analyses were performed for the tertiary treatment systems studied experimentally and for several other treatment options. A public domain conceptual costing tool (LC3 model) was developed for this purpose. MWW_SF (lime softening and sand filtration) and MWW_NF were the most cost-effective treatment options among the tertiary treatment alternatives considered because of the higher effluent quality with moderate infrastructure costs and the relatively low doses of conditioning chemicals required. Life cycle inventory (LCI) analysis along with integration of external costs of emissions with direct costs was performed to evaluate relative emissions to the environment and external costs associated with construction and operation of tertiary treatment alternatives. Integrated LCI and LCC analysis indicated that three-tiered treatment alternatives such as MWW_NSF and MWW_NFG, with regular chemical addition for treatment and conditioning and/or regeneration, tend to increase the impact costs and in turn the overall costs of tertiary treatment. River water supply and MWW_F alternatives with a single step of tertiary treatment were associated with lower impact costs, but the contribution of impact costs to overall annual costs was higher than all other treatment alternatives. MWW_NF and MWW_SF alternatives exhibited moderate external impact costs

  15. Food formulation and not processing level: Conceptual divergences between public health and food science and technology sectors.

    Science.gov (United States)

    Botelho, R; Araújo, W; Pineli, L

    2018-03-04

    Observed changes in eating and drinking behaviors in economically developing countries are associated with increase of obesity and related chronic diseases. Researchers from field of public health (PH) have attributed this problem to food processing and have created new food classification systems to support their thesis. These classifications conceptually differ from processing level concepts in food science, and state to people that food processing is directly related to nutritional impact of food. Our work aims to compare the concept of food processing from the standpoint of food science and technology (FST) and public health and to discuss differences related to formulation or level of processing of products and their impact on nutritional quality. There is a misconception between food processing/unit operation/food technology and formulation or recipes. For the public health approach, classification is based on food products selection and the use of ingredients that results in higher consumption of sugar, sodium, fat, and additives, whereas in FST, processing level is based on the intensity and amount of unit operations to enhance shelf life, food safety, food quality, and availability of edible parts of raw materials. Nutritional quality of a product or preparation is associated with formulation/recipe and not with the level of processing, with few exceptions. The impact of these recommendations on the actual comprehension of food processing and quality must be considered by the population.

  16. Public opposition to the siting of the high-level nuclear waste repository: The importance of trust

    International Nuclear Information System (INIS)

    Pijawka, K.D.; Mushkatel, A.H.

    1991-01-01

    This paper examines several dimensions of public opposition to the proposed siting of the high-level nuclear waste repository at Yucca Mountain. In order to provide a context for the public's views of the repository in metropolitan Clark County, both governmental studies of the repository siting process are analyzed, as well as elements of the Nuclear Waste Policy Act. This analysis suggests that one potentially key component of the public's opposition to the siting, as well as their perceptions of risk of the facility, may be the result of a lack of trust in the Department of Energy. Empirical analysis of survey data collected in Nevada in 1988 confirms the strong relationship between political trust and repository risk perceptions

  17. Teaching/learning strategies for the essentials of baccalaureate nursing education for entry-level community/public health nursing.

    Science.gov (United States)

    Callen, Bonnie; Smith, Claudia M; Joyce, Barbara; Lutz, Jayne; Brown-Schott, Nancy; Block, Derryl

    2013-01-01

    The purpose of this article is to describe teaching/learning strategies for each of the 15 Essentials of Baccalaureate Nursing Education for Entry-Level Community/Public Health Nursing (ACHNE, 2009). Carper's ways of knowing serve as foundations for creating classroom and clinical experiences that focus on clinical action with community as client. Each community/public health essential is defined with relevance to community/public health nursing practice. Five teaching/learning strategies have been delineated for each essential with suggestions of teaching resources and/or target population application. Teaching/learning strategies that focus on community as client, population health, and the essential knowledge and competencies of C/PH nursing will help ensure preparation of baccalaureate prepared nurses with knowledge and skills to improve the health of populations. © 2013 Wiley Periodicals, Inc.

  18. The Effect of a High School Speech Course on Public Speaking Anxiety for Students in a College-Level Public Speaking Class

    Science.gov (United States)

    Johnson, Karen Hill

    2012-01-01

    Literature suggested public speaking is American's most feared activity. Additionally, the public speaking curriculum was removed from the K-12 school system after 2001. This study aimed to examine the effect of previous public speaking instruction, public speaking extra-curricular activity, gender, and self-esteem on public speaking anxiety…

  19. Driven to Support: Individual- and County-Level Factors Associated With Public Support for Active Transportation Policies.

    Science.gov (United States)

    Cradock, Angie L; Barrett, Jessica L; Chriqui, Jamie F; Evenson, Kelly R; Goins, Karin Valentine; Gustat, Jeanette; Heinrich, Katie M; Perry, Cynthia K; Scanze, Michele; Schmid, Thomas L; Tabak, Rachel G; Umstattd Meyer, M Renee; Valko, Cheryl

    2018-03-01

    To assess predictors of stated support for policies promoting physically active transportation. Cross-sectional. US counties selected on county-level physical activity and obesity health status. Participants completing random-digit dialed telephone survey (n = 906). Survey measures assessed stated support for 5 policies to promote physically active transportation, access to active transportation facilities, and time spent in a car. County-level estimates included household car dependence and funding for bicycle-pedestrian projects. Multivariable generalized linear mixed models using binary distribution and logit link, accounting for clustering within county. Respondents supported policies for accommodating bicyclists and pedestrians through street improvements (89%), school active transportation programs (75%), employer-funded active commuting incentives (67%), and allocation of public funding (68%) and tax support (56%) for building and maintaining public transit. Residents spending >2 h/d (vs public transit (OR: 1.85; CI: 1.24-2.77) improvements. Residents in counties investing >$1.6 million in bicycle and pedestrian improvements expressed greater support for funding (OR: 1.71; CI: 1.04-2.83) and tax increases (OR: 1.73; CI: 1.08-2.75) for transit improvements compared to those with lower prior investments (transportation is higher where relevant investments in active transportation infrastructure are large (>$1.6 M), public transit is nearby, and respondents drive >2 h/d.

  20. Lead and cadmium levels of commonly administered pediatric syrups in Nigeria: A public health concern?

    International Nuclear Information System (INIS)

    Orisakwe, Orish Ebere; Nduka, John Kanayochukwu

    2009-01-01

    Fifty different pediatric syrups were randomly sampled from patent medicine stores and pharmaceutical shops within Awka, in Anambra State between November 2007 and May 2008. Syrups were ashed before digestion using conc. aqua regia, HCl:HNO 3 (3:1) and lead and cadmium were assayed with AAS 205A. Results revealed that 60 and 98% of the sample size had lead and cadmium respectively. The lead levels ranged from 0.01 in chloroquine to 1.08 mg/l in magcid suspension. The highest level of cadmium was seen in magcid suspension with concentration of 2.45 mg/l while lowest concentration of 0.01 in emzolyn and colipan. About 41.2% of the locally made syrup had none detectable levels of lead while all the syrup had detectable levels of cadmium. Lead levels ranged from 0.01 mg/l in cadiphen manufactured in Dholka, India to 0.09 in maxiquine made in England. About 68.8% of the imported syrups of the imported syrups had non detectable levels of lead. Chloramphenicol and zentel albendazole syrups had 0.60 and 0.88 mg/l of cadmium respectively. Bellis cough syrup showed the lowest level (0.01 mg/l) of cadmium. Only erythromycin suspension representing 6.3% had non detectable level of cadmium of the imported syrups. Due to the Cd and Pb levels found, we suggest that the behaviour scenario (here, self administration without medical assistance) should be properly taken under control. Along with this, contamination sources or vulnerable practices during syrups preparation should be also assessed in a tiered approach, towards the minimization of noxious presence in syrups and the promotion of quality of Nigerian-made products.

  1. Lead and cadmium levels of commonly administered pediatric syrups in Nigeria: A public health concern?

    Energy Technology Data Exchange (ETDEWEB)

    Orisakwe, Orish Ebere, E-mail: eorish@aol.com [Toxicology Unit, Department of Pharmacology,College of Health Sciences, Nnamdi Azikiwe University,Nnewi Campus. P.M.B. 5001, Nnewi, Anambra State (Nigeria); Nduka, John Kanayochukwu [Environmental Chemistry and Toxicology Research Unit, Pure and Industrial Chemistry Department, Nnamdi Azikiwe University, P.M.B. 5025, Awka Anambra State (Nigeria)

    2009-11-15

    Fifty different pediatric syrups were randomly sampled from patent medicine stores and pharmaceutical shops within Awka, in Anambra State between November 2007 and May 2008. Syrups were ashed before digestion using conc. aqua regia, HCl:HNO{sub 3} (3:1) and lead and cadmium were assayed with AAS 205A. Results revealed that 60 and 98% of the sample size had lead and cadmium respectively. The lead levels ranged from 0.01 in chloroquine to 1.08 mg/l in magcid suspension. The highest level of cadmium was seen in magcid suspension with concentration of 2.45 mg/l while lowest concentration of 0.01 in emzolyn and colipan. About 41.2% of the locally made syrup had none detectable levels of lead while all the syrup had detectable levels of cadmium. Lead levels ranged from 0.01 mg/l in cadiphen manufactured in Dholka, India to 0.09 in maxiquine made in England. About 68.8% of the imported syrups of the imported syrups had non detectable levels of lead. Chloramphenicol and zentel albendazole syrups had 0.60 and 0.88 mg/l of cadmium respectively. Bellis cough syrup showed the lowest level (0.01 mg/l) of cadmium. Only erythromycin suspension representing 6.3% had non detectable level of cadmium of the imported syrups. Due to the Cd and Pb levels found, we suggest that the behaviour scenario (here, self administration without medical assistance) should be properly taken under control. Along with this, contamination sources or vulnerable practices during syrups preparation should be also assessed in a tiered approach, towards the minimization of noxious presence in syrups and the promotion of quality of Nigerian-made products.

  2. Prevalence of cardiovascular risk factors and socioeconomic level among public-sector workers in Angola.

    Science.gov (United States)

    Capingana, Daniel P; Magalhães, Pedro; Silva, Amílcar B T; Gonçalves, Mauer A A; Baldo, Marcelo P; Rodrigues, Sérgio L; Simões, Cristóvão C F; Ferreira, Albano V L; Mill, José G

    2013-08-07

    Cardiovascular diseases are the leading cause of death in the majority of developed and developing countries. African countries are currently facing an increase in both cardiovascular and transmitted diseases. In addition, cardiovascular risk varies among different socioeconomic groups. Thus, we determined the prevalence of modifiable cardiovascular risk factors in apparently healthy public-sector workers and investigated possible relationships with socioeconomic status. We employed a cross-sectional study comprising 42.2% (n = 615) of the public-sector workers at Agostinho Neto University, 48% (n = 294) male and 52% (n= 321) female, with ages between 20 and 72 years and from various socioeconomic groups. The study was conducted from February 2009 to December 2010. Personal, anthropometric, biochemical, hemodynamic, socioeconomic, and physical activity data were collected. The prevalence rates of cardiovascular risk factors were as follows: hypertension, 45.2% (men 46.3%, women 44.2%, P > 0.05); hypercholesterolemia, 11.1% (men 10.5%, women 11.5%, P > 0.05); low high-density lipoprotein (HDL) cholesterol, 50.1% (men 36.9%, women 62.3%; P 0.05); smoking, 7.2% (men 10.2%, women 4.4%; P 0.05); overweight, 29.3% (men 27.3%, women 31.2%, P > 0.05); obesity, 19.6% (men 9.2%, women 29.0%; P socioeconomic status, 41.0% had three or more risk factors. The results of this study suggest the existence of a high prevalence of multiple risk factors for cardiovascular disease in apparently healthy public-sector workers in Angola. The workers in lower socioeconomic groups had higher incidences of hypertension, smoking, and left ventricular hypertrophy.

  3. Public and state responses to high-level nuclear waste disposal: Learning from policy failure

    International Nuclear Information System (INIS)

    Kraft, M.E.

    1991-01-01

    Nuclear waste policy in the United States has faded in large part because of public and state opposition to repository siting. However, that outcome was not inevitable. This paper argues that better policy design and greater attention to the crucial tasks of policy legitimation both by the U.S. Congress and by the Department of Energy might have significantly increased the chances for successful implementation. Even though the program now has a highly uncertain future, suggestions are offered for policy learning and change that may increase the probability of success

  4. Public perceptions of planning objectives for regional level management of wild reindeer in Norway

    OpenAIRE

    Kaltenborn, Bjørn Petter; Hongslo, Eirin; Gundersen, Vegard; Andersen, Oddgeir

    2015-01-01

    We examined community perceptions of preferred objectives for wild reindeer management in Southern Norway as the former population-based model is being replaced with an area-based, multi-level regional management model spanning large mountain regions. Communally oriented objectives are favoured over economic benefits to landowners. Environmental attitudes discriminate on many of the issues and can be useful factors in sorting out levels of support for proposed management actions and compromis...

  5. The Correlation Of Knowledge And Education Level Of The Patients With The Gastritis Incident At Sindangbarang Public Health Center Cianjur

    Directory of Open Access Journals (Sweden)

    Drs. Oktoruddin Harun

    2017-02-01

    Full Text Available Gastritis is usually regarded as a thing paltry but gastritis was the beginning of a a disease that can be big problem for us. Based on the previous research at Public Health Center sindangbarang cianjur District were found scene gastritis from 10 patients 7 had less knowledgeable 1 respondents had knowledge cased and 2 respondents had good of knowledge. It is suspected that the incidence of gastritis has to do with knowledge and education level of the patients. The purpose of this research is to identify corelation betwen knowledge and education level of the patients outpatient with the gastritis at Public Health Center sindangbarang cianjur District. Research methodology used survey analytic correlative with design cross sectional .Data analyzed by univariat and bivariat with statistics chi square test. Population in this research were out patients Public Health Center sindangbarag. The sample 120 respondents with total of sampling. The results of the study were corelation knowledge of to gastritis incident based on the analysis of bivariat by using test chi-square computerized the results of statistical corel tests obtained p value 0.013 0.05 so H0 rejected. While relations education level with the gastritis incident based on the results of the analysis bivariat test chi-square use computerized obtained the results of statistical tests obtained p value 0.0001 0.05 so H0 rejected it could be concluded a significant between knowledge and the level of education with the gastritis incident corelation at Public Health Center sindangbarang cianjur District it is advised that need to effort to promotional and preventive especially with regard to knowledge of gastritis as information about gastritis and counseling on a preventive manner gastritis that can reduce or prevent disease gastritis.

  6. Public services on a district level. The environment closer to the people. More sustainability or not?

    International Nuclear Information System (INIS)

    De Boer, J.; Van Drunen, M.A.; Lammers, P.E.M.; Olsthoorn, A.A.

    2000-01-01

    One way to stimulate households in the Netherlands socially, culturally and economically is to provide them with technological services and tools that are economically and ecologically sound and contribute to sustainability. Every technological service or tool has social, cultural and economical stimuli. However, those incentives are not used systematically in the present Dutch environmental policy. Therefore, an important question in this study is whether those incentives can be used such that they can contribute to sustainability more than the performance level of the technology. In this study special attention is paid to the level on which the services and tools for households in a specific district are organized and provided and how it can contribute to sustainability. In chapter 2 the incentives for sustainable behavior of households are described. In chapter 3 three scenarios are introduced in which the district level is explained by comparing them with two other levels: the micro-level (per households) and the macro-level (per province, national, international). In chapter 4 the expectations with respect to the services and tools and sustainability for the three scenarios are evaluated. Examples of experiments and case studies are spread over the report. 61 refs

  7. Determinants and impacts of public agricultural research in Japan: Product level evidence on agricultural Kosetsushi

    Science.gov (United States)

    Fukugawa, Nobuya

    2017-12-01

    The public sector is an important source of agricultural research as the agricultural sector in many countries consists of a number of individual farmers who have difficulty in bearing the cost of research and development. Public institutes for testing and research called Kosetsushi help agriculture and manufacturing improve labor productivity through technology transfer activities, whereby constituting an important component of regional innovation systems in Japan. This study establishes panel data of agricultural Kosetsushi and examines whether their research activities are responsive to local needs and which type of research effort is conducive to the promotion of agricultural product innovations. Estimation results reveal variations across plants in the impacts of agricultural clusters on research on the plant conducted by Kosetsushi located in the cluster. A positive impact is observed only for vegetable while negative or statistically insignificant relationships are found for rice, fruit, and flower. The impact of research on plant breeding on agricultural product innovations also varies across plants. Policy implications of the major findings are discussed.

  8. Study on Public Exposure and External Radiation Level at Gamma Green House and around MINT Dengkil Complex Boarder

    International Nuclear Information System (INIS)

    Faizal Azrin Abdul Razalim; Ismail Sulaiman; Khairuddin Mohamad Kontol; Ahmad Bazlie Abdul Kadir; Noor Fadilla Ismail; Hassan Sham; Ahmad Zainuri Mohd Dzomir

    2014-01-01

    This paper will discussing on the measurement of external radiation and the dose level which is acceptable to the public around the Gamma Green House and the border between Malaysian Nuclear Agency and housing project developed by Mah Sing Group. This research is made to verify the level of safety, especially for civilians residing in this area and to ensure compliance with the limit that has been set by the authorities, AELB (BSS/2010). Measurement method used in this research by using survey meter, TLD and OSL. (author)

  9. [Change of secondhand smoke levels in a public hospital in Budapest after implementation of anti-smoking policy in 2011].

    Science.gov (United States)

    Tárnoki, Dávid László; Tárnoki, Adám Domonkos; Csáthy, László; Travers, Mark J

    2013-04-28

    Our previous 2009 study demonstrated high secondhand smoke levels throughout a public hospital in Budapest. To compare changes in indoor air pollution level between 2009 and 2012, before and after the Hungarian anti-smoking policy legislation adopted in 2011. TSI SidePak AM510 Personal Aerosol Monitor was used. In-patient care department PM2.5 levels declined by 92% from 87.7 μg/m3 to 6.9 μg/m3. Non-patient care area PM2.5 level increased by 67% from 64.8 μg/m3 to 108.0 μg/m3. The increase was driven entirely by a large increase in the level in public toilets. Excluding these, there was a 83% drop in PM2.5 in non-patient care areas from 64.8 μg/m3 to 11.1 μg/m3. PM2.5 decreased significantly due to the 2011 law. However, smoking still occurred in the hospital, albeit in less frequently visited areas. A stricter enforcement of this beneficial law is needed to reach a comprehensive smoke-free hospital environment.

  10. Noise level in intensive care units of a public university hospital in Santa Marta (Colombia).

    Science.gov (United States)

    Garrido Galindo, A P; Camargo Caicedo, Y; Vélez-Pereira, A M

    2016-10-01

    To evaluate the noise level in adult, pediatric and neonatal intensive care units of a university hospital in the city of Santa Marta (Colombia). A descriptive, observational, non-interventional study with follow-up over time was carried out. Continuous sampling was conducted for 20 days for each unit using a type i sound level meter, filter frequency in A weighting and Fast mode. We recorded the maximum values, the 90th percentile as background noise, and the continuous noise level. The mean hourly levels in the adult unit varied between 57.40±1.14-63.47±2.13dBA, with a maximum between 71.55±2.32-77.22±1.94dBA, and a background noise between 53.51±1.16-60.26±2.10dBA; in the pediatric unit the mean hourly levels varied between 57.07±3.07-65.72±2.46dBA, with a maximum of 68.69±3.57-79.06±2.34dBA, and a background noise between 53.33±3.54-61.96±2.85dBA; the neonatal unit in turn presented mean hourly values between 59.54±2.41-65.33±1.77dBA, with a maximum value between 67.20±2.13-77.65±3.74dBA, and a background noise between 55.02±2.03-58.70±1.95dBA. Analysis of variance revealed a significant difference between the hourly values and between the different units, with the time of day exhibiting a greater influence. The type of unit affects the noise levels in intensive care units, the pediatric unit showing the highest values and the adult unit the lowest values. However, the parameter exerting the greatest influence upon noise level is the time of day, with higher levels in the morning and evening, and lower levels at night and in the early morning. Copyright © 2015 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

  11. Relationship between the public's belief in recovery, level of mental illness stigma, and previous contact.

    Science.gov (United States)

    Barczyk, Amanda N

    2015-01-01

    Disbelief exits that individuals who have a mental health condition are able to recover and fully function in life. This study analyzed 1,437 adults from the 2006 General Social Survey. Structural equation modeling (1) examined the relationship between respondents' level of prejudicial attitudes and social distance (i.e., stigma) toward individuals who have a mental health condition and their belief in the potential of recovery (2) tested whether previous contact with an individual who received treatment was a mediator. Findings indicated that the belief in recovery led to lower levels of social distance. Prejudicial attitudes were found to be a predictor of one's level of social distance. Previous contact was not a mediator however; males, minorities and those with less education were less likely to have had previous contact. Results indicated a need to emphasize the probability of recovering from a mental health condition when developing target-specific stigma reducing strategies.

  12. Blood lead level studies by the Public Health Service in an industrial stress area

    Energy Technology Data Exchange (ETDEWEB)

    Jantzen, G.

    1981-12-01

    The general directions of the European Community concerning lead resulted to be useful for analysing the biologic impact on the population living in an industrial immission area and for differentiating within this locality affected and non-affected residential districts. Consequently the social-hygienic and regional-hygienic measures are limited and justified territorially. The environmental parameters, their relation to the distance at which an industrial plant is situated and the blood lead values are indicated. Recommendations are given, which concern the protection of health and even the reconstruction of the residential area by immission-reducing measures. It was found that the lead impact on children is higher than that on grown-ups. Tables illustrate the symptomatology of lead impacts, its relation to blood lead concentration, the degree of impact measured in children and grown-ups and the corresponding necessary measures as auxiliary methods for the Public Health Service and the physicians.

  13. Serum lead levels in civil servicemen and public transport drivers in ...

    African Journals Online (AJOL)

    Background: The risk of exposure to lead varies significantly with source and exposure rates. Short-term exposure to high levels of lead can cause clinical symptoms starting from vomiting and ending with coma, even death. Objective: To describe the prevalence of occupational exposure with lead (Pb) health hazard in ...

  14. 78 FR 52116 - Request for Public Comment on a Review Level Alternative Dispute Resolution Program

    Science.gov (United States)

    2013-08-22

    .... Department of Labor's Occupational Safety and Health Administration (``OSHA'') at the trial level before an... and voluntary procedures to promote case settlement. Under the program, an administrative law judge acts as a settlement judge and oversees the ADR process. If a case does not settle, an administrative...

  15. Cost of delivering secondary-level health care services through public sector district hospitals in India

    Directory of Open Access Journals (Sweden)

    Shankar Prinja

    2017-01-01

    Interpretation & conclusions: The estimates obtained in our study can be used for Fiscal planning of scaling up secondary-level health services. Further, these may be particularly useful for future research such as benefit-incidence analysis, cost-effectiveness analysis and national health accounts including disease-specific accounts in India.

  16. The role of public involvement in managing political conflict: A comparative case study of public involvement activities in siting low-level radioactive waste disposal facilities

    International Nuclear Information System (INIS)

    Tzoumis, K.A.

