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Sample records for total contaminant burden

  1. Plasma Total Cysteine and Cardiovascular Risk Burden: Action and Interaction

    Directory of Open Access Journals (Sweden)

    Benedetta De Chiara

    2012-01-01

    Full Text Available We hypothesized that redox analysis could provide sensitive markers of the oxidative pathway associated to the presence of an increasing number of cardiovascular risk factors (RFs, independently of type. We classified 304 subjects without cardiovascular disease into 4 groups according to the total number of RFs (smoking, hypertension, hypercholesterolaemia, hyperhomocysteinaemia, diabetes, obesity, and their combination. Oxidative stress was evaluated by measuring plasma total and reduced homocysteine, cysteine (Cys, glutathione, cysteinylglycine, blood reduced glutathione, and malondialdehyde. Twenty-seven percent of subjects were in group 0 RF, 26% in 1 RF, 31% in 2 RF, and 16% in ≥3 RF. By multivariable ordinal regression analysis, plasma total Cys was associated to a higher number of RF (OR = 1.068; 95% CI = 1.027–1.110, =0.002. Total RF burden is associated with increased total Cys levels. These findings support a prooxidant effect of Cys in conjunction with RF burden, and shed light on the pathophysiologic role of redox state unbalance in preclinical atherosclerosis.

  2. Total aflatoxin, fumonisin and deoxynivalenol contamination of ...

    African Journals Online (AJOL)

    Mycotoxin contamination is a common problem in developing countries, particularly in cereals, and this poses a serious health risk to its consumers. Busaa is a Kenyan traditional brew whose cereal ingredients are prone to mycotoxin contamination. This study aimed at detecting the presence and subsequently quantifying ...

  3. National Status and Trends: Contaminant body burdens and histopathology of fish and shellfish from Alaska

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — In response to the growing concerns among Chugach communities, contaminant body burden and histopathological condition of chum and sockeye salmon (Oncorhynchus keta...

  4. Plasma Total Cysteine and Cardiovascular Risk Burden: Action and Interaction

    OpenAIRE

    De Chiara, Benedetta; Sedda, Valentina; Parolini, Marina; Campolo, Jonica; De Maria, Renata; Caruso, Raffaele; Pizzi, Gianluigi; Disoteo, Olga; Dellanoce, Cinzia; Corno, Anna Rosa; Cighetti, Giuliana; Parodi, Oberdan

    2012-01-01

    We hypothesized that redox analysis could provide sensitive markers of the oxidative pathway associated to the presence of an increasing number of cardiovascular risk factors (RFs), independently of type. We classified 304 subjects without cardiovascular disease into 4 groups according to the total number of RFs (smoking, hypertension, hypercholesterolaemia, hyperhomocysteinaemia, diabetes, obesity, and their combination). Oxidative stress was evaluated by measuring plasma total and reduced h...

  5. The current total economic burden of diabetes mellitus in the Netherlands.

    Science.gov (United States)

    Peters, M L; Huisman, E L; Schoonen, M; Wolffenbuttel, B H R

    2017-09-01

    Insight into the total economic burden of diabetes mellitus (DM) is essential for decision makers and payers. Currently available estimates for the Netherlands only include part of the total burden or are no longer up-to-date. Therefore, this study aimed to determine the current total economic burden of DM and its complications in the Netherlands, by including all the relevant cost components. The study combined a systematic literature review to identify all relevant published information and a targeted review to identify relevant information in the grey literature. The identified evidence was then combined to estimate the current total economic burden. In 2016, there were an estimated 1.1 million DM patients in the Netherlands, of whom approximately 10% had type 1 and 90% had type 2 DM. The estimated current total economic burden of DM was € 6.8 billion in 2016. Healthcare costs (excluding costs of complications) were € 1.6 billion, direct costs of complications were € 1.3 billion and indirect costs due to productivity losses, welfare payments and complications were € 4.0 billion. DM and its complications pose a substantial economic burden to the Netherlands, which is expected to rise due to changing demographics and lifestyle. Indirect costs, such as welfare payments, accounted for a large portion of the current total economic burden of DM, while these cost components are often not included in cost estimations. Publicly available data for key cost drivers such as complications were scarce.

  6. Total effective dose equivalent associated with fixed uranium surface contamination

    International Nuclear Information System (INIS)

    Bogard, J.S.; Hamm, R.N.; Ashley, J.C.; Turner, J.E.; England, C.A.; Swenson, D.E.; Brown, K.S.

    1997-04-01

    This report provides the technical basis for establishing a uranium fixed-contamination action level, a fixed uranium surface contamination level exceeding the total radioactivity values of Appendix D of Title 10, Code of Federal Regulations, part 835 (10CFR835), but below which the monitoring, posting, and control requirements for Radiological Areas are not required for the area of the contamination. An area of fixed uranium contamination between 1,000 dpm/100 cm 2 and that level corresponding to an annual total effective dose equivalent (TEDE) of 100 mrem requires only routine monitoring, posting to alert personnel of the contamination, and administrative control. The more extensive requirements for monitoring, posting, and control designated by 10CFR835 for Radiological Areas do not have to be applied for these intermediate fixed-contamination levels

  7. Endocrine disruptors in bottled mineral water: total estrogenic burden and migration from plastic bottles.

    Science.gov (United States)

    Wagner, Martin; Oehlmann, Jörg

    2009-05-01

    Food consumption is an important route of human exposure to endocrine-disrupting chemicals. So far, this has been demonstrated by exposure modeling or analytical identification of single substances in foodstuff (e.g., phthalates) and human body fluids (e.g., urine and blood). Since the research in this field is focused on few chemicals (and thus missing mixture effects), the overall contamination of edibles with xenohormones is largely unknown. The aim of this study was to assess the integrated estrogenic burden of bottled mineral water as model foodstuff and to characterize the potential sources of the estrogenic contamination. In the present study, we analyzed commercially available mineral water in an in vitro system with the human estrogen receptor alpha and detected estrogenic contamination in 60% of all samples with a maximum activity equivalent to 75.2 ng/l of the natural sex hormone 17beta-estradiol. Furthermore, breeding of the molluskan model Potamopyrgus antipodarum in water bottles made of glass and plastic [polyethylene terephthalate (PET)] resulted in an increased reproductive output of snails cultured in PET bottles. This provides first evidence that substances leaching from plastic food packaging materials act as functional estrogens in vivo. Our results demonstrate a widespread contamination of mineral water with xenoestrogens that partly originates from compounds leaching from the plastic packaging material. These substances possess potent estrogenic activity in vivo in a molluskan sentinel. Overall, the results indicate that a broader range of foodstuff may be contaminated with endocrine disruptors when packed in plastics.

  8. Study of relationship between radioactivity distribution, contamination burden and quality standard, accommodate energy of code river Yogyakarta

    International Nuclear Information System (INIS)

    Agus Taftazani and Muzakky

    2009-01-01

    Study of relationship between distribution, contamination burden of gross β radioactivity and natural radionuclide in water and sediment sample from 11 observation station Code river to quality standard and maximum capacity of Code river have been done. Natural radio nuclides identification and gross β radioactivity measurement of condensed water, dry and homogeneous sediment powder (past through 100 mesh sieve) samples have been done by using spectrometer and GM counter. Radioactivity data was analyzed descriptive with histogram to show the spreading pattern of data. Contamination burden data, quality standard and maximum capacity of river Code was to descriptive analyzed by line diagram to knowing relationship between contamination burden, quality standard, and maximum capacity of Code river. The observation of water and sediment at 11 observation station show that the emitter natural radionuclides: 210 Pb, 212 Pb, 214 Pb, 226 Ra, 208 Tl, 214 Bi, 228 Ac and 40 K were detected. The analytical result conclusion was that the pattern spread of average activity gross β and were increase from upstream to downstream of the Code river samples. Contamination burden, quality standard and maximum capacity of radionuclide activity of 210 Pb, 212 Pb, 226 Ra and 228 Ac were more smaller than quality standard of river water according to regulation of Nuclear Energy Regulatory Agency 02/Ka-BAPETEN/V-99 concerning quality standard of radioactivity. It’s mean that Code river still in good contamination burden for the four radionuclides. (author)

  9. Organochlorine residues in harp seals, Phoca groenlandica, from the Gulf of St. Lawrence and Hudson Strait: An evaluation of contaminant concentrations and burdens

    Energy Technology Data Exchange (ETDEWEB)

    Beck, G.G.; Smith, T.G. (Dept. of Fisheries and Oceans, Nanaimo, BC (Canada)); Addison, R.F. (Dept. of Fisheries and Oceans, Sidney, BC (Canada))

    1994-01-01

    Organochlorine contaminant concentrations and burdens were evaluated in blubber samples from 50 harp seals (Phoca groenlandica) obtained from the estuary and northern Gulf of St. Lawrence and Hudson Strait, Canada between December 1988 and December 1989. The concentration and burden of polychlorinated biphenyls (PCBs) increased significantly during the winter months for males occupying the St. Lawrence estuary. The potential for rapid accumulation of contaminants in the estuary was also observed among females: nine postpartum females (1 month after weaning) had higher organochlorine levels than prepartum females from the same location. The lowest observed contaminant concentrations and burdens were in seals from Hudson Strait in autumn. In winter specimens, males had DDT and PCB concentrations about 4 and 2 times as great, respectively, as females of similar age distribution and collection date. Congeners with IUPAC Nos. 138 and 153 accounted for more than 50% of total identifiable PCBs, which is consistent with their prevalence in other marine biota. The concentration of PCBs has declined and the percent p,p'-DDE of total DDT has increased between 1982 and the present study. Unlike the beluga whale (Delphinapterus leucas), harp seals occupy the more polluted waters of the estuary only seasonally, and this may account for their lower residue concentrations. 59 refs., 1 fig., 5 tabs.

  10. Resuspended contaminated sediments cause sublethal stress to oysters: A biomarker differentiates total suspended solids and contaminant effects.

    Science.gov (United States)

    Edge, Katelyn J; Dafforn, Katherine A; Simpson, Stuart L; Ringwood, Amy H; Johnston, Emma L

    2015-06-01

    Resuspended contaminated sediments represent an important route of contaminant exposure for aquatic organisms. During resuspension events, filter-feeding organisms are exposed to contaminants, in both the dissolved form (at the gills) and the particulate form (in the digestive system). In addition, these organisms must manage the physical stress associated with an increase in total suspended solids (TSS). To date, few studies have experimentally compared the contributions to biological stress of contaminated and clean suspended solids. The authors mixed field-collected sediments (cellular biomarkers (lysosomal membrane stability, lipid peroxidation, and glutathione) were measured to evaluate sublethal toxicity. Lysosomal membrane stability was the most sensitive biomarker for distinguishing effects from resuspended contaminated sediments, as increasing amounts of contaminated TSS increased lysosomal membrane destabilization. The authors' results illustrate the importance of considering contaminant exposures from resuspended sediments when assessing the toxicity of contaminants to aquatic organisms. © 2015 SETAC.

  11. Seasonal Variation of Total Mercury Burden in the American Alligator (Alligator Mississippiensis) at Merritt Island National Wildlife Refuge (MINWR), Florida

    Science.gov (United States)

    Nilsen, Frances M.; Dorsey, Jonathan E.; Long, Stephen E.; Schock, Tracey B.; Bowden, John A.; Lowers, Russell H.; Guillette, Louis J., Jr.

    2016-01-01

    Seasonal variation of mercury (Hg) is not well studied in free-ranging wildlife. Atmospheric deposition patterns of Hg have been studied in detail and have been modeled for both global and specific locations with great accuracy and correlates to environment impact. However, monitoring these trends in wildlife is complicated due to local environmental parameters (e.g., rainfall, humidity, pH, bacterial composition) that can affect the transformation of atmospheric Hg to the biologically available forms. Here, we utilized an abundant and healthy population of American alligators (Alligator mississippiensis) at Merritt Island National Wildlife Refuge (MINWR), FL, and assessed Hg burden in whole blood samples over a span of 7 years (2007 2014; n 174) in an effort to assess seasonal variation of total [Hg]. While the majority of this population is assumed healthy, 18 individuals with low body mass indices (BMI, defined in this study) were captured throughout the 7 year sampling period. These individual alligators exhibited [Hg] that were not consistent with the observed overall seasonal [Hg] variation, and were statistically different from the healthy population of alligators. The alligators with low BMI had elevated concentrations of Hg compared to their age/sex/season matched counterparts with normal BMI. Statistically significant differences were found between the winter and spring seasons for animals with normal BMI. The data in this report supports the conclusion that organismal total [Hg] do fluctuate directly with seasonal deposition rates as well as other seasonal environmental parameters, such as average rainfall and prevailing wind direction. This study highlights the unique environment of MINWR to permit annual assessment of apex predators, such as the American alligator, to determine detailed environmental impact of contaminants of concern.

  12. The organic contamination level based on the total soil mass is not a proper index of the soil contamination intensity

    Science.gov (United States)

    Hung, H.-W.; Daniel, Sheng G.; Lin, T.-F.; Su, Y.; Chiou, C.T.

    2009-01-01

    Concentrations of organic contaminants in common productive soils based on the total soil mass give a misleading account of actual contamination effects. This is attributed to the fact that productive soils are essentially water-saturated, with the result that the soil uptake of organic compounds occurs principally by partition into the soil organic matter (SOM). This report illustrates that the soil contamination intensity of a compound is governed by the concentration in the SOM (Com) rather than by the concentration in whole soil (Cs). Supporting data consist of the measured levels and toxicities of many pesticides in soils of widely differing SOM contents and the related levels in in-situ crops that defy explanation by the Cs values. This SOM-based index is timely needed for evaluating the contamination effects of food crops grown in different soils and for establishing a dependable priority ranking for intended remediation of numerous contamination sites.

  13. Understanding differences in the body burden-age relationships of bioaccumulating contaminants based on population cross sections versus individuals.

    Science.gov (United States)

    Quinn, Cristina L; Wania, Frank

    2012-04-01

    Body burdens of persistent bioaccumulative contaminants estimated from the cross-sectional biomonitoring of human populations are often plotted against age. Such relationships have previously been assumed to reflect the role of age in bioaccumulation. We used a mechanistic modeling approach to reproduce concentration-versus-age relationships and investigate factors that influence them. CoZMoMAN is an environmental fate and human food chain bioaccumulation model that estimates time trends in human body burdens in response to time-variant environmental emissions. Trends of polychlorinated biphenyl (PCB) congener 153 concentrations versus age for population cross sections were estimated using simulated longitudinal data for individual women born at different times. The model was also used to probe the influence of partitioning and degradation properties, length of emissions, and model assumptions regarding lipid content and liver metabolism on concentration-age trends of bioaccumulative and persistent contaminants. Body burden-age relationships for population cross sections and individuals over time are not equivalent. The time lapse between the peak in emissions and sample collection for biomonitoring is the most influential factor controlling the shape of concentration-age trends for chemicals with human metabolic half-lives longer than 1 year. Differences in observed concentration-age trends for PCBs and polybrominated diphenyl ethers are consistent with differences in emission time trends and human metabolic half-lives. Bioaccumulation does not monotonically increase with age. Our model suggests that the main predictors of cross-sectional body burden trends with age are the amount of time elapsed after peak emissions and the human metabolic and environmental degradation rates.

  14. Ultraviolet radiation and air contamination during total hip replacement

    International Nuclear Information System (INIS)

    Carlsson, A.S.; Nilsson, B.; Walder, M.H.; Osterberg, K.

    1986-01-01

    Ultraviolet (uv) radiation of the operating room was assessed bacteriologically in an open randomized study of 30 total hip procedures. Volumetric air-sampling demonstrated that the number of colony forming units (cfu m-3) were significantly reduced (P less than 0.001) by uv light, both close to the wound and in the periphery of the operating room. No adverse effects of the uv-irradiation were observed either in the patients or the staff. In operating rooms fitted with a zonal ventilation system and with an air change rate of about 70 h-1, the addition of uv irradiation during surgery may achieve ultra clean air. However, in conventionally ventilated operating rooms uv-irradiation alone is probably not sufficient to do so

  15. 137Cs radiation burden on children from a highly contaminated area of Belarus

    International Nuclear Information System (INIS)

    Kortmann, B.; Wendhausen, H.; Wassermann, O.; Fischer, R.; Nielsen, P.; Shaverda, V.F.

    1996-01-01

    The radiation burden from 137 Cs sources on 22 children from a small Byelorussian village was studied from 1992 to 1994. Foodstuff, whole body burden and urinary excretion of 137 Cs were measured, intake rates, biological half-lives and doses were calculated. The median value for the 137 Cs whole body incorporation level was found to be 124 Bq, the biological half life was calculated as 68 d for girls and 50 d for boys. The internal dose caused by 137 Cs was found to be negligible in comparison to that from external sources. No deviation from normal values could be shown in simultaneously studied clinico-chemical parameters

  16. Sweeping total reflection X-ray fluorescence optimisation to monitor the metallic contamination into IC manufacturing

    International Nuclear Information System (INIS)

    Borde, Yannick; Danel, Adrien; Roche, Agnes; Veillerot, Marc

    2008-01-01

    Among the methods available on the market today to control as metallic contamination in integrated circuit manufacturing, Sweeping Total reflection X-ray Fluorescence mode appears a very good method, providing fast and entire wafer mapping. With the goal of a pertinent use of Sweeping Total reflection X-ray Fluorescence in advanced Integrated Circuit manufacturing this work discusses how acceptable levels of contamination specified by the production (low levels to be detected) can be taken into account. The relation between measurement results (surface coverage, throughput, low limit of detection, limit of quantification, quantification of localized contamination) and Sweeping Total reflection X-ray Fluorescence parameters (number of measurement points and integration time per point) is presented in details. In particular, a model is proposed to explain the mismatch between actual surface contamination in a localized spot on wafer and Total reflection X-ray Fluorescence reading. Both calibration and geometric issues have been taken into account

  17. High bacterial contamination rate of electrocautery tips during total hip and knee arthroplasty.

    Science.gov (United States)

    Abdelaziz, Hussein; Zahar, Akos; Lausmann, Christian; Gehrke, Thorsten; Fickenscher, Helmut; Suero, Eduardo M; Gebauer, Matthias; Citak, Mustafa

    2018-04-01

    The aim of the study was to quantify the bacterial contamination rate of electrocautery tips during primary total joint replacement (TJR), as well as during aseptic and septic revision TJR. A total of 150 electrocautery tips were collected between April and July 2017. TJR surgeries were divided into three groups: (1) primary, (2) aseptic and (3) septic revisions. In each group, a total of 50 electrocautery tips were collected. A monopolar electrocautery with a reusable stainless-steel blade tip was used in all cases. The rate of bacterial contamination was determined for all groups. Correlation of exposure time and type of surgery was analyzed. The overall bacterial contamination rate was 14.7% (95% CI 9.4 to 21.4%). The highest contamination rate occurred in the septic revision group (30.0%; 95% CI 17.9 to 44.6%), followed by the primary cases group (10.0%; 95% CI 3.3 to 21.8%) and the aseptic revision group (4.0%; 95% CI 0.5 to 13.7%). Exposure time did not affect the bacterial contamination rate. In 12 out of 15 (80%) contaminations identified in the septic group, we found the same causative microorganism of the prosthetic joint infection on the electrocautery tip. The bacterial contamination of the electrocautery tips is relatively high, especially during septic hip revision arthroplasty. Electrocautery tips should be changed after debridement of infected tissue.

  18. America's Children and the Environment: Measures of Contaminants, Body Burdens, and Illnesses. Second Edition.

    Science.gov (United States)

    Woodruff, Tracey J.; Axelrad, Daniel A.; Kyle, Amy D.; Nweke, Onyemaechi; Miller, Gregory G.

    Noting that children may be affected by environmental contaminants in ways quite different from the way adults are affected, this report is the second on trends in measures reflecting environmental factors that may affect the U.S. children's health and well-being. A list of measures and key findings begins the report, followed by five main…

  19. Determination of total As in onion plants growing in contaminated substrates by total reflection X-ray fluorescence

    International Nuclear Information System (INIS)

    Lue-Meru Marco Parra

    2011-01-01

    The onion (Allium cepa L.) is one of the most important cultivars in the world and its production level occupies the second place in Venezuela. It becomes important to develop analytical procedures for arsenic determination and to study the effect of this element on the cultures, as well the absorption, transport and translocation processes. A TXRF method for As determination in onions was developed. Two treatments were applied to the onion plants, As contaminated and control. The contaminant was added to the plants to an amount of 100 μg, in a single time 3 weeks after the transplant of plantlets. The green leaves bulbs, and roots together with the stems were separated 45 days after transplant and analyzed by TXRF and HG-AAS for total Arsenic determination. A good agreement was found between these two techniques, demonstrating the accuracy of the TXRF procedure. It was found that the highest concentration corresponded to the root and stems (37 ± 31 μg g -1 ), followed by the bulbs (11 ± 7 μg g -1 ), being the smallest level found in the green leaves (4 ± 3 μg g -1 ). At low As contamination levels of 0.25 μg g -1 , a risk for translocation of the toxic element to the edible parts of the onion plants exists. At this level the normal development of the plant is not affected, being the only exception the root length, which is significantly higher in the contaminated treatment. (author)

  20. Synchrotron radiation total reflection X-ray fluorescence (SR-TXRF) for evaluation of food contamination

    International Nuclear Information System (INIS)

    Vives, A.E.S.; Brienza, S.M.B.; Moreira, S.; Zucchi, O.L.A.; Nascimento Filho, V.F.

    2006-01-01

    The objective of this study was to use synchrotron radiation total reflection X-ray fluorescence analysis (SR-TXRF) for the determination of metals and other elements in food available to the population in commercial establishments, in order to evaluate the risks of contamination by these products. The analyzed species were vegetables, leafy vegetables, fruits, cereal and grain. The results indicated that some species were contaminated by Cr, Cu, Zn and Pb with concentrations much higher than the reference values. (author)

  1. Persistent organohalogen contaminant burdens in Antarctic krill (Euphausia superba) from the eastern Antarctic sector: A baseline study

    International Nuclear Information System (INIS)

    Bengtson Nash, S.M.; Poulsen, A.H.; Kawaguchi, S.; Vetter, W.; Schlabach, M.

    2008-01-01

    A baseline for persistent organohalogen compound (POC) accumulation in the Antarctic keystone species, Antarctic krill (Euphausia superba) has been established for a 50 deg. longitudinal range of the eastern Antarctic sector. Samples of adult krill, caught from 12 sites distributed between 30 deg. and 80 deg. E (60-70 deg. S), were analysed for > 100 organohalogen compounds including chlorinated pesticides, polychlorinated biphenyls (PCBs), polybrominated organic compounds and polychlorinated dibenzo-p-dioxins/furans (PCDD/Fs). Organochlorine pesticides dominated measured krill contaminant burdens with hexachlorobenzene (HCB) as the single most abundant compound quantified. Krill HCB concentrations were comparable to those detected at this trophic level in both the Arctic and temperate northwest Atlantic, lending support for the hypothesis that HCB will approach global equilibrium at a faster rate than other POCs. Para, para'-dichlorodiphenylethene (p,p'-DDE) was detected at notable concentrations. Measurements of DDT and its degradation products provide an important baseline for monitoring the temporal and geographical influence of renewed, DDT usage for malaria-control in affected southern hemisphere countries. In contrast to the Arctic, PCBs did not feature prominently in contaminant burdens of Antarctic krill. The major commercial polybrominated diphenyl ether (PBDE) congeners -99 and -47 were quantified at low background levels with clear concentration spikes observed at around 70 deg. E , in the vicinity of modern, active research stations. The likelihood that local anthropogenic activities are supplementing low PBDE levels, delivered otherwise primarily via long range environmental transport, is discussed. The suspected naturally occurring brominated organic compound, 2,4,6-tribromoanisole (TBA), was a ubiquitous contaminant in all samples whereas the only PCDD/Fs quantifiable were trace levels of octachlorodibenzo-p-dioxin (OCDD) and 1,2,3

  2. Which Clinical and Patient Factors Influence the National Economic Burden of Hospital Readmissions After Total Joint Arthroplasty?

    Science.gov (United States)

    Kurtz, Steven M; Lau, Edmund C; Ong, Kevin L; Adler, Edward M; Kolisek, Frank R; Manley, Michael T

    2017-12-01

    The Affordable Care Act of 2010 advanced the economic model of bundled payments for total joint arthroplasty (TJA), in which hospitals will be financially responsible for readmissions, typically at 90 days after surgery. However, little is known about the financial burden of readmissions and what patient, clinical, and hospital factors drive readmission costs. (1) What is the incidence, payer mix, and demographics of THA and TKA readmissions in the United States? (2) What patient, clinical, and hospital factors are associated with the cost of 30- and 90-day readmissions after primary THA and TKA? (3) Are there any differences in the economic burden of THA and TKA readmissions between payers? (4) What types of THA and TKA readmissions are most costly to the US hospital system? The recently developed Nationwide Readmissions Database from the Healthcare Cost and Utilization Project (2006 hospitals from 21 states) was used to identify 719,394 primary TJAs and 62,493 90-day readmissions in the first 9 months of 2013 based on International Classification of Diseases, 9th Revision, Clinical Modification codes. We classified the reasons for readmissions as either procedure- or medical-related. Cost-to-charge ratios supplied with the Nationwide Readmissions Database were used to compute the individual per-patient cost of 90-day readmissions as a continuous variable in separate general linear models for THA and TKA. Payer, patient, clinical, and hospital factors were treated as covariates. We estimated the national burden of readmissions by payer and by the reason for readmission. The national rates of 30- and 90-day readmissions after THA were 4% (95% confidence interval [CI], 4.2%-4.5%) and 8% (95% CI, 7.5%-8.1%), respectively. The national rates of 30- and 90-day readmissions after primary TKA were 4% (95% CI, 3.8%-4.0%) and 7% (95% CI, 6.8%-7.2%), respectively. The five most important variables responsible for the cost of 90-day THA readmissions (in rank order, based

  3. Degradation of Total Petroleum Hydrocarbon (TPH) in Contaminated Soil Using Bacillus pumilus MVSV3.

    Science.gov (United States)

    Varma, Surendra Sheeba; Lakshmi, Mahalingam Brinda; Rajagopal, Perumalsam; Velan, Manickam

    2017-01-01

     A study on bioremediation of soil contaminated with petroleum sludge was performed using Bacillus pumilus/MVSV3 (Accession number JN089707). In this study, 5 kg of agricultural soil was mixed well with 5% oil sludge and fertilizers containing nitrogen, phosphorus and potassium (N:P:K). The treatment resulted in 97% removal of total petroleum hydrocarbon (TPH) in 122 d in bacteria mixed contaminated soil when compared to 12% removal of TPH in uninoculated contaminated soil. The population of the microorganism remained stable after introduced into the oil environment. The physical and chemical parameters of the soil mixed with sludge showed variation indicating improvement and the pH level decreased during the experiment period. Elemental analysis and Gas Chromatography-Mass Spectroscopy (GC-MS) analysis revealed the bacterial ability to degrade oil sludge components. Growth experiments with Trigonellafoenumgraecum (Fenugreek) showed the applicability of bioremediated soil for the production.

  4. Large scale treatment of total petroleum-hydrocarbon contaminated groundwater using bioaugmentation.

    Science.gov (United States)

    Poi, Gregory; Shahsavari, Esmaeil; Aburto-Medina, Arturo; Mok, Puah Chum; Ball, Andrew S

    2018-05-15

    Bioaugmentation or the addition of microbes to contaminated sites has been widely used to treat contaminated soil or water; however this approach is often limited to laboratory based studies. In the present study, large scale bioaugmentation has been applied to total petroleum hydrocarbons (TPH)-contaminated groundwater at a petroleum facility. Initial TPH concentrations of 1564 mg L -1 in the field were reduced to 89 mg L -1 over 32 days. This reduction was accompanied by improved ecotoxicity, as shown by Brassica rapa germination numbers that increased from 52 at day 0 to 82% by the end of the treatment. Metagenomic analysis indicated that there was a shift in the microbial community when compared to the beginning of the treatment. The microbial community was dominated by Proteobacteria and Bacteroidetes from day 0 to day 32, although differences at the genus level were observed. The predominant genera at the beginning of the treatment (day 0 just after inoculation) were Cloacibacterium, Sediminibacterium and Brevundimonas while at the end of the treatment members of Flavobacterium dominated, reaching almost half the population (41%), followed by Pseudomonas (6%) and Limnobacter (5.8%). To the author's knowledge, this is among the first studies to report the successful large scale biodegradation of TPH-contaminated groundwater (18,000 L per treatment session) at an offshore petrochemical facility. Copyright © 2018 Elsevier Ltd. All rights reserved.

  5. Total Mercury and Methylmercury Contamination in Fish from Sites along the Elbe River

    Directory of Open Access Journals (Sweden)

    P. Maršálek

    2006-01-01

    Full Text Available The aim of the study was to evaluate total mercury Hg and methylmercury MeHg contamination in muscle tissues of fish collected in 2002 from the Labe (Elbe river at sites upstream of Pardubice and downstream of Pardubice and Hřensko, and in 2004 from the Labe river upstream and downstream of the Spolana factory in Neratovice, and from the Vltava river downstream of Lenora. Eighty eight fish of the following species were sampled: bream (Abramis brama L., perch (Perca fluviatilis L., chub (Leuciscus cephalus L. and barbel (Barbus barbus L.. Total mercury content in chub, perch and bream was in the range of 0.05 - 1.96 mg kg-1 w.w., 0. 09 - 1.46 mg kg-1 w.w. and 0.35 - 0.82 mg kg-1 w.w., respectively. Methylmercury content in chub, perch and bream was in the range of 0.04 - 2.11 mg kg-1 w.w., 0.1 - 1.73 mg kg-1 w.w. and 0.371 - 0.650 mg kg-1 w.w., respectively. Significant correlation (p p < 0.05 between THg and MeHg contents were found between individual sites. In 2002, for example, the most contaminated fish were found downstream of Pardubice, followed by fish from upstream of Pardubice and from Hřensko. In 2004, fish from downstream and upstream of the Spolana factory in Neratovice were more contaminated than fish from the Vltava river downstream of Lenora. The methylmercury-tototal mercury ratio in muscle tissue was close to 1.0.

  6. A SUMMARY OF TOTAL MERCURY CONCENTRATIONS IN FLORA AND FAUNA NEAR CONTAMINANT SOURCES IN THE GULF OF MEXICO

    Science.gov (United States)

    This report summarizes total mercury concentrations for environmental media collected from near-coastal areas including those impacted by contaminant sources common to the Gulf of Mexico. Water, sediment, fish, blue crabs, oysters, clams, mussels, periphyton and seagrasses were ...

  7. SURVEY OF OYSTERS CRASSOSTREA VIRGINICA FROM TAMPA BAY, FLORIDA: ASSOCIATIONS OF INTERNAL DEFENSE MEASUREMENTS WITH CONTAMINANT BURDENS

    Science.gov (United States)

    Oysters from 16 sites in Tampa Bay, Florida, were collected during a 6-week period in winter 1993 and analyzed for both biological characteristics and tissue chemical concentrations. Using previous sediment contamination and toxicity data, oyster tissues from the selected sites w...

  8. Reducing total health burden from 2001 to 2009: an employer counter-trend success story and its implications for health care reform.

    Science.gov (United States)

    Allen, Harris; Rogers, William H; Bunn, William B; Pikelny, Dan B; Naim, Ahmad B

    2012-08-01

    To examine total health burden for an employer whose health-related focus is direct and indirect costs. To explore implications for the Final Rule for Accountable Care Organizations recently issued by the Centers for Medicare and Medicaid Services, whose focus includes direct but not indirect costs. Used 42 claims and survey-based measures to track this employer's continental US workforce burden in the aggregate and by healthy and selected disease designations from 2001-2002 to 2008-2009. Starting from equivalent baselines, this employer's aggregate total direct costs decreased 16% (8.5% adjusted) whereas comparable US per capita expenditures rose 22.1%. Even larger decreases were recorded in total indirect costs. The healthy and disease designations replicated this pattern. Minimal employee cost shifting occurred. Attention to direct and indirect costs helped put this employer's health care investment on a markedly more sustainable path than comparable national cost trends. Fully tapping the applicable lessons this and other purchasers have learned will be facilitated by amending the Final Rule to include measures of indirect costs.

  9. The total amounts of radioactively contaminated materials in forests in Fukushima, Japan

    Science.gov (United States)

    Hashimoto, Shoji; Ugawa, Shin; Nanko, Kazuki; Shichi, Koji

    2012-01-01

    There has been leakage of radioactive materials from the Fukushima Daiichi Nuclear Power Plant. A heavily contaminated area (≥ 134, 137Cs 1000 kBq m−2) has been identified in the area northwest of the plant. The majority of the land in the contaminated area is forest. Here we report the amounts of biomass, litter (small organic matter on the surface of the soil), coarse woody litter, and soil in the contaminated forest area. The estimated overall volume and weight were 33 Mm3 (branches, leaves, litter, and coarse woody litter are not included) and 21 Tg (dry matter), respectively. Our results suggest that removing litter is an efficient method of decontamination. However, litter is being continuously decomposed, and contaminated leaves will continue to fall on the soil surface for several years; hence, the litter should be removed promptly but continuously before more radioactive elements are transferred into the soil. PMID:22639724

  10. Bacterial Contamination in Tips of Electrocautery Devices During Total Hip Arthroplasty.

    Science.gov (United States)

    Shahi, Alisina; Chen, Antonia F; McKenna, Paul B; Roberts, Amity L; Manrique, Jorge; Belden, Katherine A; Austin, Matthew S

    2015-08-01

    Surgical equipment can become contaminated during surgery. It is unknown if electrocautery tips can become contaminated in clean orthopedic procedures despite the produced heat. Therefore, we conducted a prospective study to address this concern. The tips from 25 primary and 25 aseptic revision THAs were collected and an additional 5 sterile tips served as negative controls. Aerobic and anaerobic cultures were incubated for a minimum of 3 days. There were 3 positive cultures (6%); one in primary THA (4%) with Lactobacillus and Enterococcus faecalis; two among revisions (8%), one with E. faecalis and another one with alpha hemolytic streptococci and coagulase negative Staphylococcus. The mean exposure time of the contaminated tips was 132.3 minutes. Patients were followed for 90 days postoperatively and none of them developed surgical site infection. This is the first study to demonstrate that electrosurgical devices can become contaminated during THA in laminar flow equipped operating rooms. Copyright © 2015 Elsevier Inc. All rights reserved.

  11. Has Health Care Reform Legislation Reduced the Economic Burden of Hospital Readmissions Following Primary Total Joint Arthroplasty?

    Science.gov (United States)

    Kurtz, Steven M; Lau, Edmund C; Ong, Kevin L; Adler, Edward M; Kolisek, Frank R; Manley, Michael T

    2017-11-01

    The purpose of this study was to determine whether the cost of readmissions after primary total hip and knee arthroplasty (THA and TKA) has decreased since the introduction of health care reform legislation and what patient, clinical, and hospital factors drive such costs. The 100% Medicare inpatient dataset was used to identify 1,654,602 primary THA and TKA procedures between 2010 and 2014. The per-patient cost of readmissions was evaluated in general linear models in which the year of surgery and patient, clinical, and hospital factors were treated as covariates in separate models for THA and TKA. The year-to-year risk of 90-day readmission was reduced by 2% and 4% (P total joint arthroplasty volume. The top 5 factors associated with the cost of 90-day TKA readmissions were (in rank order) the length of stay, hospital's teaching status, discharge disposition, patient's gender, and age. Although readmission rates declined slightly, the results of this study do not support the hypothesis that readmission costs have decreased since the introduction of health care reform legislation. Instead, we found that clinical and hospital factors were among the most important cost drivers. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. Filtration effects of zebra mussels on pathogens and total bacterial burden in the Odra Lagoon (South Baltic).

    Science.gov (United States)

    Daeschlein, G; Fenske, C; Scholz, S; Dahlke, S; Jünger, M; Kramer, A

    2015-01-01

    As a result of their mode of filter feeding, zebra mussels (Dreissena polymorpha Pall.) have been observed to purify natural water bodies and in vitro. Therefore, the possibility of using zebra mussels for water purification was investigated in a slightly brackish water body of a large lagoon. In this study, water samples were taken above, near and at distance from zebra mussel beds (MB) in the Odra Lagoon in North East Germany. Near typical bacterial species like Aeromonas spp. pathogenic bacteria with potential relation to hospital wastewater pollution (Burkholderia cepacia, Staphylococcus aureus, Weeksella spp.) were detected. There were no correlations found between either total bacteria or pathogens and distance to MB and no antimicrobial effect of the mussels could be deduced. For bioremediation in larger water bodies like lagoons, natural zebra MB do not seem to play a major antimicrobial role and the effect of artificial mussel grids especially against hospital pathogens should be investigated.

