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Sample records for tertiary level public

  1. Costs of vaginal delivery and Caesarean section at a tertiary level public hospital in Islamabad, Pakistan

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    Zaman Shakila

    2010-01-01

    Full Text Available Abstract Background Public hospitals in developing countries, rather than the preventive and primary healthcare sectors, are the major consumers of healthcare resources. Imbalances in rational, equitable and efficient allocation of scarce resources lie in the scarcity of research & information on economic aspects of health care. The objective of this study was to determine the average cost of a spontaneous vaginal delivery and Caesarean section in a tertiary level government hospital in Islamabad, Pakistan and to estimate the out of pocket expenditures to households using these services. Methods This hospital based cost accounting cross sectional study determines the average cost of vaginal delivery and Caesarean section from two perspectives, the patient's and the hospital. From the patient's perspective direct and indirect expenditures of 133 post-partum mothers (65 delivered by Caesarean section & 68 by spontaneous vaginal delivery admitted in the maternity general ward were determined. From the hospital perspective the step down methodology was adopted, capital and recurrent costs were determined from inputs and cost centers. Results The average cost for a spontaneous vaginal delivery from the hospital's side was 40 US$ (2688 rupees and from the patient's perspective was 79 US$ (5278 rupees. The average cost for a Caesarean section from the hospital side was 162 US$ (10868 rupees and 204 US$ (13678 rupees from the patient's side. Average monthly household income was 141 ± 87 US$ for spontaneous vaginal delivery and 168 ± 97 US$ for Caesarean section. Three fourth (74% of households had a monthly income of less than 149 US$ (10000 rupees. Conclusion The apparently "free" maternity care at government hospitals involves substantial hidden and unpredicted costs. The anticipated fear of these unpredicted costs may be major factor for many poor households to seek cheaper alternate maternity healthcare.

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

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    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.

  3. Endourology in a Nigerian Tertiary Hospital – current level of ...

    African Journals Online (AJOL)

    Background: Endourology is rapidly advancing in developed countries. However, the level of practice in public tertiary hospitals in developing countries is abysmally low. Objective: To review the current practice of endourology in a Nigerian public tertiary hospital and discuss the challenges faced during the study period.

  4. 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.

  5. 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....

  6. 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.

  7. (IUCD) at a tertiary-level hospital

    African Journals Online (AJOL)

    the USA, 42% of adolescents reported having been sexually active at least once in their ... adolescents toward positive sexual behaviour with regard to sexually .... Hormone implants. 21 (10.9). 0 (0). Natural methods. 12 (6.2). 3 (1.6). Table 4. Quantitative knowledge of the IUCD related to level of education and gravidity.

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

    African Journals Online (AJOL)

    An Innovation Systems Perspectives on Tertiary-Level Agricultural Education in Sub-Saharan Africa: (Evidence From Ethiopia) ... it should also play a role in building the capacity of organizations and individuals to explore new products and processes that depend on the transmission and adaptation of existing information.

  9. Lecturers' Job Satisfaction in a Public Tertiary Institution in Singapore: Ambivalent and Non-Ambivalent Relationships between Job Satisfaction and Demographic Variables

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    Paul, Emily Pakivathy; Phua, Seok Kheng

    2011-01-01

    Increasing lecturer turnover rates and fewer qualified recruits choosing a career in academia threaten the integrity of the tertiary education system in Singapore. The purpose of this study was to ascertain the relationship between lecturers' job satisfaction levels in a public tertiary institution and selected demographic variables. The study…

  10. 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.

  11. Species distribution and susceptibility profile of Candida species in a Brazilian public tertiary hospital

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    Montelli Augusto

    2010-01-01

    Full Text Available Abstract Background Species identification and antifungal susceptibility tests were carried out on 212 Candida isolates obtained from bloodstream infections, urinary tract infections and dialysis-associated peritonitis, from cases attended at a Brazilian public tertiary hospital from January 1998 to January 2005. Findings Candida albicans represented 33% of the isolates, Candida parapsilosis 31.1%, Candida tropicalis 17.9%,Candida glabrata 11.8%, and others species 6.2%. In blood culture, C. parapsilosis was the most frequently encountered species (48%. The resistance levels to the antifungal azoles were relatively low for the several species, except for C. tropicalis and C. glabrata. Amphotericin B resistance was observed in 1 isolate of C. parapsilosis. Conclusions The species distribution and antifungal susceptibility herein observed presented several epidemiological features common to other tertiary hospitals in Latin American countries. It also exhibited some peculiarity, such as a very high frequency of C. parapsilosis both in bloodstream infections and dialysis-associated peritonitis. C. albicans also occurred in an important number of case infections, in all evaluated clinical sources. C. glabrata presented a high proportion of resistant isolates. The data emphasize the necessity to carry out the correct species identification accompanied by the susceptibility tests in all tertiary hospitals.

  12. A THIRD OF PATIENTS TREATED AT A TERTIARY LEVEL SURGICAL SERVICE COULD BE TREATED AT A SECONDARY LEVEL FACILITY.

    Science.gov (United States)

    Van Straten, S K; Stannard, C J; Bulabula, J; Paul, K; Leong, J; Klipin, M

    2017-06-01

    South Africa has an overburdened public healthcare system. Some admissions to Charlotte Maxeke Johannesburg Academic Hospital (CMJAH) may not require tertiary care. The numbers and details thereof are uncertain. Clinical research is limited by skills and access to data. A retrospective analysis of Electronic Discharge (ED) summaries from the Department of Surgery at CMJAH between 01 April 2015 and 01 April 2016. An SQL-query of the database generated a .csv file of all discharges with the fields database reference number, length of stay and level of care. The details and level of care of each record were verified by MBBCh 5 medical students using a defined level of care template with review of the full discharge summary. The data was reviewed by a senior clinician. There were 3007 discharge summaries, 97 were not classifiable, two were test records and one was a duplicate. These 100 records were excluded. There were no primary level records. Secondary level patients represented 29% (854) of patients discharged and 19% of total bed days. Tertiary and quaternary together represented 71% of the total patients and 81% of bed days. The average length of stay was 4.31 days for secondary, 6.98 days for tertiary and 9.77 days for quaternary level of care allocation. Almost a third (29%) of patients discharged from CMJAH Department of Surgery were deemed suitable for secondary level care. These admissions have a shorter length of stay and comprise 19% of total bed days. Students and electronic databases are useful research resources.

  13. 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, ...

  14. HIGH LEVELS OF MONOAROMATIC COMPOUNDS LIMIT THE USE OF SOLID-PHASE MICROEXTRACTION OF METHYL TERTIARY BUTYL ETHER AND TERTIARY BUTYL ALCOHOL

    Science.gov (United States)

    Recently, two papers reported the use of solid-phase microextraction (SPME) with polydimethylsiloxane(PDMS)/Carboxen fibers to determine trace levels of methyl tertiary butyl ether (MTBE) and tertiary butyl alcohol (tBA) in water. Attempts were made to apply this technique to th...

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

    Science.gov (United States)

    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…

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

    Science.gov (United States)

    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.

  17. 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.

  18. Perception of intellectual stimulation, creativity and innovation among health managers working in tertiary level hospitals.

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    Shahzad, Saadia; Zareen, Humaira

    2011-01-01

    Management in health sector is becoming focus of attention world over being an important subject due to resource crunch particularly in developing countries. Beside sociodemographic factors, poor management in health sector is also an important factor responsible for poor health in developing countries. Moreover, there is gross lack of effective leadership in our national setup. It is necessary for health managers to be well versed with the knowledge about emerging theories, concepts and new philosophies of management/administration and leadership. This anthropological study was done to assess the perception and knowledge of Intellectual stimulation, creativity and innovation among the health managers working in the tertiary level hospitals of Lahore. This qualitative study was conducted in two public sector tertiary care hospitals of Lahore. Observation and in-depth interviews were conducted for data collection. Open ended questionnaire, developed on the lines of Multifactor Leadership Questionnaire was used. One main domain of Intellectual stimulation and its variables were developed and emergence of different themes was noted. In the domain of Intellectual stimulation all the participants of the study showed positive themes for the variable of creativity. Seven of the health managers showed positive themes for the variable of innovation, where as three health managers showed negative responses. Health managers with management/administration qualification had better concept about the key ideas of Intellectual stimulation, creativity and innovation; as compared to those who were working at these managerial posts on the basis of their long term experience only. Female health managers were stronger in building their team members on a broader horizon as a wholesome personality and not just taking the daily routine work.

  19. English as a Foreign Language Instructors’ Induction: Early Practices of Language Teachers Teaching at Tertiary Level

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    Mustafa Öztürk

    2012-02-01

    Full Text Available This study aimed to investigate the nature of the induction process of English as a foreign language (EFL teachers teaching at tertiary level through individual interviews. In order to gather intended data, fifteen novice instructors teaching at four different public universities in Ankara were interviewed on a basis of two criteria: (a having 1 to 3 years of teaching experience, and (b teaching at higher education level. The data gathered from the interviews were transcribed, coded, and categorized under themes in a qualitative research tradition. Subsequently the Şndings were interpreted. The findings were organized around research questions and there appeared four main themes: (1 nature of induction process; (2 common concerns of novice teachers; (3 possible adaptation challenges; and (4 practices to overcome difŞculties. The results revealed that pre-service education, especially of the graduates of nonEducation Faculties, did not adequately respond to the needs of the novice teachers in induction period. Considering this insufŞcient preparation and unsatisfactory pedagogical formation processes, an effective teacher education program as well as a contributing teacher induction program was claimed to be adopted by higher education institutions

  20. English as a Foreign Language Instructors’ Induction: Early Practices of Language Teachers Teaching at Tertiary Level

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    Mustafa Öztürk

    2012-04-01

    Full Text Available This study aimed to investigate the nature of the induction process of English as a foreign language (EFL teachers teaching at tertiary level through individual interviews. In order to gather intended data, fifteen novice instructors teaching at four different public universities in Ankara were interviewed on a basis of two criteria: (a having 1 to 3 years of teaching experience, and (b teaching at higher education level. The data gathered from the interviews were transcribed, coded, and categorized under themes in a qualitative research tradition. Subsequently the findings were interpreted. The findings were organized around research questions and there appeared four main themes: (1 nature of induction process; (2 common concerns of novice teachers; (3 possible adaptation challenges; and (4 practices to overcome difficulties. The results revealed that pre-service education, especially of the graduates of non-Education Faculties, did not adequately respond to the needs of the novice teachers in induction period. Considering this insufficient preparation and unsatisfactory pedagogical formation processes, an effective teacher education program as well as a contributing teacher induction program was claimed to be adopted by higher education institutions.

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

    Science.gov (United States)

    Van Straten, S; Stannard, C; Bulabula, J; Boodhia, K; Paul, K; Leong, J; Klipin, M J

    2017-08-25

    South Africa (SA) has an overburdened public healthcare system. Some patients admitted to Charlotte Maxeke Johannesburg Academic Hospital (CMJAH), SA, may not require tertiary care, but the numbers and details are uncertain. Clinical research in SA is limited by scarce skills and limited access to data. To determine the proportion of and length of stay for secondary-, tertiary- and quaternary-level patients discharged from the Department of Surgery at CMJAH over 1 year. This is a retrospective analysis of electronic discharge (ED) summaries from the Department of Surgery at CMJAH between 1 April 2015 and 1 April 2016. An SQL query of the database generated a .csv file of all discharges with the following fields: database reference number, length of stay and level of care. The details of each record were verified by MBBCh V students, using a defined level-ofcare template and the full discharge summary. The data were reviewed by a senior clinician. There were 3 007 discharge summaries - 97 were not classifiable, two were test records and one was a duplicate. These 100 records were excluded. There were no primary-level records. Secondary-level patients represented 29% (854) of those discharged and 19% of total bed days. Tertiary- and quaternary-level patients together represented 71% of the total and 81% of bed days. The average length of stay was 4.31 days for secondary, 6.98 days for tertiary and 9.77 days for quaternary level-of-care allocation. Almost one-third (29%) of patients discharged from CMJAH's Department of Surgery were deemed suitable for secondarylevel care. These patients had a shorter length of stay and comprised 19% of total bed days. Students and electronic databases represent an important research resource.

  2. ESP at the Tertiary Level: Current Situation, Application and Expectation

    Science.gov (United States)

    Ibrahim, AbdulMahmoud Idrees

    2010-01-01

    English for Specific Purposes is an obligatory subject for the first two levels at the Sudanese Universities. It is taught as a university requirement. Accordingly, the students obsess on how to pass the examination, not to achieve any development in the language field. Even the teachers concentrate on the content rather than the skills, which the…

  3. The importance of vocabulary at tertiary level | Scheepers | Journal ...

    African Journals Online (AJOL)

    controlled productive ability' used by Laufer and Nation (1995) in their study of lexical richness in writing. This test, and its later versions, is based on the view that vocabulary consists of various levels according to frequency of occurrence ...

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

    Science.gov (United States)

    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…

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

    African Journals Online (AJOL)

    a clinical, research, management and operational level.[7]. Quaternary and tertiary ... access password-protected records for point-of-care information and administrators have ... M J Klipin,2 FCS (SA). 1 School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.

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

    OpenAIRE

    Saehu, Andang

    2016-01-01

    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. Th...

  7. Enhancing Critical Thinking At The Tertiary Level Through A Literature based Critical Thinking Program

    OpenAIRE

    ARSLAN, Recep Şahin; YILDIZ, Nazan

    2013-01-01

    This paper examines the significance of the application of a literature based critical thinking program at the tertiary level and its impact on both students’ critical thinking skills and teachers’ and students’ beliefs about literature instruction The study is based on one group pre test–post test design a quasi experimental design in which a seven week literature based critical thinking program involving 34 seniors attending an English Language and Literature Department was implemented ...

  8. [Mortality risk factors associated with healthcare infections in a tertiary level university hospital in Colombia].

    Science.gov (United States)

    Pallares, Christian José; Martínez, Ernesto

    2014-04-01

    Nosocomial infections are a public health threat. Despite multiple efforts, its incidence is still significant and it generates high costs in health care. To determine risk factors associated with mortality in patients with healthcare infections in a tertiary level hospital in Colombia. A prospective cohort observational study was performed between January and December 2011. One thousand one hundred and fifteen patients with health care infections using the CDC definition criteria were included. Exclusion criteria were those patients with no microbiologic isolate associated with the infection or hospital readmissions in the last year. Socio-demographic and clinical variables, bacterial resistance profiles and antibiotic use were evaluated. Death was the primary outcome. Survival analysis for each variable was performed using statistical significance defined by the log-rank test. Multivariate and Cox regression analyses were done. Values of p less than 0.05 were considered statistically significant. Mean age was 43 years old (57% men and 47% women); 53% of patients had a medical condition and 47% surgical diagnosis; 54% of health care infections were surgical site infections and 62% were associated to Gram-negative bacilli. The mortality rate during follow-up was 24.4%. On multivariate analysis we found an association with intensive care stay (HR=1.51; 95% CI: 1.13-2.01), inappropriate use of antibiotics (HR=3.05; 95% CI: 2.34-3.98) and use of generic antibiotics or copies (HR=1.91; 95%CI: 1.43-2.55). The use of generic molecules of antibiotics and inappropriate antibiotic treatments in patients with health care infections are modifiable factors to decrease mortality.

  9. 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.

  10. 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.

  11. 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.

  12. 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.

  13. Health Literacy Levels among Outpatients at a Tertiary Hospital in Delhi, India

    Directory of Open Access Journals (Sweden)

    Monika Sahoo

    2015-03-01

    Full Text Available Background: Health literacy is defined as the cognitive and social skills which determine the motivation and ability of individuals to gain access to, understand, and use information in ways which promote and maintain good health. This study was conducted to determine health literacy levels and the associated factors among patients attending the outpatient departments of a tertiary care hospital in Delhi. Methods: A hospital-based cross-sectional study was carried out in a tertiary care teaching hospital in Delhi over a period of four months. A total of 150 patients were included in the study. Fifty patients from the Diabetes Clinic, 50 patients from the Hypertension Clinic, and 50 patients with anemia from the Antenatal Outpatient Department (OPD were selected using a convenience sampling method. Data was analyzed using Epi Info software. Statistical analysis was conducted with the chi-square test and the Fisher’s exact test. P values less than 0.05 were considered significant. Results: Out of 50 diabetic subjects, 37 (74% understood the information about their blood sugar levels as explained to them by the doctor. Similar results were found among hypertensive subjects as well. Furthermore, education status was significantly associated with health literacy. In terms of understanding the regimen of medications, significant association was seen with age, sex, and education. Conclusion: Education status, age, and gender are important determinants of health literacy. Our results support that innovative strategies of communication should be used to improve health literacy among patients.

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

    Directory of Open Access Journals (Sweden)

    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. 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.

  16. 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

  17. 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

    2017-11-03

    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.

  18. 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.

  19. “WAYS FOR TERTIARY LEVEL STUDENTS IN BUILDING ENGLISH SPEAKING PERFORMANCE”

    Directory of Open Access Journals (Sweden)

    Fika Megawati

    2017-10-01

    Full Text Available Abstract: This study aims to find out the strategies used by tertiary level students in performing English communication. This research was a descriptive study involving English Education Study Program students. Data analysis included in-depth transcribing on the students’ speaking performance and the result of interview. The findings show that the communication strategies used in the conversation consisted of avoidance, paraphrase, borrowing, appeal for assistance, and mime. The common strategy lied on mime, while avoidance and paraphrase strategies were not frequently applied. The results show communication strategies were effective in helping the first language students in learning English as their foreign language. Communication strategies give solution to cope with difficulties in learning English. Communication strategies are highly suggested to be socialized to EFL learners as an alternative way to improve speaking performance.

  20. Creativity and Innovation in Science and Technology: Bridging the Gap between Secondary and Tertiary Levels of Education

    Science.gov (United States)

    Ramma, Yashwantrao; Samy, Martin; Gopee, Ajit

    2015-01-01

    Purpose: This paper stems from a study which was conducted as a means to first, find out whether there is a gap between the secondary and tertiary education levels, second identify any existing gap in Science and Technology education, and third, examine the impact of the above upon students' creativity and innovativeness at university level. The…

  1. Factors influencing possible delay in the diagnosis of Alzheimer's disease Findings from a tertiary Public University Hospital

    Directory of Open Access Journals (Sweden)

    Luís Felipe José Ravic de Miranda

    Full Text Available Abstract Alzheimer's disease (AD is characterized by impairment in memory and autonomy, causing excessive pressure on family and an overburdened health care system. Early diagnosis, with the appropriate treatment, is important to reduce the pattern of disease progression. Objective: The study sought to identify the most probable causes of delay in diagnosis. Methods: A cross-sectional study involving AD patients followed at an Outpatient Geriatric Clinic from a tertiary public university hospital was conducted between June 2009 and February 2011. Results: Ninety-four patients were evaluated (66% women, aged 77.76±6.8 years and with median educational level of 3 years (95% CI 2.7-3.80. Regarding severity of dementia, 51.8% of patients were classified as having mild dementia (CDR 1, 40% moderate dementia (CDR 2 and 8.2% severe dementia (CDR 3. Mean educational level of caregivers was 8.3±3.9 years. Among those who believed there was a delay, 36% stated that the "family thought that the changes were normal for the age of the patient" reporting average delay of 1.8 years (95% CI: 1.3-2.5 while 45.3% stated that the "doctor did not reach a diagnosis" reporting a median delay of 1.5 years (95% CI: 1.4-2.3. Conclusion: Based on these results, it can be concluded the time between onset of symptoms and diagnosis was excessive. This study may be useful to help increase awareness of issues not sufficiently discussed in the literature, such as diagnostic delay and influence of caregivers' educational level on treatment.

  2. Staff Perception of Relative Importance of Quality Dimensions for Patients atTertiary Public Services in Oman

    Directory of Open Access Journals (Sweden)

    Ismail Alrashdi

    2012-09-01

    Full Text Available Objective: 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.Methods: 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.Results: 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 importantquality 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.Conclusion: 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 reinforcethe culture of good quality service amongst healthcare providers, managers in particular, and to improve patient satisfaction.

  3. 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…

  4. [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.

  5. 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.…

  6. High levels of self-efficacy in patients with type 2 diabetes attending a tertiary level clinic

    Directory of Open Access Journals (Sweden)

    K. Mostert Wentzel

    2008-02-01

    Full Text Available Self-management is a vital element in the care of type 2diabetes patients.  In turn, self-efficacy plays a major role in patients’ self-management. Self-efficacy is the patient’s personal judgement of his/herconfidence in performing aspects of diabetes self-management.  This study investigated the level of self-efficacy of patients attending the Pretoria Academic Hospital Diabetes Clinic, in the light of high levels ofre-admission due to complications, suggesting low self-efficacy levels. Eighty type 2 diabetes patients, mean age of 59 years, completed thepublished IDEA LL baseline questionnaire, to establish a self-efficacyscore.  Relationships between self-efficacy and demographic factors wereinvestigated using the chi-square test. The mean self-efficacy level of thesample population is excellent (mean = 85.44%.A lthough self-reported self-efficacy levels are excellent, in comparison to the Sarkar study (2006 in which participants only scored “fair”, it is speculated that self-efficacy is not transferred to self-management behaviour in thispopulation.  Afrikaans and English speaking participants score significantly better than those from other language categories. There is a positive relationship between self-efficacy and level of education and employment status (tendedtowards significance with p values of 0.06 and 0.07 respectively. A lthough self-efficacy scores of clients at this tertiary level outpatient clinic are excellent, further research is necessary to quantify self-management strategies andto correlate these with self-efficacy levels.

  7. Limiting the level of tertiary amines on polyamines leads to biocompatible nucleic acid vectors.

    Science.gov (United States)

    Simão Carlos, Margarida Isabel; Zheng, Kai; Garrett, Natalie; Arifin, Natrah; Workman, David G; Kubajewska, Ilona; Halwani, Abdulrahman A; Moger, Julian; Zhang, Qi; Schätzlein, Andreas G; Uchegbu, Ijeoma F

    2017-06-30

    We have designed an efficient, synthetic nucleic acid vector, which is relatively non-toxic. [N-(2-ethylamino)-6-O-glycolchitosan - EAGC] polymers were 10-50 fold less toxic than Lipofectamine 2000, able to complex DNA, mRNA and siRNA into positively charged (zeta potential=+40 - 50mV), 50-450nm nanoparticles. The level of tertiary amine N-2-ethylamino substitution (DStert) was inversely proportional to the IC50 of the EAGC polymers in the A431 cell line: IC50=6.18DStert(-0.9), r(2)=0.9991. EAGC polyplexes were stable against a heparin challenge, able to protect the nucleic acids from nuclease degradation and achieve levels of transfection comparable to Lipofectamine 2000 formulations. The relative biocompatibility of the vector allowed 10 fold higher doses of DNA (1μg compared to 0.1μg per well with Lipofectamine 2000) and siRNA (10.7μg per well vs 1.3μg with Lipofectamine 2000) to be applied to cells, when compared to Lipofectamine 2000. Finally intranasal application of EAGC - siRNA complexes resulted in siRNA transfer to the neurons of the olfactory bulb. Copyright © 2017 Elsevier B.V. All rights reserved.

  8. Incorporating Cross-Cultural Videoconferencing to Enhance Content and Language Integrated Learning (CLIL) at the Tertiary Level

    Science.gov (United States)

    Loranc-Paszylk, Barbara

    2016-01-01

    This paper attempts to provide evidence of cross-cultural videoconferencing affordances with reference to a Content and Language Integrated Learning (CLIL) context at the tertiary level. At the core of CLIL lie student-centered paradigms of teaching methodologies that invite task and project work and authentic and meaningful communication, while…

  9. "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…

  10. The Effects of Extensive Reading via E-Books on Tertiary Level EFL Students' Reading Attitude, Reading Comprehension, and Vocabulary

    Science.gov (United States)

    Chen, Chin-Neng; Chen, Shu-Chu; Chen, Shu-Hui Eileen; Wey, Shyh-Chyi

    2013-01-01

    This study investigates the effects of extensive reading of e-books on tertiary level EFL students' English reading attitude, reading comprehension and vocabulary. Eighty-nine participants were assigned in two groups, with 46 students in the experimental group and the other 43 students in the control group. In addition to a traditional curriculum…

  11. A Survey on the Levels of Questioning of ELT: A Case Study in an Indonesian Tertiary Education

    Science.gov (United States)

    Ashadi, Rido Imam; Lubis, Nazriani

    2017-01-01

    This present study focused on examining the levels of questions in Indonesia tertiary education. A survey research was conducted in one of the private universities in North Sumatra. The English summative assessment in an undergraduate education was used as target of survey. There were a collection of questions that had been administered by four…

  12. Supporting Low Ability Learners in a Tertiary Level Compulsory English Programme Using CEFR Based Online Language Software

    Science.gov (United States)

    Lynch, Gavin; McKeurtan, Maureen

    2012-01-01

    This report describes the processes, methods and results of using language software based on the Common European Framework of Reference for Languages (CEFR) in a tertiary level institute in Japan in order to facilitate the learning of low ability learners of English. None of the learners were English majors, all were between the ages of 18 and 20,…

  13. 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.

  14. Level of adherence to an extravasation protocol over 10 years in a tertiary care hospital.

    Science.gov (United States)

    Molas-Ferrer, Gloria; Farré-Ayuso, Elisabet; doPazo-Oubiña, Fernando; deAndrés-Lázaro, Ana; Guell-Picazo, Jaume; Borrás-Maixenchs, Núria; Corominas-Bosch, Lourdes; Valverde-Bosch, Montserrat; Creus-Baró, Natalia

    2015-04-01

    Extravasation of chemotherapy is an undesirable complication related to the administration of antineoplastic therapy. Establishing the real incidence is difficult. Because of the importance of a quick intervention after an extravasation, every hospital should have an extravasation protocol. The purpose of this study was to determine the degree of observance of an extravasation protocol by nursing staff and to determine extravasation incidence. This descriptive, longitudinal, retrospective study was set in a tertiary-level hospital. The researchers reviewed 117 extravasation notification forms received by the pharmacy department during a 10-year period. Nursing actuation, particularly observance of the extravasation protocol, was analyzed. Protocol adherence was 89%. Twelve deviations from the protocol in the application of recommended measures were detected. An antidote was used in 41 patients, and temperature measures were applied in 14 cases. Ninety-nine patients had at least one episode of reported follow-up. No cases of necrosis or skin ulcers were described, except by one patient, who developed a delayed skin ulcer to vinorelbine. Drugs most frequently reported were etoposide, carboplatin, and paclitaxel. Nursing staff should be continuously trained in extravasation protocol because a rapid actuation can prevent skin lesions.

  15. Studying the poetry of Philip Larkin in the tertiary-level ELT classroom: a twofold approach.

    Directory of Open Access Journals (Sweden)

    Andy Dixon

    2013-07-01

    Full Text Available The paper explores the advantages gained from combining the thematic study of selected works of a significant poet - in this case Philip Larkin - and the exploitation of these works for the purpose of developing the four language skills. A detailed analysis of poems illustrative of the main themes of a particular poet's oeuvre not only provides opportunities for a wider understanding of his or her work than might be the case if the poet is being studied solely, as often occurs in tertiary-level classes, to demonstrate his or her historico-literary position and significance in the canon, but can also lead to numerous possibilities for language acquisition. As a by-product of a thematic approach, students will hopefully also be led to discover in the poetry areas of experience relevant to themselves, and this should, in turn, lead to reflection which will be given verbal or written expression. A selection of a poet's works, then, can usefully be read with a thematic focus in the context of a course in literature and simultaneously utilised as a language teaching and learning resource.

  16. Studying the poetry of Philip Larkin in the tertiary-level ELT classroom: a twofold approach.

    Directory of Open Access Journals (Sweden)

    Andy Dixon

    2013-06-01

    Full Text Available The paper explores the advantages gained from combining the thematic study of selected works of a significant poet - in this case Philip Larkin - and the exploitation of these works for the purpose of developing the four language skills. A detailed analysis of poems illustrative of the main themes of a particular poet's oeuvre not only provides opportunities for a wider understanding of his or her work than might be the case if the poet is being studied solely, as often occurs in tertiary-level classes, to demonstrate his or her historico-literary position and significance in the canon, but can also lead to numerous possibilities for language acquisition. As a by-product of a thematic approach, students will hopefully also be led to discover in the poetry areas of experience relevant to themselves, and this should, in turn, lead to reflection which will be given verbal or written expression. A selection of a poet's works, then, can usefully be read with a thematic focus in the context of a course in literature and simultaneously utilised as a language teaching and learning resource.

  17. Patient knowledge and intension to use the intrauterine contraceptive device (IUCD at a tertiary level hospital.

    Directory of Open Access Journals (Sweden)

    Nadia van der Westhuizen

    2016-11-01

    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.

  18. [Functional echocardiography in the neonatal intensive care unit; experience in a tertiary level hospital].

    Science.gov (United States)

    Hernández-Benítez, Rodrigo; Becerra-Becerra, Rosario

    The Hospital Infantil de Mexico Federico Gómez is a tertiary level hospital with a neonatal intensive care unit (NICU), which is one of the most important units in the treatment of newborn's diseases in México. In this unit, the decisions are taken based on some clinic parameters such as respiratory rate, heart rate, arterial pressure, urinary output and lactate levels. The functional echocardiography is a useful tool which improves the hemodynamic evaluation and decisions in neonatal care. Data on its use in neonatal units in Mexico is lacking. A prospective study conducted in NICU patients during 3 months from August to October 2015 at the Hospital Infantil de Mexico Federico Gómez. Gestational age, birth weight, admission criteria, days of life at examination, indication for functional echocardiography and changes in treatment were evaluated and finally, we performed a new study 24hours later. Echocardiographic evaluation included: assessment of presence/hemodynamic significance of PDA; myocardial function: ejection fraction/shortening fraction, left ventricular output, right ventricular output, systemic blood flow; and signs of pulmonary hypertension. 30 echocardiographic studies were performed in 15 patients. The average age was 9.6 days, the variability in gestational ages were 37 to 42 weeks; the average weight was 2.583kg. The most frequent diagnosis was respiratory distress, and the principal indications for echocardiography were hemodynamic instability and sepsis (53.3%). In 11 cases (73.3%), the treatment was modified posteriorly to functional echocardiography, and in 10 cases we observed improvements in the 24hours after control. Functional echocardiography is a useful tool in NICU, which may assist with clinical decision-making. Copyright © 2016 Hospital Infantil de México Federico Gómez. Publicado por Masson Doyma México S.A. All rights reserved.

  19. Trajectory of cause of death among brought dead neonates in tertiary care public facilities of Pakistan: A multicenter study.

    Science.gov (United States)

    Mustufa, Muhammad Ayaz; Sheikh, Munir Ahmed; Taseer, Ijaz-Ul-Haque; Raza, Syed Jamal; Arshad, Muhammad Sohail; Akhter, Tasleem; Arain, Ghazala Mohyuddin; Habibullah, Sultana; Safdar, Sohail; Firdous, Rukhsana; Adnan, Muhammad

    2017-02-01

    Considering the fact that Pakistan is amongst the countries with very high neonatal mortality rates, we conducted a research study to determine the possible causes and characteristics of neonates presenting dead to the emergency department of tertiary public health care facilities of Pakistan using verbal autopsies. A descriptive case series study was conducted in emergency department/pediatrics ward/neonatal ward/nursery unit of ten tertiary care public health facilities, situated in seven major cities of Pakistan from November, 2011 to June, 2013. Precoded verbal autopsy proforma was used to collect information regarding cause of death, family narratives and other associated risks accountable for pathway to mortality. We identified 431 neonates presenting dead to the emergency department (238 males and 193 females). Sepsis (26.7%), birth asphyxia (18.8%) and persistent pulmonary arrest (17.2%) were main primary causes of brought death. Around 72% brought dead neonates were referred from doctors/health care facilities and more than 28% caregivers mentioned that they were not informed about the diagnosis/ailment of their deceased newborn. Findings of our study suggest that infectious disease remains the main primary cause of neonatal mortality. Underweight in newborns (64%) was estimated as a leading associated risk. Delays in referrals to respective health care facility enlightened the concern of sub-standard prerequisites of neonatal care that could be one of the major contributing risk factor of high mortality rates.

  20. A Study of First-Year Chemistry Students' Understanding of Solution Concentration at the Tertiary Level

    Science.gov (United States)

    de Berg, Kevin

    2012-01-01

    This paper reports on students' understanding of sugar concentration in aqueous solutions presented in two different modes: a visual submicroscopic mode for particles and a verbal mode referring to macroscopic amounts of sugar. One hundred and forty-five tertiary college students studying some form of first-year chemistry participated in the…

  1. 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…

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

    OpenAIRE

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

    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 ...

  3. 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

  4. 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...

  5. 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

    BACKGROUND: Studies have found higher survival rates after out-of-hospital cardiac arrest and admission to tertiary heart centers. The aim was to examine the level-of-care at tertiary centers compared with nontertiary hospitals and the association with outcome after out-of-hospital cardiac arrest....... METHODS AND RESULTS: Consecutive out-of-hospital cardiac arrest patients (n=1078) without ST-segment-elevation myocardial infarction admitted to tertiary centers (54%) and nontertiary hospitals (46%) were included (2002-2011). Patient charts were reviewed focusing on level-of-care and comorbidity....... The adjusted odds of predefined markers of level-of-care were higher in tertiary centers: admission to intensive care unit (odds ratio [OR], 1.8 [95% confidence interval, 1.2-2.5]), temporary pacemaker (OR, 6.4 [2.2-19]), vasoactive agents (OR, 1.5 [1.1-2.1]), acute (

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

    Science.gov (United States)

    Hamid, Saima; Malik, Asmat Ullah; Kamran, Irum; Ramzan, Musarat

    2013-01-03

    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. 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. 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. The study shows that the presence of a well trained health workforce is vital, and that certain aspects of its organization are key, including numbers (available quantity), skill mix (health team balance), distribution (urban/rural), and working conditions (compensation, nonfinancial incentives, and workplace safety). This study has identified the need to reform policies for retaining the nursing workforce. Simple measures

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

    Directory of Open Access Journals (Sweden)

    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.

  8. [Device associated infection in medical surgical intensive care unit inpatients of an A level, tertiary class hospital in Beijing].

    Science.gov (United States)

    Wang, Shao-li; An, Wei-hong; Li, Hong-liang; Yuan, Xiao-ning; Zhu, Xi; Yang, Xue-song

    2011-11-01

    To understand the situation of the device-associated infection (DAI) in the medical-surgical intensive care unit(ICU)inpatients in an A-level tertiary class hospital in Beijing. DAI date were collected through a surveillance on the medical-surgical ICU inpatients in an A-level tertiary class hospital in Beijing from January 2008 to December 2010. In 2279 patients admitted to the medical-surgical ICU (with a 15,332 days total hospitalization stay), 283 were found infected. The incidence for in-hospital infection was 12.42%, and 2.452% for the incidence per patient-day. The device utilization ratios for ventilator, central venous catheter and urinary catheter were 56.76%, 59.01% and 80.07% respectively while the incidence for ventilator-associated pneumonia (VAP), central line-associated bloodstream infection (CLABSI) and catheter-associated urinary tract infection (CAUTI) were 1.632%, 0.409% and 0.350% respectively. The predominant bacteria species found in these cases were Gram-negatives and the main stay of pathogenic species were A. baumannii, P. aeruginosa, Staphylococcus, E. coli, K. pneumoniae and C. albicans etc. The incidence of DAI in the surveyed hospital is close to other hospitals in China and other developing countries but higher than hospitals in United States. More efforts should be made for its prevention / control by hospital stuff, with the cooperation from the patients.

  9. A Survey on the Levels of Questioning of ELT: A Case Study in an Indonesian Tertiary Education

    Directory of Open Access Journals (Sweden)

    Rido Imam Ashadi

    2017-06-01

    Full Text Available This present study focused on examining the levels of questions in Indonesia tertiary education. A survey research was conducted in one of the private universities in North Sumatra. The English summative assessment in an undergraduate education was used as target of survey.  There were a collection of questions that had been administered by four English lecturers from Faculty of English Education in Universitas Muslim Nusantara (UMN Al-Washliyah Medan, Indonesia. The sample of research included the sixty five questions of summative tests. The qualitative content analysis which is based on Gallagher/Aschner Bloom Classification System used to categorize the questions. It was found that the lower order thinking level still dominated the question types (69%. There was only 31% higher order questions used on the summative test.

  10. Diurnal variation in hand hygiene compliance in a tertiary level multidisciplinary intensive care unit.

    Science.gov (United States)

    Sahay, Sandeep; Panja, Sauren; Ray, Sumit; Rao, B K

    2010-09-01

    Hand hygiene compliance among health care providers is considered to be the single most effective factor to reduce hospital acquired infections. Despite continuous education and awareness, compliance with hand hygiene guidelines has remained low, particularly during evening shifts. Our objective was to determine the compliance with hand hygiene guidelines among doctors, nurses, and paramedical staff during day and night duties in a multidisciplinary intensive care unit (ICU). We used a prospective, observational, 6-month study conducted in a 34-bed ICU within a tertiary care teaching hospital. All doctors, nurses, and paramedical staff in the ICU were included. An investigator, placed within the ICU setting, observed the hand hygiene practices during day and night. Day and night shift change times were 08:00 and 20:00 hours, respectively. Of the 5639 opportunities for hand hygiene, 3383 (59.9%) were properly performed. Overall rates of compliance were 66.1% for doctors, 60.7% for nurses, and 38.6% for paramedical staff. Hand hygiene compliance dropped during the night for doctors (81% vs 46%, respectively, P hand hygiene guidelines was lower at night compared with day, irrespective of discipline in all 3 groups of health care providers, both periods of compliance would benefit from additional training focusing on the importance of hand hygiene around the clock.

  11. 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.

  12. 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

  13. Maternal care quality in near miss and maternal mortality in an academic public tertiary hospital in Yogyakarta, Indonesia: a retrospective cohort study

    OpenAIRE

    Mawarti, Yuli; Utarini, Adi; Hakimi, Mohammad

    2017-01-01

    Background Reducing maternal mortality remains a major challenge for health care systems worldwide. The factors related to maternal mortality were extensively researched, and maternal death clusters around labour, delivery and the immediate postpartum period. Studies on the quality of maternal care in academic medical centre settings in low income countries are uncommon. Methods A retrospective cohort study of maternal deaths was conducted in an academic public tertiary hospital in Yogyakarta...

  14. Assessment of Drug Information Service in Public and Private Sector Tertiary Care Hospitals in the Eastern Province of Saudi Arabia.

    Science.gov (United States)

    Alamri, Sawsan Abdullah; Ali Al Jaizani, Raniah; Naqvi, Atta Abbas; Ghamdi, Mastour Safer Al

    2017-07-04

    Drug information service is a dedicated and specialized service provided by pharmacists to enhance knowledge of medicines use, promote rational prescribing among prescribers, and reduce medication errors. Saudi Arabia has a National Drug and Poison Information Center (NDPIC) responsible for answering drug queries. There is a lack of literature that reports the current scenario of drug information services in the country, especially the Eastern Province. This study reported the current status of drug information services being provided among tertiary care hospitals of the Eastern Province of Saudi Arabia. All hospitals provided drug information services. The qualification of personnel was mostly bachelor's level (46.2%) and without proper training (54.8%). The most common queries received in a day were related to drug alternatives, dosage, and administration, as well as the availability of drugs. Physicians were the main users of the service. The most common health resources employed for the service was Lexi-Comp (76.9%) and Micromedex (69.2%). The use of Saudi National Formulary was not reported by any hospital, which highlights a potential research gap to address i.e., to investigate the lack of use of SNF by practitioners.