    1992-01-01

    A model of political conflict based on the components of scope, intensity and visibility is used to rank the degree of conflict for states hosting a low-level radioactive waste facility in the US. Data were gathered from sixty-five telephone interviews and comparisons made with ten national experts. Public involvement and compensation packages (reviewed in Chapter IV) to be potential conflict management tools for practitioners. The role of the governor and the complexity of the siting process are two additional factors that are important in escalating a conflict. Technical factors of complexity and source of the waste along with the past performance of the company handling the facility have no link to conflict. Conflict escalation is proposed as a means towards understanding the agenda-building process

  17. OPG's deep geologic repository for low and intermediate level waste - public participation and aboriginal engagement

    International Nuclear Information System (INIS)

    Wilson, M.

    2011-01-01

    Ontario Power Generation (OPG)'s Public Participation and Aboriginal Engagement Program for the proposed Deep Geologic Repository (DGR) for low and intermediate level waste (L and ILW) began with the signing of a Memorandum of Understanding (MOU) in 2002 between OPG and the Municipality of Kincardine. The MOU set out the terms under which the two parties would jointly study the feasibility of different options for the long-term management of L and ILW at the Bruce nuclear site. A consultant, independent from both the Municipality of Kincardine and OPG, was retained to manage the assessment of options as well as a communication plan to ensure the public and Aboriginal peoples were kept apprised of all activities associated with the MOU. This early commitment to transparency and openness, with its ensuing opportunities for the public and Aboriginal peoples to become informed, ask questions, and engage in meaningful two-way dialogue about the early assessment of options, established the foundation and later became the hallmark of the DGR Project's Public Participation and Aboriginal Engagement program. This paper provides an overview of the development, nature and results of that program as it has evolved through the early investigative stages of options and through the environmental assessment and licencing process for the proposed DGR Project. (author)

  18. Interactional Strategies Used by Low Level Learners in Public Speaking Class

    Directory of Open Access Journals (Sweden)

    Yuli Astutik

    2017-10-01

    Full Text Available This research article described the interactional strategies used by low learners in public speaking class. A qualitative study on whether or not low learners used the aspects of interactional strategies was the main focus. This paper also aimed to know what aspects mostly used and the factors that cause this problem. Observing and interviewing to six subjects regarding on the use of interactional strategies: exemplification, confirmation checks, comprehension checks, repetition, clarification requests, repetition requests, exemplification requests, and assistance appeal were carried out. Finding indicated that from six low learners, only two who did not apply interactional strategies in all situations. Four students have applied 3 – 4 interactional strategies in the case they were as the speaker. In another side, when they were the listeners, they did not apply the interactional strategies. The result showed that repetition was the interactional strategy mostly used by low learners. Nevertheless, the reason of using it was not proper reason. The further finding indicated some factors cause low learners did not use four interactional strategies such as fluency, grammar, lack of vocabulary and pronunciation in addition to the English practice merely in the formal situation.

  19. IRIS Toxicological Review of Ethyl Tertiary Butyl Ether (ETBE) (Interagency Science Consultation Draft)

    Science.gov (United States)

    In September 2016, EPA released the draft IRIS Toxicological Review of Ethyl Tertiary Butyl Ether (ETBE) for public comment and discussion. The draft assessment was reviewed internally by EPA and by other federal agencies and White House Offices before public release. Consistent ...

  20. Cameroon mid-level providers offer a promising public health dentistry model

    Directory of Open Access Journals (Sweden)

    Achembong Leo

    2012-11-01

    Full Text Available Background Oral health services are inadequate and unevenly distributed in many developing countries, particularly those in sub-Saharan Africa. Rural areas in these countries and poorer sections of the population in urban areas often do not have access to oral health services mainly because of a significant shortage of dentists and the high costs of care. We reviewed Cameroon’s experience with deploying a mid-level cadre of oral health professionals and the feasibility of establishing a more formal and predictable role for these health workers. We anticipate that a task-shifting approach in the provision of dental care will significantly improve the uneven distribution of oral health services particularly in the rural areas of Cameroon, which is currently served by only 3% of the total number of dentists. Methods The setting of this study was the Cameroon Baptist Convention Health Board (BCHB, which has four dentists and 42 mid-level providers. De-identified data were collected manually from the registries of 10 Baptist Convention clinics located in six of Cameroon’s 10 regions and then entered into an Excel format before importing into STATA. A retrospective abstraction of all entries for patient visits starting October 2010, and going back in time until 1500 visits were extracted from each clinic. Results This study showed that mid-level providers in BCHB clinics are offering a full scope of dental work across the 10 clinics, with the exception of treatment for major facial injuries. Mid-level providers alone performed 93.5% of all extractions, 87.5% of all fillings, 96.5% of all root canals, 97.5% of all cleanings, and 98.1% of all dentures. The dentists also typically played a teaching role in training the mid-level providers. Conclusions The Ministry of Health in Cameroon has an opportunity to learn from the BCHB model to expand access to oral health care across the country. This study shows the benefits of using a simple, workable, low

  1. Is wealthier always healthier? The impact of national income level, inequality, and poverty on public health in Latin America.

    Science.gov (United States)

    Biggs, Brian; King, Lawrence; Basu, Sanjay; Stuckler, David

    2010-07-01

    Despite findings indicating that both national income level and income inequality are each determinants of public health, few have studied how national income level, poverty and inequality interact with each other to influence public health outcomes. We analyzed the relationship between gross domestic product (GDP) per capita in purchasing power parity, extreme poverty rates, the gini coefficient for personal income and three common measures of public health: life expectancy, infant mortality rates, and tuberculosis (TB) mortality rates. Introducing poverty and inequality as modifying factors, we then assessed whether the relationship between GDP and health differed during times of increasing, decreasing, and decreasing or constant poverty and inequality. Data were taken from twenty-two Latin American countries from 1960 to 2007 from the December 2008 World Bank World Development Indicators, World Health Organization Global Tuberculosis Database 2008, and the Socio-Economic Database for Latin America and the Caribbean. Consistent with previous studies, we found increases in GDP have a sizable positive impact on population health. However, the strength of the relationship is powerfully influenced by changing levels of poverty and inequality. When poverty was increasing, greater GDP had no significant effect on life expectancy or TB mortality, and only led to a small reduction in infant mortality rates. When inequality was rising, greater GDP had only a modest effect on life expectancy and infant mortality rates, and no effect on TB mortality rates. In sharp contrast, during times of decreasing or constant poverty and inequality, there was a very strong relationship between increasing GDP and higher life expectancy and lower TB and infant mortality rates. Finally, inequality and poverty were found to exert independent, substantial effects on the relationship between national income level and health. Wealthier is indeed healthier, but how much healthier depends on how

  2. Feasibility and utility of mapping disease risk at the neighbourhood level within a Canadian public health unit: an ecological study

    Directory of Open Access Journals (Sweden)

    Wanigaratne Susitha

    2010-05-01

    Full Text Available Abstract Background We conducted spatial analyses to determine the geographic variation of cancer at the neighbourhood level (dissemination areas or DAs within the area of a single Ontario public health unit, Wellington-Dufferin-Guelph, covering a population of 238,326 inhabitants. Cancer incidence data between 1999 and 2003 were obtained from the Ontario Cancer Registry and were geocoded down to the level of DA using the enhanced Postal Code Conversion File. The 2001 Census of Canada provided information on the size and age-sex structure of the population at the DA level, in addition to information about selected census covariates, such as average neighbourhood income. Results Age standardized incidence ratios for cancer and the prevalence of census covariates were calculated for each of 331 dissemination areas in Wellington-Dufferin-Guelph. The standardized incidence ratios (SIR for cancer varied dramatically across the dissemination areas. However, application of the Moran's I statistic, a popular index of spatial autocorrelation, suggested significant spatial patterns for only two cancers, lung and prostate, both in males (p Conclusion This paper demonstrates the feasibility and utility of a systematic approach to identifying neighbourhoods, within the area served by a public health unit, that have significantly higher risks of cancer. This exploratory, ecologic study suggests several hypotheses for these spatial patterns that warrant further investigations. To the best of our knowledge, this is the first Canadian study published in the peer-reviewed literature estimating the risk of relatively rare public health outcomes at a very small areal level, namely dissemination areas.

  3. Promoting social responsibility for health: health impact assessment and healthy public policy at the community level.

    Science.gov (United States)

    Mittelmark, M B

    2001-09-01

    The 1997 Jakarta Declaration on Health Promotion into the 21st Century called for new responses to address the emerging threats to health. The declaration placed a high priority on promoting social responsibility for health, and it identified equity-focused health impact assessment as a high priority for action. This theme was among the foci at the 2000 Fifth Global Conference on Health Promotion held in Mexico. This paper, which is an abbreviation of a technical report prepared for the Mexico conference, advances arguments for focusing on health impact assessment at the local level. Health impact assessment identifies negative health impacts that call for policy responses, and identifies and encourages practices and policies that promote health. Health impact assessment may be highly technical and require sophisticated technology and expertise. But it can also be a simple, highly practical process, accessible to ordinary people, and one that helps a community come to grips with local circumstances that need changing for better health. To illustrate the possibilities, this paper presents a case study, the People Assessing Their Health (PATH) project from Eastern Nova Scotia, Canada. It places ordinary citizens, rather than community elites, at the very heart of local decision-making. Evidence from PATH demonstrates that low technology health impact assessment, done by and for local people, can shift thinking beyond the illness problems of individuals. It can bring into consideration, instead, how programmes and policies support or weaken community health, and illuminate a community's capacity to improve local circumstances for better health. This stands in contrast to evidence that highly technological approaches to community-level health impact assessment can be self-defeating. Further development of simple, people-centred, low technology approaches to health impact assessment at the local level is called for.

  4. Implementation of laser technology and treatment at county level in the Swedish Public Dental Service.

    Science.gov (United States)

    Bergholm, Åsa; Östberg, Anna-Lena; Gabre, Pia

    2014-01-01

    The aim of this study was to obtain an understanding of the factors that affected the way new technology and methods were used in dentistry after a training program. A qualitative research method was used to collect data. Nine dentists working in the Public Dental Service (PDS) in Uppsala County in Sweden agreed to be interviewed in the study. They worked in five different clinics, all with laser equipment, and had received training in the use of lasers. The interviews were tape recorded and transcribed, and were analysed using manifest and latent qualitative content analysis. The categories in this study were identified as "Prerequisites and obstacles to imple- mentation", "Attitudes to laser technology and treatments" and "Laser technology in the future'". The dentists described working with lasers as complicated and problematic. They had concerns about the method relating to the working environment, evidence of efficacy of treatment, costs, and benefits for patients and dentists. The main finding was that the decision to adopt the technology seemed to be based on individual perceptions of the value of lasers compared to other ways of achieving the same goal. They provided uniform proposals regarding how an organization should implement new methods, including an emphasis on the importance of preparation and having opportunities to be able to test and evaluate the technology. Another important factor was support from surrounding staff, colleagues and management. Despite all the barriers, the respondents were positive about working with lasers in the future, mainly due to their belief that patients would demand laser treatment. In conclusion both individual and organizational factors affected the extent to which the respondents used the laser. The main finding was the individual perception of the value of lasers compared to other methods which could achieve the same goal.

  5. Siting low-level radioactive waste disposal facilities: The public policy dilemma

    International Nuclear Information System (INIS)

    English, M.R.

    1993-01-01

    The book's focus is on one overwhelming problems facing the compacts and states: figuring out where low-level waste disposal sites should be located. The author discusses the central issues underlying this dilemma - authority, trust, risk, justice - and the roles each plays in determining whether the siting processes are regarded as legitimate. The structure of the book provides a mix of narrative, fact and philosophy and adds to the body of well researched information saying that is is not only right but more efficient to develop and implement a just process

  6. Intranet and village community: optimization of public service based on electronic government at the local level

    Science.gov (United States)

    Pradana, G. W.; Fanida, E. H.; Niswah, F.

    2018-01-01

    The demand for good governance is directed towards the realization of efficiency, effectiveness, and clean government. The move is demonstrated through national and regional levels to develop and implement electronic government concepts. Through the development of electronic government is done structuring management systems and work processes in the government environment by optimizing the utilization of information technology. One of the real forms of electronic government (e-Gov) implementation at the local level is the Intranet Sub-District program in Sukodono Sub-District, Sidoarjo. Intranet Sub-District is an innovation whose purpose is to realize the availability of information on the utilization of management, distribution, and storage of official scripts, and also the optimal delivery of information and communication in the implementation of guidance and supervision of local administration. The type of this paper is descriptive with a qualitative approach and focus on the implementation of the Intranet District Program in Sukodono District, Sidoarjo. The findings of the study are the limited number of human resources who have mastered ICT, the uneven network, the adequacy of institutional needs and the existence of budget support from the authorized institution and the information system has not accommodated all the service needs.

  7. Ten years of energy consumption in the tertiary sector

    International Nuclear Information System (INIS)

    Rabai, Yacine

    2012-11-01

    This document presents and comments data regarding electricity consumption by the tertiary sector over the last ten years in France. It notably outlines its strong increase compared to the other sectors (housing, industry, transport, agriculture). It comments the evolution of the energy mix of the tertiary sector (electricity with 47%, gas with 25% and oil with 19% are prevailing). It briefly comments the evolution of energy efficiency within this sector. It indicates and comments the shares of energy consumption, of high voltage electricity and gas consumption by the different sub-sectors (retail, automobile and motorcycle repair, public administration, health and social activity, real estate, specialised, scientific and technical activities, education, and so on)

  8. Patient and public attitudes towards informed consent models and levels of awareness of Electronic Health Records in the UK

    Science.gov (United States)

    Riordan, Fiona; Papoutsi, Chrysanthi; Reed, Julie E.; Marston, Cicely; Bell, Derek; Majeed, Azeem

    2015-01-01

    Background The development of Electronic Health Records (EHRs) forms an integral part of the information strategy for the National Health Service (NHS) in the UK, with the aim of facilitating health information exchange for patient care and secondary use, including research and healthcare planning. Implementing EHR systems requires an understanding of patient expectations for consent mechanisms and consideration of public awareness towards information sharing as might be made possible through integrated EHRs across primary and secondary health providers. Objectives To explore levels of public awareness about EHRs and to examine attitudes towards different consent models with respect to sharing identifiable and de-identified records for healthcare provision, research and planning. Methods A cross-sectional questionnaire survey was administered to adult patients and members of the public in primary and secondary care clinics in West London, UK in 2011. In total, 5331 individuals participated in the survey, and 3157 were included in the final analysis. Results The majority (91%) of respondents expected to be explicitly asked for consent for their identifiable records to be accessed for health provision, research or planning. Half the respondents (49%) did not expect to be asked for consent before their de-identified records were accessed. Compared with White British respondents, those from all other ethnic groups were more likely to anticipate their permission would be obtained before their de-identified records were used. Of the study population, 59% reported already being aware of EHRs before the survey. Older respondents and individuals with complex patterns of interaction with healthcare services were more likely to report prior awareness of EHRs. Individuals self-identifying as belonging to ethnic groups other than White British, and those with lower educational qualifications were less likely to report being aware of EHRs than White British respondents and

  9. Indoor air pollution levels in public buildings in Thailand and exposure assessment.

    Science.gov (United States)

    Klinmalee, Aungsiri; Srimongkol, Kasama; Kim Oanh, Nguyen Thi

    2009-09-01

    Levels of pollutants including PM2.5 and PM2.5 composition (black carbon and water soluble ions), SO(2), NO(2), CO, CO(2), and BTEX (benzene, toluene, ethylbenzene, xylene) were monitored for indoor and outdoor air at a university campus and a shopping center, both located in the Northern suburb of Bangkok. Sampling was done during December 2005-February 2006 on both weekdays and weekends. At the university, indoor monitoring was done in two different air conditioned classrooms which shows the I/O ratios for all pollutants to be below 0.5-0.8 during the weekends. However, on weekdays the ratios for CO(2) and most detected BTEX were above 1.0. The concept of classroom occupancy was defined using a function of the student number in a lecture hour and the number of lecture hours per day. Classroom 2, which had a higher occupancy than classroom 1, was characterized by higher concentrations of most pollutants. PM2.5 was an exception and was higher in classroom 1 (37 microg/m(3), weekdays) as compared to classroom 2 (26 microg/m(3), weekdays) which was likely linked to the dust resuspension from the carpeted floor in the former. Monitoring was also done in the shopping mall at three different sites. Indoor pollutants levels and the I/O ratios at the shopping mall were higher than at the university. Levels of all pollutants measured at the car park, except for toluene and CO(2), were the highest. I/O ratios of the pollutants at the mall were above 1.0, which indicates the relatively higher influence of the indoor sources. However, the black carbon content in PM2.5 outdoor is higher than indoor, which suggest the important contribution from outdoor combustion sources such as the traffic. Major sources of outdoor air pollution in the areas were briefly discussed. Exposure modeling was applied using the time activity and measured pollutant concentrations to assess the exposure of different groups of people in the study areas. High exposure to PM2.5, especially for the people

  10. Prevalence of carbapenem resistant Enterobacteriaceae from a tertiary care hospital in Mumbai, India

    Directory of Open Access Journals (Sweden)

    Pravin K. Nair

    2013-12-01

    Full Text Available Objective: The emergence of Carbapenem Resistant Enterobacteriaceae (CRE in recent times has become a serious threat to public health due to the high mortality, potential dissemination rates and limited treatment options associated with these organisms. Thus, the present study was conducted in our tertiary care hospital in Mumbai, to retrospectively analyze the prevalence of CRE in the hospital. Methods: The study was carried out in the microbiology department of the tertiary care hospital over a period of 12 months. The samples tested were clinical samples from hospitalized and Out-Patient Department (OPD patients sent to the department for microbiological testing. CRE isolates were identified using the Vitek 2- Compact system (BioMérieux, France. Results: A CRE prevalence rate of 12.26% was obtained from the study, from which the majority of the isolates were detected in urine samples (46%. Although most of the CRE isolates were detected in patient samples from the wards (42% and the ICU (26%, a significant number of isolates was also detected from the OPD patients (19%. Conclusion:Thus, the study shows a significant rate of carbapenem resistance among Enterobacteriaceae isolated from hospitalized and OPD patients. This emphasizes the urgent need for CRE control at the hospital and community level, and to rationalize the use of antibiotics. J Microbiol Infect Dis 2013;3(4: 207-210

  11. Legal issues in the harmonization of different levels of public authority in Russia: The case of natural resource development

    Energy Technology Data Exchange (ETDEWEB)

    Borodach, M. V; Keeping, J.

    2002-03-31

    One of the key challenges faced by policy makers in Russia is working out a reasonable division of responsibilities between the central government -- the government of the Russian Federation -- and the various political units which comprise the country. Unfortunately, the 1993 Constitution is not in all respects clear on division of powers and responsibilities. As a result, many inter-jurisdictional questions arise that unless resolved, will have incalculable impact on the development of Russia's natural resources. This article discusses some of the factors that must be considered in addressing the total harmonization of powers of the various levels of authority in Russia which have a bearing on the development of subsoil resources. These include: (1) clarification of powers possessed by different levels of public authority in the Russian federation with regard to subsoil resources; (2) mechanisms for harmonizing the powers of the various levels of public authority in Russia, (3) special features of the political organization of the Tyumen region, Russia's most important oil and gas producing area, and (4) the role of new political and territorial units in the system of Russian federalism. 6 end-notes.

  12. Development of a structural model to analyze public opinion on a high-level radioactive waste facility

    International Nuclear Information System (INIS)

    Flynn, J.; Slovic, P.; Mertz, C.K.; Burns, W.

    1991-01-01

    Studies show that Nevada residents and state officials oppose the proposed high-level radioactive waste repository project at Yucca Mountain. Nevada residents view the Yucca Mountain repository as having extremely high risk; nuclear experts, in contrast, feel the risks are very low. These experts have suggested that public risk perceptions may be reduced by better program management, increased trust in the federal government, and/or by increased benefits and compensation for accepting a repository. The model described in this paper is designed to examine the relationship between risk perception and various strategies for risk management using a confirmatory multivariate method known as covariance structure analysis

  13. Choosing wisely after publication of level I evidence in breast cancer radiotherapy.

    Science.gov (United States)

    Niska, Joshua R; Keole, Sameer R; Pockaj, Barbara A; Halyard, Michele Y; Patel, Samir H; Northfelt, Donald W; Gray, Richard J; Wasif, Nabil; Vargas, Carlos E; Wong, William W

    2018-01-01

    Recent trials in early-stage breast cancer support hypofractionated whole-breast radiotherapy (WBRT) as part of breast-conserving therapy (BCT). Evidence also suggests that radiotherapy (RT) omission may be reasonable for some patients over 70 years. Among radiation-delivery techniques, intensity-modulated RT (IMRT) is more expensive than 3-dimensional conformal RT (3DCRT). Based on this evidence, in 2013, the American Society for Radiation Oncology (ASTRO) recommended hypofractionated schedules for women aged ≥50 years with early-stage breast cancer and avoiding routine use of IMRT for WBRT. To assess response to level I evidence and adherence to ASTRO recommendations, we evaluated the pattern of RT use for early-stage breast cancer at our National Comprehensive Cancer Network institution from 2006 to 2008 and 2011 to 2013 and compared the results with national trends. Data from a prospective database were extracted to include patients treated with BCT, aged ≥50 years, with histologic findings of invasive ductal carcinoma, stage T1-T2N0M0, estrogen receptor-positive, and HER2 normal. We retrospectively reviewed the medical records and estimated costs based on 2016 Hospital Outpatient Prospective Payment System (technical fees) and Medicare Physician Fee Schedule (professional fees). Among 55 cases from 2006 to 2008, treatment regimens were 11% hypofractionated, 69% traditional schedule, and 20% RT omission (29% of patients were aged >70 years). Among 83 cases from 2011 to 2013, treatment regimens were 54% hypofractionated, 19% traditional schedule, and 27% RT omission (48% of patients were aged >70 years). 3DCRT was used for all WBRT treatments. Direct medical cost estimates were as follows: 15 fractions 3DCRT, $7,197.87; 15 fractions IMRT, $11,232.33; 25 fractions 3DCRT, $9,731.39; and 25 fractions IMRT, $16,877.45. Despite apparent resistance to shorter radiation schedules in the United States, we demonstrate that rapid practice change in response to level I

  14. Choosing wisely after publication of level I evidence in breast cancer radiotherapy

    Directory of Open Access Journals (Sweden)

    Niska JR

    2018-02-01

    Full Text Available Joshua R Niska,1 Sameer R Keole,1 Barbara A Pockaj,2 Michele Y Halyard,1 Samir H Patel,1 Donald W Northfelt,3 Richard J Gray,2 Nabil Wasif,2 Carlos E Vargas,1 William W Wong1 1Department of Radiation Oncology, 2Division of General Surgery, 3Division of Hematology and Medical Oncology, Mayo Clinic Hospital, Phoenix, AZ, USA Background: Recent trials in early-stage breast cancer support hypofractionated whole-breast radiotherapy (WBRT as part of breast-conserving therapy (BCT. Evidence also suggests that radiotherapy (RT omission may be reasonable for some patients over 70 years. Among radiation-delivery techniques, intensity-modulated RT (IMRT is more expensive than 3-dimensional conformal RT (3DCRT. Based on this evidence, in 2013, the American Society for Radiation Oncology (ASTRO recommended hypofractionated schedules for women aged ≥50 years with early-stage breast cancer and avoiding routine use of IMRT for WBRT. To assess response to level I evidence and adherence to ASTRO recommendations, we evaluated the pattern of RT use for early-stage breast cancer at our National Comprehensive Cancer Network institution from 2006 to 2008 and 2011 to 2013 and compared the results with national trends. Methods: Data from a prospective database were extracted to include patients treated with BCT, aged ≥50 years, with histologic findings of invasive ductal carcinoma, stage T1-T2N0M0, estrogen receptor-positive, and HER2 normal. We retrospectively reviewed the medical records and estimated costs based on 2016 Hospital Outpatient Prospective Payment System (technical fees and Medicare Physician Fee Schedule (professional fees. Results: Among 55 cases from 2006 to 2008, treatment regimens were 11% hypofractionated, 69% traditional schedule, and 20% RT omission (29% of patients were aged >70 years. Among 83 cases from 2011 to 2013, treatment regimens were 54% hypofractionated, 19% traditional schedule, and 27% RT omission (48% of patients were aged >70

  15. Necessary contents of public outreach for high level radioactive waste disposal

    International Nuclear Information System (INIS)

    Kanzaki, Noriko; Okamoto, Koji

    2011-01-01

    Nuclear power generation is one of the solutions for global warming. However, the nuclear power generation technology can not be completed unless the disposal method of the radioactive waste is decided. Various actions are performed about the High Level Radioactive Waste (HLW) disposal in particular in each country. However, planning of HLW disposal site was not successful, except Finland and Sweden. In Japan, geological disposal of HLW was selected. The operating body and the capital management body are also decided. Up to the present, no municipality apply the disposal site candidate. An important social element for HLW disposal is careful explanation and communication for municipality. For this purpose, a symposium to explain necessity of HLW is held in each district in Japan. The symposium is not successful, because of lack of carefulness to local situation considered. In this study, we evaluates the questionnaire by the symposium attendee to extract the idea and requests by the local people. With these questionnaire, the responsibility of the government should be more enhanced. Also, the detail answer to the people's questions are needed. Using these knowledge, the HLW disposal social acceptance has been discussed. (author)

  16. Measuring the level of public understanding of total solar eclipse from the mass media: Palembang as sample

    Science.gov (United States)

    Purwati, F. G.; Ekawanti, N.; Luthfiandari; Premadi, P. W.