  13. Total Effective Xenoestrogen Burden in Serum Samples and Risk for Breast Cancer in a Population-Based Multicase–Control Study in Spain

    Science.gov (United States)

    Pastor-Barriuso, Roberto; Fernández, Mariana F.; Castaño-Vinyals, Gemma; Whelan, Denis; Pérez-Gómez, Beatriz; Llorca, Javier; Villanueva, Cristina M.; Guevara, Marcela; Molina-Molina, José-Manuel; Artacho-Cordón, Francisco; Barriuso-Lapresa, Laura; Tusquets, Ignasi; Dierssen-Sotos, Trinidad; Aragonés, Nuria; Olea, Nicolás; Kogevinas, Manolis; Pollán, Marina

    2016-01-01

    Background: Most studies on endocrine-disrupting chemicals and breast cancer have focused on single compounds and have produced inconclusive findings. Objectives: We assessed the combined estrogenic effects of mixtures of xenoestrogens in serum and their relationship to breast cancer risk. Methods: A total of 186 incident pretreatment breast cancer cases and 196 frequency-matched controls were randomly sampled from a large population-based multicase–control study in Spain. The total effective xenoestrogen burden attributable to organohalogenated xenoestrogens (TEXB-α) and endogenous hormones and more polar xenoestrogens (TEXB-β) was determined in serum samples using high-performance liquid chromatography and E-Screen bioassay. Odds ratios for breast cancer comparing tertiles of serum TEXB-α and TEXB-β were estimated using logistic models, and smooth risk trends were obtained using spline models. Results: Cases had higher geometric mean TEXB-α and TEXB-β levels (8.32 and 9.94 Eeq pM/mL, respectively) than controls (2.99 and 5.96 Eeq pM/mL, respectively). The fully adjusted odds ratios for breast cancer (95% confidence intervals) comparing the second and third tertiles of TEXB-α with the first tertile were 1.77 (0.76, 4.10) and 3.45 (1.50, 7.97), respectively, and those for TEXB-β were 2.35 (1.10, 5.03) and 4.01 (1.88, 8.56), respectively. A steady increase in risk was evident across all detected TEXB-α levels and a sigmoidal trend was observed for TEXB-β. Individual xenoestrogens showed weak and opposing associations with breast cancer risk. Conclusions: This is the first study to show a strong positive association between serum total xenoestrogen burden and breast cancer risk, highlighting the importance of evaluating xenoestrogen mixtures, rather than single compounds, when studying hormone-related cancers. Citation: Pastor-Barriuso R, Fernández MF, Castaño-Vinyals G, Whelan D, Pérez-Gómez B, Llorca J, Villanueva CM, Guevara M, Molina-Molina JM

  14. Additional Burden of Diseases Associated with Cadmium Exposure: A Case Study of Cadmium Contaminated Rice Fields in Mae Sot District, Tak Province, Thailand

    Directory of Open Access Journals (Sweden)

    Nisarat Songprasert

    2015-08-01

    Full Text Available The cadmium (Cd contaminated rice fields in Mae Sot District, Tak Province, Thailand has been one of the major environmental problems in Thailand for the last 10 years. We used disability adjusted life years (DALYs to estimate the burden of disease attributable to Cd in terms of additional DALYs of Mae Sot residents. Cd exposure data included Cd and β2–microglobulin (β2-MG in urine (as an internal exposure dose and estimated cadmium daily intake (as an external exposure dose. Compared to the general Thai population, Mae Sot residents gained 10%–86% DALYs from nephrosis/nephritis, heart diseases, osteoporosis and cancer depending on their Cd exposure type and exposure level. The results for urinary Cd and dietary Cd intake varied according to the studies used for risk estimation. The ceiling effect was observed in results using dietary Cd intake because of the high Cd content in rice grown in the Mae Sot area. The results from β2-MG were more robust with additional DALYs ranging from 36%–86% for heart failure, cerebral infraction, and nephrosis/nephritis. Additional DALYs is a useful approach for assessing the magnitude of environmental Cd exposure. The Mae Sot population lost more healthy life compared to populations living in a non- or less Cd polluted area. This method should be applicable to various types of environmental contamination problems if exposure assessment information is available.

  15. Ultratrace element contents in rat tissues: Comparative analysis of serum and hair as indicative matrices of the total body burden

    Directory of Open Access Journals (Sweden)

    Skalny Anatoly V.

    2016-01-01

    Full Text Available The aim of this study was to investigate the distribution of ultratrace elements in rat tissues and to perform a comparative analysis of hair and serum as potential bioindicators of the total ultratrace element content. Thirty-six male Wistar rats were fed a standard chow containing 0.006±0.000, 0.001±0.000, 0.017±0.002, 0.382±0.031, 0.168±0.014, 3.211±0.134, 0.095±0.006, 0.000±0.000, 6.675±0.336, 15.327±0.564, 0.002±0.000, and 1.185±0.202 μg/g of silver (Ag, gold (Au, cesium (Cs, gallium (Ga, germanium (Ge, lanthanum (La, niobium (Nb, platinum (Pt, rubidium (Rb, titanium (Ti, thallium (Tland zirconium (Zr, respectively, from weaning to 3 months old. The ultratrace element content in the liver, kidney, muscle, heart, serum and hair was assessed using inductively coupled plasma mass spectrometry. The obtained data indicate that the highest concentrations of most of the studied elements (Ti, Zr, Ge, Nb, tungsten (W, La, uranium (U, Ag, Au, Pt are in hair, whereas the lowest were observed in the serum. Statistical analysis revealed a significant association between concentrations in the hair and other tissues for Cs, Ti, Nb, Tl, La, U and Au. At the same time, serum Cs, Rb, Ti, Ge, Nb, W, Ga, Tl and La concentrations significantly correlated with the tissue content of the respective ultratrace elements. It can be concluded that hair may be used as a potential bioindicator for certain ultratrace element content in the mammalian organism.

  16. Investigation of ethyl lactate as a green solvent for desorption of total petroleum hydrocarbons (TPH) from contaminated soil.

    Science.gov (United States)

    Jalilian Ahmadkalaei, Seyedeh Pegah; Gan, Suyin; Ng, Hoon Kiat; Abdul Talib, Suhaimi

    2016-11-01

    Treatment of oil-contaminated soil is a major environmental concern worldwide. The aim of this study is to examine the applicability of a green solvent, ethyl lactate (EL), in desorption of diesel aliphatic fraction within total petroleum hydrocarbons (TPH) in contaminated soil and to determine the associated desorption kinetics. Batch desorption experiments were carried out on artificially contaminated soil at different EL solvent percentages (%). In analysing the diesel range of TPH, TPH was divided into three fractions and the effect of solvent extraction on each fraction was examined. The experimental results demonstrated that EL has a high and fast desorbing power. Pseudo-second order rate equation described the experimental desorption kinetics data well with correlation coefficient values, R 2 , between 0.9219 and 0.9999. The effects of EL percentage, initial contamination level of soil and liquid to solid ratio (L/S (v/w)) on initial desorption rate have also been evaluated. The effective desorption performance of ethyl lactate shows its potential as a removal agent for remediation of TPH-contaminated soil worldwide.

  17. Relationship between growth and total nucleic acids in juvenile pink salmon, Oncorhynchus gorbuscha, fed crude oil contaminated food

    International Nuclear Information System (INIS)

    Wang Shiao, Y.; Lum, J.L.; Carls, M.G.; Rice, S.D.

    1993-01-01

    Total nucleic acids of junvenile pink salmon fed crude oil contaminated food were analyzed to deteremine if nucleic acid measurements can be used to evaluate growth of fish collected at oil spill sites. In general, the nucleic acid concentration (μg per mg dry weight) of salmon fry fed food contaminated with either 0.37 or 2.78 mg crude oil/g food was not significantly affected. However, RNA concentration of fry fed food contaminated with 34.83 mg/g was reduced whereas DNA concentration increased. Results over 8 weeks indicate decreased protein synthesis and cell content but maintenance of cell integrity in these fish. Growth was inversely related to the level of crude oil contamination in the food. The significant correlations between measured growth and RNA/DNA ratios and RNA contents (mg RNA per mm fork length) suggest that nucleic acid measurement can be used to compare growth of fish collected from the field. 23 refs., 4 figs

  18. Use of total {sup 137}Cs deposition to predict contamination in feed vegetation and reindeer 25 years after Chernobyl

    Energy Technology Data Exchange (ETDEWEB)

    Skuterud, Lavrans [Norwegian Radiation Protection Authority, P.O. Box 55, N-1332 Oesteraas (Norway); Norwegian Reindeer Husbandry Administration, P.O. Box 1104, N-9504 Alta (Norway); Thoerring, Haavard; Ytre-Eide, Martin A. [Norwegian Radiation Protection Authority, P.O. Box 55, N-1332 Oesteraas (Norway)

    2014-07-01

    The Chernobyl fallout has so far caused contamination challenges for animal production in various areas of Norway for nearly 30 years, particularly for sheep, goats and reindeer. The persistent uptake and long-term trends of radiocaesium in forest and mountain areas still justifies maintaining the elevated permissible level for radiocaesium of 3,000 Bq/kg in reindeer meat. In comparison, Japanese authorities chose 100 Bq/kg as the permissible level for radiocaesium in Japanese foodstuffs. The slow decline in contamination levels in reindeer during the last 10-15 years have necessitated an evaluation of the remediation strategy for reindeer herding. The former seasonal differences in contamination levels in reindeer meat made 'early slaughtering' (in autumn instead of winter) an effective measure. However, such seasonal differences are no longer systematic, and differences in contamination levels in reindeer at slaughter now appear to be more strongly related to the differences in deposition levels in the areas grazed prior to slaughter. In 2011 Norwegian authorities (i.e. the Norwegian Reindeer Husbandry Administration, Norwegian Radiation Protection Authority, and the Geological Survey of Norway) therefore carried out an aerial survey covering 2,500 km{sup 2} of the most contaminated grazing areas to obtain more detailed information on geographical variability in deposition levels. The area included major parts of the grazing areas of three reindeer herding companies. The usefulness of deposition maps as bases for directing animal grazing to less contaminated areas depends on how well the total deposition correlate with the contamination levels in grazed vegetation. In the case of reindeer this covers both green plants and lichens. In 2012 the aerial survey was therefore supplemented by geo-referenced deposition measurements and sampling of various plant and lichen species at totally 17 sites ranging in deposition levels from 2.6 to 190 kBq/m{sup 2

  19. Serum Total Tryptase Level Confirms Itself as a More Reliable Marker of Mast Cells Burden in Mast Cell Leukaemia (Aleukaemic Variant

    Directory of Open Access Journals (Sweden)

    P. Savini

    2015-01-01

    Full Text Available Mast cell leukemia (MCL is a very rare form of systemic mastocytosis (SM with a short median survival of 6 months. We describe a case of a 65-year-old woman with aleukaemic variant of MCL with a very high serum total tryptase level of 2255 μg/L at diagnosis, which occurred following an episode of hypotensive shock. She fulfilled the diagnostic criteria of SM, with a bone marrow smear infiltration of 50–60% of atypical mast cells (MCs. She tested negative for the KIT D816V mutation, without any sign of organ damage (no B- or C-findings and only few mediator-related symptoms. She was treated with antihistamine alone and then with imatinib for the appearance of anemia. She maintained stable tryptase level and a very indolent clinical course for twenty-two months; then, she suddenly progressed to acute MCL with a serum tryptase level up to 12960 μg/L. The patient died due to haemorrhagic diathesis twenty-four months after diagnosis. This clinical case maybe represents an example of the chronic form of mast cell leukemia, described as unpredictable disease, in which the serum total tryptase level has confirmed itself as a reliable marker of mast cells burden regardless of the presence of other signs or symptoms.

  20. Determination of total mercury in aluminium industrial zones and soil contaminated with red mud.

    Science.gov (United States)

    Rasulov, Oqil; Zacharová, Andrea; Schwarz, Marián

    2017-08-01

    This study investigated total mercury contents in areas impacted by aluminium plants in Tajikistan and Slovakia and in one area flooded with red mud in Hungary. We present the first determination of total mercury contents in the near-top soil (0-10 and 10-20 cm) in Tajikistan and the first comparative investigation of Tajikistan-Slovakia-Hungary. The Tajik Aluminium Company (TALCO) is one of the leading producers of primary aluminium in Central Asia. In the past 30 years, the plant has been producing large volumes of industrial waste, resulting in negative impacts on soil, groundwater and air quality of the surrounding region. Mercury concentrations were significant in Slovakia and Hungary, 6 years after the flooding. In studied areas in Slovakia and Hungary, concentrations of total mercury exceeded the threshold limit value (TLV = 0.5 mg Hg kg -1 ). However, in Tajikistan, values were below the TLV (0.006-0.074 mg kg -1 ) and did not significantly vary between depths. Total Hg in Slovakia ranged from 0.057 to 0.668 mg kg -1 and in Hungary from 0.029 to 1.275 mg kg -1 . However, in the plots near to the red mud reservoir and the flooded area, Hg concentrations were higher in the upper layers than in the lower ones.

  1. Mobile laminar air flow screen for additional operating room ventilation: reduction of intraoperative bacterial contamination during total knee arthroplasty.

    Science.gov (United States)

    Sossai, D; Dagnino, G; Sanguineti, F; Franchin, F

    2011-12-01

    Surgical site infections are important complications in orthopedic surgery. A mobile laminar air flow (LAF) screen could represent a useful addition to an operating room (OR) with conventional turbulent air ventilation (12.5 air changes/h), as it could decrease the bacterial count near the operating field. The purpose of this study was to evaluate LAF efficacy at reducing bacterial contamination in the surgical area during 34 total knee arthroplasties (TKAs). The additional unit was used in 17 operations; the LAF was positioned beside the operating table between two of the surgeons, with the air flow directed towards the surgical area (wound). The whole team wore conventional OR clothing and the correct hygiene procedures and rituals were used. Bacterial air contamination (CFU/m(3)) was evaluated in the wound area in 17 operations with the LAF unit and 17 without the LAF unit. The LAF unit reduced the mean bacterial count in the wound area from 23.5 CFU/m(3) without the LAF to 3.5 CFU/m(3) with the LAF (P contamination of the wound area significantly decreased to below the accepted level for an ultraclean OR, preventing SSI infections.

  2. A summary of total mercury concentrations in flora and fauna near common contaminant sources in the Gulf of Mexico.

    Science.gov (United States)

    Lewis, M; Chancy, C

    2008-02-01

    Total mercury concentrations are summarized for environmental media and biota collected from near-coastal areas, several impacted by contaminant sources common to the Gulf of Mexico. Water, sediment, fish, blue crabs, oysters, clams, mussels, periphyton and seagrasses were collected during 1993-2002 from targeted areas affected by point and non-point source contaminants. Mean concentrations in water and sediment were 0.02 (+/-1 standard deviation=0.06) microg l(-1) and 96.3 (230.8) ng g(-1) dry wt, respectively. Mean total mercury concentrations in fish, blue crabs, brackish clams and mussels were significantly greater than those in sediment, seagrass, colonized periphyton and oysters. Concentrations (ng g(-1) dry wt) averaged 23.1 (two seagrass species), 220.1 (oysters), 287.8 (colonized periphyton), 604.0 (four species of freshwater mussels), 772.4 (brackish clam), 857.9 (blue crabs) and 933.1 (nine fish species). Spatial, intraspecific and interspecific variability in results limited most generalizations concerning the relative mercury contributions of different stressor types. However, concentrations were significantly greater for some biota collected from areas receiving wastewater discharges and golf course runoff (fish), agricultural runoff (oysters) and urban stormwater runoff (colonized periphyton and sediment). Marine water quality criteria and proposed sediment quality guidelines were exceeded in 1-12% of total samples. At least one seafood consumption guideline, criteria or screening value were exceeded in edible tissues of blue crabs (6% total samples) and nine fish species (8-33% total samples) but all residues were less than the US Federal Drug Administration action limit of 1.0 ppm and the few reported toxic effect concentrations available for the targeted biota.

  3. Evaluation of ethyl lactate as solvent in Fenton oxidation for the remediation of total petroleum hydrocarbon (TPH)-contaminated soil.

    Science.gov (United States)

    Jalilian Ahmadkalaei, Seyedeh Pegah; Gan, Suyin; Ng, Hoon Kiat; Abdul Talib, Suhaimi

    2017-07-01

    Due to the health and environmental risks posed by the presence of petroleum-contaminated areas around the world, remediation of petroleum-contaminated soil has drawn much attention from researchers. Combining Fenton reaction with a solvent has been proposed as a novel way to remediate contaminated soils. In this study, a green solvent, ethyl lactate (EL), has been used in conjunction with Fenton's reagents for the remediation of diesel-contaminated soil. The main aim of this research is to determine how the addition of EL affects Fenton reaction for the destruction of total petroleum hydrocarbons (TPHs) within the diesel range. Specifically, the effects of different parameters, including liquid phase volume-to-soil weight (L/S) ratio, hydrogen peroxide (H 2 O 2 ) concentration and EL% on the removal efficiency, have been studied in batch experiments. The results showed that an increase in H 2 O 2 resulted in an increase in removal efficiency of TPH from 68.41% at H 2 O 2  = 0.1 M to 90.21% at H 2 O 2  = 2 M. The lowest L/S, i.e. L/S = 1, had the highest TPH removal efficiency of 85.77%. An increase in EL% up to 10% increased the removal efficiency to 96.74% for TPH, and with further increase in EL%, the removal efficiency of TPH decreased to 89.6%. EL with an optimum value of 10% was found to be best for TPH removal in EL-based Fenton reaction. The power law and pseudo-first order equations fitted well to the experimental kinetic data of Fenton reactions.

  4. Burden of Sexual Dysfunction.

    Science.gov (United States)

    Balon, Richard

    2017-01-02

    Similar to the burden of other diseases, the burden of sexual dysfunction has not been systematically studied. However, there is growing evidence of various burdens (e.g., economic, symptomatic, humanistic) among patients suffering from sexual dysfunctions. The burden of sexual dysfunction has been studied a bit more often in men, namely the burden of erectile dysfunction (ED), premature ejaculation (PE) and testosterone deficiency syndrome (TDS). Erectile dysfunction is frequently associated with chronic conditions such as cardiovascular disease, diabetes, and depression. These conditions could go undiagnosed, and ED could be a marker of those diseases. The only available report from the United Kingdom estimated the total economic burden of ED at £53 million annually in terms of direct costs and lost productivity. The burden of PE includes significant psychological distress: anxiety, depression, lack of sexual confidence, poor self-esteem, impaired quality of life, and interpersonal difficulties. Some suggest that increase in female sexual dysfunction is associated with partner's PE, in addition to significant interpersonal difficulties. The burden of TDS includes depression, sexual dysfunction, mild cognitive impairment, and osteoporosis. One UK estimate of the economic burden of female sexual dysfunctions demonstrated that the average cost per patient was higher than the per annum cost of ED. There are no data on burden of paraphilic disorders. The burden of sexual dysfunctions is underappreciated and not well studied, yet it is significant for both the patients and the society.

  5. Burden of total and cause-specific mortality related to tobacco smoking among adults aged ≥ 45 years in Asia: a pooled analysis of 21 cohorts.

    Directory of Open Access Journals (Sweden)

    Wei Zheng

    2014-04-01

    Full Text Available Tobacco smoking is a major risk factor for many diseases. We sought to quantify the burden of tobacco-smoking-related deaths in Asia, in parts of which men's smoking prevalence is among the world's highest.We performed pooled analyses of data from 1,049,929 participants in 21 cohorts in Asia to quantify the risks of total and cause-specific mortality associated with tobacco smoking using adjusted hazard ratios and their 95% confidence intervals. We then estimated smoking-related deaths among adults aged ≥45 y in 2004 in Bangladesh, India, mainland China, Japan, Republic of Korea, Singapore, and Taiwan-accounting for ∼71% of Asia's total population. An approximately 1.44-fold (95% CI = 1.37-1.51 and 1.48-fold (1.38-1.58 elevated risk of death from any cause was found in male and female ever-smokers, respectively. In 2004, active tobacco smoking accounted for approximately 15.8% (95% CI = 14.3%-17.2% and 3.3% (2.6%-4.0% of deaths, respectively, in men and women aged ≥45 y in the seven countries/regions combined, with a total number of estimated deaths of ∼1,575,500 (95% CI = 1,398,000-1,744,700. Among men, approximately 11.4%, 30.5%, and 19.8% of deaths due to cardiovascular diseases, cancer, and respiratory diseases, respectively, were attributable to tobacco smoking. Corresponding proportions for East Asian women were 3.7%, 4.6%, and 1.7%, respectively. The strongest association with tobacco smoking was found for lung cancer: a 3- to 4-fold elevated risk, accounting for 60.5% and 16.7% of lung cancer deaths, respectively, in Asian men and East Asian women aged ≥45 y.Tobacco smoking is associated with a substantially elevated risk of mortality, accounting for approximately 2 million deaths in adults aged ≥45 y throughout Asia in 2004. It is likely that smoking-related deaths in Asia will continue to rise over the next few decades if no effective smoking control programs are implemented. Please see later in the article for

  6. Evaluation of trace organic contaminants in ultra-pure water production processes by measuring total organic halogen formation potential

    International Nuclear Information System (INIS)

    Urano, Kohei; Iwase, Yoko

    1984-01-01

    A new procedure for the determination of organic substances in water with high accuracy and high sensitivity was proposed, in which a hypochlorite is added to water, and the resultant total amount of organic halogen compounds (TOX formation potential) was measured, and it was applied to the evaluation of trace organic contaminants in ultra-pure water production process. In this investigation, the TOX formation potential of the raw water which was to be used for the ultra-pure water production process, intermediately treated water and ultra-pure water was measured to clarify the behavior of organic substances in the ultra-pure water production process and to demonstrate the usefulness of this procedure to evaluate trace organic contaminants in water. The measurement of TOX formation potential requires no specific technical skill, and only a short time, and gives accurate results, therefore, it is expected that the water quality control in the ultra-pure water production process can be performed more exactly by applying this procedure. (Yoshitake, I.)

  7. Most hydrocarbonoclastic bacteria in the total environment are diazotrophic, which highlights their value in the bioremediation of hydrocarbon contaminants.

    Science.gov (United States)

    Dashti, Narjes; Ali, Nedaa; Eliyas, Mohamed; Khanafer, Majida; Sorkhoh, Naser A; Radwan, Samir S

    2015-01-01

    Eighty-two out of the 100 hydrocarbonoclastic bacterial species that have been already isolated from oil-contaminated Kuwaiti sites, characterized by 16S rRNA nucleotide sequencing, and preserved in our private culture collection, grew successfully in a mineral medium free of any nitrogenous compounds with oil vapor as the sole carbon source. Fifteen out of these 82 species were selected for further study based on the predominance of most of the isolates in their specific sites. All of these species tested positive for nitrogenase using the acetylene reduction reaction. They belonged to the genera Agrobacterium, Sphingomonas, and Pseudomonas from oily desert soil and Nesiotobacter, Nitratireductor, Acinetobacter, Alcanivorax, Arthrobacter, Marinobacter, Pseudoalteromonas, Vibrio, Diatzia, Mycobacterium, and Microbacterium from the Arabian/Persian Gulf water body. A PCR-DGGE-based sequencing analysis of nifH genes revealed the common occurrence of the corresponding genes among all the strains tested. The tested species also grew well and consumed crude oil effectively in NaNO3 -containing medium with and without nitrogen gas in the top space. On the other hand, these bacteria only grew and consumed crude oil in the NaNO3 -free medium when the top space gas contained nitrogen. We concluded that most hydrocarbonoclastic bacteria are diazotrophic, which allows for their wide distribution in the total environment. Therefore, these bacteria are useful for the cost-effective, environmentally friendly bioremediation of hydrocarbon contaminants.

  8. Total mercury and methylmercury concentrations over a gradient of contamination in earthworms living in rice paddy soil.

    Science.gov (United States)

    Abeysinghe, Kasun S; Yang, Xiao-Dong; Goodale, Eben; Anderson, Christopher W N; Bishop, Kevin; Cao, Axiang; Feng, Xinbin; Liu, Shengjie; Mammides, Christos; Meng, Bo; Quan, Rui-Chang; Sun, Jing; Qiu, Guangle

    2017-05-01

    Mercury (Hg) deposited from emissions or from local contamination, can have serious health effects on humans and wildlife. Traditionally, Hg has been seen as a threat to aquatic wildlife, because of its conversion in suboxic conditions into bioavailable methylmercury (MeHg), but it can also threaten contaminated terrestrial ecosystems. In Asia, rice paddies in particular may be sensitive ecosystems. Earthworms are soil-dwelling organisms that have been used as indicators of Hg bioavailability; however, the MeHg concentrations they accumulate in rice paddy environments are not well known. Earthworm and soil samples were collected from rice paddies at progressive distances from abandoned mercury mines in Guizhou, China, and at control sites without a history of Hg mining. Total Hg (THg) and MeHg concentrations declined in soil and earthworms as distance increased from the mines, but the percentage of THg that was MeHg, and the bioaccumulation factors in earthworms, increased over this gradient. This escalation in methylation and the incursion of MeHg into earthworms may be influenced by more acidic soil conditions and higher organic content further from the mines. In areas where the source of Hg is deposition, especially in water-logged and acidic rice paddy soil, earthworms may biomagnify MeHg more than was previously reported. It is emphasized that rice paddy environments affected by acidifying deposition may be widely dispersed throughout Asia. Environ Toxicol Chem 2017;36:1202-1210. © 2016 SETAC. © 2016 SETAC.

  9. Impact of airflow interaction on inhaled air quality and transport of contaminants in rooms with personalized and total volume ventilation

    DEFF Research Database (Denmark)

    Melikov, Arsen Krikor; Cermak, Radim; Kovar, O.

    2003-01-01

    The impact of airflow interaction on inhaled air quality and transport of contaminants between occupants was studied in regard to pollution from floor covering, human bioeffluents and exhaled air, with combinations of two personalized ventilation systems (PV) with mixing and displacement...... quality with personalized and mixing ventilation was higher or at least similar compared to mixing ventilation alone. In the case of PV combined with displacement ventilation, the interaction caused mixing of the room air, an increase in the transport of bioeffluents and exhaled air between occupants and...... ventilation. In total, 80 L/s of clean air supplied at 20°C was distributed between the ventilation systems at different combinations of personalized airflow rate. Two breathing thermal manikins were used to simulate occupants in a full-scale test room. Regardless of the airflow interaction, the inhaled air...

  10. The never ending burden: Germany in the year 1 past Chernobyl: Confused experts, distressed mothers, contaminated milk. Radiation doses went down, but the cancer risk and genetic hazards remain

    International Nuclear Information System (INIS)

    Brunner, E.; Janssen, K.H.

    1986-01-01

    Becquerel values in milk and meat are due to rise again during the next few weeks. The Federal Republic of Germany continues to live with the radioactive burden brought by the Chernobyl clouds. It is true that the radiation doses are lower than expected, but low-dose exposure, too, can have evil effects; the cancer risk and genetic hazards still remain incalculable. The article presents a survey of the radiation exposure in the country as a function of geographic data, and a rough assessment of possible consequences emanating from ingestion of contaminated food. (orig./GL) [de

  11. Optimisation of pressurised liquid extraction (PLE) for rapid and efficient extraction of superficial and total mineral oil contamination from dry foods.

    Science.gov (United States)

    Moret, Sabrina; Scolaro, Marianna; Barp, Laura; Purcaro, Giorgia; Sander, Maren; Conte, Lanfranco S

    2014-08-15

    Pressurised liquid extraction (PLE) represents a powerful technique which can be conveniently used for rapid extraction of mineral oil saturated (MOSH) and aromatic hydrocarbons (MOAH) from dry foods with a low fat content, such as semolina pasta, rice, and other cereals. Two different PLE methods, one for rapid determination of superficial contamination mainly from the packaging, the other for efficient extraction of total contamination from different sources, have been developed and optimised. The two methods presented good performance characteristics in terms of repeatability (relative standard deviation lower than 5%) and recoveries (higher than 95%). To show their potentiality, the two methods have been applied in combination on semolina pasta and rice packaged in direct contact with recycled cardboard. In the case of semolina pasta it was possible to discriminate between superficial contamination coming from the packaging, and pre-existing contamination (firmly enclosed into the matrix). Copyright © 2014 Elsevier Ltd. All rights reserved.

  12. Bioeffects Assessment in Kvichak and Nushagak Bay, Alaska: Characterization of Soft Bottom Benthic Habitats, Fish Body Burdens and Contaminant Baseline Assessment

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The goal of this project is to assess habitat conditions that influence biodiversity and distribution of benthic infaunal communities, contaminants, and chemical...

  13. Total aerobic destruction of azo contaminants with nanoscale zero-valent copper at neutral pH: promotion effect of in-situ generated carbon center radicals.

    Science.gov (United States)

    Dong, Guohui; Ai, Zhihui; Zhang, Lizhi

    2014-12-01

    In this study, nanoscale zero-valent copper (nZVC) was synthesized with a facile solvothermal method and used for the aerobic removal of azo contaminants at neutral pH for the first time. We found that both Cu(I) and OH generated during the nZVC induced molecular oxygen activation process accounted for the rapid total destruction of azo contaminants in the nZVC/Air system, where nZVC could activate molecular oxygen to produce H2O2, and also release Cu(I) to break the -NN- bond of azo contaminants via the sandmeyer reaction for the generation of carbon center radicals. The in-situ generated carbon center radicals would then react with OH produced by the Cu(I) catalyzed decomposition of H2O2, resulting in the generation of low molecular weight organic acids and their subsequent mineralization. The indispensible role of Cu(I) catalyzed sandmeyer reaction and the promotion effect of in-situ generated carbon center radicals on the rapid total destruction of azo contaminants in the nZVC/Air system were confirmed by gas chromatography-mass spectrometry analysis. This study can deepen our understanding on the degradation of organic pollutant with molecular oxygen activated by zero valent metal, and also provide a new method to remove azo contaminants at neutral pH. Copyright © 2014 Elsevier Ltd. All rights reserved.

  14. Biochemical characteristics of a free cyanide and total nitrogen assimilating Fusarium oxysporum EKT01/02 isolate from cyanide contaminated soil

    OpenAIRE

    Akinpelu, Enoch A.; Adetunji, Adewole T.; Ntwampe, Seteno K.O.; Nchu, Felix; Mekuto, Lukhanyo

    2017-01-01

    Sustainability of nutrient requirements for microbial proliferation on a large scale is a challenge in bioremediation processes. This article presents data on biochemical properties of a free cyanide resistant and total nitrogen assimilating fungal isolate from the rhizosphere of Zea mays (maize) growing in soil contaminated with a cyanide-based pesticide. DNA extracted from this isolate were PCR amplified using universal primers; TEF1-α and ITS. The raw sequence files are available on the NC...

  15. Contribution of the short lived radionuclides in food to the total radiation burden of man after the nuclear accident in Chernobyl

    International Nuclear Information System (INIS)

    Popovic, D.; Djuric, G.; Smelcerovic, M.; Maksimovic, B.

    1989-01-01

    The paper presents the results of the short lived radionuclides (I-131, Te(I)-132, Cs-136, Ce-141,144, Ru-103,106, Ba(La)-140, Zr-95, Mo-99, Nb-95, Sb-125) mass activities estimation in some foodstuff (milk and milk products), immediately after the nuclear accident in Chernobyl, in May 1986. The activities of the radionuclides were determined on Ge(Li) detector by standard gamma spectrometry, with the total error less than 20%. The results enabled the evaluation of the short lived radionuclides contribution in the total dose due to ingestion of milk and milk products, in the first month after the accident, compared to the contribution of I-131 and to the contribution of the main long lived radionuclides: Ce-134 and Cs-137 (author)

  16. Aflatoxin B1 and total fumonisin contamination and their producing fungi in fresh and stored sorghum grain in East Hararghe, Ethiopia.

    Science.gov (United States)

    Taye, Wondimeneh; Ayalew, Amare; Chala, Alemayehu; Dejene, Mashilla

    2016-12-01

    Natural contamination of sorghum grains by aflatoxin B 1 and total fumonisin and their producing toxigenic fungi has been studied. A total of 90 sorghum grain samples were collected from small-scale farmers' threshing floors and 5-6 months later from underground pits during 2013 harvest from three districts of East Hararghe, Ethiopia. Mycotoxin analysis was done using enzyme-linked immunosorbent assay (ELISA). The limits of detection were in the range 0.01-0.03 μg kg -1 . The results revealed that all sorghum grain samples were contaminated with both Aspergillus and Fusarium species. Aflatoxin B 1 was detected at levels ranging from fumonisin levels varied between 907 and 2041 µg kg -1 grain across the samples. Lowest total fumonisin was recorded in freshly harvested sorghum grain samples. Sorghum is a main staple cereal in the studied districts and its consumption per day per person is high. Daily intake of low doses of mycotoxin-contaminated food stuff over a period of time could lead to chronic mycotoxicosis.

  17. Effect of soil contamination due to wastewater irrigation on total cesium as determined by destructive and nondestructive analytical techniques in some soils of egypt

    International Nuclear Information System (INIS)

    Abdel-Sabour, M.F.; Abdel-Lattif, A.

    2005-01-01

    Fifteen soil samples were chosen from different locations to represent different soils irrigated with different sources of contaminated wastewater (sewage and industrial effluent). Sequential extraction experiment was carried out to determine different forms of Cs in soils. Moreover, Soil samples were analyzed for total Cs using two analytical methods i.e. destructive wet digestion technique (Atomic Absorption Spectrometry, AAS or by summation of all sequential extracted fractions, SUM) and non-destructive technique (Neutron Activation Analysis, NAA). The aim of this study was to evaluate soil total Cs-forms (especially, bio-available fraction) as affected by soil pollution. Cesium was mostly concentrated in the residual fraction, and its values ranged from 57.4% to 82.9 % of total Cs in sandy soils and from 31.5% to 64.5 % of total Cs in tested clayey soil. Then organically bound Cs- fraction followed by Cs-occluded in Fe-Mn fraction, carbonate, exchangeable and water soluble fractions. Results suggested that, Cs level is affected by soil organic matter content, Fe-Mn oxides and clay content. The mobile Cs fraction (the sum of soluble and exchangeable fractions) ranged from 2% up to 9.9 % of total Cs in sandy soils. However, a higher value (9.82% to 15.31 %) could be observed in case of the tested clayey soils. Soils D and E were more contaminated than other tested soils. Data show obviously, that soil contaminated due to the irrigation with either sewage effluent or industrial wastewater has resulted in a drastic increase in both metal-organic and occluded in Fe and Mn oxide fractions followed by the carbonate fraction

  18. An analysis of the impact of native oxide, surface contamination and material density on total electron yield in the absence of surface charging effects

    Energy Technology Data Exchange (ETDEWEB)

    Iida, Susumu, E-mail: susumu.iida@toshiba.co.jp [EUVL Infrastructure Development Center, Inc., 16-1 Onogawa, Tsukuba-shi, Ibaraki-ken, 305-8569 (Japan); Ohya, Kaoru [Institute of Technology and Science, The University of Tokushima, 2-1 Minamijyousanjima-cho,Tokushima, 770-8506 (Japan); Hirano, Ryoichi; Watanabe, Hidehiro [EUVL Infrastructure Development Center, Inc., 16-1 Onogawa, Tsukuba-shi, Ibaraki-ken, 305-8569 (Japan)

    2016-10-30

    Highlights: • Total electron yields were assessed in the absence of any surface charging effect. • Experimental and simulation results showed a low native oxide energy barrier. • The yield enhancement effect of a native oxide layer was confirmed. • The yield enhancement effect of a thin surface contamination layer was confirmed. • Deviations in the material density from the theoretical values were evaluated. - Abstract: The effects of the presence of a native oxide film or surface contamination as well as variations in material density on the total electron yield (TEY) of Ru and B{sub 4}C were assessed in the absence of any surface charging effect. The experimental results were analyzed using semi-empirical Monte Carlo simulations and demonstrated that a native oxide film increased the TEY, and that this effect varied with film thickness. These phenomena were explained based on the effect of the backscattered electrons (BSEs) at the interface between Ru and RuO{sub 2}, as well as the lower potential barrier of RuO{sub 2}. Deviations in the material density from the theoretical values were attributed to the film deposition procedure based on fitting simulated TEY curves to experimental results. In the case of B{sub 4}C, the TEY was enhanced by the presence of a 0.8-nm-thick surface contamination film consisting of oxygenated hydrocarbons. The effect of the low potential barrier of the contamination film was found to be significant, as the density of the B{sub 4}C was much lower than that of the Ru. Comparing the simulation parameters generated in the present work with Joy’s database, it was found that the model and the input parameters used in the simulations were sufficiently accurate.

  19. Biochemical characteristics of a free cyanide and total nitrogen assimilating Fusarium oxysporum EKT01/02 isolate from cyanide contaminated soil

    Directory of Open Access Journals (Sweden)

    Enoch A. Akinpelu

    2017-10-01

    Full Text Available Sustainability of nutrient requirements for microbial proliferation on a large scale is a challenge in bioremediation processes. This article presents data on biochemical properties of a free cyanide resistant and total nitrogen assimilating fungal isolate from the rhizosphere of Zea mays (maize growing in soil contaminated with a cyanide-based pesticide. DNA extracted from this isolate were PCR amplified using universal primers; TEF1-α and ITS. The raw sequence files are available on the NCBI database. Characterisation using biochemical data was obtained using colorimetric reagents analysed with VITEK® 2 software version 7.01. The data will be informative in selection of biocatalyst for environmental engineering application.

  20. Biochemical characteristics of a free cyanide and total nitrogen assimilating Fusarium oxysporum EKT01/02 isolate from cyanide contaminated soil.

    Science.gov (United States)

    Akinpelu, Enoch A; Adetunji, Adewole T; Ntwampe, Seteno K O; Nchu, Felix; Mekuto, Lukhanyo

    2017-10-01

    Sustainability of nutrient requirements for microbial proliferation on a large scale is a challenge in bioremediation processes. This article presents data on biochemical properties of a free cyanide resistant and total nitrogen assimilating fungal isolate from the rhizosphere of Zea mays (maize) growing in soil contaminated with a cyanide-based pesticide. DNA extracted from this isolate were PCR amplified using universal primers; TEF1-α and ITS. The raw sequence files are available on the NCBI database. Characterisation using biochemical data was obtained using colorimetric reagents analysed with VITEK ® 2 software version 7.01. The data will be informative in selection of biocatalyst for environmental engineering application.