  15. Comparison of Ramadan-specific education level in patients with diabetes seen at a Primary and a Tertiary care center of Karachi-Pakistan.

    Science.gov (United States)

    Masood, Shabeen Naz; Alvi, Syed Faraz Danish; Ahmedani, Muhammad Yakoob; Kiran, Shazia; Zeeshan, Nimra Fatima; Basit, Abdul; Shera, A Samad

    2014-01-01

    To compare Ramadan-specific education level in fasting patients with diabetes at a Primary and a Tertiary care center. An observational study was conducted in the Outpatient departments of a Primary care center and a Tertiary care center in Karachi-Pakistan. Recruitment of patients started at the end of Ramadan 2011 and continued till three months after Ramadan 2011. All patients with diabetes who observed fast during the month of Ramadan 2011 were included in the study. In Primary care center, patients were attended by physicians only, while at Tertiary care center patients were seen by physicians, diabetes educator and dietician. For data collection, standardized questionnaire based interview was conducted on one to one basis by trained healthcare professionals. Same questionnaire was used at both the centers. A total of 392 and 199 patients with diabetes recruited at Primary and Tertiary care centers, respectively. Ramadan-specific diabetes education received by 213 (55%) and 123 (61.80%) patients with diabetes at Primary and Tertiary care centers, respectively. Compared to Primary care center, patients at Tertiary care centers were more aware about components of Ramadan-specific diabetes education such as signs and symptoms of hypoglycemia and hyperglycemia, dose of medicines/insulin during Ramadan fasting, dose of medicines/insulin when not fasting, self-monitoring of blood glucose, dietary modifications, physical activity, adequate nutrition and adequate hydration during Ramadan (pRamadan-specific education level of patients at Tertiary care center was significantly better compared to patients at Primary care center. Copyright © 2014 Diabetes India. Published by Elsevier Ltd. All rights reserved.

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

    African Journals Online (AJOL)

    Records were not updated to meet with international standards (ICD-10); (22.9%) and had low rates for use in future purposes. Also low were the level of medical and environmental research, informal relationship and security, but the management had a high level of social responsibility in form of emergency and disaster ...

  17. AN ASSESSMENT OF THE TRANSPARENCY LEVEL IN ROMANIAN PUBLIC UNIVERSITIES

    Directory of Open Access Journals (Sweden)

    Andrei-Razvan CRISAN

    2016-12-01

    Full Text Available Transparency in the public sector is of paramount importance for the general sentiment of trust in the system itself, as public servants are publicly accountable for the use of and effects on public resources. In this respect, ensuring an increase in transparency would allow these public servants to discharge accountability accordingly and would provide the necessary frame for assessment of public resource use from stakeholders. This paper aims to determine whether transparency levels are adequate in the case of Romanian public universities, using a refined assessment tool which consists of multiple criteria based on principles and required elements for the reduction of information asymmetry. Our findings show that overall, in the case of Romanian public universities, the transparency level is high and there is a prerequisite to ensure the fair judgement from stakeholders.

  18. Supporting Tertiary Students with Disabilities: Individualised and Institution-Level Approaches in Practice. Research Report

    Science.gov (United States)

    Fossey, Ellie; Chaffey, Lisa; Venville, Annie; Ennals, Priscilla; Douglas, Jacinta; Bigby, Christine

    2015-01-01

    This research explores the complex factors affecting the implementation of learning supports for students with disabilities or ongoing health conditions. It focuses on two types of learning support: (1) individualised reasonable adjustments; and (2) institution-level learning supports, the latter being available to all students. These supports can…

  19. serum uric acid levels in oral cancer patients seen at tertiary ...

    African Journals Online (AJOL)

    Uric acid is the final product of purine metabolism in humans, and its circulating concentrations are regulated by the balance in its production and excretion2. ... Statistical Package for the Social Sciences, version 19.0. (SPSS19). Statistical significance was determined at P < 0.05. Results: The mean serum uric acid level in ...

  20. International EFL/ESL Master Students' Adaptation Strategies for Academic Writing Practices at Tertiary Level

    Science.gov (United States)

    Singh, Manjet Kaur Mehar

    2017-01-01

    The present research provides insights into the different forms of adaptation strategies employed by international graduate students to overcome the challenges faced in the academic writing practices and gain access to their disciplinary communities of practice at Master's level. Qualitative data was collected through semi-structured in-depth…

  1. 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.

  2. Tertiary Level Students and the Mental Health Index (MHI-5 in Ireland

    Directory of Open Access Journals (Sweden)

    Claire Dunne

    2010-01-01

    Full Text Available An examination of student mental health was conducted using the five item Mental Health Index (MHI, a subscale of the widely used SF-36 (Short Form Health Survey. Results support the use of the MHI, which was found to be to be a valid and reliable measure of mental health in Irish third-level students. As anticipated, females reported significantly higher levels of symptoms than males on the MHI. It was also noted that final year students report significantly worse mental health than other students. Comparison with a general population mean for a corresponding age group indicate significantly lower mental health status being recorded by the students in this study. Suggestions for further research are made.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.  

  6. Students’ Attitudes towards the Use of Slovene as L1 in Teaching and Learning of Business English at Tertiary Level

    Directory of Open Access Journals (Sweden)

    Nataša Gajšt

    2017-06-01

    Full Text Available Over the past decades, the monolingual (English-only approach to English language teaching and learning has prevailed. In recent years, however, the trend of using students’ first language (L1 in teaching and learning English as a foreign language has re-emerged. However, the research on the use of L1 in teaching English for specific purposes is far from extensive. The aim of this study was to investigate the use of Slovene as the students’ L1 in teaching and learning Business English at tertiary level. The specific objectives were to determine the students’ attitudes towards the teachers’ and the students’ use of Slovene during Business English lessons and the students’ use of Slovene in learning Business English. The present study was quantitative, with data gathered via a questionnaire. The results show that, on the one hand, there is some inclination towards the use of L1 both in class and during their study of Business English. On the other hand, the preference towards the use of predominantly (or exclusively English in class is also present and is positively correlated with the level of students’ knowledge of English. The results are of value to English language teachers as they suggest the contexts in which students’ L1 could be used in the process of teaching and learning English for specific purposes.

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

    Directory of Open Access Journals (Sweden)

    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.

  8. Consumer involvement in the tertiary-level education of mental health professionals: a systematic review.

    Science.gov (United States)

    Happell, Brenda; Byrne, Louise; McAllister, Margaret; Lampshire, Debra; Roper, Cath; Gaskin, Cadeyrn J; Martin, Graham; Wynaden, Dianne; McKenna, Brian; Lakeman, Richard; Platania-Phung, Chris; Hamer, Helen

    2014-02-01

    A systematic review of the published work on consumer involvement in the education of health professionals was undertaken using the PRISMA guidelines. Searches of the CINAHL, MEDLINE, and PsychINFO electronic databases returned 487 records, and 20 met the inclusion criteria. Further papers were obtained through scanning the reference lists of those articles included from the initial published work search (n = 9) and contacting researchers in the field (n = 1). Thirty papers (representing 28 studies) were included in this review. Findings from three studies indicate that consumer involvement in the education of mental health professionals is limited and variable across professions. Evaluations of consumer involvement in 16 courses suggest that students gain insight into consumers' perspectives of: (i) what life is like for people with mental illness; (ii) mental illness itself; (iii) the experiences of admission to, and treatment within, mental health services; and (iv) how these services could be improved. Some students and educators, however, raised numerous concerns about consumer involvement in education (e.g. whether consumers were pursuing their own agendas, whether consumers' views were representative). Evaluations of consumer involvement in education are limited in that their main focus is on the perceptions of students. The findings of this review suggest that public policy expectations regarding consumer involvement in mental health services appear to be slowly affecting the education of mental health professionals. Future research needs to focus on determining the effect of consumer involvement in education on the behaviours and attitudes of students in healthcare environments. © 2013 The Authors; International Journal of Mental Health Nursing © 2013 Australian College of Mental Health Nurses Inc.

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

    Directory of Open Access Journals (Sweden)

    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.

  10. 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.

  11. Tertiary Level Exchange Students’ Perspectives on Self-Efficacy: Toward EFL Writing

    Directory of Open Access Journals (Sweden)

    Fika Megawati

    2016-11-01

    Full Text Available This study aims to describe the students’ self-efficacy on their writing competence. Descriptive study was implemented by distributing closed-ended questionnaires in addition to interview and the result of writing task. The subjects of this study were three students from Thailand. The students’ responses in questionnaire were analyzed through frequency distribution and percentage. For the result of interview, it was transcribed in written form and used coding technique to classify the relevant points. The result of writing task became the supplementary data to confirm the findings and support conclusion. In a nutshell, the subjects of this study have moderate level of writing self-efficacy. Each student showed diverse selection in writing stage. The first student had moderate self-efficacy, but he relatively could cope with the writing problems. In the second student, the writing self-efficacy was the highest one, and it was proven from her better writing result. For the last student, similar to the writing quality, he considered himself weak in this skill.

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

    Directory of Open Access Journals (Sweden)

    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

  13. Hybrid Educational Methodology for the Cognitive Domain of Built Heritage Protection Interconnecting Secondary with Tertiary Level Education

    Directory of Open Access Journals (Sweden)

    Agoritsa Konstanti

    2013-10-01

    Full Text Available Normal 0 false false false MicrosoftInternetExplorer4 In the present work, a hybrid educational methodology has been developed for approaching the cognitive domain of Built Heritage Protection in an interdisciplinary and integrated way. This domain was selected as a pilot one, presenting various remarkable characteristics, such as bringing together STEM subjects with social and human sciences, proving concrete concepts, being attractive for youth, and demanding combination of technical solutions with social aspects. The methodology had the scope to interconnect secondary with tertiary level education for the achievement of the best possible results, as the latter possesses the needed specialised knowledge, expertise and infrastructure. The methodology incorporates problem - based learning, aiming at the effective solution of real and extremely complex problems encountered in monument scale, which is combined with traditional teaching methods, such as lectures, as well as contemporary elements, such as class exercise laboratory experiments, in situ field work, promoting hands - on experience of students. The pilot application and evaluation of the hybrid methodology proved to be a valuable experience for students of secondary level education, which needs to be further exploited and optimised in order to meet the expectations of the interested parties.   /* Style Definitions */ table.MsoNormalTable {mso-style-name:"????????? ???????"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman"; mso-ansi-language:#0400; mso-fareast-language:#0400; mso-bidi-language:#0400;}

  14. High-level and novel mechanisms of carbapenem resistance in Gram-negative bacteria from tertiary hospitals in Nigeria.

    Science.gov (United States)

    Ogbolu, D O; Webber, M A

    2014-05-01

    To determine the occurrence and molecular basis of carbapenem resistance in Gram-negative bacteria from tertiary hospitals in Nigeria, 182 non-duplicate Gram-negative bacterial isolates were investigated for antimicrobial susceptibility, presence of carbapenemases (tested phenotypically and genotypically), random amplified polymorphic DNA (RAPD) typing, plasmid sizing and replicon typing. Minimum inhibitory concentrations of carbapenems showed a high degree of resistance, with 67 isolates (36.8%) being resistant to all carbapenems, of which 40 (59.7%) produced enzymes able to hydrolyse imipenem. PCR and sequencing identified only 10 isolates (5.5%) carrying known carbapenemase genes, including bla(NDM), bla(VIM) and bla(GES). The majority of phenotypically carbapenem-resistant and carbapenemase-producing isolates did not carry a known carbapenemase gene. Transconjugant or transformant plasmid sizes were estimated to be 115 kb for bla(NDM)- and 93 kb for bla(VIM)-carrying plasmids. These plasmids were untypeable for replicon/incompatibility and transferred various other genes including plasmid-mediated quinolone resistance (PMQR) genes and bla(CTX-M-15). Typing showed that the isolates in this study were not clonally related. There is a high level of carbapenem resistance in Nigeria. As well as the globally relevant carbapenemases (bla(NDM), bla(VIM) and bla(GES)), there are other unknown gene(s) or variant(s) in circulation able to hydrolyse carbapenems and confer high-level resistance. Copyright © 2014 Elsevier B.V. and the International Society of Chemotherapy. All rights reserved.

  15. 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

  16. 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

    2014-10-01

    To assess the level and factors of motivation amongst permanent government employees working in a tertiary health care institution. 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. 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 personnel varied with respect to five factors of

  17. Level of motivation amongst health personnel working in a Tertiary care Government Hospital of New Delhi, India

    Directory of Open Access Journals (Sweden)

    Poonam Jaiswal

    2014-01-01

    Full Text Available 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 personnel

  18. Secondary and tertiary hyperparathyroidism.

    Science.gov (United States)

    Jamal, Sophie A; Miller, Paul D

    2013-01-01

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

  19. Future priorities of interns in public and private tertiary care hospitals of a mega city in a developing country.

    Science.gov (United States)

    Shaikh, Shiraz; Obaid, Munnaza; Memon, Sobia; Shaikh, Kulsoom; Siddiqui, Hafsa

    2017-01-01

    To determine the future priorities of young medical doctors in tertiary care hospitals in a major urban centre. This multi-centre cross-sectional study was conducted at four tertiary care hospitals of Karachi, Pakistan, from January to June 2015, and comprised medical interns. A questionnaire-based survey was conducted. The participants were inquired about their demographics, preferred places and hospitals for training in the future and reason for their choices. Differences in future choice for going abroad between gender, relationship status, household monthly income, etc. were analysed. SPSS 16 was used for data analysis. Of the 308 participants, 228(74%) were females and 80(26%) were males. The overall mean age was 24.56±1.18 years. Moreover, 118(38.3%) participants wanted to go abroad for their postgraduate training. Of them, 46(39%) wished to return to Pakistan after completing the training from abroad. Top five reasons for going abroad included better quality of training 60(50.8%), better environment and facilities 35(29.7%), security and safety 29(24.6%), better career growth 24(20.3%) and fiancé/spouse settled there 18(15.3%). Preference of pursuing postgraduate training abroad outside Pakistan was significantly higher among doctors who were males (p=0.026), had graduated from medical colleges in Karachi (p=0.003), had household monthly income of greater than Rs100,000 (pabroad (pabroad for training with only one-third among them planning to return.

  20. Paths to Upper Level Positions in Public Relations

    Science.gov (United States)

    Bishop, Patrick J.

    2010-01-01

    Preparation for a career in the field of public relations (PR) is based on a set of unique core competencies typically found in liberal arts. Though PR professionals rarely gain business degrees, they acquire knowledge, skills, perspectives, and strategies well-suited to executive-level positions in business. Additionally, managerial positions in…

  1. Questionnaire survey about use of an online appointment booking system in one large tertiary public hospital outpatient service center in China.

    Science.gov (United States)

    Zhang, MinMin; Zhang, CongXin; Sun, QinWen; Cai, QuanCai; Yang, Hua; Zhang, YinJuan

    2014-06-09

    As a part of nationwide healthcare reforms, the Chinese government launched web-based appointment systems (WAS) to provide a solution to problems around outpatient appointments and services. These have been in place in all Chinese public tertiary hospitals since 2009. Questionnaires were collected from both patients and doctors in one large tertiary public hospital in Shanghai, China.Data were analyzed to measure their satisfaction and views about the WAS. The 1000 outpatients randomly selected for the survey were least satisfied about the waiting time to see a doctor. Even though the WAS provided a much more convenient booking method, only 17% of patients used it. Of the 197 doctors surveyed, over 90% thought it was necessary to provide alternative forms of appointment booking systems for outpatients. However, about 80% of those doctors who were not associated professors would like to provide an 'on-the-spot' appointment option, which would lead to longer waits for patients. Patients were least satisfied about the waiting times. To effectively reduce appointment-waiting times is therefore an urgent issue. Despite the benefits of using the WAS, most patients still registered via the usual method of queuing, suggesting that hospitals and health service providers should promote and encourage the use of the WAS. Furthermore, Chinese health providers need to help doctors to take others' opinions or feedback into consideration when treating patients to minimize the gap between patients' and doctors' opinions. These findings may provide useful information for both practitioners and regulators, and improve recognition of this efficient and useful booking system, which may have far-reaching and positive implications for China's ongoing reforms.

  2. 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...

  3. 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.

  4. PUBLIC CERTIFICATION AND OPTIMAL LEVEL OF QUALITY STANDARD

    OpenAIRE

    ILLTAE AHN

    2014-01-01

    This paper analyzes public certification program where the government sets a quality standard and provides labels to sellers whose qualities are above the standard. Buyers are uninformed of sellers¡¯ qualities without the program. We study an optimal level of quality standard or optimal ratio of labeling that maximizes the social welfare. We find that the optimal quality standard becomes higher or the optimal ratio of labeling decreases as the unit certification cost increases and the quality...

  5. Ensuring Effective Mentoring in Tertiary Institutions in Anambra State ...

    African Journals Online (AJOL)

    One research question guided the study while one null hypothesis was tested at 0.05 level of significance using t-test statistics. A structured questionnaire ... Identified strategies should be adopted by the institutions to ensure the effectiveness of mentoring in public and private tertiary institutions in Anambra State. Key words: ...

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

    Directory of Open Access Journals (Sweden)

    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.

  7. Substitution Effect of Public Support Programs at Local Level

    Directory of Open Access Journals (Sweden)

    Valéria SZITÁSIOVÁ

    2014-12-01

    Full Text Available The paper evaluates the principle of addi-tionality in public support programs at local level. In the evaluation of public support policies a key question is whether the policy has made a differ-ence over what would have otherwise occurred. This could be measured by different ways as out-put, behavioral or input additionality. In this paper we analyze the impact of public support programs on input additionality as the extent to which the subsidy is refected in increased expenditures by supported subjects through the measurement of substitution effect. We studied public investment subsidies in the case of education support in Slo-vakia. We identifed the substitution effect in 10% of the analyzed municipalities. There are several differences in outcomes.An important factor is the size of the city as larger municipalities reduce their other activities when obtaining the support. We also showed that less developed regions have a lower tendency to misuse the support programs. The more de-veloped regions and cities reduce their own spending on a given priority when obtaining the support.

  8. The integration level of public transportation in Makassar City

    Science.gov (United States)

    Kasim, A. M. R.; Wicaksono, A. D.; Kurniawan, E. B.

    2017-06-01

    Multimodal transportation is transportation modes that can combine one with the other modes properly, efficiently and effectively so that people can move from one type of transportation to another modes with fast, cheap and convenient. The integration of transport services and infrastructure network is not fully realized, among others, can be seen from the public transport service between modes, one with the other modes, which makes people have to travel by other modes and is not served by public transport canal. Furthermore, intramoda displacement can not be done easily and quickly, some things that makes people tend to prefer private rather than public transport vehicles in doing movement. The main objective of this study was to determine the level of integration of modes of land transportation in the city of Makassar. By using analysis of physical alignment, non-physical, and analysis of travel time, which is then summarized into a canvas ratings to get an idea of the level of integration in general. The results showed that the level of integration of modes consist of two criteria with a very low value, 4 criteria with low and medium value, two criteria with a high value, as well as one criterion with very high value. Meanwhile, the variable of integration that influence people’s preferences in order from the highest value is the number of the fleet, the availability of routes, the number of passengers compared with the load factor, the location where the stopping points up and down, and the last is the location of the terminal with the place up and down the number of the fleet, availability of service, number of passengers, the location of the terminal to place up and down the passenger, as well as the location where the up and down passengers on the origin and destination. Some of the variables that have a low and very low value, is a variable that should receive greater attention from the municipality, so the concept of the integration of transport modes

  9. Vitamin D Levels in Malnourished Children under 5 Years in a Tertiary Care Center at Muhimbili National Hospital, Dar es Salaam, Tanzania-A Cross-sectional Study.

    Science.gov (United States)

    Walli, Nahida Z; Munubhi, Emmanuel K; Aboud, Said; Manji, Karim P

    2017-06-01

    : To evaluate vitamin D levels/deficiency among malnourished children <5 years admitted at a tertiary care center, the Muhimbili National Hospital, Dar es Salaam, Tanzania. Children with malnutrition may have co-existing vitamin D deficiency (VDD), which may be severe. : Serum vitamin D and alkaline phosphatase were evaluated, and X-ray of the wrist was carried out on 134 children. : VDD was found in 41 of 134 children (30.6%). The mean vitamin D level was 74.8 nmol/l. The mean alkaline phosphatase level was 176.6 U/l. Sixty-four (48%) children were found to have severe stunting, of whom 20 (31.2%) were vitamin D deficient. Marasmic children had higher odds of VDD compared with other forms of malnutrition. : The high prevalence of VDD in malnourished children underlines the need for active surveillance and aggressive management.

  10. Stress level of people with psoriasis at a public hospital.

    Science.gov (United States)

    Leovigildo, Érida Silva; David, Rose Ana Rios; Mendes, Andreia Santos

    2016-01-01

    Psoriasis is a chronic dermatosis of unknown etiology with a tendency to relapse after treatment. The disease is frequently linked to psychological stress due to the embarrassment caused by the lesions. To analyze the stress level presented by psoriasis patients followed at the Dermatology Service of a public hospital in Salvador, Bahia state, Brazil. A cross-sectional study of a consecutive convenience sample composed of 60 participants. We used Lipp's Stress Symptoms Inventory for Adults to assess stress levels. The questionnaire identifies and classifies physical and psychological symptoms according to three stages of stress: alarming, resistance, and exhaustion. We also collected socio-demographic and clinical data that could be associated with psoriasis. 85% of the participants presented stress. Lipp's questionnaire results revealed that 48% were in the resistance stage and 37% in the exhaustion stage. Women presented higher levels of stress. Of the total 28 women, 64% were in exhaustion stage, 29% in the resistance stage, and only 7% presented no stress symptoms. Of the total 32 men, 44% were in resistance stage, 34% in exhaustion stage, and 22% presented no stress symptoms. Regarding physical and psychological symptoms, psychological symptomatology was prevalent (55%). Based on the number of patients in exhaustion stage, we can conclude that stress levels of the participants were high regardless the type of psoriasis and treatment duration.

  11. 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.

  12. Implementing a simplified neonatal resuscitation protocol-helping babies breathe at birth (HBB - at a tertiary level hospital in Nepal for an increased perinatal survival

    Directory of Open Access Journals (Sweden)

    KC Ashish

    2012-10-01

    Full Text Available Abstract Background Reducing neonatal death has been an emerging challenge in low and middle income countries in the past decade. The development of the low cost interventions and their effective delivery are needed to reduce deaths from birth asphyxia. This study will assess the impact of a simplified neonatal resuscitation protocol provided by Helping Babies Breathe (HBB at a tertiary hospital in Nepal. Perinatal outcomes and performance of skilled birth attendants on management of intrapartum-related neonatal hypoxia will be the main measurements. Methods/Design The study will be carried out at a tertiary level maternity hospital in Nepal. A prospective cohort-study will include a six-month baseline a six month intervention period and a three-month post intervention period. A quality improvement process cycle will introduce the neonatal resuscitation protocol. A surveillance system, including CCD cameras and pulse oximeters, will be set up to evaluate the intervention. Discussion Along with a technique to improve health workers performance on the protocol, the study will generate evidence on the research gap on the effectiveness of the simplified neonatal resuscitation protocol on intrapartum outcome and early neonatal survival. This will generate a global interest and inform policymaking in relation to delivery care in all income settings. Trial registration ISRCTN97846009

  13. 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

  14. 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.

  15. Cost effectiveness of universal umbilical cord blood gas and lactate analysis in a tertiary level maternity unit.

    Science.gov (United States)

    White, Christopher R H; Doherty, Dorota A; Cannon, Jeffrey W; Kohan, Rolland; Newnham, John P; Pennell, Craig E

    2016-07-01

    There is an increasing body of literature supporting universal umbilical cord blood gas analysis (UCBGA) into all maternity units. A significant impediment to UCBGA's introduction is the perceived expense of the introduction and associated ongoing costs. Consequently, this study set out to conduct the first cost-effectiveness analysis of introducing universal UCBGA. Analysis was based on 42,100 consecutive deliveries ≥23 weeks of gestation at a single tertiary obstetric unit. Within 4 years of UCBGA's introduction there was a 45% reduction in term special care nursery (SCN) admissions >2499 g. Incurred costs included initial and ongoing costs associated with universal UCBGA. Averted costs were based on local diagnosis-related grouping costs for reduction in term SCN admissions. Incremental cost-effectiveness ratio (ICER) and sensitivity analysis results were reported. Under the base-case scenario, the adoption of universal UCBGA was less costly and more effective than selective UCBGA over 4 years and resulted in saving of AU$641,532 while adverting 376 SCN admissions. Sensitivity analysis showed that UCBGA was cost-effective in 51.8%, 83.3%, 99.6% and 100% of simulations in years 1, 2, 3 and 4. These conclusions were not sensitive to wide, clinically possible variations in parameter values for neonatal intensive care unit and SCN admissions, magnitude of averted SCN admissions, cumulative delivery numbers, and SCN admission costs. Universal UCBGA is associated with significant initial and ongoing costs; however, potential averted costs (due to reduced SCN admissions) exceed incurred costs in most scenarios.

  16. Obstetric fistula management and predictors of successful closure among women attending a public tertiary hospital in Rwanda: a retrospective review of records.

    Science.gov (United States)

    Egziabher, Tekle G; Eugene, Ngoga; Ben, Karenzi; Fredrick, Kateera

    2015-12-12

    Globally, 50,000-100,000 women develop obstetric fistula annually. At least 33,000 of these women live in Sub-Saharan Africa where limitations in quality obstetric care and fistula corrective repairs are prevalent. Among women with fistula seeking care at public health facilities in resource-limited settings, there is paucity of data on quality of care received. The aim of this study was to characterize obstetric fistula among Rwandan women managed at a public tertiary hospital and evaluate for predictors of successful fistula closures. A retrospective review of records for all obstetric fistula women managed at a public referral health facility between 2007 and 2013 was performed. Patient socio-demographics, obstetric characteristics and fistula repair outcomes data were reviewed. A multivariate logistic regression model was used to analyse for predictors of successful fistula repair outcomes. A total of 272 women aged between 16 to 78 years and with a mean age of 34.6 years were included. Of these, 93 (34.2 %), 48 (17.6 %), 65 (24 %) and 64 (23 %) women had vesico-vaginal fistula, recto-vaginal fistula, urethro-vaginal fistula and vesico-uteral fistula types, respectively. Successful fistula closure was achieved among 86.3 %. Women with fistula who reported being in labour for ≥3 days, having ≥1 previous fistula repair attempt, and having lived with the fistula for >1 year, had significantly lower odds of successful repair outcomes. Among 272 women with obstetric fistula managed in this study, 69.5 and 26.5 % of their fistula were causally associated with obstructed labour complications and iatrogenic factors, respectively. Successful fistula closure rates of about 89 % among women of index repair attempt were achieved. Conversely, reported histories of ≥3 days in labour, ≥1 previous failed attempts at repair and a fistula duration of >1 year, were significant determinants of failed fistula closures. To effectively mitigate obstetric fistula burden in

  17. 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.

  18. Nonadherence to anti-HIV medication is associated with higher level of anxiety: Experience from a tertiary care hospital of Odisha.

    Science.gov (United States)

    Panigrahi, Mousumee; Swain, Trupti Rekha; Mohanty, Srikanta

    2015-01-01

    To correlate the level of anxiety with nonadherence to antiretroviral medication. This observational, cross-sectional, hospital-based study was conducted in 78 patients attending antiretroviral therapy (ART) center of a tertiary care hospital of Odisha. The study duration was 6 months. Patients were designated as nonadherent by referring to the white card. Utilization of ART drugs and adverse drug reactions were included in a predesigned format. The anxiety level of all included patients was scored as per Hamilton Anxiety Rating Scale. Mean anxiety score of the adherent group was compared with that of the nonadherent group. Possible causes of nonadherence leading to high anxiety level were evaluated. 46% of patients in the nonadherent group had very severe, 17% had moderate to severe, 28% had mild to moderate and 9% had a mild level of anxiety. In the adherent group, however, mild to moderate level of anxiety was observed only in 10% patients. Anxiety is associated with sub-optimal medication adherence in HIV infected patients.

  19. 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.

  20. 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.

  1. Economic impact of treatment for surgical site infections in cases of total knee arthroplasty in a tertiary public hospital in Brazil

    Directory of Open Access Journals (Sweden)

    Karine Dal-Paz

    Full Text Available The aim of this study was to estimate the additional cost of treatment of a group of nosocomial infections in a tertiary public hospital. A retrospective observational cohort study was conducted by means of analyzing the medical records of 34 patients with infection after total knee arthroplasty, diagnosed in 2006 and 2007, who met the criteria for nosocomial infection according to the Centers for Disease Control and Prevention. To estimate the direct costs of treatment for these patients, the following data were gathered: length of hospital stay, laboratory tests, imaging examinations, and surgical procedures performed. Their costs were estimated from the minimum values according to the Brazilian Medical Association. The estimated cost of the antibiotics used was also obtained. The total length of stay in the ward was 976 days, at a cost of US$ 18,994.63, and, in the intensive care unit, it was 34 days at a cost of US$ 5,031.37. Forty-two debridement procedures were performed, at a cost of US$ 5,798.06, and 1965 tests (laboratory and imaging were also performed, at a cost of US$ 15,359.25. US$ 20,845.01 was spent on antibiotics and US$ 1,735.16 on vacuum assisted closure therapy, microsurgical flaps, implant removal, spacer use, and surgical revision. The total additional cost of these cases of hospital infection in 2006 and 2007 was of US$ 91,843.75. Based on that, we demonstrate that the high cost of treatment for hospital infections emphasizes the importance of taking measures to prevent and control hospital infection.

  2. 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.

  3. TILTING THE LEVEL PLAYING FIELD: PUBLIC ADMINISTRATION MEETS LEGAL THEORY

    National Research Council Canada - National Science Library

    Sheila Suess Kennedy

    2003-01-01

    ...." American public administrators increasingly find themselves in the position of that Rabbi, needing to acknowledge the legitimacy of competing claims on the government that are seemingly both correct...

  4. Alcohol consumption in tertiary education students

    Directory of Open Access Journals (Sweden)

    Reavley Nicola J

    2011-07-01

    Full Text Available Abstract Background Heavy alcohol consumption among adolescents and young adults is an issue of significant public concern. With approximately 50% of young people aged 18-24 attending tertiary education, there is an opportunity within these settings to implement programs that target risky drinking. The aim of the current study was to survey students and staff within a tertiary education institution to investigate patterns of alcohol use, alcohol-related problems, knowledge of current National Health and Medical Research Council (NHMRC guidelines for alcohol consumption and intentions to seek help for alcohol problems. Methods Students of an Australian metropolitan university (with staff as a comparison group participated in a telephone interview. Questions related to knowledge of NHMRC guidelines, drinking behaviour, alcohol-related problems and help-seeking intentions for alcohol problems. Level of psychological distress was also assessed. Results Of the completed interviews, 774 (65% were students and 422 (35% were staff. While staff were more likely to drink regularly, students were more likely to drink heavily. Alcohol consumption was significantly higher in students, in males and in those with a history of earlier onset drinking. In most cases, alcohol-related problems were more likely to occur in students. The majority of students and staff had accurate knowledge of the current NHMRC guidelines, but this was not associated with lower levels of risky drinking. Psychological distress was associated with patterns of risky drinking in students. Conclusions Our findings are consistent with previous studies of tertiary student populations, and highlight the disconnect between knowledge of relevant guidelines and actual behaviour. There is a clear need for interventions within tertiary education institutions that promote more effective means of coping with psychological distress and improve help-seeking for alcohol problems, particularly among

  5. High sensitivity C-reactive protein levels in Acute Ischemic Stroke and subtypes: A study from a tertiary care center.

    Science.gov (United States)

    Chaudhuri, Jaydip Ray; Mridula, Kandadai Rukmini; Umamahesh, Matapathi; Swathi, Alluri; Balaraju, Banda; Bandaru, Venkata Chandrasekher Srinivasarao

    2013-01-01

    Stroke is a heterogeneous disease with several risk factors. High sensitivity C-reactive protein (hsCRP) is a marker for cardiovascular and cerebrovascular diseases. Recent studies have shown that high hsCRP level is a risk factor for ischemic stroke. The objective of our study was to investigate the association of high hsCRP (> 3 mg/L) levels with ischemic stroke and its subtypes in Indian patients. We recruited 210 consecutive acute stroke patients and 150 age and sex matched controls. Stroke patients were admitted within 72 hours of onset, at Yashoda Hospital, Hyderabad, India. The study period was from January 2011 to December 2012. All patients underwent tests as per standard protocol for stroke workup. Serum hsCRP level was assessed in all stroke patients and controls on the day of admission. The mean hsCRP was significantly higher in stroke patients (3.8 ± 2.5) than controls (1.8 ± 1.5) (P < 0.001). High hsCRP had higher frequency in stroke patients 130 (61.9%) compared to controls 10 (6.6%), P < 0.001. High hsCRP level was more prevalent in the stroke subtypes of cardioembolic stroke (83.3%) and large artery atherosclerosis (72%). High hsCRP level was significantly associated with hypercholesterolemia (P = 0.001), age (P = 0.01), and mortality (0.04). After adjustment of regression analysis it was observed that high level hsCRP is independently associated with acute ischemic stroke (Odds 4.5; 95% CI: 2.5-12.2); especially the stroke subtypes of cardioembolic stroke, (odds ratio 3.4, 95% CI: 1.9-10.5) and large artery atherosclerosis (odds ratio 2.1, 95% CI: 1.5-3.8). High hsCRP level is strongly associated with and an independent predictor of acute ischemic stroke. The association was found in all ischemic stroke subtypes.

  6. Public-Interest and Level-of-Evidence Considerations in Cold Fusion Public Policy

    Science.gov (United States)

    Grinshaw, Thomas

    2008-03-01

    Cold fusion (CF) protagonists and antagonists would no doubt agree that scientific processes have been challenged in the CF case. The public interest in CF turns on two questions: What are the potential benefits? What is the probability that CF is ``real''? Potential benefits have been agreed on since CF announcement in 1989. The probability of CF reality may be assessed based on level of evidence (LoE): preponderance of evidence (PoE); clear and convincing evidence (CCE); and beyond a reasonable doubt (BRD). PoE, from civil law, indicates a probability of 50% or higher. BRD, from criminal law, has a probability approaching 90%. CCE, in between, thus has a 70-75% probability. CF experimental evidence, based on: 1) initial affirmations, 2) the large number of corroborations since marginalization, and 3) particularly demonstrative experiments, reasonably indicates at least a PoE level of evidence for excess heat. A case can also be made for a CCE (but probably not for a BRD) LoE. In either the PoE or CCE scenario a clear need is demonstrated for change in policy toward CR, given its potential benefits to humanity.

  7. Co-factors for abnormal lactate levels among persons with HIV disease at a tertiary HIV care setting in South India.

    Science.gov (United States)

    Sundaram, Muthu; Srinivas, Chakravarthy Narasimhachar; Shankar, Esaki Muthu; Deepak, Manohar; Murugavel, Kailapuri G; Balakrishnan, Pachamuthu; Solomon, Suniti; Kumarasamy, Nagalingeswaran

    2008-08-01

    The co-factors underlying abnormal lactate level remains to be determined in resource-limited settings. In a cross-sectional study conducted between January 2004 and July 2006, we determined the proportion of HIV-infected persons with abnormal lactate levels and correlated the association of certain co-factors of abnormal lactate levels at a tertiary HIV care centre in Chennai, Southern India. Lactate was estimated by the enzymatic method using an Olympus AU 400 autoanalyzer. Absolute CD4+T lymphocyte count was determined by the Guava personal cell analyser (Guava Technologies Inc., Hayward, CA, USA). Subjects were classified to have normal or abnormal values of lactate based on the reference interval (0.3-2.2 mmol/L). A p value 0.05 was considered statistically significant. A total of 225 HIV-infected individuals (HAART experienced 213 (95%) and HAART naïve (5%)) were included in the analysis. Mean age was 34+/-8 and 36+/-9 years for the individuals with normal and abnormal lactate levels respectively. Of these 185 (82%) had normal (0.3-2.2 mmol/L) and 40 (18%) had abnormal (>2.2 mmol/L) lactate levels. Significant difference in relation to female gender was observed between the normal and abnormal groups (p=0.03). Among the abnormal group, 39 (97.5%) subjects were HAART experienced compared to 174 (94.1%) normal group. Among the abnormal group, 24 (60%) individuals had a CD4 count of <200 cells/microL as compared to 76 (41.1%) normal subjects. Female gender should be carefully monitored with respect to their clinical, laboratory and biological data to diminish the occurrence of lactic acidosis.

  8. Maternal care quality in near miss and maternal mortality in an academic public tertiary hospital in Yogyakarta, Indonesia: a retrospective cohort study.

    Science.gov (United States)

    Mawarti, Yuli; Utarini, Adi; Hakimi, Mohammad

    2017-05-22

    Reducing maternal mortality remains a major challenge for health care systems worldwide. The factors related to maternal mortality were extensively researched, and maternal death clusters around labour, delivery and the immediate postpartum period. Studies on the quality of maternal care in academic medical centre settings in low income countries are uncommon. A retrospective cohort study of maternal deaths was conducted in an academic public tertiary hospital in Yogyakarta, and maternal near misses were used as controls. Data were obtained from medical records from February 1, 2011 to September 30, 2012. Three groups of variables were measured: (1) timeliness of care, (2) adherence to a standard of process indicators, and (3) associated extraneous variables. Variables were analysed using logistic regression to explore their effects on maternal mortality. The mean of triage response time and obstetric resident response time were longer in maternal deaths (8 ± 3.59 and 36.17 ± 23.48 min respectively) compared to near misses (1.29 ± 0.24 and 18.78 ± 4.85 min respectively). Near misses more frequently received oxytocin treatment than the maternal deaths (OR 0.13; 95%CI 0.02-0.77). Magnesium sulfate treatment in severe-preeclampsia or eclampsia was less given in maternal deaths although insignificant statistically (OR 0.19; 95% CI 0.03-1.47). Prophylactic antibiotic was also more frequently given in near misses than in maternal deaths though insignificant statistically (OR 0.3; 95% CI 0.06-1.56). Extraneous variables, such as caesarean sections were less performed in maternal deaths (OR 0.15; 95% CI 0.04-0.51), vaginal deliveries were more frequent in maternal deaths (OR 3.47; 95% CI 1.05-11.54), and more women in near misses were referred from other health care facilities (OR 0.09; 95% CI 0.01-0.91). The near misses had relatively received better quality of care compared to the maternal deaths. The near misses had received faster response time

  9. Tertiary and secondary control levels for efficiency optimization and system damping in droop controlled dc-dc converters

    DEFF Research Database (Denmark)

    Meng, Lexuan; Dragicevic, Tomislav; Quintero, Juan Carlos Vasquez

    2015-01-01

    Droop control by means of virtual resistance (VR) control loops can be applied to paralleled dc-dc converters for achieving autonomous equal power sharing. However, equal power sharing does not guarantee an efficient operation of the whole system. In order to achieve higher efficiency and lower...... algorithm is used in searching for a global efficiency optimum. In addition, a secondary control level is added to regulate the output voltage drooped by the VRs. However, system dynamics is affected when shifting up/down the VR references. Therefore, a secondary control for system damping is proposed...