    2016-11-01

    The Total Solar Eclipse (TSE) on the 9th March 2016 received a huge attention from the mass media. Some of them intensively write articles about it even months before the TSE day. As we know media plays strategic role not only in raising public awareness but also interest. The aim of this project is to study the relation between the number of accesses to the media information and how well public learned the information delivered by the media. We prepared questionnaire consisting of seven semi-multiple choices on how public got information about TSE. We gave them choices of what they had heard to measure their basic understanding of TSE. Furthermore we add two “wrong” choices in the last questions to identify less serious respondents. We analyze 60 respondents of Palembang who visited Ampera bridge area. Our result shows no correlation between the number of information access and the level of understanding about TSE. We also found that local media did not provide the scientific content of TSE as well as the national media.

  17. Deriving staff and public doses in a PET/CT facility from measured radiation levels using thermoluminescent dosimetry

    International Nuclear Information System (INIS)

    Al-Haj, A. N.; Lobriguito, A. M.; Arafah, A.; Parker, R.

    2011-01-01

    The introduction of PET/CT at King Faisal Specialist Hospital and Research Centre for whole body and brain imaging has become favourable for diagnosis of cancer. There is no data available on the PET/CT dose to staff and members of the public for different activities of 18 F [fluorodeoxyglucose (FDG)] and for longer patient holding time. The study aims to determine and evaluate staff and public doses by using thermoluminescent dosemeters monthly readings for a 7-month deployment period and by using direct measurements of dose rates at 30 cm and 1 m distances from the patients after injection. The whole body doses per procedure and per administered activity of 18 F (FDG) were estimated. A dose map inside the PET/CT was generated to provide information of the dose levels in different locations. The Pearson correlation showed a strong correlation (r 2 = 0.71) between the dose per activity and the number of patients. Optimisation of radiation protection of staff and members of the public was investigated and recommendations were given. (authors)

  18. Burden of diabetes mellitus attributable to demographic levels in Qatar: an emerging public health problem.

    Science.gov (United States)

    Bener, Abdulbari; Kim, Eun-Jung; Mutlu, Fatih; Eliyan, Afnan; Delghan, Hamsa; Nofal, Enas; Shalabi, Luma; Wadi, Nada

    2014-01-01

    Diabetes is one of the main contributors to ill health and premature mortality worldwide and its prevalence has been rising during the last decades. The aim of the present study was to quantify the burden of disease in terms of deaths and loss of healthy life years (DALYs) attributed to diabetes by its demographic levels in the State of Qatar. The methods were largely based on the established Global Burden of Disease methodology and use the burden of disease in terms of disability adjusted life years (DALYs) and the years lost due to disability (YLD) as the outcome measure. We calculated years lost due to disability (YLD) and years life lost (YLL) attributable to diabetes. The study was conducted during the period from June 2013 to January 2014. The study findings revealed that disability adjusted life years (DALYs) has been increasing across the years and reached to 4.35 in 2011 from 2.58 in 2007. DALYs for men was remarkably higher than women during the period (2007-2011). Diabetes mellitus was the 6th leading cause of disease burden in Qatar (3.8%). The YLD showed a sharp increase in men (2.52 in 2011 from 1.34 in 2007) and women (1.05 in 2011 from 0.33 in 2007) during the year 2011. YLL portion of women enlarged considerably in 2011 (0.10) compared to 2010 (0.04). YLL for men and women was fluctuating across the years with a decrease in 2011 (18%) from 2007 (35%). Men and women in the age group 30-44 years had the highest peak across the years. The study findings revealed that diabetes disease burden was considerably high in Qatar, particularly in the working age group. DALYs has been increasing across the years. Copyright © 2014 Diabetes India. Published by Elsevier Ltd. All rights reserved.

  19. Analyzing the equity of public primary care provision in Kenya: variation in facility characteristics by local poverty level

    Directory of Open Access Journals (Sweden)

    Toda Mitsuru

    2012-12-01

    Full Text Available Abstract Introduction Equitable access to health care is a key health systems goal, and is a particular concern in low-income countries. In Kenya, public facilities are an important resource for the poor, but little is known on the equity of service provision. This paper assesses whether poorer areas have poorer health services by investigating associations between public facility characteristics and the poverty level of the area in which the facility is located. Methods Data on facility characteristics were collected from a nationally representative sample of public health centers and dispensaries across all 8 provinces in Kenya. A two-stage cluster randomized sampling process was used to select facilities. Univariate associations between facility characteristics and socioeconomic status (SES of the area in which the facility was located were assessed using chi-squared tests, equity ratios and concentration indices. Indirectly standardized concentration indices were used to assess the influence of SES on facility inputs and service availability while controlling for facility type, province, and remoteness. Results For most indicators, we found no indication of variation by SES. The clear exceptions were electricity and laboratory services which showed evidence of pro-rich inequalities, with equity ratios of 3.16 and 3.43, concentration indices of 0.09 (p Conclusions The paper shows how local area poverty data can be combined with national health facility surveys, providing a tool for policy makers to assess the equity of input and service availability. There was little evidence of inequalities for most inputs and services, with the clear exceptions of electricity and laboratory services. However, efforts are required to improve the availability of key inputs and services across public facilities in all areas, regardless of SES.

  20. Level of service for pedestrian movement towards the performance of passenger information in public transport stations in Klang Valley

    Science.gov (United States)

    Ramli, M. Z.; Hanipah, M. H.; Lee, L. G.; Loo, K. F.; Wong, J. K.; Zawawi, M. H.; Fuad, N. F. S.

    2017-09-01

    Rapid growth in car ownership in Malaysia plays a major role to traffic congestion. Hence, public transportation is crucial to cater the residents in high-density area especially in Klang Valley. Signage information in public transport station is one of an important passenger information system. Poor placement of sign information will decrease the efficiency of passenger flow and caused congestion in the station. Passenger information system is very useful for trip planning and decision making. Therefore, it is interesting to study the performance of passenger information system in focusing the movement behavior of pedestrian at non-peak period. Thus, the study on pedestrian movement during non-peak period on weekdays and weekends in mass transit stations and bus transit stations in Klang Valley was carried out by using video observation. The observation of the pedestrian movement was made in Mass Transit Station 1 in the middle of Kuala Lumpur and Mass Transit Station 2 in southern of Kuala Lumpur. The other site was focused at Bus Transit Station 1 in Putrajaya and Bus Transit Station 2 in Kajang. Findings shown that Mass Transit Station 1 having the best facility in terms of passenger information which the level of service obtained is LOS A, while the lowest level of service which is LOS E was obtained in Bus Transit Station 2.

  1. Assessing public health policy approaches to level-up the gradient in health inequalities: the Gradient Evaluation Framework.

    Science.gov (United States)

    Davies, J K; Sherriff, N S

    2014-03-01

    This paper seeks to introduce and analyse the development of the Gradient Evaluation Framework (GEF) to facilitate evaluation of policy actions for their current or future use in terms of their 'gradient friendliness'. In particular, this means their potential to level-up the gradient in health inequalities by addressing the social determinants of health and thereby reducing decision-makers' chances of error when developing such policy actions. A qualitative developmental study to produce a policy-based evaluation framework. The scientific basis of GEF was developed using a comprehensive consensus-building process. This process followed an initial narrative review, based on realist review principles, which highlighted the need for production of a dedicated evaluation framework. The consensus-building process included expert workshops, a pretesting phase, and external peer review, together with support from the Gradient project Scientific Advisory Group and all Gradient project partners, including its Project Steering Committee. GEF is presented as a flexible policy tool resulting from a consensus-building process involving experts from 13 European countries. The theoretical foundations which underpin GEF are discussed, together with a range of practical challenges. The importance of systematic evaluation at each stage of the policy development and implementation cycle is highlighted, as well as the socio-political context in which policy actions are located. GEF offers potentially a major contribution to the public health field in the form of a practical, policy-relevant and common frame of reference for the evaluation of public health interventions that aim to level-up the social gradient in health inequalities. Further research, including the need for practical field testing of GEF and the exploration of alternative presentational formats, is recommended. Copyright © 2013 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  2. Distribution of physical therapists working on public and private establishments in different levels of complexity of health care in Brazil.

    Science.gov (United States)

    Costa, Larissa R; Costa, José L R; Oishi, Jorge; Driusso, Patricia

    2012-01-01

    The Brazilian Health System is organized on a regional and hierarchical form with three levels of complexity of health care. The Primary Care represents the first element of a continuing health care process, complemented by specialized actions. However, the centrality of the specialized care is still a problem in Brazil, especially in the private sector. Studies on the distribution of professionals in the health system allowing the formulation of appropriate policies are needed. To investigate the distribution of physical therapists in the levels of complexity of health care and between public and private establishments, according to data from the National Register of Health Service Providers (NRHSP). A descriptive cross-sectional study was performed considering NRHSP-national bank data collected in March 2010 and demographic census 2010 data. Data were analyzed through descriptive statistics techniques. We identified 53,181 registries of physical therapists, 60% linked to the private sector. Only 13% of all entries were linked to primary care. The predominance in specialized care occurred in the public sector (65%) and private sector (100%). The specialized establishments of private sector linked to the southeast region (16,043) were the main sites of physical therapists. Only the public sector in the south had a majority in the Primary Care. When considering the sizes of the cities, there is focus on specialist care in bigger cities. This study identified the concentration of physical therapists in the specialized care, mostly in metropolis and big cities and in the private sector, with restricted to participation in the primary care.

  3. PUBLIC EMPLOYEES' LEVEL OF AWARENESS AND PERCEPTION ON SEXUAL ABUSE OF CHILDREN IN ONLINE ENVIRONMENTS: TURKEY CASE

    Directory of Open Access Journals (Sweden)

    Sedat Şen

    2017-01-01

    Full Text Available The purpose of this study is to measure the level of awareness and perception of Turkish public personnel working in public institutions regarding the problem of online child pornography. Participants include 100 public officials positioned in various ministries. Quantitative research method was used in order to obtain information from participants. A questionnaire was submitted to the participants with meetings in person or via the Internet and data were collected. In order to ensure reliability and validity issues, expert opinion was sought as a means to measure validity and reliability. Necessary corrections were made based on the feedback provided. Outputs from the questionnaire were analyzed using the SPSS and the findings were evaluated. The results showed that participants who are rather young with high education levels, well-versed in national regulations, they have the knowledge about digital citizenship; however, it was found that they were not informed about technical issues such as international activities related to child pornography (CP, online child pornography, Darknet, p2p networks and hash databases. The findings showed that the reason behind the lack of awareness on some of these phenomena was the inherent problems in the education system and the insufficiency of the curriculum. Findings clearly show that it is necessary to establish an organic network among several ministries which are responsible for the fight with child pornography. Furthermore, to create a national CP images (Hash database which can detect the IP number and other information of the ones who share such images online using a national analysis software is another solution proposed.

  4. D-fence Against the Canadian Winter: Making Insufficient Vitamin D Levels a Higher Priority for Public Health

    Directory of Open Access Journals (Sweden)

    Jennifer D. Zwicker

    2015-04-01

    Full Text Available With most of the country situated above the latitude of the 42nd parallel north, there is a significant portion of the Canadian population that is not getting enough of the sunshine vitamin during the winter. Vitamin D is naturally produced when skin is exposed to sunlight, however during the winter months in Canada the sun is too low in the sky for this to occur. A full quarter of the Canadian population is estimated to have vitamin D levels so low as to be considered insufficient or deficient by Health Canada guidelines. Increasing vitamin D intake should be considered a public health priority. Vitamin D deficiency is known to be linked to rickets in children and osteomalacia in adults (bone softening and malformation as well as osteoporosis (loss of bone density, increasing susceptibility to fractures. However a growing body of evidence also suggests that vitamin D may have a role in the prevention of chronic diseases such as heart disease, high blood pressure, diabetes, cancer, cognitive decline, Parkinson’s disease, multiple sclerosis and arthritis. There is, of course, no way to change Canada’s proximity to the equator. But there are ways to help Canadians get more vitamin D through dietary intake. Improving the vitamin D status of the Canadian population through food fortification and dietary supplements represents an inexpensive intervention that can improve the health of the population, but debate remains over how much vitamin D the Canadian population needs and how to ensure the population adheres to whatever recommendations are made. Food fortification has already demonstrated its effectiveness in improving vitamin D levels (as it has for other public health priorities, such as with iodized salt. Decades ago, the prevalence of rickets in Canadian children led health professionals to lobby for, and win, legislation making vitamin D fortification mandatory for milk. Other foods, such as orange juice, milk of plant origin and

  5. The development of the tertiary sector in the economy and the reduction in CO2 emissions

    International Nuclear Information System (INIS)

    Morvan, R.; Hubert, M.; Gregoire, P.; Lowezanin, Ch.

    2004-09-01

    The development of the tertiary sector appears to support sustainable development since it now accounts for almost two thirds of the national economy and is responsible for low CO 2 emission levels. Between 1980 and 1997, CO 2 emissions from the tertiary sector increased by 20 % compared with a 48 % rise in the sector value added. In terms of production, CO 2 levels in the tertiary sector are low, compared with 55 % for the secondary sector (industry). However, when trade between economic activities is taken into account, there is cause to qualify the assessment. This makes it possible to ascertain emissions from the point of view of satisfying final demand for products, and to identify direct and indirect emissions in each branch of activity. Thus, when emissions from certain industrial and agricultural activities are redistributed specifically to branches of activity in the tertiary sector, CO 2 emissions in this sector account for almost one-third of total emissions. (A.L.B.)

  6. Tertiary Students' ICT Self-Efficacy Beliefs and the Factors Affecting Their ICT-Use

    Science.gov (United States)

    Turel, Vehbi; Calik, Sinan; Doganer, Adem

    2015-01-01

    This study looked at tertiary (i.e. undergraduate /a four-year degree) students' information and communication technology (ICT) self-efficacy beliefs and their level in use of certain common programmes at a newly established (i.e. 2007) university in Turkey in the spring of 2012. The study examined the tertiary students' (a) demographic…

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

    Science.gov (United States)

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

    2015-01-01

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

  8. The contribution of school-level factors to contraceptive use among adolescents in New York city public high schools

    Science.gov (United States)

    Kaplan, Deborah L.

    Every year approximately 17,000 adolescents ages 15-19 become pregnant in New York City. Most of these pregnancies are unintended and only a small percent of adolescents use effective contraception, with wide disparities by race/ethnicity and poverty level. While many studies have identified factors associated with contraceptive use, most research has focused on individual level factors, with little attention to the contribution of the school environment to sexual risk behavior and contraceptive use. This study investigates the effect of school-level factors on contraceptive use among adolescents in NYC public high schools before and after controlling for individual-level factors, and whether this effect varies with race/ethnicity. Using a cross-sectional design, the NYC Youth Risk Behavior Survey (YRBS) individual-level datasets for 2007, 2009 and 2011 were linked to a school-level dataset. Variables were selected based on empirical findings on factors associated with sexual behaviors, including contraceptive use, by adolescents. The analytic sample included all YRBS respondents aged 14 or older who reported having sexual intercourse in the past three months and had complete responses to the YRBS questions on contraceptive use at last sex (N=8,054). The chi square test of significance was used to evaluate significant associations between independent variables and contraceptive use in bivariate analyses; variables with a p value < 0.1 were included in the multivariable analyses. Binary and multinomial logistic regression analyses were conducted to estimate the strength of the associations of school-level factors with contraceptive use among sexually active adolescents. Findings included that use of any contraception and/or hormonal contraception at last sexual intercourse was associated with attending schools with a higher six-year graduation rate, higher percent of students strongly agreeing they were safe in their classrooms, higher percent of teachers at the

  9. Efficiency and Productivity of County-level Public Hospitals Based on the Data Envelopment Analysis Model and Malmquist Index in Anhui, China

    Directory of Open Access Journals (Sweden)

    Nian-Nian Li

    2017-01-01

    Conclusions: In 2010–2015, the relative service efficiency of 12 county-level public hospitals in Anhui Province showed a decreasing trend, and the service efficiency of each hospital changed. In the past 6 years, although some hospitals have been effective, the efficiency of the county-level public hospitals in Anhui Province has not improved significantly, and the total factor productivity has not been effectively improved. County-level public hospitals need to combine their own reality to find their own deficiencies.

  10. Individual- and area-level disparities in access to the road network, subway system and a public bicycle share program on the Island of Montreal, Canada.

    Science.gov (United States)

    Fuller, Daniel; Gauvin, Lise; Kestens, Yan

    2013-02-01

    Few studies have examined potential disparities in access to transportation infrastructures, an important determinant of population health. To examine individual- and area-level disparities in access to the road network, public transportation system, and a public bicycle share program in Montreal, Canada. Examining associations between sociodemographic variables and access to the road network, public transportation system, and a public bicycle share program, 6,495 adult respondents (mean age, 48.7 years; 59.0 % female) nested in 33 areas were included in a multilevel analysis. Individuals with lower incomes lived significantly closer to public transportation and the bicycle share program. At the area level, the interaction between low-education and low-income neighborhoods showed that these areas were significantly closer to public transportation and the bicycle share program controlling for individual and urbanicity variables. More deprived areas of the Island of Montreal have better access to transportation infrastructure than less-deprived areas.

  11. Epidemiología de la encefalopatía neonatal en un hospital de tercer nivel en Cuba Epidemiology of neonatal encephalopathy in a tertiary level hospital in Cuba

    Directory of Open Access Journals (Sweden)

    Gerardo Rogelio Robaina Castellanos

    2013-03-01

    Full Text Available Introducción: los factores de riesgo asociados a la ocurrencia de encefalopatía neonatal han sido poco tratados en países del tercer mundo. De igual forma, se desconoce la incidencia de esta entidad en la mayoría de los centros de atención perinatal en Cuba. Objetivo: determinar la incidencia y factores de riesgo de encefalopatía neonatal en un hospital de tercer nivel de atención perinatal en Cuba. Métodos: se realizó un estudio analítico retrospectivo que incluyó los 35 neonatos con encefalopatía neonatal, provenientes de una cohorte de 19 577 neonatos nacidos vivos en el Hospital Provincial Ginecobstétrico Docente de Matanzas, en el período de 2005-2011. Para la determinación de factores de riesgo se realizó un estudio de caso-control, mediante análisis bivariado, con una relación caso-control de 1:3. Resultados: la incidencia de encefalopatía neonatal fue de 1,78 por 1 000 nacidos vivos. La encefalopatía neonatal posasfixia se presentó en 48,5 % de los casos. La hipertensión arterial materna durante el embarazo, el antecedente materno de hipertensión arterial crónica, la procedencia materna rural y el sexo masculino, constituyeron factores de riesgo antenatales. Los factores de riesgo intranatales encontrados fueron: la presencia de depresión severa al nacer, circulares apretadas al cuello, rotura prematura de membranas, corioamnionitis clínica, placenta previa, estado fetal no tranquilizante y líquido amniótico meconial. Conclusiones: en la población estudiada los factores de riesgo perinatales y algunos antenatales tienen importancia epidemiológica.Introduction: the risk factors related to the onset of neonatal encephalopathy have been poorly treated in the Third World countries. Likewise, the incidence of this disease in most of the Cuban perinatal care centers is unknown. Objective: to determine the incidence and risk factors of neonatal encephalopathy in a tertiary perinatal care hospital. Methods: a

  12. Understanding tobacco control policy at the national level: bridging the gap between public policy and tobacco control advocacy

    Directory of Open Access Journals (Sweden)

    Marc C. Willemsen

    2018-03-01

    Full Text Available Background While some countries have advanced tobacco control policies, other countries struggle to adopt and implement FCTC's measures. This presentation uncovers the main factors that explain such variations, taking insights from public policy and political science as a starting point for a case study. Methods A case study of tobacco control policy making in the Netherlands, covering the period from the 1960s until the present. The study consisted of a systematic search and analysis of documents and proceedings of parliamentary debates on tobacco policy, supplemented with 22 interviews with key informants from the government, health organisations, politicians, and the tobacco industry. In addition, documents from the Truth Tobacco Industry Documents database, pertaining to the influence of the tobacco industry on Dutch policy making, were analysed. Results The Dutch government started relatively late to regulate tobacco. The choices in tobacco control policy making at the national level and the tempo in which they are made are explained by the interaction of the five main elements of the tobacco control policy making process: Relatively stable context factors (constitutional structures, 'rules of the policy making game', national cultural values Relatively dynamic context factors (regime changes, EU regulation and FCTC guidelines, changing social norms, public support Transfer of ideas (availability and interpretation of scientific evidence Pro and anti-tobacco control networks and coalitions (their organisational and lobby strength Agenda-setting (changes in problem definition, issue framing, media advocacy Conclusions Despite worldwide convergence of tobacco control policies, accelerated by the ratification of the FCTC treaty by most nations, governments develop approaches to tobacco control in line with cultural values, ideological preferences and specific national institutional arrangements. There is no one-size-fits-all approach. The

  13. Mainstreaming of Climate Change into the Ghanaian Tertiary Educational System

    Science.gov (United States)

    Nyarko, B. K.