  1. Uptake of Total Petroleum Hydrocarbon (TPH) and Polycyclic Aromatic Hydrocarbons (PAHs) by Oryza sativa L. Grown in Soil Contaminated with Crude Oil.

    Science.gov (United States)

    Patowary, Rupshikha; Patowary, Kaustuvmani; Devi, Arundhuti; Kalita, Mohan Chandra; Deka, Suresh

    2017-01-01

    The purpose of this study was to determine whether total petroleum hydrocarbon (TPH) and polycyclic aromatic hydrocarbons (PAHs) present in crude oil contaminated sites are transferred to roots, shoots and finally the grains of rice crops (Oryza sativa L.) grown in those sites. Soil was artificially contaminated with crude oil at concentrations of 0, 1000, 5000, 10,000, and 15,000 mg/kg, followed by planting of rice seedlings. After harvest, TPH in plant samples were measured, and it was determined that the uptake of TPH by the plants gradually increased as the concentration of oil in soil increased. Further, from GC-MS analysis, it was observed that PAHs including naphthalene and phenanthrene bioaccumulated in rice plant parts. Vital physico-chemical properties of soil were also altered due to crude oil contamination. Our study revealed that rice plants grown in crude oil polluted sites can uptake TPH including PAHs, thus emphasising the importance of prior investigation of soil condition before cultivation of crops.

  2. Blood gas sample spiking with total parenteral nutrition, lipid emulsion, and concentrated dextrose solutions as a model for predicting sample contamination based on glucose result.

    Science.gov (United States)

    Jara-Aguirre, Jose C; Smeets, Steven W; Wockenfus, Amy M; Karon, Brad S

    2018-05-01

    Evaluate the effects of blood gas sample contamination with total parenteral nutrition (TPN)/lipid emulsion and dextrose 50% (D50) solutions on blood gas and electrolyte measurement; and determine whether glucose concentration can predict blood gas sample contamination with TPN/lipid emulsion or D50. Residual lithium heparin arterial blood gas samples were spiked with TPN/lipid emulsion (0 to 15%) and D50 solutions (0 to 2.5%). Blood gas (pH, pCO2, pO2), electrolytes (Na+, K+ ionized calcium) and hemoglobin were measured with a Radiometer ABL90. Glucose concentration was measured in separated plasma by Roche Cobas c501. Chart review of neonatal blood gas results with glucose >300 mg/dL (>16.65 mmol/L) over a seven month period was performed to determine whether repeat (within 4 h) blood gas results suggested pre-analytical errors in blood gas results. Results were used to determine whether a glucose threshold could predict contamination resulting in blood gas and electrolyte results with greater than laboratory-defined allowable error. Samples spiked with 5% or more TPN/lipid emulsion solution or 1% D50 showed glucose concentration >500 mg/dL (>27.75 mmol/L) and produced blood gas (pH, pO 2 , pCO 2 ) results with greater than laboratory-defined allowable error. TPN/lipid emulsion, but not D50, produced greater than allowable error in electrolyte (Na + ,K + ,Ca ++ ,Hb) results at these concentrations. Based on chart review of 144 neonatal blood gas results with glucose >250 mg/dL received over seven months, four of ten neonatal intensive care unit (NICU) patients with glucose results >500 mg/dL and repeat blood gas results within 4 h had results highly suggestive of pre-analytical error. Only 3 of 36 NICU patients with glucose results 300-500 mg/dL and repeat blood gas results within 4 h had clear pre-analytical errors in blood gas results. Glucose concentration can be used as an indicator of significant blood sample contamination with either TPN

  3. Effect Of Soil Contamination Due To Wastewater Irrigation On Total Co As Determined By Neutron Activation And Other Conventional Analytical Techniques In Some Soils Of Egypt

    International Nuclear Information System (INIS)

    Abdel-Sabour, M. F.; Al-Salama, Y. J.

    2004-01-01

    Fifteen soil samples were chosen from different locations (five different locations at north greater Cairo, Egypt) to represent different soils (alluvial and sandy) as well as different sources of contaminated wastewater (sewage and industrial effluent). Using sequential extraction technique (extracting the soil with different solutions, which is designed to separate metal fractions), Co was separated into six operationally defined fractions: water soluble, exchangeable, carbonate bound, Fe-Mn oxides bound, organic bound and residual fractions. Moreover, total-Co in soils as determined by three analytical methods (sum of sequential extracting, Atomic Absorption Spectrometry (AAS) and neutron activation analysis (NAA) techniques) were compared. Cobalt distribution between different extractants shows that the greatest amounts are found in the residual and Occluded in Fe and Mn-Oxides fractions followed by carbonate or organic fractions. In most cases the proportion of all tested Co-forms has increased in contaminated soil layers with higher enrichment in organically bound Co, occluded in Fe and Mn oxides, carbonate exchangeable and soluble fractions. Results indicate that soil properties have a significant role on Co fractions in soil. In the mean time, soil properties are affected by pollution factors such as source of pollution and load of pollution on the studied soil. Data showed that values of total Co determined by NAA method were always higher than the relevant values determined by AAS or those calculated after the sequential extraction method. (Authors)

  4. Development, optimization, validation and application of faster gas chromatography - flame ionization detector method for the analysis of total petroleum hydrocarbons in contaminated soils.

    Science.gov (United States)

    Zubair, Abdulrazaq; Pappoe, Michael; James, Lesley A; Hawboldt, Kelly

    2015-12-18

    This paper presents an important new approach to improving the timeliness of Total Petroleum Hydrocarbon (TPH) analysis in the soil by Gas Chromatography - Flame Ionization Detector (GC-FID) using the CCME Canada-Wide Standard reference method. The Canada-Wide Standard (CWS) method is used for the analysis of petroleum hydrocarbon compounds across Canada. However, inter-laboratory application of this method for the analysis of TPH in the soil has often shown considerable variability in the results. This could be due, in part, to the different gas chromatography (GC) conditions, other steps involved in the method, as well as the soil properties. In addition, there are differences in the interpretation of the GC results, which impacts the determination of the effectiveness of remediation at hydrocarbon-contaminated sites. In this work, multivariate experimental design approach was used to develop and validate the analytical method for a faster quantitative analysis of TPH in (contaminated) soil. A fractional factorial design (fFD) was used to screen six factors to identify the most significant factors impacting the analysis. These factors included: injection volume (μL), injection temperature (°C), oven program (°C/min), detector temperature (°C), carrier gas flow rate (mL/min) and solvent ratio (v/v hexane/dichloromethane). The most important factors (carrier gas flow rate and oven program) were then optimized using a central composite response surface design. Robustness testing and validation of model compares favourably with the experimental results with percentage difference of 2.78% for the analysis time. This research successfully reduced the method's standard analytical time from 20 to 8min with all the carbon fractions eluting. The method was successfully applied for fast TPH analysis of Bunker C oil contaminated soil. A reduced analytical time would offer many benefits including an improved laboratory reporting times, and overall improved clean up

  5. Spatial and temporal analysis of the risks posed by total petroleum hydrocarbon and trace element contaminants in coastal waters of Kuwait.

    Science.gov (United States)

    Nicolaus, E E M; Wright, S R; Barry, J; Bolam, T P C; Ghareeb, K; Ghaloom, M; Al-Kanderi, N; Harley, B F M; Le Quesne, W J F; Devlin, M J; Lyons, B P

    2017-07-15

    Nine trace elements including As, Cd, Cu, Fe, Hg, Ni, Pb, V and Zn, and total petroleum hydrocarbons were analysed from water samples collected from 23 stations since 1984 from Kuwaiti coastal waters. Here it was investigated whether concentrations of these determinants are at levels above Kuwaiti and internationally established assessment criteria (AC). The results indicate that Cu and Cd had the most Kuwaiti AC breaches over time. Comparing the data of the last sampled year to the least stringent international AC, then Cu and Cd showed breaches at all stations. The trends for trace metals are significantly downwards, especially for Cd and Hg. No determinant measured showed a significant upward trend, indicating that water pollution for these contaminants is not a worsening situation. However, further sampling should be carried out to confirm these findings, especially at shoreline locations, where routine monitoring ceased in 2011 to investigate any recent changes. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  6. Operating theatre ventilation systems and microbial air contamination in total joint replacement surgery: results of the GISIO-ISChIA study.

    Science.gov (United States)

    Agodi, A; Auxilia, F; Barchitta, M; Cristina, M L; D'Alessandro, D; Mura, I; Nobile, M; Pasquarella, C

    2015-07-01

    Recent studies have shown a higher rate of surgical site infections in hip prosthesis implantation using unidirectional airflow ventilation compared with turbulent ventilation. However, these studies did not measure the air microbial quality of operating theatres (OTs), and assumed it to be compliant with the recommended standards for this ventilation technique. To evaluate airborne microbial contamination in OTs during hip and knee replacement surgery, and compare the findings with values recommended for joint replacement surgery. Air samplings were performed in 28 OTs supplied with unidirectional, turbulent and mixed airflow ventilation. Samples were collected using passive sampling to determine the index of microbial air contamination (IMA). Active sampling was also performed in some of the OTs. The average number of people in the OT and the number of door openings during the sampling period were recorded. In total, 1228 elective prosthesis procedures (60.1% hip and 39.9% knee) were included in this study. Of passive samplings performed during surgical activity in unidirectional airflow ventilation OTs (U-OTs) and mixed airflow OTs (M-OTs), 58.9% and 87.6% had IMA values >2, respectively. Of samplings performed during surgical activity in turbulent airflow OTs (T-OTs) and in turbulent airflow OTs with the surgical team wearing Steri-Shield Turbo Helmets (TH-OTs), 8.6% and 60% had IMA values ≤ 2, respectively. Positive correlation was found between IMA values and the number of people in the OT and the number of door openings (P systems always provide acceptable airborne bacterial counts. Copyright © 2015 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  7. Diet, Lifestyle and Chronic disease burden

    NARCIS (Netherlands)

    Struijk, E.A.

    2014-01-01

    Background Diet, Body Mass Index (BMI), physical activity and smoking are among the most important lifestyle factors that influence global disease burden. In this thesis we investigate the relations of these factors with total disease burden in a large Dutch population, the EPIC-NL cohort. In this

  8. FRAMES User Defined Body Burden Concentration File Module Documentation

    International Nuclear Information System (INIS)

    Pelton, Mitchell A.; Rutz, Frederick C.; Eslinger, Melany A.; Gelston, Gariann M.

    2001-01-01

    The Framework for Risk Analysis in Multimedia Environmental Systems (FRAMES) Body Burden Concentration File (BBF) contains time-varying, instantaneous, constituent concentrations for body burden by contaminant. This report contains the requirements for this file and will be used by software engineers and testers to ensure that the file inputs properly.

  9. The Global Cancer Burden

    Centers for Disease Control (CDC) Podcasts

    2012-02-02

    This podcast describes the global burden of cancer and efforts by CDC and others to reduce that burden.  Created: 2/2/2012 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 2/2/2012.

  10. Determination of the total mercury in contaminated soils by direct solid sampling atomic absorption spectrometry using an AMA-254 device and radiochemical neutron activation analysis

    Czech Academy of Sciences Publication Activity Database

    Sysalová, J.; Kučera, Jan; Fikrle, Marek; Drtinová, B.

    2013-01-01

    Roč. 110, SEP (2013), s. 691-694 ISSN 0026-265X R&D Projects: GA ČR GAP503/12/0682; GA ČR(CZ) GBP108/12/G108 Institutional support: RVO:61389005 Keywords : Mercury * contaminated soils * AMA-254 * RNAA Subject RIV: BG - Nuclear, Atomic and Molecular Physics, Colliders Impact factor: 3.583, year: 2013

  11. Environment of care: Is it time to reassess microbial contamination of the operating room air as a risk factor for surgical site infection in total joint arthroplasty?

    Science.gov (United States)

    Parvizi, Javad; Barnes, Sue; Shohat, Noam; Edmiston, Charles E

    2017-11-01

    In the modern operating room (OR), traditional surgical mask, frequent air exchanges, and architectural barriers are viewed as effective in reducing airborne microbial populations. Intraoperative sampling of airborne particulates is rarely performed in the OR because of technical difficulties associated with sampling methodologies and a common belief that airborne contamination is infrequently associated with surgical site infections (SSIs). Recent studies suggest that viable airborne particulates are readily disseminated throughout the OR, placing patients at risk for postoperative SSI. In 2017, virtually all surgical disciplines are engaged in the implantation of selective biomedical devices, and these implants have been documented to be at high risk for intraoperative contamination. Approximately 1.2 million arthroplasties are performed annually in the United States, and that number is expected to increase to 3.8 million by the year 2030. The incidence of periprosthetic joint infection is perceived to be low (<2.5%); however, the personal and fiscal morbidity is significant. Although the pharmaceutic and computer industries enforce stringent air quality standards on their manufacturing processes, there is currently no U.S. standard for acceptable air quality within the OR environment. This review documents the contribution of air contamination to the etiology of periprosthetic joint infection, and evidence for selective innovative strategies to reduce the risk of intraoperative microbial aerosols. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  12. Burden of Rabies

    Science.gov (United States)

    ... this? Submit Button Past Emails The Burden of Rabies Recommend on Facebook Tweet Share Compartir Learn how ... bitten by an animal that has the disease. Rabies in the U.S. Rabies continues to be a ...

  13. Fate of polychlorinated biphenyls in a contaminated lake ecosystem: Combining equilibrium passive sampling of sediment and water with total concentration measurements of biota

    DEFF Research Database (Denmark)

    Mäenpää, Kimmo; Leppänen, Matti T.; Figueiredo, Kaisa

    2015-01-01

    Equilibrium sampling devices can be applied to study and monitor the exposure and fate of hydrophobic organic chemicals on a thermodynamic basis. They can be used to determine freely dissolved concentrations and chemical activity ratios and to predict equilibrium partitioning concentrations...... of hydrophobic organic chemicals in biota lipids. The authors' aim was to assess the equilibrium status of polychlorinated biphenyls (PCBs) in a contaminated lake ecosystem and along its discharge course using equilibrium sampling devices for measurements in sediment and water and by also analyzing biota....... The authors used equilibrium sampling devices (silicone rubber and polyethylene [PE]) to determine freely dissolved concentrations and chemical activities of PCBs in the water column and sediment porewater and calculated for both phases the corresponding equilibrium concentrations and chemical activities...

  14. Fate of polychlorinated biphenyls in a contaminated lake ecosystem: combining equilibrium passive sampling of sediment and water with total concentration measurements of biota.

    Science.gov (United States)

    Mäenpää, Kimmo; Leppänen, Matti T; Figueiredo, Kaisa; Mayer, Philipp; Gilbert, Dorothea; Jahnke, Annika; Gil-Allué, Carmen; Akkanen, Jarkko; Nybom, Inna; Herve, Sirpa

    2015-11-01

    Equilibrium sampling devices can be applied to study and monitor the exposure and fate of hydrophobic organic chemicals on a thermodynamic basis. They can be used to determine freely dissolved concentrations and chemical activity ratios and to predict equilibrium partitioning concentrations of hydrophobic organic chemicals in biota lipids. The authors' aim was to assess the equilibrium status of polychlorinated biphenyls (PCBs) in a contaminated lake ecosystem and along its discharge course using equilibrium sampling devices for measurements in sediment and water and by also analyzing biota. The authors used equilibrium sampling devices (silicone rubber and polyethylene [PE]) to determine freely dissolved concentrations and chemical activities of PCBs in the water column and sediment porewater and calculated for both phases the corresponding equilibrium concentrations and chemical activities in model lipids. Overall, the studied ecosystem appeared to be in disequilibrium for the studied phases: sediment, water, and biota. Chemical activities of PCBs were higher in sediment than in water, which implies that the sediment functioned as a partitioning source of PCBs and that net diffusion occurred from the sediment to the water column. Measured lipid-normalized PCB concentrations in biota were generally below equilibrium lipid concentrations relative to the sediment (CLip ⇌Sed ) or water (CLip ⇌W ), indicating that PCB levels in the organisms were below the maximum partitioning levels. The present study shows the application versatility of equilibrium sampling devices in the field and facilitates a thermodynamic understanding of exposure and fate of PCBs in a contaminated lake and its discharge course. © 2015 SETAC.

  15. Gastroesophageal reflux disease burden in Iran.

    Science.gov (United States)

    Delavari, Alireza; Moradi, Ghobad; Elahi, Elham; Moradi-Lakeh, Maziar

    2015-02-01

    Gastroesophageal reflux disease is one of the most common disorders of the gastrointestinal tract. The prevalence of this disease ranges from 5% to 20% in Asia, Europe, and North America. The aim of this study was to estimate the burden of gastroesophageal reflux disease in Iran. Burden of gastroesophageal reflux disease in Iran was estimated for one year from 21 March 2006 to 20 March 2007. The definition was adjusted with ICD-code of K21. Incident-based disability-adjusted life year (DALY) was used as the unit of analysis to quantify disease burden. A simplified disease model and DisMod II software were used for modeling. The annual incidence for total population of males and females in Iran was estimated 17.72 and 28.06 per 1000, respectively. The average duration of gastroesophageal reflux disease as a chronic condition was estimated around 10 years in both sexes. Total DALYs for an average of 59 symptomatic days per year was estimated 153,554.3 (60,330.8 for males and 93,223.5 for females).   The results of this study showed that reflux imposes high burden and high financial costs on the Iranian population. The burden of this disease in Iran is more similar to that of European countries rather than Asian countries. It is recommended to consider the disease as a public health problem and make decisions and public health plans to reduce the burden and financial costs of the disease in Iran.

  16. Contamination Analyzer

    Science.gov (United States)

    1994-01-01

    Measurement of the total organic carbon content in water is important in assessing contamination levels in high purity water for power generation, pharmaceutical production and electronics manufacture. Even trace levels of organic compounds can cause defects in manufactured products. The Sievers Model 800 Total Organic Carbon (TOC) Analyzer, based on technology developed for the Space Station, uses a strong chemical oxidizing agent and ultraviolet light to convert organic compounds in water to carbon dioxide. After ionizing the carbon dioxide, the amount of ions is determined by measuring the conductivity of the deionized water. The new technique is highly sensitive, does not require compressed gas, and maintenance is minimal.

  17. Total mesophilic counts underestimate in many cases the contamination levels of psychrotrophic lactic acid bacteria (LAB) in chilled-stored food products at the end of their shelf-life.

    Science.gov (United States)

    Pothakos, Vasileios; Samapundo, Simbarashe; Devlieghere, Frank

    2012-12-01

    The major objective of this study was to determine the role of psychrotrophic lactic acid bacteria (LAB) in spoilage-associated phenomena at the end of the shelf-life of 86 various packaged (air, vacuum, modified-atmosphere) chilled-stored retail food products. The current microbiological standards, which are largely based on the total viable mesophilic counts lack discriminatory capacity to detect psychrotrophic LAB. A comparison between the total viable counts on plates incubated at 30 °C (representing the mesophiles) and at 22 °C (indicating the psychrotrophs) for 86 food samples covering a wide range - ready-to-eat vegetable salads, fresh raw meat, cooked meat products and composite food - showed that a consistent underestimation of the microbial load occurs when the total aerobic mesophilic counts are used as a shelf-life parameter. In 38% of the samples, the psychrotrophic counts had significantly higher values (+0.5-3 log CFU/g) than the corresponding total aerobic mesophilic counts. A total of 154 lactic acid bacteria, which were unable to proliferate at 30 °C were isolated. In addition, a further 43 with a poor recovery at this temperature were also isolated. This study highlights the potential fallacy of the total aerobic mesophilic count as a reference shelf-life parameter for chilled food products as it can often underestimate the contamination levels at the end of the shelf-life. Copyright © 2012 Elsevier Ltd. All rights reserved.

  18. The economic burden of schizophrenia in Malaysia.

    Science.gov (United States)

    Teoh, Siew Li; Chong, Huey Yi; Abdul Aziz, Salina; Chemi, Norliza; Othman, Abdul Razak; Md Zaki, Nurzuriana; Vanichkulpitak, Possatorn; Chaiyakunapruk, Nathorn

    2017-01-01

    Schizophrenia (SCZ) is a highly debilitating disease despite its low prevalence. The economic burden associated with SCZ is substantial and mainly attributed to productivity loss. To improve the understanding of economic burden of SCZ in the low- and middle-income country regions, we aimed to determine the economic burden of SCZ in Malaysia. A retrospective study was conducted using a prevalence-based approach from a societal perspective in Malaysia with a 1 year period from 2013. We used micro-costing technique with bottom-up method and included direct medical cost, direct non-medical cost, and indirect cost. The main data source was medical chart review which was conducted in Hospital Kuala Lumpur (HKL). The medical charts were identified electronically by matching the unique patient's identification number registered under the National Mental Health Schizophrenia Registry and the list of patients in HKL in 2013. Other data sources were government documents, literatures, and local websites. To ensure robustness of result, probabilistic sensitivity analysis was conducted. The total estimated number of treated SCZ cases in Malaysia in 2015 was 15,104 with the total economic burden of USD 100 million (M) which was equivalent to 0.04% of the national gross domestic product. On average, the mean cost per patient was USD 6,594. Of the total economic burden of SCZ, 72% was attributed to indirect cost, costing at USD 72M, followed by direct medical cost (26%), costing at USD 26M, and direct non-medical cost (2%), costing at USD 1.7M. This study highlights the magnitude of economic burden of SCZ and informs the policy-makers that there is an inadequate support for SCZ patients. More resources should be allocated to improve the condition of SCZ patients and to reduce the economic burden.

  19. Determination of ultra trace contaminants on silicon wafer surfaces using total-reflection X-ray fluorescence TXRF 'state-of-the-art'

    Science.gov (United States)

    Pahlke, S.; Fabry, L.; Kotz, L.; Mantler, C.; Ehmann, T.

    2001-11-01

    In a well balanced system of highly motivated, well trained personnel and automated equipment, pure reagents and bulk media, cleanrooms and integrated data management, total-reflection X-ray fluorescence (TXRF) can and must contribute to quality assurance and process stability, support and canalize creative engineering by continuous learning about materials and processes. TXRF has the advantage of controlled one-point calibration, a linear dynamic range of three orders of magnitude, high grade of automation in operation and data management, high up-time, and a simple control of data plausibility.

  20. Assessment of the Total Body Burden of Caesium-137 in Humans by the Analysis of Blood; Determination de la Charge Corporelle de Cesium 137 chez l'Homme, par Analyse Du Sang; 041e 041f 0420 0415 0414 ; Evaluacion de la Carga Corporal Total de Cesio-137 en el Hombre por Analisis de Sangre

    Energy Technology Data Exchange (ETDEWEB)

    Yamagata, N. [Institute of Public Health, Tokyo (Japan)

    1964-11-15

    Analysis of post-mortem samples for caesium-137 has been carried on in Japan because whole-body counters are limited in number and not mobile, making the assessment of the population mean levels inconvenient. However, the collection of muscles from autopsies throughout the country is complicated and inconvenient in that a sample should be taken immediately after death. Considering that only such data as are useful for the assessment of the mean levels of caesium-137 in people are required and it is unnecessary to know individual values, the composite samples of as many individuals as possible would be enough for the analysis. For this purpose, whole blood samples were considered as the best substitute for muscles, as the blood collection system covers the whole country, including 47 licensed blood banks and about 100 hospitals. Sampling inspection is made continuously of citrated whole blood at the National Institute of Health, Tokyo, where about 500 ampoules are checked, representing more than three million donors throughout the country per year. Less than half the blood in an ampoule was consumed for inspection and the remaining half was stocked to make a composite for the determination of caesium-137 level. Blood ashes were analysed for the stable caesium content by a neutron activation method. The results afforded the relation between the concentration in the whole blood and the total body amount (1.4 mg for 70 kg man) and this relation would be identical to that for caesium-137 in an equilibrium condition. The results of blood analysis for caesium-137 obtained since June 1963 were compared with those of muscle analyses made during the same period. Good agreement was observed and the blood analysis was found to be the best means for assessing the total body burden of caesium-137 in a population. (author) [French] Au Japon, on a dose le cesium 137 d'echantillons de tissus musculaires preleves au cours d'autopsies, car il n'y a qu'un petit nombre d

  1. Chemometrics methods for the investigation of methylmercury and total mercury contamination in mollusks samples collected from coastal sites along the Chinese Bohai Sea.

    Science.gov (United States)

    Yawei, Wang; Lina, Liang; Jianbo, Shi; Guibin, Jiang

    2005-06-01

    The development and application of chemometrics methods, principal component analysis (PCA), cluster analysis and correlation analysis for the determination of methylmercury (MeHg) and total mecury (HgT) in gastropod and bivalve species collected from eight coastal sites along the Chinese Bohai Sea are described. HgT is directly determined by atomic fluorescence spectrometry (AFS), while MeHg is measured by a laboratory established high performance liquid chromatography-atomic fluorescence spectrometry system (HPLC-AFS). One-way ANOVA and cluster analysis indicated that the bioaccumulation of Rap to accumulate Hg was significantly (P<0.05) different from other mollusks. Correlation analysis shows that there is linear relationship between MeHg and HgT in mollusks samples collected from coastal sites along the Chinese Bohai Sea, while in mollusks samples collected from Hongqiao market in Beijing City, there is not any linear relationship.

  2. Burden control by artificial intelligence

    Energy Technology Data Exchange (ETDEWEB)

    Saxen, H.; Nikus, M. [Aabo Akademi, Turku (Finland). Heat Engineering Lab.

    1998-07-01

    The burden distribution plays an important role for the fuel economy of the blast furnace. By an appropriate burden distribution, the operation of the furnace is smooth and the gas is utilized well, the burden descends steadily and the wear of the lining is minimal. Since it is very difficult to obtain reliable information about the burden distribution in operating blast furnaces, this research project developed methods for interpretation of burden and gas distribution in the shaft mainly based on temperature measurements from above-burden probes.

  3. The economic burden of tuberculosis in Indonesia.

    Science.gov (United States)

    Collins, D; Hafidz, F; Mustikawati, D

    2017-09-01

    Indonesia has a high prevalence of tuberculosis (TB) and is one of the 22 countries with the highest TB burdens in the world. To understand the economic burden of TB in Indonesia. TB data for 2015 were combined with cost data using a simple type of cost-benefit analysis in a decision tree model to show the economic burden under different scenarios. In Indonesia, there were an estimated 1 017 378 new active TB cases in 2015, including multidrug-resistant TB. It is estimated that 417 976 of these cases would be treated and cured, 160 830 would be unsuccessfully treated and would die, 131 571 would be untreated and would achieve cure spontaneously, and 307 000 would be untreated and would die. The total economic burden related to treated and untreated cases would be approximately US$6.9 billion. Loss of productivity due to premature death would be by far the largest element, comprising US$6.0 billion (discounted), which represents 86.6% of the total cost. Loss of productivity due to illness would be US$700 million (10.1%), provider medical costs US$156 million (2.2%), and direct non-medical costs incurred by patients and their households US$74 million (1.1%). The economic burden of TB in Indonesia is extremely high. Detecting and treating more cases would result not only in major reductions in suffering but also in economic savings to society.

  4. Response Burden in Official Business Surveys: Measurement and Reduction Practices of National Statistical Institutes

    Directory of Open Access Journals (Sweden)

    Bavdaž Mojca

    2015-12-01

    Full Text Available Response burden in business surveys has long been a concern for National Statistical Institutes (NSIs for three types of reasons: political reasons, because response burden is part of the total administrative burden governments impose on businesses; methodological reasons, because an excessive response burden may reduce data quality and increase data-collection costs; and strategic reasons, because it affects relations between the NSIs and the business community. This article investigates NSI practices concerning business response burden measurement and reduction actions based on a survey of 41 NSIs from 39 countries. Most NSIs monitor at least some burden aspects and have implemented some actions to reduce burden, but large differences exist between NSIs’ methodologies for burden measurement and actions taken to reduce burden. Future research should find ways to deal with methodological differences in burden conceptualization, operationalization, and measurement, and provide insights into the effectiveness and efficiency of burden-reduction actions.

  5. Chemometrics methods for the investigation of methylmercury and total mercury contamination in mollusks samples collected from coastal sites along the Chinese Bohai Sea

    International Nuclear Information System (INIS)

    Wang Yawei; Liang Lina; Shi Jianbo; Jiang Guibin

    2005-01-01

    The development and application of chemometrics methods, principal component analysis (PCA), cluster analysis and correlation analysis for the determination of methylmercury (MeHg) and total mercury (HgT) in gastropod and bivalve species collected from eight coastal sites along the Chinese Bohai Sea are described. HgT is directly determined by atomic fluorescence spectrometry (AFS), while MeHg is measured by a laboratory established high performance liquid chromatography-atomic fluorescence spectrometry system (HPLC-AFS). One-way ANOVA and cluster analysis indicated that the bioaccumulation of Rap to accumulate Hg was significantly (P<0.05) different from other mollusks. Correlation analysis shows that there is linear relationship between MeHg and HgT in mollusks samples collected from coastal sites along the Chinese Bohai Sea, while in mollusks samples collected from Hongqiao market in Beijing City, there is not any linear relationship. - Rapana venosa might be used as a potential biomonitor for Hg pollution in the Bohai Sea, China

  6. The burden of allergic rhinitis.

    Science.gov (United States)

    Nathan, Robert A

    2007-01-01

    Although formerly regarded as a nuisance disease, allergic rhinitis (AR) has a considerable effect on quality of life and can have significant consequences if left untreated. The total burden of this disease lies not only in impaired physical and social functioning but also in a financial burden made greater when considering evidence that AR is a possible causal factor in comorbid diseases such as asthma or sinusitis. Compared with matched controls, patients with AR have an approximate twofold increase in medication costs and 1.8-fold the number of visits to health practitioners. Hidden direct costs include the treatment of comorbid asthma, chronic sinusitis, otitis media, upper respiratory infection, and nasal polyposis. Nasal congestion, the most prominent symptom in AR, is associated with sleep-disordered breathing, a condition that can have a profound effect on mental health, including increased psychiatric disorders, depression, anxiety, and alcohol abuse. Furthermore, sleep-disordered breathing in childhood and adolescence is associated with increased disorders of learning performance, behavior, and attention. In the United States, AR results in 3.5 million lost workdays and 2 million lost schooldays annually. Patients struggle to alleviate their misery, frequently self-adjusting their treatment regimen of over-the-counter and prescription medications because of lack of efficacy, deterioration of efficacy, lack of 24-hour relief, and bothersome side effects. Ironically, health care providers overestimate patient satisfaction with therapy. Therefore, improvement in patient-practitioner communication may enhance patient adherence with prescribed regimens.

  7. EAMJ Jan. Burden.indd

    African Journals Online (AJOL)

    2009-01-01

    Jan 1, 2009 ... developed world where the burden of disease is accurately determined. ... Projections indicate an expected yearly incidence of 15 to 20 million new .... of global mortality and burden of diseases from 2002 to 2030. Plos. Med.

  8. Atmospheric contamination

    International Nuclear Information System (INIS)

    Gruetter, Juerg

    1997-01-01

    It is about the levels of contamination in center America, the population's perception on the problem, effects of the atmospheric contamination, effects in the environment, causes of the atmospheric contamination, possibilities to reduce the atmospheric contamination and list of Roeco Swisscontac in atmospheric contamination

  9. The economic burden of schizophrenia in Malaysia

    Directory of Open Access Journals (Sweden)

    Teoh SL

    2017-07-01

    Full Text Available Siew Li Teoh,1 Huey Yi Chong,1 Salina Abdul Aziz,2 Norliza Chemi,2 Abdul Razak Othman,2 Nurzuriana Md Zaki,2 Possatorn Vanichkulpitak,3 Nathorn Chaiyakunapruk1,4–6 1School of Pharmacy, Monash University Malaysia, Selangor, 2Department of Psychiatry and Mental Health, Hospital Kuala Lumpur, Kuala Lumpur, Malaysia; 3Faculty of Pharmacy, Silpakorn University, Nakhon Pathom, 4Center of Pharmaceutical Outcomes Research (CPOR, Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand; 5School of Pharmacy, University of Wisconsin, Madison, WI, USA; 6Health and Well-being Cluster, Global Asia in the 21st Century (GA21 Platform, Monash University Malaysia, Selangor, MalaysiaIntroduction: Schizophrenia (SCZ is a highly debilitating disease despite its low prevalence. The economic burden associated with SCZ is substantial and mainly attributed to productivity loss. To improve the understanding of economic burden of SCZ in the low- and middle-income country regions, we aimed to determine the economic burden of SCZ in Malaysia.Methods: A retrospective study was conducted using a prevalence-based approach from a societal perspective in Malaysia with a 1 year period from 2013. We used micro-costing technique with bottom-up method and included direct medical cost, direct non-medical cost, and indirect cost. The main data source was medical chart review which was conducted in Hospital Kuala Lumpur (HKL. The medical charts were identified electronically by matching the unique patient’s identification number registered under the National Mental Health Schizophrenia Registry and the list of patients in HKL in 2013. Other data sources were government documents, literatures, and local websites. To ensure robustness of result, probabilistic sensitivity analysis was conducted.Results: The total estimated number of treated SCZ cases in Malaysia in 2015 was 15,104 with the total economic burden of USD 100 million

  10. Salmonella burden in Lebanon.

    Science.gov (United States)

    Malaeb, M; Bizri, A R; Ghosn, N; Berry, A; Musharrafieh, U

    2016-06-01

    Salmonellosis is a disease that represents a major public health concern in both developing and developed countries. The aim of this article is to evaluate the public health burden of Salmonella illness in Lebanon. The current scope of the Salmonella infection problem was assessed in relation to disease incidence and distribution with respect to age, gender and district. Factors that provide a better understanding of the magnitude of the problem were explored and highlighted. Data reported to the Epidemiologic Surveillance Department at the Lebanese Ministry of Public Health between 2001 and 2013 was reviewed. Information obtained was compared to information reported regionally and globally. The estimated true incidence was derived using multipliers from the CDC and Jordan. A literature review of all published data from Lebanon about Salmonella susceptibility/resistance patterns and its serious clinical complications was conducted. The estimated incidence was 13·34 cases/100 000 individuals, most cases occurred in the 20-39 years age group with no significant gender variation. Poor and less developed districts of Lebanon had the highest number of cases and the peak incidence was in summer. Reflecting on the projected incidence derived from the use of multipliers indicates a major discrepancy between what is reported and what is estimated. We conclude that data about Salmonella infection in Lebanon and many Middle Eastern and developing countries lack crucial information and are not necessarily representative of the true incidence, prevalence and burden of illness.

  11. Environmental monitoring of Columbia River sediments: Grain-size distribution and contaminant association

    Energy Technology Data Exchange (ETDEWEB)

    Blanton, M.L.; Gardiner, W.W.; Dirkes, R.L.

    1995-04-01

    Based on the results of this study and literature review, the following conclusions can be made: Sediment grain size and TOC (total organic carbon) influence contaminant fate and transport (in general, sediments with higher TOC content and finer grain-size distribution can have higher contaminant burdens than sediments from a given river section that have less TOC and greater amounts of coarse-grained sediments). Physiochemical sediment characteristics are highly variable among monitoring sites along the Columbia River. Sediment grain characterization and TOC analysis should be included in interpretations of sediment-monitoring data.

  12. Environmental monitoring of Columbia River sediments: Grain-size distribution and contaminant association

    International Nuclear Information System (INIS)

    Blanton, M.L.; Gardiner, W.W.; Dirkes, R.L.

    1995-04-01

    Based on the results of this study and literature review, the following conclusions can be made: Sediment grain size and TOC (total organic carbon) influence contaminant fate and transport (in general, sediments with higher TOC content and finer grain-size distribution can have higher contaminant burdens than sediments from a given river section that have less TOC and greater amounts of coarse-grained sediments). Physiochemical sediment characteristics are highly variable among monitoring sites along the Columbia River. Sediment grain characterization and TOC analysis should be included in interpretations of sediment-monitoring data

  13. Burden of Stroke in Qatar.

    Science.gov (United States)

    Ibrahim, Faisal; Deleu, Dirk; Akhtar, Naveed; Al-Yazeedi, Wafa; Mesraoua, Boulenouar; Kamran, Sadaat; Shuaib, Ashfaq

    2015-12-01

    Qatar is located on the northeastern coast of the Arabian Peninsula. The total population is over 2.1 million with around 15% being Qatari citizens. Hamad General Hospital (HGH) is the only tertiary referral governmental hospital in Qatar which admits acute (thrombolysis-eligible) stroke patients. To provide an overview of the burden of stroke in Qatar. Data from literature databases, online sources and our stroke registry were collated to identify information on the burden of stroke in Qatar. Overall, over 80% of all stroke patients in Qatar are admitted in HGH. In 2010, the age-standardized incidence for first-ever ischemic stroke was 51.88/100,000 person-years. To date our stroke registry reveals that 79% of all stroke patients are male and almost 50% of stroke patients are 50 years or less. Hypertension, diabetes and dyslipidemia are the main predisposing factors for stroke, with ischemic stroke being more common (87%) than hemorrhagic stroke (13%). Despite the lack of a stroke unit, 9% of ischemic stroke patients are being thrombolyzed. However the presence of a stroke ward allows swift turnover of patients with a length of stay of less than 5 days before discharge or, if required, transfer to the fully-equipped hospital-based rehabilitation service. Several community awareness programs are ongoing, in addition to several research programs funded by the Qatar National Research Fund and Hamad Medical Corporation. In a country where over 15% of the population suffers from diabetes there is continuous need for national community-based awareness campaigns, prevention and educational programs particularly targeting patients and health care workers. Copyright © 2015 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  14. Mercury burdens in Chinese mitten crabs (Eriocheir sinensis) in three tributaries of southern San Francisco Bay, California, USA

    Energy Technology Data Exchange (ETDEWEB)

    Hui, Clifford A. [US Geological Survey, 7801 Folsom Blvd, Suite 101, Sacramento, CA 95826 (United States)]. E-mail: bioinvestigations@sbcglobal.net; Rudnick, Deborah [Department of Environmental Science, Policy and Management, University of California, Berkeley, CA 94720 (United States); Williams, Erin [US Fish and Wildlife Service, 4001 N. Wilson Way, Stockton, CA 95205 (United States)

    2005-02-01

    Chinese mitten crabs (Eriocheir sinensis), endemic to Asia, were first reported in the San Francisco Bay in 1992. They are now established in nearly all San Francisco Bay tributaries. These crabs accumulate more metals, such as mercury, than crustaceans living in the water column. Because their predators include fish, birds, mammals and humans, their mercury burdens have an exceptional potential to impact the ecosystem and public health. We sought to elucidate the potential threat of mitten crab mercury burdens in three adjacent streams in southern San Francisco Bay, one of which is known to be contaminated with mercury. Mitten crabs had hepatopancreas concentrations of total mercury and methylmercury that did not differ among streams. The maximum burden we measured was below the action level of 1 ppm recommended by the USEPA. Hepatopancreas concentrations of methylmercury declined with increasing crab size, suggesting a mechanism for mercury excretion and that predators might reduce mercury exposure if they select larger crabs. Because mercury may be heterogeneously distributed among tissues, estimation of the impacts of crab mercury burdens on the environment requires more data on the feeding preferences of predators. - Hepatopancreas concentrations of mercury decline with crab size, which may have important consequences for bio-magnification in food webs.