  10. 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.

  11. 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.

  12. LEVEL OF AWARENESS AND ATTITUDE REGARDING EYE DONATION AMONGST NURSING AND PARAMEDICAL STAFF WORKING IN TERTIARY CARE CENTRE

    Directory of Open Access Journals (Sweden)

    Mary Jenifa

    2016-05-01

    Full Text Available BACKGROUND Corneal diseases constitute significant cause of visual impairment and blindness in the developing countries, it can be prevented through corneal transplantation. There is a large gap between demand and supply of corneal tissue due to lack of awareness about eye donation. Nurses and paramedical staff are potential source that is underutilised as they are in constant touch with the patients and their relatives and can be inspired to pledge their cornea for eye donation. Aim of the study is to assess the level of awareness among the nursing and paramedical staff regarding eye donation. METHODOLOGY A cross-sectional study was carried out to get the information from nursing and paramedical staff. RESULTS Total 66.16% nursing and 33.83% paramedical staff participated. Among the participants about 60% nurses and 68% paramedics did not know about any existing eye bank in Bhopal. Only 69% of nurses and 13.43% paramedical staff knew that eyes can be removed within 6 hours of death for effective use, 59.54% nurses knew that cornea is used for grafting, but among paramedical staff only 13.43% showed any awareness about the subject. Only 24.42% nurses and 13.43% paramedical staff had good knowledge about eye donation. Total 65% were not willing to donate their own eyes. CONCLUSION Result of this study indicates that there is lack of awareness and poor attitude related to eye donation amongst nurses and paramedical staff. This also indicates a high level of ignorance about eye donation in society in general.

  13. Knowing Where Public Health Is Going: Levels and Determinants of Workforce Awareness of National Public Health Trends.

    Science.gov (United States)

    Shah, Gulzar H; Madamala, Kusuma

    2015-01-01

    Several recent developments are trending in public health, providing an important window into the future of policy and practice in the field. The extent to which public health workforce is aware of these trends has not been assessed. This research examined the extent to which the public health workforce is familiar with 8 important developments and trends in public health and explored factors associated with variation in awareness levels. This study characterizes an observational cross-sectional design, based on analysis of secondary data collected by the Association of State and Territorial Health Officials through the Public Health Workforce Interests and Needs Survey (PH WINS). Our study used data from those states for which representative samples for the local health department (LHD) employees were also available. We included survey responses from employees of state health agencies' central offices and LHDs. The primary outcome variable for the analysis was the level of awareness about emerging public health trends in the public health workforce. Awareness of emerging trends was lowest for Public Health Systems and Services Research; roughly 1 in 4 employees were aware of this trend. The second least heard of trends were Health in All Policies, and cross-jurisdictional sharing. The public health trends about which the highest proportion of public health employees had heard were implementation of the Patient Protection and Affordable Care Act and evidence-based public health practice. Awareness about public health trends was generally higher among state health agency employees than among LHD employees. Work environment, supervisory status, employee education, and female gender were significantly associated with higher awareness levels for both state health agency and LHD employees. Public health trends that are important for health agencies should be brought to the spotlight in national dialogue in order to increase practitioner involvement in those initiatives.

  14. 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.

  15. Prevalence of sleep disorders and severity of insomnia in psychiatric outpatients attending a tertiary level mental health care facility in Punjab, India.

    Science.gov (United States)

    Mondal, Gargi; Bajaj, Vikrant; Goyal, B L; Mukherjee, Nirmalya

    2018-02-01

    Sleep disorders are frequently associated with psychiatric disorders and can be both cause and effect of the same. To study the prevalence of sleep disorders and the severity of insomnia in psychiatric outpatients. 500 patients were randomly selected using purposive sampling from patients attending a tertiary level mental health care facility were evaluated for the presence of any sleep disorder along with their sleep quality. In patients having insomnia, severity of the same was determined. 83.4% of the population had some type of sleep disorder. Symptoms of insomnia were reported by 78.2% of the population and 29.2% had moderate to severe insomnia. 78.4% of the population had poor sleep quality. Significant difference was noted among the different psychiatric groups when insomnia severity index (ISI) was compared. In multinomial logistic regression, chance of severe insomnia is more if the diagnosis is depression, but less if mania or ocd, compared to psychosis. This study was the first in India to assess the prevalence of sleep disorders in psychiatric outpatients. Our study underscores the importance of careful evaluation of sleep problems for proper management of the patients. Copyright © 2017 Elsevier B.V. All rights reserved.

  16. Feto-maternal Outcomes in Cesarean Section Compared to Vaginal Delivery in Eclamptic Patients in a Tertiary Level Hospital

    Directory of Open Access Journals (Sweden)

    Arifa Akter Jahan

    2013-07-01

    Full Text Available Background: Over half-a-million women die each year from pregnancy-related causes, and 99 percent of these occur in developing countries. In Bangladesh though maternal mortality rate (MMR declined significantly around 40% in the past decade, still eclampsia accounts for 20% of maternal deaths. Eclampsia is uniquely a disease of pregnancy, and the only cure is delivery regardless of gestational age. A rational therapy for general management of hypertension and convulsion has been established in Bangladesh by the Eclampsia Working Group. But controversy still exists regarding obstetric management. Objective: To evaluate the feto-maternal outcome in cesarean section compared to vaginal delivery in eclamptic patients. Materials and Methods: This prospective cohort study was conducted in the department of Obstretics & Gynecology, Dhaka Medical College & Hospital (DMCH, from January to December 2011. A total 100 eclamptic women with term pregnancy and live fetus were purposively included in the study (Group I, 50 patients with vaginal delivery and Group II, 50 with cesarean section. Results: Out of these 100 patients 56% were aged ≤20 years, 71% were primigravida and 77% were from low socioeconomic status. Sixteen percent patients from vaginal delivery group and 18% from cesarean section group had no antenatal care. The mean gestational age was about 38 weeks in two groups. No significant difference was found between the two groups regarding blood pressure, proteinuria, consciousness level and convulsion. Recurrence of convulsion occurred in 30% patients of vaginal delivery group compared to 6% in cesarean section group. Maternal complications such as postpartum hemorrhage, cerebrovascular accident, renal failure, obstetric shock and abruptio placenta were higher among vaginal delivery group patients (46% than cesarean section patients (16%. Maternal mortality was 6% in the vaginal delivery group and none in the cesarean section group. Regarding

  17. 76 FR 9004 - Public Comment on Setting Achievement Levels in Writing

    Science.gov (United States)

    2011-02-16

    ... Public Comment on Setting Achievement Levels in Writing AGENCY: U.S. Department of Education, National Assessment Governing Board. ACTION: Notice, Public Comment on Setting Achievement Levels in Writing. SUMMARY... recommendations to improve the design proposed for setting achievement levels for NAEP in writing. This notice...

  18. Mesotelioma pleural maligno: experiência multidisciplinar em hospital público terciário Malignant pleural mesothelioma: multidisciplinary experience in a public tertiary hospital

    Directory of Open Access Journals (Sweden)

    Ricardo Mingarini Terra

    2008-01-01

    Full Text Available OBJETIVOS: Avaliar a experiência com o diagnóstico e a terapêutica do mesotelioma pleural maligno (MPM acumulada durante 5 anos em um hospital público terciário. MÉTODOS: Avaliação retrospectiva dos prontuários dos pacientes com diagnóstico de MPM entre janeiro de 2000 e fevereiro de 2005. RESULTADOS: Foram analisados 17 pacientes, 14 homens e 3 mulheres, com idade média de 54,1 (13-75 anos. Os espécimes de biópsia para exame histopatológico foram obtidos por meio de pleuroscopia em 9 pacientes (53%, agulha de Cope em 5 (29,5% e biópsia pleural aberta em 3 (17,5%. Os tipos histológicos foram: epitelial em 14 pacientes (82%, sarcomatóide em 1 (6% e bifásico em 2 (12%. As terapêuticas instituídas foram: multimodal (pleuropneumonectomia com radioterapia e quimioterapia adjuvante em 6 pacientes (35%, quimioterapia e radioterapia em 6 (35%, radioterapia exclusiva em 3 (17,5% e quimioterapia exclusiva em 2 (12%. A sobrevida média foi de 11 (1-26 meses. CONCLUSÕES: Na presente experiência foi empregada a abordagem multidisciplinar integrada, e contou-se com uma estrutura hospitalar de alta complexidade para o diagnóstico e tratamento do MPM, como preconizado na literatura. Apesar disso, a sobrevida média observada foi de apenas 11 meses, refletindo a agressividade da doença.OBJECTIVE: To evaluate the experience in diagnosing and treating malignant pleural mesothelioma (MPM accumulated over 5 years in a tertiary public hospital. METHODS: The medical charts of the patients diagnosed with MPM between January of 2000 and February of 2005 were evaluated retrospectively. RESULTS: Of the 17 patients analyzed, 14 were male and 3 were female. The mean age was 54.1 years (range, 13-75 years. The biopsy specimens for histopathological examination were obtained through thoracoscopy in 9 patients (53%, Cope needle in 5 (29.5%, and open pleural biopsy in 3 (17.5%. The following histological types were identified: epithelial, in 14 patients

  19. Tertiary lymphoid tissue

    Science.gov (United States)

    Di Caro, Giuseppe; Marchesi, Federica

    2014-01-01

    Tumor-infiltrating lymphocytes influence colorectal cancer progression. We have recently documented that tertiary lymphoid tissue in the colorectal cancer microenvironment orchestrates lymphocyte infiltration and that tertiary lymphoid tissue and lymphocytes cooperate in a coordinated antitumor immune response to improve patient outcome. Thus, tertiary lymphoid tissue represents a potential target in the design of tailored immune-based therapeutic approaches. PMID:25083321

  20. 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.

  1. 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.

  2. Scale Economies in Public Education: Evidence from School Level Data.

    Science.gov (United States)

    Bowles, Tyler J.; Bosworth, Ryan

    2002-01-01

    Begins with a discussion of cost and efficiency in education. Presents an empirical model to estimate school-level economies of scale. Applies model to expenditure data set by school from 17 Wyoming school districts. Finds that it costs more per student in a small school than in large schools to achieve similar educational outcomes, thus…

  3. Correlation of Friedewald's calculated low-density lipoprotein cholesterol levels with direct low-density lipoprotein cholesterol levels in a tertiary care hospital

    Science.gov (United States)

    Nanda, Sunil Kumar; Bharathy, M; Dinakaran, Asha; Ray, Lopamudra; Ravichandran, K

    2017-01-01

    Background: One of the risk factors for the development of coronary heart disease is high low-density lipoprotein (LDL) cholesterol levels. National Cholesterol Education Program ATP III guidelines suggest drug therapy to be considered at LDL-cholesterol levels >130 mg/dl. This makes accurate reporting of LDL cholesterol crucial in the management of Coronary heart disease. Estimation of LDL cholesterol by direct LDL method is accurate, but it is expensive. Hence, We compared Friedewald's calculated LDL values with direct LDL values. Aim: To evaluate the correlation of Friedewalds calculated LDL with direct LDL method. Materials and Methods: We compared LDL cholesterol measured by Friedewald's formula with direct LDL method in 248 samples between the age group of 20–70 years. Paired t-test was used to test the difference in LDL concentration obtained by a direct method and Friedewald's formula. The level of significance was taken as P < 0.05. Pearsons correlation formula was used to test the correlation between direct LDL values with Friedewald's formula. Results: There was no significant difference between the direct LDL values when compared to calculated LDL by Friedewalds formula (P = 0.140). Pearson correlation showed there exists good correlation between direct LDL versus Friedewalds formula (correlation coefficient = 0.98). The correlation between direct LDL versus Friedewalds calculated LDL was best at triglycerides values between 101 and 200 mg/dl. Conclusion: This study indicates calculated LDL by Friedewalds equation can be used instead of direct LDL in patients who cannot afford direct LDL method. PMID:28251110

  4. 77 FR 75491 - Entry-Level Driver Training; Public Listening Session

    Science.gov (United States)

    2012-12-20

    ... Federal Motor Carrier Safety Administration 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 hold a public listening session to solicit ideas and information on...

  5. Implementation of quality of care indicators for third-level public hospitals in Mexico

    Directory of Open Access Journals (Sweden)

    Pedro Jesús Saturno-Hernández

    2017-05-01

    Full Text Available Objective. To select, pilot test and implement a set of indi­cators for tertiary public hospitals. Materials and meth­ods. Quali-quantitative study in four stages: identification of indicators used internationally; selection and prioritization by utility, feasibility and reliability; exploration of the quality of sources of information in six hospitals; pilot feasibility and reliability, and follow-up measurement. Results. From 143 indicators, 64 were selected and eight were prioritized. The scan revealed sources of information deficient. In the pilot, three indicators were feasible with reliability limited. Has conducted workshops to improve records and sources of information; nine hospitals reported measurements of a quarter. Conclusions. Eight priority indicators could not be measured immediately due to limitations in the data sources for its construction. It is necessary to improve mechanisms of registration and processing of data in this group of hospital.

  6. 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.

  7. Clinical, demographic, and epidemiologic characteristics of hepatitis B virus-infected patients at a tertiary public hospital in Presidente Prudente, State of São Paulo, Brazil.

    Science.gov (United States)

    Prestes-Carneiro, Luiz Euribel; Vieira, Jessyka Thaiza Menezes; Isaac, Luiza Bellintani; Portelinha Filho, Alexandre Martins

    2016-02-01

    Few studies have addressed the primary characteristics of patients infected with hepatitis B virus (HBV) in the general population, especially those living in small- and medium-sized cities in Brazil. We aimed to determine the clinical, demographic, and epidemiologic characteristics of patients diagnosed with HBV who were followed up at an infectious diseases clinic of a public hospital in State of São Paulo, Brazil. Medical records of patients aged >18 years and diagnosed with HBV infection between January 2000 and December 2013 were reviewed. Seventy-five patients were enrolled with male-female main infection-associated risk factors; 9 (12%) were co-infected with human immunodeficiency virus (HIV), 5 (6.7%) with hepatitis C virus (HCV), and 3 (4%) were co-infected with both HIV and HCV. Antiviral HBV therapy was applied in 21 (28%) patients and tenofovir monotherapy was the most prescribed medication. After approximately 2 years of antiviral treatment, the HBV-DNA viral load was undetectable in 12 (92.3%) patients and lower levels of alanine aminotransferase were found in these patients. Over a 13-year interval, very few individuals infected with HBV were identified, highlighting the barriers for caring for patients with HBV in developing countries. New measures need to be implemented to complement curative practices.

  8. Clinical, demographic, and epidemiologic characteristics of hepatitis B virus-infected patients at a tertiary public hospital in Presidente Prudente, State of São Paulo, Brazil

    Directory of Open Access Journals (Sweden)

    Luiz Euribel Prestes-Carneiro

    2016-02-01

    Full Text Available Abstract: INTRODUCTION: Few studies have addressed the primary characteristics of patients infected with hepatitis B virus (HBV in the general population, especially those living in small- and medium-sized cities in Brazil. We aimed to determine the clinical, demographic, and epidemiologic characteristics of patients diagnosed with HBV who were followed up at an infectious diseases clinic of a public hospital in State of São Paulo, Brazil. METHODS: Medical records of patients aged >18 years and diagnosed with HBV infection between January 2000 and December 2013 were reviewed. RESULTS: Seventy-five patients were enrolled with male-female main infection-associated risk factors; 9 (12% were co-infected with human immunodeficiency virus (HIV, 5 (6.7% with hepatitis C virus (HCV, and 3 (4% were co-infected with both HIV and HCV. Antiviral HBV therapy was applied in 21 (28% patients and tenofovir monotherapy was the most prescribed medication. After approximately 2 years of antiviral treatment, the HBV-DNA viral load was undetectable in 12 (92.3% patients and lower levels of alanine aminotransferase were found in these patients. CONCLUSIONS: Over a 13-year interval, very few individuals infected with HBV were identified, highlighting the barriers for caring for patients with HBV in developing countries. New measures need to be implemented to complement curative practices.

  9. 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…

  10. Public Entrepreneurship and the Politics of Regeneration in Multi-Level Governance

    OpenAIRE

    Catney, P.; Henneberry, J.M.

    2015-01-01

    The paper uses a case study of urban regeneration policy in Sheffield, UK, to explore local public entrepreneurship in a system of multi-level governance. Recent analyses of public entrepreneurs have directed attention to the macro-political structural and institutional conditions that enable and constrain these actors, and to their individual characteristics and attributes. The stress has been on the national level and on individual action at the expense of the agency of local networks of en...

  11. 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.

  12. Nosocomial infections in the intensive care unit: Incidence, risk factors, outcome and associated pathogens in a public tertiary teaching hospital of Eastern India.

    Science.gov (United States)

    Dasgupta, Sugata; Das, Soumi; Chawan, Neeraj S; Hazra, Avijit

    2015-01-01

    The increased morbidity and mortality associated with nosocomial infections in the intensive care unit (ICU) is a matter of serious concern today. To determine the incidence of nosocomial infections acquired in the ICU, their risk factors, the causative pathogens and the outcome in a tertiary care teaching hospital. This was a prospective observational study conducted in a 12 bedded combined medical and surgical ICU of a medical college hospital. The study group comprised 242 patients admitted for more than 48 h in the ICU. Data were collected regarding severity of the illness, primary reason for ICU admission, presence of risk factors, presence of infection, infecting agent, length of ICU and hospital stay, and survival status and logistic regression analysis was done. The nosocomial infection rate was 11.98% (95% confidence interval 7.89-16.07%). Pneumonia was the most frequently detected infection (62.07%), followed by urinary tract infections and central venous catheter associated bloodstream infections. Prior antimicrobial therapy, urinary catheterization and length of ICU stay were found to be statistically significant risk factors associated with nosocomial infection. Nosocomial infection resulted in a statistically significant increase in length of ICU and hospital stay, but not in mortality. Nosocomial infections increase morbidity of hospitalized patients. These findings can be utilized for planning nosocomial infection surveillance program in our setting.

  13. 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. 

  14. 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.

  15. 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...

  16. 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

  17. 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)…

  18. 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.

  19. 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.

  20. Tuberculosis in hospital environment: clinical profile in a tertiary hospital from Ceará and level of knowledge of health personnel about control measures

    Directory of Open Access Journals (Sweden)

    Roberto da Justa Pires Neto

    2010-09-01

    Full Text Available Objectives: To describe clinical and epidemiological characteristics of inpatients with tuberculosis (TB and to assess the knowledge of health personnel on fundamental concepts about TB and control measures for pulmonary tuberculosis in a hospital environment. Methods: The study was conducted in a tertiary hospital in Fortaleza-CE and involved patients admitted with TB and health professionals responsible for assistance. A first phase was characterized by a retrospective study of medical records of patients admitted with suspected TB. In a second stage, a cross-sectional study with application of a structured questionnaire assessed the knowledge of health personnel on TB control measures in a hospital environment. Results: Sixty-seven patients admitted with suspected TB had their medical records assessed. Among the confirmed cases, the most frequent clinical form was pulmonary (81.3%. Out of 55 patients admitted with suspected pulmonary tuberculosis, only 29 (52.7% were admitted in a respiratory isolation bed. Twenty-six patients with suspected pulmonary tuberculosis on admission stayed a total of 148 days out of a respiratory isolation bed (average 4.1 days / patient. The knowledge of 159 health professionals about TB was assessed. Regarding the transmission of TB, 107 (67.2% were unaware of airborne transmission and 109 (68.5% ignored the clinical forms that require respiratory isolation. Conclusions: Pulmonary tuberculosis is the most frequent clinical form among inpatients in a tertiary hospital in Fortaleza-CE. Considerable fraction of health personnel doesn’t know key concepts related to tuberculosis and essential for the proper and safe care. Descriptors: Tuberculosis; Infectious Disease Transmission; Exposure to Biological Agents; Health personnel.

  1. Fundamentals of tertiary oil recovery. Pt. 1. Why tertiary recovery

    Energy Technology Data Exchange (ETDEWEB)

    Herbeck, E.F.; Heintz, R.C.; Hastings, J.R.

    1976-01-01

    Secondary recovery projects initiated annually by Atlantic Richfield Co. in the U.S. show a general trend somewhat characteristic of all U.S. producers. Why did the number of project starts decline. Simply because there was a lack of prospects for Atlantic Richfield to apply waterflooding economically. This raises the question of what is the next step to maintain U.S. oil producing rates. One answer is to recover a third crop of oil from those fields which have already undergone secondary recovery. It is becoming evident that tertiary recovery must be undertaken while the existing wells and surface equipment are still intact and usable. Very few prospects are expected to be so profitable that economics will permit redrilling of wells and replacement of surface equipment, but tertiary recovery will be applicable to many of the existing oil fields. Engineers and production personnel at all organizational levels must make an effort to recognize those fields under their supervision which are candidates for tertiary recovery applications.

  2. Tertiary Education and Training in Australia, 2009

    Science.gov (United States)

    National Centre for Vocational Education Research (NCVER), 2011

    2011-01-01

    Sourcing data from the National VET Provider Collection and the Higher Education Statistics Collection, this publication provides a summary of participation in tertiary education and training in Australia. It covers participation in Australian Qualifications Framework certificate I qualifications through to doctorates by research, as well as…

  3. 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.

  4. 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.

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

    Science.gov (United States)

    Aluttis, Christoph; den Broucke, Stephan Van; Chiotan, Cristina; Costongs, Caroline; Michelsen, Kai; Brand, Helmut

    2014-03-26

    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 agreedupon 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 them into a new

  6. Measuring Public Procurement for Innovation on the Country Level and the Role of ICT Support

    Directory of Open Access Journals (Sweden)

    Kristina Detelj

    2015-07-01

    Full Text Available Using of public procurement as a tool for promoting innovations has captured interest of many researchers in recent years. However, most of the research is focused on the impact of public procurement on the company's innovativeness. The article discusses the findings of the literature on this topic and proposes a model on how to transfer the concept from the company level to the level of the whole country. One of the biggest problems is unavailability of appropriate measures of this phenomenon, so the authors suggest that the concept of Public procurement for innovation can be approximated by participation of criterion of the most economically advantageous tender (MEAT. Implementation of this criterion in choosing the best offer can be supported and facilitated by using of ICT which can improve the efficiency of procurement process and enable more innovations.

  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. 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

  10. 76 FR 10810 - Public Workshop to Discuss Low-Level Radioactive Waste Management

    Science.gov (United States)

    2011-02-28

    ... COMMISSION 10 CFR Part 61 Public Workshop to Discuss Low-Level Radioactive Waste Management AGENCY: Nuclear... has been in place for about 11 years and applies to management of radioactive waste within the DOE... radioactive waste management decision-making. DOE recently started a comprehensive revision of Order 435.1...

  11. 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…

  12. 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.

  13. 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.

  14. 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.

  15. 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

  16. Rising Level of Public Exposure to Mobile Phones: Accumulation through Additivity and Reflectivity

    Science.gov (United States)

    Hondou, Tsuyoshi

    2002-02-01

    A dramatic development occurring in our daily life is the increasing use of mobile equipment including mobile phones and wireless access to the Internet. They enable us to access several types of information more easily than in the past. Simultaneously, the density of mobile users is rapidly increasing. When hundreds of mobile phones emit radiation, their total power is found to be comparable to that of a microwave oven or a satellite broadcasting station. Thus, the question arises: what is the public exposure level in an area with many sources of electromagnetic wave emission? We show that this level can reach the reference level for general public exposure (ICNIRP Guideline) in daily life. This is caused by the fundamental properties of electromagnetic field, namely, reflection and additivity. The level of exposure is found to be much higher than that estimated by the conventional framework of analysis that assumes that the level rapidly decreases with the inverse square distance between the source and the affected person. A simple formula for the exposure level is derived by applying energetics to the electromagnetic field. The formula reveals a potential risk of intensive exposure.

  17. Evaluation of Teaching and Learning in American Public Higher Education : Institutional, State and National Levels

    OpenAIRE

    山崎, 博敏

    2002-01-01

    The purpose of this paper is to depict organizational systems of evaluation of teaching and learning in American public higher education. At first, academic achievement of American student and completion rate are examined. It is showed that these are beyond of Japanese commonsense. Second, historical development of credit system, student evaluation of teaching and self-studies at campus level are discussed. The uses of student evaluation of teaching at several universities are examined. Third...

  18. Concentrations of undeclared allergens in food products can reach levels that are relevant for public health.

    Science.gov (United States)

    Spanjersberg, M Q I; Knulst, A C; Kruizinga, A G; Van Duijn, G; Houben, G F

    2010-02-01

    Food products can become contaminated with food allergens due to cross-contact. Precautionary 'may contain' labelling may alert to the possible presence of an allergen, but guidance for such labelling is lacking. As a result, allergy information on the packaging may not be reliable and allergic consumers might be at risk of allergic reactions after consuming unlabelled, but indeed contaminated, products. Recently, a cow's milk protein allergic patient experienced a severe allergic reaction to a dark chocolate product containing undeclared milk proteins. This case induced the authors to investigate to what extent allergen concentrations of unlabelled products reach levels that are of public health relevance. The concentrations of milk proteins in the complaint sample and a collection of products of other batches and brands purchased from different stores were analysed. Together with appropriate threshold and food consumption data, the risks of allergic reactions and the severity of these reactions within the adult milk-allergic population were determined using probabilistic risk assessment techniques. The results show that milk protein concentrations in unlabelled products reach levels that may elicit allergic reactions in up to 68% of the adult allergic consumers. Therefore, concentrations of allergens in unlabelled products could reach levels that are of public health relevance. Application of probabilistic risk assessment can be an aid in revealing the public health consequences of undeclared allergens in food, in risk management decision-making and developing guidance in terms of risk-based concentration limits for precautionary labelling.

  19. Organizational level indicators to address health equity work in local public health agencies: A scoping review.

    Science.gov (United States)

    Salter, Katherine; Salvaterra, Rosana; Antonello, Deborah; Cohen, Benita E; Kothari, Anita; LeBer, Marlene Janzen; LeMieux, Suzanne; Moran, Kathy; Rizzi, Katherine; Robson, Jordan; Wai, Caroline

    2017-09-14

    To determine what organizational level indicators exist that could be used by local Ontario public health agencies to monitor and guide their progress in addressing health equity. This scoping review employed Arksey and O'Malley's (2005) six-stage framework. Multiple online databases and grey literature sources were searched using a comprehensive strategy. Studies were included if they described or used indicators to assess an organization's health equity activity. Abstracted indicator descriptions were classified using the roles for public health action identified by the Canadian National Collaborating Centre for Determinants of Health (NCCDH). Health equity experts participated in a consultation phase to examine items extracted from the literature. Eighteen peer-reviewed studies and 30 grey literature reports were included. Abstracted indicators were considered for 1) relevance for organizational assessment, 2) ability to highlight equity-seeking populations, and 3) potential feasibility for application. Twenty-eight items formed the basis for consultation with 13 selected health equity experts. Items considered for retention were all noted to require significant clarification, definition and development. Those eliminated were often redundant or not an organizational level indicator. Few evidence-based, validated indicators to monitor and guide progress to address health inequities at the level of the local public health organization were identified. There is a need for continued development of identified indicator items, including careful operationalization of concepts and establishing clear definitions for key terms.

  20. Public perceptions of low-level waste risks -- Lessons learned in Pennsylvania

    Energy Technology Data Exchange (ETDEWEB)

    Dornsife, W.; Serie, P.

    1989-11-01

    People in Pennsylvania are no different than citizens of other eastern states, other states, or any place in the world--they care most deeply about their health, the safety and security of their families, their investments, and their autonomy. How a particular risk is perceived depends on how it is believed to affect those valued possessions. The perception of risk from exposure to the radioactivity contained in low-level radioactive low-level waste disposal facility. The Commonwealth`s program, administered by the Department of Environmental Resources, places high priority on public dialogue on this issue. This paper discusses the Department`s program to develop and promulgate low-level waste regulations, provide a framework for selection of a qualified disposal facility operator, contract with the selected firm, and oversee its activities in siting, licensing, constructing, and operating the facility. This facility will meet the needs of the states of the Appalachian States Compact, including, in addition to Pennsylvania, West Virginia, Maryland, and Delaware. The focus of the paper is on the public information and outreach program accomplished to date, and the lessons learned regarding public perceptions of risk.

  1. 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

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

    Directory of Open Access Journals (Sweden)

    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.

  3. Visibility of natural tertiary rainbows.

    Science.gov (United States)

    Lee, Raymond L; Laven, Philip

    2011-10-01

    Naturally occurring tertiary rainbows are extraordinarily rare and only a handful of reliable sightings and photographs have been published. Indeed, tertiaries are sometimes assumed to be inherently invisible because of sun glare and strong forward scattering by raindrops. To analyze the natural tertiary's visibility, we use Lorenz-Mie theory, the Debye series, and a modified geometrical optics model (including both interference and nonspherical drops) to calculate the tertiary's (1) chromaticity gamuts, (2) luminance contrasts, and (3) color contrasts as seen against dark cloud backgrounds. Results from each model show that natural tertiaries are just visible for some unusual combinations of lighting conditions and raindrop size distributions.

  4. Alarming Prevalence of Emergency Hypertension Levels in the General Public Identified by a Hypertension Awareness Campaign.

    Science.gov (United States)

    Caligiuri, Stephanie P B; Austria, Jose Alejandro; Pierce, Grant N

    2017-03-01

    Hypertension is a major cause of mortality and morbidity today. The "silent" nature of hypertension makes it critical to determine its prevalence and its severity in the general public and to identify strategies to identify people unaware of its presence. A mobile hypertension awareness campaign was created to: (i) determine the prevalence and types of hypertension in an urban North American center, (ii) increase hypertension awareness, and (iii) identify reasons for lack of therapy adherence. Mobile clinics were provided at shopping malls, workplaces, hospitals, and community centres to measure blood pressure in the public. Blood pressure recordings were done on a voluntary basis. Of 1097 participants, 50% presented with high blood pressure which was higher than expected. Of particular clinical significance, an unexpectedly large number of participants (2%) exhibited a hypertensive urgency/emergency. Most of these people were not adherent to medications (if their hypertension was detected previously), were unaware of their hypertensive state, and/or unwilling to acknowledge or ignored the clinical significance of the extremely high blood pressure readings. Reasons for lack of adherence included: denial, being unaware of health consequences, and proper management of hypertension. A relatively large segment of an urban population lives unaware of severe emergency levels of hypertension. A public mobile hypertension clinic provides a valuable strategy for identifying hypertension in the general public and for knowledge translation of hypertension management.

  5. The evaluation of public health nursing students' skill achievement levels by educational improvement.

    Science.gov (United States)

    Suzuki, Yoshimi; Saito, Emiko; Kishi, Emiko; Sawai, Minako; Kakemoto, Satori; Igarashi, Chiyo; Nakada, Harumi; Asahara, Kiyomi

    2018-01-25

    This study aimed to evaluate the educational improvement outcomes after introducing undergraduate public health nursing electives from the perspective of students, teachers, and public health nurses. Post-test design with control group was used. We surveyed three groups of participants on the relevance of achieved skill items. These groups were as follows: fourth-year students, teaching staff from seven universities, and public health nurses from special districts of Tokyo who had pioneered the introduction of public health nursing electives. The three participant groups were surveyed in 2013 and 2014 to compare the students' levels of achievement in the 98 skill items presented by the Japanese Ministry of Health, Labour, and Welfare. Practical training introduced educational reform in 2014. Anonymous self-administrated questionnaires were used. The mean achievement rates of the 98 items in 2013 and 2014 were 67.9% and 72.6%, respectively, for students; 40.9% and 59.7% for teachers; and 44.4% and 59.4% for PHNs. A significant difference was observed between ratios of 2013 and 2014 in all three groups. The results demonstrated that the introduction of educational reform increased the achievement rates of students through the electives. © 2018 Wiley Periodicals, Inc.

  6. 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.

  7. Smart Utilization of Tertiary Instructional Modes

    Science.gov (United States)

    Hamilton, John; Tee, Singwhat

    2010-01-01

    This empirical research surveys first year tertiary business students across different campuses regarding their perceived views concerning traditional, blended and flexible instructional approaches. A structural equation modeling approach shows traditional instructional modes deliver lower levels of student-perceived learning quality, learning…

  8. High-level gentamicin resistance and vancomycin resistance in clinical isolates of enterococci in a tertiary care hospital in eastern Nepal.

    Science.gov (United States)

    Nepal, H P; Khanal, B; Acharya, A; Gyawali, N; Jha, P K; Paudel, R

    2012-03-01

    High-level gentamicin resistance and vancomycin resistance in enterococci, a family of important opportunistic pathogens, have emerged as a significant clinical problem over recent years. The present study was conducted to determine the high-level gentamicin and vancomycin resistance among the clinical isolates of enterococci. A total of 110 phenotypically identified enterococcal isolates were subjected to determination of high-level gentamicin resistance (by disk diffusion and agar dilution methods) and vancomycin resistance (by agar screening and agar dilution methods). About 36% of the isolates were found to have high-level gentamicin resistance, which indicates that gentamicin no longer remains an appropriate choice for inclusion in combination therapy with cell wall-active agents. Ten percent isolates exhibited resisance to vancomycin during screening. However, agar dilution confirmed that the isolates did not have resistance to vancomycin but had reduced susceptibility to it, which indicates their impending emergence of resistance to vancomycin.

  9. Low physical activity levels and associated factors in Brazilian adolescents from public high schools.

    Science.gov (United States)

    Silva, Roberto Jerônimo dos Santos; Silva, Diego Augusto Santos; Oliveira, Antônio C

    2014-09-01

    Several studies have shown that physical activity levels have declined in many countries, even with the regular practice of physical education in schools. The purpose of this study was to identify the prevalence of low physical activity levels and associated factors in adolescents enrolled in public high schools in Northeastern Brazil. The sample was composed of 2259 adolescents (62.3% female) aged 16.26 ± 1.1 years. A questionnaire was applied to collect data on physical activity levels, sociodemographic information, tobacco use and alcohol consumption, nutritional status and sedentary behavior. Descriptive statistics and Poisson regression hierarchized model with Prevalence Rate (PR) and P ≤ .05 were used. Higher prevalence of low physical activity level (89.1%) was observed. It was observed that 19.6% of individuals did not attend physical education classes regularly. Association was identified between low physical activity level and older girls (P = .02) and not attending physical education classes (P physical activity level was those whose parents studied until three years (P = .04). Low physical activity level was present in most adolescents, more evident in girls. Lifestyle changes are needed, with substitution of sedentary activities for physical and sport activities in schools.

  10. 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.

  11. 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.

    Science.gov (United States)

    Martínez-Mier, G; Esquivel-Torres, S; Nava-Lacorte, A; Lajud-Barquín, F A; Zilli-Hernández, S; Vázquez-Ramírez, L M

    Preoperative serum alpha-fetoprotein levels can have predictive value for hepatocellular carcinoma survival. Our aim was to analyze the correlation between preoperative serum alpha-fetoprotein levels and survival, following the surgical treatment of hepatocellular carcinoma. 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). 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). Elevated preoperative serum alpha-fetoprotein levels have predictive value for hepatocellular carcinoma survival. Copyright © 2017 Asociación Mexicana de Gastroenterología. Publicado por Masson Doyma México S.A. All rights reserved.

  12. 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.

  13. 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.

  14. Positive and negative impact of increased tertiary attainment

    OpenAIRE

    Alena Bušíková

    2013-01-01

    The theory of human capital clearly states that the investments into the education bring many benefits and are worth the cost. The OECD Education at a Glance analysis provides support for both public and private investing in tertiary education as the net present value is positive for all observed countries. Considering the benefits of education, a growth in tertiary education should be viewed very positively. In this context, the European Strategy Europe 2020 set up one of its main goals for ...

  15. 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

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

    Directory of Open Access Journals (Sweden)

    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.

  17. 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...

  18. Policy Innovation and Tertiary Education Graduation Rates: A Cross-Country Analysis

    Science.gov (United States)

    Delaney, Jennifer A.; Yu, Patricia

    2013-01-01

    This study extends Trow's theory of higher education development to examine changes in national-level tertiary education graduation rates. Applying Trow's framework we arrive at three stages: (1) elite systems with gross tertiary graduation rates less than 15%, (2) massified systems with gross tertiary graduation rates between 15% and 50%, and (3)…

  19. WIDENING ACCESS TO TERTIARY EDUCATION FOR WOMEN IN GHANA THROUGH DISTANCE EDUCATION

    Directory of Open Access Journals (Sweden)

    Olivia Adwoa Tiwaah Frimpong KWAPONG

    2004-10-01

    Full Text Available Distance education (DE is seen as a tool for widening access to education at all levels. It is an educational tool that breaks most of the divides in education – age, gender, race, income, space, time etc. For the past decades, irrespective of the extensive expansion of tertiary institutions in the country, provision of tertiary education in Ghana has not been adequate enough to absorb all qualified applicants. This situation has peculiar effect on women who for socio-cultural factors drop out of formal education as they climb the ladder. The limited access to tertiary education has been the concern of various governments in the country. Various educational reforms have been made to this effect. In view of the exclusive potential of DE in widening access to education in a unique way, it has been recommended in the most recent educational reform that DE be promoted by establishing an open university and open colleges in addition to encouraging dual mode of delivery in the existing public universities. By its peculiar nature of being flexible and bridging space and time, studies have confirmed that DE has been an educational format that suits women’s study plans and learning styles. This paper explores the unique nature of DE for widening access to tertiary education most especially for women in Ghana and the issues to consider in the process.

  20. Prevalence of high level gentamicin and vancomycin resistance among clinical isolates of enterococci from a tertiary care hospital in central Nepal.

    Science.gov (United States)

    Amatya, R; Jha, B; Shrestha, S; Adhikari, R P; Timsina, S

    2014-12-01

    High level aminoglycoside resistance is an established phenomenon in enterococci. With the increasing use of broad spectrum cephalosporins and glycopeptides, vancomycin resistant enterococci are being increasingly reported from different parts of the world. The objective of our study was to determine the prevalence of high level gentamicin resistant (HLAR) enterococci among the clinical isolates in our hospital and to find the minimum inhibitory concentration (MIC) of vancomycin against these isolates. The enterococci isolated over a year (n = 41) were subjected to HLAR screening by disc diffusion and MIC of vancomycin by agar dilution method. HLAR prevalence was 63%. MIC of vancomycin showed none in the resistant range. However, 4 (9.7%) isolates were in the intermediate range heralding the eminent emergence of VRE if adequate control measures are not implemented in time.

  1. 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

  2. Prognocean Plus: the Science-Oriented Sea Level Prediction System as a Tool for Public Stakeholders

    Science.gov (United States)

    Świerczyńska, M. G.; Miziński, B.; Niedzielski, T.