    2013-12-01

    The impact of Climate Change has a far-reaching implication for economies and people living in the fragile Regions of Africa analysts project that by 2020, between 75 million and 250 million people will be exposed various forms of Climate Change Stresses. Education as a key strategy identified under Agenda 21 has been incorporated into the efforts of various educational institutions as a means of mitigating climate change and enhancing sustainability. Climate Change education offers many opportunities and benefits for educators, researchers, learners, and for wider society, but there are also many challenges, which can hinder the successful mainstreaming of climate change education. The study aims at understanding barriers for Climate Change Education in selected tertiary institutions in Ghana. The study was conducted among Geoscience Departments of the 7 main public universities of Ghana. The transcript analysis identified issues that hinders the mainstreaming of Climate Change, these includes existing levels of knowledge and understanding of the concept of climate change, appreciating the threshold concepts, ineffective teaching of Climate Change and some Departments are slow in embracing Climate Change as a discipline. Hence to develop strategies to mainstream climate change education it is important to recognise that increasing the efficiency and delivery of Climate Change education requires greater attention and coordination of activities and updating the educators knowledge and skill's. Various Ministries should be challenged to develop and integrate climate change into education policies. In the design of curriculum, there is a need to integrate Climate Change Education into curricula without compromising already overstretched programmes of study. There is a need to encourage and enhance innovative teaching approaches such as Problem-based learning (PBL) is an approach that challenges students to learn through engagement in a real problem. Institutions and

  14. AWARENESS AS A FACTOR OF INFLUENCE ON THE LEVEL OF PUBLIC SATISFACTION WITH LOCAL SELF-GOVERNMENT ACTIVITIES

    Directory of Open Access Journals (Sweden)

    Kiseleva N. V.

    2014-12-01

    Full Text Available In the modern period of the development of statehood in Russia the significant increase of attention is attributed to the issue of effectiveness of state power and government not only on the federal and regional levels, but on the local level as well. In 2009 there was developed and implemented the system of indicators of the effectiveness’ estimates of the activity of local self-government. The system of effectiveness’ estimates included sociological indices of satisfaction of population. Implementation of sociological indices in the system of effectiveness’ estimates of the activity of local self-government brought positive responses from academic community, politicians, managers, and the public. In the article the analysis of influence of cognitive factor (being kept informed on the level of social contentment of the activity of local self-government’ bodies is done. We do this, based on the results of sociological studies of the major Russian research organizations and data from the aggregate reports, which deal with the monitoring of effectiveness of local self-government of some subjects in the Central federal district of Russia.

  15. Level of risk for alcohol consumption among the drivers of an urban public transportation company in Medellín

    Directory of Open Access Journals (Sweden)

    Carlos F. Molina C

    2011-11-01

    Full Text Available Objective: to study the level of risk for alcohol consumption among drivers from a public transportation company. Methodology: a cross-sectional observational study with a sample of 145 drivers from a transportation company in Medellin, Colombia. A self-survey was used that included socio-demographic data, work organization data, and the audittest to measure the level of risk for alcohol consumption. Results: the socio-demographic and work organization profiles, together with the risk level values are consistent with the findings of previous national and international studies. The audit test results showed that 12.5% of the subjects had a score greater than or equal to 8. This is a global indicator of risky and harmful consumption. Furthermore, the score of 17% of the subjects suggested probable dependence. Conclusions: this study’s findings suggest that further research is required in order to establish the grounds for designing a coordinated proposal integrating the actions of each of the Social Security System’s actors. Such proposal should be based on the policy for decreasing consumption of psychoactive substances in the working population

  16. Utilizing public scientific web lectures to teach contemporary physics at the high school level: A case study of learning

    Directory of Open Access Journals (Sweden)

    Shulamit Kapon1,*

    2011-10-01

    Full Text Available This paper describes a teaching experiment designed to examine the learning (i.e., retention of content and conceptual development that takes place when public scientific web lectures delivered by scientists are utilized to present advanced ideas in physics to students with a high school background in physics. The students watched an exemplary public physics web lecture that was followed by a collaborative generic activity session. The collaborative session involved a guided critical reconstruction of the main arguments in the lecture, and a processing of the key analogical explanations. Then the students watched another exemplary web lecture on a different topic. The participants (N=14 were divided into two groups differing only in the order in which the lectures were presented. The students’ discussions during the activities show that they were able to reason and demonstrate conceptual progress, although the physics ideas in the lectures were far beyond their level in physics. The discussions during the collaborative session contributed significantly to the students’ understanding. We illustrate this point through an analysis of one of these discussions between two students on an analogical explanation of the Aharonov-Bohm effect that was presented in one of the lectures. The results from the tests that were administered to the participants several times during the intervention further support this contention.

  17. Utilizing public scientific web lectures to teach contemporary physics at the high school level: A case study of learning

    Science.gov (United States)

    Kapon, Shulamit; Ganiel, Uri; Eylon, Bat Sheva

    2011-12-01

    This paper describes a teaching experiment designed to examine the learning (i.e., retention of content and conceptual development) that takes place when public scientific web lectures delivered by scientists are utilized to present advanced ideas in physics to students with a high school background in physics. The students watched an exemplary public physics web lecture that was followed by a collaborative generic activity session. The collaborative session involved a guided critical reconstruction of the main arguments in the lecture, and a processing of the key analogical explanations. Then the students watched another exemplary web lecture on a different topic. The participants (N=14) were divided into two groups differing only in the order in which the lectures were presented. The students’ discussions during the activities show that they were able to reason and demonstrate conceptual progress, although the physics ideas in the lectures were far beyond their level in physics. The discussions during the collaborative session contributed significantly to the students’ understanding. We illustrate this point through an analysis of one of these discussions between two students on an analogical explanation of the Aharonov-Bohm effect that was presented in one of the lectures. The results from the tests that were administered to the participants several times during the intervention further support this contention.

  18. Level of satisfaction of clients of public pharmacies dispensing high-cost drugs in Espírito Santo, Brazil

    Directory of Open Access Journals (Sweden)

    Karla Oliveira dos Santos Cassaro

    Full Text Available ABSTRACT The aim of this study was to evaluate the level of satisfaction of pharmaceutical services and to determine the socioeconomic profile of public pharmacy clients. This is a cross-sectional observational study using a quantitative approach. The sample was calculated from the monthly number of patients seen in pharmacies and was stratified for each pharmacy. Data were analysed using SPSS 11.5 software and by observing the simple relative frequencies for qualitative variables. For the quantitative variables, the analysis of variance (ANOVA and post-hoc Fisher tests were performed. Data are expressed as mean ± standard deviation (SD. The results show that, in general, patients at "Farmácias cidadãs" are satisfied with the services. However, when stratified, we found that the greatest satisfaction was related only to structural and organizational aspects, while the pharmaceutical services are unsatisfactory. When relating satisfaction to the socioeconomic characteristics, a difference between waiting time (39.07 ± 19.53, attendance by pharmacist (8.91 ± 5.14 and education was observed. It is concluded that users are satisfied with the services of state "Farmácias cidadãs" of Espírito Santo, but there should be improvements in relation to pharmaceutical services and the interpersonal relationships between health professionals and users of the public health system in Brazil.

  19. 1987 annual report on low-level radioactive waste management progress: Report to Congress in response to Public Law 99-240

    International Nuclear Information System (INIS)

    1988-08-01

    In response to Section 7(b) of the Low-Level Radioactive Waste Policy Amendments Act of 1985 (Public Law 99-240), this report summarizes the progress of states and low-level radioactive waste compacts in 1987 in establishing new low-level waste disposal facilities. It also reports the volume of low-level waste received for disposal in 1987 by commercially operated low-level waste disposal facilities

  20. Publications | Page 316 | IDRC - International Development ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Results 3151 - 3160 of 6374 ... Through books, articles, research publications, and studies, we aim to widen the impact of our investment and advance development research. ... in tertiary education, Educational Contents of Compulsory ICT Training in Tertiary Education of Mongolia and Evaluation ON ICT education contents.

  1. Proposed nomination of Yucca Mountain as a potential high-level radioactive waste repository. Correspondence and request for oral presentations for US Department of Energy public hearings

    International Nuclear Information System (INIS)

    1983-01-01

    This volume contains correspondence and requests by the public citizens for oral presentation at the public hearings for the proposed nomination of Yucca Mountain as a potential high-level radioactive waste repository. Written comments are also included on: the proposed nomination; the issues to be addressed in the Environmental Assessment; and the issues to be addressed by any Site Characterization Plan, if developed

  2. Clinical and laboratory profile of pediatric outpatients with type 1 diabetes mellitus, attended in the tertiary public hospital of Sorocaba, São Paulo, Brazil, and its relationship with the treatment adherence

    Directory of Open Access Journals (Sweden)

    Caroline Rosa Pellicciari

    2017-06-01

    Full Text Available Objectives: To evaluate the clinical and laboratory profile of children and adolescents with type 1 diabetes mellitus (DM1 and their relationship with the values of glycated hemoglobin (HbA1c. Methods: We analyzed medical records of 56 patients (2 to 17 years treated at the pediatric endocrinology unit of the Conjunto Hospitalar de Sorocaba, São Paulo, Brazil, during the period from August 2013 to July 2014. Data such as: age, duration of disease, diabetes etiology (autoimmune or idiopathic, type and number of daily insulin injections, caster at the application site, the HbA1c levels, blood glucose monitoring, candy and soft drinks intake and physical activity were analyzed. For statistical analysis, the patients were divided in two groups: bad control = HbA1c>9%; and good control = HbA1c≤9%, according to the International Society of Pediatric and Adolescent Diabetes (ISPAD. Results: The mean age of the patients studied was equal to 10.5 years; 53.6% (n=30 of them were in a state of diabetic ketoacidosis diagnosis; and 57.1% (n=32 of the group had HbA1c>9%. Bad control group showed older age, being mainly composed of adolescents (p=0,0230. The weekly intake of soft drinks is associated with the bad control group (p=0,0500. The other factors studied showed no statistical difference between the groups. Conclusions: A large percentage of patients with DM1 had inadequate control of the disease, especially in the adolescent age group. The diagnosis of DM1 in childhood and adolescence is still late, with high presence of diabetic ketoacidosis at diagnosis.

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

    Science.gov (United States)

    Vestergaard, Peter; Thomsen, Susanna vid Strym

    2011-04-01

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

  4. Recruitment Of International Students Into Cameroon Tertiary ...

    African Journals Online (AJOL)

    Recruitment Of International Students Into Cameroon Tertiary Institutions In The Absence Of International Offices. ... The present system of recruiting international students is haphazardly been handled by ... AJOL African Journals Online.

  5. Learning Enhancement in Tertiary Institutions Using Mobile ...

    African Journals Online (AJOL)

    2012-12-01

    Dec 1, 2012 ... model that is still by far the dominant mode of education and learning in tertiary institutions. In addition to identifying ... education has there been a technology that ..... Determinant of Mobile Learning Acceptance: An Empirical.

  6. The Role of Pr in the Public Sector. Case Study on Pr Professionalization at the Local Level in Romania

    Directory of Open Access Journals (Sweden)

    Delia Cristiana BALABAN

    2009-10-01

    Full Text Available Although the idea of creating internal andexternal links within and between institutions isa relatively established one, the public relationsdomain can be considered a new branch of thepromotion process, mainly in the public sector inRomania. This paper aims at creating an overviewof the profile of public relations departments withinpublic institutions. In this research we aspire touncover the main elements that characterize theprofile of public relations departments within publicinstitutions, from the point of view of their qualityand professionalism. Moreover, this researchaims to establish whether there are differencesconcerning the public relations profile betweenpublic administration institutions and other specific public institutions.

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

    Science.gov (United States)

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

    2010-05-14

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

  8. ACNP Public Education Program on nuclear medicine and related low-level waste issues. Final technical report, 7 July 1980-30 June 1983

    International Nuclear Information System (INIS)

    The goal of the ACNP Public Education Program was to educate and inform the greatest number of people in the areas of radiation and health and, in turn, to gain the public's understanding of Nuclear Medicine. The related low-level waste issues also were incorporated into the program. To carry out the program's objectives and design to educate the public, the ACNP established a Speaker Bureau which consists of those members of the ACNP and the Society of Nuclear Medicine (SNM) who go through the training seminars, conducted by ACNP, and are available to speak publicly about Nuclear Medicine and related low-level waste issues. In addition, the ACNP developed the necessary audiovisual and printed materials to be used in their own right or as supplemental tools. Promotion of the Speakers Bureau and the audiovisual materials to the media and other various public forums was undertaken

  9. Levels and Patterns of Objectively Assessed Physical Activity and Compliance with Different Public Health Guidelines in University Students

    Science.gov (United States)

    Arias-Palencia, Natalia María; Solera-Martínez, Monserrat; Gracia-Marco, Luis; Silva, Pedro; Martínez-Vizcaíno, Vicente; Cañete-García-Prieto, Jorge; Sánchez-López, Mairena

    2015-01-01

    Background Physical activity (PA) is associated with health enhancement. The aim of this study was to assess: 1) levels and patterns of PA in university students by using accelerometers; and 2) the percentage of fulfilment of PA recommendations for adults, according to different public health guidelines. Methods Observational cross-sectional study (Cuenca’s Adults Study) involving 296 (206 women) healthy Spanish university students aged 18–25 years old. Participants wore the ActiGraph GT1M accelerometer for seven consecutive days. Total PA, steps and time spent in sedentary time, light, moderate, vigorous, and moderate to vigorous PA (MVPA) was assessed, and the prevalence of sufficient PA was calculated according to various public health guidelines. Results No sex differences in total PA were found. University students were more sedentary during weekend days than weekdays (pstudents met the recommendation of 150 min/week of MVPA or 75 min/week of vigorous PA, in PA bouts of at least 10 min. using the same definition, but on five or more days a week, only 0.5% students were found to meet the recommendation. In addition, only 0.5% of students met the recommendation of 30 min/day of MVPA, at least five days a week and in bouts of at least 10 min. Finally, 28.1% of the students met the recommendation of 10,000 steps/day. Conclusions Our study shows a high incidence of sedentary time in university students. The number of students meeting PA recommendations significantly differed depending on the recommendation proposed. Specific strategies to promote PA in this population are necessary as well as an agreement as to which PA guidelines should be used. PMID:26536605

  10. To determine the level of satisfaction among medical students of a public sector medical university regarding their academic activities

    Directory of Open Access Journals (Sweden)

    Manzar Bushra

    2011-10-01

    Full Text Available Abstract Background An ongoing evaluation system is essential to determine if the academic system in place has worked to produce a better product, hence the objective of our study was to evaluate the satisfaction level among medical students regarding their academic teaching and assessment method and what measures will they suggest for the future to rectify the current situation. This questionnaire based cross sectional study was conducted in a public sector medical university from February to July 2010. A well structured questionnaire was administered to a random sample of 375 final year medical students. However 292 of the students provided informed consent and filled in the questionnaire which included their demographic profile as well as questions in line with the study objective. Data was entered in a Statistical Package for Social Sciences (SPSS version.16 and analyzed using descriptive statistics. Findings The male to female ratio in our study was 1:2. Most of the students (57.2% were dissatisfied with the quality of teaching in the university. Fifty-seven percent of the participants believed that the current standard of their institute were not at par with those of international medical universities. BCQ's were the mode of examination questions preferred by the majority of the students. Most of the students (66.1% wanted the university to conduct career planning seminars to help them plan their career. Conclusions These results suggest that the students of public sector medical universities are unsatisfied from current academic facilities and teaching activities. Students recommend increased emphasis on better lectures and practical training as well as a need to incorporate career planning sessions for the students to help plan them their future career paths.

  11. Impact of Texas Public School Board Members' Level of Training and Professional Development on Superintendent Tenure

    Science.gov (United States)

    Flores, Alexandro Miguel

    2017-01-01

    The role of the public school superintendent, with its increasing challenges and demands, can be considered one of the most daunting roles in American public education today. Consequently, frequent turnover in the top leadership position inhibits many public schools from reaching set academic, financial, and organizational goals. As a result, any…

  12. Report to Congress in response to Public Law 99-240: 1990 Annual report on low-level radioactive waste management progress

    International Nuclear Information System (INIS)

    1991-09-01

    This report summarizes the progress during 1990 of states and compact regions in establishing new low-level radioactive waste disposal facilities. It also provides summary information on the volume of low-level radioactive waste received for disposal in 1990 by commercially operated low-level radioactive waste disposal facilities. This report is in response to section 7 (b) of the Low-Level Radioactive Waste Policy Act, as amended by Public Law 99-240

  13. Ocular disorders in stroke patients in a tertiary hospital in Nigeria

    African Journals Online (AJOL)

    2015-08-06

    Aug 6, 2015 ... Abstract. Background: Stroke is a medical emergency of public health ... Aim: To determine the prevalence of ocular disorders in patients with stroke in a Tertiary Hospital in Nigeria. ... Risk factors include old age, high blood pressure, previous .... such as cataract, refractive errors, and age‑related changes.

  14. A study on the utilization of serial resources in selected tertiary ...

    African Journals Online (AJOL)

    A study on the utilization of serial resources in selected tertiary institutions in Ogun State. ... Lagos Journal of Library and Information Science ... Serial resources are publications either in printed form or electronic format issued in successive parts usually having numerical or chronological designations and intended to be ...

  15. Differentiation and Articulation in Tertiary Education Systems : A Study of Twelve African Countries

    OpenAIRE

    Ng'ethe, Njuguna; Subotzky, George; Afeti, George

    2008-01-01

    This study strives to sketch an initial map of the extent and nature of institutional and program differentiation within African systems of tertiary education. In doing so, it also seeks to chart the patterns of articulation that have emerged or been consciously put in place between the different institutional types (such as public universities, private universities, polytechnics, training...

  16. Incidence of dog bite injuries and clinical rabies in a tertiary health ...

    African Journals Online (AJOL)

    Background: It is widely recognized that rabies is grossly under-reported even though it is a notifiable disease and a lack of accurate figures has rendered rabies a low public health and veterinary priority. This study aimed at determining the incidence of dog bite injuries and clinical rabies in a tertiary health care centre.

  17. IRIS Toxicological Review of Ethyl Tertiary Butyl Ether (ETBE) (External Review Draft, 2009)

    Science.gov (United States)

    EPA is conducting a peer review and public comment of the scientific basis supporting the human health hazard and dose-response assessment of ethyl tertiary butyl ether (ETBE) that when finalized will appear on the Integrated Risk Information System (IRIS) database.

  18. On the level of coverage and citation of publications by mechanicians of the national academy of sciences of Ukraine in the Scopus database

    Science.gov (United States)

    Guz, A. N.; Rushchitsky, J. J.

    2009-11-01

    The paper analyzes the level of coverage and citation of publications by mechanicians of the National Academy of Sciences of Ukraine (NASU) in the Scopus database. Two groups of mechanicians are considered. One group includes 66 doctors of sciences of the S. P. Timoshenko Institute of Mechanics as representatives of the oldest institute of the NASU. The other group includes 34 members (academicians and corresponding members) of the Division of Mechanics of the NASU as representatives of the authoritative community of mechanicians in Ukraine. The results are presented for each scientist in the form of two indices—the total number of publications accessible in the database as the level of coverage of the scientist's publications in this database and the h-index as the citation level of these publications. This paper may be considered to continue the papers [6-12] published in Prikladnaya Mekhanika (International Applied Mechanics) in 2005-2009

  19. Vigilancia de los niveles de uso de antibióticos y perfiles de resistencia bacteriana en hospitales de tercer nivel de la Ciudad de México Surveillance of antibiotic utilization and bacterial resistance profiles in tertiary level hospitals in Mexico City

    Directory of Open Access Journals (Sweden)

    Lilia Benavides-Plascencia

    2005-06-01

    Full Text Available OBJETIVO: Determinar los niveles de uso de antibióticos y el perfil de resistencia de las bacterias nosocomiales, e identificar y proponer estrategias para disminuir la resistencia a los antibióticos. MATERIAL Y MÉTODOS: Estudio descriptivo, retrolectivo (1994-1995, hecho en seis hospitales de tercer nivel de la Ciudad de México. RESULTADOS: La resistencia del grupo hospitalario fue de 86%, mientras que el consumo total de antibióticos por institución varió entre 44 y 195 dosis diarias definidas/100 camas-día. CONCLUSIONES: Se identificaron los elementos para instrumentar un sistema de vigilancia integral que mejore el uso de antibióticos y la valoración de la resistencia bacteriana.OBJECTIVE: To identify the levels of antibiotic utilization and the resistance profiles of nosocomial bacteria, as well as the strategies to diminish resistance to antibiotics. MATERIAL AND METHODS: A descriptive, retrospective (1994-1995 study was conducted in six tertiary level hospitals in Mexico City. RESULTS: A total of 86% antibiotic resistance was observed in these hospitals. The overall consumption of antibiotics per hospital ranged between 44 and 195 Defined Daily Doses/100 day-beds. CONCLUSIONS: We identified the components to frame an integral surveillance system aimed at improving the use of antibiotics and the quality of the bacterial resistance assessment in these hospitals.

  20. Effects of a blended learning approach on student outcomes in a graduate-level public health course.

    Science.gov (United States)

    Kiviniemi, Marc T

    2014-03-11

    Blended learning approaches, in which in-person and online course components are combined in a single course, are rapidly increasing in health sciences education. Evidence for the relative effectiveness of blended learning versus more traditional course approaches is mixed. The impact of a blended learning approach on student learning in a graduate-level public health course was examined using a quasi-experimental, non-equivalent control group design. Exam scores and course point total data from a baseline, "traditional" approach semester (n = 28) was compared to that from a semester utilizing a blended learning approach (n = 38). In addition, student evaluations of the blended learning approach were evaluated. There was a statistically significant increase in student performance under the blended learning approach (final course point total d = 0.57; a medium effect size), even after accounting for previous academic performance. Moreover, student evaluations of the blended approach were very positive and the majority of students (83%) preferred the blended learning approach. Blended learning approaches may be an effective means of optimizing student learning and improving student performance in health sciences courses.

  1. The Effect of Corporate Tax Avoidance on the Level of Corporate Cash Holdings: Evidence from Indonesian Public Listed Companies

    Directory of Open Access Journals (Sweden)

    Muhammad Irham Kurniawan

    2017-12-01

    Full Text Available This study aims to examine the effect of corporate tax avoidance to the corporate cash holdings. Recent tax avoidance research found that tax avoidance is able to facilitate managerial rent extraction in the form of transfer of resources owned by the company. This study attempts to test how the relationship of tax avoidance with the amount of cash held by the company. The sample consists of 46 non-financial, non-property, non-real estate and non-construction companies from 2009-2016, with a total 368 observations. The study uses two different cash holdings measures to test the robustness of the research results. This study cannot find evidence that tax avoidance have a significant relationship to the level of cash holdings in public companies in Indonesia. Both measurements of cash holdings gave the same conclusions to the results of the study. This study provides an insight that agency theory in the context of tax avoidance and corporate cash holdings in developing countries such as Indonesia needs to be explored further as the agency conflict in Indonesia as a developing country is more principal-principal conflicts.

  2. Estimating the Potential Risks of Sea Level Rise for Public and Private Property Ownership, Occupation and Management

    Directory of Open Access Journals (Sweden)

    Georgia Warren-Myers

    2018-04-01

    Full Text Available The estimation of future sea level rise (SLR is a major concern for cities near coastlines and river systems. Despite this, current modelling underestimates the future risks of SLR to property. Direct risks posed to property include inundation, loss of physical property and associated economic and social costs. It is also crucial to consider the risks that emerge from scenarios after SLR. These may produce one-off or periodic events that will inflict physical, economic and social implications, and direct, indirect and consequential losses. Using a case study approach, this paper combines various forms of data to examine the implications of future SLR to further understand the potential risks. The research indicates that the financial implications for local government will be loss of rates associated with total property loss and declines in value. The challenges identified are not specific to this research. Other municipalities worldwide experience similar barriers (i.e., financial implications, coastal planning predicaments, data paucity, knowledge and capacity, and legal and political challenges. This research highlights the need for private and public stakeholders to co-develop and implement strategies to mitigate and adapt property to withstand the future challenges of climate change and SLR.