  15. Mercury burdens in Chinese mitten crabs (Eriocheir sinensis) in three tributaries of southern San Francisco Bay, California, USA

    International Nuclear Information System (INIS)

    Hui, Clifford A.; Rudnick, Deborah; Williams, Erin

    2005-01-01

    Chinese mitten crabs (Eriocheir sinensis), endemic to Asia, were first reported in the San Francisco Bay in 1992. They are now established in nearly all San Francisco Bay tributaries. These crabs accumulate more metals, such as mercury, than crustaceans living in the water column. Because their predators include fish, birds, mammals and humans, their mercury burdens have an exceptional potential to impact the ecosystem and public health. We sought to elucidate the potential threat of mitten crab mercury burdens in three adjacent streams in southern San Francisco Bay, one of which is known to be contaminated with mercury. Mitten crabs had hepatopancreas concentrations of total mercury and methylmercury that did not differ among streams. The maximum burden we measured was below the action level of 1 ppm recommended by the USEPA. Hepatopancreas concentrations of methylmercury declined with increasing crab size, suggesting a mechanism for mercury excretion and that predators might reduce mercury exposure if they select larger crabs. Because mercury may be heterogeneously distributed among tissues, estimation of the impacts of crab mercury burdens on the environment requires more data on the feeding preferences of predators. - Hepatopancreas concentrations of mercury decline with crab size, which may have important consequences for bio-magnification in food webs

  16. CAREGIVER BURDEN AMONG PEOPLE CARING FOR PATIENTS WITH SCHIZOPHRENIA

    Directory of Open Access Journals (Sweden)

    Shivani Bansal

    2017-04-01

    Full Text Available BACKGROUND Caregivers of patients suffering from mental illness report burden in different areas including effects on family functioning, psychological problems, financial problems and health. The aim of the study is to determine the sociodemographic profile and caregiver burden among caregivers of persons with schizophrenia and to study the effect of patients’ psychopathology on caregiver burden scale. MATERIALS AND METHODS The present study was conducted in the Psychiatry Department, Government Medical College, Amritsar. A sample size of 34 was taken who were primary caregivers (preferably parents or spouse of schizophrenia patients diagnosed using ICD10. Measures included caregiver’s demographic variables and caregiver’s burden using the Zarit burden interview and PANSS scale in patients. Statistical Analysis- Data was analysed using SPSS software version 21. RESULTS The mean age of the caregiver was 42 SD (12.16 years. The majority of the caregivers were parents, married and employed. The mean average score of the responses to Zarit burden interview was (SD=59.52 ± 20.92. Majority of the caregivers experienced severe burden (52.9%, 9 (26.4% caregivers had reported moderate burden and 6 (17.6% had reported mild burden. The mean duration of illness was 6.89 (SD=5.03 years. The level of burden experienced was significantly associated with total PANSS score, negative symptoms, positive symptoms, general psychopathology score and duration of schizophrenia illness (p=0.00. CONCLUSION There is need for psychological assistance and social support for the vulnerable caregivers to help them reduce the burden levels and employ positive coping strategies.

  17. Some remarks on the natural radiation burden of population

    International Nuclear Information System (INIS)

    Feher, I.; Gemesi, J.; Toth, A.

    1975-04-01

    A large scale of the population's radiation burden is due to the natural radioactivity of building materials. An appropriate model has been developed for the calculation of the burden of population from the concentration of radioisotopes in building materials. The external and internal radiation burden of Hungary's population were determined (weighted means were 33 mrem/year and the bronhial dose 730 mrad/year, respectively) and the effect of new building technologies and materials on the radiation burden was studied. In dwellings built of precast concrete slabs containing low-activity ballast available in Hungary the radiation burden was found to be significantly lower than the present average. The increase in the contamination hazard expected from the peaceful uses of atomic energy could be compensated by reducing the average external radiation burden together with the average bronchial dose. This reduction can be 1.6 mrem/year and 58 mrad/year, respectively (according to our estimations based on simple assumptions), requiring acceptable excess cost. (K.A.)

  18. The prevalence and burden of mental and substance use disorders in Australia: Findings from the Global Burden of Disease Study 2015.

    Science.gov (United States)

    Ciobanu, Liliana G; Ferrari, Alize J; Erskine, Holly E; Santomauro, Damian F; Charlson, Fiona J; Leung, Janni; Amare, Azmeraw T; Olagunju, Andrew T; Whiteford, Harvey A; Baune, Bernhard T

    2018-05-01

    Timely and accurate assessments of disease burden are essential for developing effective national health policies. We used the Global Burden of Disease Study 2015 to examine burden due to mental and substance use disorders in Australia. For each of the 20 mental and substance use disorders included in Global Burden of Disease Study 2015, systematic reviews of epidemiological data were conducted, and data modelled using a Bayesian meta-regression tool to produce prevalence estimates by age, sex, geography and year. Prevalence for each disorder was then combined with a disorder-specific disability weight to give years lived with disability, as a measure of non-fatal burden. Fatal burden was measured as years of life lost due to premature mortality which were calculated by combining the number of deaths due to a disorder with the life expectancy remaining at the time of death. Disability-adjusted life years were calculated by summing years lived with disability and years of life lost to give a measure of total burden. Uncertainty was calculated around all burden estimates. Mental and substance use disorders were the leading cause of non-fatal burden in Australia in 2015, explaining 24.3% of total years lived with disability, and were the second leading cause of total burden, accounting for 14.6% of total disability-adjusted life years. There was no significant change in the age-standardised disability-adjusted life year rates for mental and substance use disorders from 1990 to 2015. Global Burden of Disease Study 2015 found that mental and substance use disorders were leading contributors to disease burden in Australia. Despite several decades of national reform, the burden of mental and substance use disorders remained largely unchanged between 1990 and 2015. To reduce this burden, effective population-level preventions strategies are required in addition to effective interventions of sufficient duration and coverage.

  19. Economic Burden of Human Papillomavirus-Related Diseases in Italy

    Science.gov (United States)

    Baio, Gianluca; Capone, Alessandro; Marcellusi, Andrea; Mennini, Francesco Saverio; Favato, Giampiero

    2012-01-01

    Introduction Human papilloma virus (HPV) genotypes 6, 11, 16, and 18 impose a substantial burden of direct costs on the Italian National Health Service that has never been quantified fully. The main objective of the present study was to address this gap: (1) by estimating the total direct medical costs associated with nine major HPV-related diseases, namely invasive cervical cancer, cervical dysplasia, cancer of the vulva, vagina, anus, penis, and head and neck, anogenital warts, and recurrent respiratory papillomatosis, and (2) by providing an aggregate measure of the total economic burden attributable to HPV 6, 11, 16, and 18 infection. Methods For each of the nine conditions, we used available Italian secondary data to estimate the lifetime cost per case, the number of incident cases of each disease, the total economic burden, and the relative prevalence of HPV types 6, 11, 16, and 18, in order to estimate the aggregate fraction of the total economic burden attributable to HPV infection. Results The total direct costs (expressed in 2011 Euro) associated with the annual incident cases of the nine HPV-related conditions included in the analysis were estimated to be €528.6 million, with a plausible range of €480.1–686.2 million. The fraction attributable to HPV 6, 11, 16, and 18 was €291.0 (range €274.5–315.7 million), accounting for approximately 55% of the total annual burden of HPV-related disease in Italy. Conclusions The results provided a plausible estimate of the significant economic burden imposed by the most prevalent HPV-related diseases on the Italian welfare system. The fraction of the total direct lifetime costs attributable to HPV 6, 11, 16, and 18 infections, and the economic burden of noncervical HPV-related diseases carried by men, were found to be cost drivers relevant to the making of informed decisions about future investments in programmes of HPV prevention. PMID:23185412

  20. Total protein

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/003483.htm Total protein To use the sharing features on this page, please enable JavaScript. The total protein test measures the total amount of two classes ...

  1. Socioeconomic differences in the burden of disease in Sweden

    DEFF Research Database (Denmark)

    Ljung, Rickard; Peterson, Stefan; Hallqvist, Johan

    2005-01-01

    OBJECTIVE: We sought to analyse how much of the total burden of disease in Sweden, measured in disability-adjusted life years (DALYs), is a result of inequalities in health between socioeconomic groups. We also sought to determine how this unequal burden is distributed across different disease...... of disease that take both mortality and morbidity into account can help policy-makers understand the magnitude of inequalities in health for different disease groups....... groups and socioeconomic groups. METHODS: Our analysis used data from the Swedish Burden of Disease Study. We studied all Swedish men and women in three age groups (15-44, 45-64, 65-84) and five major socioeconomic groups. The 18 disease and injury groups that contributed to 65% of the total burden...

  2. Global burden of disease--a race against time

    DEFF Research Database (Denmark)

    Meyrowitsch, Dan W; Bygbjerg, Ib Christian

    2007-01-01

    Low-income communities will within the next decades undergo rapid changes. The burden of non-communicable diseases (NCDs), such as diabetes, cardio-vascular disease and cancer, will comprise an increasing proportion of the total disease burden. The results of projections indicate that the already...... constrained health systems will face a double burden of disease, in which HIV/AIDS and other common infectious diseases will co-exist with the new NCDs. In order for preventive measures directed towards NCD to be cost-effective, these have to be implemented within the next 10-20 years....

  3. Some aspects of radiocesium retention in naturally contaminated captive snakes

    International Nuclear Information System (INIS)

    Staton, M.A.; Brisbin, I.L. Jr.; Geiger, R.A.

    1974-01-01

    Thirty-two captive snakes from contaminated natural habitats on or near the Savannah River Plant showed single-phase 137 Cs bioelimination curves suggesting that, in the wild state, they were near equilibrium with respect to this radionuclide at the time of capture. Radiocesium biological half-lives in the snakes averaged 131.3 +- 15.7 (SE) days with extreme values of 430.0 and 23.7 days. There was no correlation between radiocesium loss rate and initial body burden. Radiocesium loss rate showed a positive linear correlation with caloric intake and a negative exponential correlation with body weight. Less than 1 percent of radiocesium excretion could be accounted for in shed skins, the remainder being lost mainly through the feces. Two females which laid eggs in captivity transferred 6.37 and 6.43 percent of their total body burden to their eggs. Radiocesium showed a greater concentration in skeletal muscle than in kidney or liver, while fat bodies contained the lowest concentrations. Radiocesium concentrations of feces and stomach contents were generally low and were not correlated with total body burdens. (U.S.)

  4. Evaluation of the absorbed doses in conditions of external and internal contamination with radionuclides

    International Nuclear Information System (INIS)

    Milivojevic, K.; Stojanovic, D.; Markovic, P.

    1981-01-01

    In experimental conditions of contamination with radionuclides of the skin and skin injuries, an evaluation of the degree of local irradiation in decontamined region and doses absorbed in organs of selective accumulating was carried out by use of mathematical models and tissue-equivalent thermoluminescent dosemeters. The evaluation of the absorbed doses based on conception, that in adequate analyses of decontamination effect, as a most efficient medico-prophilactic measure from local and total irradiation, should be taken into account the total body burden of the penetrated radionuclide, selective accumulating in critical organs or tissues, as well as the residual radioactivity in decontaminated region. (author)

  5. HIV / AIDS: An Unequal Burden

    Science.gov (United States)

    Skip Navigation Bar Home Current Issue Past Issues HIV / AIDS HIV / AIDS: An Unequal Burden Past Issues / Summer 2009 ... high-risk category, emphasizes Dr. Cargill. Photo: iStock HIV and Pregnancy Are there ways to help HIV- ...

  6. Socioeconomic burden of hereditary angioedema

    DEFF Research Database (Denmark)

    Aygören-Pürsün, Emel; Bygum, Anette; Beusterien, Kathleen

    2014-01-01

    who were working or in school (n = 120), 72 provided work/school absenteeism data, resulting in an estimated 20 days missing from work/school on average per year; 51% (n = 84) indicated that HAE has hindered their career/educational advancement. CONCLUSION: HAE poses a considerable burden on patients...... and their families in terms of direct medical costs and indirect costs related to lost productivity. This burden is substantial at the time of attacks and in between attacks....

  7. The personal financial burden of chronic rhinosinusitis: A Canadian perspective.

    Science.gov (United States)

    Yip, Jonathan; Vescan, Allan D; Witterick, Ian J; Monteiro, Eric

    2017-07-01

    Previous studies describe the financial burden of chronic rhinosinusitis (CRS) from the perspective of third-party payers, but, to our knowledge, none analyze the costs borne by patients (i.e., out-of-pocket expenses [OOPE]). Furthermore, this burden has not been previously investigated in the context of a publicly funded health care system. The purpose of this study was to characterize the financial impact of CRS on patients, specifically by evaluating its associated OOPEs and the perceived financial burden. The secondary aim was to determine the factors predictive of OOPEs and perceived burden. Patients with CRS at a tertiary care sinus center completed a self-administered questionnaire that assessed their socioeconomic characteristics, disease-specific quality of life (22-item Sino-Nasal Outcome Test [SNOT-22]), workdays missed due to CRS, perceived financial burden, and direct medical and nonmedical OOPEs over a 12-month period. Total OOPEs were calculated from the sum of direct medical and nonmedical OOPEs. Regression analyses determined factors predictive of OOPEs and the perceived burden. A total of 84 patients completed the questionnaires. After accounting for health insurance coverage and the median direct medical, direct nonmedical, and total OOPEs per patient over a 12-month period were Canadian dollars (CAD) $336.00 (2011) [U.S. $339.85], CAD $129.87 [U.S. $131.86], and CAD $607.10 [U.S. $614.06], respectively. CRS resulted in an average of 20.6 workdays missed over a 12-month period. Factors predictive of a higher financial burden included younger age, a greater number of previous sinus surgeries, financial burden and consider counseling them on strategies to offset expenses, including obtaining travel grants, using telemedicine for follow-up assessments, providing drug samples, and streamlining diagnostic testing with medical visits.

  8. ANALYSIS OF TAX BURDEN PARAMETERS OF UKRAINE'S ECONOMY

    Directory of Open Access Journals (Sweden)

    I. Moyseyenko

    2017-11-01

    Full Text Available The need to solve the problems of macro-economic stabilization of the country's economy on the basis of determining the tax system efficiency led to the actuality and importance of developing methodological issues of macro-economic tax regulation. In terms of macro-financial stability for the purpose of strategic analysis, the macroeconomic category of tax burden and its fiscal efficiency in terms of direct and indirect taxation is considered. Tax burden indicators at a macro-level quantitatively measure the total level of tax payment and pumping up the budget. Based on the analysis of tax burden it is found that in Ukraine the major fiscal function is performed by consumption taxes (indirect taxes. The methodological principles of the diagnostics of tax burden influence on macro-indices of economic stabilization are as follows: selecting parameters of monitoring tax burden state and fiscal burden efficiency; the assessment of an impact on fiscal efficiency on macro-indices. To prognosticate the efficiency of fiscal burden performance in terms of indirect taxes linear and exponential trend equations are calculated. In terms of the analysis of macro-financial stability the usage of tax rates of indirect taxes as indicators of fiscal efficiency provides sufficient reasons for the conclusions regarding long-term trends of pumping the budget.

  9. Factors influencing aquatic-to-terrestrial contaminant transport to terrestrial arthropod consumers in a multiuse river system.

    Science.gov (United States)

    Alberts, Jeremy M; Sullivan, S Mažeika P

    2016-06-01

    Emerging aquatic insects are important vectors of contaminant transfer from aquatic to terrestrial food webs. However, the environmental factors that regulate contaminant body burdens in nearshore terrestrial consumers remain largely unexplored. We investigated the relative influences of riparian landscape composition (i.e., land use and nearshore vegetation structure) and contaminant flux via the emergent aquatic insect subsidy on selenium (Se) and mercury (Hg) body burdens of riparian ants (Formica subsericea) and spiders of the family Tetragnathidae along 11 river reaches spanning an urban-rural land-use gradient in Ohio, USA. Model-selection results indicated that fine-scale land cover (e.g., riparian zone width, shrub cover) in the riparian zone was positively associated with reach-wide body burdens of Se and Hg in both riparian F. subsericea and tetragnathid spiders (i.e., total magnitude of Hg and Se concentrations in ant and spider populations, respectively, for each reach). River distance downstream of Columbus, Ohio - where study reaches were impounded and flow through a large urban center - was also implicated as an important factor. Although stable-isotope analysis suggested that emergent aquatic insects were likely vectors of Se and Hg to tetragnathid spiders (but not to F. subsericea), emergent insect contaminant flux did not emerge as a significant predictor for either reach-wide body burdens of spider Hg or Se. Improved understanding of the pathways and influences that control aquatic-to-terrestrial contaminant transport will be critical for effective risk management and remediation. Copyright © 2016 Elsevier Ltd. All rights reserved.

  10. Total algorithms

    NARCIS (Netherlands)

    Tel, G.

    We define the notion of total algorithms for networks of processes. A total algorithm enforces that a "decision" is taken by a subset of the processes, and that participation of all processes is required to reach this decision. Total algorithms are an important building block in the design of

  11. The heterogeneity in financial and time burden of caregiving to children with chronic conditions.

    Science.gov (United States)

    Zan, Hua; Scharff, Robert L

    2015-03-01

    We examine the financial and time burdens associated with caring for children with chronic conditions, focusing on disparities across types of conditions. Using linked data from the 2003 to 2006 National Health Interview Survey and 2004-2008 Medical Expenditure Panel Survey, we created measures of financial burden (out-of-pocket healthcare costs, the ratio of out-of-pocket healthcare costs to family income, healthcare costs paid by insurance, and total healthcare costs) and time burden (missed school time due to illness or injury and the number of doctor visits) associated with 14 groups of children's chronic conditions. We used the two-part model to assess the effect of condition on financial burden and finite mixture/latent class model to analyze the time burden of caregiving. Controlling for the influences of other socio-demographic characteristics on caregiving burden, children with chronic conditions have higher financial and time burdens relative to caregiving burdens for healthy children. Levels of financial burden and burden sharing between families and insurance system also vary by type of condition. For example, children with pervasive developmental disorder or heart disease have a relatively low financial burden for families, while imposing a high cost on the insurance system. In contrast, vision difficulties are associated with a high financial burden for families relative to the costs borne by others. With respect to time burden, conditions such as cerebral palsy and heart disease impose a low time burden, while conditions such as pervasive developmental disorder are associated with a high time burden. This study demonstrates that differences exist in caregiving burden for children by type of chronic condition. Each condition has a unique profile of time and financial cost burden for families and the insurance system. These results have implications for policymakers and for families' savings and employment decisions.

  12. Light contamination

    International Nuclear Information System (INIS)

    Cepeda Pena, William Enrique

    1998-01-01

    The article tries on the wrong use of the artificial light, of the main problems of the light contamination, dispersion of the light, noxious effects of the light contamination, ecological effects, effects on the man's biological rhythm, economic effects and effects about the civic and vial security, among other topics

  13. Burden of Proof in Bioethics.

    Science.gov (United States)

    Koplin, Julian J; Selgelid, Michael J

    2015-11-01

    A common strategy in bioethics is to posit a prima facie case in favour of one policy, and to then claim that the burden of proof (that this policy should be rejected) falls on those with opposing views. If the burden of proof is not met, it is claimed, then the policy in question should be accepted. This article illustrates, and critically evaluates, examples of this strategy in debates about the sale of organs by living donors, human enhancement, and the precautionary principle. We highlight general problems with this style of argument, and particular problems with its use in specific cases. We conclude that the burden ultimately falls on decision-makers (i.e. policy-makers) to choose the policy supported by the best reasons. © 2015 John Wiley & Sons Ltd.

  14. Totally James

    Science.gov (United States)

    Owens, Tom

    2006-01-01

    This article presents an interview with James Howe, author of "The Misfits" and "Totally Joe". In this interview, Howe discusses tolerance, diversity and the parallels between his own life and his literature. Howe's four books in addition to "The Misfits" and "Totally Joe" and his list of recommended books with lesbian, gay, bisexual, transgender,…

  15. Development of an LC-MS/MS Determination Method for T-2 Toxin and Its Glucoside and Acetyl Derivatives for Estimating the Contamination of Total T-2 Toxins in Staple Flours.

    Science.gov (United States)

    Nakagawa, Hiroyuki; Matsuo, Yosuke; McCormick, Susan; Lim, Chee Wei

    2018-05-01

    A determination method previously validated for trichothecenes and zearalenone by means of liquid chromatography-tandem mass spectrometry (LC-MS/MS) was adapted for the quantification of T-2 toxin (T-2) as well as its glucoside and acetyl derivatives, T-2-3-glucoside (T-2-3G) and 3-acetyl-T-2 (3A-T-2). HT-2 toxin (HT-2) and its acetyl derivative 3-acetyl-HT-2 (3A-HT-2) were also included as the target chemicals. Staple flours (56 samples collected from the Singapore market) were examined for contamination from T-2 and/or HT-2 and their derivatives. Among them, 16 flours were found to be contaminated with T-2 and/or HT-2, whereas none was contaminated with T-2-3G and 3A-HT-2, except for trace 3A-T-2 detected in 2 rye samples. Rye flour samples were frequently contaminated with both T-2 and HT-2. Some of the reference materials (RMs) were further analyzed, and T-2-3G and 3A-T-2 were quantitatively detected in corn and wheat RMs. The ratio of T-2-3G to T-2 in the RMs seemed to be much lower than the ratio of deoxynivalenol-3-glucoside to deoxynivalenol usually reported in former studies. To the best of our knowledge, the natural contamination of 3A-T-2 in staple flour is reported here for the first time.

  16. School Trouble: A Mother's Burden.

    Science.gov (United States)

    Dudley-Marling, Curt

    2001-01-01

    Used interviews with a diverse group of parents of children who struggled academically in school to examine the effects of school troubles on mothers. Overall, the material and emotional burden for children's schoolwork fell to the mothers, many of whom felt overwhelmed and believed that the demands of schooling had diminished their quality of…

  17. Indigenous identity: burden or liberation?

    DEFF Research Database (Denmark)

    Steur, Luisa Johanna

    2010-01-01

    With the rise of ‘adivasi’ (‘indigenous’ or ‘tribal’) movements in different parts of South Asia in the past two decades, the question of how to understand ‘adivasi identity’ has become hotly debated: is it a burden, inviting distorted stereotypical depictions of subaltern people...

  18. The Physical Burdens of Secrecy

    Science.gov (United States)

    Slepian, Michael L.; Masicampo, E. J.; Toosi, Negin R.; Ambady, Nalini

    2012-01-01

    The present work examined whether secrets are experienced as physical burdens, thereby influencing perception and action. Four studies examined the behavior of people who harbored important secrets, such as secrets concerning infidelity and sexual orientation. People who recalled, were preoccupied with, or suppressed an important secret estimated…

  19. Water Contamination

    Science.gov (United States)

    ... Statistics Training & Education Policy & Recommendations Fast Facts Healthy Water Sites Healthy Water Drinking Water Healthy Swimming Global ... type=”submit” value=”Submit” /> Healthy Water Home Water Contamination Recommend on Facebook Tweet Share Compartir On ...

  20. Reconditioning contaminated gravel

    International Nuclear Information System (INIS)

    Walsh, H.; Bowers, J.S.; Cadwell, K.

    1995-02-01

    Lawrence Livermore National Laboratory (LLNL) has developed a portable screening system that will recondition radioactively contaminated gravel in the field. The separation technique employed by this system removes dirt, contaminated debris, and other fine particles from gravel. At LLNL, gravel is used in conjunction with the experimental testing of explosives to reduce shock wave propagation. The gravel surrounds the experimental device and buffers the energy generated from the explosion. During an explosion, some of the gravel is broken down into small particles and mixed with contaminants. Contaminants in the used gravel originate from metal sheathing and other parts comprising, the experimental device. These contaminants may consist of radionuclides and metals that are considered hazardous by the State of California when disposed. This paper describes the process that conveys contaminated material into the screener system, sprays the material with recycled water or other mild cleaning chemicals, and separates particles based on size. Particles greater than a specified size are discharged out of the screener separator and recycled back into use, thereby reducing the amount of mixed waste generated and minimizing the need for new gravel. The fines or silt are flushed out of the separator with the water and are removed from the water and consolidated into a drum with the use of a hydrocyclone separator and drum decant system. Because the water in the spray system is recycled, minimal makeup water is needed. The system monitors pH and total dissolved solids

  1. The economic burden of prematurity in Canada.

    Science.gov (United States)

    Johnston, Karissa M; Gooch, Katherine; Korol, Ellen; Vo, Pamela; Eyawo, Oghenowede; Bradt, Pamela; Levy, Adrian

    2014-04-05

    Preterm birth is a major risk factor for morbidity and mortality among infants worldwide, and imposes considerable burden on health, education and social services, as well as on families and caregivers. Morbidity and mortality resulting from preterm birth is highest among early (prematurity due to the larger number of late preterm infants relative to early and moderate preterm infants. The aim in this study was to characterize the burden of premature birth in Canada for early, moderate, and late premature infants, including resource utilization, direct medical costs, parental out-of-pocket costs, education costs, and mortality, using a validated and published decision model from the UK, and adapting it to a Canadian setting based on analysis of administrative, population-based data from Québec. Two-year survival was estimated at 56.0% for early preterm infants, 92.8% for moderate preterm infants, and 98.4% for late preterm infants. Per infant resource utilization consistently decreased with age. For moderately preterm infants, hospital days ranged from 1.6 at age two to 0.09 at age ten. Cost per infant over the first ten years of life was estimated to be $67,467 for early preterm infants, $52,796 for moderate preterm infants, and $10,010 for late preterm infants. Based on population sizes this corresponds to total national costs of $123.3 million for early preterm infants, $255.6 million for moderate preterm infants, $208.2 million for late preterm infants, and $587.1 million for all infants. Premature birth results in significant infant morbidity, mortality, healthcare utilization and costs in Canada. A comprehensive decision-model based on analysis of a Canadian population-based administrative data source suggested that the greatest national-level burden is associated with moderate preterm infants due to both a large cost per infant and population size while the highest individual-level burden is in early preterm infants and the largest total population size is

  2. The economic burden of kidney disorders in Korea.

    Science.gov (United States)

    Kim, Ju Hee; Ho, Seung Hee; Kim, Hyun-Jin; Lee, Sol

    2018-03-01

    To estimate the economic burden of kidney disorders in Korea. The economic burden of kidney disorders was estimated using a prevalence-based approach. Related kidney diseases in patients with kidney disorders (RPWKD) were defined using codes from the tenth International Classification of Disease (E70-E90, F30-F48, F60-F69, F90-F99, K65-K67, N00-N08, N17-N19, and N30-N39). All diseases in patients with kidney disorders (APWKD) were defined as kidney disorders that involved all disease codes. Economic costs were divided into direct costs (medical costs and non-medical costs) and indirect costs (productivity loss because of morbidity and premature mortality). The prevalence of kidney disorders increased from 0.08% (2008) to 0.11% (2011). The total economic burden of RPWKD also substantially increased from $898.9 million (2008) to $1.43 billion (2011). This ∼59.4% increase in the economic burden was equal to 0.12% of the Korean gross domestic product. The economic burden of APWKD also increased during the study period: $1.06 billion (2008), $1.23 billion (2009), $1.44 billion (2010), and $1.46 billion (2011). The present study provides the first data regarding the economic burden of kidney disorders in Korea. The findings support the need for early intervention services and prevention programs to prevent, identify, and manage kidney disorders.

  3. Disease burden of methylmercury in the German birth cohort 2014.

    Directory of Open Access Journals (Sweden)

    Julia Lackner

    Full Text Available This study aimed to estimate the disease burden of methylmercury for children born in Germany in the year 2014. Humans are mainly exposed to methylmercury when they eat fish or seafood. Prenatal methylmercury exposure is associated with IQ loss. To quantify this disease burden, we used Monte Carlo simulation to estimate the incidence of mild and severe mental retardation in children born to mothers who consume fish based on empirical data. Subsequently, we calculated the disease burden with the disability-adjusted life years (DALY-method. DALYs combine mortality and morbidity in one measure and quantify the gap between an ideal situation, where the entire population experiences the standard life expectancy without disease and disability, and the actual situation. Thus, one DALY corresponds to the loss of one year of life in good health. The methylmercury-induced burden of disease for the German birth cohort 2014 was an average of 14,186 DALY (95% CI 12,915-15,440 DALY. A large majority of the DALYs was attributed to morbidity as compared to mortality. Of the total disease burden, 98% were attributed to mild mental retardation, which only leads to morbidity. The remaining disease burden was a result of severe mental retardation with equal proportions of premature death and morbidity.

  4. Economic burden of disease-associated malnutrition in China.

    Science.gov (United States)

    Linthicum, Mark T; Thornton Snider, Julia; Vaithianathan, Rhema; Wu, Yanyu; LaVallee, Chris; Lakdawalla, Darius N; Benner, Jennifer E; Philipson, Tomas J

    2015-05-01

    Disease-associated malnutrition (DAM) is a well-recognized problem in many countries, but the extent of its burden on the Chinese population is unclear. This article reports the results of a burden-of-illness study on DAM in 15 diseases in China. Using data from the World Health Organization (WHO), the China Health and Nutrition Survey, and the published literature, mortality and disability-adjusted life years (DALYs) lost because of DAM were calculated; a financial value of this burden was calculated following WHO guidelines. DALYs lost annually to DAM in China varied across diseases, from a low of 2248 in malaria to a high of 1 315 276 in chronic obstructive pulmonary disease. The total burden was 6.1 million DALYs, for an economic burden of US$66 billion (Chinese ¥ 447 billion) annually. This burden is sufficiently large to warrant immediate attention from public health officials and medical providers, especially given that low-cost and effective interventions are available. © 2014 APJPH.

  5. Bacterial contamination of water samples in Gabon, 2013

    Directory of Open Access Journals (Sweden)

    Jonas Ehrhardt

    2017-10-01

    Full Text Available Contamination of water is a major burden in the public health setting of developing countries. We therefore assessed the quality of water samples in Gabon in 2013. The main findings were a contamination rate with coliforms of 13.5% and the detection of a possible environmental reservoir for extended spectrum beta-lactamase-producing bacteria.

  6. Management of contaminated forests

    International Nuclear Information System (INIS)

    Jouve, A.; Tikhomirov, F.A.; Grebenkov, A.; Dubourg, M.; Belli, M.; Arkhipov, N.

    1996-01-01

    This paper examines the main radioecological issues, the consequence of which are the distribution of doses for critical group of populations living in the vicinity of contaminated forest after the Chernobyl accident and the effects on the forestry economy. The main problems that have to be tackled are to avert doses for the population and forest workers, mitigate the economical burden of the lost forestry production and comply with the permissible levels of radionuclides in forest products. Various options are examined with respect to their application, and their cost effectiveness in terms of dose reduction when such attribute appears to be relevant. It is found that the cost effectiveness of the various options is extremely dependant of the case in which it is intended to be applied. Little actions are available for decreasing the doses, but most of them can lead to an economical benefit

  7. Disease burden of infectious diseases in Europe: a pilot study

    NARCIS (Netherlands)

    Lier EA van; Havelaar AH; LZO

    2007-01-01

    Consequences of different infectious diseases cannot be adequately compared with each other on the basis of the number of patients or mortality data only. It is better to combine all health effects and express the total impact as disease burden, which also takes duration and severity of diseases

  8. Economic burden associated with hospital postadmission dehydration.

    Science.gov (United States)

    Pash, Elizabeth; Parikh, Niraj; Hashemi, Lobat

    2014-11-01

    Development of dehydration after hospital admission can be a measure of quality care, but evidence describing the incidence, economic burden, and outcomes of dehydration in hospitalized patients is lacking. The objective of this study was to compare costs and resource utilization of U.S. patients experiencing postadmission dehydration (PAD) with those who do not in a hospital setting. All adult inpatient discharges, excluding those with suspected dehydration present on admission (International Classification of Diseases, Ninth Revision, Clinical Modification [ICD-9-CM] codes for dehydration: 276.0, 276.1, 276.5), were identified from the Premier database using ICD-9-CM codes. PAD and no-PAD (NPAD) groups were matched on propensity score adjusting for demographics (age, sex, race, medical, elective patients), patient severity (All Patient Refined Diagnosis-Related Groups severity scores), and hospital characteristics (geographic location, bed size, teaching and urban hospital). Costs, length of stay (LOS), and incidence of mortality and catheter-associated urinary tract infection (CAUTI) were compared between groups using the t test for continuous variables and the χ(2) test for categorical variables. In total, 86,398 (2.1%) of all the selected patients experienced PAD. Postmatching mean total costs were significantly higher for the PAD group compared with the NPAD group ($33,945 vs $22,380; P < .0001). Departmental costs were also significantly higher for the PAD group (all P < .0001). Compared with the NPAD group, the PAD group had a higher mean LOS (12.9 vs 8.2 days), a higher incidence of CAUTI (0.6% vs 0.5%), and higher in-hospital mortality (8.6% vs 7.8%) (all P < .05). The results for subgroup analysis also showed significantly higher total cost and longer LOS days for patients with PAD (all P < .05). The economic burden associated with hospital PAD in medical and surgical patients was substantial. © 2014 American Society for Parenteral and Enteral

  9. Prevalence of Parasitic Contamination

    Science.gov (United States)

    Ismail, Yazan

    2016-01-01

    One of the main ways in transmitting parasites to humans is through consuming contaminated raw vegetables. The aim of this study was to evaluate the prevalence of parasitological contamination (helminthes eggs, Giardia and Entamoeba histolytica cysts) of salad vegetables sold at supermarkets and street vendors in Amman and Baqa’a – Jordan. A total of 133 samples of salad vegetables were collected and examined for the prevalence of parasites. It was found that 29% of the samples were contaminated with different parasites. Of the 30 lettuce, 33 tomato, 42 parsley and 28 cucumber samples examined the prevalence of Ascaris spp. eggs was 43%, 15%, 21% and 4%; Toxocara spp. eggs was 30%, 0%, 0% and 4%; Giardia spp. cysts was 23%, 6%, 0% and 0%; Taenia/Echinococcus eggs was 20%, 0%, 5% and 0%; Fasciola hepatica eggs was 13%, 3%, 2% and 0%; and E. histolytica cysts was 10%, 6%, 0% and 0%, respectively. There was no significant difference in the prevalence of parasite in salad vegetables either between supermarkets and street vendors, or between Amman and Baqa’a, Ascaris spp. was found to be the highest prevalent parasite in salad vegetables from supermarkets and street vendors and from Amman and Baqa’a. Our results pointed out that, the parasitic contamination of salad vegetables found in our study might be caused by irrigating crops with faecal contaminated water. We concluded that salad vegetables sold in Amman and Baqa’a may cause a health risk to consumers.

  10. Separation of contaminated concrete

    International Nuclear Information System (INIS)

    Bakiewicz, J.L.; Reymer, A.P.S.

    1990-01-01

    Separating the contaminated parts from the non-contaminated parts from decommissioned nuclear facilities may strongly reduce the amount of contaminated concrete. The reduction in volume of the radioactive contaminated concrete is dependent on how much cementstone is in the concrete. This research program shows that the radioactive contamination is mostly in the cementstone. However the choice that the cementstone parts, (or better said the radioactive parts) are smaller than 1 mm may not always be true. Normally the cementstone takes about 30% of the total concrete volume. A separation procedure composed by a combination of milling and thermal shock has been assessed. Both the cold and hot thermal shock in combination with milling are not able to separate the cementstone from the larger aggregates completely. However, the cementstone from the concrete with a low nominal grain size seems to be almost completely removed by the combination cold thermal shock/milling, while the cementstone from the concrete with a high nominal grain size seems to be almost completely removed by the combination hot thermal shock/milling. After both methods a layer of cementstone was still visible on the aggregates. Washing followed by a nitric acid treatment removed each 2 wt% of cementstone

  11. Contamination shield

    International Nuclear Information System (INIS)

    Bayer, W.; Pecornik, D.