    2015-12-01

    The novel real-time system for sea level prediction, known as Prognocean Plus, has been developed as a new generation service available through the Polish supercomputing grid infrastructure. The researchers can access the service at https://prognocean.plgrid.pl/. Although the system is science-oriented, we wish to discuss herein its potentials to enhance ocean management studies carried out routinely by public stakeholders. The system produces the short- and medium-term predictions of global altimetric gridded Sea Level Anomaly (SLA) time series, updated daily. The spatial resolution of the SLA forecasts is 1/4° x 1/4°, while the temporal resolution of prognoses is equal to 1 day. The system computes the predictions of time-variable ocean topography using five data-based models, which are not computationally demanding, enabling us to compare their skillfulness in respect to physically-based approaches commonly used by different sea level prediction systems. However, the aim of the system is not only to compute the predictions for science purposes, but primarily to build a user-oriented platform that serves the prognoses and their statistics to a broader community. Thus, we deliver the SLA forecasts as a rapid service available online. In order to provide potential users with the access to science results the Web Map Service (WMS) for Prognocean Plus is designed. We regularly publish the forecasts, both in the interactive graphical WMS service, available from the browser, as well as through the Web Coverage Service (WCS) standard. The Prognocean Plus system, as an early-response system, may be interesting for public stakeholders. It may be used for marine navigation as well as for climate risk management (delineate areas vulnerable to local sea level rise), marine management (advise offered for offshore activities) and coastal management (early warnings against coastal floodings).

  3. 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.

  4. 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

  5. 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.

  6. 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

  7. 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)

  8. 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.

  9. 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

  10. Aquatic Life Criteria - Methyl Tertiary-Butyl Ether (MTBE)

    Science.gov (United States)

    Information pertaining to the 1999 Acute and Chronic Ambient Aquatic Life Water Quality Criteria for Methyl Tertiary-Butyl Ether (MTBE) for freshwater and salt water. Information includes the safe levels of MTBE that should protect the majority of species.

  11. Language and Literature in Tertiary Education: The Case for Stylistics.

    Science.gov (United States)

    Buckledee, Steve

    2002-01-01

    Advocates the use of stylistics for teaching English-as-a-Foreign-Language at the tertiary level. Describes stylistics, discusses discourse conventions and grammatical structure, and examines stylistic analysis of a Shakespearian sonnet and a poem. (Author/VWL)

  12. Individual- and school-level sociodemographic predictors of obesity among New York City public school children.

    Science.gov (United States)

    Rundle, Andrew; Richards, Catherine; Bader, Michael D M; Schwartz-Soicher, Ofira; Lee, Karen K; Quinn, James; Lovasi, Gina S; Weiss, Christopher; Neckerman, Kathryn

    2012-12-01

    To identify student- and school-level sociodemographic characteristics associated with overweight and obesity, the authors conducted cross-sectional analyses of data from 624,204 public school children (kindergarten through 12th grade) who took part in the 2007-2008 New York City Fitnessgram Program. The overall prevalence of obesity was 20.3%, and the prevalence of overweight was 17.6%. In multivariate models, the odds of being obese as compared with normal weight were higher for boys versus girls (odds ratio (OR) = 1.39, 95% confidence interval (CI): 1.36, 1.42), for black (OR = 1.11, 95% CI: 1.07, 1.15) and Hispanic (OR = 1.48, 95% CI: 1.43, 1.53) children as compared with white children, for children receiving reduced-price (OR = 1.17, 95% CI: 1.13, 1.21) or free (OR = 1.12, 95% CI: 1.09, 1.15) school lunches as compared with those paying full price, and for US-born students (OR = 1.54, 95% CI: 1.50, 1.58) as compared with foreign-born students. After adjustment for individual-level factors, obesity was associated with the percentage of students who were US-born (across interquartile range (75th percentile vs. 25th), OR = 1.10, 95% CI: 1.07, 1.14) and the percentage of students who received free or reduced-price lunches (across interquartile range, OR = 1.13, 95% CI: 1.10, 1.18). The authors conclude that individual sociodemographic characteristics and school-level sociodemographic composition are associated with obesity among New York City public school students.

  13. 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.

  14. How Trace Element Levels of Public Drinking Water Affect Body Composition in Turkey.

    Science.gov (United States)

    Cetin, Ihsan; Nalbantcilar, Mahmut Tahir; Tosun, Kezban; Nazik, Aydan

    2017-02-01

    Since waterborne minerals appear in ionic form and are readily absorbed by the gastrointestinal tract, drinking water could be a crucial source of mineral intake. However, no comprehensive research has yet determined how trace elements in drinking water relate to body composition. We aimed to assess the relationship between clinically important trace elements in public drinking water and body composition in average, overweight and obese individuals in Turkey. The study's population consisted of 423 participants: 143 overweight, 138 obese and 142 healthy control individuals, grouped according to clinical cutoff points of body mass index (BMI). We measured levels of lithium (Li), nickel (Ni), lead (Pb), silicon (Si), tin (Sn), strontium (Sr), boron (B), aluminium (Al), barium (Ba) and rubidium (Rb) in samples from wells of municipal water by using inductively coupled plasma mass spectrometry. We gauged all the participants' body composition measurements with a BC-418 body composition analyser. In all the participants, body weight values showed significant positive correlations with Ni levels in drinking water, as did BMI values with Al levels and percentage of obesity with Ni, Si and B levels. In particular, Ni levels showed significant positive correlations with the basal metabolic rate, activity calories, and total activity of participants. Giving findings showing correlations between obesity-related parameters and Al, Si, B and Ni content in drinking water, we hope that these associations will be clarified with further studies including cellular, experimental and clinical studies. Hence, medical practitioners must be aware of trace element levels in drinking water for overweight and obese patients.

  15. Capacity-Building for the Transformation of Public Service: A Case of Managerial-Level Public Servants in Egypt

    Science.gov (United States)

    Wafa, Dina

    2015-01-01

    The past few years have witnessed a wave of unrest in Egypt toppling down two regimes in less than three years. Yet was this sufficient to bringing the demanded change and meeting people's expectations? In several Arab countries, citizens are offered patronage through public sector employment, subsidies, and limited taxation (Razzaz and Razzaz,…

  16. 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

  17. System-level factors affecting clinicians' perceptions and use of interpreter services in California public hospitals.

    Science.gov (United States)

    Baurer, Danielle; Yonek, Julie C; Cohen, Alan B; Restuccia, Joseph D; Hasnain-Wynia, Romana

    2014-04-01

    Professional language interpreters are skilled in the nuances of interpretation and are less likely to make errors of clinical significance but clinicians infrequently use them. We examine system-level factors that may shape clinicians' perceptions and use of professional interpreters. Exploratory qualitative study in 12 California public hospitals. We conducted in-person key informant interviews with hospital leadership, clinical staff, and administrative staff. Five emergent themes highlight system-level factors that may influence clinicians' perceptions and use of professional interpreters in hospitals: (1) organization-wide commitment to improving language access for LEP patients; (2) organizational investment in remote interpreter technologies to increase language access; (3)training clinicians on how to access and work with interpreters; (4) hospital supports the training and certification of bilingual staff to serve as interpreters to expand in-person, on-site, interpreter capacity; and (5)organizational investment in readily accessible telephonic interpretation. Multiple system-level factors underlie clinicians' use of professional interpreters. Interventions that target these factors could improve language services for patients with limited English proficiency.

  18. Preparations for the public release of high-level CMS data

    CERN Document Server

    McCauley, Thomas

    2016-01-01

    The CMS Collaboration is preparing for a public release up to a half of the reconstructed collision data collected in 2010, in accordance with its commitment to open access and data preservation. Efforts are at present focused on the usability of the data in education. The data will be accompanied by example applications tailored for different levels, including ready-to-use web-based applications for histogramming or visualising individual collision events, and a virtual machine image of the CMS software environment that is compatible with these data. The VM image will contain instructions for using the data with the online applications as well as examples of simple analyses. The novelty of this initiative is two-fold: in terms of open science, it lies in releasing the data in a format that is good for analysis; from an outreach perspective, it is to provide the possibility for people outside CMS to build educational applications using our public data. CMS will rely on services for data preservation and open ...

  19. A cloud-based workflow to quantify transcript-expression levels in public cancer compendia.

    Science.gov (United States)

    Tatlow, P J; Piccolo, Stephen R

    2016-12-16

    Public compendia of sequencing data are now measured in petabytes. Accordingly, it is infeasible for researchers to transfer these data to local computers. Recently, the National Cancer Institute began exploring opportunities to work with molecular data in cloud-computing environments. With this approach, it becomes possible for scientists to take their tools to the data and thereby avoid large data transfers. It also becomes feasible to scale computing resources to the needs of a given analysis. We quantified transcript-expression levels for 12,307 RNA-Sequencing samples from the Cancer Cell Line Encyclopedia and The Cancer Genome Atlas. We used two cloud-based configurations and examined the performance and cost profiles of each configuration. Using preemptible virtual machines, we processed the samples for as little as $0.09 (USD) per sample. As the samples were processed, we collected performance metrics, which helped us track the duration of each processing step and quantified computational resources used at different stages of sample processing. Although the computational demands of reference alignment and expression quantification have decreased considerably, there remains a critical need for researchers to optimize preprocessing steps. We have stored the software, scripts, and processed data in a publicly accessible repository (https://osf.io/gqrz9).

  20. Current levels of conflict of interest disclosure in medical publications from Korea.

    Science.gov (United States)

    Kang, Bo Hyoung; Moon, Jae Young; Chang, Youjin; Koo, Young-Mo; Koh, Younsuck

    2013-07-01

    Medical research should be fully transparent. The aims of this study were to determine the prevalence of author-related conflict of interest (COI) policies and evaluate the actual state of COI disclosure in Korean medical journals. To determine the prevalence of author-related COI policies, we examined the 198 medical journals listed in the KoreaMed database. To investigate the actual state of COI disclosures in published papers, we analyzed the publications in a representative medical journal, the Journal of the Korean Medical Science, from the perspective of the relevance of the ethics of COI disclosure. A total of 164 (82.8%) journals required an author's statement of COI as a criterion for publication. Of these 164, most of them focused on financial COI, with 101 (61.6%) presenting the information related to COI disclosures as a separate paragraph with a clear title. We identified 114 articles published by the Journal of the Korean Medical Science over a seven-year period, from January, 2006 to December, 2012. Of these, 65 papers (57%) included an author's statement of COI. We found that the policies of Korean medical journals regarding the disclosure of author COIs are still behind the internationally suggested level.

  1. Territorial Public Self-Government as a Development Institution at the Municipal Level

    Directory of Open Access Journals (Sweden)

    Aleksandr Nikolaevich Chekavinskii

    2015-12-01

    Full Text Available Under the conditions of insufficient financial and economic independence of Russia’s municipalities, greater importance is attached to various forms of people’s self-organization created for the purpose of participating in municipal administration, in the implementation of projects and activities that ensure the achievement of strategic goals and objectives of territorial development with minimum cost. One such form is territorial public self-government (TPSG; but, despite its effectiveness, it is not widespread in Russian regions. This is due both to the passivity of the population and to the fact that the status of TPSG has not been established clearly in the system of local government. That is why it is very important to study the best practices of organization and functioning of TPSG and substantiate its role as a development institution at the municipal level. The present work uses the example of Vologda city and several RF subjects to show that TPSG can solve many local issues (in the sphere of social protection, improvement of territories, promotion of comfortable living, etc.. It is a really effective form of people’s participation in the management of development of territories. However, in order to achieve the greatest social and economic effect, it is necessary that TPSG receive state support through specially developed programs to co-finance the projects within the framework of territorial public self-government. In this regard, the authors of the present paper offer a conceptual scheme and an algorithm of functioning of TPSG as a development institution at the municipal level and provide recommendations to the authorities about the forms of its support (in particular, the establishment of a council for the development of TPSG under the head of the municipal formation

  2. 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.

  3. Positive and negative impact of increased tertiary attainment

    Directory of Open Access Journals (Sweden)

    Alena Bušíková

    2013-04-01

    Full Text Available The theory of human capital clearly states that the investments into the education bring many benefits and are worth the cost. The OECD Education at a Glance analysis provides support for both public and private investing in tertiary education as the net present value is positive for all observed countries. Considering the benefits of education, a growth in tertiary education should be viewed very positively. In this context, the European Strategy Europe 2020 set up one of its main goals for EU27 countries as follows: to increase the educated population so that it reaches 40% (tertiary educated people aged 30-34. This article, on an example of Slovakia, provides an analysis of both positive and negative impact of increased tertiary attainment.

  4. A push for public health: the effect of e-bikes on physical activity levels

    Directory of Open Access Journals (Sweden)

    Hanne Beate Sundfør

    2017-10-01

    Full Text Available Abstract Background Cycling is considered to have a positive effect on public health through increased physical activity. In Norway, the e-bike is seen as a way of getting more people to cycle. However, the motorized assistance of an e-bike potentially eliminates any physical activity associated with its use. It is possible that the assumed health effect of increased cycling is “erased” through a reduction in other physical activities (a substitution effect. In this paper we study the public health effects of e-bikes using a combined cross-sectional and quasi-experimental design. First, we explore the existence of potentially hedonistic values in relation to interest in acquiring an e-bike and, second, we conduct an intervention study of physical activity pre- and post-purchase. Methods A sample of 340 people responded to a questionnaire before buying an e-bike and follow-up 4 weeks later, when 45 had bought one. A further 28 (mainly physically inactive were recruited through a Norwegian NGO. For a comparison group, 1995 people were recruited through the Falck National Register of Bicycle Owners. All respondents were asked about the intensity of their cycling, (kilometres cycled in the previous week, walking and physical activity in addition to cycling as means of transport (days and hours. Results A structural equation model showed that hedonistic life values, and general physical activity, were predictive of interest in buying an e-bike. However people who already cycled a lot showed less interest. The trial showed that increased cycling – whether as a mean of transport or exercise –was related to higher levels of total physical activity in both groups compared to a comparison group (one-way ANOVA. Conclusions Our findings indicate that in the Norwegian cycle population there is no substantial substitution effect of physical activity with the introduction of an e-bike. The appeal of the e-bike is strongest among those with little

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

    Science.gov (United States)

    Sørensen, Nina N; Tetens, Inge; Løje, Hanne; Lassen, Anne D

    2016-12-01

    To measure the effect of organic food conversion projects on the percentage of organic food used in Danish public kitchens participating in the Danish Organic Action Plan 2020. The current longitudinal study was based on measurements of organic food percentages in Danish public kitchens before 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 (Ppublic kitchen type, the increase remained significant for seven out of eight kitchens. Furthermore, the proportion of public kitchens eligible for the Organic Cuisine Label in either silver (60-90 % organic food procurement) or gold (90-100 % organic food procurement) level doubled from 31 % to 62 %, respectively, during the conversion period. Conversion project curriculum mostly included elements of 'theory', '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 projects include adding key curriculum components to the project's educational content and measuring changes in organic food percentage to increase the chances of successful implementation.

  6. 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.

  7. Exploring Tertiary Students' Understanding of Covalent Bonding

    Science.gov (United States)

    Coll, Richard K.; Treagust, David F.

    2002-02-01

    There has been little research into learners' mental models of chemical bonding at any level, let alone the tertiary level. Undergraduate and graduate students encounter a plethora of sophisticated and highly abstract mental models for chemical bonding, and this study sought to investigate if there are preferred mental models for the concept of covalent bonding for secondary, undergraduate, and graduate chemistry learners. In particular, it was of interest to see whether exposure to increasingly sophisticated mental models at different points in a chemistry education showed up in patterns of preference and use of models in interpreting common physical properties and phenomena. The study revealed that, despite evidencing expertise in a number of highly complex and mathematically sophisticated mental models, tertiary students, including graduates (MSc and PhD), show a strong preference for simple realistic mental models. Furthermore, the students struggled to use their mental models to explain the physical properties of covalently bonded substances.

  8. COMPARATIVE STUDY ON THE LEVEL OF BACTERIOLOGICAL CONTAMINATION OF AUTOMATIC TELLER MACHINES, PUBLIC TOILETS AND PUBLIC TRANSPORT COMMERCIAL MOTORCYCLE CRASH HELMETS IN KIGALI CITY, RWANDA.

    Science.gov (United States)

    Nigatu, W; Fabiola, N S; Flora, I J; Mukahirwa, M A; Omar, M; Nsengimana, J; Nsabimana, A

    2014-12-01

    The environments can be contaminated by infectious agents that constitute a major health hazards as sources of community and hospital-acquired infections due to various activities. A comparative study on the level of bacteriological contamination of automatic teller machines (ATMs), public toilets and commercial motorcycle crash helmets were conducted in Kigali city during the period of January to March, 2013. Samples were collected from selected ATMs, public toilets and commercial motorcycle crash helmets surfaces. Micro-organisms identified from these samples were associated to infecting organisms recovered from unwashed hands surfaces and recorded results in the nearby hospital. Samples from each device and subject were transported to the laboratory where they were analysed for the presence of coliforms and other airborne, human skin and intestinal disease causing microorganisms. Microbiological methods including spread plate techniques and some biochemical tests were used to partially identify the microorganisms. Subjects involved in this study were consented students from University of Rwanda and Kigali motorcyclists for collections of samples from hands and crash helmets respectively. The following pathogenic bacteria have been found on the devices, Staphylococcus aureus, Staphylococcus epidermis, Streptococcus species, Escherichia coli, Salmonella, Klebsiella, Enterobacter aerogenes, Pseudomonas. The commercial motorcycle crash helmets had the highest level of bacteriological contamination compared to ATMs and public toilets. There was no growth observed on samples collected after treatment from ATMs, public toilets, and commercial motorcycle crash helmets. Attempt to correlate this finding with infecting organisms recovered from unwashed hands surfaces and recorded results in the nearby hospital show that the presences of some of these infectious pathogens. This study has revealed the ability of these public devices to serve as vehicle of transmission of

  9. 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

  10. Grecia: Nivel IV. Basado en el curso de estudios sociales de Montgomery County Public Schools. (Greece. Level 6. Based on the Montgomery County Public Schools Social Studies Program).

    Science.gov (United States)

    Maldonado, Marisol

    This curriculum unit, developed by the Montgomery County Public Schools, Maryland, was designed for use in an elementary level foreign language immersion program. It is geared toward the sixth grade social studies classroom. The unit includes instructional and performance objectives, necessary vocabulary lists, optional language structure…

  11. Comparisons of referral criteria for public screening of blood cholesterol levels.

    Science.gov (United States)

    Wones, R G; Kerman, K M; Hissa, D C; Meloy, N; Stein, E A

    1989-01-01

    Total and high-density lipoprotein (HDL) cholesterol levels of 2,387 adults were screened at a worksite and a bloodbank. Hypothetical referral decisions were made according to three sets of guidelines: the 1984 National Institutes of Health Consensus Conference guidelines (NIHCC), a single referral cutpoint of 5.2 millimoles per liter (mmol per L), and the current National Cholesterol Education Program (NCEP) guidelines for screening in physicians' office. Under the NIHCC guidelines, 31 percent of the participants would have been referred to their physicians, 32 percent under the NCEP guidelines, and 56 percent would have been referred had the 5.2 mmol per L cutpoint been used. Twenty-four percent of the participants would have been referred under both the NIHCC and NCEP guidelines; 7 percent would have been referred under the NIHCC guidelines, but not the NCEP's. Eight percent would have been referred under the NCEP guidelines, but not the NIHCC's. Those who would have been referred were older, and more likely to be male and to have low levels of HDL cholesterol than the 7 percent who would have been referred under NIHCC guidelines only. All of the 8 percent had coronary heart disease, or two or more other coronary risk factors, whereas none of the 7 percent did. If low HDL had been used as a risk factor under NCEP guidelines, the number of persons referred would have increased slightly (to 34 percent) and low HDL levels would have become one of the most prevalent risk factors. The researchers concluded that public cholesterol screening programs should use the NCEP guidelines (with or without HDL), rather than the NIHCC guidelines, or a single 5.2 mmol per L cutpoint.

  12. Population-Level Measures to Predict Obesity Burden in Public Schools: Looking Upstream for Midstream Actions.

    Science.gov (United States)

    Jayawardene, Wasantha P; Lohrmann, David K; Dickinson, Stephanie; Torabi, Mohammad R

    2016-10-05

    To estimate school-level obesity burden, as reflected in prevalence of obesity, based on the characteristics of students' socioeconomic and geographic environments. Secondary analysis of cross-sectional data. Public schools (N = 504) from 43 of 67 counties in Pennsylvania. Kindergarten through grade 12 students (N = 255 949). School-level obesity prevalence for the year 2014 was calculated from state-mandated student body mass index (BMI) measurements. Eighteen aggregate variables, characterizing schools and counties, were retrieved from federal data sources. Three classification variables-excess weight (BMI ≥ 85th percentile), obesity (BMI ≥ 95th percentile), and severe obesity (BMI > 35% or 120% of 95th percentile)-each with 3 groups of schools (low-, average-, and high-prevalence) were created for discriminant function analysis, based on state mean and standard deviation of school distribution. Analysis tested each classification model to reveal school- and county-level dimensions on which school groups differed from each other. Discriminant functions for obesity, which contained school enrollment, percentage of students receiving free/reduced-price lunch, percentage of black/Hispanic students, school location (suburban/other), percentage of county adults with postsecondary education, and percentage of county adults with obesity, yielded 67.86% correct classification (highest accuracy), compared to 34.23% schools classified by chance alone. In the absence of mandated student BMI screenings, the model developed in this study can be used to identify schools most likely to have high obesity burden and, thereafter, determine dissemination of enhanced resources for the implementation of proven prevention policies and programs. © The Author(s) 2016.

  13. [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.

  14. 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.

  15. Changes in Humoral and Cellular Immunity in Tertiary Peritonitis

    OpenAIRE

    Matviychuk, Oleh

    2017-01-01

    The objective of the research was to give a comparative characteristic of parameters of humoral and cellular immunity in the development of secondary and tertiary peritonitis.Materials and methods. The research enrolled 109 patients with secondary peritonitis, 20 of whom developed tertiary peritonitis. Changes in humoral and cellular immunity were evaluated by serial blood tests for the determination of leukocyte count, the relative number of lymphocytes, Ig A, M, and G levels, as well as by ...

  16. 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.

  17. Assessing Constituent Levels in Smokeless Tobacco Products: A New Approach to Engaging and Educating the Public.

    Science.gov (United States)

    Borgida, Eugene; Loken, Barbara; Williams, Allison L; Vitriol, Joseph; Stepanov, Irina; Hatsukami, Dorothy

    2015-11-01

    Providing accurate information about the constituents in nicotine-containing products may help tobacco users make informed decisions about product choices. An experimental study examined a novel approach for presenting accurate constituent information about brands and types of smokeless tobacco (SLT) that could be understood by the general public. Participants were recruited through Amazon's Mechanical Turk and presented information online about 2 constituent dimensions of SLT products-nicotine and/or toxicity (for simplicity, "toxicity" in this study refers to carcinogenic constituents) Participants completed measures of knowledge and tobacco health risks at 2 time points: before and after exposure to constituent information. Participants were found to increase their knowledge that toxicity contributes to disease risk and nicotine contributes to addiction, that SLT products vary in their levels of nicotine and toxicity, and that both SLT and cigarette products have higher toxicity than medicinal nicotine replacement therapies (e.g., nicotine lozenges). Study results showed no differences when presenting toxicity information alone versus presenting it in conjunction with nicotine information, and found no misperceptions or confusions about the relative harmfulness of cigarettes, SLT, or nicotine replacement therapy. Providing tobacco constituent information to smokers and nonsmokers will improve their knowledge about the relative toxicity across products and variations within a class of tobacco products without compromising the health risks associated with tobacco use. © The Author 2015. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  18. 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...

  19. 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 ...

  20. 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 ...

  1. 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.

  2. 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.

  3. An analysis of the cost of incomplete abortion to the public health ...

    African Journals Online (AJOL)

    treatment settings. Setting. Public hospitals in South Africa. Participants. A panel of 15 senior level obstetricianJ gynaecologists and a second panel of 11 patient care managers representing district, regional and tertiary level ..... colpopuncture, hysterectomy. Postoperative care could take place ;n the ICU if one is available.

  4. Are Individuals with High Levels of Public Service Motivation Satisfied in MPA Degree Programs?

    Science.gov (United States)

    Bright, Leonard

    2017-01-01

    Many scholars have suggested that public service motivation (PSM) is a defining characteristic of public and non-profit employees. However, interest and motivation alone are not the sole determinates of success in any organization. Employees must also possess the knowledge and skills that will help them accomplish the difficult tasks that arise in…

  5. 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

    To measure the effect of organic food conversion projects on the percentage of organic food used in Danish public kitchens participating in the Danish Organic Action Plan 2020. The current longitudinal study was based on measurements of organic food percentages in Danish public kitchens before an...... projects include adding key curriculum components to the project’s educational content and measuring changes in organic food percentage to increase the chances of successful implementation.......To measure the effect of organic food conversion projects on the percentage of organic food used in Danish public kitchens participating in the Danish Organic Action Plan 2020. The current longitudinal study was based on measurements of organic food percentages in Danish public kitchens before......’, ‘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...

  6. Assessment of the Public Sector Scale in the Russian Federation Regions and Its Relationship to the Level of Economic Development

    Directory of Open Access Journals (Sweden)

    Margarita V. Kurbatova

    2016-09-01

    Full Text Available The need to reduce the public sector of the Russian economy is often discussed in the modern economics. Regulatory evaluation based on a comparison of the effectiveness of the private and public sectors is usually dominated. The problem of determining the role of the public sector from the point of its regulatory capabilities with regional differentiation is outside of the view. Comprehensive assessment of the public sector scale in the Russian regions economy is fulfilled based on statistical data on selected indicators of the State participation. To assess the volume of the public sector in the Russian regions a method to calculate the integral measure of the comprehensive assessment of the scale of the public sector is used in the paper. This indicator is measured in a quantitative scale that allows to use it in the statistical analysis of the data, particularly in the correlation analysis to identify the relationship between the public sector and the volume of GDP per capita. Assessment of the relationship of this indicator to the level of economic development of the Russian region is fulfilled. It is shown that the scale of the public sector is strongly differentiated by region due to the requirements of its regulatory impact determined by the type of region.

  7. Pattern of childhood malignant tumours in two tertiary teaching ...

    African Journals Online (AJOL)

    Background: Cancer is a public health problem worldwide affecting all categories of persons. It is the second common cause of death in developed countries and among the three leading causes of death in developing countries. Objective: To compare the patterns of malignant childhood tumours in two tertiary hospitals in ...

  8. Hospital mortality in cirrhotic patients at a tertiary care center.

    Science.gov (United States)

    Zubieta-Rodríguez, R; Gómez-Correa, J; Rodríguez-Amaya, R; Ariza-Mejia, K A; Toloza-Cuta, N A

    Cirrhosis of the liver is known for its high risk of mortality associated with episodes of acute decompensation. There is an even greater risk in patients that present with acute-on-chronic liver failure. The identification of patients at higher risk for adverse outcomes can aid in making the clinical decisions that will improve the prognosis for these patients. To determine in-hospital mortality and evaluate the epidemiologic and clinical characteristics of patients with cirrhosis of the liver seen at a tertiary referral hospital. A descriptive, observational, cohort study was conducted on adult patients with cirrhosis of the liver, admitted to a tertiary care center in Bucaramanga, Colombia, within the time frame of March 1, 2015 and February 29, 2016. Eighty-one patients with a mean age of 62 years were included in the study. The main etiology of the cirrhosis was alcoholic (59.3%). In-hospital mortality was 23.5% and the most frequent cause of death was septic shock (68.4%), followed by hypovolemic shock (10.5%). A MELD score≥18, a leukocyte count>12,000/ul, and albumin levels below<2.5g/dl were independent factors related to hospital mortality. In-hospital mortality in cirrhotic patients is high. Sepsis and bleeding are the 2 events leading to acute-on-chronic liver failure and death. A high MELD score, elevated leukocyte count, and low level of albumin are related to poor outcome during hospitalization. Adjusted prevention-centered public health measures and early and opportune diagnosis of this disease are needed to prevent the development of complications and to improve outcome in cirrhotic patients. Copyright © 2017 Asociación Mexicana de Gastroenterología. Publicado por Masson Doyma México S.A. All rights reserved.

  9. 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,

  10. 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.

  11. Factors affecting turnover intentions among public hospital doctors in a middle-level city in central China.

    Science.gov (United States)

    Zhang, Fengfan; Luo, Zhenni; Chen, Ting; Min, Rui; Fang, Pengqian

    2017-05-01

    Objective The aim of the present study was to explore prominent factors affecting turnover intentions among public hospital doctors in urban areas, particularly in Xiangyang City, Hubei Province, a middle-level city in central China. Methods Questionnaires were used to collect data from 284 public hospital doctors. Pearson's Chi-squared was used to assess whether sociodemographic and other factors were related to the turnover intentions of public hospital doctors. Binary logistic regression was performed to determine the significant factors that influence turnover intentions. Results The analysis revealed that 28.2% of public hospital doctors intended to leave the hospital where they were currently employed. Dissatisfaction with working conditions and hospital management processes, as well as work pressures, were significant factors contributing to the turnover intentions of public hospital doctors. Conclusion Research into turnover intentions indicates that public hospital doctors surveyed in urban China give greater weight to their professional environment and career development rather than salary in their employment decisions. What is known about the topic? Turnover of medical staff is a concern to hospital administrators because it is costly and detrimental to organisational performance and quality of care. Most studies have focused on the effects of individual and organisational factors on nurses' intentions to leave their employment. Income dissatisfaction was one of the determining factors of turnover intentions in previous studies. What does this paper add? The satisfaction of public hospital doctors with regard to income is not a determining factor of turnover intentions. In contrast with findings of previous studies, the doctors in public hospitals in urban China in the present study gave greater weight to their professional environment and career development in their employment decisions. What are the implications for practitioners? The findings suggest

  12. 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.

  13. Using Public AID Programs to Finance Innovation in Multi-Level Governance Systems

    Directory of Open Access Journals (Sweden)

    Manuel GUISADO-GONZÁLEZ

    2013-02-01

    Full Text Available This paper explores how different public administrations (regional, national, European and Framework Program allocate public resources to promote innovation among innovative companies in the Spanish manufacturing industry. We incorporate variables that have never been treated in this line of research before, such as exportoriented and Pavitt’s taxonomy among others. In order to know the preferences of each public program aimed at promoting innovation we use two econometric estimation techniques: first, a binary logistic regression and, second, another binary logistic regression corrected for selection bias derived from the lack of consideration of certain relevant characteristics of manufacturing firms that do not innovate. We check if the importance and statistical significance of certain explanatory variables depend on the estimation method used. We found that the four public administrations preferably assign public resources to Spanish companies that cooperate with other domestic companies. We also found that European programs (EU and Framework Program show their allocation preferences towards innovative firms that export outside EU. The public aid from the Spanish central administration seeks to promote the creation of large ‘national champions’.

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

    Directory of Open Access Journals (Sweden)

    Harahap Nida P

    2009-04-01

    Full Text Available Abstract Background 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. Methods 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. Results 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

  15. 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.

  16. 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

  17. 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

  18. 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…

  19. The invisibility of public health: population-level measures in a politics of market individualism.

    Science.gov (United States)

    Burris, S

    1997-01-01

    This paper models the prevailing political attack on government as a heuristic, a judgmental strategy that simplifies complex phenomena by applying simple tests to a limited set of relevant data. The heuristic of market individualism offers three tools for analyzing the problems of governing: the supremacy of the free market as a regulatory device, a belief in individual freedom of choice and personal responsibility, and the elevation of individual satisfaction as the chief goal of society. Because public health is inherently concerned with the health of the population rather than individual health, because the market itself is a major source of ill health, and because individual choice is socially mediated, use of the heuristic precludes the recognition of the value of public health work. Although some degree of accommodation to current political realities is a practical necessity, public health advocates must not neglect the task of fashioning radically different alternative visions over the long term. PMID:9357340

  20. 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…

  1. Teacher Socialization of EFL Teachers at Public School Levels in Central Mexico

    Science.gov (United States)

    Lengeling, M. Martha; Mora Pablo, Irasema; Barrios Gasca, Blanca Lucía

    2017-01-01

    This study aimed at exploring the processes of teacher socialization and identity formation of nine English as a foreign language teachers at public schools in central Mexico. These teachers began their careers in the National English Program in Basic Education. Qualitative research and narrative inquiry were used as a basis for this research. The…

  2. Street-level diplomacy? Communicative and adaptive work at the front line of implementing public health policies in primary care.

    Science.gov (United States)

    Gale, Nicola; Dowswell, George; Greenfield, Sheila; Marshall, Tom

    2017-03-01

    Public services are increasingly operating through network governance, requiring those at all levels of the system to build collaborations and adapt their practice. Agent-focused implementation theories, such as 'street-level bureaucracy', tend to focus on decision-making and the potential of actors to subvert national policy at a local level. While it is acknowledged that network leaders need to be adaptable and to build trust, much less consideration has been given to the requirement for skills of 'diplomacy' needed by those at the front line of delivering public services. In this article, drawing on theoretical insights from international relations about the principles of 'multi-track diplomacy', we propose the concept of street level diplomacy, offer illustrative empirical evidence to support it in the context of the implementation of public health (preventative) policies within primary care (a traditionally responsive and curative service) in the English NHS and discuss the contribution and potential limitations of the new concept. The article draws on qualitative data from interviews conducted with those implementing case finding programmes for cardiovascular disease in the West Midlands. The importance of communication and adaptation in the everyday work of professionals, health workers and service managers emerged from the data. Using abductive reasoning, the theory of multi-track diplomacy was used to aid interpretation of the 'street-level' work that was being accomplished. Copyright © 2017. Published by Elsevier Ltd.

  3. Sexism and Sexual Harassment in Tertiary Institutions | Akpotor ...

    African Journals Online (AJOL)

    Sexual harassment is a recurring decimal in tertiary institutions. The paper therefore investigates the effects of sexual harassment on the academic performance of female students, using Delta State University, Abraka, as case study. The participants were randomly selected 200level – 500level students from various ...

  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. 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.

  6. 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:...

  7. Measuring New Public Management at the Local Level: Experiences from EU Cities

    Directory of Open Access Journals (Sweden)

    Irena BAČLIJA

    2012-10-01

    Full Text Available Economic globalization, growingly differentiated and unstable markets, fiscal crises in light of increasing public expenditure are the elements of an uncertain future for local communities. Local communities are captured between the local service provision demands and the global market of local communities that compete for investors. In the context of this ever demanding environment the functions of local administration should be reformed. The article presents the specifics of local management and alongside its reform process under the principles of new public management. The empirical part of the article explains the findings of an extensive study of local administrations in the European Union and their reforms with implications that show the effects of reformed local administration on the economic performance of the local community.

  8. Performance level analyses of public transportation using importance-performance analysis method

    Directory of Open Access Journals (Sweden)

    Hidayat Nursyamsu

    2018-01-01

    Full Text Available Yogyakarta, one of the middle cities in Indonesia, has been developing BRT system named Trans Jogja to reduce growth of motorization. However, the performance tends to decrease year by year, therefore the system and management upgrading must be carried out continuously to restore public trust. This research tries to investigate public satisfaction, their expectation, and some attributes considered important based on public’s perspective using IPA method that can be used as useful information systems to evaluate service quality by prioritizing or focusing on areas where improvement is needed. The results reveal that decision maker must focus and allocate their resources to improve Trans Jogja system on the following attributes: a keep punctuality, b shorten waiting time in the bus stop, c improve bus comfort, d provide safety for child passenger, e improve bus stop comfort, f create new bus route to enlarge accessibility, and g shorten bus travel time.

  9. 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.

  10. 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.

  11. Level of Eletronic Disclosure of Public Accounting of Municipalities of Paraná in the Internet Environment

    Directory of Open Access Journals (Sweden)

    Luciane Maria Gonçalves Franco

    2014-04-01

    Full Text Available The objective is to identify the level of electronic transparency of financial statements in municipal districts, arranged in the internet environment. The research presents descriptive approach, ex-post facto, held in October of 2011. The study is based on legislation and literature of Accounting Science and Public Administration. Among respects, it was found that 81.25 % of municipalities with 50,000 or more inhabitants provide reports of the Fiscal Responsibility Law in their web pages and this figure drops to 29.43% in municipalities with fewer than 50,000 inhabitants. It is a significant number of municipalities that do not use electronics to publicize their acts , corresponding to 70.57 %, or 259 municipalities out of the total surveyed. It is emphasized that transparency of public accounts is of limitations in terms of availability of information, so he will need improvement and viability for the benefit of the results.

  12. 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…

  13. Relationship of experience and the place of work to the level of competency among public health nurses in Japan.

    Science.gov (United States)

    Okamoto, Reiko; Shiomi, Misa; Iwamoto, Saori; Hatono, Yoko; Chiba, Yumi; Ojima, Toshiyuki; Bessyo, Yuko; Nakayama, Kimiko; Inoue, Kiyomi

    2008-06-01

    To examine the actual competencies of public health nurses (PHNs) working in public organizations in Japan in order to clarify the relationship between the level of competency and the number of years of experience and the place of work. The subjects were 1799 full-time PHNs working at 135 prefectural public health centers and 115 municipal health centers, which were randomly selected. Each subject received a questionnaire in the mail, requesting basic personal information and a self-evaluation of six levels of achievement in 11 topics in five categories of competencies. The number of respondents was 1261 (70.1%), with a total of 1184 valid responses (65.8%). In terms of the level of competency, the average score was >3 for all items and the number of PHNs who achieved Ladders 5 and 6 was low, with very few achieving Ladder 6, despite having more years of experience. Furthermore, the level of achievement depended on the workplace, position, and academic background. The tasks regarding the education of PHNs in Japan are to establish achievement goals clearly and incrementally and to develop methods and systems that consistently and systematically increase competencies, not only in basic undergraduate education, but also for employed PHNs, through specialized education. In particular, educational methods that lead to high-quality experiences need to be selected in order to develop competencies.

  14. 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

    2016-07-20

    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.

  15. Clinical and financial burdens of secondary level care in a public ...

    African Journals Online (AJOL)

    The costs of providing secondary level care for patients on or immediately preceding ART initiation can be significant and should be included in the government's strategic planning: (i) so that the service can be expanded to meet current and future needs; and (ii) to avoid crowding out other secondary level health services.

  16. What We Know about the Public's Level of Concern for Farm Animal Welfare in Food Production in Developed Countries.

    Science.gov (United States)

    Cornish, Amelia; Raubenheimer, David; McGreevy, Paul

    2016-11-16

    Population growth and rising consumption of meat, dairy, eggs and fish are forcing the world to face the intersecting challenges of how to sustainably feed a population expected to exceed 9 billion by 2050, while also controlling the impact of food production on the planet, on people and on animals. This review acknowledges the absence of a globally accepted definition of animal welfare and then explores the literature regarding different levels of concern for animal welfare in food production by such stakeholders as veterinarians, farmers, and the general public. It focuses on the evidence that the general public's level of concern for animal welfare is linked to various demographic and personal characteristics, such as age, gender, religion, location, meat eating, and knowledge of animal welfare. Certain animals have characteristics that influence concern for their welfare, with those species that are considered more intelligent being afforded more concern. There is compelling evidence that the general public's understanding of animal welfare in food production is poor. Acknowledging that public concern can be a driving force to change current production methods, the authors suggest widespread consciousness raising to redefine socially acceptable methods of food production from animals and to ensure that it remains in step with societal concerns.

  17. The Los Angeles County Community Disaster Resilience Project - a community-level, public health initiative to build community disaster resilience.