  3. Effects of a blended learning approach on student outcomes in a graduate-level public health course

    Science.gov (United States)

    2014-01-01

    Background Blended learning approaches, in which in-person and online course components are combined in a single course, are rapidly increasing in health sciences education. Evidence for the relative effectiveness of blended learning versus more traditional course approaches is mixed. Method The impact of a blended learning approach on student learning in a graduate-level public health course was examined using a quasi-experimental, non-equivalent control group design. Exam scores and course point total data from a baseline, “traditional” approach semester (n = 28) was compared to that from a semester utilizing a blended learning approach (n = 38). In addition, student evaluations of the blended learning approach were evaluated. Results There was a statistically significant increase in student performance under the blended learning approach (final course point total d = 0.57; a medium effect size), even after accounting for previous academic performance. Moreover, student evaluations of the blended approach were very positive and the majority of students (83%) preferred the blended learning approach. Conclusions Blended learning approaches may be an effective means of optimizing student learning and improving student performance in health sciences courses. PMID:24612923

  4. CLINICAL SPECTRUM OF HYPONATRAEMIA IN TERTIARY CENTRE

    Directory of Open Access Journals (Sweden)

    Suresh Chincholi

    2017-02-01

    Full Text Available BACKGROUND Hyponatraemia is defined as a serum sodium level less than 135 mEq/L. High mortality among the patients of hyponatraemia is secondary to the underlying medical condition. Frequency is high in elderly patients. MATERIALS AND METHODS The study was conducted at a tertiary care centre (Basaveshwar Teaching and General Hospital, Gulbarga, from the period September 2014 to August 2016. These patients were evaluated for the underlying cause of hyponatraemia, which included detailed history and physical examination followed by appropriate laboratory investigations. Patients were followed up till the hyponatraemia was treated or patients were discharged from the hospital. RESULTS 100 patients of hyponatraemia were included in the study. 46% of the patients were asymptomatic. 33% patients had lethargy, 28% patients had postural dizziness and 19% had abnormal behaviour. Overall incidence of hyponatraemia was 4.58% in the hospitalised population, whereas its incidence in ICU patients was 22.4%. Twelve patients of symptomatic severe hyponatraemia were treated with hypertonic saline infusion, 25% patients were given loop diuretics with oral supplementation of sodium chloride for free water excretion in SIADH cases and in patients with hypervolaemia, hyponatraemia, fluid restriction was advised to 44 patients, oral supplementation of sodium chloride was given in 36 patients and 64 patients received normal saline. 9 patients included in the study died, 5 of which had advanced cirrhosis of liver as underlying cause. One patient developed Osmotic Demyelination Syndrome (ODS. CONCLUSION The possible cause of hyponatraemia should always be sought as outcome in severe hyponatraemia is governed by aetiology, and not by the serum sodium level. Treatment of severe symptomatic hyponatraemia with hypertonic saline is safe if recommendation for the rate of correction of hyponatraemia is strictly followed.

  5. Older Australian's Motivation for University Enrollment and Their Perception of the Role of Tertiary Education in Promoting Healthy Aging: A National Cross-Sectional Study

    Science.gov (United States)

    Brownie, Sonya

    2014-01-01

    The aims of this study were to describe the characteristics of older Australian university students (aged 60+ years); to identify the factors that motivate late-life, tertiary-level learning; and to capture older students' views about the role of tertiary-level learning in promoting healthy aging. In 2012, an invitation to participate in the study…

  6. League tables as policy instruments: the political economy of accountability in tertiary education

    OpenAIRE

    Salmi, Jamil; Saroyan, Alenoush

    2007-01-01

    The main objective of this article is to examine the role and usefulness of public information mechanisms, such as the rankings and similar classification instruments that are increasingly relied upon to measure and compare the performance of tertiary education institutions. The article begins with a typology of ranking instruments used for public accountability purposes, followed by a discussion of the political economy of the ranking phenomenon. It then attempts to assess their respective ...

  7. The Impact of Low-Level Lead Toxicity on School Performance among Hispanic Subgroups in the Chicago Public Schools.

    Science.gov (United States)

    Blackowicz, Michael J; Hryhorczuk, Daniel O; Rankin, Kristin M; Lewis, Dan A; Haider, Danish; Lanphear, Bruce P; Evens, Anne

    2016-08-01

    Environmental lead exposure detrimentally affects children's educational performance, even at very low blood lead levels (BLLs). Among children in Chicago Public Schools (CPS), the severity of the effects of BLL on reading and math vary by racial subgroup (White vs. Hispanic vs. non-Hispanic Black). We investigated the impact of BLL on standardized test performance by Hispanic subgroup (Mexican, Puerto Rican, and Other Hispanic). We examined 12,319 Hispanic children born in Chicago between 1994 and 1998 who were tested for BLL between birth and 2006 and enrolled in the 3rd grade at a CPS school between 2003 and 2006. We linked the Chicago birth registry, the Chicago Blood Lead Registry, and 3rd grade Illinois Standard Achievement Test (ISAT) scores to examine associations between BLL and school performance. Primary analyses were restricted to children with BLL below 10 µg/dL (0.483 µmol/L). BLLs below 10 µg/dL (0.483 µmol/L) were inversely associated with reading and math scores in all Hispanic subgroups. Adjusted Relative Risks (RRadj) and 95% confidence intervals (CI) for reading and math failure were 1.34 (95% CI = 1.25, 1.63) and 1.53 (95% CI = 1.32, 1.78), respectively, per each additional 5 µg/dL of lead exposure for Hispanic children; RRadj did not differ across subgroups. We estimate that 7.0% (95% CI = 1.8, 11.9) of reading and 13.6% (95% CI = 7.7, 19.2) of math failure among Hispanic children can be attributed to exposure to BLLs of 5-9 µg/dL (0.242 to 0.435 µmol/L) vs. 0-4 µg/dL (0-0.193 µmol/L). The RRadj of math failure for each 5 µg/dL (0.242 µmol/L) increase in BLL was notably (p = 0.074) stronger among black Puerto Rican children (RRadj = 5.14; 95% CI = 1.65-15.94) compared to white Puerto Rican children (RRadj = 1.50; 95% CI = 1.12-2.02). Early childhood lead exposure is associated with poorer achievement on standardized reading and math tests in the 3rd grade for Mexican, Puerto Rican, and Other Hispanic children enrolled in Chicago

  8. How Much Do We Spend? Creating Historical Estimates of Public Health Expenditures in the United States at the Federal, State, and Local Levels.

    Science.gov (United States)

    Leider, Jonathon P; Resnick, Beth; Bishai, David; Scutchfield, F Douglas

    2018-04-01

    The United States has a complex governmental public health system. Agencies at the federal, state, and local levels all contribute to the protection and promotion of the population's health. Whether the modern public health system is well situated to deliver essential public health services, however, is an open question. In some part, its readiness relates to how agencies are funded and to what ends. A mix of Federalism, home rule, and happenstance has contributed to a siloed funding system in the United States, whereby health agencies are given particular dollars for particular tasks. Little discretionary funding remains. Furthermore, tracking how much is spent, by whom, and on what is notoriously challenging. This review both outlines the challenges associated with estimating public health spending and explains the known sources of funding that are used to estimate and demonstrate the value of public health spending.

  9. Public involvement: the critical path in siting controversial facilities. Proceedings of the Nuclear Energy Low-Level Waste Mangement Program conference

    International Nuclear Information System (INIS)

    1986-01-01

    The purpose of the conference was to: exchange information among those responsible for, or interested in, the development of new low-level waste disposal facilities; acquaint participants with past experiences of states and organizations in enfranchising the public in the siting of controversial facilities; and discuss various mechanisms and techniques for effectively involving the public in decision-making processes. The conference addressed four major topics: lessons from past experiences; mechanisms and techniques for public involvement, conflict resolution, and working constructively with the media. A series of presentations on each topic was followed by questions and discussion among presenters and conference participants. Several key points emerged as the conference proceeded

  10. Relative political and value proximity in mediated public diplomacy: The effect of state-level homophily on international frame building

    NARCIS (Netherlands)

    Sheafer, T.; Shenhav, S.R.; Takens, J.H.; van Atteveldt, W.H.

    2014-01-01

    This article applies the homophily thesis to public diplomacy and offers an empirical examination of a country's success in its mediated public diplomacy efforts. It analyzes international frame building, the process of creating or changing media frames in the international communications arena, by

  11. The art of alignment transaction cost economics and the provision of public services at the local level

    NARCIS (Netherlands)

    van Genugten, M.L.

    2008-01-01

    This book is situated against the background of the debate on recent institutional changes in the public sector. These changes concern the privatization, liberalization and autonomization of different kinds of public services. The main incentives for introducing such new modes of governance were,

  12. Review to give the public clear information on near surface disposal project of low-level radioactive wastes generated from research, industrial and medical facilities

    International Nuclear Information System (INIS)

    Shobu, Nobuhiro; Amazawa, Hiroya; Koibuchi, Hiroto; Nakata, Hisakazu; Kato, Masatoshi; Takao, Tomoe; Terashima, Daisuke; Tanaka, Yoshie; Shirasu, Hisanori

    2013-12-01

    Japan Atomic Energy Agency (hereafter abbreviated as “JAEA”) has promoted near surface disposal project for low-level radioactive wastes generated from research, industrial and medical facilities after receiving project approval from the government in November 2009. JAEA has carried out public information about low-level radioactive wastes disposal project on the web site. When some town meetings are held toward mutual understanding with the public, more detailed and clear explanations for safety management of near surface disposal are needed especially. Therefore, the information provision method to make the public understand should be reviewed. Moreover, a web-based survey should be carried out in order to get a sense of what the public knows, what it values and where it stands on nuclear energy and radiation issues, because the social environment surrounding nuclear energy and radiation issues has drastically changed as a result of the accident at the Fukushima Daiichi Nuclear Power Station on March 11, 2011. This review clarified the points to keep in mind about public information on near surface disposal project for low-level radioactive wastes generated from research, industrial and medical facilities, and that public awareness and understanding toward nuclear energy and radiation was changed before and after the accident at Fukushima Daiichi Nuclear Power Plant. (author)

  13. ASSESSING EXPOSURE TO THE PUBLIC FROM LOW LEVEL RADIOACTIVE WASTE (LLW) TRANSPORTATION TO THE NEVADA TEST SITE

    International Nuclear Information System (INIS)

    Miller, J.J.; Campbell, S.; Church, B.W.; Shafer, D. S.; Gillespie, D.; Sedano, S.; Cebe, J.J.

    2003-01-01

    The United States (U.S.) Department of Energy (DOE) Nevada Test Site (NTS) is one of two regional sites where low-level radioactive waste (LLW) from approved DOE and U.S. DOD generators across the United States is disposed. In federal fiscal year (FY) 2002, over 57,000 cubic meters of waste was transported to and disposed at the NTS. DOE and U.S. Department of Transportation (DOT) regulations ensure that radiation exposure from truck shipments to members of the public is negligible. Nevertheless, particularly in rural communities along transportation routes in Utah and Nevada, there is perceived risk from members of the public about incremental exposure from LLW trucks, especially when ''Main Street'' and the LLW transportation route are the same. To better quantify the exposure to gamma radiation, a stationary monitoring array of four pressurized ion chambers (PICs) have been set up in a pullout just before LLW trucks reach the entrance to the NTS. The PICs are positioned at a distance of one meter from the sides of the truck trailer and at a height appropriate for the design of the trucks that will be used in FY2003 to haul LLW to the NTS. The use of four PICs (two on each side of the truck) is to minimize and to correct for non-uniformity where radiation levels from waste packages vary from side to side, and from front to back in the truck trailer. The PIC array is being calibrated by collecting readings from each PIC exposed to a known 137Cs source that was positioned at different locations on a flatbed stationed in the PIC array, along with taking secondary readings from other known sources. Continuous data collection using the PICs, with and without a truck in the array, is being used to develop background readings. In addition, acoustic sensors are positioned on each side of the PIC array to record when a large object (presumably a truck) enters the array. In FY2003, PIC surveys from as many incoming LLW trucks as possible will be made and survey data

  14. Benign Prostatic Hyperplasia: Health Seeking Behaviour of patients at a tertiary care hospital.

    Directory of Open Access Journals (Sweden)

    Aman Deep

    2010-03-01

    Full Text Available BackgroundBenign Prostatic Hyperplasia is a widely prevalent conditionaffecting elderly men throughout the world. With increasinglife expectancy, there has been a rise in the percentage ofelderly men and so for this disease across the globe. There islack of information about health seeking behaviour of patientswith Benign Prostatic Hyperplasia. Therefore the study wasdesigned with the objectives of assessing health-seekingbehaviour and the effect of literacy on it among adult andolder subjects suffering from Benign Prostatic Hyperplasiaattending a tertiary care hospital.MethodA series of 81 patients suffering from Benign ProstaticHyperplasia above the age of 50 years, attending surgical OutPatient Department of a tertiary care hospital in Delhi, wereassessed for their health seeking behaviour using a pre-testedand a modified questionnaire designed for assessing healthseeking behaviour.ResultsPositive health seeking behaviour of patients was observed in44%, who reported to a doctor within a month of noticingtheir problem. A greater proportion of the literates was awareabout the symptoms suggestive of enlarged prostate andconsulted a qualified health care practitioner as their firstaction. More literates approached the higher level of healthcare facility on being referred and had maximum faith inallopathic system of medicine. Also, lesser number of literateshad performed pooja (Hindi word for worship or othertraditional rituals for relief of their problems.ConclusionWe concluded that majority of subjects suffering fromBenign Prostatic Hypertrophy were not aware of theirdisease and their health-seeking behaviour was poor andcould be related to literacy. Our data highlights the needfor public awareness program targeting the younger malepopulation so that early detection and treatment can beoffered.

  15. Halitosis amongst students in tertiary institutions in Lagos state.

    Science.gov (United States)

    Arinola, J E; Olukoju, O O

    2012-12-01

    Halitosis is defined as a noticeable unpleasant odor from the mouth. It is a medico-social problem that affects a significant number of people around the world. Research reveals that nearly 50% of the adult population has halitosis. To determine level of awareness of halitosis and prevalence of the condition amongst students in tertiary institutions as a baseline survey. For this project, 100 students from three tertiary institutions in Lagos state were chosen: University of Lagos, Lagos State University, Ojo campus and Yaba College of Technology. A semi-structured questionnaire and practical testing/diagnostic tool were utilized. Data collected was collated and analyzed using Microsoft Excel 2007 and SPSS statistical software. Most of the respondents were single and Christian. Level of awareness of halitosis was high. Results showed that 15%, 2% and 22% from UNILAG, LASU and YCT respectively said they had halitosis. Using the diagnostic tool, 6%, 8% and 2% respectively were positive for halitosis. There is high level of awareness of halitosis among the respondents. The prevalence of the disorder is low, however, it is recommended that enlightenment campaigns be mounted in schools to improve level of awareness and treatment seeking.

  16. Tertiary recovery and tritide injection equipment

    International Nuclear Information System (INIS)

    Li Lin

    1989-01-01

    The exploitation of an oil field is a continously developing process, undergoing seveal stages, such as the low production, the high production, the stable production and the decline. The tertiary recovery is an important means of the enhanced oil recovery. Since the object of the tertiary recovery is to treat the oil in micropores which is difficult to be produced, it is more necessary to know further the reservoir. Tritide can be used as a tracer and is an ideal marker of knowing the reservoir and the state of the fluid movement. The paper presents the tritide injection equipment

  17. Impact of Type 2 Myocardial Infarction (MI) on Hospital-Level MI Outcomes: Implications for Quality and Public Reporting.

    Science.gov (United States)

    Arora, Sameer; Strassle, Paula D; Qamar, Arman; Wheeler, Evan N; Levine, Alexandra L; Misenheimer, Jacob A; Cavender, Matthew A; Stouffer, George A; Kaul, Prashant

    2018-03-26

    The International Classification of Diseases (ICD) coding system does not recognize type 2 myocardial infarction (MI) as a separate entity; therefore, patients with type 2 MI continue to be categorized under the general umbrella of non-ST-segment-elevation myocardial infarction (NSTEMI). We aim to evaluate the impact of type 2 MI on hospital-level NSTEMI metrics and discuss the implications for quality and public reporting. We conducted a single-center retrospective analysis of 1318 patients discharged with a diagnosis of NSTEMI between July 2013 and October 2014. The Third Universal Definition was used to define type 1 and type 2 MI. Weighted Kaplan-Meier curves were used to analyze risk of mortality and readmission. Overall, 1039 patients met NSTEMI criteria per the Third Universal Definition; of those, 264 (25.4%) had type 2 MI. Patients with type 2 MI were older, were more likely to have chronic kidney disease, and had lower peak troponin levels. Compared with type 1 MI patients, those with type 2 MI had higher inpatient mortality (17.4% versus 4.7%, P <0.0001) and were more likely to die from noncardiovascular causes (71.7% versus 25.0%, P <0.0001). Despite weighting for patient characteristics and discharge medications, patients with type 2 MI had higher mortality at both 30 days (risk ratio: 3.63; 95% confidence interval, 1.67-7.88) and 1 year (risk ratio: 1.98; 95% confidence interval, 1.44-2.73) after discharge. Type 2 MI was also associated with a lower 30-day cardiovascular-related readmission (risk ratio: 0.49; 95% confidence interval, 0.12-2.06). NSTEMI metrics are significantly affected by type 2 MI patients. Type 2 MI patients have distinct etiologies, are managed differently, and have higher mortality compared with patients with type 1 MI. Moving forward, it may be appropriate to exclude type 2 MI data from NSTEMI quality metrics. © 2018 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

  18. Energy Management Systems and tertiary regulation in hierarchical control architectures for islanded micro-grids

    DEFF Research Database (Denmark)

    Sanseverino, Eleonora Riva; Di Silvestre, Maria Luisa; Quang, Ninh Nguyen

    2015-01-01

    In this paper, the structure of the highest level of a hierarchical control architecture for micro-grids is proposed. Such structure includes two sub-levels: the Energy Management System, EMS, and the tertiary regulation. The first devoted to energy resources allocation in each time slot based...

  19. What we need to know ...and when. Educating the public about nuclear terrorist risks can help raise levels of security

    International Nuclear Information System (INIS)

    Khripunov, I.

    2006-01-01

    Nuclear power infrastructures could be the target of terrorist acts of theft, sabotage, unauthorized access or other malicious acts given their radiological and chemical content and potential for building weapons. Attacks on its major components, including fuel production, reactors, waste handling, and reprocessing facilities, would lead to serious consequences-even if there is little or no damage to a nuclear power plant itself and other related structures. Public fear of nuclear radiation, in combination with a possibly massive resultant blackout and other aggravating factors, could create significant distress and panic. In other words, successful terrorist attempts to attack nuclear power infrastructure can easily bring about systemic disaster. Systemic risks impact society on a large scale and their effects may spread much further from the original hazardous source. Those risks widely affect systems that society depends on, such as health, transport, environment, telecommunications. Their consequences may be technical, social, environmental, psychological and economic and involve different stakeholders. In this context, however, one important stakeholder has been under-appreciated, under-utilized and somewhat misunderstood: the general public. The nuclear power infrastructure must learn how to efficiently communicate to the public and develop better options for public risk communication that relate to deliberate attacks or accidents. The public is also a challenging stockholder because citizens are deeply split regarding the acceptability and value of nuclear power generation and tend to express their feelings emotionally. However, there is growing recognition that because of skyrocketing oil prices and evidence of the greenhouse effect, nuclear power may be approaching renaissance. Hence, the public must no longer be looked upon only as potential victims or panicked masses but rather as an important contributing factor for better nuclear security throughout

  20. Intense acidic volcanism at the Cretaceous-Tertiary boundary

    International Nuclear Information System (INIS)

    Javoy, M.; Courtillot, V.

    1989-01-01

    A 87 Sr/ 86 Sr spike in seawater strontium with amplitude 2 x 10 -4 and duration of order 2 Ma is superimposed on longer-term variations at the Cretaceous-Tertiary boundary. The anomaly has been attributed to increased continental runoff due either to meteorite impact-related acid rain or sea-level regression. We speculate here that the spike could have resulted from intense, explosive acid volcanism preceding the development of the Deccan traps. A good model, both in tectonic position and geochemical characteristics, for these as yet elusive acidic products is provided by granites in the Seychelles Islands and particularly Mahe. (orig.)

  1. Seres Vivos. Nivel I. Basado en el curso de estudios de Ciencia de Montgomery County Public Schools. (Living Beings. Level 1. Based on the Montgomery County Public Schools Science Studies Program).

    Science.gov (United States)

    Senger, Graciela

    This curriculum unit, developed by the Montgomery County Public Schools, Maryland, was designed for use in the elementary level foreign language immersion program. It is geared toward the first grade science classroom. The unit includes instructional and performance objectives, necessary vocabulary lists, optional language structure sections,…

  2. Exploring the linkages among urban form travel behavior and public health with person level data from smart phone applications.

    Science.gov (United States)

    2013-09-01

    The interaction between the built environment, travel behavior and public health is now a major concern for both : researchers and urban planners. Currently, there is little empirical research that explores and examines the : relationship between eac...

  3. Efficiency and Productivity of County-level Public Hospitals Based on the Data Envelopment Analysis Model and Malmquist Index in Anhui, China.

    Science.gov (United States)

    Li, Nian-Nian; Wang, Cun-Hui; Ni, Hong; Wang, Heng

    2017-12-05

    China began to implement the national medical and health system and public hospital reforms in 2009 and 2012, respectively. Anhui Province is one of the four pilot provinces, and the medical reform measures received wide attention nationwide. The effectiveness of the above reform needs to get attention. This study aimed to master the efficiency and productivity of county-level public hospitals based on the data envelopment analysis (DEA) model and Malmquist index in Anhui, China, and then provide improvement measures for the future hospital development. We chose 12 country-level hospitals based on geographical distribution and the economic development level in Anhui Province. Relevant data that were collected in the field and then sorted were provided by the administrative departments of the hospitals. DEA models were used to calculate the dynamic efficiency and Malmquist index factors for the 12 institutions. During 2010-2015, the overall average relative service efficiency of 12 county-level public hospitals was 0.926, and the number of hospitals achieved an effective DEA for each year from 2010 to 2015 was 4, 6, 7, 7, 6, and 8, respectively, as measured using DEA. During this same period, the average overall production efficiency was 0.983, and the total productivity factor had declined. The overall production efficiency of five hospitals was >1, and the rest are productivity has not been effectively improved. County-level public hospitals need to combine their own reality to find their own deficiencies.

  4. Solvent effects on the magnetic shielding of tertiary butyl alcohol

    African Journals Online (AJOL)

    )4 and tetramethyl ammonium cation N(CH3)4(+) have also been presented. KEY WORDS: Solvent effects, Magnetic shielding, Tertiary butyl alcohol, Tertiary butyl amine, Continuum solvation calculations, Chemical shift estimation methods

  5. Modelling the harmonized tertiary Institutions Salary Structure ...

    African Journals Online (AJOL)

    This paper analyses the Harmonized Tertiary Institution Salary Structure (HATISS IV) used in Nigeria. The irregularities in the structure are highlighted. A model that assumes a polynomial trend for the zero step salary, and exponential trend for the incremental rates, is suggested for the regularization of the structure.

  6. American Tertiary mollusks of the genus Clementia

    Science.gov (United States)

    Woodring, W.P.