    1982-01-01

    An acrylate resin is presented as contamination protection coating for components and instruments in nuclear facilities and for spent fuel transport containers. The resin is evaporated or sublimated at 130 0 C and can thus be removed easily from the protected component. The radioactive particles entrained during evaporation are retained by suitable filters. (TK) [de

  12. Cotton contamination

    CSIR Research Space (South Africa)

    Van der Sluijs, MHJ

    2018-05-01

    Full Text Available This review focusses on physical forms of contaminant including the presence, prevention and/or removal of foreign bodies, stickiness and seed-coat fragments rather than the type and quantity of chemical residues that might be present in cotton...

  13. Validity and reliability of Turkish Caregiver Burden Scale among family caregivers of haemodialysis patients.

    Science.gov (United States)

    Cil Akinci, Ayse; Pinar, Rukiye

    2014-02-01

    To investigate the validity and reliability of the Caregiver Burden Scale in family members who provide primary care for haemodialysis patients. In Turkey, there is a need for a multi-dimensional instrument to evaluate the caregiver burden in people who provide care for patients with chronic diseases. A methodological study. The study sample consisted of 161 family members who provide primary care for haemodialysis patients. The forward-backward translation method was used to develop the Turkish Caregiver Burden Scale. The reliability was based on internal consistency investigated by Cronbach's alpha and item-total correlation. The factorial construct validity of the scale was tested with confirmatory factor analysis. By means of convergent and divergent validity, correlation between Caregiver Burden Scale and 36-Item Short Form Health Survey (SF-36) and correlation between Caregiver Burden Scale and the Maslach Burnout Scale were investigated. Cronbach's alpha and item-total correlations results suggested that there was good internal reliability. We found five underlying factors similar to original Scale's five-factor solution. The confirmatory factor analysis five-factor model represented an acceptable fit. Factor loadings were significant, with standardised loadings ranging from 0·43-0·81. By means of divergent validity, all sub-dimension scores and the total score of the Caregiver Burden Scale were negatively correlated with the SF-36, whereas there was a positive correlation with the emotional exhaustion and depersonalisation subscales of the Maslach Burnout Scale as expected. These results suggest that the Caregiver Burden Scale is a reliable and valid instrument which can be used with confidence in Turkish caregivers for haemodialysis patients to screen caregiver burden. The burden experienced by people who provide care for patients with chronic diseases can be evaluated with the Caregiver Burden Scale. Additionally, the Caregiver Burden Scale can be used

  14. Global economic burden of schizophrenia: a systematic review

    Directory of Open Access Journals (Sweden)

    Chong HY

    2016-02-01

    Full Text Available Huey Yi Chong,1 Siew Li Teoh,1 David Bin-Chia Wu,1 Surachai Kotirum,1 Chiun-Fang Chiou,2 Nathorn Chaiyakunapruk1,3–5 1School of Pharmacy, Monash University Malaysia, Selangor, Malaysia; 2Janssen Pharmaceutical Companies Asia Pacific, Singapore; 3Center of Pharmaceutical Outcomes Research (CPOR, Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand; 4School of Pharmacy, University of Wisconsin, Madison, WI, USA; 5School of Population Health, University of Queensland, Brisbane, Australia Background: Schizophrenia is one of the top 25 leading causes of disability worldwide in 2013. Despite its low prevalence, its health, social, and economic burden has been tremendous, not only for patients but also for families, caregivers, and the wider society. The magnitude of disease burden investigated in an economic burden study is an important source to policymakers in decision making. This study aims to systematically identify studies focusing on the economic burden of schizophrenia, describe the methods and data sources used, and summarize the findings of economic burden of schizophrenia. Methods: A systematic review was performed for economic burden studies in schizophrenia using four electronic databases (Medline, EMBASE, PsycINFO, and EconLit from inception to August 31, 2014. Results: A total of 56 articles were included in this review. More than 80% of the studies were conducted in high-income countries. Most studies had undertaken a retrospective- and prevalence-based study design. The bottom-up approach was commonly employed to determine cost, while human capital method was used for indirect cost estimation. Database and literature were the most commonly used data sources in cost estimation in high-income countries, while chart review and interview were the main data sources in low and middle-income countries. Annual costs for the schizophrenia population in the country ranged from US$94

  15. Prognostic factors in Hodgkin's disease stage III with special reference to tumour burden

    DEFF Research Database (Denmark)

    Specht, L.; Nissen, N.I.

    1988-01-01

    of lymphographically involved regions), histologic subtype, B-symptoms, number of involved regions, mediastinal involvement, pretreatment ESR, sex, age, laparotomy, and substage were examined in multivariate analysis. With regard to disease-free survival, total tumour burden (intraabdominal and peripheral...... regarding early stage disease to the effect that tumour burden is the single most important prognostic factor in Hodgkin's disease....

  16. Estimating the burden of paratyphoid a in Asia and Africa.

    Directory of Open Access Journals (Sweden)

    Michael B Arndt

    2014-06-01

    Full Text Available Despite the increasing availability of typhoid vaccine in many regions, global estimates of mortality attributable to enteric fever appear stable. While both Salmonella enterica serovar Typhi (S. Typhi and serovar Paratyphi (S. Paratyphi cause enteric fever, limited data exist estimating the burden of S. Paratyphi, particularly in Asia and Africa. We performed a systematic review of both English and Chinese-language databases to estimate the regional burden of paratyphoid within Africa and Asia. Distinct from previous reviews of the topic, we have presented two separate measures of burden; both incidence and proportion of enteric fever attributable to paratyphoid. Included articles reported laboratory-confirmed Salmonella serovar classification, provided clear methods on sampling strategy, defined the age range of participants, and specified the time period of the study. A total of 64 full-text articles satisfied inclusion criteria and were included in the qualitative synthesis. Paratyphoid A was commonly identified as a cause of enteric fever throughout Asia. The highest incidence estimates in Asia came from China; four studies estimated incidence rates of over 150 cases/100,000 person-years. Paratyphoid A burden estimates from Africa were extremely limited and with the exception of Nigeria, few population or hospital-based studies from Africa reported significant Paratyphoid A burden. While significant gaps exist in the existing population-level estimates of paratyphoid burden in Asia and Africa, available data suggest that paratyphoid A is a significant cause of enteric fever in Asia. The high variability in documented incidence and proportion estimates of paratyphoid suggest considerable geospatial variability in the burden of paratyphoid fever. Additional efforts to monitor enteric fever at the population level will be necessary in order to accurately quantify the public health threat posed by S. Paratyphi A, and to improve the prevention

  17. Economic Burden for Lung Cancer Survivors in Urban China.

    Science.gov (United States)

    Zhang, Xin; Liu, Shuai; Liu, Yang; Du, Jian; Fu, Wenqi; Zhao, Xiaowen; Huang, Weidong; Zhao, Xianming; Liu, Guoxiang; Mao, Zhengzhong; Hu, Teh-Wei

    2017-03-15

    With the rapid increase in the incidence and mortality of lung cancer, a growing number of lung cancer patients and their families are faced with a tremendous economic burden because of the high cost of treatment in China. This study was conducted to estimate the economic burden and patient responsibility of lung cancer patients and the impact of this burden on family income. This study uses data from a retrospective questionnaire survey conducted in 10 communities in urban China and includes 195 surviving lung cancer patients diagnosed over the previous five years. The calculation of direct economic burden included both direct medical and direct nonmedical costs. Indirect costs were calculated using the human capital approach, which measures the productivity lost for both patients and family caregivers. The price index was applied for the cost calculation. The average economic burden from lung cancer was $43,336 per patient, of which the direct cost per capita was $42,540 (98.16%) and the indirect cost per capita was $795 (1.84%). Of the total direct medical costs, 35.66% was paid by the insurer and 9.84% was not covered by insurance. The economic burden for diagnosed lung cancer patients in the first year following diagnosis was $30,277 per capita, which accounted for 171% of the household annual income, a percentage that fell to 107% after subtracting the compensation from medical insurance. The economic burden for lung cancer patients is substantial in the urban areas of China, and an effective control strategy to lower the cost is urgently needed.

  18. Burden of serious fungal infections in Ukraine.

    Science.gov (United States)

    Osmanov, Ali; Denning, David W

    2015-10-01

    Ukraine has high rates of TB, AIDS and cancer. We estimated the burden of fungal disease from epidemiology papers and specific populations at risk and fungal infection frequencies. HIV/AIDS cases and deaths (2012) and tuberculosis statistics were obtained from the State Service of Ukraine, while chronic obstructive pulmonary disease (COPD) cases were from M. Miravitlles et al., Thorax 64, 863-868 (2009). Annual estimates are 893,579 Ukrainian women get recurrent vaginal thrush (≥4× per year), 50,847 cases of oral candidiasis and 13,727 cases of oesophageal candidiasis in HIV, and 101 (1%) of 10,085 new AIDS cases develop cryptococcal meningitis, 6152 cases of Pneumocystis pneumonia (13.5 cases per 100,000). Of the 29,265 cases of active respiratory TB in 2012, it is estimated that 2881 new cases of chronic pulmonary aspergillosis (CPA) occurred and that the 5-year period prevalence is 7724 cases with a total CPA burden of 10,054 cases. Assuming adult asthma prevalence is ~2.9%, 28,447 patients with allergic bronchopulmonary aspergillosis (ABPA) are likely and 37,491 with severe asthma with fungal sensitisation. We estimate 2278 cases and 376 postsurgical intra-abdominal Candida infections. Invasive aspergillosis in immunocompromised patients is estimated at 303 patients annually; 930 cases in COPD patients. Ninety cases of mucormycosis (2 per 1,000,000) are estimated. In total, ~1,000,000 (2.2%) people in Ukraine develop serious fungal infections annually. © 2015 Blackwell Verlag GmbH.

  19. Psoriasis causes significant economic burden to patients.

    Science.gov (United States)

    Mustonen, A; Mattila, K; Leino, M; Koulu, L; Tuominen, R

    2014-06-01

    Psoriasis results in expenses to patients from many cost sources. Psoriasis treatments may result in considerable time and traveling costs, yet many studies fail to account for these costs. The objective of this study was to evaluate the multidimensional economic burden of psoriasis to patients. The study was based on 232 Finnish patients with psoriasis or psoriatic arthritis visiting a tertiary level dermatological clinic during a 1-year study period between October 1, 2009 and September 30, 2010. The data were based on a patient questionnaire, clinical data from the medical records and reimbursement data from the Finnish Social Insurance Institution. Item costs were based on true costs charged from the patients and all time cost estimates were based on the Human Capital Approach method. 199 patients with psoriasis and 33 with psoriatic arthritis were included in the study. Total costs were higher for patients receiving traditional systemic medications or phototherapy than those not receiving such treatment. Travel costs and travel time costs accounted for more than 60% of the costs of phototherapy. Skin care at home was time consuming and thus caused significant burden to patients. The majority of the visit costs arose from hospital visits and only a small proportion were attributed to visiting primary health care providers. Visit charges and other patient co-payments were estimated to play a minor role in the total cost of psoriasis incurred by patients, while travel costs and lost time comprised the majority of the costs, which should not be omitted in future studies regarding costs of treatments.

  20. Economic burden of cervical cancer in Malaysia

    Directory of Open Access Journals (Sweden)

    Sharifa E.W. Puteh

    2008-12-01

    Full Text Available Cervical cancers form the second highest number of female cancers in Malaysia, imposing a substantial amount of cost burden on its management. However, an estimation of cost burden of abnormal smears, cervical pre-invasive and invasive diseases needs to be done to show how much spending has been allocated to the problem. An expert panel committee came up with the clinical pathway and management algorithm of  cervical pre invasive and invasive diseases from July-December 2006 Malaysia. An activity based costing for each clinical pathway was done. Results were converted to USD. The cost of managing pre-invasive cervical cancers stage is USD 420,150 (Range: USD 197,158-879,679. Management of invasive cancer (new cases costs USD 51,533,233.44 (Range: USD 32,405,399.69 - USD 129,014,768.40. The cost of managing existing cases is USD 17,005,966.87 (Range: USD 10,693,781.90 - USD  28,901,587.12. The total cost of managing cervical cancers by health care providers in a public setting is around USD 75,888,329.45 (Range: USD 48,083,804.60 - USD 48,083,804.60. The outcome of this study has shown that preventive modalities such as screening have only contributed to 10.3 % of the total management cost of cervical cancer. The major cost contribution (67% came from treatment of invasive cancer especially at more advanced stages of cancer, followed by treatment of existing cases (22% and lastly on pre-invasive disease (0.6%. This study revealed that proportion of preventive modality in this country was still low, and the major cost came from actual treatment cost of cervical cancer. Therefore, heightened public cervical cancer screening in the country is needed. (Med J Indones 2008; 17: 272-80Keywords: cervical cancers, pre invasive disease, HPV vaccination

  1. The increasing burden of depression

    Directory of Open Access Journals (Sweden)

    Lépine J-P

    2011-05-01

    Full Text Available Jean-Pierre Lépine1, Mike Briley21Hôpital Lariboisière Fernand Widal, Assistance Publique Hôpitaux de Paris Unité INSERM 705 CNRS UMR 8206, Université Paris Diderot, Paris, France; 2NeuroBiz Consulting and Communication, Castres, FranceAbstract: Recent epidemiological surveys conducted in general populations have found that the lifetime prevalence of depression is in the range of 10% to 15%. Mood disorders, as defined by the World Mental Health and the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, have a 12-month prevalence which varies from 3% in Japan to over 9% in the US. A recent American survey found the prevalence of current depression to be 9% and the rate of current major depression to be 3.4%. All studies of depressive disorders have stressed the importance of the mortality and morbidity associated with depression. The mortality risk for suicide in depressed patients is more than 20-fold greater than in the general population. Recent studies have also shown the importance of depression as a risk factor for cardiovascular death. The risk of cardiac mortality after an initial myocardial infarction is greater in patients with depression and related to the severity of the depressive episode. Greater severity of depressive symptoms has been found to be associated with significantly higher risk of all-cause mortality including cardiovascular death and stroke. In addition to mortality, functional impairment and disability associated with depression have been consistently reported. Depression increases the risk of decreased workplace productivity and absenteeism resulting in lowered income or unemployment. Absenteeism and presenteeism (being physically present at work but functioning suboptimally have been estimated to result in a loss of $36.6 billion per year in the US. Worldwide projections by the World Health Organization for the year 2030 identify unipolar major depression as the leading cause of disease burden

  2. Schizophrenia: management and family burden.

    Science.gov (United States)

    Sebit, M B

    2007-01-01

    To explore schizophrenia with respect to its management, causes, risk factors as well as the impact it has in families regarding the burden and social networks support. Desk literature reviews. The findings are that patients with schizophrenia typically have great difficulty following a medication regimen, but they also have the greatest potential for benefiting from adherence. As with other chronic diseases that lack a definitive cure, the individual's service/recovery plan must include treatment interventions directed towards decreasing manifestations of the illness, rehabilitative services, enhancing adaptive skills, and social support mobilization aimed at optimizing function and quality of life. Finally, this paper is not exhaustive, but a pointer for further readings.

  3. Burden of pediatric hepatitis C

    OpenAIRE

    El-Shabrawi, Mortada Hassan; Kamal, Naglaa Mohamed

    2013-01-01

    Hepatitis C virus (HCV) is a major health burden infecting 170-210 million people worldwide. Additional 3-4 millions are newly-infected annually. Prevalence of pediatric infection varies from 0.05%-0.36% in the United States and Europe; up to 1.8%-5.8% in some developing countries. The highest prevalence occurs in Egypt, sub-Saharan Africa, Amazon basin and Mongolia. HCV has been present in some populations for several centuries, notably genotypes 1 and 2 in West Africa. Parenteral anti-schis...

  4. Burden of pediatric hepatitis C.

    Science.gov (United States)

    El-Shabrawi, Mortada Hassan; Kamal, Naglaa Mohamed

    2013-11-28

    Hepatitis C virus (HCV) is a major health burden infecting 170-210 million people worldwide. Additional 3-4 millions are newly-infected annually. Prevalence of pediatric infection varies from 0.05%-0.36% in the United States and Europe; up to 1.8%-5.8% in some developing countries. The highest prevalence occurs in Egypt, sub-Saharan Africa, Amazon basin and Mongolia. HCV has been present in some populations for several centuries, notably genotypes 1 and 2 in West Africa. Parenteral anti-schistosomal therapy practiced in the 1960s until the early 1980s had spread HCV infection throughout Egypt. Parenteral acquisition of HCV remains a major route for infection among Egyptian children. Insufficient screening of transfusions, unsterilized injection equipment and re-used needles and syringes continue to be major routes of HCV transmission in developing countries, whereas vertical transmission and adolescent high-risk behaviors (e.g., injection drug abuse) are the major routes in developed countries. The risk of vertical transmission from an infected mother to her unborn/newborn infant is approximately 5%. Early stages of HCV infection in children do not lead to marked impairment in the quality of life nor to cognitive, behavioral or emotional dysfunction; however, caregiver stress and family system strain may occur. HCV slowly progresses to serious complications as cirrhosis (1%-2%) and hepatocellular carcinoma (HCC) especially in the presence of risk factors as hemolytic anemias, obesity, treated malignancy, and concomitant human immune deficiency and/or hepatitis B virus co-infection. HCV vaccine remains elusive to date. Understanding the immune mechanisms in patients who successfully cleared the infection is essential for vaccine development. The pediatric standard of care treatment consists of pegylated interferon-α 2a or b plus ribavirin for 24-48 wk. The new oral direct acting antivirals, approved for adults, need further evaluation in children. Sustained

  5. ESTIMATION OF THE BURDEN OF PESTICIDE RESIDUES IN SLOVAK POPULATION

    Directory of Open Access Journals (Sweden)

    Jozef Sokol

    2010-07-01

    Full Text Available Pesticides used in the agriculture have to be applied according to the requirements of good agricultural practice and appropriate law. Pesticides leave detectable residues in agricultural crops, raw materials and ecosystem components. Pesticides reach the human population through the food chain. Information on the type and concentration of pesticide residues in food is in Slovakia collected trough the monitoring programs. Health risks associated with pesticides contaminants in human nutrition are very important and are recently studied by several expert groups. Prerequisite programs are necessary to protect public health. Risk analysis and monitoring of the population burden by pesticide contaminants have to be performed in expert level. The general strategy for assessment of toxicity of pesticides is listed by the World health Organisation. Scientific risk assessment is the basis for taking action and making the legislation at national and European community level.doi:10.5219/69

  6. Beyond Attributable Burden: Estimating the Avoidable Burden of Disease Associated with Household Air Pollution.

    Directory of Open Access Journals (Sweden)

    Randall Kuhn

    , though for different reasons. ALRI impacts diminish due to the declining burden of ALRI in the base case forecast, particularly apparent in South Asia and Southeast Asia. Although NCD burdens are rising in regions affected by HAP, the avoidable risk of NCD nonetheless diminishes due to lagged effects. Because the stove transition and the decline of ALRI are proceeding more slowly in Sub-Saharan Africa, avoidable impacts would also be more persistent (3.9% of total DALY due to HAP compared to South Asia (3.6% or Southeast Asia (2.5%.Our results illustrate how a temporal dynamic calculation of avoidable risk may yield different estimates, compared to a static attributable risk estimate, of the global and regional burden of disease. Our results suggest a window of rising and falling opportunity for HAP interventions that may have already closed in Southeast Asia and may be closing quickly in South Asia, but may remain open longer in Sub-Saharan Africa. A proper accounting of global health priorities should apply an avoidable risk framework that considers the role of ongoing social, economic and health transitions in constantly altering the disease and risk factor landscape.

  7. World Health Organization Global Estimates and Regional Comparisons of the Burden of Foodborne Disease in 2010

    NARCIS (Netherlands)

    Havelaar, Arie H|info:eu-repo/dai/nl/072306122; Kirk, Martyn D; Torgerson, Paul R; Gibb, Herman J; Hald, Tine; Lake, Robin J; Praet, Nicolas; Bellinger, David C; de Silva, Nilanthi R; Gargouri, Neyla; Speybroeck, Niko; Cawthorne, Amy; Mathers, Colin; Stein, Claudia; Angulo, Frederick J; Devleesschauwer, Brecht

    2015-01-01

    Illness and death from diseases caused by contaminated food are a constant threat to public health and a significant impediment to socio-economic development worldwide. To measure the global and regional burden of foodborne disease (FBD), the World Health Organization (WHO) established the Foodborne

  8. 45 CFR 672.17 - Burden of presentation; burden of persuasion.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 3 2010-10-01 2010-10-01 false Burden of presentation; burden of persuasion. 672.17 Section 672.17 Public Welfare Regulations Relating to Public Welfare (Continued) NATIONAL SCIENCE FOUNDATION ENFORCEMENT AND HEARING PROCEDURES § 672.17 Burden of presentation; burden of persuasion. The...

  9. 40 CFR 305.33 - Burden of presentation; burden of persuasion.

    Science.gov (United States)

    2010-07-01

    ... persuasion. 305.33 Section 305.33 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED... Hearing Procedure § 305.33 Burden of presentation; burden of persuasion. The Requestor has the burden of... justified. Accordingly, the Requestor bears the burdens of presentation and persuasion. Following the...

  10. Burden of Diarrhea in the Eastern Mediterranean Region, 1990–2013: Findings from the Global Burden of Disease Study 2013

    Science.gov (United States)

    Khalil, Ibrahim; Colombara, Danny V.; Forouzanfar, Mohammad Hossein; Troeger, Christopher; Daoud, Farah; Moradi-Lakeh, Maziar; El Bcheraoui, Charbel; Rao, Puja C.; Afshin, Ashkan; Charara, Raghid; Abate, Kalkidan Hassen; El Razek, Mohammed Magdy Abd; Abd-Allah, Foad; Abu-Elyazeed, Remon; Kiadaliri, Aliasghar Ahmad; Akanda, Ali Shafqat; Akseer, Nadia; Alam, Khurshid; Alasfoor, Deena; Ali, Raghib; AlMazroa, Mohammad A.; Alomari, Mahmoud A.; Al-Raddadi, Rajaa Mohammad Salem; Alsharif, Ubai; Alsowaidi, Shirina; Altirkawi, Khalid A.; Alvis-Guzman, Nelson; Ammar, Walid; Antonio, Carl Abelardo T.; Asayesh, Hamid; Asghar, Rana Jawad; Atique, Suleman; Awasthi, Ashish; Bacha, Umar; Badawi, Alaa; Barac, Aleksandra; Bedi, Neeraj; Bekele, Tolesa; Bensenor, Isabela M.; Betsu, Balem Demtsu; Bhutta, Zulfiqar; Bin Abdulhak, Aref A.; Butt, Zahid A.; Danawi, Hadi; Dubey, Manisha; Endries, Aman Yesuf; Faghmous, Imad D. A.; Farid, Talha; Farvid, Maryam S.; Farzadfar, Farshad; Fereshtehnejad, Seyed-Mohammad; Fischer, Florian; Fitchett, Joseph Robert Anderson; Gibney, Katherine B.; Ginawi, Ibrahim Abdelmageem Mohamed; Gishu, Melkamu Dedefo; Gugnani, Harish Chander; Gupta, Rahul; Hailu, Gessessew Bugssa; Hamadeh, Randah Ribhi; Hamidi, Samer; Harb, Hilda L.; Hedayati, Mohammad T.; Hsairi, Mohamed; Husseini, Abdullatif; Jahanmehr, Nader; Javanbakht, Mehdi; Jibat, Tariku; Jonas, Jost B.; Kasaeian, Amir; Khader, Yousef Saleh; Khan, Abdur Rahman; Khan, Ejaz Ahmad; Khan, Gulfaraz; Khoja, Tawfik Ahmed Muthafer; Kinfu, Yohannes; Kissoon, Niranjan; Koyanagi, Ai; Lal, Aparna; Latif, Asma Abdul Abdul; Lunevicius, Raimundas; El Razek, Hassan Magdy Abd; Majeed, Azeem; Malekzadeh, Reza; Mehari, Alem; Mekonnen, Alemayehu B.; Melaku, Yohannes Adama; Memish, Ziad A.; Mendoza, Walter; Misganaw, Awoke; Mohamed, Layla Abdalla Ibrahim; Nachega, Jean B.; Le Nguyen, Quyen; Nisar, Muhammad Imran; Peprah, Emmanuel Kwame; Platts-Mills, James A.; Pourmalek, Farshad; Qorbani, Mostafa; Rafay, Anwar; Rahimi-Movaghar, Vafa; Ur Rahman, Sajjad; Rai, Rajesh Kumar; Rana, Saleem M.; Ranabhat, Chhabi L.; Rao, Sowmya R.; Refaat, Amany H.; Riddle, Mark; Roshandel, Gholamreza; Ruhago, George Mugambage; Saleh, Muhammad Muhammad; Sanabria, Juan R.; Sawhney, Monika; Sepanlou, Sadaf G.; Setegn, Tesfaye; Sliwa, Karen; Sreeramareddy, Chandrashekhar T.; Sykes, Bryan L.; Tavakkoli, Mohammad; Tedla, Bemnet Amare; Terkawi, Abdullah S.; Ukwaja, Kingsley; Uthman, Olalekan A.; Westerman, Ronny; Wubshet, Mamo; Yenesew, Muluken A.; Yonemoto, Naohiro; Younis, Mustafa Z.; Zaidi, Zoubida; Zaki, Maysaa El Sayed; Al Rabeeah, Abdullah A.; Wang, Haidong; Naghavi, Mohsen; Vos, Theo; Lopez, Alan D.; Murray, Christopher J. L.; Mokdad, Ali H.

    2016-01-01

    Diarrheal diseases (DD) are leading causes of disease burden, death, and disability, especially in children in low-income settings. DD can also impact a child's potential livelihood through stunted physical growth, cognitive impairment, and other sequelae. As part of the Global Burden of Disease Study, we estimated DD burden, and the burden attributable to specific risk factors and particular etiologies, in the Eastern Mediterranean Region (EMR) between 1990 and 2013. For both sexes and all ages, we calculated disability-adjusted life years (DALYs), which are the sum of years of life lost and years lived with disability. We estimate that over 125,000 deaths (3.6% of total deaths) were due to DD in the EMR in 2013, with a greater burden of DD in low- and middle-income countries. Diarrhea deaths per 100,000 children under 5 years of age ranged from one (95% uncertainty interval [UI] = 0–1) in Bahrain and Oman to 471 (95% UI = 245–763) in Somalia. The pattern for diarrhea DALYs among those under 5 years of age closely followed that for diarrheal deaths. DALYs per 100,000 ranged from 739 (95% UI = 520–989) in Syria to 40,869 (95% UI = 21,540–65,823) in Somalia. Our results highlighted a highly inequitable burden of DD in EMR, mainly driven by the lack of access to proper resources such as water and sanitation. Our findings will guide preventive and treatment interventions which are based on evidence and which follow the ultimate goal of reducing the DD burden. PMID:27928080

  11. Contaminant-associated health effects in fishes from the Ottawa and Ashtabula Rivers, Ohio

    Science.gov (United States)

    Iwanowicz, Luke R.; Blazer, Vicki S.; Walsh, Heather L.; Shaw, Cassidy H.; DeVault, David S.; Banda, Jo A.

    2018-01-01

    The health of resident fishes serves as a biologically relevant barometer of aquatic ecosystem integrity. Here, the health of the Ottawa River and Ashtabula River (both within the Lake Erie Basin) were assessed using morphological and immunological biomarkers in brown bullheads (Ameiurus nebulosus) and largemouth bass (Micropterus salmoides). Biomarker metrics were compared to fish collected from a reference site (Conneaut Creek). Data utilized for analyses were collected between 2003 and 2011. Fish collected from all three river systems had markedly different contaminant profiles. Total PCBs were the dominant contaminant class by mass. In bullhead, PCBs were highest in fish from the Ashtabula River and there were no differences in fish collected pre- or post-remediation of Ashtabula Harbor (median = 4.6 and 5.5 mg/kg respectively). Excluding PCBs, the Ottawa River was dominated by organochlorine pesticides. Liver tumor prevalence exceeded the 5% trigger level at both the Ashtabula (7.7%) and Ottawa Rivers (10.2%), but was not statistically different than that at the reference site. There was no statistically significant association between microscopic lesions, gross pathology and contaminant body burdens. Collectively, contaminant body burdens were generally negatively correlated with functional immune responses including bactericidal, cytotoxic-cell and respiratory burst activity in both species. Exceptions were positive correlations of HCB and heptachlor epoxide with respiratory burst activity in largemouth bass, and HCB with respiratory burst activity in bullhead and ΣBHC for all three functional assays in bullhead. Data here provide additional support that organochlorine contamination is associated with immunomodulation, and that species differences exist within sites.

  12. Total Thyroidectomy

    Directory of Open Access Journals (Sweden)

    Lopez Moris E

    2016-06-01

    Full Text Available Total thyroidectomy is a surgery that removes all the thyroid tissue from the patient. The suspect of cancer in a thyroid nodule is the most frequent indication and it is presume when previous fine needle puncture is positive or a goiter has significant volume increase or symptomes. Less frequent indications are hyperthyroidism when it is refractory to treatment with Iodine 131 or it is contraindicated, and in cases of symptomatic thyroiditis. The thyroid gland has an important anatomic relation whith the inferior laryngeal nerve and the parathyroid glands, for this reason it is imperative to perform extremely meticulous dissection to recognize each one of these elements and ensure their preservation. It is also essential to maintain strict hemostasis, in order to avoid any postoperative bleeding that could lead to a suffocating neck hematoma, feared complication that represents a surgical emergency and endangers the patient’s life.It is essential to run a formal technique, without skipping steps, and maintain prudence and patience that should rule any surgical act.

  13. [The perceived burden of care and its correlates in schizophrenia].

    Science.gov (United States)

    Gülseren, Leyla; Cam, Birmay; Karakoç, Berna; Yiğit, Tamer; Danacı, Ayşen Esen; Cubukçuoğlu, Zeynep; Taş, Cumhur; Gülseren, Seref; Mete, Levent

    2010-01-01

    The present study aimed to investigate the perceived level of burden of care and its correlates in family members of schizophrenia patients. The study included 239 schizophrenic patients that were followed-up at the psychiatric outpatient clinics of Izmir Ataturk Education and Research Hospital, and Celal Bayar University Medical School, and 239 of their primary caregivers. Patients were assessed using the Positive and Negative Syndrome Scale (PANNS), Global Assessment of Functioning Scale (GAF), Social Functioning Scale (SFS), Brief Cognitive State Examination (BCE), and UKU Side Effect Rating Scale. Their primary caregivers were assessed using the Perceived Family Burden Scale (PFBS), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI). Caregiver PFBS scores ere correlated with male patients, female caregivers, inadequate social support, economic difficulty, the presence of chronic physical disorder in the caregivers, patient violence toward the caregivers, total duration of illness, the number of patient hospitalizations, PANNS total and subscale scores, and SFS, BDI, and BAI scores. Perceived burden of care was predicted by the severity of the patients' positive symptoms, SFS independence/competence and interpersonal functioning subscale scores, and caregivers' anxiety and depression levels. In order to decrease the burden of care in schizophrenia we recommend effective management of patient symptoms, enhancement of patient social functioning, interventions that target caregivers with high levels anxiety and depression, and social support provided by healthcare professionals.

  14. The Burden of Cholera in Uganda

    Science.gov (United States)

    Bwire, Godfrey; Malimbo, Mugagga; Maskery, Brian; Kim, Young Eun; Mogasale, Vittal; Levin, Ann

    2013-01-01

    Introduction In 2010, the World Health Organization released a new cholera vaccine position paper, which recommended the use of cholera vaccines in high-risk endemic areas. However, there is a paucity of data on the burden of cholera in endemic countries. This article reviewed available cholera surveillance data from Uganda and assessed the sufficiency of these data to inform country-specific strategies for cholera vaccination. Methods The Uganda Ministry of Health conducts cholera surveillance to guide cholera outbreak control activities. This includes reporting the number of cases based on a standardized clinical definition plus systematic laboratory testing of stool samples from suspected cases at the outset and conclusion of outbreaks. This retrospective study analyzes available data by district and by age to estimate incidence rates. Since surveillance activities focus on more severe hospitalized cases and deaths, a sensitivity analysis was conducted to estimate the number of non-severe cases and unrecognized deaths that may not have been captured. Results Cholera affected all ages, but the geographic distribution of the disease was very heterogeneous in Uganda. We estimated that an average of about 11,000 cholera cases occurred in Uganda each year, which led to approximately 61–182 deaths. The majority of these cases (81%) occurred in a relatively small number of districts comprising just 24% of Uganda's total population. These districts included rural areas bordering the Democratic Republic of Congo, South Sudan, and Kenya as well as the slums of Kampala city. When outbreaks occurred, the average duration was about 15 weeks with a range of 4–44 weeks. Discussion There is a clear subdivision between high-risk and low-risk districts in Uganda. Vaccination efforts should be focused on the high-risk population. However, enhanced or sentinel surveillance activities should be undertaken to better quantify the endemic disease burden and high-risk populations

  15. Burden Sharing with Climate Change Impacts

    Science.gov (United States)

    Tavoni, M.; van Vuuren, D.; De Cian, E.; Marangoni, G.; Hof, A.

    2014-12-01

    Efficiency and equity have been at the center of the climate change policy making since the very first international environmental agreements on climate change, though over time how to implement these principles has taken different forms. Studies based on Integrated Assessment Models have also shown that the economic effort of achieving a 2 degree target in a cost-effective way would differ widely across regions (Tavoni et al. 2013) because of diverse economic and energy structure, baseline emissions, energy and carbon intensity. Policy instruments, such as a fully-fledged, global emission trading schemes can be used to pursuing efficiency and equity at the same time but the literature has analyzed the compensations required to redistribute only mitigation costs. However, most of these studies have neglected the potential impacts of climate change. In this paper we use two integrated assessment models -FAIR and WITCH- to explore the 2°C policy space when accounting for climate change impacts. Impacts are represented via two different reduced forms equations, which despite their simplicity allows us exploring the key sensitivities- Our results show that in a 2 degree stabilization scenarios residual damages remain significant (see Figure 1) and that if you would like to compensate those as part of an equal effort scheme - this would lead to a different allocation than focusing on a mitigation based perspective only. The residual damages and adaptation costs are not equally distributed - and while we do not cover the full uncertainty space - with 2 different models and 2 sets of damage curves we are still able to show quite similar results in terms of vulnerable regions and the relative position of the different scenarios. Therefore, accounting for the residual damages and the associated adaptation costs on top of the mitigation burden increases and redistributes the full burden of total climate change.

  16. The global burden of cholera

    Science.gov (United States)

    Lopez, Anna Lena; You, Young Ae; Kim, Young Eun; Sah, Binod; Maskery, Brian; Clemens, John

    2012-01-01

    Abstract Objective To estimate the global burden of cholera using population-based incidence data and reports. Methods Countries with a recent history of cholera were classified as endemic or non-endemic, depending on whether they had reported cholera cases in at least three of the five most recent years. The percentages of the population in each country that lacked access to improved sanitation were used to compute the populations at risk for cholera, and incidence rates from published studies were applied to groups of countries to estimate the annual number of cholera cases in endemic countries. The estimates of cholera cases in non-endemic countries were based on the average numbers of cases reported from 2000 to 2008. Literature-based estimates of cholera case-fatality rates (CFRs) were used to compute the variance-weighted average cholera CFRs for estimating the number of cholera deaths. Findings About 1.4 billion people are at risk for cholera in endemic countries. An estimated 2.8 million cholera cases occur annually in such countries (uncertainty range: 1.4–4.3) and an estimated 87 000 cholera cases occur in non-endemic countries. The incidence is estimated to be greatest in children less than 5 years of age. Every year about 91 000 people (uncertainty range: 28 000 to 142 000) die of cholera in endemic countries and 2500 people die of the disease in non-endemic countries. Conclusion The global burden of cholera, as determined through a systematic review with clearly stated assumptions, is high. The findings of this study provide a contemporary basis for planning public health interventions to control cholera. PMID:22461716

  17. Assessment of the risk of foodborne transmission and burden of hepatitis E in Switzerland.

    Science.gov (United States)

    Müller, Alexandra; Collineau, Lucie; Stephan, Roger; Müller, Andrea; Stärk, Katharina D C

    2017-02-02

    The objective of this study was i) to quantify the risk of hepatitis E for Swiss consumers by specified pork products and ii) to estimate the total burden of human food-borne hepatitis E in Switzerland. A quantitative risk assessment from slaughter to consumption was carried out according to the Codex Alimentarius framework. In the hazard characterization, assumptions were made due to the lack of a dose-response relationship for oral exposure to hepatitis E virus (HEV). The prevalence of HEV in 160 pig livers of 40 different Swiss fattening farms was examined and determined to be 1.3% (CI 0.3%; 4.4%). This result was used as input in the risk assessment model, together with data from other published studies. The annual burden of hepatitis E was estimated in terms of Disability Adjusted Life Years (DALY), using data about hepatitis E cases diagnosed between 2010 and 2015 at two major hospitals located in the canton Ticino. Only the risk of foodborne hepatitis E from products containing pork liver was evaluated, as those containing only pork meat could not be evaluated because of lack of data on HEV load in pork. Assuming that successful oral infection occurs in 1% of servings contaminated with high HEV loads (>10 5 genome copies), and that acute illness develops in 5% of susceptible consumers, the most likely annual number of foodborne hepatitis E cases in Switzerland was estimated to be 1481 (95% CI 552; 4488) if all products containing pork liver were considered. If only high-risk products, such as plain pork liver and liver sausages (e.g. Saucisse au Foie), were considered, the annual number of cases was estimated to be 176 (95% CI 64; 498). We were unable to calculate the total burden of hepatitis E in Switzerland due to lack of data. Yet, for the canton Ticino, it was shown that a significant increase had occurred from 50 DALY per 100,000 inhabitants in 2015. This change could partly be due to an increased reporting and higher awareness among medical

  18. Proposal for derivation of limit values for skin contamination

    International Nuclear Information System (INIS)

    Schieferdecker, H.; Koelzer, W.; Henrichs, K.