    Science.gov (United States)

    Eisenman, David; Chandra, Anita; Fogleman, Stella; Magana, Aizita; Hendricks, Astrid; Wells, Ken; Williams, Malcolm; Tang, Jennifer; Plough, Alonzo

    2014-08-19

    Public health officials need evidence-based methods for improving community disaster resilience and strategies for measuring results. This methods paper describes how one public health department is addressing this problem. This paper provides a detailed description of the theoretical rationale, intervention design and novel evaluation of the Los Angeles County Community Disaster Resilience Project (LACCDR), a public health program for increasing community disaster resilience. The LACCDR Project utilizes a pretest-posttest method with control group design. Sixteen communities in Los Angeles County were selected and randomly assigned to the experimental community resilience group or the comparison group. Community coalitions in the experimental group receive training from a public health nurse trained in community resilience in a toolkit developed for the project. The toolkit is grounded in theory and uses multiple components to address education, community engagement, community and individual self-sufficiency, and partnerships among community organizations and governmental agencies. The comparison communities receive training in traditional disaster preparedness topics of disaster supplies and emergency communication plans. Outcome indicators include longitudinal changes in inter-organizational linkages among community organizations, community member responses in table-top exercises, and changes in household level community resilience behaviors and attitudes. The LACCDR Project is a significant opportunity and effort to operationalize and meaningfully measure factors and strategies to increase community resilience. This paper is intended to provide public health and academic researchers with new tools to conduct their community resilience programs and evaluation research. Results are not yet available and will be presented in future reports.

  18. 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.

  19. Multi-level innovation policy in southern EU countries.An additionality evaluation of the Italian and Spanish public interventions

    OpenAIRE

    Alberto Marzucchi

    2011-01-01

    The present paper aims to analyse the innovation policies implemented in Italy and Spain. It adopts a multi-level perspective to investigate the effects induced by regional and national public supports and a multi-dimensional approach to disentangle the different types of additionality impacts on firms’ innovation process. In particular input, output and behavioural additionality are considered. The results, obtained through a propensity score matching estimation of the average treatment ef...

  20. 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.

  1. Local diagnostic reference levels for intraoral dental radiography in the public hospitals of Cyprus.

    Science.gov (United States)

    Christofides, Stelios; Pitri, Elina; Lampaskis, Marios; Papaefstathiou, Christos

    2016-11-01

    The purpose of this study was to determine local DRLs for children and adults undergoing intraoral dental examinations at the intraoral radiology units of the public hospitals in Cyprus. Measurements were made on all the twenty intraoral X-ray units of the public hospitals in Cyprus with the intention to establish the local DRLs for all the possible intraoral X-ray examinations for children and adults. All units are film based. The measurements were made by a Dose Area Product (DAP) meter (GAMMEX RMI 841-RD) placed at the surface of the dental unit's X-ray shaping cone (FSD 20cm). A diagnostic radiology dosimeter (Dosimax Plus A) was also placed at an FSD of 100cm to compare the dose reading between the two dosimeters. DRLs were established at the 3rd quartile for 7 exposure settings corresponding to 12 types of teeth (Adult and children mandibular and maxillary incisor, premolar and molar) with values of 197, 163, 128, 102, 81, 65 and 49mGycm-2 and 7.23, 5.94, 4.75, 3.68, 3.10, 2.41 and 1.88mGy for benchmark nominal exposure times of 1000, 800, 640, 500, 400, 320 and 250ms respectively, at a nominal exposure voltage of 70kVp. The local DRLs of the present study compare well with other similar published DRLs. Copyright © 2016 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  2. Relationship between Site Quality and the Disclosure Level of the Public Employees Remuneration

    Directory of Open Access Journals (Sweden)

    Alex Eckert

    2016-12-01

    Full Text Available The transparency of public accounts is one of the main pillars of democratic rights, especially sanctioned by the laws of access to information, transparency and fiscal responsibility. Therefore, the quality of information provided on the websites is essential for the understanding of people, including remuneration information of the servers that represent a significant part of public spending. In this sense, this study aims to evaluate how it can be evaluated the quality of information the websites of the municipalities of Serra Gaúcha, in Brazil, especially regarding the disclosure of the remuneration of their employees. Therefore, the methodology used on the technical procedures was the multiple case studies, descriptive, qualitative and quantitative analysis. The results indicate that there is no relationship between the quality of information and full disclosure of remuneration. In addition, the disclosures need to be improved to be useful to the population, especially as regards the update of data. With regard to wages, many municipalities already disclose this information. However, there are still great difficulties in access to this information by people.

  3. Tuberculosis in hospital environment: clinical profile in a tertiary hospital from Ceará and level of knowledge of health personnel about control measures - doi:10.5020/18061230.2010.p260

    Directory of Open Access Journals (Sweden)

    Roberto da Justa Pires Neto

    2012-01-01

    Full Text Available (TB and to assess the knowledge of health personnel on fundamental concepts about TB and control measures for pulmonary tuberculosis in a hospital environment. Methods: The study was conducted in a tertiary hospital in Fortaleza-CE and involved patients admitted with TB and health professionals responsible for assistance. A first phase was characterized by a retrospective study of medical records of patients admitted with suspected TB. In a second stage, a cross-sectional study with application of a structured questionnaire assessed the knowledge of health personnel on TB control measures in a hospital environment. Results: Sixty-seven patients admitted with suspected TB had their medical records assessed. Among the confirmed cases, the most frequent clinical form was pulmonary (81.3%. Out of 55 patients admitted with suspected pulmonary tuberculosis, only 29 (52.7% were admitted in a respiratory isolation bed. Twenty-six patients with suspected pulmonary tuberculosis on admission stayed a total of 148 days out of a respiratory isolation bed (average 4.1 days / patient. The knowledge of 159 health professionals about TB was assessed. Regarding the transmission of TB, 107 (67.2% were unaware of airborne transmission and 109 (68.5% ignored the clinical forms that require respiratory isolation. Conclusions: Pulmonary tuberculosis is the most frequent clinical form among inpatients in a tertiary hospital in Fortaleza- CE. Considerable fraction of health personnel doesn’t know key concepts related to tuberculosis and essential for the proper and safe care.

  4. Widening Access to Tertiary Education for Women in Ghana through Distance Education

    Science.gov (United States)

    Kwapong, Olivia Adwoa Tiwaah Frimpong

    2007-01-01

    Distance education (DE) is seen as a tool for widening access to education at all levels. It is an educational tool that breaks most of the divides in education--age, gender, race, income, space, time etc. For the past decades, irrespective of the extensive expansion of tertiary institutions in the country, provision of tertiary education in Ghana…

  5. Willing and Enabled: The Academic Outcomes of a Tertiary Enabling Program in Regional Australia

    Science.gov (United States)

    Andrewartha, Lisa; Harvey, Andrew

    2014-01-01

    This paper examines the achievement levels of students undertaking the Tertiary Enabling Program (TEP) at La Trobe University. The TEP is an alternative pathway program that traverses multiple institutions, campuses, and disciplinary areas, and is designed to prepare a diverse student cohort for tertiary study. The Program integrates several…

  6. Inside the Collaborative Inter-Arts Improvisatory Process: Tertiary Music Students' Perspectives

    Science.gov (United States)

    Blom, Diana

    2012-01-01

    While research has explored aspects of inter-arts collaboration at professional and primary level, there is little on inter-arts collaboration in the tertiary environment. This article explores aspects of the learning of tertiary music students undertaking a short-term collaborative inter-arts improvisation project with dance and theater peers,…

  7. The Petasis Reaction: Microscale Synthesis of a Tertiary Amine Antifungal Analog

    Science.gov (United States)

    Koroluk, Katherine J.; Jackson, Derek A.; Dicks, Andrew P.

    2012-01-01

    Students prepare a tertiary amine antifungal analog in an upper-level undergraduate organic laboratory. A microscale Petasis reaction is performed to generate a liquid compound readily characterized via IR and proton NMR spectroscopy. The biological relevance of the product is highlighted, with the tertiary amine scaffold being an important…

  8. 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.

  9. 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.

  10. The State at the Level of the Street: Exploring Child Care as a Public Task

    DEFF Research Database (Denmark)

    Møller, Marie Østergaard; Hill, Michael

    ‘It takes a village to raise a child.’ In the context of the neo-interventionist state, this classic pedagogical dictum has an entirely different meaning. In this paper the case of child care is explored as a contribution to the use of comparative analysis of street level activity to enhance...... in childcare provision as a street-level practice which can be studied across national contexts suggesting the case for the exploration of various perspectives derived from the existing literature...

  11. Biomarkers, dementia, and public health.

    Science.gov (United States)

    Wright, C F; Hall, A; Matthews, F E; Brayne, C

    2009-10-01

    Public health is defined as the organized efforts of society to improve health. This is often framed in terms of prevention, with primary, secondary, and tertiary prevention representing, respectively, fundamental prevention through understanding of causation, to alteration of natural history, through understanding of pathophysiological mechanisms and palliation. Biomarkers play a role in all of these levels of prevention of dementias. The clearest application of biomarkers from a public health perspective is in the setting of screening. Screening has particular meaning for public health and includes early detection as a core element, coupled with treatments or preventative actions to reduce the burden of disease. Here, we will cover the range of evidence required if biomarkers are to play a part in population prevention of dementia, including scientific and technical aspects together with ethical, legal, and social considerations. Ensuring research activity that addresses these wider perspectives is essential.

  12. 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 ...

  13. Aspiration Levels of Certified Aspiring and Incumbent Female and Male Public School Administrators.

    Science.gov (United States)

    Pavan, Barbara Nelson

    To determine if women or men have lower aspiration levels for school administrative positions, male and female administrative certificate holders were asked for their ultimate career goal. The most frequent response was superintendent (36 percent), followed by elementary principal, out of education, and professor (12 percent for each choice). The…

  14. 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...

  15. 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.

  16. 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 ...

  17. 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…

  18. 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…

  19. Auditing surgical service provision at a South African tertiary institution

    African Journals Online (AJOL)

    Conclusion: The HEMR system enabled the Pietermaritzburg Metropolitan Department of Surgery to quantify the burden of surgical disease and map district referral patterns. Thirty percent of operative procedures performed were assessed as district-level operations. Potentially correctable deficits identified within the tertiary ...

  20. Learning Assessment in Tertiary Business Education with Revised Taxonomy

    Science.gov (United States)

    Hossain, Md. Shajjad

    2017-01-01

    The goal of this study was to evaluate the assessment criteria of learning in tertiary education of Bangladesh. The study was aimed at identifying percentage of questions during learning assessment of business graduates following cognitive levels of Bloom's in revised Taxonomy and to test whether there was any significant difference in the…

  1. Sexual behaviour among students in tertiary institutions in Kano ...

    African Journals Online (AJOL)

    Conclusion: In the light of the high level of sexual activity detected, it is recommended that family life or sexuality education, starting early, through primary, secondary and tertiary education be institutionalised. This is to equip our youths with correct information to enable them make informed choices about responsible sexual ...

  2. Statistical air quality predictions for public health surveillance: evaluation and generation of county level metrics of PM2.5 for the environmental public health tracking network.

    Science.gov (United States)

    Vaidyanathan, Ambarish; Dimmick, William Fred; Kegler, Scott R; Qualters, Judith R

    2013-03-14

    The Centers for Disease Control and Prevention (CDC) developed county level metrics for the Environmental Public Health Tracking Network (Tracking Network) to characterize potential population exposure to airborne particles with an aerodynamic diameter of 2.5 μm or less (PM(2.5)). These metrics are based on Federal Reference Method (FRM) air monitor data in the Environmental Protection Agency (EPA) Air Quality System (AQS); however, monitor data are limited in space and time. In order to understand air quality in all areas and on days without monitor data, the CDC collaborated with the EPA in the development of hierarchical Bayesian (HB) based predictions of PM(2.5) concentrations. This paper describes the generation and evaluation of HB-based county level estimates of PM(2.5). We used three geo-imputation approaches to convert grid-level predictions to county level estimates. We used Pearson (r) and Kendall Tau-B (τ) correlation coefficients to assess the consistency of the relationship, and examined the direct differences (by county) between HB-based estimates and AQS-based concentrations at the daily level. We further compared the annual averages using Tukey mean-difference plots. During the year 2005, fewer than 20% of the counties in the conterminous United States (U.S.) had PM(2.5) monitoring and 32% of the conterminous U.S. population resided in counties with no AQS monitors. County level estimates resulting from population-weighted centroid containment approach were correlated more strongly with monitor-based concentrations (r = 0.9; τ = 0.8) than were estimates from other geo-imputation approaches. The median daily difference was -0.2 μg/m(3) with an interquartile range (IQR) of 1.9 μg/m(3) and the median relative daily difference was -2.2% with an IQR of 17.2%. Under-prediction was more prevalent at higher concentrations and for counties in the western U.S. While the relationship between county level HB-based estimates and AQS-based concentrations is

  3. 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

  4. 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.

  5. 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

  6. A Case Study of the Librarian-Initiated Publications Discovery Activities in State Level Digital Depositories in the United States

    Directory of Open Access Journals (Sweden)

    Chi-Shiou Lin

    2008-12-01

    Full Text Available This article describes the novel phenomenon of librarian-initiated publications discovery (LIPD in state-level digital depositories in the United States. LIPD is a series of actions taken by digital depository librarians to discover and inspect government Web sites and select Web content qualifying as government publications for inclusion in the state depositories. In a current popular model in which states employ OCLC Digital Archive™ for the depositories, the power of content selection has shifted from government agencies (content producers to digital depositories. This study systematically documented and compared the LIPD actions in four case states and developed a LIPD process model for descriptive and analytic purposes. It also discusses the impacts and challenges facing the changing practices in preserving government information as historical record. [Article content in Chinese

  7. A theory of the availability and level of consumer protection in online and mobile payments for public economic services

    Directory of Open Access Journals (Sweden)

    Luminiţa Ionescu

    2013-06-01

    Full Text Available The mainstay of the paper is formed by an analysis of the factors that influence the community use of mobile payment for e-Government services, the use of mobile payment for the exchange of government goods and services, the types of e-Government services for which mobile payment is suitable, and real and perceived risks associated with mobile financial services. This paper presents a theory of the level of consumer protection and especially the availability of online payment systems and mobile public economic services, and highlights the use of Internet technology to provide effective and efficient public services. We underline the need to configure citizen-centric government services, accessibility challenges associated with the use of mobile, and diverse and transient nature of mobile technology use.

  8. 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......Security is both in academic and popular discourses often depicted as the opposition to violence, fear of violence and insecurity in general. In this paper I intent to focus on the politics of as well as the social implications of security governance - that is governing and surveillance practices...

  9. Anxiety levels among Turkish public transportation drivers: a relation to restless legs syndrome?

    Science.gov (United States)

    Ozder, Aclan; Eker, Hasan Huseyin

    2014-01-01

    The aim of this study was to estimate the prevalence of individuals who are at high risk for state and trait anxiety as well as to investigate the relationship of anxiety levels of urban transportation drivers from Istanbul, Turkey with restless legs syndrome (RLS). The data was gathered between April 2013 and June 2013 by the use of a questionnaire prepared for the purpose of this study, completed anonymously. Restless leg syndrome and anxiety level were evaluated in the group; data obtained was analyzed using the SPSS version 16. Chi-square, correlation and student-t tests were used. Restless leg syndrome symptoms were determined by a self-assessment questionnaire, including the International Restless Legs Syndrome Study Group (IRLSSG) diagnostic criteria, to determine RLS symptoms and Spielberger State-Trait Anxiety Inventory (STAI) to determine anxiety levels of the participants. In the present study, the four RLS criteria were reported in 31.2%. STAI-state and STAI-trait scores were 40.82 ± 9.55 and 42.99 ± 8.54 respectively. The state and trait anxiety mean scores were different among participants with RLS in this study (p < 0.05). It was found a significant difference between tobacco usage and state anxiety (p < 0.05). There were a significant difference between RLS and age, number of cigarettes daily consumed and employment time (p < 0.05). The state and trait anxiety scores were found high among bus drivers with RLS in this study. PMID:25035782

  10. Developing a model to assess community-level risk of oral diseases for planning public dental services in Australia.

    Science.gov (United States)

    de Silva, Andrea M; Gkolia, Panagiota; Carpenter, Lauren; Cole, Deborah

    2016-03-31

    Poor oral health is a chronic condition that can be extremely costly to manage. In Australia, publicly funded dental services are provided to community members deemed to be eligible-those who are socio-economically disadvantaged or determined to be at higher risk of dental disease. Historically public dental services have nominally been allocated based on the size of the eligible population in a geographic area. This approach has been largely inadequate for reducing disparities in dental disease, primarily because the approach is treatment-focused, and oral health is influenced by a variety of interacting factors. This paper describes the developmental process of a multi-dimensional community-level risk assessment model, to profile a community's risk of poor oral health. A search of the evidence base was conducted to identify robust frameworks for conceptualisation of risk factors and associated performance indicators. Government and other agency websites were also searched to identify publicly available data assets with items relevant to oral diseases. Data quality and analysis considerations were assessed for the use of mixed data sources. Several frameworks and associated indicator sets (twelve national and eight state-wide data collections with relevant indicators) were identified. Determination of the system inputs for the Model were primarily informed by the World Health Organisation's (WHO) operational model for an Integrated Oral Health-Chronic Disease Prevention System, and Australia's National Oral Health Plan 2004-2013. Data quality and access informed the final selection of indicators. Despite limitations in the quality and regularity of data collections, there are numerous data sources available that provide the required data inputs for community-level risk assessment for oral health. Assessing risk in this way will enhance our ability to deliver appropriate public oral health care services and address the uneven distribution of oral disease across the

  11. 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

  12. Multiobjective Level-Wise Scientific Workflow Optimization in IaaS Public Cloud Environment

    Directory of Open Access Journals (Sweden)

    Phyo Thandar Thant

    2017-01-01

    Full Text Available Cloud computing in the field of scientific applications such as scientific big data processing and big data analytics has become popular because of its service oriented model that provides a pool of abstracted, virtualized, dynamically scalable computing resources and services on demand over the Internet. However, resource selection to make the right choice of instances for a certain application of interest is a challenging problem for researchers. In addition, providing services with optimal performance at the lowest financial resource deployment cost based on users’ resource selection is quite challenging for cloud service providers. Consequently, it is necessary to develop an optimization system that can provide benefits to both users and service providers. In this paper, we conduct scientific workflow optimization on three perspectives: makespan minimization, virtual machine deployment cost minimization, and virtual machine failure minimization in the cloud infrastructure in a level-wise manner. Further, balanced task assignment to the virtual machine instances at each level of the workflow is also considered. Finally, system efficiency verification is conducted through evaluation of the results with different multiobjective optimization algorithms such as SPEA2 and NSGA-II.

  13. 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

  14. 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

    2015-04-01

    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. 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. 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. 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 respondents with degree-level education

  15. 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.

  16. Public versus Private Education in Hawaii

    Directory of Open Access Journals (Sweden)

    Antonina Espiritu

    2001-10-01

    Full Text Available This study presents a time-series evidence on the timing and degree of feedback relationship between participation in education and income growth in Hawaii. Using the unrestricted vector autoregression approach and two related measures of linear dependence and feedback, the results suggest that across all educational levels, i.e., K-12 and tertiary, participation in public education could be a good predictor of income growth in Hawaii. However, decomposing the feedback effect by frequency suggests that the dominance of public education over private education in explaining the variation in income growth to be concentrated mainly on the short-run to medium-run for tertiary level and long-run to permanent effect for K-12 level. Hawaii state legislature and educators should perhaps take these results as a motivation not to ignore the problems plaguing Hawaii's public schools but should work towards greater improvement and support for public education given its predicted significant overall contribution to the Hawaiian economy.

  17. 47 Economic and Financial Studies on the Public Pension System in Romania at Local and Global Level

    Directory of Open Access Journals (Sweden)

    Georgeta Dragomir

    2010-10-01

    Full Text Available The National pension system, in the light of major economic and financial transactions thattake place today, can be challenging, through the difficulties that they create and the solutions thatthey offer. This paper is a comprehensive study on the public pension system in Romania facing thecurrent global crisis, based on local case studies in an attempt to identify the main gaps and topropose viable solutions. The obtained results are based on multifactorial analysis at local level, bypersonal processing of relevant data, the evolving activity collected from a county pension facilitythat meets the characteristics of the retirement pension system nationwide.

  18. Seven years of external control of fluoride levels in the public water supply in Bauru, Sao Paulo, Brazil

    Directory of Open Access Journals (Sweden)

    Marilia Afonso Rabelo BUZALAF

    2013-01-01

    Full Text Available Fluoridation of the public water supplies is recognized as among the top ten public health achievements of the twentieth century. However, the positive aspects of this measure depend on the maintenance of fluoride concentrations within adequate levels. Objective To report the results of seven years of external control of the fluoride (F concentrations in the public water supply in Bauru, SP, Brazil in an attempt to verify, on the basis of risk/benefit balance, whether the levels are appropriate. Material and Methods From March 2004 to February 2011, 60 samples were collected every month from the 19 supply sectors of the city, totaling 4,641 samples. F concentrations in water samples were determined in duplicate, using an ion-specific electrode (Orion 9609 coupled to a potentiometer after buffering with TISAB II. After the analysis, the samples were classified according to the best risk-benefit adjustment. Results Means (±standard deviation of F concentrations ranged between 0.73±0.06 and 0.81±0.10 mg/L for the different sectors during the seven years. The individual values ranged between 0.03 and 2.63 mg/L. The percentages of the samples considered “low risk” for dental fluorosis development and of “maximum benefit” for dental caries prevention (0.55-0.84 mg F/L in the first, second, third, fourth, fifth, sixth, and seventh years of the study were 82.0, 58.5, 37.4, 61.0, 89.9, 77.3, and 72.4%, respectively, and 69.0% for the entire period. Conclusions Fluctuations of F levels were found in the public water supply in Bauru during the seven years of evaluation. These results suggest that external monitoring of water fluoridation by an independent assessor should be implemented in cities where there is adjusted fluoridation. This measure should be continued in order to verify that fluoride levels are suitable and, if not, to provide support for the appropriate adjustments.

  19. Association between education level and dentition status in Japanese adults: Japan public health center-based oral health study.

    Science.gov (United States)

    Ueno, Masayuki; Ohara, Satoko; Inoue, Manami; Tsugane, Shoichiro; Kawaguchi, Yoko

    2012-12-01

    The aim of this study was to examine whether there is an educational gradient in dentition status among Japanese adults who are under the universal public health insurance system. Subjects were 1201 community residents aged 55-75 years as of May 2005 who completed a self-administered questionnaire and had a standard clinical oral examination. Analysis focused on the association of three education levels (junior high school, senior high school, and any college or higher education) with dentition status. The proportion of subjects with 20 or more teeth (P education level after adjusting for confounders. The significant trend of these values in dental indexes indicated a poorer dentition status with a lower education level. The results suggest that the level of education has an independent impact on dentition status in a group of Japanese adults, even after taking into account oral health-related factors. Therefore, providing appropriate oral health information from an early age within a compulsory school education program appears necessary to enhance health literacy and lessen the inequalities in dental health by educational level. © 2012 John Wiley & Sons A/S.

  20. Mapping heatwave health risk at the community level for public health action.

    Science.gov (United States)

    Buscail, Camille; Upegui, Erika; Viel, Jean-François

    2012-09-13

    Climate change poses unprecedented challenges, ranging from global and local policy challenges to personal and social action. Heat-related deaths are largely preventable, but interventions for the most vulnerable populations need improvement. Therefore, the prior identification of high risk areas at the community level is required to better inform planning and prevention. We aimed to demonstrate a simple and flexible conceptual framework relying upon satellite thermal data and other digital data with the goal of easily reproducing this framework in a variety of urban configurations. The study area encompasses Rennes, a medium-sized French city. A Landsat ETM + image (60 m resolution) acquired during a localized heatwave (June 2001) was used to estimate land surface temperature (LST) and derive a hazard index. A land-use regression model was performed to predict the LST. Vulnerability was assessed through census data describing four dimensions (socio-economic status, extreme age, population density and building obsolescence). Then, hazard and vulnerability indices were combined to deliver a heatwave health risk index. The LST patterns were quite heterogeneous, reflecting the land cover mosaic inside the city boundary, with hotspots of elevated temperature mainly observed in the city center. A spatial error regression model was highly predictive of the spatial variation in the LST (R² = 0.87) and was parsimonious. Three land cover descriptors (NDVI, vegetation and water fractions) were negatively linked with the LST. A sensitivity analysis (based on an image acquired on July 2000) yielded similar results. Southern areas exhibited the most vulnerability, although some pockets of higher vulnerability were observed northeast and west of the city. The heatwave health risk map showed evidence of infra-city spatial clustering, with the highest risks observed in a north-south central band. Another sensitivity analysis gave a very high correlation between 2000 and

  1. Mapping heatwave health risk at the community level for public health action

    Directory of Open Access Journals (Sweden)

    Buscail Camille

    2012-09-01

    Full Text Available Abstract Background Climate change poses unprecedented challenges, ranging from global and local policy challenges to personal and social action. Heat-related deaths are largely preventable, but interventions for the most vulnerable populations need improvement. Therefore, the prior identification of high risk areas at the community level is required to better inform planning and prevention. We aimed to demonstrate a simple and flexible conceptual framework relying upon satellite thermal data and other digital data with the goal of easily reproducing this framework in a variety of urban configurations. Results The study area encompasses Rennes, a medium-sized French city. A Landsat ETM + image (60 m resolution acquired during a localized heatwave (June 2001 was used to estimate land surface temperature (LST and derive a hazard index. A land-use regression model was performed to predict the LST. Vulnerability was assessed through census data describing four dimensions (socio-economic status, extreme age, population density and building obsolescence. Then, hazard and vulnerability indices were combined to deliver a heatwave health risk index. The LST patterns were quite heterogeneous, reflecting the land cover mosaic inside the city boundary, with hotspots of elevated temperature mainly observed in the city center. A spatial error regression model was highly predictive of the spatial variation in the LST (R2 = 0.87 and was parsimonious. Three land cover descriptors (NDVI, vegetation and water fractions were negatively linked with the LST. A sensitivity analysis (based on an image acquired on July 2000 yielded similar results. Southern areas exhibited the most vulnerability, although some pockets of higher vulnerability were observed northeast and west of the city. The heatwave health risk map showed evidence of infra-city spatial clustering, with the highest risks observed in a north–south central band. Another sensitivity analysis gave

  2. 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.

  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. 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.

  5. Harmonic allocation of authorship credit: source-level correction of bibliometric bias assures accurate publication and citation analysis.

    Directory of Open Access Journals (Sweden)

    Nils T Hagen

    Full Text Available Authorship credit for multi-authored scientific publications is routinely allocated either by issuing full publication credit repeatedly to all coauthors, or by dividing one credit equally among all coauthors. The ensuing inflationary and equalizing biases distort derived bibliometric measures of merit by systematically benefiting secondary authors at the expense of primary authors. Here I show how harmonic counting, which allocates credit according to authorship rank and the number of coauthors, provides simultaneous source-level correction for both biases as well as accommodating further decoding of byline information. I also demonstrate large and erratic effects of counting bias on the original h-index, and show how the harmonic version of the h-index provides unbiased bibliometric ranking of scientific merit while retaining the original's essential simplicity, transparency and intended fairness. Harmonic decoding of byline information resolves the conundrum of authorship credit allocation by providing a simple recipe for source-level correction of inflationary and equalizing bias. Harmonic counting could also offer unrivalled accuracy in automated assessments of scientific productivity, impact and achievement.

  6. Educational Levels and Risk of Suicide in Japan: The Japan Public Health Center Study (JPHC) Cohort I.

    Science.gov (United States)

    Kimura, Takashi; Iso, Hiroyasu; Honjo, Kaori; Ikehara, Satoyo; Sawada, Norie; Iwasaki, Motoki; Tsugane, Shoichiro

    2016-06-05

    Suicide rates have been related to educational level and other socioeconomic statuses. However, no prospective study has examined the association between educational level and the risk of suicide in Japan. We examined the association of education level and suicide risk in a population-based cohort of Japanese men and women aged 40-59 years in the Japan Public Health Center-based Prospective Study Cohort I. In the baseline survey initiated in 1990, a total of 46 156 subjects (21 829 men and 24 327 women) completed a self-administered questionnaire, which included a query of educational level, and were followed up until the end of December 2011. Educational levels were categorized into four groups (junior high school, high school, junior or career college, and university or higher education). During a median follow-up of 21.6 years, the hazard ratios (HRs) and 95% confidence intervals (CIs) of suicide according to educational level were estimated using the Cox proportional hazards regression model adjusted for age; study area; previous history of stroke, ischemic heart disease, or cancer; self-reported stress; alcohol consumption; smoking; living with spouse; and employment status. A total of 299 deaths attributed to suicide occurred. The HR for university graduates or those with higher education versus junior high school graduates was 0.47 (95% CI, 0.24-0.94) in men, and that for high school graduates versus junior high school graduates was 0.44 (95% CI, 0.24-0.79) in women. High educational levels were associated with a reduced risk of suicide for both Japanese men and women.

  7. Tensions in Learner Support and Tutor Support in Tertiary Web-based English Education in China

    National Research Council Canada - National Science Library

    Tong Wang

    2005-01-01

      Based on the findings of a national survey conducted in 2004 designed to examine the support systems for both learners and tutors engaged in tertiary-level Web-based English education in mainland...

  8. Tertiary hypothyroidism in a dog

    Directory of Open Access Journals (Sweden)

    Shiel Robert E

    2007-02-01

    Full Text Available A nine-year-old male entire Labrador was diagnosed with pituitary dependent hyperadrenocorticism. Following seven months of successful mitotane therapy, the dog presented with marked weight gain, seborrhoea and alopecia. Routine clinicopathological analyses revealed marked hypercholesterolaemia. Serum total and free thyroxine (T4 concentrations were below their respective reference ranges. Serum thyroid stimulating hormone (cTSH concentration was within reference range. TSH and thyrotropin releasing hormone (TRH response tests revealed adequate stimulation of total T4 in both, and cTSH in the latter test. Magnetic resonance imaging revealed a mass arising from the pituitary fossa, with suprasellar extension. A diagnosis of tertiary hypothyroidism was made. Following four weeks of levothyroxine therapy, circulating cholesterol concentration had declined, weight loss had ensued and dermatological abnormalities had improved. Euthanasia was performed four months later due to the development of neurological signs. A highly infiltrative pituitary adenoma, with effacement of the overlying hypothalamus was identified on post mortem examination. Tertiary hypothyroidism has not been previously reported in dogs.

  9. 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

  10. 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

  11. A Call for Further Research on the Impact of State-Level Immigration Policies on Public Health

    Science.gov (United States)

    Getrich, Christina M.; Quezada, Julio C.; Guay, Amanda; Michalowski, Raymond J.; Henley, Eric

    2012-01-01

    Arizona’s Support Our Law Enforcement and Safe Neighborhoods Act, signed into law in April 2010, is already adversely affecting public health in the state. Our findings from a study on childhood obesity in Flagstaff suggest that the law changed health-seeking behaviors of residents of a predominantly Latino neighborhood by increasing fear, limiting residents’ mobility, and diminishing trust of officials. These changes could exacerbate barriers to healthy living, limit access to care, and affect the overall safety of the neighborhood. Documentation of the on-the-ground impact of Arizona's law and similar state-level immigration policies is urgently needed. To inform effective policymaking, such research must be community engaged and include safety measures beyond the usual protocols. PMID:22594736

  12. 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 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 school for over two years, and having a School-Based Health Center (SBHC) in the building. No known study has examined the contribution of school-level effects to contraceptive use in a dataset

  13. GRASr2 evaluation of aliphatic acyclic and alicyclic terpenoid tertiary alcohols and structurally related substances used as flavoring ingredients.

    Science.gov (United States)

    Marnett, Lawrence J; Cohen, Samuel M; Fukushima, Shoji; Gooderham, Nigel J; Hecht, Stephen S; Rietjens, Ivonne M C M; Smith, Robert L; Adams, Timothy B; Bastaki, Maria; Harman, Christie L; McGowen, Margaret M; Taylor, Sean V

    2014-04-01

    This publication is the 1st in a series of publications by the Expert Panel of the Flavor and Extract Manufacturers Assoc. summarizing the Panel's 3rd re-evaluation of Generally Recognized as Safe (GRAS) status referred to as the GRASr2 program. In 2011, the Panel initiated a comprehensive program to re-evaluate the safety of more than 2700 flavor ingredients that have previously met the criteria for GRAS status under conditions of intended use as flavor ingredients. Elements that are fundamental to the safety evaluation of flavor ingredients include exposure, structural analogy, metabolism, pharmacokinetics, and toxicology. Flavor ingredients are evaluated individually and in the context of the available scientific information on the group of structurally related substances. Scientific data relevant to the safety evaluation of the use of aliphatic acyclic and alicyclic terpenoid tertiary alcohols and structurally related substances as flavoring ingredients are evaluated. The group of aliphatic acyclic and alicyclic terpenoid tertiary alcohols and structurally related substances was reaffirmed as GRAS (GRASr2) based, in part, on their rapid absorption, metabolic detoxication, and excretion in humans and other animals; their low level of flavor use; the wide margins of safety between the conservative estimates of intake and the no-observed-adverse effect levels determined from subchronic studies and the lack of significant genotoxic and mutagenic potential. © 2014 Institute of Food Technologists®

  14. Microstructural Characterization of Alloy 617 Crept into the Tertiary Regime

    Energy Technology Data Exchange (ETDEWEB)

    Lillo, Thomas Martin [Idaho National Laboratory; Wright, Richard Neil [Idaho National Laboratory

    2015-07-01

    The microstructure of Alloy 617 was characterized following creep tests interrupted at total creep strains ranging from 2-20%. A range of creep temperatures (750-1000oC) and initial creep stresses (10-145 MPa) produced creep test durations ranging from 1 to 5800 hours. Image analysis of optical photomicrographs on longitudinal sections of the gage length was used to document the fraction of creep porosity as a function of creep parameters. Creep porosity was negligible below tertiary creep strains of 10% and increased with tertiary creep strain, thereafter. For a given temperature and total creep strain, creep porosity increased with decreasing creep stress. Creep porosity increased linearly with duration of the creep experiment. TEM performed on the gage sections did not reveal significant creep cavity formation on grain boundaries at the sub-micron level. It was concluded that the onset of tertiary creep did not result from creep cavitation and more likely arose due to the formation of low energy dislocation substructures with increasing tertiary strain.

  15. Determination of tobacco smoke exposure by plasma cotinine levels in infants and children attending urban public hospital clinics.

    Science.gov (United States)

    Dempsey, Delia A; Meyers, Matthew J; Oh, Sam S; Nguyen, Elizabeth A; Fuentes-Afflick, Elena; Wu, Alan H B; Jacob, Peyton; Benowitz, Neal L

    2012-09-01

    OBJECTIVE To determine the prevalence of secondhand smoke (SHS) exposure among infants and young children who received preventive care at pediatric preventative care clinics associated with an urban public hospital. Cotinine, a metabolite of nicotine, has been used to study SHS exposure in population-based studies of children 3 years of age or older. DESIGN Retrospective study using a convenience sample. SETTING Urban county pediatric primary care clinics in San Francisco, California. PARTICIPANTS A total of 496 infants and children (mean [SD] age, 2.4 [1.9] years). INTERVENTIONS Discarded plasma samples (which were routinely collected for lead screening) were tested, and medical records were reviewed, for SHS exposure. MAIN OUTCOME MEASURE Secondhand smoke exposure based on cotinine plasma level and history of exposure in the medical record. RESULTS Thirteen percent of parents reported that their child was exposed to SHS, yet biochemical testing detected cotinine in 55% of samples, at a geometric mean (SD) of 0.23 (3.55) ng/mL. There were no significant sex or age differences. African American children had much higher mean cotinine levels than did Latino children (multiplicative factor change in cotinine, 6.01 ng/ml [95% Cl, 4.49-8.05 ng/ml] [correction]. CONCLUSION In a city with a low smoking rate (12%) and public smoking bans, we documented 55% exposure among infants and young children, using a plasma biomarker, compared with 13% exposure reported by parents. Because SHS is associated with significant respiratory diseases and parents underreport exposure, routine biochemical screening should be considered as a tool to identify and reduce SHS exposure.

  16. Pharmaceutical care and medication adherence in management of psychosis in a Nigerian tertiary hospital

    Science.gov (United States)

    Danladi, Jonathan; Falang, Kakjing D.; Barde, Raymond A.; Jimam, Nanlok S.; Dangiwa, Dauda A.; Jimoh, Hafsat O.

    2013-01-01

    Objective: The primary objective of this study is to examine the medication adherence levels (as a function of pharmaceutical care) and its contributing factors in schizophrenic patients receiving antipsychotic drugs. Methods: This was a cross-sectional study administering a structured questionnaire to 231 patients. Adherence was measured through patient self-reporting. Association between independent variables and adherence to antipsychotics were measured through odds ratios (OR) in the univariate analysis while the best predictors of adherence were determined through the multiple logistic regressions. Findings: Adherence level was found to be 65.8% (95% confidence interval [CI]: 59.3-71.9%). The following factors were identified to be associated with adherence in the univariate analysis: age (OR 1.088), sex (OR 1.231), employment (OR 0.366), marital status (singles, OR 0.022), drug adherence counseling (OR 11.641), twice a day frequency (OR 8.434), alcohol non-intake (OR 1.469), educational level (primary OR 1.9312, secondary OR 11.022, tertiary OR 4.771), occupation (public servant 6.273). In the multivariate analysis, age, three times a day frequency of drug intake, singles and educational levels such as primary, secondary or tertiary school, strongly affected adherence (P < 0.05). Conclusion: Although patients adherence level was high (65.8%), there is a need to emphasize that pharmacists spend more time in counseling and educating patients, especially younger ones on drug adherence before any antipsychotic medications are dispensed. Furthermore, patients should be taught the use of adherence devices such as reminders so that adherence to antipsychotic medications can be optimized. PMID:24991609

  17. 1014 enforcement of entrepreneurship in the public and private schools: high and medium level career in the city of Villavicencio, Meta

    Directory of Open Access Journals (Sweden)

    Dora Navarro-Quintero

    2012-12-01

    development and growth of nations. The exploratory and descriptive research design appropriate experimental is-not where the population is composed of 55 public and private institutions of secondary and intermediate vocational level in the city of Villavicencio - Meta

  18. Three necessary conditions for progress in low-level waste management: Political commitment, managerial skill, and public involvement

    Energy Technology Data Exchange (ETDEWEB)

    Wiltshire, S.

    1989-11-01

    Since the late 1970`s many people have worked hard to resolve the question of how this nation will manage its low-level radioactive waste. However, many problems persist. No new disposal facilities have been built since the early 1970`s and some states do not appear to be making much headway on the problem. The current alignment of states in compacts may lead to the designation of more sites than necessary, thus wasting resources and sites that might be used for something else and causing dissension and disruption in more communities than is really necessary. However, progress has been made: low-level waste is on the political agenda in an effective way in many states; much more management attention and skill are being devoted to waste management; and more experience has increased the understanding and skill necessary for management and government officials to be able to involve the public effectively in waste management decision-making. What conditions have produced this progress? What has been learned from ten years of work on the problem? How can these lessons be applied to future decisions, including those about the cleanup and isolation of defense waste? The paper attempts to answer these questions.