    1927-01-01

    Aside from its value as an aid in determining the age of Tertiary beds, the chief interest of the genus Clementia lies in the anomalous features of its present and former distribution. An attempt is made in this paper to trace its geologic history, to point out its paleobiologic significance, and to describe all the known American Tertiary species. The fossils from Colombia used in preparing this report were collected during explorations made under the direction of Dr. 0. B. Hopkins, chief geologist of the Imperial Oil Co. (Ltd.), who kindly donated them to the United States National Museum. Dr. T. Wayland Vaughan, of the Scripps Institution of Oceanography, furnished information relating to specimens collected by him in Mexico. Dr. Bruce L. Clark, of the University of California; Dr. G. Dallas Hanna, of the California Academy of Sciences; Dr. H. A. Pilsbry, of the Philadelphia Academy of Natural Sciences; and Dr. W. D. Matthew, of the American Museum of Natural History, generously loaned type specimens and other material. Doctor Clark and Doctor Hanna also gave information concerning the Tertiary species from California. Mr. Ralph B. Stewart, of the University of California, read the manuscript, and I have taken advantage of his suggestions. I am also indebted to Mr. L. R. Cox, of the British Museum, for information relating to the fossil species from Persia, Zanzibar, and Burma, and to Dr. Axel A. Olsson, of the International Petroleum Co., for data concerning undescribed Tertiary species from Peru.

  7. Misconception of emergency contraception among tertiary school ...

    African Journals Online (AJOL)

    Objective: To assess the degree of awareness and use of emergency contraception among tertiary school students in Akwa Ibom State, Nigeria. Design: A self-administered questionnaire survey. Setting: The Akwa Ibom State Polytechnic, Ikot Osurua, located on the outskirts of Ikot Ekpene local government area between ...

  8. Understanding Australian Aboriginal Tertiary Student Needs

    Science.gov (United States)

    Oliver, Rhonda; Rochecouste, Judith; Bennell, Debra; Anderson, Roz; Cooper, Inala; Forrest, Simon; Exell, Mike

    2013-01-01

    Drawing from a study of the experiences of Australian Aboriginal and Torres Strait Islander university students, this paper presents an overview of the specific needs of these students as they enter and progress through their tertiary education. Extracts from a set of case studies developed from both staff and student interviews and an online…

  9. Indigenous Students in the Tertiary Education Sector

    Science.gov (United States)

    Bandias, Susan; Fuller, Don; Larkin, Steven

    2014-01-01

    Important recent objectives of indigenous education policy in Australia have been aimed at redressing indigenous economic and social disadvantage through increasing student retention, progression and completion rates in both compulsory and post-compulsory education. The two sectors of the tertiary education system, vocational education and…

  10. SECTORAL ANALYSIS: GROWTH ACCOUNTING OF TERTIARY INDUSTRIES

    Directory of Open Access Journals (Sweden)

    Yahya Z. ALSHEHHI

    2017-08-01

    Full Text Available The tertiary sector is one of the modern styles of economic systems in view of the share it occupies in the field of production as well as employment occupied share. Hence, just like other lands, the UAE, witnessed an economic structural change similar to developed and developing nations, where the tertiary industries contributed 55.4% in 2015 to total country’s income. The empirical study aimed to analyze the contribution portion of growth in the tertiary industries through using the growth accounting framework in time-series from 1990 to 2015. The empirical study found that most of the industries contributed significantly to the growth of the tertiary sector. The contribution shares of growth due to labor and capital varied among industries. The main observed results show that there was a vice versa relationship between TFP performance and the size of labor, where the TFP positively corresponded with the decline in the size of labor specifically from 2010-2015.

  11. Presenting signs of retinoblastoma at a tertiary level teaching ...

    African Journals Online (AJOL)

    The commonest presenting sign was proptosis 22(53.7%) followed by leucocorea nine (22%),ocular inflammation four (9.0 %), strabismus three (7.3%), glaucoma one (2.4%), loss of vision one (2.4%)and hyphemaone (2.4%). Conclusion: The commonest presenting signs of retinoblastoma in our set up were Proptosis ...

  12. Entrepreneurship Education at Tertiary Education Level: Implication to Historical Studies

    Science.gov (United States)

    Lawal, Salahu Mohammed

    2013-01-01

    Nigeria is richly endowed with both human and material resources that when well utilized can make her one of the richest and developed nation in the world. But poor utilization of the resources, corruption and dwindling fortune in her education system made her among the first twenty five poorest nations in the world. Similarly, report shows that…

  13. Assessing Education Needs at Tertiary Level: The Focus Group Method

    Directory of Open Access Journals (Sweden)

    Elena-Mirela Samfira

    2015-10-01

    Full Text Available The goal of the paper is to point out the advantages and disadvantages of the focus group method in assessing the education needs of teachers and students in veterinary medicine. It is the first stage of a wider research aiming at developing problem-based teaching and learning methodologies in the field of veterinary medicine. The materials used consisted of literature documents on focus group as a research method in social sciences. The authors studied the literature available in the field and synthesised its main advantages and disadvantages. The paper is the first of this kind in Romania. Results show that there is no agreement yet on the advantages and disadvantages of this method. The research limitation is that there is almost no Romanian literature on focus group as a method. The usefulness of the paper is obvious: it allows other researchers in the field of education see the benefits of using such a research method. The originality of the paper consists in the fact that there has been no such research so far in Romanian higher education. Based on the results of the focus groups organised, the authors will design and implement a problem-based learning methodology for the students in veterinary medicine.

  14. Portfolio at Tertiary Level – Lifelong Learning Tool

    Directory of Open Access Journals (Sweden)

    Galina Kavaliauskienė

    2011-04-01

    Full Text Available The use of electronic language portfolios has been preferable to the use of common paper portfolios for ease of application – there is no need for accumulating a number of files of written papers, which solves the problem of storing space and, to some extent, helps reduce students’ and teachers’ workload.The study investigated learners’ perceptions of employing electronic language portfolios for conducting various assignments in English for Specific Purposes. The research involved university students of different specializations. Learners’ experience of employing portfolios and opinions on their benefits for improving language skills have been analyzed and statistically treated using SPSS software. The results show that students are positive about application of electronic portfolios in ESP classes. The use of online portfolios for various assignments helps teachers foster students’ learning, encourages critical thinking, develops creativity, motivates learners to use digital technology, encourages collaboration of learners, and in the long run, leads to lifelong learning.

  15. Introducing the Process into Tertiary Level ESP Writing Classes.

    Science.gov (United States)

    Rea, Simon; Brewster, Eric

    1993-01-01

    Insights from first- and second-language learning research have been used to help prepare a process-based writing course for large nonnative speaker classes at a commercial and technical university in Austria. Methods used during the 21-hour course are described, including think-aloud writing tapes. (Contains 32 references.) (Author/LB)

  16. Continuous assessment for tertiary-level language teaching: an aid ...

    African Journals Online (AJOL)

    In 2004, based on the findings of scholarlyenquiry, the French Section of theUniversity of Cape Town decided to prioritise continuous assessment to measurelanguage acquisition, partly with a view to enabling students to monitor their progressmore effectively. In a spirit of quality control (De Ketele, 2003), the purpose of ...

  17. SPECTRUM OF SINONASAL MASS AT A TERTIARY LEVEL HOSPITAL

    Directory of Open Access Journals (Sweden)

    Amit Kumar Bhardwaj

    2016-11-01

    Full Text Available BACKGROUND Lesions of the sinonasal region are commonly encountered in clinical practice. These lesions are important from clinical and pathological view as they have a variety of histological spectrum with different managements. MATERIALS AND METHODS Present study included 106 polypoidal lesions of the nasal cavity. The study period constituted from March 2003 to August 2014. All the tissues were fixed in 10% buffered formalin, processed and stained with Haematoxylin and Eosin and studied for various histopathological patterns. RESULTS Among 106 cases, 87 cases (82.07% were nonneoplastic and 19 cases (17.92% were neoplastic. Among the noninflammatory lesion, nasal polyp was found in 76 cases (87.7% and was the commonest lesion. Benign tumours were 11 in number (10.35% and were more frequent than malignant tumours, which were 8 in number (7.54%. Among benign neoplastic lesions, angiofibroma and haemangioma (each 4 in number (36.36% were the commonest lesion. All lesions were common in second and third decades with male predominance in benign, while malignant lesions were more common in female gender. Among the malignant lesions, squamous cell carcinoma and undifferentiated nasopharyngeal carcinoma were the most common malignant lesions, each were three in number. CONCLUSION Categorisation of the sinonasal mass according to their histopathological features and comparing them with the existing data guides the treatment and prognosis of the disease, so far every polypoidal lesions histological examination is advised.

  18. original article an innovation systems perspectives on tertiary-level

    African Journals Online (AJOL)

    agricultural education from an innovation systems perspective, an approach ... 5 Sustainable Agriculture, Land and Water, Lancaster Environment Centre ( ... Ethiopia's capacity to leverage science ..... mobilization, project management; and.

  19. Rajiv Aarogyasri Community Health Insurance Scheme in Andhra Pradesh, India: a comprehensive analytic view of private public partnership model.

    Science.gov (United States)

    Reddy, Sunita; Mary, Immaculate

    2013-01-01

    The Rajiv Aarogyasri Community Health Insurance (RACHI) in Andhra Pradesh (AP) has been very popular social insurance scheme with a private public partnership model to deal with the problems of catastrophic medical expenditures at tertiary level care for the poor households. A brief analysis of the RACHI scheme based on officially available data and media reports has been undertaken from a public health perspective to understand the nature and financing of partnership and the lessons it provides. The analysis of the annual budget spent on the surgeries in private hospitals compared to tertiary public hospitals shows that the current scheme is not sustainable and pose huge burden on the state exchequers. The private hospital association's in AP, further acts as pressure groups to increase the budget or threaten to withdraw services. Thus, profits are privatized and losses are socialized.

  20. Tertiary Education in the Czech Republic: The Pathway to Change

    Science.gov (United States)

    Pesik, Richard; Gounko, Tatiana

    2011-01-01

    This article analyzes recent policy proposals to reform Czech tertiary education. A brief overview of the evolution of Czech tertiary education presents the background against which emerging policy trends in education are examined. We relate the changes in tertiary education to the policy framework and recommendations of the OECD, underpinned by…

  1. Medical tourism in India: perceptions of physicians in tertiary care hospitals.

    Science.gov (United States)

    Qadeer, Imrana; Reddy, Sunita

    2013-12-17

    Senior physicians of modern medicine in India play a key role in shaping policies and public opinion and institutional management. This paper explores their perceptions of medical tourism (MT) within India which is a complex process involving international demands and policy shifts from service to commercialisation of health care for trade, gross domestic profit, and foreign exchange. Through interviews of 91 physicians in tertiary care hospitals in three cities of India, this paper explores four areas of concern: their understanding of MT, their views of the hospitals they work in, perceptions of the value and place of MT in their hospital and their views on the implications of MT for medical care in the country. An overwhelming majority (90%) of physicians in the private tertiary sector and 74.3 percent in the public tertiary sector see huge scope for MT in the private tertiary sector in India. The private tertiary sector physicians were concerned about their patients alone and felt that health of the poor was the responsibility of the state. The public tertiary sector physicians' however, were sensitive to the problems of the common man and felt responsible. Even though the glamour of hi-tech associated with MT dazzled them, only 35.8 percent wanted MT in their hospitals and a total of 56 percent of them said MT cannot be a public sector priority. 10 percent in the private sector expressed reservations towards MT while the rest demanded state subsidies for MT. The disconnect between their concern for the common man and professionals views on MT was due to the lack of appreciation of the continuum between commercialisation, the denial of resources to public hospitals and shift of subsidies to the private sector. The paper highlights the differences and similarities in the perceptions and context of the two sets of physicians, presents evidence, that questions the support for MT and finally analyzes some key implications of MT on Indian health services, ethical

  2. Medical tourism in india: perceptions of physicians in tertiary care hospitals

    Science.gov (United States)

    2013-01-01

    Senior physicians of modern medicine in India play a key role in shaping policies and public opinion and institutional management. This paper explores their perceptions of medical tourism (MT) within India which is a complex process involving international demands and policy shifts from service to commercialisation of health care for trade, gross domestic profit, and foreign exchange. Through interviews of 91 physicians in tertiary care hospitals in three cities of India, this paper explores four areas of concern: their understanding of MT, their views of the hospitals they work in, perceptions of the value and place of MT in their hospital and their views on the implications of MT for medical care in the country. An overwhelming majority (90%) of physicians in the private tertiary sector and 74.3 percent in the public tertiary sector see huge scope for MT in the private tertiary sector in India. The private tertiary sector physicians were concerned about their patients alone and felt that health of the poor was the responsibility of the state. The public tertiary sector physicians’ however, were sensitive to the problems of the common man and felt responsible. Even though the glamour of hi-tech associated with MT dazzled them, only 35.8 percent wanted MT in their hospitals and a total of 56 percent of them said MT cannot be a public sector priority. 10 percent in the private sector expressed reservations towards MT while the rest demanded state subsidies for MT. The disconnect between their concern for the common man and professionals views on MT was due to the lack of appreciation of the continuum between commercialisation, the denial of resources to public hospitals and shift of subsidies to the private sector. The paper highlights the differences and similarities in the perceptions and context of the two sets of physicians, presents evidence, that questions the support for MT and finally analyzes some key implications of MT on Indian health services, ethical

  3. Prevención de la transmisión vertical del VIH-1 en un hospital público de complejidad terciaria de Buenos Aires, Argentina Prevention of vertical HIV-1 transmission in a tertiary care public hospital in Buenos Aires, Argentina

    Directory of Open Access Journals (Sweden)

    Diego Cecchini

    2011-09-01

    Full Text Available OBJETIVO: Describir las características de los binomios madre-hijo, la profilaxis antirretroviral, la evolución temporal de la transmisión vertical del VIH-1 y sus variables asociadas en una población asistida por un hospital público de complejidad terciaria de Argentina. MÉTODOS: Estudio descriptivo prospectivo desarrollado por el Grupo de trabajo en prevención de la Transmisión Vertical del Hospital General de Agudos Dr. Cosme Argerich, Buenos Aires, Argentina, entre 1998 y 2008. Se compararon los períodos 1998-2003 y 2004-2008, y se identificaron las variables asociadas a esta vía de contagio. RESULTADOS: De 357 binomios madre-hijo, 21,0% de las madres presentaron coinfección con el virus de la hepatitis C y 68,0% linfocitos CD4 OBJECTIVE: To describe characteristics of mother-child binomium (MCB, antiretroviral (ARV prophylaxis, time trends, and variables associated with vertical transmission of HIV-1 in a population assisted by a tertiary public hospital in Argentina. METHODS: Prospective descriptive study undertaken by the Hospital Cosme Argerich s Vertical Transmission Working Group, Buenos Aires city, Argentina 1998-2008. Periods 1998-2003 vs. 2004-2008 were compared and variables associated with vertical transmission identified. RESULTS: Of 357 MCB, 21.0% of the mothers had HCV coinfection and 68.0% CD4 < 500/µL. During pregnancy, 75.0% received ARV: zidovudine (17.8%, zidovudinelamivudine (19.8%, zidovudine-lamivudine-nevirapine (41.9%, and zidovudinelamivudine-protease inhibitor (11.4%; 74.0% had viral load (VL peripartum < 1 000 copies/mL. Caesarean delivery: 58.0%. Intrapartum zidovudine: 83.4%; 98.0% of infants received prophylaxis; zidovudine monotherapy was the most frequently used (73.0%. Of neonates, 15.4% had low birthweight and 6.7% were premature. The global vertical transmission was 3.3% (10/302. Comparing both periods, an increase in triple ARV and VL < 1 000 copies/mL in peripartum and a decrease in the

  4. RISK ANALYSIS AND INTERNAL CONTROL ASSESSMENT - PREMISES FOR IMPROVING MANAGEMENT AT THE LEVEL OF ROMANIAN PUBLIC ENTITIES

    Directory of Open Access Journals (Sweden)

    CRISTINA MARIA VOINEA

    2015-10-01

    Full Text Available Romania, as a European Union member state, has undergone, in recent years, a complex process of reform in all activity fields. This includes the current process of public administration reform, which aims to improve the management, the administrative capacity and the manner in which the entire Romanian public sector is organized. In this study, we intend to portray the manner in which the internal control system and the internal audit structure of a Romanian public entity are shaped into form. For exemplification, we chose the internal audit mission titled “The Accounting System and Its Reliability”. We will identify the risks, we will assess them and we will also propose measures through which the entity’s management may mitigate these risks by correcting registered deviations.

  5. Navigating the evidentiary turn in public health: Sensemaking strategies to integrate genomics into state-level chronic disease prevention programs.

    Science.gov (United States)

    Senier, Laura; Smollin, Leandra; Lee, Rachael; Nicoll, Lauren; Shields, Michael; Tan, Catherine

    2018-06-23

    In the past decade, healthcare delivery has faced two major disruptions: the mapping of the human genome and the rise of evidence-based practice. Sociologists have documented the paradigmatic shift towards evidence-based practice in medicine, but have yet to examine its effect on other health professions or the broader healthcare arena. This article shows how evidence-based practice is transforming public health in the United States. We present an in-depth qualitative analysis of interview, ethnographic, and archival data to show how Michigan's state public health agency has navigated the turn to evidence-based practice, as they have integrated scientific advances in genomics into their chronic disease prevention programming. Drawing on organizational theory, we demonstrate how they managed ambiguity through a combination of sensegiving and sensemaking activities. Specifically, they linked novel developments in genomics to a long-accepted public health planning model, the Core Public Health Functions. This made cutting edge advances in genomics more familiar to their peers in the state health agency. They also marshaled state-specific surveillance data to illustrate the public health burden of hereditary cancers in Michigan, and to make expert panel recommendations for genetic screening more locally relevant. Finally, they mobilized expertise to help their internal colleagues and external partners modernize conventional public health activities in chronic disease prevention. Our findings show that tools and concepts from organizational sociology can help medical sociologists understand how evidence-based practice is shaping institutions and interprofessional relations in the healthcare arena. Copyright © 2018 Elsevier Ltd. All rights reserved.

  6. EXPLORING THE TERTIARY EFL STUDENTS' ACADEMIC WRITING COMPETENCIES

    Directory of Open Access Journals (Sweden)

    Aunurrahman Aunurrahman

    2017-05-01

    Full Text Available For tertiary English as a Foreign Language (EFL students, academic writing is not an easy task. It requires knowledge of the academic writing genres with their particular linguistic features. Moreover, academic writing demands good critical thinking. This research aims to explore the students' academic writing competencies that also focus on critical thinking. The research involved thirty-six first-year tertiary EFL students from a regular class of a private university in Pontianak, West Kalimantan, Indonesia. The source for data collection was the students’ texts. Three texts were selected and the students were categorized into low, medium, and high levels of writing achievement. The text analysis utilized functional grammar rooted in systemic functional linguistics (Emilia, 2014. The analysis shows that the students, regardless of their levels of writing achievement, have little control over the schematic structure and linguistic features of an argumentative writing. The text analysis also shows that the students’ texts have some limitations as regards their critical thinking capacity. Still, a few examples of academic language were detected in the texts. The findings suggest that the lecturer should incorporate explicit teaching and cooperative learning activities to alleviate the students' difficulties and develop their academic writing and critical thinking capacity.

  7. Critical Factors for Open Data Publication and Use : A Comparison of City-level, Regional, and Transnational Cases

    NARCIS (Netherlands)

    susha, Iryna; Zuiderwijk-van Eijk, AMG; Charalabidis, Y; Parycek, P; Janssen, M.F.W.H.A.

    2015-01-01

    There is a lack of research concerning the factors influencing the success or failure of open data initiatives. Based on the results of two workshops, we provide a list of 47 success factors for open data publication and 18 success factors for open data use. We further use three case studies

  8. The Relationship of Public Relations and Board-Level Boundary-Spanning Roles to Corporate Social Responsibility.

    Science.gov (United States)

    Ferguson, Mary Ann; And Others

    The annual reports of 197 publicly held American corporations were analyzed to determine the relationship of corporate social responsibility activities to boundary-spanning activities (attempts to relate the firm to the outside world). Data gathered included (1) the number of directors from inside and outside a corporation, (2) the number of…

  9. [Intersectoral experience to bridge the gap between human resources in public health and the technical-operational level for Peruvian Voluntary Military Service members].

    Science.gov (United States)

    Romaní-Romaní, Franco; Curisinche-Rojas, Maricela; Arteaga, Norka Rojas; Lopez, Pedro Riega; Cabezas, César

    2016-01-01

    There is a gap between human resources and technical-operational education that limits the Peruvian health system's ability to implement public health interventions. The Peruvian Ministry of Health, through the National Health Institute and the Ministry of Defense, implemented a Public Health Training Program addressed to young full-time military servicemen, on the basis of the competency profile of a public health technician. The program consists of seven thematic units given in 390 hours, 200 of which correspond to classroom and field practices. Between July 2014 and December 2015, the program has been carried out in 10 venues of the three armed forces, training and certifying 405 young servicemen. The intervention provides the military service with an additional educational benefit, making it more appealing as a chance for development and opens up a line of work in the public health sector for young people in more remote areas. This experience seeks to increase public health-trained human resources to a technical-operational level. In collaboration with regional governments, graduates are expected to be welcomed and included in the public health system.

  10. Waste isolation in the U.S., technical programs and public education. Volume 2 - low level waste, volume reduction methodologies and economics. Vol. 2

    International Nuclear Information System (INIS)

    Post, R.G.

    1984-01-01

    This volume presents information regarding low-level waste, volume reduction methodologies and economics. Topics include: public education on nuclear waste; economics of low-level waste management systems; operating experience with advanced volume reduction techniques; solidification of waste; operating experience with advanced volume reduction techniques--incineration; regional plans for the disposal of low-level waste; radwaste system modifications at nuclear power plants; operating experience with advanced volume reduction techniques--operations and on-site storage issues; and economic impact of 10CFR61

  11. Does public health system provide adequate financial risk protection to its clients? Out of pocket expenditure on inpatient care at secondary level public health institutions: Causes and determinants in an eastern Indian state.

    Science.gov (United States)

    Rout, Sarit Kumar; Choudhury, Sarmistha

    2018-02-09

    This study is undertaken to estimate the out of pocket expenditure (OOPE) for various diseases and its determinants at secondary level public health facilities in Odisha. A cross-sectional survey was conducted among the inpatients utilising secondary level public health facilities in the 2 districts of Odisha. More than 80% of the inpatients were selected conveniently, and data on OOPE and socioeconomic status of patients were collected. The OOPE was estimated separately on surgery, nonsurgery, and child birth conditions. Ordinary least square regression models were developed to explain the factors determining OOPE. The mean OOPE for the secondary care facility was Indian National Rupee 3136.14, (95% CI: 2869.08-3403.19), of which, Indian National Rupee 1622.79 (95% CI: 1462.70-1782.89) was on medicine constituting 79% of total medical expenditure. The mean OOPE on surgery was highest followed by nonsurgery and child birth conditions. The OOPE is mainly influenced by caste and educational status of patients as revealed by the regression results. With increase in social status, the OOPE increases and the results are statistically significant. This evidence should be used to design financial strategies to reduce OOPE at secondary care public health facilities, which is largely due to medicine, diagnostic services, and transport expenditure. Efforts should be made to protect the interest of the poor, who utilise public health facility in a low resource setting in India. Copyright © 2018 John Wiley & Sons, Ltd.

  12. Palynological and iridium anomalies at Cretaceous-Tertiary boundary, south-central Saskatchewan

    Science.gov (United States)

    Nichols, D.J.; Jarzen, D.M.; Orth, C.J.; Oliver, P.Q.