    1985-04-01

    From the primary limit value for the skin dose secondary limit values are derived for skin contamination which can be used in practical radiation protection work. In analogy to the secondary limit value for the maximum permissible body burden in case of incorporation, limit values for the 'maximum permissible skin burden' are calculated with the help of dose factors for application in case of skin contamination. They can be derived from the skin dose limit values. Considering that the skin is exposed to contamination but temporarily, in analogy to the annual limit on intake in case of incorporation a 'limit value of skin contamination' is derived for immediately removable contaminations and for one day of exposure, whereas with respect to non-removable contamination and taking into account the renewal of the skin, a limit value of annual skin contamination is defined for non-removable skin contaminations. An investigation level for skin contamination is assumed as a threshold above which defined measures must be taken. Regarding these measures not more than three times appropriate washing is recommended with the subsequent procedure determined by the level of residual contamination. The respective limit values are indicated for some radionuclides selected as examples (C-14, Co-60, Sr-90, Y-90, I-131, Cs-137, Ce-141, Pu-239). (orig./HP) [de

  19. The Burden of Schizophrenia on Caregivers

    OpenAIRE

    Filiz Adana; Hulya Arslantas

    2011-01-01

    Caregivers’ burden in schizophrenia is a complex concept often with negative connotations. The concept refers to the impact of having a schizophrenia patient in the family including emotional, psychological, physical, economic distress and feelings of shame, embarrassment, guilt, and self-blame expe-rienced by the caregivers. There are objective and subjective aspects of care-givers’ burden. The objective burden refers to observed and verifiable impact of the diseased person in the family suc...

  20. Screening for 137Cs body burden due to the Chernobyl accident in Korosten city, Zhitomir, Ukraine. 1996-2008

    International Nuclear Information System (INIS)

    Hayashida, Naomi; Sekitani, Yui; Yamashita, Shunichi; Takamura, Noboru; Kozlovsky, A.; Rafalsky, R.; Gutevich, A; Daniliuk, V.

    2011-01-01

    During the Chernobyl Nuclear Power Plant (CNPP) accident on 26 April 1986, large amounts of radionuclides were released and spread to vast areas. Inhabitants residing around CNPP have been exposed to external and internal irradiation due to the long half-life of 137 Cs (30 years). In this study, we screened for internal whole-body 137 Cs concentration using a whole-body counter in the Zhitomir state of Ukraine. The total number of participants was 144,972 (96,149 females and 48,823 males). The median body burden of 137 Cs per body weight decreased from 1996 to 2008. In particular, after 2003, more than half of subjects had internal exposure doses below the detectable level. A weak seasonal effect was found in measurement data from 1997 to 1999, but no such effects were observed in later years. We also calculated annual dose for each year and confirmed that doses have been decreasing gradually. In particular, after 2003, the annual effective dose decreased to 0.1 mSv y -1 for 95% of the participants. Only two persons were found to have received more than 5 mSv y -1 since 2007. Although the health effects of 137 Cs body burden due to the Chernobyl accident remain uncertain, further screening is needed to monitor the health status and to allay the anxiety of inhabitants in the contaminated areas around CNPP. (author)

  1. Caregiver Burden in Alcohol Dependence Syndrome

    Directory of Open Access Journals (Sweden)

    Ramanujam Vaishnavi

    2017-01-01

    Full Text Available Background. Alcoholism is a major threat to the individual as well as the society and the maximum burden of the illness is borne by the family. Aim. The study is aimed at assessing the pattern of burden on the caregivers of alcohol dependent patients and at assessing the relationship between the severity of dependence and the burden on caregivers. Settings and Design. Cross-sectional descriptive study conducted in the Department of Psychiatry, Sri Ramachandra Medical College and Research Institute. Materials and Methods. A cross-sectional assessment was done in 200 patients with alcohol dependence and their caregivers. The severity of dependence and the pattern of burden on caregivers were assessed. Statistical Analysis. The data thus collected was analyzed using SPSS version 20. Results. The study demonstrates that caregivers of alcohol dependent patients reported significant objective burden and subjective burden. Furthermore, the severity of alcohol dependence and the domains of burden such as financial burden, disruption of family interaction, and disruption of family routine activities were positively correlated with high level of significance. Conclusion. The current study has illustrated that all the caregivers experienced significant amount of burden which has to be addressed for better treatment outcome of the patients.

  2. Estimation of 137Cs body burden in Japanese, 2

    International Nuclear Information System (INIS)

    Uchiyama, Masashi

    1978-01-01

    The biological half-life of 137 Cs in the total body of human subjects was determined in 23 individuals of Japanese male adult in their normal works by measuring amount of 137 Cs in both their total body and daily urine in the same period. For the group, the value was determined by averaging the half-lives for individuals, by comparing the mean body burden and the mean daily urinary excretion, or by applying a curve fitting method to the body burden estimate. The biological half-life averaged 86 days, ranging from 50 to 161 days. The averages of the biological half-lives for the group were 83, 87 and 82 days in the different periods of observation. By the curve fitting method, 85 days was found for the group. The biological half-life for the individuals depended on both body weight and age, to a lesser extent, of the subjects. (author)

  3. Psychometrics of the Zarit Burden Interview in Caregivers of Patients With Heart Failure.

    Science.gov (United States)

    Al-Rawashdeh, Sami Y; Lennie, Terry A; Chung, Misook L

    Identification of family caregivers who are burdened by the caregiving experience is vital to prevention of poor outcomes associated with caregiving. The Zarit Burden Interview (ZBI), a well-known measure of caregiving burden in caregivers of patients with dementia, has been used without being validated in caregivers of patients with heart failure (HF). The purpose of this study is to examine the reliability and validity of the ZBI in caregivers of patients with HF. A total of 124 primary caregivers of patients with HF completed survey questionnaires. Caregiving burden was measured by the ZBI. Reliability was examined using Cronbach's α and item-total/item-item correlations. Convergent validity was examined using correlations with the Oberst Caregiving Burden Scale. Construct validity was demonstrated by exploratory factor analysis and known hypothesis testing (ie, the hypothesis of the association between caregiving burden and depressive symptoms). Cronbach's α for the ZBI was .921. The ZBI had good item-total (r = 0.395-0.764) and item-item (mean r = 0.365) correlations. Significant correlations between the ZBI and the Oberst Caregiving Burden Scale (r = 0.466 for the caregiving time subscale and 0.583 for the caregiving task difficulty subscale; P < .001 for both) supported convergent validity. Four factors were identified (ie, consequences of caregiving, patient's dependence, exhaustion with caregiving and uncertainty, and guilt and fear for the patient's future) using factor analysis, which are consistent with previous studies. Caregivers with high burden scores had significantly higher depressive symptoms than did caregivers with lower burden scores (7.0 ± 6.8 vs 3.1 ± 4.3; P < .01). The findings provide evidence that the ZBI is a reliable and valid measure for assessing burden in caregivers of patients with HF.

  4. Estimating Cryptosporidium and Giardia disease burdens for children drinking untreated groundwater in a rural population in India.

    Science.gov (United States)

    Daniels, Miles E; Smith, Woutrina A; Jenkins, Marion W

    2018-01-01

    In many low-income settings, despite improvements in sanitation and hygiene, groundwater sources used for drinking may be contaminated with enteric pathogens such as Cryptosporidium and Giardia, which remain important causes of childhood morbidity. In this study, we examined the contribution of diarrhea caused by Cryptosporidium and Giardia found in groundwater sources used for drinking to the total burden of diarrheal disease among children cause (i.e., all fecal-oral enteric pathogens and exposure pathways) child diarrhea prevalence rates observed in the study population during two monsoon seasons (2012 and 2013). We used site specific and regional studies to inform assumptions about the human pathogenicity of the Cryptosporidium and Giardia species present in local groundwater. In all three human pathogenicity scenarios evaluated, the mean daily risk of Cryptosporidium or Giardia infection (0.06-1.53%), far exceeded the tolerable daily risk of infection from drinking water in the US (water was as high as 6.5% or as low as cause diarrhea disease burden measured in children causing diarrhea than did Giardia. Diarrhea prevalence estimates for waterborne Cryptosporidium infection appeared to be most sensitive to assumptions about the probability of infection from ingesting a single parasite (i.e. the rate parameter in dose-response model), while Giardia infection was most sensitive to assumptions about the viability of parasites detected in groundwater samples. Protozoa in groundwater drinking sources in rural India, even at low concentrations, especially for Cryptosporidium, may account for a significant portion of child diarrhea morbidity in settings were tubewells are used for drinking water and should be more systematically monitored. Preventing diarrheal disease burdens in Puri District and similar settings will benefit from ensuring water is microbiologically safe for consumption and consistent and effective household water treatment is practiced.

  5. The Hierarchical Clustering of Tax Burden in the EU27

    Directory of Open Access Journals (Sweden)

    Simkova Nikola

    2015-09-01

    Full Text Available The issue of taxation has become more important due to a significant share of the government revenue. There are several ways of expressing the tax burden of countries. This paper describes the traditional approach as a share of tax revenue to GDP which is applied to the total taxation and the capital taxation as a part of tax systems affecting investment decisions. The implicit tax rate on capital created by Eurostat also offers a possible explanation of the tax burden on capital, so its components are analysed in detail. This study uses one of the econometric methods called the hierarchical clustering. The data on which the clustering is based comprises countries in the EU27 for the period of 1995 – 2012. The aim of this paper is to reveal clusters of countries in the EU27 with similar tax burden or tax changes. The findings suggest that mainly newly acceding countries (2004 and 2007 are in a group of countries with a low tax burden which tried to encourage investors by favourable tax rates. On the other hand, there are mostly countries from the original EU15. Some clusters may be explained by similar historical development, geographic and demographic characteristics.

  6. Subjective caregiver burden: validity of the 10-item short version of the Burden Scale for Family Caregivers BSFC-s.

    Science.gov (United States)

    Graessel, Elmar; Berth, Hendrik; Lichte, Thomas; Grau, Hannes

    2014-02-20

    Subjective burden is a central variable describing the situation encountered by family caregivers. The 10-item short version of the Burden Scale for Family Caregivers (BSFC-short/BSFC-s) was developed to provide an economical measure of this variable. The present study examined the reliability and validity of the BSFC-s. Comprehensive data from "the IDA project" were the basis of the calculations, which included 351 dyads and examined medical data on people with dementia, interview data from their family caregivers, and health insurance data. A factor analysis was performed to explore the structure of the BSFC-s; Cronbach's alpha was used to evaluate the internal consistency of the scale. The items were analyzed to determine the item difficulty and the discriminatory power. Construct validity was tested with five hypotheses. To establish the predictive validity of the BSFC-s, predictors of institutionalization at a follow-up time of 2.5 years were analyzed (binary logistic regression). The BSFC-s score adhered to a one-factor structure. Cronbach's alpha for the complete scale was .92. A significant increase in the BSFC-s score was observed when dementia progressed, disturbing behavior occurred more frequently, care requirements increased, and when caregivers were diagnosed with depression. Caregiver burden was the second strongest predictor of institutionalization out of a total of four significant predictors. All hypotheses that referred to the construct validity were supported. The BSFC-short with its ten items is a very economical instrument for assessing the caregiver's total subjective burden in a short time frame. The BSFC-s score has predictive validity for the institutionalization of people with dementia. Therefore it is an appropriate outcome measure to evaluate caregiver interventions. The scale is available for free in 20 languages (http://www.caregiver-burden.eu). This availability facilitates the comparison of international research findings.

  7. Burden of gout in the Nordic region, 1990-2015: findings from the Global Burden of Disease Study 2015.

    Science.gov (United States)

    Kiadaliri, A A; Uhlig, T; Englund, M

    2018-01-29

    To explore the burden of gout in the Nordic region, with a population around 27 million in 2015 distributed across six countries. We used the findings of the 2015 Global Burden of Diseases study to report prevalence and disability associated with gout in the Nordic region. From 1990 to 2015, the number of prevalent gout cases rose by 30% to 252 967 [95% uncertainty interval (UI) 223 478‒287 288] in the Nordic region. In 2015, gout contributed to 7982 (95% UI 5431‒10 800) years lived with disability (YLDs) in the region, an increase of 29% (95% UI 24‒35%) from 1990. While the crude YLD rate of gout increased by 12.9% (95% UI 7.8‒18.1%) between 1990 and 2015, the age-standardized YLD rate remained stable. Gout was ranked as the 63rd leading cause of total YLDs in the region in 2015, with the highest rank in men aged 55-59 years (38th leading cause of YLDs). The corresponding rank at the global level was 94. Of 195 countries studied, four Nordic countries [Greenland (2nd), Iceland (12th), Finland (14th), and Sweden (15th)] were among the top 15 countries with the highest age-standardized YLD rate of gout. The burden of gout is rising in the Nordic region. Gout's contribution to the total burden of diseases in the region is more significant than the global average. Expected increases in gout burden owing to population growth and ageing call for stronger preventive and therapeutic strategies for gout management in Nordic countries.

  8. The gamma contamination food factor

    International Nuclear Information System (INIS)

    Kukoc, A.H.; Anicin, I.V.; Adzic, P.R.

    1992-01-01

    We suggest that radioactive food contamination, as determined solely by a quantitative gamma-ray spectroscopic measurement, may, apart from the total activity per unit mass, be for quick reference conveniently characterized by another single figure which we call the ''Gamma Contamination Food Factor'' (GCFF). This factor may be defined as the ratio of the total specific activity of gamma-ray-emitting radionuclides in the food sample (except that of 40 K) to the specific activity of 40 K either in the sample itself or in an ''average man''. We discuss briefly the meaning and advantages of these definitions. (author)

  9. Internal radioactive contamination in selected groups of CRNL employees

    International Nuclear Information System (INIS)

    Evans, D.W.S.

    1975-10-01

    This report details the development and execution of a 30 month program designed to characterize the magnitude and distribution of internal radioactive contaminaton amongst selected groups of employees at Chalk River Nuclear Laboratories, using a shadow shield whole-body counter. The results show that the levels of contamination in these employees are very low, and no contaminant was present in amounts exceeding 10% of the maximum permissible body burden, with the exception of a medically administered radionuclide (selenium-75). Details of the time course of some of the body burdens are also furnished. (author)

  10. Relationships between family resilience and posttraumatic growth in breast cancer survivors and caregiver burden.

    Science.gov (United States)

    Liu, Ye; Li, Yuli; Chen, Lijun; Li, Yurong; Qi, Weiye; Yu, Li

    2018-04-01

    To examine the relationships between family resilience and posttraumatic growth (PTG) of breast cancer survivors and caregiver burden among principal caregivers in China. Participants in this cross-sectional study comprised 108 women aged 26 to 74 years (M = 49, SD = 9) with early-stage breast cancer and 108 principal caregivers. Participants were recruited from a comprehensive cancer center of a public hospital in Shandong Province, China. The principal caregivers completed the Shortened Chinese Version of the Family Resilience Assessment Scale and the Chinese Version of the Zarit Caregiver Burden Interview; patients completed the Short Form of the Posttraumatic Growth Inventory and questions designed to obtain sociodemographic information. Hierarchical regression analysis was conducted to assess the adjusted association between family resilience and PTG and caregiver burden, while controlling for sociodemographics. Families showed a slightly elevated level of family resilience since the cancer experience, and patients showed a moderate degree of PTG. Principal caregivers reported moderate burden. The Shortened Chinese Version of the Family Resilience Assessment Scale total score was positively related to the Short Form of the Posttraumatic Growth Inventory total score (β = .28, P Caregiver Burden Interview total score (β = -.28, P resilience impacts PTG of breast cancer survivors and caregiver burden. Our findings indicated the necessity of interventions to facilitate family resilience, promote PTG among breast cancer survivors, and decrease family members' caregiver burden. Copyright © 2018 John Wiley & Sons, Ltd.

  11. Formalising arguments about the burden of persuasion.

    NARCIS (Netherlands)

    Prakken, H.; Sartor, G.

    2007-01-01

    This paper presents an argument-based logic for reasoning about allocations of the burden of persuasion. The logic extends the system of Prakken (2001), which in turn modified the system of Prakken & Sartor (1996) with the possibility to distribute the burden of proof over both sides in an argument

  12. 40 CFR 22.24 - Burden of presentation; burden of persuasion; preponderance of the evidence standard.

    Science.gov (United States)

    2010-07-01

    ... persuasion; preponderance of the evidence standard. 22.24 Section 22.24 Protection of Environment... Burden of presentation; burden of persuasion; preponderance of the evidence standard. (a) The complainant has the burdens of presentation and persuasion that the violation occurred as set forth in the...

  13. 40 CFR 179.91 - Burden of going forward; burden of persuasion.

    Science.gov (United States)

    2010-07-01

    ... persuasion. 179.91 Section 179.91 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED...; burden of persuasion. (a) The party whose request for an evidentiary hearing was granted has the burden... FFDCA has the burden of persuasion in the hearing on that issue, whether the proceeding concerns the...

  14. The global burden of dengue: an analysis from the Global Burden of Disease Study 2013

    NARCIS (Netherlands)

    J.D. Stanaway (Jeffrey D.); D.S. Shepard (Donald); E.A. Undurraga (Eduardo); Halasa, Y.A. (Yara A); L.E. Coffeng (Luc); Brady, O.J. (Oliver J); Hay, S.I. (Simon I); Bedi, N. (Neeraj); I.M. Bensenor (Isabela M.); C.A. Castañeda-Orjuela (Carlos A); T.-W. Chuang (Ting-Wu); K.B. Gibney (Katherine B); Z.A. Memish (Ziad); A. Rafay (Anwar); K.N. Ukwaja (Kingsley N); N. Yonemoto (Naohiro); C.J.L. Murray (Christopher)

    2016-01-01

    textabstractBackground Dengue is the most common arbovirus infection globally, but its burden is poorly quantified. We estimated dengue mortality, incidence, and burden for the Global Burden of Disease Study 2013. Methods We modelled mortality from vital registration, verbal autopsy, and

  15. Proposed derivation of skin contamination and skin decontamination limits

    International Nuclear Information System (INIS)

    Schieferdecker, H.; Koelzer, W.; Henrichs, K.

    1986-01-01

    From the primary dose limits for the skin, secondary dose limits were derived for skin contamination which can be used in practical radiation protection work. Analogous to the secondary dose limit for the maximum permissible body burden in the case of incorporation, dose limits for the 'maximum permissible skin burden' were calculated, with the help of dose factors, for application in the case of skin contamination. They can be derived from the skin dose limit values. For conditions in which the skin is exposed to temporary contamination, a limit of skin contamination was derived for immediately removable contamination and for one day of exposure. For non-removable contamination a dose limit of annual skin contamination was defined, taking into account the renewal of the skin. An investigation level for skin contamination was assumed, as a threshold, above which certain measures must be taken; these to include appropriate washing not more than three times, with the subsequent procedure determined by the level of residual contamination. The dose limits are indicated for selected radionuclides. (author)

  16. Effective dose and time-integrated effective dose to humans from internal contamination of 134Cs and 137Cs: Results from a compilation of a Swedish national database of internal body burden of radiocaesium in various populations between 1964 and 2002

    International Nuclear Information System (INIS)

    Raeaef, L.C.; Zakaria, M.; Hubbard, L.; Falk, R.; Aagren, G.; Vesanen, R.

    2003-01-01

    A compilation of data on the whole-body burden of 134 Cs, 137 Cs and 40 K in various Swedish populations between 1964 and 2002 has been made. The compilation was carried out in co-operation with the Department of Radiation Physics in Malmoe, the Swedish Radiation Protection Authority (SSI), the Swedish Defence Research Agency Department (FOI) and the Department of Radiation Physics, Goeteborg University. Individual body burden values have been inserted into a calculation spread sheet, with data on body weight, gender, age, occupation (if available) and place of residence. The database enables a study of the time-pattern and geographical dependence of radiocaesium transfer from ground deposition to man, and the associated absorbed dose. The Swedish government has assigned SSI the responsibility for obtaining and assuring one of Sweden's national environmental quality objectives, A Safe Radiation Environment. A natural consequence of this responsibility is that a means for quantifying progress towards the objective is necessary. The data compilation discussed here is one important component in the national environmental monitoring programme that is currently (2002) being developed at SSI. The new program for monitoring environmental radiation has the goal of following geographical and ecological differences in the radiological effects to both mankind and the environment, and assessing relevant doses and risks. During the period between 1964 and 2002, fallout of radiocaesium from nuclear weapons tests (only 137 Cs) and from the Chernobyl accident in 1986 (both 134 Cs and 137 Cs) have occurred in Sweden. The ground deposition of the radiocaesium has gradually been transferred through different ecological pathways to man. From the database it can be deduced that large regional variations in the body burden of radiocaesium in man have occurred through this period. Three populations exhibit considerably higher body content levels than others; (i) reindeer herders in

  17. The total artificial heart.

    Science.gov (United States)

    Cook, Jason A; Shah, Keyur B; Quader, Mohammed A; Cooke, Richard H; Kasirajan, Vigneshwar; Rao, Kris K; Smallfield, Melissa C; Tchoukina, Inna; Tang, Daniel G

    2015-12-01

    The total artificial heart (TAH) is a form of mechanical circulatory support in which the patient's native ventricles and valves are explanted and replaced by a pneumatically powered artificial heart. Currently, the TAH is approved for use in end-stage biventricular heart failure as a bridge to heart transplantation. However, with an increasing global burden of cardiovascular disease and congestive heart failure, the number of patients with end-stage heart failure awaiting heart transplantation now far exceeds the number of available hearts. As a result, the use of mechanical circulatory support, including the TAH and left ventricular assist device (LVAD), is growing exponentially. The LVAD is already widely used as destination therapy, and destination therapy for the TAH is under investigation. While most patients requiring mechanical circulatory support are effectively treated with LVADs, there is a subset of patients with concurrent right ventricular failure or major structural barriers to LVAD placement in whom TAH may be more appropriate. The history, indications, surgical implantation, post device management, outcomes, complications, and future direction of the TAH are discussed in this review.

  18. Caregivers' burden in patients with COPD.

    Science.gov (United States)

    Miravitlles, Marc; Peña-Longobardo, Luz María; Oliva-Moreno, Juan; Hidalgo-Vega, Álvaro

    2015-01-01

    Chronic obstructive pulmonary disease (COPD) is a very prevalent and invalidating disease. The aim of this study was to analyze the burden borne by informal caregivers of patients with COPD. We used the Survey on Disabilities, Personal Autonomy, and Dependency Situations (Encuesta sobre Discapacidad, Autonomía personal y Situaciones de Dependencia [EDAD]-2008) to obtain information on the characteristics of disabled individuals with COPD and their caregivers in Spain. Additionally, statistical multivariate analyses were performed to analyze the impact that an increase in dependence would have on the problems for which caregivers provide support, in terms of health, professional, and leisure/social dimensions. A total of 461,884 individuals with one or more disabilities and with COPD were identified, and 220,892 informal caregivers were estimated. Results showed that 35% of informal caregivers had health-related problems due to the caregiving provided; 83% had leisure/social-related problems; and among caregivers of working age, 38% recognized having profession-related problems. The probability of a problem arising was significantly associated with the degree of dependence of the patient receiving care. Caregivers of patients with great dependence showed a 39% higher probability of presenting health-related problems, 27% more professional problems, and 23% more leisure problems compared with those with nondependent patients. The results show the large impact on society in terms of the welfare of informal caregivers of patients with COPD. A higher level of dependence was associated with more severe problems in caregivers, in all dimensions.

  19. Analysis of surfaces for characterization of fungal burden – Does it matter?

    Directory of Open Access Journals (Sweden)

    Carla Viegas

    2016-08-01

    Full Text Available Objectives: Mycological contamination of occupational environments can be a result of fungal spores’ dispersion in the air and on surfaces. Therefore, it is very important to assess it in both types of the samples. In the present study we assessed fungal contamination in the air and in the surface samples to show relevance of surfaces sampling in complementing the results obtained in the air samples. Material and Methods: In total, 42 settings were assessed by the analysis of air and surfaces samples. The settings were divided into settings with a high fungal load (7 poultry farms and 7 pig farms, 3 cork industries, 3 waste management plants, 2 wastewater treatment plants and 1 horse stable and a low fungal load (10 hospital canteens, 8 college canteens and 1 maternity hospital. In addition to culture-based methods, molecular tools were also applied to detect fungal burden in the settings with a higher fungal load. Results: From the 218 sampling sites, 140 (64.2% presented different species in the examined surfaces when compared with the species identified in the air. A positive association in the high fungal load settings was found between the presence of different species in the air and surfaces. Wastewater treatment plants constituted the setting with the highest number of different species between the air and surface. Conclusions: We observed that surfaces sampling and application of molecular tools showed the same efficacy of species detection in high fungal load settings, corroborating the fact that surface sampling is crucial for a correct and complete analysis of occupational scenarios.

  20. Analysis of surfaces for characterization of fungal burden - Does it matter?

    Science.gov (United States)

    Viegas, Carla; Faria, Tiago; Meneses, Márcia; Carolino, Elisabete; Viegas, Susana; Gomes, Anita Quintal; Sabino, Raquel

    2016-01-01

    Mycological contamination of occupational environments can be a result of fungal spores' dispersion in the air and on surfaces. Therefore, it is very important to assess it in both types of the samples. In the present study we assessed fungal contamination in the air and in the surface samples to show relevance of surfaces sampling in complementing the results obtained in the air samples. In total, 42 settings were assessed by the analysis of air and surfaces samples. The settings were divided into settings with a high fungal load (7 poultry farms and 7 pig farms, 3 cork industries, 3 waste management plants, 2 wastewater treatment plants and 1 horse stable) and a low fungal load (10 hospital canteens, 8 college canteens and 1 maternity hospital). In addition to culture-based methods, molecular tools were also applied to detect fungal burden in the settings with a higher fungal load. From the 218 sampling sites, 140 (64.2%) presented different species in the examined surfaces when compared with the species identified in the air. A positive association in the high fungal load settings was found between the presence of different species in the air and surfaces. Wastewater treatment plants constituted the setting with the highest number of different species between the air and surface. We observed that surfaces sampling and application of molecular tools showed the same efficacy of species detection in high fungal load settings, corroborating the fact that surface sampling is crucial for a correct and complete analysis of occupational scenarios. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

  1. The radium contamination in the Southern Black Forest

    International Nuclear Information System (INIS)

    Schuettelkopf, H.; Kiefer, H.

    1980-01-01

    The high natural radium contamination prevailing in the Southern Black Forest was used to assess the degree of contamination of the environment, the mechanisms of radium transport to man, as well as the radiation impact on the population from natural Ra-226. The Ra-226 concentration was determined in samples of soil, river and lake water, ground and spring water, drinking water and foodstuffs including potatoes, corn, flour, meat, milk, vegetables, fish, eggs and entrails; these values were compared to a summary of values taken from the literature. Ra-226 concentrations were also determined in the environmental air, grass and hay samples and wild plants. Transfer factors were calculated for fish/water, sediment/water, grass/milk, grass/soil, milk/soil and the individual foodstuffs. The maximum permissible intake per annum for the population living in this region was calculated to be 7.1 nCi/a, assuming that the total demand for foodstuffs is satisfied by local produces; this corresponds to a body burden of 7.4 nCi of Ra-226. Whole-body counting of a sample of the population showed the calculated level of Ra-226 intake to be an overestimate. (UK)

  2. Treatment of plutonium contaminations

    International Nuclear Information System (INIS)

    Lafuma, J.

    1983-01-01

    Three kinds of plutonium contaminations were considered: skin contamination; contaminated wounds; contamination by inhalation. The treatment of these contaminations was studied for insoluble (oxide and metal forms) and soluble plutonium (complexes). The use of DTPA and therapeutic problems encountered with stable plutonium complexes were analyzed. The new possibilities of internal decontamination using Puchel and LICAM were evaluated [fr

  3. The burden of mental disorders in the Eastern Mediterranean region, 1990-2015: findings from the global burden of disease 2015 study.

    Science.gov (United States)

    2017-08-03

    Mental disorders are among the leading causes of nonfatal burden of disease globally. We used the global burden of diseases, injuries, and risk factors study 2015 to examine the burden of mental disorders in the Eastern Mediterranean region (EMR). We defined mental disorders according to criteria proposed in the diagnostic and statistical manual of mental disorders IV and the 10th International Classification of Diseases. Mental disorders contributed to 4.7% (95% uncertainty interval (UI) 3.7-5.6%) of total disability-adjusted life-years (DALYs), ranking as the ninth leading cause of disease burden. Depressive disorders and anxiety disorders were the third and ninth leading causes of nonfatal burden, respectively. Almost all countries in the EMR had higher age-standardized mental disorder DALYs rates compared to the global level, and in half of the EMR countries, observed mental disorder rates exceeded the expected values. The burden of mental disorders in the EMR is higher than global levels, particularly for women. To properly address this burden, EMR governments should implement nationwide quality epidemiological surveillance of mental disorders and provide adequate prevention and treatment services.

  4. Evaluation of the Relationship between Current Internal 137Cs Exposure in Residents and Soil Contamination West of Chernobyl in Northern Ukraine.

    Science.gov (United States)

    Kimura, Yuko; Okubo, Yuka; Hayashida, Naomi; Takahashi, Jumpei; Gutevich, Alexander; Chorniy, Sergiy; Kudo, Takashi; Takamura, Noboru

    2015-01-01

    After the Chernobyl Nuclear Power Plant accident, the residents living around the Chernobyl were revealed to have been internally exposed to 137Cs through the intake of contaminated local foods. To evaluate the current situation of internal 137Cs exposure and the relationship between the 137Cs soil contamination and internal exposure in residents, we investigated the 137Cs body burden in residents who were living in 10 selected cities from the northern part of the Zhitomir region, Ukraine, and collected soil samples from three family farms and wild forests of each city to measured 137Cs concentrations. The total number of study participants was 36,862, of which 68.9% of them were female. After 2010, the annual effective doses were less than 0.1 mSv in over 90% of the residents. The 137Cs body burden was significantly higher in autumn than other seasons (p Chernobyl accident, the internal exposure doses to residents living in contaminated areas of northern Ukraine is limited but still related to 137Cs soil contamination. Furthermore, the consumption of local foods is considered to be the cause of internal exposure.

  5. Geotechnical properties of crude oil contaminated sand

    International Nuclear Information System (INIS)

    Puri, V.K.; Das, B.M.; Cook, E.E.; Shin, E.C.

    1994-01-01

    Contamination of soil due to an oil spill influences its subsequent engineering behavior. An investigation was conducted to study the effect of crude oil contamination on compaction characteristics, shear strength, one-dimensional compression, and coefficient of permeability. Water permeability was also determined by using commercial grade motor oils as contaminants. The test results indicate that the compaction characteristics are influenced by oil contamination. The angle of internal friction of sand (based on total stress condition) decreases due to presence of oil within the pore spaces in sand. One dimensional compression characteristics of sand are significantly influenced by oil contamination resulting in a decrease in the value of constrained modulus with increase in the degree of oil contamination compared to the case of dry sand. Water permeability was observed to be a function of the initial viscosity and the degree of saturation due to the contaminating oil

  6. Contaminant Hazard Reviews (compilation)

    Science.gov (United States)

    Eisler, R.; Munro, R.E.; Loges, L.M.; Boone, K.; Paul, M.M.; Garrett, L.J.

    2000-01-01

    This compact disc (CD) contains the 35 reports in the Contaminant Hazard Reviews (CHR) that were published originally between 1985 and 1999 in the U.S. Department of the Interior Biological Report series. The CD was produced because printed supplies of these reviews--a total of 105,000--became exhausted and demand remained high. Each review was prepared at the request of environmental specialists of the U.S. Fish and Wildlife Service and each contained specific information on the following: mirex, cadmium, carbofuran, toxaphene, selenium, chromium, polychlorinated biphenyls, dioxins, diazinon, mercury, polycyclic aromatic hydrocarbons, arsenic, chlorpyrifos, lead, tin, index issue, pentachlorophenol, atrazine, molybdenum, boron, chlordane, paraquat, cyanide, fenvalerate, diflubenzuron, zinc, famphur, acrolein, radiation, sodium monofluoroacetate, planar PCBs, silver, copper, nickel, and a cumulative index to chemicals and species. Each report reviewed and synthesized the technical literature on a single contaminant and its effects on terrestrial plants and invertebrates, aquatic plants and animals, avian and mammalian wildlife, and other natural resources. The subtopics include contaminant sources and uses; physical, chemical, and metabolic properties; concentrations in field collections of abiotic materials and living organisms; deficiency effects, where appropriate; lethal and sublethal effects, including effects on survival, growth, reproduction, metabolism, mutagenicity, teratogenicity, and carcinogenicity; proposed criteria for the protection of human health and sensitive natural resources; and recommendations for additional research.

  7. The Burden of Tick-Borne Encephalitis in Disability-Adjusted Life Years (DALYs) for Slovenia.

    Science.gov (United States)

    Šmit, Renata; Postma, Maarten J

    2015-01-01

    Tick-borne encephalitis (TBE) presents an increasing burden in many parts of Europe, Asian Russia, Siberia, Asian former USSR and Far East. Incidence can be considered as one way to express the burden. A more comprehensive measure concerns disability-adjusted life years (DALYs), better characterizing the full burden of TBE. TBE burden in DALYs has not yet been estimated, nor has it been specified by the Global Burden of Disease (GBD) studies. The purpose of the present study is to estimate the burden of TBE in Slovenia, expressed in DALYs, both from the population and individual perspectives. We discuss the impact of TBE burden on public health and potential strategies to reduce this burden in Slovenia. The burden of TBE is estimated by using the updated DALYs' methodology first introduced in the GBD project. The DALYs᾽ calculations are based on the health outcomes of the natural course of the disease being modelled. Corrections for under-reporting and under-ascertainment are applied. The impact of uncertainty in parameters in the model was assessed using sensitivity analyses. From the population perspective, total DALYs amount to 3,450 (167.8 per 100,000 population), while from the individual perspective they amount to 3.1 per case in 2011. Notably, the consequences of TBE present a larger burden than TBE itself. TBE presents a relatively high burden expressed in DALYs compared with estimates for other infectious diseases from the GBD 2010 study for Slovenia. Raising awareness and increasing vaccination coverage are needed to reduce TBE and its consequences.

  8. Periodontal disease burden and pathological changes in organs of dogs.

    Science.gov (United States)

    Pavlica, Zlatko; Petelin, Milan; Juntes, Polona; Erzen, Damjan; Crossley, David A; Skaleric, Uros

    2008-06-01

    Bacterial plaque associated periodontal disease is the most common chronic infection in man and dogs. In man, there is an association between periodontal disease and myocardial infarction and stroke, while in dogs it has also been associated with changes in internal organs. Inflamed periodontal tissues present a 'periodontal disease burden' to the host and the extent of this inflammatory disease burden is likely to affect the degree of associated pathological change in distant organs. This hypothesis was investigated in dogs with naturally occurring periodontal disease. Post-mortem investigations including periodontal assessment, standard necropsy, and organ histology were performed on 44 mature toy and miniature Poodles (related, periodontitis predisposed breeds) that died naturally or were euthanized based on clinical disease. Animals with gross primary organ pathology were excluded. The periodontal disease burden was estimated from the total surface area of periodontal pocket epithelium using six measurements of probing depth for each tooth and the tooth circumferences. Ordinal logistic regression (OR) analysis established that for each square centimeter of periodontal disease burden there was a 1.4-times higher likelihood of greater changes being present in the left atrio-ventricular valves (OR = 1.43), plus 1.2 and 1.4 times higher likelihoodfor greater liver and kidney pathology (OR = 1.21; OR = 1.42), respectively The results show that there is a link between the estimated 'periodontal disease burden' resulting from plaque-bacteria associated periodontal disease and the level of internal pathology in this population, implying that periodontitis might contribute to the development of systemic pathology in dogs.

  9. Economic burden of irritable bowel syndrome in China.

    Science.gov (United States)

    Zhang, Fang; Xiang, Wei; Li, Chun-Yan; Li, Shu-Chuen

    2016-12-21

    To estimate annual direct and indirect costs for patients diagnosed with irritable bowel syndrome (IBS) and subtypes. Patients completed a standardized questionnaire concerning usage of healthcare resources, travel costs, meals, and productivity loss of patients when seeking treatment for IBS. Total annual costs per patient were calculated as the sum of direct (including medical and nonmedical) and indirect costs. Total annual costs per patient among various IBS subtypes were compared. Analysis of variance and bootstrapped independent sample t -tests were performed to determine differences between groups after controlling for IBS subtypes. A total of 105 IBS patients (64.80% female), mean age of 57.12 years ± 10.31 years), mean disease duration of 4.31 years ± 5.40 years, were included. Total annual costs per patient were estimated as CNY18262.84 (USD2933.08). Inpatient and outpatient healthcare use were major cost drivers, accounting for 46.41%and 23.36% of total annual costs, respectively. Productivity loss accounted for 25.32% of total annual costs. The proportions of direct and indirect costs were similar to published studies in other countries. Nationally, the total costs of managing IBS would amount to CNY123.83 billion (USD1.99 billion). Among the IBS subtypes, total annual costs per patient of IBS-M was highest at CNY18891.18 (USD3034). Furthermore, there was significant difference in productivity loss among IBS subtypes ( P = 0.031). IBS imposes a huge economic burden on patients and healthcare systems, which could account for 3.3% of the total healthcare budget for the entire Chinese nation. More than two-thirds of total annual costs of IBS consist of inpatient and outpatient healthcare use. Among the subtypes, IBS-M patients appear to have the greatest economic burden but require further confirmation.