  19. Private and Public EFL Teachers’ Level of Burnout and its Relationship with their Emotional Intelligence: A Comparative Study

    Directory of Open Access Journals (Sweden)

    Akbar Heiran

    2015-07-01

    Full Text Available The study aimed to investigate EFL teachers’ level of burnout and its relationship with their emotional intelligence in both Iranian Public Schools (IPS and Private Language Institutes (PLI contexts. To this end, quantitative method of gathering data was used. 100 EFL teachers teaching at IPS and PLI contexts participated in this study. They were asked to complete Maslach Burnout Inventory-Educators Survey and Revised Emotional Intelligence Scale. Data were analyzed using Correlation, Multiple Regression, and T-tests. The results of the study indicated a significant relationship between emotional intelligence and burnout among EFL teachers teaching at both IPS and PLI contexts. However, the results of multiple regression analyses indicated different patterns of relationships among the subscales of the two questionnaires for IPS and PLI teachers. The result of the T-tests also showed that the level of burnout among IPS teachers was higher than that of PLI teachers. The overall results of the study were discussed and the theoretical implications for further studies and the practical recommendations for EFL teacher education programs were made.

  20. Accounting for cross-country differences in intergenerational earnings persistence: The impact of taxation and public education expenditure

    OpenAIRE

    Holter, Hans A.

    2011-01-01

    I document a strong negative cross-country correlation between intergenerational earnings persistence and measures of tax progressivity and level, and between intergenerational earnings persistence and public expenditure on tertiary education. To explain these correlations, I then develop an intergenerational life-cycle model of human capital accumulation and earnings that features progressive taxation, public education expenditure, and borrowing constraints among the determinants of earnings...

  1. Levels and Patterns of Objectively Assessed Physical Activity and Compliance with Different Public Health Guidelines in University Students.

    Directory of Open Access Journals (Sweden)

    Natalia María Arias-Palencia

    Full Text Available 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.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.No sex differences in total PA were found. University students were more sedentary during weekend days than weekdays (p<0.05. Only 30.3% of participants accumulated 30 min/day at least five days a week of MVPA. A total of 5.4% of students 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.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.

  2. 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

  3. 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.

  4. 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

  5. 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.

  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. 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

  8. WIDENING ACCESS TO TERTIARY EDUCATION FOR WOMEN IN GHANA THROUGH DISTANCE EDUCATION

    OpenAIRE

    KWAPONG, Olivia Adwoa Tiwaah Frimpong

    2004-01-01

    Distance education (DE) is seen as a tool for widening access to education at all levels. It is an educational tool that breaks most of the divides in education – age, gender, race, income, space, time etc. For the past decades, irrespective of the extensive expansion of tertiary institutions in the country, provision of tertiary education in Ghana has not been adequate enough to absorb all qualified applicants. This situation has peculiar effect on women who for socio-cultural factors drop ...

  9. 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.

  10. 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.

  11. Air nicotine levels in public places in ahmedabad, India: before and after implementation of the smoking ban.

    Science.gov (United States)

    Yang, Jingyan; Modi, Bhavesh V; Tamplin, Stephen A; Aghi, Mira B; Dave, Paresh V; Cohen, Joanna E

    2015-01-01

    To compare air nicotine levels in public places in Ahmedabad, India, before (June 2008) and after (January, 2010) the implementation of a comprehensive smoking ban which was introduced in October 2008. Air nicotine concentrations were measured by sampling of vapor-phase nicotine using passive monitors. In 2008 (baseline), monitors were placed for 5-7 working days in 5 hospitals, 10 restaurants, 5 schools, 5 government buildings, and 10 entertainment venues, of which 6 were hookah bars. In 2010 (follow-up), monitors were placed in 35 similar venues for the same duration. Comparison of the overall median nicotine concentration at baseline (2008) (0.06 μg/m(3) Interquartile range (IQR): 0.02-0.22) to that of follow-up (2010) (0.03 μg/m(3) IQR: 0.00-0.13), reflects a significant decline (% decline = 39.7, P = 0.012) in exposure to second-hand smoke (SHS). The percent change in exposure varied by venue-type. The most significant decrease occurred in hospitals, from 0.04 μg/m(3) at baseline to concentrations under the limit of detection at follow-up (%decline = 100, P places after the smoke-free legislation came into force. However, nicotine concentrations were still detected in most of the venues indicating imperfect compliance with the comprehensive ban.

  12. RISK ANALYSIS AND INTERNAL CONTROL ASSESSMENT - PREMISES FOR IMPROVING MANAGEMENT AT THE LEVEL OF ROMANIAN PUBLIC ENTITIES

    OpenAIRE

    CRISTINA MARIA VOINEA; VIOLETA STATE

    2015-01-01

    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...

  13. 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

  14. misconception of emergency contraception among tertiary school ...

    African Journals Online (AJOL)

    formation of reproductive health clubs in our tertiary institutions and training of peer group educators in all our communities ... social issue in.the developing worldl. In Nigeria .... and alcohol (illicit gin and stout-6. 1%). .... They are cheap, readily.

  15. Tertiary oil recovery: potential application and constraints

    Energy Technology Data Exchange (ETDEWEB)

    Geffen, C. A.

    1978-06-01

    The technology of tertiary oil recovery methods is described and potential economic and environmental constraints to future commercial application are identified. Oil recoverable by tertiary techniques represents a domestic resource of between 11- and 42-billion barrels. Estimates of additional oil supplies from tertiary methods by the year 2000 range from 1 to 8 million barrels per day, depending on the price of oil and the rate of technological development. The principal constraints to large-scale application of tertiary methods at the present time include environmental, economic and technological concerns. Regulatory action associated with the Clean Air Act Amendments of 1977 currently delay the expansion of thermal recovery operations in California and may discourage future projects. The high production costs of tertiary projects also hamper process implementation. Further testing and research is necessary to develop the technology of tertiary recovery methods and prove these techniques successful on a field-wide scale. To enable tertiary oil recovery to play a significant role in augmenting domestic energy supplies, further research and development is necessary. More accurate methods of determining reservoir structure and residual oil saturations are required, as well as means for assuring the technical feasibility and success of a tertiary method in different reservoir types. Technical process limitations must also be resolved. The severity of potential environmental impacts and constraints identified in this report should be determined. These concerns include the air pollutant emissions from steam generation in thermal processes; acceptable methods of brine disposal; damage due to runoff or accidental discharge of oil-rich chemicals into surface waters; the impacts of fluid injection on deep aquifers and the prevailing geological structure; and an adequate supply of high quality fresh water.

  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. 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,…

  18. 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.

  19. Tertiary Logistics in the Focus of All Logistics

    OpenAIRE

    Ratko Zelenika; Mirjana Grèiæ; Helga Pavliæ Skender

    2008-01-01

    Trade logistics, traffic logistics, transport logistics and warehouse logistics are just some of the tertiary logistics which enables production processes of all economic sector products and services. Tertiary logistics representing the tertiary economic sector is the most sofisticated and the most important logistics due to the characteristics of the tertiary sector as a service sector that promotes business conditions in all economic sectors. Accordingly, tertiary logistics has a crucial ro...

  20. Is increasing complexity of algorithms the price for higher accuracy? virtual comparison of three algorithms for tertiary level management of chronic cough in people living with HIV in a low-income country

    Directory of Open Access Journals (Sweden)

    Mukabatsinda Constance

    2012-01-01

    Full Text Available Abstract Background The algorithmic approach to guidelines has been introduced and promoted on a large scale since the 1970s. This study aims at comparing the performance of three algorithms for the management of chronic cough in patients with HIV infection, and at reassessing the current position of algorithmic guidelines in clinical decision making through an analysis of accuracy, harm and complexity. Methods Data were collected at the University Hospital of Kigali (CHUK in a total of 201 HIV-positive hospitalised patients with chronic cough. We simulated management of each patient following the three algorithms. The first was locally tailored by clinicians from CHUK, the second and third were drawn from publications by Médecins sans Frontières (MSF and the World Health Organisation (WHO. Semantic analysis techniques known as Clinical Algorithm Nosology were used to compare them in terms of complexity and similarity. For each of them, we assessed the sensitivity, delay to diagnosis and hypothetical harm of false positives and false negatives. Results The principal diagnoses were tuberculosis (21% and pneumocystosis (19%. Sensitivity, representing the proportion of correct diagnoses made by each algorithm, was 95.7%, 88% and 70% for CHUK, MSF and WHO, respectively. Mean time to appropriate management was 1.86 days for CHUK and 3.46 for the MSF algorithm. The CHUK algorithm was the most complex, followed by MSF and WHO. Total harm was by far the highest for the WHO algorithm, followed by MSF and CHUK. Conclusions This study confirms our hypothesis that sensitivity and patient safety (i.e. less expected harm are proportional to the complexity of algorithms, though increased complexity may make them difficult to use in practice.

  1. 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...

  2. 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.

  3. MISR Level 3 Global Cloud public Product in netCDF format covering a year V002

    Data.gov (United States)

    National Aeronautics and Space Administration — The Level 3 Yearly Component Global Cloud Product is a global summary of the Level 1 and Level 2 cloud parameters of interest averaged over a year and reported on a...

  4. Knowledge and attitudes toward epilepsy among primary, secondary and tertiary level teachers Atitude e percepção sobre epilepsia entre professores de primeiro, segundo e terceiro graus

    Directory of Open Access Journals (Sweden)

    Fábio Galvão Dantas

    2001-09-01

    Full Text Available The attitudes toward people with epilepsy are influenced by the degree of knowledge of the condition. Teachers usually do not receive any formal instruction on epilepsy during their training. This study was done to access three hundred teachers' knowledge and attitudes toward epilepsy by answering a questionnaire in order to quantify their knowledge, attitude and practice toward epilepsy. Almost all the teachers had heard about epilepsy yet could not demonstrate discrimination among the students. Some teachers still thought that epilepsy was contagious. A few others either objected to having epileptic children in their classes or did not think that an epileptic child could achieve higher studies. The knowledge about the clinical characteristics and initial procedures to attend a person during a seizure was unsatisfactory. We conclude that schools should offer some kind of knowledge or assistance in health services and physicians must ensure that these teachers have sufficient knowledge of epilepsy. Also general public education campaigns should be encouraged in this field.As atitudes referentes a pacientes com epilepsia são influenciadas pelo grau de conhecimento acerca desta patologia. Os professores geralmente não recebem instruções formais a este respeito. Este estudo procurou avaliar o grau de conhecimento e atitude quanto à epilepsia em trezentos professores, os quais responderam um questionário que quantifica o conhecimento, atitude e prática. Quase todos os professores já tinham ouvido falar sobre epilepsia e não discriminavam seus alunos. Alguns ainda acreditavam em contágio e poucos professores referiram objeções à presença de alunos com epilepsia em suas classes ou achavam que uma criança com epilepsia não poderia se tornar um bom professor. O conhecimento quanto às características clínicas ou procedimentos iniciais diante de uma crise epiléptica foi insatisfatório. Os resultados evidenciam que escolas médicas e m

  5. 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.

  6. Topological constraints are major determinants of tRNA tertiary structure and dynamics and provide basis for tertiary folding cooperativity.

    Science.gov (United States)

    Mustoe, Anthony M; Brooks, Charles L; Al-Hashimi, Hashim M

    2014-10-01

    Recent studies have shown that basic steric and connectivity constraints encoded at the secondary structure level are key determinants of 3D structure and dynamics in simple two-way RNA junctions. However, the role of these topological constraints in higher order RNA junctions remains poorly understood. Here, we use a specialized coarse-grained molecular dynamics model to directly probe the thermodynamic contributions of topological constraints in defining the 3D architecture and dynamics of transfer RNA (tRNA). Topological constraints alone restrict tRNA's allowed conformational space by over an order of magnitude and strongly discriminate against formation of non-native tertiary contacts, providing a sequence independent source of folding specificity. Topological constraints also give rise to long-range correlations between the relative orientation of tRNA's helices, which in turn provides a mechanism for encoding thermodynamic cooperativity between distinct tertiary interactions. These aspects of topological constraints make it such that only several tertiary interactions are needed to confine tRNA to its native global structure and specify functionally important 3D dynamics. We further show that topological constraints are conserved across tRNA's different naturally occurring secondary structures. Taken together, our results emphasize the central role of secondary-structure-encoded topological constraints in defining RNA 3D structure, dynamics and folding. © The Author(s) 2014. Published by Oxford University Press on behalf of Nucleic Acids Research.

  7. Hepatitis B virus infection and vaccination status among health care workers of a tertiary care hospital in Bangladesh

    Directory of Open Access Journals (Sweden)

    Rajat Sanker Roy Biswas

    2015-01-01

    Full Text Available Background: Hepatitis B virus (HBV infection is a global public health challenge. Health care workers (HCWs have an extra risk of getting infected from their workplace. This study aimed at estimating prevalence of HBV infection and vaccination compliance among HCWs in a tertiary hospital in Chittagong, Bangladesh. Materials and Methods: Data were obtained from a stratified survey conducted in a tertiary care hospital Chittagong, Bangladesh among HCWs in the year 2012. A proportionate to size random sample was drawn per HCWs category. A structured questionnaire was used to collect data on sociodemographic characteristics and risk factors. With 10 ml collected venous blood enzyme-linked immunosorbent assay (ELISA techniques were used to test sera for hepatitis B surface antigen (HBsAg, hepatitis B surface antibody (anti-HBs, and total hepatitis B core antibody (anti-HBc. Descriptive models were used for analysis with the software SPSS-20. Results: Among the 113 participants, the overall seroprevalence of HBsAg, anti-HBs, and anti-HBc was 8%, 30.1%, and 48.7%, respectively. Fifty-four (47% subjects were vaccinated. A significantly higher prevalence of vaccination compliance rates was observed among doctors (100% and nurses (44.4% than technicians (45% and assistants (47.8%. Among the 113 subjects, 2 (22.8% doctors were anti-HBc-positive though all of them were vaccinated and 19 (52.8% nurses, 7 (17.5% technicians, and 6 (30.0% assistants were anti-HBc-positive. Among all the participants, 30.7% HCWs were susceptible to infection of HBV and could potentially be protected through vaccination. Conclusions: A significant numbers of HCWs are unvaccinated even at health care center of tertiary care level suggesting a need for early implementation of HBV vaccination program.

  8. 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.

  9. 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.

  10. 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

  11. Complexity of Innovation in the Public Sector: A Workgroup-Level Analysis of Related Factors and Outcomes

    NARCIS (Netherlands)

    Arundel, A.V.; Torugsa, N.

    2015-01-01

    Complex innovation incorporates more than one innovation type. Using the number of dimensions of the ‘most significant innovation’ implemented by each public employee’s workgroup as a proxy for innovation complexity, this study explores factors that are associated with complexity and examines how

  12. Detailed analysis of electricity consumption in tertiary buildings as a basis for energy efficiency policies

    Energy Technology Data Exchange (ETDEWEB)

    Gruber, Edelgard [Fraunhofer Inst. for Systems and Innovation Research (Fraunhofer ISI) (Germany); Sofronis, Ilias [Centre for Renewable Energy Sources (CRES) (Greece); Dusee, Rinto [Weerdenburg Huisvesting Consultants (WHC) (Netherlands); Plesser, Stefan [Inst. for Building and Solar Technology (IGS), Technical Univ. Braunschweig (Germany)

    2007-07-01

    Electricity consumption in the tertiary sector is still increasing - by 3 % per year between 1995 and 2005 in the EU-25 countries - and a further increase is expected of more than 2 % per year over the next 15 years. The tertiary sector includes companies and institutions of public and private services with very heterogeneous economic and energy-related characteristics. A study of the current state of data in the tertiary sector in European countries revealed that the availability of disaggregated data on electricity consumption and its use by purpose (lighting, office equipment, ventilation, air conditioning, etc.) is poor. Building managers and decision-makers are not well enough informed about the electricity consumption structure and electricity-saving potentials. EL-TERTIARY develops a harmonised methodology for monitoring electricity consumption and applies it in more than 100 cases in 12 EU countries. Implications for dissemination and energy efficiency policies will be derived. It is regarded as important to have an exchange of experiences on these issues within the scientific community and with actors and decision-makers in order to develop efficient instruments for practical use. EL-TERTIARY is an EU Intelligent Energy project under Key Action 4 'Energy efficient equipment and products'.

  13. 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.

  14. Stress among nurses: a comparative study of two tertiary health care ...

    African Journals Online (AJOL)

    The aim of this study was to compare the levels and sources of stress between nurses working in two tertiary health care settings in Jos, Nigeria. A total of 192 nurses participated in the study, with 92 from JUTH and from 100 PSH. The Expanded Nurses Stress Scale (ENSS) was used to measure the levels of stress and ...

  15. From Ramachandran Maps to Tertiary Structures of Proteins.

    Science.gov (United States)

    DasGupta, Debarati; Kaushik, Rahul; Jayaram, B

    2015-08-27

    Sequence to structure of proteins is an unsolved problem. A possible coarse grained resolution to this entails specification of all the torsional (Φ, Ψ) angles along the backbone of the polypeptide chain. The Ramachandran map quite elegantly depicts the allowed conformational (Φ, Ψ) space of proteins which is still very large for the purposes of accurate structure generation. We have divided the allowed (Φ, Ψ) space in Ramachandran maps into 27 distinct conformations sufficient to regenerate a structure to within 5 Å from the native, at least for small proteins, thus reducing the structure prediction problem to a specification of an alphanumeric string, i.e., the amino acid sequence together with one of the 27 conformations preferred by each amino acid residue. This still theoretically results in 27(n) conformations for a protein comprising "n" amino acids. We then investigated the spatial correlations at the two-residue (dipeptide) and three-residue (tripeptide) levels in what may be described as higher order Ramachandran maps, with the premise that the allowed conformational space starts to shrink as we introduce neighborhood effects. We found, for instance, for a tripeptide which potentially can exist in any of the 27(3) "allowed" conformations, three-fourths of these conformations are redundant to the 95% confidence level, suggesting sequence context dependent preferred conformations. We then created a look-up table of preferred conformations at the tripeptide level and correlated them with energetically favorable conformations. We found in particular that Boltzmann probabilities calculated from van der Waals energies for each conformation of tripeptides correlate well with the observed populations in the structural database (the average correlation coefficient is ∼0.8). An alpha-numeric string and hence the tertiary structure can be generated for any sequence from the look-up table within minutes on a single processor and to a higher level of accuracy

  16. Public perceptions of healthcare in Singapore.

    Science.gov (United States)

    Lim, Jeremy Fy; Joshi, Veena Dhanajay

    2008-02-01

    Understanding public perceptions of healthcare delivery is important to guide policy formulation and practice as well as to identify areas where public health communication needs to be strengthened to overcome misconceptions and allay unfounded concerns. We conducted a survey of Singapore residents to determine perceptions of the affordability and quality of healthcare in Singapore. A sampling frame was drawn from the 2005/2006 edition of the telephone directory. One thousand seven hundred and eighty-three respondents were interviewed via telephone and asked to rank their agreement with statements pertaining to healthcare cost and quality on a 5-point Likert scale. Respondents were representative of the general population in ethnicity and housing type but lower income households were over-represented. 79.6% of respondents agreed that Singapore had a good healthcare system and 57.5% agreed that the government provided good and affordable healthcare to Singaporeans. The majority agreed that healthcare was generally affordable, especially at polyclinics (78%) and restructured hospitals (50%) and that the quality of healthcare in Singapore was high. Comparing primary and tertiary care, there was uniformity in the perception of quality at both levels but respondents assessed tertiary healthcare to be less affordable (P Singapore healthcare is generally regarded to be high although there are growing concerns regarding the affordability of healthcare.

  17. Local stakeholders' perspectives on improving the urban environment to reduce child pedestrian injury: implementing effective public health interventions at the local level.

    Science.gov (United States)

    Frattaroli, Shannon; Defrancesco, Susan; Gielen, Andrea C; Bishai, David M; Guyer, Bernard

    2006-01-01

    Local-level public health interventions require action from multiple agencies, organizations and individuals, yet little is known about how best to work with stakeholders to facilitate change. We sought local stakeholders' perspectives on how best to address impediments to implementing interventions designed to reduce child pedestrian injury by improving the pedestrian environment. We conducted 20 in-person, key informant interviews with people who would be the likely advocates for environmental change to improve the pedestrian environment in one US city, Baltimore, Maryland. We discuss the importance of reframing child pedestrian injury risk as a livability issue, increasing awareness about the potential impact of environmental changes to improve public safety, and the need for a formal efficient process to facilitate communication between local government and other stakeholders. These findings provide public health professionals and advocates with useful insight into how local stakeholders view the issue and their perspectives on how best to achieve change.

  18. A CEFR-based Curriculum Design for Tertiary Education Level

    Directory of Open Access Journals (Sweden)

    Abdullah ARSLAN

    2017-09-01

    Full Text Available The aim of this research was to present a possible EFL curriculum design in line with the principles on the CEFR (Common European Framework of Reference for Languages. The qualitative data of the research were obtained through the interviews with the experts at TEFL through the semi-structured interview form developed by the researcher. The participants of the research were comprised of academics majored in both TEFL and the CEFR who were selected via purposeful sampling method. In order to analyse the qualitative data of this research, the content and thematic analyses were carried out using QSR Nvivo 8. According to the findings of the research, it was pointed out that the development of four language skills in order for language learners to be able to communicate, the consistency of content for learning and teaching EFL skills with real life situations, the employment of communicative language teaching methods, strategies, and techniques, and the use of alternative testing and assessment should be taken into consideration in the process of designing and developing key components of a CEFR-based EFL curriculum.

  19. original article an innovation systems perspectives on tertiary-level ...

    African Journals Online (AJOL)

    diversified, and commercialized agricultural sector. This transformation will likely generate significant demand for agricultural professionals with new qualifications to facilitate commercialization of smallholder production, as .... classroom practices are out-of-touch with modern educational methods. Potential solutions to ...

  20. Arab EFL Learners' Writing Dilemma at Tertiary Level

    Science.gov (United States)

    Ezza, El-Sadig

    2010-01-01

    There is a general belief among researchers and speakers at conferences and symposia that Arab EFL Learners are primarily responsible for their weak writing performance. Educational policies usually evade criticism. This study is an attempt to show that educational policies can have their role in the learner's writing problems. Viz. it posits that…

  1. 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.

  2. 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 ...

  3. Challenges in Teaching Pronunciation at Tertiary Level in Bangladesh

    Directory of Open Access Journals (Sweden)

    Tanzina Tahereen

    2015-03-01

    Full Text Available Teaching pronunciation is one the most challenging parts of ELT in Bangladesh. Very few research and least attention on pronunciation teaching has instigated those challenges more. Moreover, setting an ambitious target to achieve native like pronunciation and teaching without considering the Bangladeshi context are more specific reasons for creating those problems. Therefore, this paper concentrates on the discussion of the existing condition of teaching pronunciation in Bangladesh. Consequently, it starts with presenting existing circumstances of pronunciation teaching in Bangladesh, and showing what the achievable and realistic goal should be for this situation. Then, it talks about the challenges that the teachers face while teaching pronunciation in ELT classroom. This discussion provides deep insight into those challenges which are only applicable to Bangladeshi students. Finally, the paper suggests some contextual and practical solutions to those specific problems.

  4. 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…

  5. Threshold Concepts: Impacts on Teaching and Learning at Tertiary Level

    Science.gov (United States)

    Peter, Mira; Harlow, Ann

    2014-01-01

    This project explored teaching and learning of hard-to-learn threshold concepts in first-year English, an electrical engineering course, leadership courses, and in doctoral writing. The project was envisioned to produce disciplinary case studies that lecturers could use to reflect on and refine their curriculum and pedagogy, thereby contributing…

  6. 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.

  7. [A framework for assessing essential public health nursing skills and achievement levels required for students graduating from schools that provide education for obtaining a license as a public health nurse in Japan].

    Science.gov (United States)

    Asahara, Kiyomi; Omori, Junko; Kobayashi, Maasa; Hirano, Yuko; Suzuki, Yoshimi; Arakida, Mikako; Oki, Sachiko; Okamoto, Reiko; Okuyama, Noriko; Kaihara, Itsuko; Sudo, Hiroko; Nagae, Hiroko; Miyazaki, Misako; Murashima, Sachiyo

    2010-03-01

    This study aimed to develop a framework for essential skills and the achievement levels necessary for students graduating from schools that provide education for obtaining a license as a public health nurse (PHN) in Japan. Two rounds of questionnaire-based investigations using the Delphi methodology were conducted. Subjects were 197 PHNs from municipalities or companies and 146 nurse educators from universities, colleges, junior colleges, or technical nursing schools. (1) The essential skills framework consisted of three (macro, intermediate and micro) levels. Macro-level items were based on the principle of justice, a primary pillar of health care: (A) community assessment to identify health problems; (B) solving and improving particular health problems in collaboration with people to enable them to promote their own health; (C) promoting equitable access and distribution of community resources for health and daily living. Micro-level items had four achievement levels: (I) independent; (II) instructor-guided; (III) laboratory exercise; (IV) theoretical understanding. Micro-level items for A and B had two domains for achievement: individual/family and group/community. (2) In the first round over 70% of respondents said "very important," "important" or "acceptable" for all micro-level items. In the second round, over 90% said all micro-level items fit within macro and intermediate-level items. (3) In the second round, micro-level items attained 70% consensus among PHNs and nurse educators were 71 of 93 (76.3%). Micro-level expression was used for adjustment and the final framework of essential skills yielded 3 macro, 8 intermediate and 59 micro-level items and 95 levels of achievement. (4) In the final framework, the level of achievement for "individual/family" (Macro-level A and B) was almost level I, and for "group/community" almost II or III. The number of micro-level items at level IV for C was 14 of 21 (66.7%). (5) Compared with PHNs, educators generally

  8. 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.

  9. Adapting Cooperative Learning in Tertiary ELT

    Science.gov (United States)

    Ning, Huiping

    2011-01-01

    An updated guideline for tertiary ELT in China has shifted the emphasis to the development of learners' ability to communicate in English. Using group work and getting learners actively involved in the actual use of English are highlighted more than before. This article focuses on adapting cooperative learning methods for ELT with tertiary…

  10. Tertiary Aminourea-Catalyzed Enantioselective Iodolactonization

    Science.gov (United States)

    Veitch, Gemma E.

    2010-01-01

    Binding the anion: A highly enantioselective iodolactonization of 5-hexenoic acids has been achieved using a tertiary aminourea-catalyst. The use of catalytic iodine in this process is critical to enhancing both the reactivity and enantioselectivity of the stoichiometric I+source.The mechanism is proposed to involve binding of an iodonium imidate intermediate by the H-bond donor catalyst. PMID:20803601

  11. Simple tertiary phosphines to hexaphosphane ligands: Syntheses ...

    Indian Academy of Sciences (India)

    Abstract. Designing efficient phosphorus-based ligands to make catalysts for homogeneous catalysis has been a great challenge for chemists. Despite a plethora of phosphorus ligands ranging from simple tertiary phosphines to polyphosphines are known, the enthusiasm to generate new ones is mainly due to the demand.

  12. Recruitment Of International Students Into Cameroon Tertiary ...

    African Journals Online (AJOL)

    This paper highlights the importance of Cameroon\\'s tertiary institutions\\' cooperation links with other African Universities given the rebirth of Organisation of African Unity as African Union, and the New Partnership for Africa Development (NEPAD). The present system of recruiting international students is haphazardly been ...

  13. Misconception of emergency contraception among tertiary school ...

    African Journals Online (AJOL)

    Community enlightenment about emergency contraception using specifically designed programmes, the formation of reproductive health clubs in our tertiary institutions and training of peer group educators in all our communities are advocated. Patent medicine dealers in our communities should have basic training in ...

  14. Sexual promiscuity among female undergraduates in tertiary ...

    African Journals Online (AJOL)

    The study focused on sexual promiscuity among female undergraduates and the attendant health implications. It was carried out in the tertiary institutions in Imo State using 415 final year degree students drawn from four institutions in the State. Three research questions were formulated to guide the study. The design was a ...

  15. HIV test counselling at a tertiary hospital

    African Journals Online (AJOL)

    AIDS training course presented either by the medical school or an AIDS training centre. In view of the perceived lack of training in general counselling, this would perhaps be most effective as part of a formal general counselling programme for all undergraduates. In a tertiary hospital one has the added benefit of a large.

  16. 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

  17. 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

  18. Low levels of physical activity and metabolic syndrome: cross-sectional study in the Brazilian public health system

    OpenAIRE

    Turi, Bruna Camilo; Codogno, Jamile Sanches; Fernandes, Rômulo Araújo; Monteiro, Henrique Luiz

    2016-01-01

    Abstract This study investigated whether low levels of physical activity in different domains is associated with risk factors for the occurrence of metabolic syndrome or metabolic syndrome itself. Habitual physical activity level was assessed among 963 participants, aged 50 years old or more, using Baecke’s questionnaire. Risk factors for metabolic syndrome followed the recommendations of “The IDF Consensus Worldwide Definition of the Metabolic Syndrome”. All the participants were users of th...

  19. Low levels of physical activity and metabolic syndrome: cross-sectional study in the Brazilian public health system

    OpenAIRE

    Bruna Camilo Turi; Jamile Sanches Codogno; Rômulo Araújo Fernandes; Henrique Luiz Monteiro

    2016-01-01

    Abstract This study investigated whether low levels of physical activity in different domains is associated with risk factors for the occurrence of metabolic syndrome or metabolic syndrome itself. Habitual physical activity level was assessed among 963 participants, aged 50 years old or more, using Baecke’s questionnaire. Risk factors for metabolic syndrome followed the recommendations of “The IDF Consensus Worldwide Definition of the Metabolic Syndrome”. All the participant...

  20. Constructing Knowledge Societies : New Challenges for Tertiary Education

    OpenAIRE

    World Bank

    2002-01-01

    This report describes how tertiary education contributes to building up a country's capacity for participation in an increasingly knowledge-based world economy and investigates policy options for tertiary education that have the potential to enhance economic growth and reduce poverty. It examines the following questions: What is the importance of tertiary education for economic and social ...

  1. Cultural Perceptions and Leadership Style of School Administrators: The Effects on the Maturity Level of ICT Usage among Public Secondary Schools

    Directory of Open Access Journals (Sweden)

    Jay Pe L. Paculanan

    2017-02-01

    Full Text Available This study determined the effects of cultural perceptions and leadership styles of administrators on maturity level of ICT usage among public secondary schools of Misamis Oriental, Philippines. This descriptive method of research employed the three sets of adapted research instruments and sampling size was determined using Slovin’s formula. Descriptive statistics used were mode and mean. The findings revealed that cultural perceptions of the administrators on relevance to ICT usage were positive and it significantly affect the management, administrators, infrastructures and teachers domains to the ICT maturity level. Administrators applied transactional leadership style in managing ICT in school as perceived by both the administrators and teachers and it affects the ICT maturity level of students. The maturity level of ICT usage among public secondary schools in Misamis Oriental was categorized as defined level. Finally, it was anticipated that the data obtained from the study will open new lines of inquiry about the crucial roles of administrators in the adoption of ICT and will contribute to the decisions about future developmental needs towards preparedness for further changes in ICT.

  2. 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.

  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. Perceived stress level and risk of cancer incidence in a Japanese population: the Japan Public Health Center (JPHC)-based Prospective Study.

    Science.gov (United States)

    Song, Huan; Saito, Eiko; Sawada, Norie; Abe, Sarah K; Hidaka, Akihisa; Shimazu, Taichi; Yamaji, Taiki; Goto, Atsushi; Iwasaki, Motoki; Sasazuki, Shizuka; Ye, Weimin; Inoue, Manami; Tsugane, Shoichiro

    2017-10-11

    Evidence regarding stress as a risk factor for cancer onset is inconsistent. In this study, based on the Japan Public Health Center-based Prospective Study, we enrolled 101,708 participants aged 40-69 years from 1990-1994. The self-reported perceived stress level was collected at baseline and updated through 5-year follow-up. The association between perceived stress and cancer risk was measured by Cox proportional hazards regression model, adjusted for all known confounders. During follow-up (mean = 17.8 years), we identified 17,161 cancer cases. We found no association between baseline perceived stress level and cancer incidence. However, by taking account of the dynamic changes in perceived stress, time-varying analyses revealed a slightly (4-6%) increased overall cancer risk for subjects under elevated perceived stress levels compared to the 'low stress level' group. Analyses concerning long-term perceived stress level showed that individuals with constantly high perceived stress level had an 11% (95% confidence interval 1-22%) excess risk for cancer compared to subjects with persistently low stress levels. This association was confined to men (20% excess risk), and was particularly strong among smokers, alcohol drinkers, obese subjects, and subjects without family history of cancer. Therefore, we concluded high perceived stress level might contribute to excess overall cancer incidence among men.

  5. 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

  6. Assessing the energy and environmental performance of algae-mediated tertiary treatment of estrogenic compounds.

    Science.gov (United States)

    Colosi, Lisa M; Resurreccion, Eleazer P; Zhang, Yongli

    2015-02-01

    This study uses a systems-level modeling approach to illustrate a novel synergy between municipal wastewater treatment and large-scale algaculture for production of bio-energy, whereby algae-mediated tertiary treatment provides efficient removal of unregulated, strongly estrogenic steroid hormones from the secondary effluent. Laboratory results from previously published studies suggested that algae-mediated treatment could deliver roughly 75-85% removal of a model estrogen (17β-estradiol) within typical algae pond residence times. As such, experimental results are integrated into a comprehensive life cycle assessment (LCA) framework, to assess the environmental performance of an algae-based tertiary treatment system relative to three conventional tertiary treatments: ozonation, UV irradiation, and adsorption onto granular activated carbon. Results indicate that the algae-mediated tertiary treatment is superior to the selected benchmarks on the basis of raw energy return on investment (EROI) and normalized energy use per mass of estrogenic toxicity removed. It is the only tertiary treatment system that creates more energy than it consumes, and it delivers acceptable effluent quality for nutrient and coliform concentrations while rendering a significant reduction in estrogenic toxicity. These results highlight the dual water and energy sustainability benefits that accrue from the integration of municipal wastewater treatment and large-scale algae farming.

  7. Tertiary dendritic instability in late stage solidification of Ni-based superalloys

    Science.gov (United States)

    Franke, M. M.; Singer, R. F.; Steinbach, I.

    2014-03-01

    Derivatives of the commercial alloy CMSX-4 were directionally solidified and characterized with respect to their final dendrite microstructure. The results indicate that Ni-based superalloys with high segregation levels show significant instability in secondary dendrite arms and an increased tendency for tertiary arm formation, respectively. Phase-field simulations were used to explore the impact of chemical composition on morphological instability and tertiary arm formation during the directional solidification of Ni-based superalloys. It is found that an increase in specific alloying elements in the overall alloy composition leads to pronounced segregation at the end of solidification. This causes strong growth restriction of the secondary arms and triggers tertiary arm formation. The proposed mechanism explains experimental microstructures found in modifications of the base alloy CMSX-4.

  8. 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.

  9. 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…

  10. University Support, Adjustment, and Mental Health in Tertiary Education Students in Hong Kong

    Science.gov (United States)

    Leung, Chi Hung

    2017-01-01

    Depression, anxiety, and stress of moderate to severe levels were found in 21, 41, and 27% of university students in Hong Kong, respectively. The development of a screening tool for assessing adjustment difficulties among tertiary education students is helpful for counseling professionals in university. The Student Perception of University Support…

  11. 878787Sr/868686Sr anomalies in Late Cretaceous-Early Tertiary ...

    Indian Academy of Sciences (India)

    Cretaceous–Tertiary boundary; strontium isotope; biotic turnover; sea level changes. .... or volcanic activity in Godavari basin could have ...... climate and the. 87. Sr/. 86. Sr ratio of seawater; Earth Planet. Sci. Lett. 188 459–474. Donovan A D, Baum G R, Blechschmidt L, Loutit T S,. Pflum C E and Vail P R 1988 Sequence ...

  12. 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…

  13. What Aspects of Schooling Are Important? School Effects on Tertiary Entrance Performance

    Science.gov (United States)

    Marks, Gary N.

    2010-01-01

    The purpose of this paper is to identify school effects on student performance for tertiary entrance in Australia, taking into account student-level predictors using longitudinal data from the 2003 Programme for International Student Assessment (PISA) study. It finds that aspects of schooling, such as positive attitudes to school and disciplinary…

  14. Tertiary fatty amides as diesel fuel substitutes

    Energy Technology Data Exchange (ETDEWEB)

    Serdari, Aikaterini; Lois, Euripides; Stournas, Stamoulis [National Technical Univ. of Athens, Dept. of Chemical Engineering, Athens (Greece)

    2000-07-01

    This paper presents experimental results regarding the impact of adding different tertiary amides of fatty acids to mineral diesel fuel; an assessment of the behaviour of these compounds as possible diesel fuel extenders is also included. Measurements of cetane number, cold flow properties (cloud point, pour point and CFPP), density, kinematic viscosity, flash point and distillation temperatures are reported, while initial experiments concerning the effects on particulate emissions are also described. Most of the examined tertiary fatty amides esters have very good performance and they can be easily prepared from fatty acids (biomass). Such compounds or their blends could be used as mineral diesel fuel or even fatty acid methylesters (FAME, biodiesel) substitutes or extenders. (Author)

  15. Missed injury and the tertiary trauma survey.

    Science.gov (United States)

    Thomson, Charles B; Greaves, Ian

    2008-01-01

    Missed injury in the context of major trauma remains a persistent problem, both from a clinical and medico-legal point-of-view. Estimates of the incidence vary widely, dependent on the precise parameters of the studied population, the definition of missed injury and the extent of follow-up, but may be as high as 38%. The tertiary survey, in which formal repeated examination of the patient is undertaken after initial resuscitation and treatment have taken place, has been suggested as a way of identifying injuries not found at presentation. This paper appraises the concept of the tertiary survey, and also reviews the literature on missed injury in order to identify the risk factors, the types of injury and the reasons for error.

  16. 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.

  17. [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.

  18. Regional tertiary cross sections: Texas Gulf Coast

    Energy Technology Data Exchange (ETDEWEB)

    Debout, D.G.; Luttrell, P.E.; Seo, J.H.

    1976-01-01

    Regional studies of the Frio Formation along the Texas Gulf Coast were conducted to evaluate potential geothermal energy from deep, geopressured sandstone reservoirs. Published regional cross sections, unpublished cross sections provided by several major oil companies, and extensive micropaleontological and electrical-log files at the Bureau of Economic Geology served as basic data. These sections are meant to show gross regional distribution of sand and shale facies both laterally and vertically throughout the entire Tertiary section along the Texas Gulf Coast.

  19. SPEAKING STRATEGIES USED BY INDONESIAN TERTIARY STUDENTS

    Directory of Open Access Journals (Sweden)

    Wawa Puja Prabawa

    2016-06-01

    Full Text Available Speaking is considered to be difficult thing, moreover English as a foreign language. Students' performance depends on their personalities. Students who have low participation in speaking activity in the classroom lose their opportunity to practice their speaking skill which may cause poor speaking skill and achievement. However, some of students are active in speaking activity in the classroom that leads them to have good skill and achievement in speaking. This study attempts to reveal: (1 speaking strategies used by Indonesian tertiary students in terms of speaking English and strategies to improve their speaking ability, and (2 to identify speaking strategies mostly used by the students when they speak English and improve their speaking ability. This study is a descriptive research since its purpose is to describe the Indonesian tertiary students’ learning strategies in learning speaking English. The data from 15 tertiary students, who have good performance and achievement in speaking, from one of schools of higher education in Cimahi were collected using a 21 items questionnaire of a modified version of Strategy Inventory Language Learning (SILL and 5 items interview questions. The result of the study revealed that some speaking strategies are used in terms of speaking English and improve speaking ability, namely cognitive, metacognitive and compensation strategy. In the type of speaking strategy that mostly used by the student in terms of speaking English is compensation strategy, while cognitive strategy was indicated as the mostly speaking strategies used by the Indonesian tertiary students in improving their speaking ability. Considering to the study conducted, it is recommended to students that they should know what strategies that appropriate and can help them in learning speaking English. The students should be able to choose strategies they need in learning and analyze which strategies that give better effect on their own learning.