    1986-01-01

    The Cretaceous-Tertiary boundary in south-central Saskatchewan is marked by coincident anomalies in abundance of iridium and fern spores at the extinction level of a suite of Cretaceous pollen taxa. Evidence of disruption of the terrestrial flora includes the fern-spore abundance anomaly and local extinction of as much as 30 percent of angiosperm species. The reorganized earliest Tertiary flora is made up largely of surviving species that assumed new roles of dominance. Persistence of climatically sensitive taxa across the boundary indicates that if paleoclimate was altered by the terminal Cretaceous event, it returned quickly to the pre-event condition.

  13. The Daily Mail has been trying to raise public anxiety over teenagers, sex and the contraceptive pill to reckless levels.

    Science.gov (United States)

    Corcoran, C

    The Daily Mail is opposed to the provision of family planning counseling and argues that all family planning advice is a conspiracy of the Left. The publication recently devoted its front page to a story claiming that 10% of girls take oral contraception by reaching age 15 years. This study was based upon 13 words in a 13-page Department of Health document published weeks earlier which stated that an estimated 10% of resident women aged 14-15 years attended family planning clinics. Only like-minded conservatives were called upon to comment in the publication. The Family Planning Association's press office fielded many calls the morning the story broke, explaining to callers that the organization was pleased to see that so many young people were using family planning clinics' services and that it hoped the figures would increase in the future in the interest of checking the incidence of unplanned pregnancy, abortion, and sexually transmitted diseases. Related radio news coverage ensued.

  14. Augmented Reality in Scientific Publications-Taking the Visualization of 3D Structures to the Next Level.

    Science.gov (United States)

    Wolle, Patrik; Müller, Matthias P; Rauh, Daniel

    2018-03-16

    The examination of three-dimensional structural models in scientific publications allows the reader to validate or invalidate conclusions drawn by the authors. However, either due to a (temporary) lack of access to proper visualization software or a lack of proficiency, this information is not necessarily available to every reader. As the digital revolution is quickly progressing, technologies have become widely available that overcome the limitations and offer to all the opportunity to appreciate models not only in 2D, but also in 3D. Additionally, mobile devices such as smartphones and tablets allow access to this information almost anywhere, at any time. Since access to such information has only recently become standard practice, we want to outline straightforward ways to incorporate 3D models in augmented reality into scientific publications, books, posters, and presentations and suggest that this should become general practice.

  15. Encouraging planetary sciences students at the Master level with observations using small telescopes that lead to their publication

    Science.gov (United States)

    Sanchez-Lavega, A.; Ordoñez-Etxeberria, I.; del Rio Gaztelurrutia, T.; Illarramendi, M. A.; Perez-Hoyos, S.; Hueso, R.; Rojas, J. F.

    2017-12-01

    We present a set of practical experiments carried out with the students of the Master in Space Science and Technology of the University of the Basque Country (A. Sanchez-Lavega et al., Eur. J. of Eng. Education. 2014) using small telescopes that have been published in refereed journals. The telescopes (from 15 to 50 cm in aperture) and instruments pertain to the Aula EspaZio Gela Observatory (http://www.ehu.eus/aula-espazio/presentacion.html). The students have participated in some cases as co-authors of the publications or in presentations at meetings which encourages them to continue their scientific career towards PhD studies. Dedicated observations with these small telescopes with the participation of the planetary amateur community have also been employed in scientific research and publications. A series of examples are presented.

  16. Chinese Tertiary English Educators' Perceptions of Foreign Teacher Involvement in Their Professional Development

    Science.gov (United States)

    Bleistein, Tasha Maria

    2013-01-01

    China continues to invite expatriate tertiary-level English language educators to teach. Foreign English language teachers and local Chinese English educators who wish to develop professionally have an ever-increasing body of research regarding Chinese culture, education, professional development, and intercultural communication; however, research…

  17. Emotions or Science? Pre-Tertiary Males' Accounts of Psychology as a Subject Choice

    Science.gov (United States)

    Mercer, Jenny; Sander, Paul; Williams, Stella; Jones, Tim

    2013-01-01

    It is well established that the number of males studying psychology in the UK, both at A-level and on degree courses, is disproportionately low compared to females. There is a paucity of research, however, which discusses how psychology is viewed by this group. The present study employed focus groups with 35 pre-tertiary males (some of whom were…

  18. Characterisation of Teacher Professional Knowledge and Skill through Content Representations from Tertiary Chemistry Educators

    Science.gov (United States)

    Schultz, M.; Lawrie, G. A.; Bailey, C. H.; Dargaville, B. L.

    2018-01-01

    An established tool for collating secondary teachers' pedagogical content knowledge (Loughran's CoRe) has been adapted for use by tertiary educators. Chemistry lecturers with a range of levels of experience were invited to participate in workshops through which the tool was piloted, refined and applied. We now present this refined tool for the…

  19. Adapting the Academic Motivation Scale for Use in Pre-Tertiary Mathematics Classrooms

    Science.gov (United States)

    Lim, Siew Yee; Chapman, Elaine

    2015-01-01

    The Academic Motivation Scale (AMS) is a comprehensive and widely used instrument for assessing motivation based on the self-determination theory. Currently, no such comprehensive instrument exists to assess the different domains of motivation (stipulated by the self-determination theory) in mathematics education at the pre-tertiary level (grades…

  20. Tertiary Treatment Process of Preserved Wastewater

    Directory of Open Access Journals (Sweden)

    Wang Qingyu

    2016-01-01

    Full Text Available The effects of the composite coagulants on coagulation sedimentation for the preserved wastewater was investigated by changing the composite coagulant dosages, and the coagulant was composed of polymeric ferric sulfate (PFS, polyaluminium chloride (PAC, and polyaluminum ferric silicate (PAFSC, while the effect of the tertiary treatment process on the preserved wastewater was tested, which was exceeded the standard seriously. The results showed that 400 mg/L was the optimum composite coagulant dosage. The removal rates of salt and sugar were as high as 99.1% and 99.5% respectively, and the removal rates of CODCr and SS were 99.3% and 96.0%, respectively after the preserved wastewater was treated by the tertiary treatment technology, which both reached the primary standard of “The Integrated Wastewater Discharge Standard” (GB8978-1996.

  1. Optimising Tertiary Student Accommodation within University Neighbourhoods

    OpenAIRE

    Ike, Nnenna; Baldwin, Claudia; Lathouras, Athena

    2017-01-01

    Tertiary students’ activities within neighbourhoods adjacent to universities engender positive and negative impacts that have consequences for neighbourhood sustainability. This might lead to studentification, a process that triggers physical, economic and socio-cultural transformation of university towns. Where non-student residents perceive negative impacts, it can lead to conflict and resentment towards the student population, mistrust between student and local resident groups and a decrea...

  2. Tertiary lymphoid organs in Takayasu Arteritis

    OpenAIRE

    Marc eClement; Marc eClement; Adrien eGaly; Patrick eBruneval; Marion eMorvan; Fabien eHyafil; Fabien eHyafil; Khadija eBenali; Nicoletta ePasi; Lydia eDeschamps; Quentin ePellenc; Quentin ePellenc; Thomas ePapo; Antonino eNicoletti; Antonino eNicoletti

    2016-01-01

    Objective: The role of B cells in the pathogenesis of Takayasu arteritis (TA) is controversial. We aimed to study the presence of tertiary lymphoid organs (TLOs) in the aortic wall of TA patients.Methods: Hematoxylin and eosin–stained sections from aorta specimens from patients with TA were screened for TLOs. The presence of B cell aggregates (CD20), follicular dendritic cells (FDCs, CD21), and high endothelial venules (HEVs, PNAd) was investigated by immunohistochemistry. Immune cells from t...

  3. Tertiary Lymphoid Organs in Takayasu Arteritis

    OpenAIRE

    Clement, Marc; Galy, Adrien; Bruneval, Patrick; Morvan, Marion; Hyafil, Fabien; Benali, Khadija; Pasi, Nicoletta; Deschamps, Lydia; Pellenc, Quentin; Papo, Thomas; Nicoletti, Antonino; Sacre, Karim

    2016-01-01

    Objective The role of B cells in the pathogenesis of Takayasu arteritis (TA) is controversial. We aimed to study the presence of tertiary lymphoid organs (TLOs) in the aortic wall of TA patients. Methods Hematoxylin and eosin-stained sections from aorta specimens from patients with TA were screened for TLOs. The presence of B cell aggregates (CD20), follicular dendritic cells (FDCs, CD21), and high endothelial venules (HEVs, PNAd) was investigated by immunohistochemistry. Immune ce...

  4. An assessment on the trustworthiness of engineers in higher tertiary institutions

    Science.gov (United States)

    Ooi Kuan, Tan; Lloyd, Ling; Mou Chuan, Cheng

    2017-10-01

    In Malaysian higher education history, the evolution from public funded to private funded and now to private non profit oriented model has been taking place since 80s. The evolution also demarcated higher learning institution into academic or research based university. As such, postgraduate studies became increasingly competitive in students intake. The evolution also created doubt to the public in term of the quality of postgraduate education offered by different classifications. This study investigates the gender specific perception and trustworthiness of engineering postgraduate students in private non profit oriented higher tertiary institution. An equally divided gender groups of 118 respondents were chosen for the study. Non-parametric statistics were used and the result showed that there was no difference and no correlation of genders in perception on teaching role and trustworthiness among the future engineers in private non profit oriented higher tertiary institution.

  5. Availability, Level of Use and Constraints to Use of Electronic Resources by Law Lecturers in Public Universities in Nigeria

    Science.gov (United States)

    Amusa, Oyintola Isiaka; Atinmo, Morayo

    2016-01-01

    (Purpose) This study surveyed the level of availability, use and constraints to use of electronic resources among law lecturers in Nigeria. (Methodology) Five hundred and fifty-two law lecturers were surveyed and four hundred and forty-two responded. (Results) Data analysis revealed that the level of availability of electronic resources for the…

  6. Extraterrestrial cause for the Cretaceous-Tertiary extinction

    International Nuclear Information System (INIS)

    Alvarez, L.W.; Alvarez, W.; Asaro, F.; Michel, H.V.

    1980-01-01

    Platinum metals are depleted in the earth's crust relative to their cosmic abundance; concentrations of these elements in deep-sea sediments may thus indicate influxes of extraterrestrial material. Deep-sea limestones exposed in Italy, Denmark, and New Zealand show iridium increases of about 30, 160, and 20 times, respectively, above the background level at precisely the time of the Cretaceous-Tertiary extinctions, 65 million years ago. Reasons are given to indicate that this iridium is of extraterrestrial origin, but did not come from a nearby supernova. A hypothesis is suggested which accounts for the extinctions and the iridium observations. Impact of a large earth-crossing asteroid would inject about 60 times the object's mass into the atmosphere as pulverized rock; a fraction of this dust would stay in the stratosphere for several years and be distributed worldwide. The resulting darkness would suppress photosynthesis, and the expected biological consequences match quite closely the extinctions observed in the paleontological record. One prediction of this hypothesis has been verified: the chemical composition of the boundary clay, which is thought to come from the stratospheric dust, is markedly different from that of clay mixed with the Cretaceous and Tertiary limestones, which are chemically similar to each other. Four different independent estimates of the diameter of the asteroid give values that lie in the range 10 +- 4 kilometers

  7. Secondary and tertiary hyperparathyroidism in chronic kidney disease

    Directory of Open Access Journals (Sweden)

    Lilit V. Egshatyan

    2017-12-01

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

  8. Bahrain’s tertiary education reform : a step towards sustainable economic development

    OpenAIRE

    Karolak, Magdalena

    2012-01-01

    Bahrain has been experiencing along with other Gulf Council Cooperation countries a rapid development of its tertiary sector of education. The 2000's were marked by a boom in education with the opening of twelve private universities in this country of roughly 1 million inhabitants. Some institutions were locally based, while others worked in affiliation with foreign based universities. It is in sharp contrast with the 1990's, when only three public universities served as centers of higher edu...

  9. Echocardiographic evaluation of simple versus complex congenital heart disease in a tertiary care Paediatrics Hospital

    OpenAIRE

    Uttam Kumar Sarkar; Anish Chatterjee; Suprit Basu; Atanu Pan; Sumit Periwal

    2017-01-01

    Background & Objectives:Congenital heart diseases are treatable either by catheter based intervention or open heart surgery according to their quality. In our study we aim to analyze congenital heart disease echocardiographically into simple versus complex heart disease at a tertiary care centre with a public health planning and policy making perspective.Materials & Methods:This hospital based study was done on 1010 patients, both from in-patient and out-patient, who were clinically s...

  10. Present-Day Dillemas And Challenges Of The South African Tertiary System

    OpenAIRE

    N. Mouton; G. P. Louw; G. L. Strydom

    2013-01-01

    The Education White Paper 3 on Higher Education aimed to transform the higher education system. Change within tertiary education included adjusting the size and shape of institutions, the meaning of autonomy and accountability, the nature of higher education, the character of student demographic distribution, management and governance, roles of student politics, models of delivery, the notion of higher education in terms of the relationship between free trade and public good, programme change...

  11. Present-day dilemmas and challenges of the South African tertiary system

    OpenAIRE

    Mouton, N.; Louw, G.P.; Strydom, G.L.

    2013-01-01

    The Education White Paper 3 on Higher Education aimed to transform the higher education system. Change within tertiary education included adjusting the size and shape of institutions, the meaning of autonomy and accountability, the nature of higher education, the character of student demographic distribution, management and governance, roles of student politics, models of delivery, the notion of higher education in terms of the relationship between free trade and public good, p...

  12. Trans-Regional Logistics in Carinthia: Perspectives and Vision on the Transport Infrastructure Development on the Business and Public Level

    Directory of Open Access Journals (Sweden)

    Michael Plasch

    2014-06-01

    Full Text Available Regional logistics development plans have become a key element for an effective – regional economy in Austria. Efforts to develop the region of Carinthia – which represents a substantial transport hub on the Baltic–Adriatic Axis – depend on targeted infrastructure investments combined with well-utilized and accessible modes of transport. As decisions on transport mode choice are made within companies, their involvement in planning processes is crucial. Therefore a more consistent approach to Carinthia’s logistics infrastructure developments is required. The view of regional businesses is considered a significant basis for further public and managerial decision making with regard to the importance of future logistics developments.

  13. The effect of the development of an emergency transfer system on the travel time to tertiary care centres in Japan

    Directory of Open Access Journals (Sweden)

    Arima Hideaki

    2006-06-01

    Full Text Available Abstract Background In Japan, the emergency medical system is categorized into three levels: primary, secondary, and tertiary, depending on the severity of the condition of the patient. Tertiary care centres accept patients who require 24-h monitoring. In this research, the average travel times (minutes from the centroids of all municipalities in Japan to the nearest tertiary care centre were estimated, using the geographic information system. The systems affecting travel time to tertiary care centres were also examined. Regression analysis was performed to determine the factors affecting the travel time to tertiary care centres, using selected variables representing road conditions and the emergency transfer system. Linear regression analysis was performed to identify specific benchmarks that would be effective in reducing the average travel time to tertiary care centres in prefectures with travel times longer than the average 57 min. Results The mean travel time was 57 min, the range was 83 min, and the standard deviation was 20.4. As a result of multiple regression analysis, average coverage area per tertiary care centre, kilometres of highway road per square kilometre, and population were selected as variables with impact on the average travel time. Based on results from linear regression analysis, benchmarks for the emergency transfer system that would effectively reduce travel time to the mean value of 57 min were identified: 26% pavement ratio of roads (percentage of paved road to general roads, and three tertiary care centres and 108 ambulances. Conclusion Regional gaps in the travel time to tertiary care centres were identified in Japan. The systems we should focus on to reducing travel time were identified. Further reduction of travel time to tertiary care centres can be effectively achieved by improving these specific systems. Linear regression analysis showed that a 26% pavement ratio and three tertiary care centres are beneficial to

  14. Awareness of Breast Cancer among Female Care Givers in Tertiary Cancer Hospital, China

    Science.gov (United States)

    Dinegde, Negalign Getahun; Xuying, Li

    2017-01-01

    Objective: Breast cancer is a worldwide public health issue and most common cancer diagnosed among women including China, where advanced stages at diagnosis appears to be increasing and an ever-rising incidence twice as fast as global rates. The study was conducted to describe the awareness of breast cancer and associated factors among care giver women in tertiary Cancer Hospital, China. Methods: Institutional based cross-sectional study was conducted among 261 women selected by systematic random sampling. Information provided by the participants was converted into awareness scores for analysis using SPSS version 23. Awareness scores were dichotomized in to ‘good awareness and ‘poor awareness’ taking median score=11 as the cut-off point. Data analysis was performed using the binary logistic regression. A p-value of awareness. Breast lump was the most commonly known symptom of cancer by 61.7% of the respondents. Slightly more than half of the study participants acknowledged having a past history of breast cancer, drinking alcohol and having close relative with breast cancer as potential risk factors for breast cancer (63.6%, 58.6%, and 55.6% respectively). Nevertheless, a vast majority of the study participants were unable to appreciate modifiable risk factors of the disease. More than half of the participants had never/rarely checked their breasts and all of the participants wrongly answered breast cancer knowledge age related risk. Awareness level was significantly associated with entertainment preference (OR=3.57; 95%CI=1.71, 7.44) and residence setting areas (OR=2.4; 95%CI=1.04, 5.69). Conclusion: The study indicated suboptimal awareness while entertainment preference and residence setting were significantly associated with awareness level. Public awareness campaigns should be made by dissemination of information about breast cancer through health education and printed Medias with great emphases on women living in rural areas. PMID:28749635

  15. Predictors and consequences of rural clients' satisfaction level in the district public-private mixed health system of Bangladesh

    NARCIS (Netherlands)

    Roy, Ashim; van der Weijden, Trudy; de Vries, Nanne

    2017-01-01

    Background: We investigated predictors of the rural clients' satisfaction level (CSL), and interlinks between perceived specific service quality (PSSQ), perceived utility value (PUV), CSL, and clients' reactions (CR) towards current and future utilization of providers and facilities in the

  16. Surgeon-level reporting presented by funnel plot is understood by doctors but inaccurately interpreted by members of the public.

    Science.gov (United States)

    Bhalla, Ashish; Mehrotra, Prerna; Amawi, Falah; Lund, Jonathan N

    2015-01-01

    Risk-adjusted outcome data for general surgeons practicing in the United Kingdom were published for the first time in 2013 with the aim of increasing transparency, improving standards, and providing the public with information to aid decision making. Most specialties used funnel plots to present their data. We assess the ability of members of the public (MoP), medical students, nonsurgical doctors (NSD), and surgeons to understand risk-adjusted surgical outcome data. A fictitious outcome dataset was created and presented in the form of a funnel plot to 10 participants from each of the aforementioned group. Standard explanatory text was provided. Each participant was given 5 minutes to review the funnel plot and complete a questionnaire. For each question, there was only 1 correct answer. Completion rate was 100% (n = 40). No difference existed between NSD and surgeons. A significant difference for identification of the "worst performing surgeon" was noted between surgeons and MoP (p plot significantly "more difficult" to interpret than surgeons did (p < 0.01) and NSD (p < 0.01). MoP found these data significantly more "difficult to understand" and were less likely to both spot "outliers" and use this data to inform decisions than doctors. Surgeons should be aware that outcome data may require an alternative method of presentation to be understood by MoP. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  17. Pollution level, phase distribution and health risk of polycyclic aromatic hydrocarbons in indoor air at public places of Hangzhou, China

    International Nuclear Information System (INIS)

    Lu Hao; Zhu Lizhong; Chen Shuguang

    2008-01-01

    PAHs pollution survey in air of public places was conducted in Hangzhou, China. The most serious PAHs pollution was observed in indoor air of shopping centers and the slightest was in train stations. The molecular weight of chrysene (MW 228) appeared to be the dividing line for the PAHs with a larger or smaller distribution in the vapor or particulate phase. Concentrations of 15 PAHs on PM 2.5 accounted for 71.3% of total particulate PAHs, and followed by PM 2.5-10 fraction (17.6%) and >PM 10 fraction (11.1%). In shopping centers and supermarkets, emission of 2-4 rings PAHs occurred from indoor sources, whereas 5-6 rings PAHs predominantly originated from transport of outdoor air. In temples, PAHs in indoor air mainly originated from incense burning. Health risks associated with the inhalation of PAHs were assessed, and naphthalene made the greatest contribution (62.4%) to the total health risks. - Concentrations of PAHs in the air of selected public places in Hangzhou correspond to 10 -3 life-time lung cancer risk

  18. Public Reporting of Hospital-Level Cancer Surgical Volumes in California: An Opportunity to Inform Decision Making and Improve Quality.

    Science.gov (United States)

    Clarke, Christina A; Asch, Steven M; Baker, Laurence; Bilimoria, Karl; Dudley, R Adams; Fong, Niya; Holliday-Hanson, Merry L; Hopkins, David S P; Imholz, Elizabeth M; Malin, Jennifer; Moy, Lisa; O'Sullivan, Maryann; Parker, Joseph P; Saigal, Christopher S; Spurlock, Bruce; Teleki, Stephanie; Zingmond, David; Lang, Lance

    2016-10-01

    Most patients, providers, and payers make decisions about cancer hospitals without any objective data regarding quality or outcomes. We developed two online resources allowing users to search and compare timely data regarding hospital cancer surgery volumes. Hospital cancer surgery volumes for all California hospitals were calculated using ICD-9 coded hospital discharge summary data. Cancer surgeries included (bladder, brain, breast, colon, esophagus, liver, lung, pancreas, prostate, rectum, and stomach) were selected on the basis of a rigorous literature review to confirm sufficient evidence of a positive association between volume and mortality. The literature could not identify threshold numbers of surgeries associated with better or worse outcomes. A multidisciplinary working group oversaw the project and ensured sound methodology. In California in 2014, about 60% of surgeries were performed at top-quintile-volume hospitals, but the per-hospital median numbers of surgeries for esophageal, pancreatic, stomach, liver, or bladder cancer surgeries were four or fewer. At least 670 patients received cancer surgery at hospitals that performed only one or two surgeries for a particular cancer type; 72% of those patients lived within 50 miles of a top-quintile-volume hospital. There is clear potential for more readily available information about hospital volumes to help patient, providers, and payers choose cancer surgery hospitals. Our successful public reporting of hospital volumes in California represents an important first step toward making publicly available even more provider-specific data regarding cancer care quality, costs, and outcomes, so those data can inform decision-making and encourage quality improvement.

  19. Tutorial Continuing Education: Innovative Strategy in a Tertiary Specialized Health Unit

    Directory of Open Access Journals (Sweden)

    Flaviana Maciel

    2017-06-01

    Full Text Available Hospital Pelopidas Silveira-IMIP/SES/SUS is a tertiary-unit, specialized in cardiology, neurology, neurosurgery and interventional radiology. It is the only hospital of Brazilian Public-Health-System (SUS with this profile and a 24h-acute-cardio/neurovascular facility. Challenges of Continuing-Education include a guaranteeing appropriate level of basic knowledge, b empowering clinical staff to remain up to date in current knowledge. HPS Continuing-Education Program is based on three branches: a Classroom-Tutorials (CT, b Online-Tutorials at "Pelopidas Digital" Virtual-Teaching-Platform (PD-VTP and c Daily-Practice Evaluation (DPE. This paper presents logistic details of HPS Continuing-Education Program. Training team coordinates tutorial meetings and performs continuous statistical analysis. Evaluation team visit hospital departments daily, observing in practice the incorporation of information provided, and retraining individuals in their work scenarios. Both teams perform curriculum development, meeting planning and creation of digital-training-modules. Tutorial meetings have pre/post-tests, allowing monitoring of attendance, topic significance and short-term retention. Tutorial groups are formed by 6-12 employees sharing similarities in training needs. CT is offered to 4 groups-of-interest: a nurses, b nursing assistants, c administrative staff, porters, drivers, d cleaning, laundry and security staff. Problematization and active strategies have resulted into an attractive, structured educational program customized to produce short-term results. The strategy is of interest to institutions sharing similar challenges.