  10. Burden of Serious Fungal Infections in Jordan

    Directory of Open Access Journals (Sweden)

    Jamal Wadi

    2018-01-01

    Full Text Available Objective: To estimate the burden of fungal infections in Jordan for the first time. Material and Methods: Population data was from UN 2011 statistics and TB cases from WHO in 2012. Fewer than 100 patients with HIV were recorded in Jordan in 2013. Approximately 100 renal transplants and eight liver transplants are performed annually. There were 12,233 major surgical procedures in Jordan in 2013, of which 5.3% were major abdominal surgeries; candidemia was estimated in 5% of the population based on other countries, with 33% occurring in the ICU. Candida peritonitis/intra-abdominal candidiasis was estimated to affect 50% of the number of ICU candidemia cases. No adult asthma rates have been recorded for Jordan, so the rate from the Holy Land (8.54% clinical asthma from To et al. has been used. There are an estimated 49,607 chronic obstructive pulmonary disease (COPD patients in Jordan, with 64% symptomatic, 25% Gold stage 3% or 4%, and 7% (3472 are assumed to be admitted to hospital each year. No cystic fibrosis cases have been recorded. Literature searches on fungal infections revealed few data and no prevalence data on fungal keratitis or tinea capitis, even though tinea capitis comprised 34% of patients with dermatophytoses in Jordan. Results: Jordan has 6.3 million inhabitants (65% adults, 6% are >60 years old. The current burden of serious fungal infections in Jordan was estimated to affect ~119,000 patients (1.9%, not including any cutaneous fungal infections. Candidemia was estimated at 316 cases and invasive aspergillosis in leukemia, transplant, and COPD patients at 84 cases. Chronic pulmonary aspergillosis prevalence was estimated to affect 36 post-TB patients, and 175 in total. Allergic bronchopulmonary aspergillosis (ABPA and severe asthma with fungal sensitization (SAFS prevalence in adults with asthma were estimated at 8900 and 11,748 patients. Recurrent vulvovaginal candidiasis was estimated to affect 97,804 patients, using a 6

  11. Cost and disease burden of Dengue in Cambodia

    Directory of Open Access Journals (Sweden)

    Beauté Julien

    2010-08-01

    Full Text Available Abstract Background Dengue is endemic in Cambodia (pop. estimates 14.4 million, a country with poor health and economic indicators. Disease burden estimates help decision makers in setting priorities. Using recent estimates of dengue incidence in Cambodia, we estimated the cost of dengue and its burden using disability adjusted life years (DALYs. Methods Recent population-based cohort data were used to calculate direct and productive costs, and DALYs. Health seeking behaviors were taken into account in cost estimates. Specific age group incidence estimates were used in DALYs calculation. Results The mean cost per dengue case varied from US$36 - $75 over 2006-2008 respectively, resulting in an overall annual cost from US$3,327,284 in 2008 to US$14,429,513 during a large epidemic in 2007. Patients sustain the highest share of costs by paying an average of 78% of total costs and 63% of direct medical costs. DALY rates per 100,000 individuals ranged from 24.3 to 100.6 in 2007-2008 with 80% on average due to premature mortality. Conclusion Our analysis confirmed the high societal and individual family burden of dengue. Total costs represented between 0.03 and 0.17% of Gross Domestic Product. Health seeking behavior has a major impact on costs. The more accurate estimate used in this study will better allow decision makers to account for dengue costs particularly among the poor when balancing the benefits of introducing a potentially effective dengue vaccine.

  12. Clinical and Economic Burden of Revision Knee Arthroplasty

    Directory of Open Access Journals (Sweden)

    Mohit Bhandari

    2012-01-01

    Full Text Available Surgery is indicated for symptomatic knee osteoarthritis (OA when conservative measures are unsuccessful. High tibial osteotomy (HTO, unicompartmental knee arthroplasty (UKA, and total knee arthroplasty (TKA are surgical options intended to relieve knee OA pain and dysfunction. The choice of surgical intervention is dependent on several factors such as disease location, patient age, comorbidities, and activity levels. Regardless of surgical treatment, complications such as infection, loosening or lysis, periprosthetic fracture, and postoperative pain are known risks and are indications for revision surgery. The clinical and economic implications for revision surgery are underappreciated. Over 55,000 revision surgeries were performed in 2010 in the US, with 48% of these revisions in patients under 65 years. Total costs associated with each revision TKA surgery have been estimated to be in excess of $49,000. The current annual economic burden of revision knee OA surgery is $2.7 billion for hospital charges alone. By 2030, assuming a 5-fold increase in the number of revision procedures, this economic burden will exceed $13 billion annually. It is appealing to envision a therapy that could delay or obviate the need for arthroplasty. From an actuarial standpoint, this would have the theoretical downstream effect of substantially reducing the number of revision procedures. Although no known therapies currently meet these criteria, such a breakthrough would have a tremendous impact in lessening the clinical and economic burden of knee OA revision surgery.

  13. Burden of care in the caregivers of patients with anxiety disorders

    Directory of Open Access Journals (Sweden)

    Manu Agarwal

    2017-01-01

    Full Text Available Introduction: Anxiety disorders are one of the frequently encountered psychiatric disorders in psychiatric clinics which have significant impact on the psychosocial well-being of the patient as well as their caregivers. Study Design and Aims: This study is a non- invasive, cross sectional study of 91 patients with anxiety disorder (except obsessive compulsive disorder aimed to assess the burden of care on their key-relatives and to study various socio demographic and clinical variables of the patient in relation to burden of care on key-relatives. Methodology: Patients diagnosed with anxiety disorders other than obsessive compulsive disorder and their key relatives satisfying the selection criteria were enrolled in the study. Assessment was done on semi-structured proforma, ICD 10 DCR, SCAN (Schedules for Clinical Assessment in Neuropsychiatry, International Personality Disorder Examination (IPDE, Burden assessment schedule, Hamilton Anxiety Rating Scale (HAM-A. Result: Total adjusted burden score in our study was 40.41 which is suggestive of mild burden. It was found that the burden of care was higher in male gender, married individuals, in joint families, among spouses, urban background, in the age group 41 to 50 years, low income group particularly on farmers and laborers. Generalized anxiety disorder was associated with more burden of care in comparison to other anxiety disorders. Conclusion: Key relatives of patients with anxiety disorder have significant burden of care in different domains along the socio-demographic strata.

  14. The Burden of Schizophrenia on Caregivers

    Directory of Open Access Journals (Sweden)

    Filiz Adana

    2011-06-01

    Full Text Available Caregivers’ burden in schizophrenia is a complex concept often with negative connotations. The concept refers to the impact of having a schizophrenia patient in the family including emotional, psychological, physical, economic distress and feelings of shame, embarrassment, guilt, and self-blame expe-rienced by the caregivers. There are objective and subjective aspects of care-givers’ burden. The objective burden refers to observed and verifiable impact of the diseased person in the family such as the patients disturbing behaviors, economic difficulties, and loss of income, restricted social activities, distressed household atmosphere, and undesirable influences on physical and mental health of the family members. The subjective burden refers to the extent of emotional distress caused by the objective burden. The data in the pertinent literature suggest an association between caregivers’ burden and sex, ethnicity, culture, caregivers’ health and quality of life, social support, and the symptomatology as presented by the patient. In order to promote mental health of schizophrenia patients along with their caregivers, the mental health workers should strive to find the means of supporting, informing, and cooperating with the family members. Psychosocial interventions designed for families and psychosocial rehabilitations programs designed for schizophrenia patients are effective means of easing caregivers’ burden.

  15. Contamination vs. Exposure

    Science.gov (United States)

    ... into the environment can cause air, water, surfaces, soil, plants, buildings, people, or animals to become contaminated. ... water to remove contamination. This process is called decontamination. Try to avoid spreading contamination to parts of ...

  16. CONCEPT OF OPERATIONS PLANS for Phase I the INTERNATIONAL PILOT FOR Global Radiological source SORTING, Tracking, AND MONITORING (GradSStraM) Using eMERGING RFID AND WEB 2.0 TECHNOLOGIES TO PROVIDE TOTAL ASSET AND INFORMATION VISUALIZATIONA United States-European Union Lighthouse Priority Project for fostering trade and reducing regulatory burden

    International Nuclear Information System (INIS)

    Walker, Randy M.

    2009-01-01

    Thousands of shipments of radioisotopes developed in the United States (US) are transported domestically and internationally for medical and industrial applications, including to partner laboratories in European Union (EU) countries. Over the past five years, the Environmental Protection Agency (EPA), the Department of Energy (DOE), and Oak Ridge National Laboratory (ORNL) have worked with state regulatory compliance personnel, key private sector shippers and carriers, the Department of Homeland Security (DHS), the Department of Transportation (DOT), the Department of Defense (DoD) and the Nuclear Regulatory Commission (NRC) on Radio Frequency Identification (RFID) tracking and monitoring of medical and industrial radioisotopes in commerce. The EPA Radiological Source Tracking and Monitoring (RadSTraM) project tested, evaluated, and integrated RFID technologies in laboratory settings, and at multiple private-sector shipping and distribution facilities (Perkin Elmer and DHL) using common radioisotopes used in everyday commerce. The RFID tracking was also tested in association with other deployed technologies including radiation detection, chemical/explosives detection, advanced imaging, lasers, and infrared scanning. At the 2007 EU-US Summit, the leaders of the US Department of Commerce (DOC) and EU European Commission (EC) committed to pursue jointly directed Lighthouse Priority Projects. These projects are intended to 'foster cooperation' and 'reduce regulatory burdens' with respect to transatlantic commerce. The Transatlantic Economic Council (TEC) Lighthouse Project on Radio Frequency Identification (RFID) has been directed to 'develop a joint framework for cooperation on identification and development of best practices for Radio Frequency Identification (RFID) technologies.' The RFID Lighthouse Priority Project commits both sides to endeavor to align U.S. and EU regulatory and policy approaches on RFID technologies, including pilot projects in the public sector

  17. Association of leukemia with radium groundwater contamination

    International Nuclear Information System (INIS)

    Lyman, G.H.; Lyman, C.G.; Johnson, W.

    1985-01-01

    Radiation exposure, including the ingestion of radium, has been causally associated with leukemia in man. Groundwater samples from 27 counties on or near Florida phosphate lands were found to exceed 5 pCi/L total radium in 12.4% of measurements. The incidence of leukemia was greater in those counties with high levels of radium contamination (greater than 10% of the samples contaminated) than in those with low levels of contamination. Rank correlation coefficients of .56 and .45 were observed between the radium contamination level and the incidence of total leukemia and acute myeloid leukemia, respectively. The standardized incidence density ratio for those in high-contamination counties was 1.5 for total leukemia and 2.0 for acute myeloid leukemia. Further investigation is necessary, however, before a causal relationship between groundwater radium content and human leukemia can be established

  18. The burden of rotavirus disease in Denmark 2009-2010

    DEFF Research Database (Denmark)

    Fischer, Thea Kølsen; Rungø, Christine; Jensen, Claus Sixtus

    2011-01-01

    BACKGROUND: This study sought to determine the incidence and the burden of severe diarrheal disease in Denmark with emphasis on rotavirus (RV) disease. METHODS: This study was designed as a national prospective disease surveillance of children gastroenteritis...... in Denmark during March 2009 to April 2010, using rapid RV and adenovirus antigen detection. RESULTS: A total of 3100 hospitalizations annually among Danish children gastroenteritis and 1210 (39%) of these to RV disease. The majority of RV...... demonstrated RV-associated hospitalizations throughout the year. Genotyping of a subset of RV-samples demonstrated high frequency of G1 (39%) and G4 (32%). Adenovirus was detected in 350 acute gastroenteritis-associated hospitalizations (11.2%). CONCLUSION: In conclusion, we present national disease burden...

  19. Organ burdens and elimination rates of inhaled thorium and plutonium

    International Nuclear Information System (INIS)

    Unnikrishnan, K.; Murthy, K.B.S.; Sunta, C.M.

    1986-01-01

    For the purpose of interpreting observations from internal monitoring programmes, organ burdens and excretion rates resulting from inhalation of long-lived isotopes of plutonium and thorium have been calculated, on the basis of the ICRP model. Two types of inhalation, instantaneous (acute) and at a steady rate (chronic) are considered. The expected buildups of the burden in lungs, lymph nodes, bone, liver and other tissues, as well as the excretion rates, have been calculated for aerosol classes W and Y, and particle sizes of AMAD 1 μm and 6 μm. Further, in view of their use in selecting the periodicity of routine monitoring, theoretical results are also presented for the case of a total inhalation of 1 ALI in one year, instantaneously or at a constant rate. (author)

  20. Radiation contamination monitors

    International Nuclear Information System (INIS)

    Kato, Tsutomu; Iba, Hiroshi; Sato, Hiroshi

    1999-01-01

    To make sure of no contamination on people, used articles and working uniforms coming out of the radiation controlled area, nuclear power plants are equipped with radioactive contamination monitors. This paper outlines the basic specifications and advantages of our personnel surface contamination monitors to inspect whole-body surface contamination of people coming out, article surface contamination monitors to inspect the surface and inside contamination of used articles brought out, laundry monitors to inspect surface contamination of working uniforms used in the area before and after a wash, and whole-body counters to inspect and measure the internal contamination of a person out of the area. (author)

  1. Economic burden of stroke in a large county in Sweden

    Directory of Open Access Journals (Sweden)

    Persson Josefine

    2012-09-01

    Full Text Available Abstract Background Stroke remains to be a major burden of disease, often causing death or physical impairment or disability. This paper estimates the economic burden of stroke in a large county of 1.5 million inhabitants in western Sweden. Methods The economic burden of stroke was estimated from a societal perspective with an incidence approach. Data were collected from clinical registries and 3,074 patients were included. In the cost calculations, both direct and indirect costs were estimated and were based on costs for 12 months after a first-ever stroke. Results The total excess costs in the first 12 months after the first-ever stroke for a population of 1.5 million was 629 million SEK (€69 million. Men consumed more acute care in hospitals, whereas women consumed more rehabilitation and long-term care provided by the municipalities. Younger patients brought a significantly higher burden on society compared with older patients due to the loss of productivity and the increased use of resources in health care. Conclusions The results of this cost-of-illness study were based on an improved calculation process in a number of fields and are consistent with previous studies. In essence, 50% of costs for stroke care fall on acute care hospital, 40% on rehabilitation and long-time care and informal care and productivity loss explains 10% of total cost for the stroke disease. The result of this study can be used for further development of the methods for economic analyses as well as for analysis of improvements and investments in health care.

  2. Reduction of Airborne Bacterial Burden in the OR by Installation of Unidirectional Displacement Airflow (UDF) Systems.

    Science.gov (United States)

    Fischer, Sebastian; Thieves, Martin; Hirsch, Tobias; Fischer, Klaus-Dieter; Hubert, Helmine; Beppler, Steffen; Seipp, Hans-Martin

    2015-08-13

    Intraoperative bacterial contamination is a major risk factor for postoperative wound infections. This study investigated the influence of type of ventilation system on intraoperative airborne bacterial burden before and after installation of unidirectional displacement air flow systems. We microbiologically monitored 1286 surgeries performed by a single surgical team that moved from operating rooms (ORs) equipped with turbulent mixing ventilation (TMV, according to standard DIN-1946-4 [1999], ORs 1, 2, and 3) to ORs with unidirectional displacement airflow (UDF, according to standard DIN-1946-4, annex D [2008], ORs 7 and 8). The airborne bacteria were collected intraoperatively with sedimentation plates. After incubation for 48 h, we analyzed the average number of bacteria per h, peak values, and correlation to surgery duration. In addition, we compared the last 138 surgeries in ORs 1-3 with the first 138 surgeries in ORs 7 and 8. Intraoperative airborne bacterial burden was 5.4 CFU/h, 5.5 CFU/h, and 6.1 CFU/h in ORs 1, 2, and 3, respectively. Peak values of burden were 10.7 CFU/h, 11.1 CFU/h, and 11.0 CFU/h in ORs 1, 2, and 3, respectively). With the UDF system, the intraoperative airborne bacterial burden was reduced to 0.21 CFU/h (OR 7) and 0.35 CFU/h (OR 8) on average (pAirborne bacterial burden increased linearly with surgery duration in ORs 1-3, but the UDF system in ORs 7 and 8 kept bacterial levels constantly low (airborne bacterial burden (5 CFU/h vs. 0.29 CFU/h, pairborne bacterial burden under real clinical conditions by more than 90%. Although decreased postoperative wound infection incidence was not specifically assessed, it is clear that airborne microbiological burden contributes to surgical infections.

  3. World Health Organization Global Estimates and Regional Comparisons of the Burden of Foodborne Disease in 2010

    DEFF Research Database (Denmark)

    Havelaar, Arie H.; Kirk, Martyn D.; Torgerson, Paul R.

    2015-01-01

    parasitic helminths, were highly localised. Thus, the burden of FBD is borne particularly by children under five years old-although they represent only 9% of the global population-and people living in low-income regions of the world. These estimates are conservative, i.e., underestimates rather than......Illness and death from diseases caused by contaminated food are a constant threat to public health and a significant impediment to socio-economic development worldwide. To measure the global and regional burden of foodborne disease (FBD), the World Health Organization (WHO) established...... different burdens of FBD, with the greatest falling on the subregions in Africa, followed by the subregions in South-East Asia and the Eastern Mediterranean D subregion. Some hazards, such as non-typhoidal S. enterica, were important causes of FBD in all regions of the world, whereas others, such as certain...

  4. Evaluation of modelling body burden of Cs-137

    Energy Technology Data Exchange (ETDEWEB)

    Bergstroem, U; Nordlinder, S

    1996-05-01

    Within the IAEA/CEC VAMP-program one working group studied the precision in dose assessment models when calculating body burden of {sup 137}Cs as a result of exposure through multiple exposure pathways. One scenario used data from southern Finland regarding contamination of various media due to the fallout from the Chernobyl accident. In this study, a time dependent multiple exposure pathway model was constructed based on compartment theory. Uncertainties in model responses due to uncertainties in input parameter values were studied. The initial predictions for body burden were good, within a factor of 2 of the observed, while the time dynamics of levels in milk and meat did not agree satisfactorily. Some results, nevertheless, showed good agreement with observations due to compensatory effects. After disclosure of additional observational data, major reasons for mispredictions were identified as lack of consideration of time dependence of fixation of {sup 137}Cs in soils, and the selection of parameter values. When correction of this was made, a close agreement between predictions and observations was obtained. This study shows that the dose contribution due to {sup 137}Cs in food products from the seminatural environment is important for long-term exposure to man. The evaluation provided a basis for improvements of crucial parts in the model. 14 refs, 18 figs, 8 tabs.

  5. Evaluation of modelling body burden of Cs-137

    International Nuclear Information System (INIS)

    Bergstroem, U.; Nordlinder, S.

    1996-05-01

    Within the IAEA/CEC VAMP-program one working group studied the precision in dose assessment models when calculating body burden of 137 Cs as a result of exposure through multiple exposure pathways. One scenario used data from southern Finland regarding contamination of various media due to the fallout from the Chernobyl accident. In this study, a time dependent multiple exposure pathway model was constructed based on compartment theory. Uncertainties in model responses due to uncertainties in input parameter values were studied. The initial predictions for body burden were good, within a factor of 2 of the observed, while the time dynamics of levels in milk and meat did not agree satisfactorily. Some results, nevertheless, showed good agreement with observations due to compensatory effects. After disclosure of additional observational data, major reasons for mispredictions were identified as lack of consideration of time dependence of fixation of 137 Cs in soils, and the selection of parameter values. When correction of this was made, a close agreement between predictions and observations was obtained. This study shows that the dose contribution due to 137 Cs in food products from the seminatural environment is important for long-term exposure to man. The evaluation provided a basis for improvements of crucial parts in the model. 14 refs, 18 figs, 8 tabs

  6. Economic Study of Global Tobacco Burden

    Science.gov (United States)

    In an interview on Cancer Currents, Dr. Mark Parascandola discusses findings from an economics study showing that, globally, tobacco use burdens economies with more than US $1 trillion annually in health care costs and lost productivity.

  7. Economic and psychological burden of scheduled surgery ...

    African Journals Online (AJOL)

    Background: Cancellation of scheduled surgery creates a financial burden for hospitals, caregivers and ..... costs and disregard some of the aspects mentioned in the ..... cancellation of elective surgical procedures in a Spanish general.

  8. The Global Burden of Cancer 2013

    OpenAIRE

    2015-01-01

    Importance Cancer is among the leading causes of death worldwide. Current estimates of cancer burden in individual countries and regions are necessary to inform local cancer control strategies. Objective To estimate mortality, incidence, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs) for 28 cancers in 188 countries by sex from 1990 to 2013. Evidence Review The general methodology of the Global Burden of Disease (GBD) 2013 study was us...

  9. Burden of disease attributable to the Hebei Spirit oil spill in Taean, Korea

    OpenAIRE

    Kim, Young-Min; Park, Jae-Hyun; Choi, Kyusik; Noh, Su Ryeon; Choi, Young-Hyun; Cheong, Hae-Kwan

    2013-01-01

    Objectives We aimed to assess the burden of disease (BOD) of the residents living in contaminated coastal area with oil spill and also analysed the BOD attributable to the oil spill by disease, age, sex and subregion. Design Health impact assessment by measuring years lived with disability (YLD) due to an oil spill. Setting A whole population of a community affected by an anthropogenic environmental disaster and secondary health outcome data. Participants Based on the health outcome survey in...

  10. Burdens of Proof, Presumptions and Standards of Proof in Criminal ...

    African Journals Online (AJOL)

    Worku_Y

    evidential and persuasive burdens of proof as between the state and the ..... scholars have observed that the evidential burden is a function of the burden of ..... required to convince judges by creating such an intensity of belief in their minds.

  11. Distribution of major health risks: findings from the Global Burden of Disease study.

    Directory of Open Access Journals (Sweden)

    Anthony Rodgers

    2004-10-01

    Full Text Available Most analyses of risks to health focus on the total burden of their aggregate effects. The distribution of risk-factor-attributable disease burden, for example by age or exposure level, can inform the selection and targeting of specific interventions and programs, and increase cost-effectiveness.For 26 selected risk factors, expert working groups conducted comprehensive reviews of data on risk-factor exposure and hazard for 14 epidemiological subregions of the world, by age and sex. Age-sex-subregion-population attributable fractions were estimated and applied to the mortality and burden of disease estimates from the World Health Organization Global Burden of Disease database. Where possible, exposure levels were assessed as continuous measures, or as multiple categories. The proportion of risk-factor-attributable burden in different population subgroups, defined by age, sex, and exposure level, was estimated. For major cardiovascular risk factors (blood pressure, cholesterol, tobacco use, fruit and vegetable intake, body mass index, and physical inactivity 43%-61% of attributable disease burden occurred between the ages of 15 and 59 y, and 87% of alcohol-attributable burden occurred in this age group. Most of the disease burden for continuous risks occurred in those with only moderately raised levels, not among those with levels above commonly used cut-points, such as those with hypertension or obesity. Of all disease burden attributable to being underweight during childhood, 55% occurred among children 1-3 standard deviations below the reference population median, and the remainder occurred among severely malnourished children, who were three or more standard deviations below median.Many major global risks are widely spread in a population, rather than restricted to a minority. Population-based strategies that seek to shift the whole distribution of risk factors often have the potential to produce substantial reductions in disease burden.

  12. Predictors of caregiver burden in Iranian family caregivers of cancer patients.

    Science.gov (United States)

    Mirsoleymani, Seyed Reza; Rohani, Camelia; Matbouei, Mahsa; Nasiri, Malihe; Vasli, Parvaneh

    2017-01-01

    Caregiver burden threatens the psychological, emotional, functional and even physical health of caregivers. The aims of this study were to determine caregiver burden and family distress and the relationship between them, also to explore predictors of caregiver burden in a sample of Iranian family caregivers of cancer patients. This is a cross-sectional study with correlational design. A total of 104 family caregivers of cancer patients were asked to respond to the Caregiver Burden Inventory (CBI) and the Family Distress Index (FDI) together with a sociodemographic questionnaire. For evaluating the relationship between CBI and FDI scores, the Pearson's product-moment correlation was used. In addition, multiple linear regression analysis was applied to explore the predictive factors of caregiver burden. A high burden was experienced by almost half of the caregivers (48.1%). The FDI mean score was 9.76 ± 5.40 ranged from 0 to 24. A strong positive correlation was found between the caregiver burden and family distress ( r = 0.76). Multiple linear regression results showed the predictive role of FDI score (β = 0.71, P = 0.001), patient's gender (β = -0.25, P = 0.001), and early cancer diagnosis (β =0.13, P = 0.027) in caregiver burden. They could explain 65% of variance in the level of burden in family caregivers. Family nurses should consider the caregivers burden and vulnerability of families with cancer patient, especially if the patient is a male or has a new diagnosis. They should also design special programs for the whole family as a system that family can adapt to the new situation.

  13. Air suctioning during colon biopsy forceps removal reduces bacterial air contamination in the endoscopy suite.

    Science.gov (United States)

    Vavricka, S R; Tutuian, R; Imhof, A; Wildi, S; Gubler, C; Fruehauf, H; Ruef, C; Schoepfer, A M; Fried, M

    2010-09-01

    Bacterial contamination of endoscopy suites is of concern; however studies evaluating bacterial aerosols are lacking. We aimed to determine the effectiveness of air suctioning during removal of biopsy forceps in reducing bacterial air contamination. This was a prospective single-blinded trial involving 50 patients who were undergoing elective nontherapeutic colonoscopy. During colonoscopy, endoscopists removed the biopsy forceps first without and then with suctioning following contact with the sigmoid mucosa. A total of 50 L of air was collected continuously for 30 seconds at 30-cm distance from the biopsy channel valve of the colonoscope, with time starting at forceps removal. Airborne bacteria were collected by an impactor air sampler (MAS-100). Standard Petri dishes with CNA blood agar were used to culture Gram-positive bacteria. Main outcome measure was the bacterial load in endoscopy room air. At the beginning and end of the daily colonoscopy program, the median (and interquartile [IQR] range) bioaerosol burden was 4 colony forming units (CFU)/m (3) (IQR 3 - 6) and 16 CFU/m (3) (IQR 13 - 18), respectively. Air suctioning during removal of the biopsy forceps reduced the bioaerosol burden from a median of 14 CFU/m (3) (IQR 11 - 29) to a median of 7 CFU/m (3) (IQR 4 - 16) ( P = 0.0001). Predominantly enterococci were identified on the agar plates. The bacterial aerosol burden during handling of biopsy forceps can be reduced by applying air suction while removing the forceps. This simple method may reduce transmission of infectious agents during gastrointestinal endoscopies. Copyright Georg Thieme Verlag KG Stuttgart . New York.

  14. World Health Organization Estimates of the Global and Regional Disease Burden of 11 Foodborne Parasitic Diseases, 2010 : A Data Synthesis

    NARCIS (Netherlands)

    Torgerson, Paul R; Devleesschauwer, Brecht; Praet, Nicolas; Speybroeck, Niko; Willingham, Arve Lee; Kasuga, Fumiko; Rokni, Mohammad B; Zhou, Xiao-Nong; Fèvre, Eric M; Sripa, Banchob; Gargouri, Neyla; Fürst, Thomas; Budke, Christine M; Carabin, Hélène; Kirk, Martyn D; Angulo, Frederick J; Havelaar, Arie; de Silva, Nilanthi

    2015-01-01

    BACKGROUND: Foodborne diseases are globally important, resulting in considerable morbidity and mortality. Parasitic diseases often result in high burdens of disease in low and middle income countries and are frequently transmitted to humans via contaminated food. This study presents the first

  15. Musculoskeletal disease burden of hereditary hemochromatosis.

    Science.gov (United States)

    Sahinbegovic, Enijad; Dallos, Tomáš; Aigner, Elmar; Axmann, Roland; Manger, Bernhard; Englbrecht, Matthias; Schöniger-Hekele, Maximilian; Karonitsch, Thomas; Stamm, Tanja; Farkas, Martin; Karger, Thomas; Stölzel, Ulrich; Keysser, Gernot; Datz, Christian; Schett, Georg; Zwerina, Jochen

    2010-12-01

    To determine the prevalence, clinical picture, and disease burden of arthritis in patients with hereditary hemochromatosis. In this cross-sectional observational study of 199 patients with hemochromatosis and iron overload, demographic and disease-specific variables, genotype, and organ involvement were recorded. The prevalence, intensity, and localization of joint pain were assessed, and a complete rheumatologic investigation was performed. Radiographs of the hands, knees, and ankles were scored for joint space narrowing, erosions, osteophytes, and chondrocalcinosis. In addition, the number and type of joint replacement surgeries were recorded. Joint pain was reported by 72.4% of the patients. Their mean ± SD age at the time of the initial joint symptoms was 45.8 ± 13.2 years. If joint pain was present, it preceded the diagnosis of hemochromatosis by a mean ± SD of 9.0 ± 10.7 years. Bony enlargement was observed in 65.8% of the patients, whereas synovitis was less common (13.6%). Joint space narrowing and osteophytes as well as chondrocalcinosis of the wrist and knee joints were frequent radiographic features of hemochromatosis. Joint replacement surgery was common, with 32 patients (16.1%) undergoing total joint replacement surgery due to severe OA. The mean ± SD age of these patients was 58.3 ± 10.4 years at time of joint replacement surgery. Female sex, metacarpophalangeal joint involvement, and the presence of chondrocalcinosis were associated with a higher risk of early joint failure (i.e., the need for joint replacement surgery). Arthritis is a frequent, early, and severe symptom of hemochromatosis. Disease is not confined to involvement of the metacarpophalangeal joints and often leads to severe damage requiring the replacement of joints. Copyright © 2010 by the American College of Rheumatology.

  16. Burden of Serious Fungal Infections in Argentina

    Directory of Open Access Journals (Sweden)

    Fernando O. Riera

    2018-04-01

    Full Text Available The number of fungal infections at any given time in Argentina is not known. Here we estimate the burden of serious fungal infections in Argentina for the first time. Specific population statistics were searched from multiple sources, local literature was identified, and estimates made. Some additional data were sourced from the Ministry of Health, the Global Initiative for Asthma (GINA program, and national haematology and transplant societies. Argentina has a population of 43.8 million, with 25% of this total being children under 15 years. The predicted candidemia annual incidence is 2193 cases, with 50% occurring in the ICU. At a 6% prevalence rate, an estimated 593,695 women suffer from recurrent vulvovaginal candidiasis. Invasive aspergillosis is relatively common because of high smoking and chronic obstructive pulmonary disease (COPD rates, with 268 cases in immunocompromised patients and another 1938 in the 168,000 COPD patients admitted to hospital. Asthma is also common, affecting 14% of adults, and so allergic bronchopulmonary aspergillosis (ABPA and severe asthma with fungal sensitization (SAFS are major problems. An estimated 432 cases of cryptococcal meningitis (CM—90% of them in AIDS patients—and 1177 cases of Pneumocystis pneumonia (PCP occur each year. The estimated annual case number of disseminated histoplasmosis is 404 in AIDS patients, almost as frequent as CM. Paracoccidioidomycosis annual incidence is estimated at 219, and coccidioidomycosis at 16 cases. At least 881,023 people (>2.01% in Argentina are affected by a serious fungal disease annually, with considerable morbidity and mortality.

  17. Caregivers’ burden in patients with COPD

    Science.gov (United States)

    Miravitlles, Marc; Peña-Longobardo, Luz María; Oliva-Moreno, Juan; Hidalgo-Vega, Álvaro

    2015-01-01

    Objective Chronic obstructive pulmonary disease (COPD) is a very prevalent and invalidating disease. The aim of this study was to analyze the burden borne by informal caregivers of patients with COPD. Methods We used the Survey on Disabilities, Personal Autonomy, and Dependency Situations (Encuesta sobre Discapacidad, Autonomía personal y Situaciones de Dependencia [EDAD]-2008) to obtain information on the characteristics of disabled individuals with COPD and their caregivers in Spain. Additionally, statistical multivariate analyses were performed to analyze the impact that an increase in dependence would have on the problems for which caregivers provide support, in terms of health, professional, and leisure/social dimensions. Results A total of 461,884 individuals with one or more disabilities and with COPD were identified, and 220,892 informal caregivers were estimated. Results showed that 35% of informal caregivers had health-related problems due to the caregiving provided; 83% had leisure/social-related problems; and among caregivers of working age, 38% recognized having profession-related problems. The probability of a problem arising was significantly associated with the degree of dependence of the patient receiving care. Caregivers of patients with great dependence showed a 39% higher probability of presenting health-related problems, 27% more professional problems, and 23% more leisure problems compared with those with nondependent patients. Conclusion The results show the large impact on society in terms of the welfare of informal caregivers of patients with COPD. A higher level of dependence was associated with more severe problems in caregivers, in all dimensions. PMID:25709429

  18. [The burden of disability in Cameroon].

    Science.gov (United States)

    Foti, Calogero; Albensi, Caterina; Giordani, Laura; Azeufack Ngueko, Yannick; Sanou Sobze, Martin; Colizzi, Vittorio

    2017-01-01

    Rehabilitation services for disabled persons are lacking in countries with limited economic resources. Reliable and objective data are needed to plan for their implementation and to determine the burden of disability in these countries. A descriptive cross-sectional study conducted in June 2013 among people living in Dschang Health District, in the West region of Cameroon, to collect information about socio-demographic aspects of physically disabled subjects and health determinants of disabilities. Data was collected using a standard questionnaire in French. In total, 159 physically disabled subjects were enrolled in the study. Mean age was 36 years [± SD 17.26], 55.9% of subjects were female, and 33.8% had a low educational-level. The most frequently reported disabilities were orthopaedic problems (mainly fractures) [45.8%], infectious diseases [29.1%]), and neurological disabilities (mainly hemiplegia [33.3%], hemiparesis [23.8%], and monoplegia [23.8%]). The main causes of disability were trauma due to traffic accidents (17.8%) and inappropriate medical interventions (14.5%). Disability was related to age and 50% of participants experienced social discrimination. Disabled subjects with low-incomes (from 50.000 to 200.000 XAF) were required to pay for rehabilitative care (XAF 10.000 to 100.000), and up to 83% had appealed for improved quality of Rehabilitation Medicine. Although Law n. 83/013 for the protection of persons with disabilities in Cameroon dates back to 1983, the results of this study show that disabled people, and children in particular, are still marginalized, vulnerable and have little chance of recovery. Therefore, there is a clear need to improve the quality and availability of rehabilitative care services , with programmatic interventions that ensure implementation of existing laws, improve access to rehabilitative services, provide disabled persons with the necessary specialty medical products, and eliminate barriers to their social

  19. Survival, reproduction, and arsenic body burdens in Chironomus riparius exposed to arsenate and phosphate

    Energy Technology Data Exchange (ETDEWEB)

    Mogren, Christina L., E-mail: christina.mogren@email.ucr.edu [Department of Entomology, University of California, Riverside, 900 University Ave, Riverside, CA 92521 (United States); Kiparski, Guntram R. von; Parker, David R. [Department of Environmental Science, University of California, Riverside, 900 University Ave, Riverside, CA 92521 (United States); Trumble, John T. [Department of Entomology, University of California, Riverside, 900 University Ave, Riverside, CA 92521 (United States)

    2012-05-15

    Despite the increasing awareness of arsenic (As) contamination in surface waters worldwide, little is known about how As alone and in the presence of other chemicals affects aquatic insects. Larvae of Chironomus riparius were exposed in a laboratory investigation to factorial combinations of 0, 0.13, 2.0, 5.3, and 13 {mu}mol As l{sup -1} and 0, 0.15, and 15 {mu}mol PO{sub 4} l{sup -1} throughout development from first instar to pupal emergence. The time between male and female emergence increased from 1.8 {+-} 0.17 days to 2.9 {+-} 0.34 days with exposure at higher As levels. The highest As exposure also decreased the number of eggs per egg mass, which may affect population maintenance. For these parameters, there was no effect from PO{sub 4}, and no interaction between As and PO{sub 4}. Total As determination of larval and adult tissues was conducted using Hydride Generated Atomic Absorption Spectroscopy (HGAAS) and revealed concentrations ranging from 2.48 {+-} 0.363 to 30.5 {+-} 0.473 {mu}g/g and 1.03 {+-} 0.286 to 8.97 {+-} 0.662 {mu}g/g, respectively, indicating elimination of approximately 72% of total As body burdens between the fourth instar and adult stages. There was no effect of PO{sub 4}, indicating PO{sub 4} does not alter uptake of As in C. riparius. The potential for movement of As to terrestrial systems exists, though trophic transfer may be more likely during the aquatic larval stage. - Highlights: Black-Right-Pointing-Pointer We evaluate how sublethal concentrations of As and P affect C. riparius. Black-Right-Pointing-Pointer High As exposure significantly increased the time between male and female emergence. Black-Right-Pointing-Pointer High As exposure significantly decreased the number of eggs per egg mass. Black-Right-Pointing-Pointer Fourth instar larvae eliminate 72% of As body burdens before the adult stage.