  20. SCORECARD LEVEL OF DEVELOPMENT AND AVAILABLE TO THE PUBLIC INFORMATION AND COMMUNICATION TECHNOLOGIES: THE RUSSIAN PRACTICE AND INTERNATIONAL EXPERIENCE

    Directory of Open Access Journals (Sweden)

    Vitalij G. Minashkin

    2014-01-01

    Full Text Available The article is concerned with the improvement of the statistical indicators system of the development level and the availability for the population of information and communication technologies. The main target indicators of information society building contained in the strategic documents of the Russian Federation and international organizations are identified and summarized. A comparative analysis of the individual countries’ ICT indicators was carried out. The basic approaches to actualization of the indicators included in the existing forms of federal statistical observation were formulated.

  1. 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....... A functional region affecting index (Θ) is employed as a fitness function for the AFSAVP driven optimisation, in which a gross domestic product (GDP) based method is utilised to estimate the CO2 emission of all provinces. A simulation for the administrative provinces of China has been implemented...

  2. A review of low-level air pollution and adverse effects on human health: implications for epidemiological studies and public policy.

    Science.gov (United States)

    Olmo, Neide Regina Simoes; Saldiva, Paulo Hilário do Nascimento; Braga, Alfésio Luís Ferreira; Lin, Chin An; Santos, Ubiratan de Paula; Pereira, Luiz Alberto Amador

    2011-01-01

    The aim of this study was to review original scientific articles describing the relationship between atmospheric pollution and damage to human health. We also aimed to determine which of these studies mentioned public policy issues. Original articles relating to atmospheric pollution and human health published between 1995 and 2009 were retrieved from the PubMed database and analyzed. This study included only articles dealing with atmospheric pollutants resulting primarily from vehicle emissions. Three researchers were involved in the final selection of the studies, and the chosen articles were approved by at least two of the three researchers. Of the 84 non-Brazilian studies analyzed, 80 showed an association between atmospheric pollution and adverse effects on human health. Moreover, 66 showed evidence of adverse effects on human health, even at levels below the permitted emission standards. Three studies mentioned public policies aimed at changing emission standards. Similarly, the 29 selected Brazilian studies reported adverse associations with human health, and 27 showed evidence of adverse effects even at levels below the legally permitted emission standards. Of these studies, 16 mentioned public policies aimed at changing emission standards. Based on the Brazilian and non-Brazilian scientific studies that have been conducted, it can be concluded that, even under conditions that are compliant with Brazilian air quality standards, the concentration of atmospheric pollutants in Brazil can negatively affect human health. However, as little discussion of this topic has been generated, this finding demonstrates the need to incorporate epidemiological evidence into decisions regarding legal regulations and to discuss the public policy implications in epidemiological studies.

  3. A review of low-level air pollution and adverse effects on human health: implications for epidemiological studies and public policy

    Science.gov (United States)

    Olmo, Neide Regina Simões; do Nascimento Saldiva, Paulo Hilário; Braga, Alfésio Luís Ferreira; Lin, Chin An; de Paula Santos, Ubiratan; Pereira, Luiz Alberto Amador

    2011-01-01

    The aim of this study was to review original scientific articles describing the relationship between atmospheric pollution and damage to human health. We also aimed to determine which of these studies mentioned public policy issues. Original articles relating to atmospheric pollution and human health published between 1995 and 2009 were retrieved from the PubMed database and analyzed. This study included only articles dealing with atmospheric pollutants resulting primarily from vehicle emissions. Three researchers were involved in the final selection of the studies, and the chosen articles were approved by at least two of the three researchers. Of the 84 non-Brazilian studies analyzed, 80 showed an association between atmospheric pollution and adverse effects on human health. Moreover, 66 showed evidence of adverse effects on human health, even at levels below the permitted emission standards. Three studies mentioned public policies aimed at changing emission standards. Similarly, the 29 selected Brazilian studies reported adverse associations with human health, and 27 showed evidence of adverse effects even at levels below the legally permitted emission standards. Of these studies, 16 mentioned public policies aimed at changing emission standards. Based on the Brazilian and non-Brazilian scientific studies that have been conducted, it can be concluded that, even under conditions that are compliant with Brazilian air quality standards, the concentration of atmospheric pollutants in Brazil can negatively affect human health. However, as little discussion of this topic has been generated, this finding demonstrates the need to incorporate epidemiological evidence into decisions regarding legal regulations and to discuss the public policy implications in epidemiological studies. PMID:21655765

  4. A review of low-level air pollution and adverse effects on human health: implications for epidemiological studies and public policy

    Directory of Open Access Journals (Sweden)

    Neide Regina Simoes Olmo

    2011-01-01

    Full Text Available The aim of this study was to review original scientific articles describing the relationship between atmospheric pollution and damage to human health. We also aimed to determine which of these studies mentioned public policy issues. Original articles relating to atmospheric pollution and human health published between 1995 and 2009 were retrieved from the PubMed database and analyzed. This study included only articles dealing with atmospheric pollutants resulting primarily from vehicle emissions. Three researchers were involved in the final selection of the studies, and the chosen articles were approved by at least two of the three researchers. Of the 84 non-Brazilian studies analyzed, 80 showed an association between atmospheric pollution and adverse effects on human health. Moreover, 66 showed evidence of adverse effects on human health, even at levels below the permitted emission standards. Three studies mentioned public policies aimed at changing emission standards. Similarly, the 29 selected Brazilian studies reported adverse associations with human health, and 27 showed evidence of adverse effects even at levels below the legally permitted emission standards. Of these studies, 16 mentioned public policies aimed at changing emission standards. Based on the Brazilian and non-Brazilian scientific studies that have been conducted, it can be concluded that, even under conditions that are compliant with Brazilian air quality standards, the concentration of atmospheric pollutants in Brazil can negatively affect human health. However, as little discussion of this topic has been generated, this finding demonstrates the need to incorporate epidemiological evidence into decisions regarding legal regulations and to discuss the public policy implications in epidemiological studies.

  5. The Los Angeles County Community Disaster Resilience Project — A Community-Level, Public Health Initiative to Build Community Disaster Resilience

    Directory of Open Access Journals (Sweden)

    David Eisenman

    2014-08-01

    Full Text Available Public health officials need evidence-based methods for improving community disaster resilience and strategies for measuring results. This methods paper describes how one public health department is addressing this problem. This paper provides a detailed description of the theoretical rationale, intervention design and novel evaluation of the Los Angeles County Community Disaster Resilience Project (LACCDR, a public health program for increasing community disaster resilience. The LACCDR Project utilizes a pretest–posttest method with control group design. Sixteen communities in Los Angeles County were selected and randomly assigned to the experimental community resilience group or the comparison group. Community coalitions in the experimental group receive training from a public health nurse trained in community resilience in a toolkit developed for the project. The toolkit is grounded in theory and uses multiple components to address education, community engagement, community and individual self-sufficiency, and partnerships among community organizations and governmental agencies. The comparison communities receive training in traditional disaster preparedness topics of disaster supplies and emergency communication plans. Outcome indicators include longitudinal changes in inter-organizational linkages among community organizations, community member responses in table-top exercises, and changes in household level community resilience behaviors and attitudes. The LACCDR Project is a significant opportunity and effort to operationalize and meaningfully measure factors and strategies to increase community resilience. This paper is intended to provide public health and academic researchers with new tools to conduct their community resilience programs and evaluation research. Results are not yet available and will be presented in future reports.

  6. The Los Angeles County Community Disaster Resilience Project — A Community-Level, Public Health Initiative to Build Community Disaster Resilience

    Science.gov (United States)

    Eisenman, David; Chandra, Anita; Fogleman, Stella; Magana, Aizita; Hendricks, Astrid; Wells, Ken; Williams, Malcolm; Tang, Jennifer; Plough, Alonzo

    2014-01-01

    Public health officials need evidence-based methods for improving community disaster resilience and strategies for measuring results. This methods paper describes how one public health department is addressing this problem. This paper provides a detailed description of the theoretical rationale, intervention design and novel evaluation of the Los Angeles County Community Disaster Resilience Project (LACCDR), a public health program for increasing community disaster resilience. The LACCDR Project utilizes a pretest–posttest method with control group design. Sixteen communities in Los Angeles County were selected and randomly assigned to the experimental community resilience group or the comparison group. Community coalitions in the experimental group receive training from a public health nurse trained in community resilience in a toolkit developed for the project. The toolkit is grounded in theory and uses multiple components to address education, community engagement, community and individual self-sufficiency, and partnerships among community organizations and governmental agencies. The comparison communities receive training in traditional disaster preparedness topics of disaster supplies and emergency communication plans. Outcome indicators include longitudinal changes in inter-organizational linkages among community organizations, community member responses in table-top exercises, and changes in household level community resilience behaviors and attitudes. The LACCDR Project is a significant opportunity and effort to operationalize and meaningfully measure factors and strategies to increase community resilience. This paper is intended to provide public health and academic researchers with new tools to conduct their community resilience programs and evaluation research. Results are not yet available and will be presented in future reports. PMID:25153472

  7. Increasing Public Access to Scientific Research through Stakeholder Involvement: Ecological Effects of Sea Level Rise in the Northern Gulf of Mexico

    Science.gov (United States)

    Hagen, S. C.; Stephens, S. H.; DeLorme, D. E.; Ruple, D.; Graham, L.

    2013-12-01

    Sea level rise (SLR) has the potential to have a myriad of deleterious effects on coastal ecology and human infrastructure. Stakeholders, including managers of coastal resources, must be aware of potential consequences of SLR and adjust their plans accordingly to protect and preserve the resources under their care. Members of the public, particularly those who live or work in coastal areas, should also be informed about the results of scientific research on the effects of SLR. However, research results are frequently published in venues or formats to which resource managers and the broader public have limited access. It is imperative for scientists to move beyond traditional publication venues in order to more effectively disseminate the results of their research (Dennison, W. 2007, Estu. Coast. Shelf Sci. 77, 185). One potentially effective way to advance public access to research is to incorporate stakeholder involvement into the research project process in order to target study objectives and tailor communication products toward stakeholder needs (Lemos, M. & Morehouse, B. 2005, Glob. Env. Chg. 15, 57). However, it is important to manage communication and clarify participant expectations during this type of research (Gawith, M. et al. 2009, Glob. Env. Chg. 19, 113). This presentation describes the process being undertaken by an ongoing 5-year multi-disciplinary NOAA-funded project, Ecological Effects of Sea Level Rise in the Northern Gulf of Mexico (EESLR-NGOM), to improve accessibility and utility of scientific research results through stakeholder engagement. The EESLR-NGOM project is assessing the ecological risks from SLR along the Mississippi, Alabama and Florida Panhandle coasts, coastal habitats, and floodplains. It has incorporated stakeholder involvement throughout the research process so as to better target and tailor the emerging research products to meet resource managers' needs, as well as to facilitate eventual public dissemination of results. An

  8. Ukraine Public Finance Review

    OpenAIRE

    World Bank

    2017-01-01

    Despite bold efforts to consolidate public finances, Ukraine’s growth potential remains undermined by a large public sector, high public debt levels and inefficient provision of critical public services. The Ukraine government faces new public spending pressures which, if realized, would reverse recent fiscal consolidation gains. In this context, the objective of this Public Finance Review...

  9. Street-level bureaucracy and policy implementation in community public health nursing: a qualitative study of the experiences of student and novice health visitors.

    Science.gov (United States)

    Hughes, Alison; Condon, Louise

    2016-11-01

    Aim To explore the experiences of student and novice health visitors in implementing health visiting policy reform pre- and post-qualification. In England, public health nursing has been subject to major policy reform. The Health Visitor Implementation Plan (2011) set out a plan to recruit increasing numbers of nurses and midwives to the profession to deliver an expanded and refocussed health visiting service. Exploring this policy change from the viewpoint of those new to health visiting offers a unique perspective into how a specific policy vision is translated into nursing practice. A descriptive qualitative study in which participants were enrolled on a one-year post-graduate health visiting course at a University in South West of England. Qualitative data were collected pre- and post-qualification. A total of 16 interviews and a focus group were conducted with nine participants between September 2012 and March 2013. Findings Descriptive data were interpreted using Lipsky's theoretical framework of street-level bureaucracy. Three themes emerged which relate to this 'bottom-up' perspective on policy implementation; readiness to operationalise policy, challenges in delivering the service vision; and using discretion in delivering the vision. Community public health nurses operate as street-level bureaucrats in negotiating the demands of policy and practice, and by this means, attempt to reconcile professional values with institutional constraints. Barriers to policy implementation at a local level mediate the effects of policy reform, ultimately impacting upon outcomes for children and families.

  10. Quantitative Analysis of Dynamic Behaviours of Rural Areas at Provincial Level Using Public Data of Gross Domestic Product

    Directory of Open Access Journals (Sweden)

    Yi Chen

    2012-12-01

    Full Text Available 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. A functional region affecting index θ is employed as a fitness function for the AFSAVP driven optimisation, in which a gross domestic product (GDP based method is utilised to estimate the CO2 emission of all provinces. A simulation for the administrative provinces of China has been implemented, 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. Clinical and demographic features of patients with dementia attended in a tertiary outpatient clinic

    Directory of Open Access Journals (Sweden)

    Vale Francisco A.C.

    2002-01-01

    Full Text Available We describe clinical and socio-demographic features of patients with dementia attended in a tertiary outpatient clinic during a three years period (56.9% of the total attendance. Most of them were men, white, from the local community, urban district. Nobody had a job at the moment, two thirds of them got social welfare benefit. They lived with their family, the caregiver being the spouse or a daughter. The education level was very low, a quarter of them being illiterate. They were referred mostly from the public health care service, by neurologists or psychiatrists due to cognitive disorders. Family history as well as individual history of previous neurological/psychiatric disorders were frequent, especially alcoholism, stroke, head trauma and dementia. The neurological exam showed abnormalities in two thirds of cases, chiefly extra-pyramidal and pyramidal signs. Alzheimer's disease was the most frequent cause, followed by cerebrovascular disorder; alcoholism and normal pressure hydrocephalus were also frequent causes. Most patients presented concomitant non-etiological neurological/psychiatric disorders, mainly alcoholism and depression, and non-neurological/psychiatric diseases, predominantly hypertension, cardiopathy and diabetes. Most patients had been referred under medication, frequently politherapy, including psychotropics.

  12. Breast Cancer Association with Cytomegalo Virus-A Tertiary Center Case-Control Study.

    Science.gov (United States)

    Surendran, Anilkumar; Chisthi, Meer M

    2017-12-18

    Cytomegalo virus is a ubiquitous virus often associated with congenital infections. Some studied have claimed an association between infection with this virus and development of breast cancer. The aim of this prospective research was to study the difference in Cytomegalo virus sero-positivity among patients with breast cancer and benign breast diseases, and thereby to prove any association. This was a hospital based Case-Control study conducted at the General Surgery wards of our hospital, a tertiary level public sector health care institution. This study was done on 130 patients with breast swellings who underwent surgical excision of their lumps over a 1-year period. Patients with histologically proven malignancies were selected as cases while proven benign cases were deemed to be the controls. IgG and IgM antibodies to Cytomegalo virus were checked in the patients from both groups. All of the studied patients turned out to be positive for Immunoglobulin G against Cytomegalo virus while all the patients were found to be negative for Immunoglobulin M. There was no difference in the antibody titers among the benign and malignant cases in the study. Logistic regression calculation was also carried out including the study parameters and other known risk factors. We conclude that there is no association between Cytomegalo virus sero-positivity and breast cancer. Another conclusion is that the studied adult population has been exposed to Cytomegalo virus in some point of their lives. Further studies of a larger magnitude are essential to confirm our results.

  13. 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.

  14. 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.

  15. Treatment pathways of extrapulmonary patients diagnosed at a tertiary care hospital in Delhi, India

    Directory of Open Access Journals (Sweden)

    Manoj Grover

    2014-01-01

    Full Text Available Background: In order to put extrapulmonary tuberculosis patients early on treatment, it is important to study pathways, which these patients adopt in for seeking treatment. Materials and Methods: In order to study the treatment pathways of extrapulmonary patients and assess appropriate points for intervention, a cross-sectional study was conducted in chest clinic of a tertiary care hospital in Delhi. Results: Factors associated with longer paths included reason for going to first health facility (nearness and known provider, availing more than one health facilities, presenting symptoms of fever, joint pain, nodular skin swelling and skin lesion. Self-referral to the chest clinic was associated with shorter paths. Lower level of education, occupation, non-serious perception of the disease and visiting five health facilities were significantly associated with patient delay of more than 3.5 weeks. Symptoms of fever, joint pain and skin lesion, visiting private health facility first, availing more than two health facilities and travelling distance of more than 100 km to reach chest clinic were significantly associated with the health facility delay of more than 4.5 weeks. Conclusions: Increasing public awareness, training of private practitioners and capacity building of government facilities will help in reducing delay.

  16. 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

  17. Perceived stress level and risk of cancer incidence in a Japanese population: the Japan Public Health Center (JPHC)-based Prospective Study

    OpenAIRE

    Song, Huan; Saito, Eiko; Sawada, Norie; Abe, Sarah K.; Hidaka, Akihisa; Shimazu, Taichi; Yamaji, Taiki; Goto, Atsushi; Iwasaki, Motoki; Sasazuki, Shizuka; Ye, Weimin; Inoue, Manami; Tsugane, Shoichiro

    2017-01-01

    Evidence regarding stress as a risk factor for cancer onset is inconsistent. In this study, based on the Japan Public Health Center-based Prospective Study, we enrolled 101,708 participants aged 40–69 years from 1990–1994. The self-reported perceived stress level was collected at baseline and updated through 5-year follow-up. The association between perceived stress and cancer risk was measured by Cox proportional hazards regression model, adjusted for all known confounders. During follow-up ...

  18. Scoring methods and results for qualitative evaluation of public health impacts from the Hanford high-level waste tanks. Integrated Risk Assessment Program

    Energy Technology Data Exchange (ETDEWEB)

    Buck, J.W.; Gelston, G.M.; Farris, W.T.

    1995-09-01

    The objective of this analysis is to qualitatively rank the Hanford Site high-level waste (HLW) tanks according to their potential public health impacts through various (groundwater, surface water, and atmospheric) exposure pathways. Data from all 149 single-shell tanks (SSTs) and 23 of the 28 double-shell tanks (DSTs) in the Tank Waste Remediation System (TWRS) Program were analyzed for chemical and radiological carcinogenic as well as chemical noncarcinogenic health impacts. The preliminary aggregate score (PAS) ranking system was used to generate information from various release scenarios. Results based on the PAS ranking values should be considered relative health impacts rather than absolute risk values.

  19. 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...... on marginal production costs, the latter aiming at finding the match between production and consumption satisfying the constraints set by the EMS level about the energy production in each time slot. Neglecting the efficiency of the different energy generation systems as well as that of the infrastructure...... for electrical energy distribution, the problem dealt with by the EMS sub-level is linear and can be solved by well known Linear Programming optimization procedures. The tertiary sub-level, below the EMS, optimizes mainly technical objectives and requires the solution of the Optimal Power Flow problem. After...

  20. Investigation of the Health Literacy Level of Women in Reproductive Age as a Public Health Problem in Zahedan

    Directory of Open Access Journals (Sweden)

    Marzieh Rakhshkhorshid

    2017-06-01

    Full Text Available Introduction: The aim of this study was to evaluate health literacy (HL status among women of reproductive age who referred to urban health centers in Zahedan. Methods: In this cross-sectional descriptive study, 250 women of reproductive age (15-49 years old who referred to urban health centers in Zahedan, Iran were assessed using the Iranian Health Literacy Questionnaire. To analyze the data, SPSS 15 software and statistical tests including independent sample t test and chi-square test were used. Results: The mean ± standard deviation (SD age of participants in this study was 26.32 ± 5.83 with a minimum of 15 and maximum of 45 years. The majority of the participants (32.4% held a high school diploma and 88.8% of them were housewives. The mean HL score was computed 7.15 out of 20 indicating that 100% of the participants had inadequate HL. There were significant relationships between HL score and age, occupation, educational degree, language and living location (P < 0.05. Conclusion: Considering high levels of inadequate HL among women of reproductive age in Zahedan, it is recommended to use HL measures to screen people with inadequate HL, to provide each individual with information and services which are appropriate to their HL skills and to be able to reduce the consequences of inadequate HL.

  1. Beyond the cold hit: measuring the impact of the national DNA data bank on public safety at the city and county level.

    Science.gov (United States)

    Gabriel, Matthew; Boland, Cherisse; Holt, Cydne

    2010-01-01

    Over the past decade, the Combined DNA Index System (CODIS) has increased solvability of violent crimes by linking evidence DNA profiles to known offenders. At present, an in-depth analysis of the United States National DNA Data Bank effort has not assessed the success of this national public safety endeavor. Critics of this effort often focus on laboratory and police investigators unable to provide timely investigative support as a root cause(s) of CODIS' failure to increase public safety. By studying a group of nearly 200 DNA cold hits obtained in SFPD criminal investigations from 2001-2006, three key performance metrics (Significance of Cold Hits, Case Progression & Judicial Resolution, and Potential Reduction of Future Criminal Activity) provide a proper context in which to define the impact of CODIS at the City and County level. Further, the analysis of a recidivist group of cold hit offenders and their past interaction with law enforcement established five noteworthy criminal case resolution trends; these trends signify challenges to CODIS in achieving meaningful case resolutions. CODIS' effectiveness and critical activities to support case resolutions are the responsibility of all criminal justice partners in order to achieve long-lasting public safety within the United States.

  2. High levels of mercury in wetland resources from three river basins in Ghana: a concern for public health.

    Science.gov (United States)

    Gbogbo, Francis; Otoo, Samuel D; Huago, Robert Quaye; Asomaning, Obed

    2017-02-01

    Crustaceans, mollusks, and fish are wetland resources that constitute an important source of protein and foreign exchange for the Ghanaian population, and many species of these are sold in the open market and restaurants, yet studies on their heavy metal contents are generally scarce. This paper evaluates the levels of mercury in five species of crustaceans, two species of mollusks, and ten species of fish inhabiting three river basins with different catchment activities in Ghana. These include the Ankobra Basin, characterized with mining and agriculture, Densu Basin, associated with urban waste discharges and agriculture, and Lower Volta River Basin, associated with agricultural activities. Mercury concentration was highest in Ankobra (2.5 ± 2.59 μg g-1) followed by Densu (1.75 ± 1.35 μg g-1) and Volta (0.74 ± 1.46 μg g-1). The mercury load of the organisms range from mercury was not detected, mercury loads of all the organisms were above the permissible limit of 0.5 mg kg-1 established by Commission Regulation-EC (2006) for fishery products and muscle meat of fish. Weekly quantities of crustaceans and mollusks considered safe for consumption by adults ranged from 88 and 1000 g while that of the fishes were between 70 and 700 g (on a dry weight basis) depending on the species. It was clear that some caution needs to be exercised in the consumption of Ghana's fresh and brackish water fisheries.

  3. A new standard of Efficacy for Low Level Laser Therapy (LLLT) in Pain Attenuation in Japan (a secondary publication).

    Science.gov (United States)

    Shiroto, Chiyuki; Ohshiro, Toshio

    2014-09-30

    The assessment of the efficacy of low level laser therapy (LLLT) for pain attenuation varies among institutions, all having their own method of assessment with no common standards. At the author's institution in the beginning, the patients were asked how they assessed their pain relief immediately after the treatment. They were to choose from excellent, good, fair, no change and poor. The overall efficacy rate was calculated by the numbers of patients scoring excellent and good, expressed as a percentage of the total number of patients. However, a large number of institutions have utilized the Visual Analogue Scale (VAS) or the Pain Relief Score (PRS) for the assessment of treatment; but even then, the evaluation could not be considered uniform. Therefore, the standardization of the efficacy rate was continuously discussed among the practitioners of LLLT, dating back to the 9(th) annual meeting of the Japan Laser Therapy Association (JaLTA) in 1997. It took four years (including the 1997 meeting) until finally an agreement was reached and a new standard of efficacy was presented at the 12(th) JaLTA meeting in 2000, based on the PRS. The new standard defined excellent as pain reduction in any treatment session from 10 to 0 or 1, good as reduction from 10 to 2∼5, fair as reduction from 10 to 6∼8, no change as a reduction from 10 to 9∼10 and poor was defined as exacerbation of pain from 10 to 11 or greater. Efficacy rate was calculated by the number of patients scoring excellent and good expressed as a percentage of the total number of patients. For the purpose of reference, the VAS was to be used for patients receiving the treatment for the first time.

  4. Views of Ethical Best Practices in Sharing Individual-Level Data From Medical and Public Health Research: A Systematic Scoping Review.

    Science.gov (United States)

    Bull, Susan; Roberts, Nia; Parker, Michael

    2015-07-01

    There is increasing support for sharing individual-level data generated by medical and public health research. This scoping review of empirical research and conceptual literature examined stakeholders' perspectives of ethical best practices in data sharing, particularly in low- and middle-income settings. Sixty-nine empirical and conceptual articles were reviewed, of which, only five were empirical studies and eight were conceptual articles focusing on low- and middle-income settings. We conclude that support for sharing individual-level data is contingent on the development and implementation of international and local policies and processes to support ethical best practices. Further conceptual and empirical research is needed to ensure data sharing policies and processes in low- and middle-income settings are appropriately informed by stakeholders' perspectives. © The Author(s) 2015.

  5. Gestational Trophoblastic Disease - Clinicopathological Study at Tertiary Care Hospital.

    Science.gov (United States)

    Jagtap, Sunil Vitthalrao; Aher, Vidhya; Gadhiya, Suchi; Jagtap, Swati Sunil

    2017-08-01

    Gestational Trophoblastic Disease (GTD) is a term used for a group of pregnancy-related tumours. These consist of various tumours and tumour like lesions characterized by proliferation of trophoblastic tissue. Amongst GTD, hydatidiform moles are the most common form. These lesions sometimes may develop into invasive moles, or, in rare cases, into choriocarcinoma. To study the clinicopathologic characteristics and prevalence of different forms of gestational trophoblastic disease in a tertiary care hospital. The present study was descriptive, observational, analytical type done in Department of Pathology at tertiary care hospital from May 2012 to April 2016. All cases clinically suspected of GTD were included and confirmation was done by histopathological study on H&E stained slides. The cases of GTD were classified according to WHO classification. Detailed histomorphological features and beta human Chorionic Gonadotropin (hCG) levels were correlated. During study period, 18345 deliveries were reported; out of which 77 cases were diagnosed as GTD. Almost 97.40% cases were of hydatidiform moles, 1.30% cases of choriocarcinoma and 1.30% cases of Placental Site Trophoblastic Tumour (PSTT). Among the cases of hydatidiform mole 57.34% were complete mole and 41.33% cases were of partial mole. The common clinical presentation was per vaginal bleeding and amenorrhea. The blood group A was most commonly observed in patient (49.35%). In majority of cases beta hCG levels were between 50,000 to 100000 mIU/ml. The correlation between beta hCG level and GTD were done. Pregnant females clinically presenting with abnormal vaginal bleeding must be evaluated for GTD. Histopathological examination is helpful for confirmatory diagnosis. Follow up of such patients is essential for early detection of malignant trophoblastic tumours.

  6. Impact on the performance of health workers adopted performance-related contracts in the provision of basic public health service at village and township levels.

    Science.gov (United States)

    Zhao, Yaojun; Huo, Zhen'ang; Wu, Jian; Xie, Shuangbao; Zhang, Liang; Feng, Zhanchun

    2013-01-01

    This paper focus on the impact on the performance of health workers at village and township levels in the provision of a government stipulated package of basic public health service, which adopted the performance-related contracts mode. The concept of balanced scorecard was adopted and developed to gather the 11 evaluation indicators distributed in four quadrants. These were implemented using on-site questionnaire and interview design. Four thousand and twenty-one respondents at 30 administrative villages including 2674 respondents at 20 pilot villages and 1347 at 10 control villages were investigated. Meanwhile, 62 administration officials from three counties and nine townships were interviewed. Eight of 11 evaluation indicators were obviously better in pilot counties than in Control County, The remaining three indicators respectively represented that equal, inferior to control county, and could not clear judge. The performance of health workers at village and township levels in the provision of basic public health service in pilot counties, which adopted the performance-related contracts mode, is better than before and control county.

  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. Behavior and cortisol levels of dogs in a public animal shelter, and an exploration of the ability of these measures to predict problem behavior after adoption.

    Science.gov (United States)

    Hennessy, M B.; Voith, V L.; Mazzei, S J.; Buttram, J; Miller, D D.; Linden, F

    2001-08-01

    Behavior and plasma cortisol levels were examined in puppies and juvenile/adult dogs admitted to a public animal shelter. A behavioral test was developed to assess the responses of the dogs to novel or threatening conditions. Factor analysis of the behavioral responses of 166 dogs on day 3 in the shelter yielded six factors (locomotor activity, flight, sociability, timidity, solicitation, and wariness) that accounted for 68% of the total variance. Among those dogs remaining in the shelter for 9 days, plasma cortisol levels declined from day 2 to 9. Cortisol levels were weakly related to factor scores. In order to explore the relation of measures in the shelter to later behavior, questionnaires assessing problem behaviors were mailed to new owners of dogs 2 weeks and 6 months following adoption. Among puppies, wariness scores were negatively correlated with behavior problems at 2 weeks and cortisol levels were negatively correlated with behavior problems at 6 months. These results suggest how measures of behavior and endocrine activity obtained in shelters might prove useful for screening dogs for adoption or targeting dogs for behavioral intervention.

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

    DEFF Research Database (Denmark)

    Thomsen, Súsanna v.; Vestergaard, Peter

    2011-01-01

    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...

  10. Publicity and public relations

    Science.gov (United States)

    Fosha, Charles E.

    1990-01-01

    This paper addresses approaches to using publicity and public relations to meet the goals of the NASA Space Grant College. Methods universities and colleges can use to publicize space activities are presented.

  11. 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.

  12. Laundry in a washing machine as a mediator of secondary and tertiary DNA transfer.

    Science.gov (United States)

    Voskoboinik, Lev; Amiel, Merav; Reshef, Ayeleth; Gafny, Ron; Barash, Mark

    2017-06-12

    The aim of this work was to investigate the possibility of secondary and tertiary DNA transfer during laundry. The modes of transfer tested were mixed and separate laundry of worn and unworn garments in household and public washing machines. In addition, the possibility of a background DNA carry-over from a washing machine's drum was investigated. In the mixed (worn and unworn garments washed together) laundry experiment, 22% of samples from new unworn socks with no traceable DNA prior to experiment produced DNA profiles post-laundry. In the tertiary DNA transfer experiment performed in a public washing machine (unworn garments only), no detectable DNA profiles were observed. Samples collected from the internal drum of 25 washing and drying machines did not produce detectable STR profiles. The implications of these results are discussed in the context of forensic DNA casework analysis. Graphical Abstract ᅟA real-life scenario of secondary DNA transfer between worn and unworn garments during machine washing has been evaluated. Experiments demonstrated this scenario is possible (22% of samples) and may in fact result in high quality DNA profiles. On the contrary, testing washing machine's interior for deposition of biological material between separate washing cycles to serve as a mediator of tertiary DNA transfer resulted in no DNA profiles.

  13. NAGT: Partnering to Expand and Improve the Teaching of Earth Sciences at all Levels of Instruction while Increasing Earth Literacy to the General Public

    Science.gov (United States)

    Herbstrith, K. G.

    2016-12-01

    Now more than ever, we need an Earth literate public and a workforce that can develop and be engaged in viable solutions to current and future environmental and resource challenges. The National Association of Geoscience Teachers (NAGT) is a member driven organization dedicated to fostering improvement in the teaching of the Earth Sciences at all levels of formal and informal instruction, to emphasizing the cultural significance of the Earth sciences and to disseminating knowledge in this field to the general public. NAGT offers a number of ways to partner and collaborate including our sponsored sessions, events and programs; two publications; workshop programming; three topical focused divisions; educational advocacy; and website offerings hosted through the Science Education Resource Center (SERC). A growing number of associations, institutions, projects, and individual educators are strengthening their professional networks by partnering with NAGT. Locating and connecting members of the Earth education community with shared values and interest is an important part of collaborating and NAGT's topical divisions assist community members who wish to work on the topics of 2-year college faculty, geoscience education research, and teacher preparation. The NAGT website and the linked websites of its collaborating partners provides a peer reviewed venue for educators to showcase their pedagogy and to learn best practices of others. The annual Earth Educators' Rendezvous is an opportunity to network face-to-face with the Earth education community, strengthening our relationships while working with those who share our interests and challenges while also learning from those who have divergent experiences. NAGT is a non-profit organization that advocates for the advancement of the geosciences and supports the work of Earth educators and geoscience education researchers. For more information about NAGT, visit our website at www.nagt.org

  14. STUDY ON KAP OF OCULAR COMPLICATIONS DUE TO DIABETES AMONG TYPE II DIABETICS VISITING A TERTIARY TEACHING HOSPITAL

    Directory of Open Access Journals (Sweden)

    Jacob Koshy

    2012-03-01

    Full Text Available Introduction: Diabetes mellitus is a major public health problem worldwide. Diabetic patients are at risk of developing blindness from diabetic retinopathy. While occurrence of diabetic retinopathy cannot be prevented, its complications can be minimized. This requires awareness of the sight-threatening potential of diabetes and the need for regular eye examinations. Aim: To study the knowledge of ocular complications of diabetes, among type II diabetics visiting a tertiary level hospital. Settings and Design: This was a prospective study in a tertiary care teaching hospital. Methods and Material: This was a questionnaire based study on 350 type II diabetics. All patients were interviewed by the same investigator. Statistical analysis used: The data was analysed using chi square test. Results: With increase in the duration of illness, the awareness about diabetic retinopathy is more. Even though the awareness of the disease increased with increasing duration of the disease, 51.4% of the diabetics did not know how diabetes can affect the eye, 49.7% of diabetics did not know if diabetic retinopathy can be treated and 67.4% had not heard of any treatment modality for diabetic retinopathy. This shows that lack of knowledge about the disease was significant. Conclusions: Prevention of non-communicable disease through increased awareness needs to be the thrust of the effort in resource poor contexts, where the treatment can be prohibitively costly. These measures would help to bring about more awareness and understanding about the disease among the patients and therefore prevent sight-threatening complications by timely intervention and management.

  15. Clinical and financial burdens of secondary level care in a public sector antiretroviral roll-out setting (G. F. Jooste Hospital).

    Science.gov (United States)

    Kevany, Sebastian; Meintjes, Graeme; Rebe, Kevin; Maartens, Gary; Cleary, Susan

    2009-05-01

    Antiretroviral therapy (ART) is being extended across South Africa. While efforts have been made to assess the costs of providing ART via accredited service points, little information is available on its downstream costs, particularly in public secondary level hospitals. To determine the cost of care for inpatients and outpatients at a dedicated antiretroviral referral unit treating and caring for antiretroviral-related conditions in a South African peri-urban setting; to identify key epidemiological cost drivers; and to examine the associated clinical and outcome data. A prospective costing study on 48 outpatients and 25 inpatients was conducted from a health system perspective. Incremental economic costs and clinical data were collected from primary sources at G. F. Jooste Hospital, Cape Town, over a 1-month period (March 2005). Incremental cost per outpatient was R1 280, and per inpatient R5 802. Costs were dominated by medical staff costs (62% inpatient and 58% outpatient, respectively). Infections predominated among diagnoses and costs--55% and 67% respectively for inpatients, and 49% and 54% respectively for outpatients. Most inpatients and outpatients were judged by attending physicians to have improved or stabilised as a result of treatment (52% and 59% respectively). The costs of providing secondary level care for patients on or immediately preceding ART initiation can be significant and should be included in the government's strategic planning: (i) so that the service can be expanded to meet current and future needs; and (ii) to avoid crowding out other secondary level health services.

  16. The Use of Twitter to Track Levels of Disease Activity and Public Concern in the U.S. during the Influenza A H1N1 Pandemic

    Science.gov (United States)

    Signorini, Alessio; Segre, Alberto Maria; Polgreen, Philip M.

    2011-01-01

    Twitter is a free social networking and micro-blogging service that enables its millions of users to send and read each other's “tweets,” or short, 140-character messages. The service has more than 190 million registered users and processes about 55 million tweets per day. Useful information about news and geopolitical events lies embedded in the Twitter stream, which embodies, in the aggregate, Twitter users' perspectives and reactions to current events. By virtue of sheer volume, content embedded in the Twitter stream may be useful for tracking or even forecasting behavior if it can be extracted in an efficient manner. In this study, we examine the use of information embedded in the Twitter stream to (1) track rapidly-evolving public sentiment with respect to H1N1 or swine flu, and (2) track and measure actual disease activity. We also show that Twitter can be used as a measure of public interest or concern about health-related events. Our results show that estimates of influenza-like illness derived from Twitter chatter accurately track reported disease levels. PMID:21573238

  17. Foreign Language Anxiety in Saudi Classroom: A Case Study of Saudi Tertiary Female Students in Prince Sattam University

    Science.gov (United States)

    Balla, Asjad Ahmed Saeed

    2017-01-01

    This paper investigates the level of anxiety due to learning English as a foreign language. It tries to answer these questions: (1) Is anxiety a factor in hindering English proficiency? (2) Does anxiety lead to fear of communication? (3) Which type of anxiety is high among tertiary level female Saudi students? The Foreign Language Anxiety…

  18. Shrinking the Public Safety Net or Helping the Poor Play by the Rules? The Changes in the State-Level Policies That Affected Low-Income Families with Children in the Welfare Reform Era: 1994-2002

    Science.gov (United States)

    Aratani, Yumiko; Lu, Hsien-Hen; Aber, J. Lawrence

    2014-01-01

    Despite the claimed success of the 1996 Welfare Reform, little research using multivariate regression has examined changes in multiple public safety-net programs. Thus, we still do not know whether public safety-net programs for the poor have shrunk or increased nationwide, along with the sharp declines in cash assistance. Using state-level data…

  19. Observation of long-range tertiary interactions during ligand binding by the TPP riboswitch aptamer.

    Science.gov (United States)

    Duesterberg, Van K; Fischer-Hwang, Irena T; Perez, Christian F; Hogan, Daniel W; Block, Steven M

    2015-12-28

    The thiamine pyrophosphate (TPP) riboswitch is a cis-regulatory element in mRNA that modifies gene expression in response to TPP concentration. Its specificity is dependent upon conformational changes that take place within its aptamer domain. Here, the role of tertiary interactions in ligand binding was studied at the single-molecule level by combined force spectroscopy and Förster resonance energy transfer (smFRET), using an optical trap equipped for simultaneous smFRET. The 'Force-FRET' approach directly probes secondary and tertiary structural changes during folding, including events associated with binding. Concurrent transitions observed in smFRET signals and RNA extension revealed differences in helix-arm orientation between two previously-identified ligand-binding states that had been undetectable by spectroscopy alone. Our results show that the weaker binding state is able to bind to TPP, but is unable to form a tertiary docking interaction that completes the binding process. Long-range tertiary interactions stabilize global riboswitch structure and confer increased ligand specificity.