  20. Mainstreaming Climate Change Into Geosciences Curriculum of Tertiary Educational Systems in Ghana

    Science.gov (United States)

    Nyarko, B. K.

    2015-12-01

    The impact of Climate Change has a far-reaching implication for economies and people living in the fragile Regions of Africa analysts project that by 2020, between 75 million and 250 million people will be exposed various forms of Climate Change Stresses. Education as a key strategy identified under Agenda 21 has been incorporated into the efforts of various educational institutions as a means of mitigating climate change and enhancing sustainability. Climate Change education offers many opportunities and benefits for educators, researchers, learners, and for wider society, but there are also many challenges, which can hinder the successful mainstreaming of climate change education. The study aims at understanding barriers for Climate Change Education in selected tertiary institutions in Ghana. The study was conducted among Geoscience Departments of the 7 main public universities of Ghana and also juxtapose with the WASCAL graduate school curriculum. The transcript analysis identified issues that hinders the mainstreaming of Climate Change, these includes existing levels of knowledge and understanding of the concept of climate change, appreciating the threshold concepts, ineffective teaching of Climate Change and some Departments are slow in embracing Climate Change as a discipline. Hence to develop strategies to mainstream climate change education it is important to recognize that increasing the efficiency and delivery of Climate Change education requires greater attention and coordination of activities and updating the educators knowledge and skill's. Institutions and Educator should be encouraged to undertake co-curricula activities and finding ways to make Climate Change education practical.

  1. Exposure level of carbon monoxide and respirable suspended particulate in public transportation modes while commuting in urban area of Guangzhou, China

    Science.gov (United States)

    Chan, L. Y.; Lau, W. L.; Zou, S. C.; Cao, Z. X.; Lai, S. C.

    This study examined commuter exposure to respirable suspended particulate (PM 10 and PM 2.5) and carbon monoxide (CO) in public transportation modes in Guangzhou, China. During the sampling period, a total of 80 CO, 80 PM 10 and 56 PM 2.5 samples were conducted in four popular commuting modes (subway, air-conditioned bus, non-air-conditioned bus and taxi) while running in typical urban routes. The results show that the PM 10 as well as CO level is greatly influenced by the mode of transport. The highest mean PM 10 and CO level was obtained in a non-air-conditioned bus (203 μg m -3) and in an air-conditioned taxi (28.7 ppm) , respectively. Noticeably, the exposure levels in subway are lower than those in the roadway transports. The ventilation condition of the transport is also a crucial factor affecting the in-vehicle level. There was statistically significant difference of PM10 (ptransports, which provide service at regular intervals regardless of the time of day. The PM 2.5 inter-microenvironment variation is similar to the pattern of PM 10. The PM 2.5 to PM 10 ratio in the transports was high, ranging from 76% to 83%. The poor vehicle emission controls, poor vehicle maintenance, plus the slow moving traffic condition with frequent stops are believed to be the major causes of high in-vehicle levels in some public commuting trips.

  2. Public Health and Climate Change Adaptation at the Federal Level: One Agency’s Response to Executive Order 13514

    Science.gov (United States)

    Schramm, Paul J.; Luber, George

    2014-01-01

    Climate change will likely have adverse human health effects that require federal agency involvement in adaptation activities. In 2009, President Obama issued Executive Order 13514, Federal Leadership in Environmental, Energy, and Economic Performance. The order required federal agencies to develop and implement climate change adaptation plans. The Centers for Disease Control and Prevention (CDC), as part of a larger Department of Health and Human Services response to climate change, is developing such plans. We provide background on Executive Orders, outline tenets of climate change adaptation, discuss public health adaptation planning at both the Department of Health and Human Services and the CDC, and outline possible future CDC efforts. We also consider how these activities may be better integrated with other adaptation activities that manage emerging health threats posed by climate change. PMID:24432931

  3. Public health economic evaluation of different European Union-level policy options aimed at reducing population dietary trans fat intake.

    Science.gov (United States)

    Martin-Saborido, Carlos; Mouratidou, Theodora; Livaniou, Anastasia; Caldeira, Sandra; Wollgast, Jan

    2016-11-01

    The adverse relation between dietary trans fatty acid (TFA) intake and coronary artery disease risk is well established. Many countries in the European Union (EU) and worldwide have implemented different policies to reduce the TFA intake of their populations. The aim of this study was to assess the added value of EU-level action by estimating the cost-effectiveness of 3 possible EU-level policy measures to reduce population dietary TFA intake. This was calculated against a reference situation of not implementing any EU-level policy (i.e., by assuming only national or self-regulatory measures). We developed a mathematical model to compare different policy options at the EU level: 1) to do nothing beyond the current state (reference situation), 2) to impose mandatory TFA labeling of prepackaged foods, 3) to seek voluntary agreements toward further reducing industrially produced TFA (iTFA) content in foods, and 4) to impose a legislative limit for iTFA content in foods. The model indicated that to impose an EU-level legal limit or to make voluntary agreements may, over the course of a lifetime (85 y), avoid the loss of 3.73 and 2.19 million disability-adjusted life-years (DALYs), respectively, and save >51 and 23 billion euros when compared with the reference situation. Implementing mandatory TFA labeling can also avoid the loss of 0.98 million DALYs, but this option incurs more costs than it saves compared with the reference option. The model indicates that there is added value of an EU-level action, either via a legal limit or through voluntary agreements, with the legal limit option producing the highest additional health benefits. Introducing mandatory TFA labeling for the EU common market may provide some additional health benefits; however, this would likely not be a cost-effective strategy.

  4. Number of Salmonella on Chicken Breast Filet at Retail Level and Its Implications for Public Health Risk

    NARCIS (Netherlands)

    Straver, J.M.; Janssen, A.F.W.; Linnemann, A.R.; Boekel, van T.; Beumer, R.R.; Zwietering, M.H.

    2007-01-01

    This study aimed to characterize the number of Salmonella on chicken breast filet at the retail level and to evaluate if this number affects the risk of salmonellosis. From October to December 2005, 220 chilled raw filets (without skin) were collected from five local retail outlets in The

  5. Calling genotypes from public RNA-sequencing data enables identification of genetic variants that affect gene-expression levels

    NARCIS (Netherlands)

    Deelen, Patrick; Zhernakova, Daria V.; de Haan, Mark; van der Sijde, Marijke; Bonder, Marc Jan; Karjalainen, Juha; van der Velde, K. Joeri; Abbott, Kristin M.; Fu, Jingyuan; Wijmenga, Cisca; Sinke, Richard J.; Swertz, Morris A.; Franke, Lude

    2015-01-01

    Background: RNA-sequencing (RNA-seq) is a powerful technique for the identification of genetic variants that affect gene-expression levels, either through expression quantitative trait locus (eQTL) mapping or through allele-specific expression (ASE) analysis. Given increasing numbers of RNA-seq

  6. State-Level Farmers Market Activities: A Review of CDC-Funded State Public Health Actions That Support Farmers Markets.

    Science.gov (United States)

    Kahin, Sahra A; Wright, Demia S; Pejavara, Anu; Kim, Sonia A

    Introducing farmers markets to underserved areas, or supporting existing farmers markets, can increase access and availability of fruits and vegetables and encourage healthy eating. Since 2003, the Centers for Disease Control and Prevention (CDC)'s Division of Nutrition, Physical Activity, and Obesity (DNPAO) has provided guidance and funding to state health departments (SHDs) to support the implementation of interventions, including activities around farmers markets, to address healthy eating, and improve the access to and availability of fruits and vegetables at state and community levels. For this project, we identified state-level farmers market activities completed with CDC's DNPAO funding from 2003 to 2013. State-level was defined as actions taken by the state health department that influence or support farmers market work across the state. We completed an analysis of SHD farmers market activities of 3 DNPAO cooperative agreements from 2003 to 2013: State Nutrition and Physical Activity Programs to Prevent Obesity and Other Chronic Diseases; Nutrition, Physical Activity and Obesity Program; and Communities Putting Prevention to Work. To identify state farmers market activities, data sources for each cooperative agreement were searched using the key words "farm," "market," "produce market," and "produce stand." State data with at least one state-level farmers market action present were then coded for the presence of itemized activities. Across all cooperative agreements, the most common activities identified through analysis included the following: working on existing markets and nutrition assistance benefit programs, supporting community action, and providing training and technical assistance. Common partners were nutrition assistance benefit program offices and state or regional Department of Agriculture or agricultural extension offices. Common farmers market practices and evidence-based activities, such as nutrition assistance benefits programs and land

  7. Defining English Language Proficiency for Malaysian Tertiary Education: Past, Present and Future Efforts

    Directory of Open Access Journals (Sweden)

    Chan Swee Heng

    2012-07-01

    Full Text Available Any attempt to define English language proficiency can never be divorced from the theories that describe the nature of language, language acquisition and human cognition. By virtue of such theories being socially constructed, the descriptions are necessarily value-laden. Thus, a definition of language proficiency can only, at best, be described as developmental, following changes that are linguistic, pragmatic, cultural and political. In defining English proficiency for tertiary education, the context is naturally also linked to the focus on university education. The argument has been that an ‘acceptable’ level of language competence of a university applicant is anything but constant. Tremendous social changes have seen traditional values of elitism in university education giving way to the ‘massification’ of education. As Kaplan and Baldauf (1997:257 affirms, “The principal problem in tertiary education is not declining literacy standards but rather it is about meeting changed societal, cultural and informational requirements and circumstances”. In the light of these changes, this paper attempts to trace influencing factors that help define an ‘acceptable’ level of English proficiency for Malaysian tertiary education. The paper examines past and present efforts of establishing an English language policy and assessment practice for tertiary education, and concludes with some views on future development that could evolve from the current indicative pursuits of establishing language learning and ability.

  8. Development of intervention levels for the protection of the public in the event of a major nuclear accident. Past, present and future

    International Nuclear Information System (INIS)

    Emmerson, B.W.

    1989-01-01

    Since the mid-1950's nuclear energy has played an increasing role in meeting the world demand for electricity production. Although during this period incidents and accidents have occurred, in most cases their effect was confined to the plant. Three accidents, however, were sufficienty serious as to involve off-site consequences for the public. The experience from each contributed significantly in the development of current emergency response criteria and planning arrangements at the national and international level. This paper summarizes these contributions as they relate to the development of intervention levels for the protection of the public in the event of an accidental release of radioactive materials to the environment. It indicates the various measures taken by those countries that were affected by the release from the Chernobyl accident and reviews the subsequent actions by relevant international organizations to provide more comprehensive guidance on applying the principles of intervention and developing derived levels, particularly those aimed at controlling the consumption of contamined foodstuffs, or their movement in international trade. Finally, it considers the prospects for developing a more harmonized intervention approach based on the guidance now being completed at the international level [fr

  9. Stress Factors among Nurses at the Primary and Secondary Level of Public Sector Health Care: The Case of Slovenia

    OpenAIRE

    Jasmina Starc

    2018-01-01

    BACKGROUND: Working in nursing is mentally and physically demanding and is one of the most stressful professions. AIM: To determine the basic causes of stress and examine the symptoms of stress among healthcare professionals at the primary and secondary level of health care. MATERIAL AND METHODS: The research was based on the descriptive and causal non-experimental method of empirical research. The independent samples t-test was used. RESULTS: The survey results have shown that th...

  10. Quantitative Analysis of Dynamic Behaviours of Rural Areas at Provincial Level Using Public Data of Gross Domestic Product

    DEFF Research Database (Denmark)

    Chen, Yi; Zhang, Guangfeng; Li, Yiyang

    2013-01-01

    A spatial approach that incorporates three economic components and one environmental factor has been developed to evaluate the dynamic behaviours of the rural areas at a provincial level. An artificial fish swarm algorithm with variable population size (AFSAVP) is proposed for the spatial problem......, and the results have shown that the modelling method based on GDP data can assess the spatial dynamic behaviours and can be taken as an operational tool for the policy planners....

  11. Assessment of pediatric residents burnout in a tertiary academic centre

    Directory of Open Access Journals (Sweden)

    Roaa S. Jamjoom

    2018-03-01

    Full Text Available Objectives: To study burnout among pediatric residents at King Abdulazaiz University Hospital in Jeddah, Saudi Arabia. Methods: This is a cross-sectional survey that was administered to all pediatric residents enrolled in the Saudi Paediatric Board program (PGY1-PGY4 in a large tertiary academic hospital in the Western region of Saudi Arabia (King Abdulaziz University Hospital. The survey were sent via E-mail to 50 registered general pediatric residents. Results: Seventy percent of the pediatric residents completed the survey. More than 70% of residents experiencing severe burnout. Forty-three percent suffering emotional exhaustion, 71.8% experiencing depersonalization and 40.6% suffering from low accomplishment. Conclusion: Burnout syndrome appear to be a serious threat to resident well-being in our program. Moreover, pediatric residents in our institute experienced higher levels of depersonalization than their peers nationally and internationally.

  12. Do Physical Proximity and Availability of Adequate Infrastructure at Public Health Facility Increase Institutional Delivery? A Three Level Hierarchical Model Approach.

    Science.gov (United States)

    Patel, Rachana; Ladusingh, Laishram

    2015-01-01

    This study aims to examine the inter-district and inter-village variation of utilization of health services for institutional births in EAG states in presence of rural health program and availability of infrastructures. District Level Household Survey-III (2007-08) data on delivery care and facility information was used for the purpose. Bivariate results examined the utilization pattern by states in presence of correlates of women related while a three-level hierarchical multilevel model illustrates the effect of accessibility, availability of health facility and community health program variables on the utilization of health services for institutional births. The study found a satisfactory improvement in state Rajasthan, Madhya Pradesh and Orissa, importantly, in Bihar and Uttaranchal. The study showed that increasing distance from health facility discouraged institutional births and there was a rapid decline of more than 50% for institutional delivery as the distance to public health facility exceeded 10 km. Additionally, skilled female health worker (ANM) and observed improved public health facility led to significantly increase the probability of utilization as compared to non-skilled ANM and not-improved health centers. Adequacy of essential equipment/laboratory services required for maternal care significantly encouraged deliveries at public health facility. District/village variables neighborhood poverty was negatively related to institutional delivery while higher education levels in the village and women's residing in more urbanized districts increased the utilization. "Inter-district" variation was 14 percent whereas "between-villages" variation for the utilization was 11 percent variation once controlled for all the three-level variables in the model. This study suggests that the mere availability of health facilities is necessary but not sufficient condition to promote utilization until the quality of service is inadequate and inaccessible considering

  13. Do Physical Proximity and Availability of Adequate Infrastructure at Public Health Facility Increase Institutional Delivery? A Three Level Hierarchical Model Approach.

    Directory of Open Access Journals (Sweden)

    Rachana Patel

    Full Text Available This study aims to examine the inter-district and inter-village variation of utilization of health services for institutional births in EAG states in presence of rural health program and availability of infrastructures. District Level Household Survey-III (2007-08 data on delivery care and facility information was used for the purpose. Bivariate results examined the utilization pattern by states in presence of correlates of women related while a three-level hierarchical multilevel model illustrates the effect of accessibility, availability of health facility and community health program variables on the utilization of health services for institutional births. The study found a satisfactory improvement in state Rajasthan, Madhya Pradesh and Orissa, importantly, in Bihar and Uttaranchal. The study showed that increasing distance from health facility discouraged institutional births and there was a rapid decline of more than 50% for institutional delivery as the distance to public health facility exceeded 10 km. Additionally, skilled female health worker (ANM and observed improved public health facility led to significantly increase the probability of utilization as compared to non-skilled ANM and not-improved health centers. Adequacy of essential equipment/laboratory services required for maternal care significantly encouraged deliveries at public health facility. District/village variables neighborhood poverty was negatively related to institutional delivery while higher education levels in the village and women's residing in more urbanized districts increased the utilization. "Inter-district" variation was 14 percent whereas "between-villages" variation for the utilization was 11 percent variation once controlled for all the three-level variables in the model. This study suggests that the mere availability of health facilities is necessary but not sufficient condition to promote utilization until the quality of service is inadequate and

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

    Science.gov (United States)

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

    2013-09-12

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

  15. managing tertiary institutions for the promotion of lifelong learning

    African Journals Online (AJOL)

    Global Journal

    KEYWORDS: Managing, tertiary institutions, promotion, lifelong learning. INTRODUCTION ... science, medicine and technology towards the ... different environments, whether formal, informal ... schools considering that each day gives birth to.

  16. Derived intervention levels for application in controlling radiation doses to the public in the event of a nuclear accident or radiological emergency

    International Nuclear Information System (INIS)

    1986-01-01

    This document sets out the principles and procedures for estimating derived intervention levels (DILs) and illustrates the application of these procedures to the estimation of DILs for a range of nuclides and exposure pathways, as aids to decisions on the application of protective measures for the public in the early and intermediate phases of a nuclear accident. The levels are derived subject to a number of assumptions about the intervention level of dose, the characteristics of the released material, the habits of the exposed individuals and local environmental conditions. Some guidance is given on the sensitivity of the estimated DILs to plausible variations in the above assumptions. The detailed procedures described in the document for estimating DILs and illustrations of their application are limited to accidental releases to the atmosphere

  17. Non-state security governances and the implications for local-level citizenship in Danish semi-public city spaces

    DEFF Research Database (Denmark)

    Jensen, Thomas Søgaard

    directed at promoting peace and restoring the feel good factor - in public city space in Denmark. What precisely "security" is, what it should mean, and what should be done to guarantee it, has always been contested on an empirically level. The reason for this is that security often deals with social order......, being both the ontological condition of order, in the sense of absence of "real" and culturally constructed dangers, risks, and anxieties, and the political means to ensure this order. Based on a 5 month ethnographic field work among private security guards policing new kinds of public city spaces...... the globalisation and privatisation/commercialisation of security provision and how this development can be explained. Drawing on my own empirical data I hereafter argue that commercial security governance and local understandings of threats to (feelings of) security are not so much shaped by imaginaries...

  18. Bioeffects and health risks of low-level exposures to radiofrequency and microwave fields-scientific facts and public concerns

    International Nuclear Information System (INIS)

    Szmigielski, Stanislaw

    2001-01-01

    Radiofrequency (RF) and microwave (MW) radiations, parts of the electromagnetic spectrum at wave frequencies of 0.1 - 300 MHz and 300 MHz - 300 GHz, respectively, can penetrate human tissues and exert various bioeffects at relatively low field power densities. Exposure of the general public to RF/MW radiation in the environment is generally below intensities which are considered as responsible for evoking such bioeffects. Use of mobile phones (MP) considerably increased local exposure to 900 or 1800 MHz MWs and raised concerns of the risk of brain tumors and other neoplasms of the head. At present the experimental and epidemiological bulk of evidence is too limited for valid assessment of the risks. Health consequences of long-term use of MPs are not known in detail, but available data indicate that development of non-specific health symptoms is possible, at least in 'MW-hypersensitive' subjects. In contrast to cellular terminals, which emit locally relatively high intensity MW fields, transmitting antennas and base stations contribute to MW environmental contaminations only with a small portion of the energy and do not pose established health risks. Two available epidemiological studies of brain cancer morbidity in MP users did not confirm an increased risk for all types of neoplasms, but unexplained excesses of particular types and/or locations of the tumors has been reported. Experimental investigations revealed the possibility of epigenetic activity of certain MW exposures (frequently limited to particular frequencies and/or modulations of the carrier wave), but there exists no satisfactory support from epidemiological studies for the increased cancer risk in MW-exposed subjects. However, there exist single epidemiological studies which indicate increased mortality of certain types of neoplasms in workers exposed to microwave radiation. As an example, the multiyear study of cancer morbidity in Polish military personnel exposed to 2 - 10 W/m2 will be presented

  19. Levels of Depression and Anxiety Post-Mastectomy in Breast Cancer Patients at a Public Sector Hospital in Karachi.

    Science.gov (United States)

    Khan, Sara; Khan, Naveed Ali; Rehman, Ata Ur; Khan, Iqra; Samo, Khursheed A; Memon, Amjad Siraj

    2016-01-01

    There is a noticeable change in the approach with which women nowadays seek help for diseases like breast cancer, primarily due to awareness campaigns, but what happens after surgical procedures is of great significance too. This study focused on the several psychological connotations attached to mastectomy and how the patients cope. To understand the pattern of anxiety and level of depression among Pakistani patients undergoing mastectomy. The sample size consisted of 88 patients who had undergone mastectomy at the different surgical units of the Civil Hospital, Karachi, from January 2012- December 2014; The questionnaire was administered before they were discharged i.e. within 3 days of surgical procedures. The patients were asked if they were willing to participate in this study, those who agreed signed the consent form and then we preceded by asking questions with a standardized tool. A self made questionnaire was constructed keeping in mind the nature and specification of the disease, which consisted of 20 questions related to anxiety and depression, focusing on a mixture of psychological and physiological symptoms. There were a total of 88 patients out of which 36 (41%) were aged 51 to 60 years, 24 (27.2%) of the patients were in the age category of 41 to 50 years, 17 aged 61 and above (19.3%) and only 11 (12.5%) 30-40 years of age, the youngest of all the age categories. The pattern of depression and anxiety was found to be similar among all age categories, severe depression and anxiety predominating over moderate level of such symptoms, with only relatively few patients sufering mild or no depression symptoms. It was concluded that going through mastectomy leads to moderate to severe levels of depression and anxiety, primarily because the females feel incomplete and insecure after losing a part of themselves.

  20. [Identification of mycobacteria to the species level by molecular methods in the Public Health Laboratory of Bogotá, Colombia].

    Science.gov (United States)

    Hernández-Toloza, Johana Esther; Rincón-Serrano, María de Pilar; Celis-Bustos, Yamile Adriana; Aguillón, Claudia Inés

    2016-01-01

    Global epidemiology of non-tuberculous mycobacteria (NTM) is unknown due to the fact that notification is not required in many countries, however the number of infection reports and outbreaks caused by NTM suggest a significant increase in the last years. Traditionally, mycobacteria identification is made through biochemical profiles which allow to differentiate M. tuberculosis from NTM, and in some cases the mycobacteria species. Nevertheless, these methods are technically cumbersome and time consuming. On the other hand, the introduction of methods based on molecular biology has improved the laboratory diagnosis of NTM. To establish the NTM frequency in positive cultures for acid-fast bacilli (AAFB) which were sent to Laboratorio de Salud Pública de Bogotá over a 12 month period. A total of 100 positive cultures for acid-fast bacilli from public and private hospitals from Bogotá were identified by both biochemical methods and the molecular methods PRA (PCR-restriction enzyme analysis) and multiplex-PCR. Furthermore, low prevalence mycobacteria species and non-interpretable results were confirmed by 16SrDNA sequentiation analysis. Identification using the PRA method showed NMT occurrence in 11% of cultures. In addition, this molecular methodology allowed to detect the occurrence of more than one mycobacteria in 4% of the cultures. Interestingly, a new M. kubicae pattern of PCR-restriction analysis is reported in our study. Using a mycobacteria identification algorithm, which includes the molecular method PRA, improves the diagnostic power of conventional methods and could help to advance both NTM epidemiology knowledge and mycobacteriosis control. Copyright © 2015 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.