  20. FUNDING PUBLIC INSTITUTIONS IN ROMANIA

    Directory of Open Access Journals (Sweden)

    Florin-Constantin, DIMA

    2014-11-01

    Full Text Available The development of this article started from the fact that in the field of public institutions accounting there have been many changes and it aims to capture the essential aspects of their financing. Thus the article covers a series of issues related to the credit officers, to employment, to settlement and payment of public institutions expenditure, to the budgeting and budgetary credits accounting. It also presents a brief classification of the public institutions according to several criteria, as well as their financing sources. The paper also practically presents the accounting of the budgetary credits and their sharing mechanism between the principal, secondary and tertiary budgetary credits officers.

  1. Contraceptive Awareness and Practice Among Antenatal Attendees in a Tertiary Hospital in South-South Nigeria

    Directory of Open Access Journals (Sweden)

    Aniekan Monday Abasiattai

    2011-02-01

    Full Text Available Background: Use of effective contraceptive methods has been shown to improve health, sexual life and partner relations and also significantly reduce maternal and infant mortality by protecting against unplanned pregnancy, high fertility and high parity. The aim of this study is to determine the degree of awareness and practice of contraception by women in Uyo, Nigeria. Materials and Methods: Semi-structured questionnaires were administered to three hundred and seventy women in the antenatal clinic of the University of Uyo Teaching Hospital. Results: Majority of the respondents were 21-30 years old (64.1%, 53.8% were multiparous and 66.5% had tertiary level education. Three hundred and twenty women (87.6% had heard about contraception (OR=49.6, P< 0.001, while only 49.5% of the respondents had practiced contraception previously (OR=0.96, P=0.76 of which the male condom (40.0% and the safe period/calendar method (31.1% were the most commonly practiced methods. Majority of the respondents (66.8% preferred to have 3 to 4 children and 78.4% of the respondents would want to used a method of contraception to either space their family or limit child bearing (OR=13.14, P< 0.001. Fear of side effects (20.0% and previous bad experience (8.8% were the most common reasons given by those respondents who would not want to practice contraception. Conclusion: This study reveals a high level of awareness of contraception but a significant unmet need among the respondents. There is need to intensify public enlightenment campaigns in our environment emphasizing the benefits and safety of modern contraceptive methods. Community leaders and heads of social groups and women organisations should be co-opted in the dissemination of accurate information on contraception. [TAF Prev Med Bull 2011; 10(1.000: 29-34

  2. Physical Activity Level and Sedentary Behaviors among Public School Children in Dakar (Senegal Measured by PAQ-C and Accelerometer: Preliminary Results

    Directory of Open Access Journals (Sweden)

    Adama Diouf

    2016-10-01

    Full Text Available Background: Physical inactivity and sedentary lifestyles are major risk factors of childhood obesity. This study aimed to measure physical activity (PA levels by accelerometer and Physical Activity Questionnaire for Older Children (PAQ-C among Senegalese school children and the relation with Body Mass Index (BMI and body composition. Methodology: 156 pupils 8–11 years old were randomly selected in four elementary public schools of Dakar. BMI z-score was used to categorize children according to their weight status. PA was measured by PAQ-C in the 156 pupils and by accelerometer (Actigraph GT3X+, Pensacola, FL, USA in a subsample of 42 children. Body composition was determined by deuterium dilution method. Results: PAQ-C results were comparable in the 156 and 42 pupils. The 42 pupils presented a light activity measured by accelerometer, while PAQ-C classified the majority of them (57%; n = 24 in the moderate PA level. Children spent most of their time (min/day in sedentary activities and light activities than in moderate and intense activity levels. Accumulation of 60 min/day Moderate-to-Vigorous Physical Activity (MVPA was achieved by 54.8% (n = 23 of the pupils. MVPA decreased in girls in relation to their body fatness. There was a significant difference in MVPA between boys and girls. Similarly, overweight/obese (45 ± 16 min/day children had lower MVPA than their normal and underweight peers (88 ± 34 and 74 ± 36 min/day, respectively; p = 0.004. Conclusions: The two methods are inconsistent for measuring light and moderate PA levels. Although PAQ-C is an uncomplicated routine method, various activities were not adapted for genuine activities in Senegalese children and therefore needs to be validated in African children.

  3. Evaluation of the Special Tertiary Admissions Test (STAT)

    Science.gov (United States)

    Coates, Hamish; Friedman, Tim

    2010-01-01

    This paper reports findings from the first national Australian study of the predictive validity of the Special Tertiary Admissions Test (STAT). Background on tertiary admissions procedures in Australia is presented, followed by information on STAT and the research methods. The results affirm that STAT, through the provision of baseline and…

  4. Academic mentoring and the future of tertiary education in Nigeria ...

    African Journals Online (AJOL)

    Tertiary education is a major outlet for the provision of high manpower for national development. This paper therefore highlighted the challenges of tertiary education in Nigeria, early perspectives of mentoring undergraduates, the rationale for academic mentoring, the role of a mentor, and the role of library as catalyst in the ...

  5. Opinions of Nigerian students in tertiary institutions on family size ...

    African Journals Online (AJOL)

    The study examined the opinions of Nigerian students in tertiary institutions on their ideal family size. It was conducted among students in four tertiary institutions in Edo State of Nigeria. A sample size of 454 final year students was randomly drawn from the halls of residence in the institutions using the stratified sampling ...

  6. Cost-minimization analysis of antimicrobial therapy in a tertiary ...

    African Journals Online (AJOL)

    Cost Minimization Analysis of antimicrobial therapy in a tertiary health care institution in a developing economy country was carried out. The most applicable tool for generic equivalent drugs was used in Ahmadu Bello University Teaching Hospital, a tertiary healthcare Institution in Nigeria, between 2005 and 2007. Relevant ...

  7. Conceptualising English as a lingua franca (ELF) as a tertiary ...

    African Journals Online (AJOL)

    This contribution draws on the notion of English as a lingua franca, especially as discussed in James (2006) and Smit (2010), to conceptualise English-medium tertiary education in settings where English functions as additional language and where tertiary education has a history of being undertaken in other, usually ...

  8. Solvent effects on the magnetic shielding of tertiary butyl alcohol ...

    African Journals Online (AJOL)

    The magnetic shielding and its polarizabilities, have been calculated for tertiary butyl alcohol and tertiary butyl amine. These have been used to rationalise the solvent shifts of the proton spectra of the interesting cosolvent systems with water recently measured by Kipkemboi, et al. Continuum solvation calculations and ...

  9. Crime and Crime Management in Nigeria Tertiary Institutions

    Science.gov (United States)

    Adebanjo, Margaret Adewunmi

    2014-01-01

    This paper examines crime and its management in Nigerian tertiary institutions. Tertiary institutions today have become arenas for crime activities such as rape, cultism, murder, theft, internet fraud, drug abuse, and examination malpractices. This paper delves into what crime is, and its causes; and the positions of the law on crime management.…

  10. Pursuing Discipline and Ethical Issues in Tertiary Institutions in Nigeria

    African Journals Online (AJOL)

    Discipline and ethics are twin issues that tend to undermine the provision of quality education in tertiary institutions in Nigeria. This is because the overall goals of tertiary institutions as enunciated in the National Policy of. Education can hardly be achieved by all the stakeholders without strict conformity and adherence to the ...

  11. 10 CFR 212.78 - Tertiary incentive crude oil.

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 3 2010-01-01 2010-01-01 false Tertiary incentive crude oil. 212.78 Section 212.78 Energy DEPARTMENT OF ENERGY OIL MANDATORY PETROLEUM PRICE REGULATIONS Producers of Crude Oil § 212.78 Tertiary incentive crude oil. Annual prepaid expenses report. By January 31 of each year after 1980, the project...

  12. Seepage characteristics of the second tertiary combined model

    Directory of Open Access Journals (Sweden)

    Huan ZHAO

    2015-08-01

    Full Text Available The second tertiary combined model experiment zone has been developed in Block B, Field L. The percolation feature of the second tertiary combined develop model shows great importance to rational and efficient development of the reservoir. In order to clearly illuminate its percolation feature, the typical reservoir numerical model is built by Eclipse, which is a reservoir numerical simulation software. The percolation features of original and added perforation interval under the second tertiary combined model are studied, and the variation features of general water-cut, recovery percentage, wellbore pressure, reservoir pressure and water saturation on condition of higher injection rate under the second tertiary combined model are analyzed. The research indicates that the second tertiary combined enhances the recovery of remaining oil on top of thick reservoir by developing and enhancing original perforation interval under water drive, then improves development results by polymer flooding, and gains higher recovery rate by synthetic action of water driver and polymer flooding.

  13. Navigating the global space of tertiary education:

    DEFF Research Database (Denmark)

    Wilken, Lisanne

    to the Bologna model in order to ease mobility (at least within Europe). This paper which is based on some very preliminary findings from an ongoing research project exploring internationalization of university education in Denmark, discusses educational strategies of students attending internationalized English......Over the past ten years the number of students who go abroad to pursue tertiary education has more than doubled, from 1, 9 million in 2000 to 4.1 million in 2010 (OECD 2012). This growing number of students studying abroad contributes to the overall flow of individuals and ideas across borders...... at lesser known universities in smaller European countries such as Sweden, Norway, Denmark and the Netherlands where the national language is not one of the major world languages but where courses and educations are increasingly offered in English and where the educational structures are adapted...

  14. Grignard Synthesis of Various Tertiary Alcohols

    Science.gov (United States)

    Everett, T. Stephen

    1998-01-01

    A general Grignard procedure is presented for the synthesis of aliphatic, tertiary alcohols containing six to nine carbons. Without revealing the specific starting materials, students are challenged to identify their unknown products from physical (boiling points, refractive indices) and spectral (infrared O-H, C-H and fingerprint regions) data. Once a product is identified retro-synthetic considerations point to which alkyl halide and ketone were required as starting materials. This laboratory exercise in organic synthesis incorporates anhydrous techniques, distillation, and infrared analysis. RX + Mg ---> [RMgX] + R'R"C=O ---> [RR'R"COMgX] ---> RR'R"COH Criteria RX = C2-C5 1' alkyl bromide (unbranched) R'R"C=O = C3-C5 ketone RR'R"COH = C6-C9 3' alcohol

  15. Market-level exposure to state antismoking media campaigns and public support for tobacco control policy in the United States, 2001-2002.

    Science.gov (United States)

    Niederdeppe, Jeff; Kellogg, Maxwell; Skurka, Christofer; Avery, Rosemary J

    2017-03-18

    This study tests whether exposure to state antismoking media campaigns is associated with increased support for comprehensive bans on smoking indoors and cigarette advertising. We combine commercially available data on market-level state-sponsored antismoking advertisements with three waves of the Current Population Survey's Tobacco Use Supplement to test the relationship between market-level volume of state antismoking advertising exposure and support for tobacco control policy between 2001 and 2002. We use logistic regression to assess which message themes employed in the advertisements are associated with increased support for tobacco control policy. The overall market-level volume of exposure to state antismoking ads targeted to adults or the general population was associated with significant increases in support for comprehensive indoor smoking bans. These effects were driven by exposure to ads emphasising the health consequences of smoking to others, anti-industry appeals and irrationality/addiction appeals. Evidence of campaign impact on support for tobacco advertising bans was less clear and, when statistically significant, small in magnitude relative to the impact of the state economic and tobacco control policy environment. This study shows that that large-scale antismoking media campaigns can have a meaningful secondary impact on support for comprehensive indoor smoking bans. Future research should identify the conditions under which mass media campaigns primarily targeting smoking behaviour may influence public support for a variety of other tobacco control policies. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  16. The effect of a behaviour change intervention on the diets and physical activity levels of women attending Sure Start Children's Centres: results from a complex public health intervention.

    Science.gov (United States)

    Baird, Janis; Jarman, Megan; Lawrence, Wendy; Black, Christina; Davies, Jenny; Tinati, Tannaze; Begum, Rufia; Mortimore, Andrew; Robinson, Sian; Margetts, Barrie; Cooper, Cyrus; Barker, Mary; Inskip, Hazel

    2014-07-15

    The UK government's response to the obesity epidemic calls for action in communities to improve people's health behaviour. This study evaluated the effects of a community intervention on dietary quality and levels of physical activity of women from disadvantaged backgrounds. Non-randomised controlled evaluation of a complex public health intervention. 527 women attending Sure Start Children's Centres (SSCC) in Southampton (intervention) and 495 women attending SSCCs in Gosport and Havant (control). Training SSCC staff in behaviour change skills that would empower women to change their health behaviours. Main outcomes dietary quality and physical activity. Intermediate outcomes self-efficacy and sense of control. 1-year post-training, intervention staff used skills to support behaviour change significantly more than control staff. There were statistically significant reductions of 0.1 SD in the dietary quality of all women between baseline and follow-up and reductions in self-efficacy and sense of control. The decline in self-efficacy and control was significantly smaller in women in the intervention group than in women in the control group (adjusted differences in self-efficacy and control, respectively, 0.26 (95% CI 0.001 to 0.50) and 0.35 (0.05 to 0.65)). A lower decline in control was associated with higher levels of exposure in women in the intervention group. There was a statistically significant improvement in physical activity in the intervention group, with 22.9% of women reporting the highest level of physical activity compared with 12.4% at baseline, and a smaller improvement in the control group. The difference in change in physical activity level between the groups was not statistically significant (adjusted difference 1.02 (0.74 to 1.41)). While the intervention did not improve women's diets and physical activity levels, it had a protective effect on intermediate factors-control and self-efficacy-suggesting that a more prolonged exposure to the

  17. What can existing overeducation tell us about the situation in supply and demand of tertiary educate

    OpenAIRE

    Miroslav Štefanik

    2011-01-01

    The submitted article deals with the problem of overeducation. It offers a brief overview of existing explanations and introduces a method of overeducation measurement based on internationally used classifications ISCO and ISCED. It also brings some evidence on overeducation measured by this method, using data mostly from the National level census and European Community Household Panel. The analysis is focused on the overeducation of workers with tertiary degrees, which becomes especially int...

  18. Global discourses and experiential speculation: Secondary and tertiary graduate Malawians dissect the HIV/AIDS epidemic

    Directory of Open Access Journals (Sweden)

    Myroniuk Tyler W

    2011-10-01

    Full Text Available Abstract Background Since the beginning of the HIV/AIDS epidemic, the perspectives of secondary and tertiary school graduates in sub-Saharan Africa regarding the effectiveness of government and international HIV/AIDS policies and programmes have not been thoroughly examined. When extensive monetary aid is directed toward "development" in a country like Malawi, it is the educated elites - secondary and tertiary graduates who are heavily involved and influential in the domestic re-distribution and implementation of millions of dollars worth of aid - on whom international expectations fall to decrease the transmission of HIV. Many Malawian jobs related to public health and HIV/AIDS are created as a direct result of this funding and are occupied by the few secondary and tertiary graduates. Thus, it is a practical venture to understand their perspectives on highly contentious and heavily funded HIV/AIDS issues that affect their nation. Methods Qualitative data was collected in this study in efforts to discover in-depth perspectives on the HIV/AIDS epidemic. Thirty-eight secondary and tertiary graduate Malawians took part in semi-structured interviews. Data was analysed using an early grounded theory approach and subsequent themes of "global discourses" and "experiential knowledge of HIV/AIDS" emerged. Results This group of Malawians frequently responded to questions regarding healthcare and access to medicine, sexual behaviours and methods of reducing the spread of HIV/AIDS by citing and explaining the widespread, international and "proper" responses. The secondary and tertiary graduate Malawians also discussed these same topics in terms of what they perceive or have experienced. Experiential responses, such as the counter-productivity of circumcision and condoms, the overestimation of HIV/AIDS prevalence, and calls for more authoritarian policing of commercial sex work, were remarkably divergent from the HIV/AIDS discourse. Conclusions The opinions

  19. Elimination of enteric bacteria in biological-chemical wastewater treatment and tertiary filtration units.

    Science.gov (United States)

    Koivunen, Jari; Siitonen, Anja; Heinonen-Tanski, Helvi

    2003-02-01

    The occurrence and removal of salmonellae and faecal indicators in four conventional municipal wastewater treatment plants (MWTP) were investigated. In addition, we tested the efficiency of a semi-technical scale biological nutrient removal process and three pilot-scale tertiary filtration units in microbial removal. All influent samples collected from MWTPs contained salmonellae from 93 to 11,000 MPN/100 ml and indicator bacteria from about 10(7) to 10(8) CFU/100 ml. The reductions in salmonella numbers achieved in full-scale biological-chemical wastewater treatment and semi-technical scale biological nutrient removal processes were usually between 94% and virtually 100% (99.9%) and indicator bacteria reductions between 2 and 3 log units. Microbial numbers in MWTP effluents could be modelled as a function of effluent residual organic matter, suspended solids and total phosphorus concentrations. Pilot-scale tertiary treatment by rapid sand contact filter, chemical contact filter and biological-chemical contact filter reduced salmonella numbers below the detection limit and faecal coliform numbers on average by 99%, 39% and 71%, respectively. A total of 32 Salmonella serovars were identified among 197 Salmonella isolates from municipal wastewaters. Of the isolates, 32% were resistant to nalidixic acid, indicating reduced sensitivity to ciprofloxacin, the drug of choice in the treatment of salmonellosis. In addition, 18% of the isolates were multiresistant. Our results, especially antibiotic resistant Salmonella strains, indicate that conventional municipal wastewater treatment without efficient tertiary treatment, like filtration or disinfection, may constitute a risk for public health.

  20. An analytical framework for assessing drug and therapeutics committee structure and work processes in tertiary Brazilian hospitals.

    Science.gov (United States)

    Lima-Dellamora, Elisangela da Costa; Caetano, Rosângela; Gustafsson, Lars L; Godman, Brian B; Patterson, Ken; Osorio-de-Castro, Claudia Garcia Serpa

    2014-09-01

    University teaching hospitals usually provide tertiary care and are subject to early adoption of new technologies, which may compromise healthcare systems when uncritically adopted. Knowledge on the decision-making process - drug selection by drug selection committees or DTCs - is crucial to improve the quality of care. There are no models for studying the selection of drugs in Brazilian healthcare services. This study aims to discuss DTC structure and the processes regarding adoption of medicines in tertiary university hospitals in Brazil and to propose an analytical structure for providing direction for the future. State of the art content regarding drug selection processes and DTC procedures was reviewed in three databases. Information on the medicine selection process in a Brazilian gold standard teaching hospital was collected through observations and a review of existing procedures. A structured discussion on medicine selection and DTC procedures in tertiary hospitals ensued. This discussion resulted in findings that were organized in three dimensions, composing an analytical framework for the application in tertiary Brazilian hospitals (i) motivations for the adoption of drugs; (ii) necessary structural and organizational aspects for decision-making; and (iii) criteria and methods employed by the decision-making process. We believe that the suggested framework is compatible with tertiary Brazilian hospitals, because a gold standard in the country was able to conduct all its procedures in the light of WHO and international recommendations. We hope to contribute in producing knowledge which may hopefully be adopted in tertiary hospitals across Brazil. © 2014 Nordic Association for the Publication of BCPT (former Nordic Pharmacological Society).

  1. Carriage of antibiotic-resistant Enterobacteriaceae in hospitalised children in tertiary hospitals in Harare, Zimbabwe.

    Science.gov (United States)

    Magwenzi, Marcelyn T; Gudza-Mugabe, Muchaneta; Mujuru, Hilda A; Dangarembizi-Bwakura, Mutsa; Robertson, Valerie; Aiken, Alexander M

    2017-01-01

    Extended-spectrum β-lactamase-producing and gentamicin resistant Enterobacteriaceae are increasingly recognised as a major cause of infection in low-income countries. We assessed the prevalence of gastrointestinal carriage of these bacteria in hospitalised children in Harare, Zimbabwe. We conducted a cohort study in paediatric inpatients at two tertiary-referral hospitals between May and July 2015. Rectal swabs and faecal samples were collected within 24 h of admission and further follow-up samples were collected on alternate days during hospitalization. Disc-based, selective and enrichment methods were used to detect carriage of these two forms of resistance. Standard methods were used to confirm resistance status and determine the susceptibility of resistant isolates to other commonly-used antibiotics. One hundred and sixty four paediatric inpatient admissions (median age = 1.0 year, IQR = 0.2-2.2years) were enrolled, and an average of 1.9 faecal samples per patient were collected. On admission, 68/164 (41%) patients had both ESBL and gentamicin-resistant Enterobacteriaceae detected, 18 (11%) had ESBL only, 17 (10%) had gentamicin resistance only and 61 (37%) had negative screening for both forms of resistance. During hospitalisation, 32/164 (20%) patients were found to have a type of resistant organism which was not present in their admission sample. We found that faecal samples and use of a selective enrichment broth enhanced the detection of resistant organisms. Amongst resistant bacteria isolated, there were high levels of resistance to ciprofloxacin and chloramphenicol, but not ertapenem. More than half of children had enteric carriage of a clinically-relevant form of antibiotic resistance on admission to public-sector hospitals in urban Zimbabwe. Additionally, a fifth of children acquired a further form of resistance during hospitalisation. Urgent action is needed to tackle the spread of antibiotic resistant enteric bacteria in African hospitals.

  2. Profile of catering staff at a tertiary care hospital in Mumbai.

    Science.gov (United States)

    Bobhate, Prateek S; R Shrivastava, Saurabh; Gupta, Pankaj

    2011-01-01

    Food borne illnesses, even today, continue to be a major public health problem in both developing and developed nations. Food handlers play an important role in ensuring food safety throughout the chain of production, processing, storage and preparation.Health of food handlers is of great importance for maintaining hygienic quality of food prepared and served by them. Thus, the present study was conducted to study socio-demographic characteristics, morbidity pattern and immunization status of catering staff at a tertiary care hospital in Mumbai A cross sectional study was conducted from August 2010 to November 2010. Out of the total of 162 food handlers working in 11 food service establishments, 137 were interviewed face to face using a semi-structured questionnaire, while remaining 25 food handlers were excluded because of either their absence or not giving consent. The food handlers were assessed clinically for personal hygiene and investigated for hemoglobin, stool routine and sputum AFB examination. 82 (59.8%) food handlers were from the age group 10 - 29 years, 113 (82.5%) male, 95 (69%) married, 59 (43.1%) educated up to primary level. Only 7 (5.1%) had ever received a dose of typhoid vaccine. 103 (75.2%) had an addiction, majority consuming gutkha 59 (57.3%). Dental caries 32 (23.4%) was the most common morbidity identified. Entamoeba histolytica was isolated in 13 (9.5%) subjects. This study has confirmed an association between educational status and personal hygiene suggesting the need for greater personal hygiene in this group. Preemployment and periodical medical examination should be encouraged.

  3. Seroprevalence of Hepatitis C viral antibodies in pregnancy in a tertiary health facility in Nigeria.

    Science.gov (United States)

    Onakewhor, J U E; Okonofua, F E

    2009-03-01

    Liver disease due to Hepatitis C viral (HCV) infection is the most common indication for liver transplant. It is a viral pandemic that is five times as widespread as the human immunodeficiency virus type 1 infection. In spite of this, vaccines were yet unavailable for protection of the human race due to the morphology and fastidious nature of the organism. While the scanty data available on this infection in our environment are limited to blood donors, people continue to be screened for and deprived of renal dialysis if any patient is found to have HCV infection. Also in this environment, data on HCV infection in pregnancy is virtually nonexistent even though the infection can have a deleterious effect on materno-fetal outcome. To determine the seroprevalence of hepatitis C viral antibodies among antenatal women attending a tertiary health facility in Nigeria. This was a prospective cross-sectional study whose subjects were booked consecutive antenatal women volunteers attending the University of Benin Teaching Hospital, Benin City, Nigeria between June 1 and December 31, 2005. Hepatitis C viral antibodies were determined and confirmed using a second and a third generation Enzyme Linked immunosorbent assay respectively. Both HCV sero-positive and seronegative women had both pre-and post-test counseling. Of the 269 samples screened for HCV antibodies, 5 (1.86%) samples were confirmed seropositive. None of the HCV seropositive women had liver enzyme derangement. Hepatitis C viral infection in pregnancy is not uncommon in Nigeria. It's prevalence in pregnant women South-South of Nigerian is similar to that of their Cameroonian counterparts, an immediate neighbouring country. A multi-centre study to determine the national prevalence of HCV and in addition to elevation of public awareness is suggested. Hepatitis C viral-induced liver disease remains the major indication for liver transplant for which our present levels of economy and health infrastructures can least

  4. Wildfires and animal extinctions at the Cretaceous/Tertiary boundary

    Science.gov (United States)

    Adair, Robert K.

    2010-06-01

    Persuasive models of the ejection of material at high velocities from the Chicxulub asteroid impact marking the Cretaceous/Tertiary boundary have led to the conclusion that upon return, that material, heated in passage through the upper atmosphere, generated a high level of infrared energy density over the Earth's surface. That radiant energy has been considered to be a direct source of universal wildfires, which were presumed to be a major cause of plant and animal species extinctions. The extinction of many animal species, especially the dinosaurs, has also been attributed to the immediate lethal effects of the radiation. I find that the absorption of the radiation by the atmosphere, by cloud formations, and by ejecta drifting in the lower atmosphere reduced the radiation at the surface to a level that cannot be expected to have generated universal fires. Although the reduced radiation will have likely caused severe injuries to many animals, such insults alone seem unlikely to have generated the overall species extinctions that have been deduced.

  5. Assessing uncertainty in outsourcing clinical services at tertiary health centers.

    Science.gov (United States)

    Billi, John E; Pai, Chih-Wen; Spahlinger, David A

    2007-01-01

    When tertiary health centers face capacity constraint, one feasible strategy to meet service demand is outsourcing clinical services to qualified community providers. Clinical outsourcing enables tertiary health centers to meet the expectations of service timeliness and provides good opportunities to collaborate with other health care providers. However, outsourcing may result in dependence and loss of control for the tertiary health centers. Other parties involved in clinical outsourcing such as local partners, patients, and payers may also encounter potential risks as well as enjoy benefits in an outsourcing arrangement. Recommendations on selecting potential outsourcing partners are given to minimize the risks associated with an outsourcing contract. Copyright (c) 2006 John Wiley & Sons, Ltd.

  6. Service Quality Of Diagnostic Fine Needle Aspiration Cytology In A Tertiary Care Hospital Of Lahore (Process Measure As Patient's Perspective).

    Science.gov (United States)

    Rizvi, Zainab; Usmani, Rabia Arshed; Rizvi, Amna; Wazir, Salim; Zahra, Taskeen; Rasool, Hafza

    2017-01-01

    Quality of any service is the most important aspect for the manufacturer as well as the consumer. The primary objective of any nation's health system is to provide supreme quality health care services to its patients. The objective of this study was to assess the quality of diagnostic fine needle aspiration cytology service in a tertiary care hospital. As Patient's perspectives provide valuable information on quality of process, therefore, patient's perception in terms of satisfaction with the service was measured. In this cross sectional analytical study, 291 patients undergoing fine needle aspiration cytology in Mayo Hospital were selected by systematic sampling technique. Information regarding satisfaction of patients with four dimensions of service quality process, namely "procedure, sterilization, conduct and competency of doctor" was collected through interview on questionnaire. The questionnaire was developed on SERVQUAL model, a measurement tool, for quality assessment of services provided to patients. All items were assessed on 2- point likert scale (0=dissatisfied, 1=satisfied). Frequencies and percentages of satisfied and dissatisfied patients were recorded for each item and all items in each dimension were scored. If the percentage of sum of all item scores of a dimension was ≥60, the dimension was 'good quality'. Whereas quality' dimension. Data was analysed using epi-info-3.5.1. Fisher test was applied to check statistical significance. (p-value service quality process, Procedure (48.8%), Sterilization (51.5%) and practitioner conduct (50.9%) were perceived as 'poor' by the patients. Only practitioner competency (67.4%) was perceived as 'good'. Comparison of dimensions of service quality scoring with overall level of patient satisfaction revealed that all 4 dimensions were significantly related to patient dissatisfaction (pservice quality of therapeutic and diagnostic procedures in public hospitals should be routinely monitored from the patients

  7. Aspects on the Role of the Educational Process in Increasing the Quality of Human Resources at the Level of Public Administration

    Directory of Open Access Journals (Sweden)

    Carmen - Marina Dragomir

    2011-04-01

    Full Text Available This theme has as necessity the requirements for the public administration staff’seffectiveness, increasing professional performance directly related to policies and strategies forquality assurance in the national education system from Romania, for high and sustained training ofspecialists. We propose the analysis of some interaction directions between higher education and theentities to whom the educational offer addresses, in case of active involvement of higher education inhuman resources from the public administration and administration specialists in education process,aiming at developing the administrative capacity of public, central and local institutions, andintroducing and maintaining the quality standards for public services.

  8. Genetic diversity, genetic structure, and mating system of brewer spruce (Pinaceae), a relict of the acto-tertiary forest

    Science.gov (United States)

    F. Thomas Ledig; Paul D. Hodgskiss; David R. Johnson

    2005-01-01

    Brewer spruce (Picea breweriana), a relict of the widespread Arcto-Tertiary forests, is now restricted to a highly fragmented range in the Klamath Region of California and Oregon. Expected heterozygosity for 26 isozyme loci, averaged over 10 populations, was 0.121. More notable than the relatively high level of diversity when compared to other woody...

  9. CLINICAL PROFILE OF ANAEMIA IN A TERTIARY CARE HOSPITAL

    Directory of Open Access Journals (Sweden)

    Ather Akhtar

    2016-04-01

    Full Text Available BACKGROUND Anaemia causes a reduction in the oxygen carrying capacity of the blood resulting in tissue hypoxia. Cardiac output at rest is not usually increased in most chronic anaemia until haemoglobin levels fall below 7 g/dL, but abnormal rise in output with exercise may occur with levels as high as 10 g/dL. The increase in cardiac output has been observed to correlate well with the degree of anaemia. Other compensatory mechanisms to chronic anaemia available to the body include decreased circulation time and increased tissue oxygen uptake. The latter is facilitated by a shift to the right of the oxygen haemoglobin dissociation curve. Cardiomegaly may also be as a result of the increased workload on the heart from the increased viscosity of blood in anaemia patients. Anaemia in the elderly is an extremely common problem that is associated with increased mortality and poorer health-related quality of life, regardless of the underlying cause of the low haemoglobin. A study of anaemia in elderly patients found a wide variation in prevalence, ranging from 2.9% to 61% in men and 3.3% to 41% in women. Higher rates were found in hospitalised patients than in community dwellers. It is easy to overlook anaemia in the elderly, since such symptoms as fatigue, weakness, or shortness of breath may be attributed to the ageing process itself. Our objective is to show the prevalence of anaemia even in a tertiary health care centre. METHODS One hundred patients were identified who were admitted in the Department of Medicine, Deccan College of Medical Sciences. Among the 100 patients, 38 were male and 62 were female. The study was conducted from Jan 2014 To Jan 2015. Patients having haemoglobin less than 10 g% in the medical wards were enrolled in the study. RESULTS Among the 100 patients, 38 were male and 62 were female. The average haemoglobin was 6.4 g%, the lowest being 2.8 g%. Peripheral blood smear showed hypochromic picture in 58, macrocytic picture in

  10. Potential impact of tertiary oil recovery

    Energy Technology Data Exchange (ETDEWEB)

    Kastrop, J.E.

    1975-11-01

    Tertiary oil recovery is America's energy ace-in-the-hole and the technology developed here over the past decade could well offer the rest of the world a big incremental boost in its future oil supplies. While U.S. producers are carefully engineering fields that have finished secondary phases of oil production, international operators are commencing pressure maintenance projects by water and gas injection, the first stage of improved oil recovery. Oil recovery authorities who have dealt with the problem for decades estimate that from 25 to 50 billion bbl could be recovered by relatively new sophisticated processes initially developed in the research laboratory and tested in the field. There are 4 basic processes that indicate promise of commercial applications. These are (1) hydrocarbon miscible which includes high-pressure gas drive, rich gas or LPG driven by gas; (2) carbon dioxide miscible with CO/sub 2/ driven by gas or water; (3) chemical flooding, such as surfactant, micellar slugs driven by an aqueous polymer solution; and (4) thermal processes.

  11. The Tertiary tectonics of the southeast Asia

    Energy Technology Data Exchange (ETDEWEB)

    Honza, Eiichi (Geological Survey of Japan, Tsukuba (Japan))

    1990-06-01

    Most of the terranes in eastern Asia appear to be relics of arcs, oceanic islands, and subduction complexes. They have collided and accreted from the inner (northwestern) side in China since the Silurian. They are characterized by three stages of Pacific and Tethys evolution. The first collision is related to the Pacific domain in the Permian in which these movements are not clearly reconstructed. The second collision is related to the closure of the Paleo-Tethys in the Late Triassic to Early Jurassic. The third is related to closure of the Neo-Tethys and the subsequent collision of India in the Tertiary. Southeast Asia is in one of the most enigmatic plate boundaries in the world, forming many small plates, collisions, and consumptions. This complication is also suggested to be a result of the northward movement of Australia since its break-up from Gondwanaland in the Cretaceous. During their evolution, most of them have associated with arcs. These arcs also have formed superimpositions on the older exotic blocks of terranes. They are reconstructed on the base of the regular duration on the formation of arcs and backarc basins, which can be seen in the Western Pacific Arc Chain.

  12. Knowledge of Playing-Related Musculoskeletal Disorders Among Classical Piano Students at Tertiary Institutions in Malaysia.

    Science.gov (United States)

    Ling, Chia-Ying; Loo, Fung-Chiat; Hamedon, Titi Rahmawati

    2016-12-01

    Performance injuries among musicians have been widely discussed for decades. However, despite the growing number of classical pianists, this is still a new issue in Malaysia. Therefore, this study aimed to investigate the level of knowledge of playing-related musculoskeletal disorders (PRMDs) among tertiary music students in Malaysia. A survey was conducted among classical piano students at tertiary institutions of Kuala Lumpur and Selangor. Out of 192 respondents, 76% knew that piano playing can cause PRMDs. Slightly over three-quarters of respondents (77.1%) learned about PRMDs from music educators. The survey revealed that the belief in "no pain, no gain" was still ingrained in their minds, as 50.5% respondents believed that pain experienced while playing the piano was normal and 51.6% of them considered that pain must be experienced to improve their piano skill. The respondents were also scored on questions on terminologies of pianist injury and specific PRMD examples: 7.8% of respondents scored high in the questions on the general terminology, while 99.5% of them scored low in the questions on the specific examples of PRMDs. This finding indicated a lack of knowledge of specific musicians' injuries among classical piano students. The attitudes to pain and the level of understanding of the significance of potential injuries indicate that increasing PRMD awareness and introducing courses on PRMD prevention at tertiary institutions are warranted.

  13. Middle-Class Societies Invest More in Public Education: A Stronger Middle Class Is Associated with Higher Levels of Spending on Education

    Science.gov (United States)

    Madland, David; Bunker, Nick

    2011-01-01

    America's economic future depends in large part on the quality of the nation's public education. Education increases productivity, sparks innovation, and boosts the economic competitiveness. Not surprisingly, the American public thinks that there should be greater investments in education, with polls showing strong and growing support for…

  14. Instrumental vaginal delivery - an assessment of use in a tertiary ...

    African Journals Online (AJOL)

    O'SHEHU

    Instrumental vaginal delivery - an assessment of use in a tertiary care centre. Constance E SHEHU. Joel C OMEMBELEDE. Dept of Obstetrics &. Gynaecology, Usmanu. Danfodiyo, University. Teaching Hospital Sokoto. NIGERIA. Author for Correspondence. Constance E SHEHU. Dept of Obstetrics &. Gynaecology, Usmanu.

  15. DIRECT SYNTHESIS OF TERTIARY AMINES IN WATER USING MICROWAVES

    Science.gov (United States)

    A direct synthesis of tertiary amines is presented that proceeds expeditiously via N-alkylation of amines using alkyl halides in alkaline aqueous medium. This environmentally benign reaction is accelerated upon exposure to microwave irradiation resulting in shortened reaction tim...

  16. Pregnancy outcome in unbooked mothers at a tertiary health ...

    African Journals Online (AJOL)

    demographical characteristics and feto-maternal outcome in unbooked mothers who delivered at a tertiary referral ... Data obtained from the theatre records, delivery registers and case notes were analysed using the statistical package SPSS 20.

  17. Social Activities and Manifest Anxiety among Freshmen in Tertiary ...

    African Journals Online (AJOL)

    ) in tertiary institutions in Lagos state of Nigeria were analysed to determine the relationship between social activities and manifest anxiety. Social activities in the study were measured in terms of freshmen adjustment to religious activities and ...

  18. Primary Index Term Secondary Index Term Tertiary Index term ...

    Indian Academy of Sciences (India)

    chaubey

    Tertiary Index term. Geosciences. Solid earth. Tectonics. Structural Geology. Geodynamics. Seismology. Exploration geophysics. Seismic hazards. Geomagnetism. Mineralogy. Petrology. Metamorphic. Igneous. Sedimentary. Fossil fuels. Petroleum and coal. Isotope geology. Geochronology. Isotope geology. Landform and.

  19. Public Relations in the Public Sector

    DEFF Research Database (Denmark)

    Valentini, Chiara

    2013-01-01

    Purpose of the paper: The aim of this study is to examine the level of strategic management of public administrations and information and communication programs by public communication officers in Italy. Methodology: The study is quantitative in nature. It was constructed according to the findings...... of the Excellence Project in Public Relations and thus applies a research instrument similar to that used in other international scholarly investigations in public relations. The population comprises civil servants working in information and communication activities for Italian public administrations. Findings......: The majority of public communication officers in the Italian public administration are not involved in the strategic management of public administrations but rather contribute to operational activities. They report directly to the senior manager of their department/unit and they use a mixed model of public...

  20. [Health impact and treatment costs of community-acquired pneumonia in children in the first level of public attention in Argentina].

    Science.gov (United States)

    Bernztein, Ricardo; Drake, Ignacio

    2009-04-01

    Community acquired pneumonia in children remains an important cause of childhood deaths throughout the world that can be prevented by the use of antibiotics and access to medical care. Both were reduced in 2001 when Argentina suffered a severe social crisis. Among the responses to the crisis, the Remediar Program provided free essential medicines to the socially vulnerable population. Assess the health impact and costs of the provision of free medicines at the first level of public attention for childhood pneumonia. Three designs: 1. Ecological study with cross comparisons of diagnoses, prescriptions, beneficiaries by individual provinces of Remediar forms. children under 15 years old attended at 6 thousand health centres in Argentina, encompassing 24 Argentine provinces from March 2005 until February 2006. 2. Counterfactual approach. 3. Calculation of drug costs per unit of outcome. Over 15 million prescriptions were identified, 2,420 children under 1 year, 19,205 of 1 to 4 years and 15,977 from 5 to 14 years old with pneumonia. 90% of beneficiaries received antibiotics, most often amoxicillin. In children's under 5 years of age, Remediar coverage was 27.8%, with greater impact in the poorest provinces. The likely impact was 4,322 lives saved or 310,325 years of life lost avoided if mortality without antibiotics was 20%. Indigents who had children with pneumonia saved by medicines 14.3% of their income. Each life saved could have cost US $ 6.46 and each year of life lost averted US $ 0.09. This work highlights the impact of a low-cost health program for the treatment of vulnerable populations with childhood pneumonia in Argentina.