  20. Radioactive surface contamination monitors

    International Nuclear Information System (INIS)

    Aoyama, Kei; Minagoshi, Atsushi; Hasegawa, Toru

    1994-01-01

    To reduce radiation exposure and prevent contamination from spreading, each nuclear power plant has established a radiation controlled area. People and articles out of the controlled area are checked for the surface contamination of radioactive materials with surface contamination monitors. Fuji Electric has repeatedly improved these monitors on the basis of user's needs. This paper outlines typical of a surface contamination monitor, a personal surface contamination monitor, an article surface contamination monitor and a laundry monitor, and the whole-body counter of an internal contamination monitor. (author)

  1. Evaluation of Unfixed Tritium Surface Contamination

    International Nuclear Information System (INIS)

    Postolache, C.; Matei, Lidia

    2005-01-01

    Surface unfixed radioactive contamination represents the amount of surface total radioactive contamination which can be eliminated by pure mechanical processes. This unfixed contamination represents the main risk factor for contamination of the personnel which operates in tritium laboratories. Unfixed contamination was determined using sampling smears type FPCSN-PSE-AA. Those FPCSN-PSE-AA smears are disks of expanded polystyrene which contain acrylic acid fragments superficially grafted. Sampling factor was determinated by contaminated surface wiping with moisten smears in 50 μL butylic alcohol and activity measuring at liquid scintillation measuring device. Sampling factor was determined by the ratio between measured activity and initially real conventional activity. The sampling factor was determined for Tritium Laboratory existent surfaces: stainless steel, aluminum, glass, ceramics, linoleum, washable coats, epoxy resins type ALOREX LP-52.The sampling factors and the reproducibility were determined in function of surface nature

  2. Burden of injury of serious road injuries in six EU countries.

    Science.gov (United States)

    Weijermars, Wendy; Bos, Niels; Filtness, Ashleigh; Brown, Laurie; Bauer, Robert; Dupont, Emmanuelle; Martin, Jean Louis; Perez, Katherine; Thomas, Pete

    2018-02-01

    Information about the burden of (non-fatal) road traffic injury is very useful to further improve road safety policy. Previous studies calculated the burden of injury in individual countries. This paper estimates and compares the burden of non-fatal serious road traffic injuries in six EU countries/regions: Austria, Belgium, England, The Netherlands, the Rhône region in France and Spain. It is a cross-sectional study based on hospital discharge databases. of study are patients hospitalized with MAIS3+ due to road traffic injuries. The burden of injury (expressed in years lived with disability (YLD)) is calculated applying a method that is developed within the INTEGRIS study. The method assigns estimated disability information to the casualties using the EUROCOST injury classification. The average burden per MAIS3+ casualty varies between 2.4 YLD and 3.2 YLD per casualty. About 90% of the total burden of injury of MAIS3+ casualties is due to lifelong consequences that are experienced by 19% to 33% of the MAIS3+ casualties. Head injuries, spinal cord injuries and injuries to the lower extremities are responsible for more than 90% of the total burden of MAIS3+ road traffic injuries. Results per transport mode differ between the countries. Differences between countries are mainly due to differences in age distribution and in the distribution over EUROCOST injury groups of the casualties. The analyses presented in this paper can support further improvement of road safety policy. Countermeasures could for example be focused at reducing skull and brain injuries, spinal cord injuries and injuries to the lower extremities, as these injuries are responsible for more than 90% of the total burden of injury of MAIS3+ casualties. Copyright © 2017 Elsevier Ltd. All rights reserved.

  3. A step forward for understanding the morbidity burden in Guinea: a national descriptive study

    Directory of Open Access Journals (Sweden)

    Hu Guoqing

    2011-06-01

    Full Text Available Abstract Background Little evidence on the burden of disease has been reported about Guinea. This study was conducted to demonstrate the morbidity burden in Guinea and provide basic evidence for setting health priorities. Methods A retrospective descriptive study was designed to present the morbidity burden of Guinea. Morbidity data were extracted from the National Health Statistics Report of Guinea of 2008. The data are collected based on a pyramid of facilities which includes two national hospitals (teaching hospitals, seven regional hospitals, 26 prefectural hospitals, 8 communal medical centers, 390 health centers, and 628 health posts. Morbidity rates were calculated to measure the burden of non-fatal diseases. The contributions of the 10 leading diseases were presented by sex and age group. Results In 2008, a total of 3,936,599 cases occurred. The morbidity rate for males was higher than for females, 461 versus 332 per 1,000 population. Malaria, respiratory infections, diarrheal diseases, helminthiases, and malnutrition ranked in the first 5 places and accounted for 74% of the total burden, respectively having a rate of 148, 64, 33, 32, and 14 per 1,000 population. The elderly aged 65+ had the highest morbidity rate (611 per 1,000 population followed by working-age population (458 per 1,000 population and children (396 per 1,000 population while the working-age population aged 25-64 contributed the largest part (39% to total cases. The sex- and age-specific spectrum of morbidity burden showed a similar profile except for small variations. Conclusion Guinea has its unique morbidity burden. The ten leading causes of morbidity burden, especially for malaria, respiratory infections, diarrheal diseases, helminthiases, and malnutrition, need to be prioritized in Guinea.

  4. Body burdens of heavy metals in Lake Michigan wetland turtles.

    Science.gov (United States)

    Smith, Dayna L; Cooper, Matthew J; Kosiara, Jessica M; Lamberti, Gary A

    2016-02-01

    Tissue heavy metal concentrations in painted (Chrysemys picta) and snapping (Chelydra serpentina) turtles from Lake Michigan coastal wetlands were analyzed to determine (1) whether turtles accumulated heavy metals, (2) if tissue metal concentrations were related to environmental metal concentrations, and (3) the potential for non-lethal sampling techniques to be used for monitoring heavy metal body burdens in freshwater turtles. Muscle, liver, shell, and claw samples were collected from painted and snapping turtles and analyzed for cadmium, chromium, copper, iron, lead, magnesium, manganese, and zinc. Turtle tissues had measurable quantities of all eight metals analyzed. Statistically significant correlations between tissue metal concentrations and sediment metal concentrations were found for a subset of metals. Metals were generally found in higher concentrations in the larger snapping turtles than in painted turtles. In addition, non-lethal samples of shell and claw were found to be possible alternatives to lethal liver and muscle samples for some metals. Human consumption of snapping turtles presents potential health risks if turtles are harvested from contaminated areas. Overall, our results suggest that turtles could be a valuable component of contaminant monitoring programs for wetland ecosystems.

  5. Harvesting contaminants from liquid

    Science.gov (United States)

    Simpson, John T.; Hunter, Scott R.

    2016-05-31

    Disclosed are examples of apparatuses for evaporative purification of a contaminated liquid. In each example, there is a vessel for storing the contaminated fluid. The vessel includes a surface coated with a layer of superhydrophobic material and the surface is at least partially in contact with the contaminated liquid. The contaminants do not adhere to the surface as the purified liquid evaporates, thus allowing the contaminants to be harvested.

  6. Neuropsychiatric Symptoms in Parkinson’s Disease Dementia Are Associated with Increased Caregiver Burden

    Directory of Open Access Journals (Sweden)

    Yoon-Sang Oh

    2015-01-01

    Full Text Available Objective Neuropsychiatric symptoms are common in Parkinson’s disease dementia (PDD. Frequent and severe neuropsychiatric symptoms create high levels of distress for patients and caregivers, decreasing their quality of life. The aim of this study was to investigate neuropsychiatric symptoms that may contribute to increased caregiver burden in PDD patients. Methods Forty-eight PDD patients were assessed using the 12-item Neuropsychiatric Inventory (NPI to determine the frequency and severity of mental and behavioral problems. The Burden Interview and Caregiver Burden Inventory were used to evaluate caregiver burden. Results All but one patient showed one or more neuropsychiatric symptoms. The three most frequent neuropsychiatric symptoms were apathy (70.8% and anxiety (70.8%, followed by depression (68.7%. More severe neuropsychiatric symptoms were significantly correlated with increased caregiver burden. The domains of delusion, hallucination, agitation and aggression, anxiety, irritability and lability, and aberrant motor behavior were associated with caregiver stress. After controlling for age and other potential confounding variables, total NPI score was significantly associated with caregiver burden. Conclusions The results of this study confirm that neuropsychiatric symptoms are frequent and severe in patients with PDD and are associated with increased caregiver distress. A detailed evaluation and management of neuropsychiatric symptoms in PDD patients appears necessary to improve patient quality of life and reduce caregiver burden.

  7. Caregiver burden among relatives of patients with schizophrenia in Katsina, Nigeria

    Directory of Open Access Journals (Sweden)

    Abdulkareem Jika Yusuf

    2009-06-01

    Full Text Available Objective: Caring for patients’ with schizophrenia leads to an enormous burden on the caregivers. However, the magnitude of this problem remains largely unknown in Sub-Saharan Africa. The objective of this study was to determine the burden of care giving among relatives of patients with schizophrenia. Materials and method: A total of 129 primary care-givers of patients with schizophrenia attending out-patient clinic of Katsina state Psychiatric Hospital were interviewed using a socio-demographic data collection sheet and Zarith Burden Interview (ZBI. Data obtained was analysed using Statistical Package for Social Sciences version 13. Results: The mean age of the respondents was 45.07±8.91. Majority of the caregivers are females. High level of burden was found in 47.3% of the respondents. The level of burden experienced was significantly associated with place of residence and family size. Conclusion: Schizophrenia is associated with high level of caregiver burden and effort should be made at alleviating this burden for better out come in both the patients and caregivers.

  8. Emotional Problems, Quality of Life, and Symptom Burden in Patients With Lung Cancer.

    Science.gov (United States)

    Morrison, Eleshia J; Novotny, Paul J; Sloan, Jeff A; Yang, Ping; Patten, Christi A; Ruddy, Kathryn J; Clark, Matthew M

    2017-09-01

    Lung cancer is associated with a greater symptom burden than other cancers, yet little is known about the prevalence of emotional problems and how emotional problems may be related to the physical symptom burden and quality of life in newly diagnosed patients with lung cancer. This study aimed to identify the patient and disease characteristics of patients with lung cancer experiencing emotional problems and to examine how emotional problems relate to quality of life and symptom burden. A total of 2205 newly diagnosed patients with lung cancer completed questionnaires on emotional problems, quality of life, and symptom burden. Emotional problems at diagnosis were associated with younger age, female gender, current cigarette smoking, current employment, advanced lung cancer disease, surgical or chemotherapy treatment, and a lower Eastern Cooperative Oncology Group performance score. Additionally, strong associations were found between greater severity of emotional problems, lower quality of life, and greater symptom burden. Certain characteristics place patients with lung cancer at greater risk for emotional problems, which are associated with a reduced quality of life and greater symptom burden. Assessment of the presence of emotional problems at the time of lung cancer diagnosis provides the opportunity to offer tailored strategies for managing negative mood, and for improving the quality of life and symptom burden management of patients with lung cancer. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. Factors Associated With Higher Caregiver Burden Among Family Caregivers of Elderly Cancer Patients: A Systematic Review.

    Science.gov (United States)

    Ge, Lixia; Mordiffi, Siti Zubaidah

    Caring for elderly cancer patients may cause multidimensional burden on family caregivers. Recognition of factors associated with caregiver burden is important for providing proactive support to caregivers at risk. The aim of this study was to identify factors associated with high caregiver burden among family caregivers of elderly cancer patients. A systematic search of 7 electronic databases was conducted from database inception to October 2014. The identified studies were screened, and full text was further assessed. The quality of included studies was assessed using a checklist, and relevant data were extracted using a predeveloped data extraction form. Best-evidence synthesis model was used for data synthesis. The search yielded a total of 3339 studies, and 7 studies involving 1233 family caregivers were included after screening and full assessment of 116 studies. Moderate evidence supported that younger caregivers, solid tumors, and assistance with patient's activities of daily living were significantly associated with high caregiver burden. Eighteen factors were supported by limited evidence, and 1 was a conflicting factor. The scientific literature to date proved that caregiver burden was commonly experienced by family caregivers of elderly cancer patients. The evidence indicated that family caregivers who were at younger age, caring for solid tumor patients, and providing assistance with patient's activities of daily living reported high caregiver burden. The data provide evidence in identifying family caregivers at high risk of high caregiver burden. More high-quality studies are needed to clarify and determine the estimates of the effects of individual factors.

  10. Health and economic burden of obesity in Brazil.

    Directory of Open Access Journals (Sweden)

    Ketevan Rtveladze

    Full Text Available INTRODUCTION: Higher and lower-middle income countries are increasingly affected by obesity. Obesity-related diseases are placing a substantial health and economic burden on Brazil. Our aim is to measure the future consequences of these trends on the associated disease burden and health care costs. METHOD: A previously developed micro-simulation model is used to project the extent of obesity, obesity-related diseases and associated healthcare costs to 2050. In total, thirteen diseases were considered: coronary heart disease, stroke, hypertension, diabetes, osteoarthritis, and eight cancers. We simulated three hypothetical intervention scenarios: no intervention, 1% and 5% reduction in body mass index (BMI. RESULTS: In 2010, nearly 57% of the Brazilian male population was overweight or obese (BMI ≥25 kg/m(2, but the model projects rates as high as 95% by 2050. A slightly less pessimistic picture is predicted for females, increasing from 43% in 2010 to 52% in 2050. Coronary heart disease, stroke, hypertension, cancers, osteoarthritis and diabetes prevalence cases are projected to at least double by 2050, reaching nearly 34,000 cases of hypertension by 2050 (per 100,000. 1% and 5% reduction in mean BMI will save over 800 prevalence cases and nearly 3,000 cases of hypertension by 2050 respectively (per 100,000. The health care costs will double from 2010 ($5.8 billion in 2050 alone ($10.1 billion. Over 40 years costs will reach $330 billion. However, with effective interventions the costs can be reduced to $302 billion by 1% and to $273 billion by 5% reduction in mean BMI across the population. CONCLUSION: Obesity rates are rapidly increasing creating a high burden of disease and associated costs. However, an effective intervention to decrease obesity by just 1% will substantially reduce obesity burden and will have a significant effect on health care expenditure.

  11. The social and economic burden of frontotemporal degeneration.

    Science.gov (United States)

    Galvin, James E; Howard, David H; Denny, Sharon S; Dickinson, Susan; Tatton, Nadine

    2017-11-14

    To quantify the socioeconomic burden of frontotemporal degeneration (FTD) compared to previously published data for Alzheimer disease (AD). A 250-item internet survey was administered to primary caregivers of patients with behavioral-variant FTD (bvFTD), primary progressive aphasia, FTD with motor neuron disease, corticobasal syndrome, or progressive supranuclear palsy. The survey included validated scales for disease staging, behavior, activities of daily living, caregiver burden, and health economics, as well as investigator-designed questions to capture patient and caregiver experience with FTD. The entire survey was completed by 674 of 956 respondents (70.5%). Direct costs (2016 US dollars) equaled $47,916 and indirect costs $71,737, for a total annual per-patient cost of $119,654, nearly 2 times higher than reported costs for AD. Patients ≥65 years of age, with later stages of disease, and with bvFTD correlated with higher direct costs, while patients <65 years of age and men were associated with higher indirect costs. An FTD diagnosis produced a mean decrease in household income from $75,000 to $99,000 12 months before diagnosis to $50,000 to $59,999 12 months after diagnosis, resulting from lost days of work and early departure from the workforce. The economic burden of FTD is substantial. Counting productivity-related costs, per-patient costs for FTD appear to be greater than per-patient costs reported for AD. There is a need for biomarkers for accurate and timely diagnosis, effective treatments, and services to reduce this socioeconomic burden. Copyright © 2017 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology.

  12. A neurodegenerative vascular burden index and the impact on cognition

    Directory of Open Access Journals (Sweden)

    Sebastian eHeinzel

    2014-07-01

    Full Text Available A wide range of vascular burden factors have been identified to impact vascular function and structure as indicated by carotid intima-media thickness (IMT. On the basis of their impact on IMT, vascular factors may be selected and clustered in a vascular burden index (VBI. Since many vascular factors increase the risk of Alzheimer's disease (AD, a multifactorial neurodegenerative VBI may be related to early pathological processes in AD and cognitive decline in its preclinical stages.We investigated an elderly cohort at risk for neurodegeneration (TREND study, n = 1102 for the multifactorial influence of vascular burden factors on IMT measured by ultrasound. To create a VBI for this cohort, vascular factors and their definitions (considering medical history, medication and/or blood marker data were selected based on their statistical effects on IMT in multiple regressions including age and sex. The impact of the VBI on cognitive performance was assessed using the Trail-Making Test (TMT and the CERAD neuropsychological battery.IMT was significantly predicted by age (standardized β = .26, sex (.09; males > females and the factors included in the VBI: obesity (.18, hypertension (.14, smoking (.08, diabetes (.07, and atherosclerosis (.05, whereas other cardiovascular diseases or hypercholesterolemia were not significant. Individuals with 2 or more VBI factors compared to individuals without had an odds ratio of 3.17 regarding overly increased IMT (≥1.0 mm. The VBI showed an impact on executive control (log(TMT B-A, p = .047 and a trend towards decreased global cognitive function (CERAD total score, p = .057 independent of age, sex and education.A VBI established on the basis of IMT may help to identify individuals with overly increased vascular burden linked to decreased cognitive function indicating neurodegenerative processes. The longitudinal study of this risk cohort will reveal the value of the VBI as prodromal marker for cognitive decline and

  13. The global burden of cataract.

    Science.gov (United States)

    Rao, Gullapalli N; Khanna, Rohit; Payal, Abhishek

    2011-01-01

    To review the previous year's literature related to prevalence of blindness in general, blindness due to cataract, cataract surgical coverage (CSC) and cataract surgical rates (CSRs). Cataracts are the major cause of blindness and visual impairment in developing countries and contributes to more than 90% of the total disability adjusted life years. This review shows that coverage continues to be a problem in many countries, especially for the female population, those residing in rural areas and those who are illiterate. Although CSR is an indicator of the availability and acceptability of services, for measuring the impact of the program, we should look at combining CSR with CSC. This strategy would also enable us achieve our goal of eliminating avoidable blindness due to cataracts by the year 2020. Cataracts still continue- to be a major cause of blindness globally and with the rapidly aging population, it is a challenge to tackle. We need to plan a comprehensive strategy addressing issues related to availability, affordability, accessibility and acceptability of eye-care services.

  14. Radiocesium dynamics in herons inhabiting a contaminated reservoir system

    International Nuclear Information System (INIS)

    Dombey, A.H.; Paine, D.; McFarlane, R.W.

    1977-01-01

    The little blue heron (Florida caerulea) and the green heron (Butorides virescens) nest at a radionuclide-contaminated reservoir on the Savannah River Plant near Aiken, South Carolina. Green herons distributed their nests singly along the periphery of the reservoir but fed their nestlings exclusively upon amphibians collected from adjacent uncontaminated Carolina bays. Radiocesium burdens in green heron nestlings did not exceed 5 pCi/g wet wt. and 12 regurgitated food pellets averaged 0.2 pCi/g. Twelve pairs of little blue herons established a heronry upon a small island and fed their nestlings fish and amphibians foraged from within the differentially radionuclide-contaminated reservoir system. Nestlings within the same nest did not exhibit significant differences in body burdens, and the maximum radiocesium burden determined was 27.4 pCi/g wet wt. Substantial differences were found between nestlings from different nests however. The radiocesium level of 43 regurgitated food pellets had a high correlation with observed levels in the nestlings, and variation in food contamination is believed to be the major contributor in the observed variation in the nestlings. The variable contamination of primary prey species was correlated with the differentially contaminated foraging sites and indicates that adult little blue herons tended to spatially partition the available foraging areas. (author)

  15. Uncertainties in Organ Burdens Estimated from PAS

    International Nuclear Information System (INIS)

    La Bone, T.R.

    2004-01-01

    To calculate committed effective dose equivalent, one needs to know the quantity of the radionuclide in all significantly irradiated organs (the organ burden) as a function of time following the intake. There are two major sources of uncertainty in an organ burden estimated from personal air sampling (PAS) data: (1) The uncertainty in going from the exposure measured with the PAS to the quantity of aerosol inhaled by the individual, and (2) The uncertainty in going from the intake to the organ burdens at any given time, taking into consideration the biological variability of the biokinetic models from person to person (interperson variability) and in one person over time (intra-person variability). We have been using biokinetic modeling methods developed by researchers at the University of Florida to explore the impact of inter-person variability on the uncertainty of organ burdens estimated from PAS data. These initial studies suggest that the uncertainties are so large that PAS might be considered to be a qualitative (rather than quantitative) technique. These results indicate that more studies should be performed to properly classify the reliability and usefulness of using PAS monitoring data to estimate organ burdens, organ dose, and ultimately CEDE

  16. Subjective burden on spouses of schizophrenia patients

    Directory of Open Access Journals (Sweden)

    Surekha Kumari

    2009-01-01

    Full Text Available Background : There is limited information from India on subjective burden on spouses of schizophrenia patients. The aim of the present study was to assess and compare patterns of subjective burden on spouses of schizophrenia patients. Materials and Methods: The present study was conducted at the OPD level, and follow-up was done at the Ranchi Institute of Neuropsychiatry and Sciences (RINPAS during the period May 2008 to November 2008. Tools utilized were sociodemographic data sheet, Family Burden Interview Schedule developed by Pai and R. L. Kapur (1981. The sample comprised of 50 samples of spouses (25 male and 25 female spouses of schizophrenia patients. Results: The findings suggest that both the groups, viz., male and female spouses of schizophrenia patients, showed moderate level of subjective burden, i.e., 13 (52% and 15 (60% male and female spouses, respectively, which was statistically found to be insignificant. Conclusion : No significant difference was found between male and female spouses of schizophrenia patients with regard to the level of subjective burden.

  17. Burden of childhood-onset arthritis

    Directory of Open Access Journals (Sweden)

    Hassett Afton L

    2010-07-01

    Full Text Available Abstract Juvenile arthritis comprises a variety of chronic inflammatory diseases causing erosive arthritis in children, often progressing to disability. These children experience functional impairment due to joint and back pain, heel pain, swelling of joints and morning stiffness, contractures, pain, and anterior uveitis leading to blindness. As children who have juvenile arthritis reach adulthood, they face possible continuing disease activity, medication-associated morbidity, and life-long disability and risk for emotional and social dysfunction. In this article we will review the burden of juvenile arthritis for the patient and society and focus on the following areas: patient disability; visual outcome; other medical complications; physical activity; impact on HRQOL; emotional impact; pain and coping; ambulatory visits, hospitalizations and mortality; economic impact; burden on caregivers; transition issues; educational occupational outcomes, and sexuality. The extent of impact on the various aspects of the patients', families' and society's functioning is clear from the existing literature. Juvenile arthritis imposes a significant burden on different spheres of the patients', caregivers' and family's life. In addition, it imposes a societal burden of significant health care costs and utilization. Juvenile arthritis affects health-related quality of life, physical function and visual outcome of children and impacts functioning in school and home. Effective, well-designed and appropriately tailored interventions are required to improve transitioning to adult care, encourage future vocation/occupation, enhance school function and minimize burden on costs.

  18. The Spanish Burden of Disease 2010: Neurological, mental and substance use disorders.

    Science.gov (United States)

    Lara, Elvira; Garin, Noé; Ferrari, Alize J; Tyrovolas, Stefanos; Olaya, Beatriz; Sànchez-Riera, Lidia; Whiteford, Harvey A; Haro, Josep Maria

    2015-01-01

    We used data from the Global Burden of Disease, Injuries, and Risk Factors Study 2010 to report on the burden of neuropsychiatric disorders in Spain. The summary measure of burden used in the study was the disability-adjusted life-year (DALY), which sums of the years of life lost due to premature mortality (YLLs) and the years lived with disability (YLDs). DALYs were adjusted for comorbidity and estimated with 95% uncertainty intervals. The burden of neuropsychiatric disorders accounted for 18.4% of total all-cause DALYs generated in Spain for 2010. Within this group, the top five leading causes of DALYs were: depressive disorders, Alzheimer's disease, migraine, substance-use disorders, and anxiety disorder, which accounted for 70.9% of all DALYs due to neuropsychiatric disorders. Neurological disorders represented 5.03% of total all cause YLLs, whereas mental and substance-use disorders accounted for 0.8%. Mental and substance-use disorders accounted for 22.4% of total YLDs, with depression being the most disabling disorder. Neurological disorders represented 8.3% of total YLDs. Neuropsychiatric disorders were one of the leading causes of disability in 2010. This finding contributes to our understanding of the burden of neuropsychiatric disorders in the Spanish population and highlights the importance of prioritising neuropsychiatric disorders in the Spanish public health system. Copyright © 2014 SEP y SEPB. Published by Elsevier España. All rights reserved.

  19. Analysis of bacterial strains from contaminated and non ...

    African Journals Online (AJOL)

    Administrator

    2007-05-02

    May 2, 2007 ... A total 18 strains were collected from non-contaminated and contaminated environments, and were purified. All purified strains were characterized for Gram reaction and biochemical analysis. Screening for bioplastic production was done by Sudan black staining. Strains isolated from non-contaminated.

  20. High perceived caregiver burden for relatives of patients following hip fracture surgery

    DEFF Research Database (Denmark)

    Ariza-Vega, Patrocinio; Ortiz-Piña, Mariana; Kristensen, Morten Tange

    2018-01-01

    treatment strategies such as the support and training of the caregivers in patient handling during hospital stay could be carried out to reduce caregiver burden. Implications for rehabilitation The main caregiver of a hip fracture patient is usually a woman who is the daughter of the patient, and reducing...... her burden of care should be included as one of the objectives of rehabilitation treatment. The caregivers of hip fracture patients must be considered as part of the treatment during the patient's recovery period, and patient handling training should be provided to the caregivers of hip fracture......PURPOSE: To determine the profile of the main informal caregivers, the evolution of the caregiver burden, and the influencing factors of caregiver burden at 1-year after hip fracture surgery. METHODS: In this prospective cohort study, a total of 172 informal caregivers of patients were interviewed...

  1. Materials SIG quantification and characterization of surface contaminants

    Science.gov (United States)

    Crutcher, E. Russ

    1992-01-01

    When LDEF entered orbit its cleanliness was approximately a MIL-STD-1246B Level 2000C. Its burden of contaminants included particles from every part of its history including a relatively small contribution from the shuttle bay itself. Although this satellite was far from what is normally considered clean in the aerospace industry, contaminating events in orbit and from processing after recovery were easily detected. The molecular contaminants carried into orbit were dwarfed by the heavy deposition of UV polymerized films from outgassing urethane paints and silicone based materials. Impacts by relatively small objects in orbit could create particulate contaminants that easily dominated the particle counts within a centimeter of the impact site. During the recovery activities LDEF was 'sprayed' with a liquid high in organics and water soluble salts. With reentry turbulence, vibration, and gravitational loading particulate contaminants were redistributed about LDEF and the shuttle bay.

  2. The unrecognized burden of typhoid fever.

    Science.gov (United States)

    Obaro, Stephen K; Iroh Tam, Pui-Ying; Mintz, Eric Daniel

    2017-03-01

    Typhoid fever (TF), caused by Salmonella enterica serovar Typhi, is the most common cause of enteric fever, responsible for an estimated 129,000 deaths and more than 11 million cases annually. Although several reviews have provided global and regional TF disease burden estimates, major gaps in our understanding of TF epidemiology remain. Areas covered: We provide an overview of the gaps in current estimates of TF disease burden and offer suggestions for addressing them, so that affected communities can receive the full potential of disease prevention offered by vaccination and water, sanitation, and hygiene interventions. Expert commentary: Current disease burden estimates for TF do not capture cases from certain host populations, nor those with atypical presentations of TF, which may lead to substantial underestimation of TF cases and deaths. These knowledge gaps pose major obstacles to the informed use of current and new generation typhoid vaccines.

  3. The global burden of periodontal disease

    DEFF Research Database (Denmark)

    Petersen, Poul E; Ogawa, Hiroshi

    2012-01-01

    Chronic diseases are accelerating globally, advancing across all regions and pervading all socioeconomic classes. Unhealthy diet and poor nutrition, physical inactivity, tobacco use, excessive use of alcohol and psychosocial stress are the most important risk factors. Periodontal disease...... is a component of the global burden of chronic disease, and chronic disease and periodontal disease have the same essential risk factors. In addition, severe periodontal disease is related to poor oral hygiene and to poor general health (e.g. the presence of diabetes mellitus and other systemic diseases......). The present report highlights the global burden of periodontal disease: the ultimate burden of periodontal disease (tooth loss), as well as signs of periodontal disease, are described from World Health Organization (WHO) epidemiological data. High prevalence rates of complete tooth loss are found in upper...

  4. The Global Burden of Occupational Disease.

    Science.gov (United States)

    Rushton, Lesley

    2017-09-01

    Burden of occupational disease estimation contributes to understanding of both magnitude and relative importance of different occupational hazards and provides essential information for targeting risk reduction. This review summarises recent key findings and discusses their impact on occupational regulation and practice. New methods have been developed to estimate burden of occupational disease that take account of the latency of many chronic diseases and allow for exposure trends and workforce turnover. Results from these studies have shown in several countries and globally that, in spite of improvements in workplace technology, practices and exposures over the last decades, occupational hazards remain an important cause of ill health and mortality worldwide. Major data gaps have been identified particularly regarding exposure information. Reliable data on employment and disease are also lacking especially in developing countries. Burden of occupational disease estimates form an important part of decision-making processes.

  5. [Estimation on the indirect economic burden of disease-related premature deaths in China, 2012].

    Science.gov (United States)

    Yang, Juan; Feng, Luzhao; Zheng, Yaming; Yu, Hongjie

    2014-11-01

    To estimate the indirect economic burden of disease-related premature deaths in China, 2012. Both human capital approach and friction cost methods were used to compute the indirect economic burden of premature deaths from the following sources: mortality from the national disease surveillance system in 2012, average annual income per capita from the China Statistic Yearbook in 2012, population size from the 2010 China census, and life expectancy in China from the World Health Organization life table. Data from the Human Capital Approach Estimates showed that the indirect economic burden of premature deaths in China was 425.1 billion in 2012, accounting for 8‰ of the GDP. The indirect economic burden of chronic non-communicable diseases associated premature deaths was accounted for the highest proportion(67.1%, 295.4 billion), followed by those of injuries related premature deaths (25.6% , 108.9 billion), infectious diseases, maternal and infants diseases, and malnutrition related deaths (6.4% , 26.9 billion). The top five premature deaths that cause the indirect economic burden were malignancy, cardiovascular diseases, unintentional injuries, intentional injuries, and diseases of the respiratory system. The indirect economic burden of premature deaths mainly occurred in the population of 20-59 year-olds. Under the Friction Cost method, the estimates appeared to be 0.11%-3.49% of the total human capital approach estimates. Premature death caused heavy indirect economic burden in China. Chronic non-communicable diseases and injuries seemed to incur the major disease burden. The indirect economic burden of premature deaths mainly occurred in the working age group.

  6. Effect of caregivers’ expressed emotion on the care burden and rehospitalization rate of schizophrenia

    Directory of Open Access Journals (Sweden)

    Wang X

    2017-09-01

    Full Text Available Xia Wang,1 Qiongni Chen,2 Min Yang1 1Xiangya School of Nursing, 2Nursing Department, Second Xiangya Hospital, Central South University, Changsha, Hunan, People’s Republic of China Background: This study assessed the effect of expressed emotion (EE among caregivers of schizophrenia patients on their care burden and the illness rehospitalization rate. Subjects and methods: A total of 64 schizophrenia patients hospitalized for the first time and their key caregivers were recruited. The Chinese version of the Camberwell Family Interview (CFI-CV was used to evaluate the EE of the key caregivers. A family burden questionnaire was used to evaluate the care burden. The patients’ rehospitalization rate and medication compliance were evaluated by the self-designated criteria. The data collection was carried out at the first meeting in the hospital, at 6 months and 12 months after hospital discharge by using the same instruments. Results: The subjective stress burden and subjective demand burden scores were higher in caregivers before and after discharge with statistical difference between the various observation time points (P<0.05. Significant differences were observed in the rehospitalization rate between patients with high medication adherence and low medication adherence at 12 months (P<0.01 and between patients with high expressed emotion (HEE and low expressed emotion (LEE; P<0.05. The rehospitalization rate in patients with HEE caregivers was higher than that in those with LEE caregivers. The subjective stress burden scores were statistically significant between HEE and LEE caregivers (P<0.05.Conclusion: HEE is a predictor of rehospitalization rate in schizophrenic patients. The burdens of care scores are high in caregivers of schizophrenic patients. The caregivers with HEE have a high score in burden of care compared with those with LEE. Keywords: expressed emotion, care burden, schizophrenia, rehospitalization rate, caregivers

  7. Burden experience of caregivers of acute lymphoblastic leukemia: Impact of coping and spirituality

    Directory of Open Access Journals (Sweden)

    Usha Chivukula

    2018-01-01

    Full Text Available Background: When a child is diagnosed with cancer the parents as caregivers experience severe anxiety, trauma, ambiguity, and grief. Caregivers of cancer patients thus deal with the management of their own psychological distress along with the child's illness.Aim: Coping plays a crucial role in improving the caregivers' physical and emotional well-being. Spirituality is an important means of consolation, strength, and emotional support during this phase. The present study aims to investigate the impact of coping and spirituality on caregiver burden.Methods: A total of 100 caregivers of children between the age group of 3–11 years, diagnosed with acute lymphoblastic leukemia were the participants of the study. The participants were recruited from cancer hospitals in Hyderabad. The study adopted a between-group design to find out if mothers and fathers differed in their coping strategies, spirituality, and caregiver burden. The study also adopted a correlation design to find the relationship between coping, spirituality, and caregiver burden. Descriptive statistics and multiple linear regression analysis were conducted to identify if coping and spirituality predict caregiver burden.Results: The results showed no significant difference in the burden experienced by both mothers and fathers; however, mothers and fathers used different coping strategies and differed on the dimensions of spirituality. The results of multiple linear regression indicated that dimensions of coping and spirituality were significant predictors of caregiver burden.Conclusion: Cancer in the child impacts the parent's burden but providing sufficient support and implementing effective coping strategies, will help in mitigating the intensity of caregiver burden. It is essential that the hospital authorities and policymakers understand that a professional health psychologist could be a liaison between the doctor, patient, and the caregiver in bringing down the levels of burden

  8. The psychosocial burden of psoriatic arthritis.

    Science.gov (United States)

    Husni, M Elaine; Merola, Joseph F; Davin, Sara

    2017-12-01

    To assess the psychosocial impact of psoriatic arthritis (PsA), describe how health-related quality of life (QoL) is affected in patients with PsA, discuss measures used to evaluate the psychosocial impact of PsA, and review studies examining the effect of therapy on QoL. A targeted review on the impact of PsA on QoL and the role of tailored psychosocial management in reducing the psychosocial burden of the disease was performed. PubMed literature searches were conducted using the terms PsA, psychosocial burden, QoL, and mood/behavioral changes. Articles were deemed relevant if they presented information regarding the psychosocial impact of PsA, methods used to evaluate these impacts, or ways to manage/improve management of PsA and its resulting comorbidities. The findings of this literature search are descriptively reviewed and the authors׳ expert opinion on their interpretation is provided. The psychosocial burden of PsA negatively affects QoL. Patients suffer from sleep disorders, fatigue, low-level stress, depression and mood/behavioral changes, poor body image, and reduced work productivity. Additionally, each patient responds to pain differently, depending on a variety of psychological factors including personality structure, cognition, and attention to pain. Strategies for evaluating the burdens associated with PsA and the results of properly managing patients with PsA are described. PsA is associated with a considerable psychosocial burden and new assessment tools, specific to PsA, have been developed to help quantify this burden in patients. Future management algorithms of PsA should incorporate appropriate assessment and management of psychological and physical concerns of patients. Furthermore, patients with PsA should be managed by a multidisciplinary team that works in coordination with the patient and their family or caregivers. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  9. Burden attributable to child maltreatment in Australia.

    Science.gov (United States)

    Moore, Sophie E; Scott, James G; Ferrari, Alize J; Mills, Ryan; Dunne, Michael P; Erskine, Holly E; Devries, Karen M; Degenhardt, Louisa; Vos, Theo; Whiteford, Harvey A; McCarthy, Molly; Norman, Rosana E

    2015-10-01

    Child maltreatment is a complex phenomenon, with four main types (childhood sexual abuse, physical abuse, emotional abuse, and neglect) highly interrelated. All types of maltreatment have been linked to adverse health consequences and exposure to multiple forms of maltreatment increases risk. In Australia to date, only burden attributable to childhood sexual abuse has been estimated. This study synthesized the national evidence and quantified the burden attributable to the four main types of child maltreatment. Meta-analyses, based on quality-effects models, generated pooled prevalence estimates for each maltreatment type. Exposure to child maltreatment was examined as a risk factor for depressive disorders, anxiety disorders and intentional self-harm using counterfactual estimation and comparative risk assessment methods. Adjustments were made for co-occurrence of multiple forms of child maltreatment. Overall, an estimated 23.5% of self-harm, 20.9% of anxiety disorders and 15.7% of depressive disorders burden in males; and 33.0% of self-harm, 30.6% of anxiety disorders and 22.8% of depressive disorders burden in females was attributable to child maltreatment. Child maltreatment was estimated to cause 1.4% (95% uncertainty interval 0.4-2.3%) of all disability-adjusted life years (DALYs) in males, and 2.4% (0.7-4.1%) of all DALYs in females in Australia in 2010. Child maltreatment contributes to a substantial proportion of burden from depressive and anxiety disorders and intentional self-harm in Australia. This study demonstrates the importance of including all forms of child maltreatment as risk factors in future burden of disease studies. Copyright © 2015 Elsevier Ltd. All rights reserved.

  10. A preliminary study into the economic burden of cerebral palsy in China.

    Science.gov (United States)

    Wang, Bin; Chen, Yingyao; Zhang, Jie; Li, Jun; Guo, Yan; Hailey, David

    2008-08-01

    To measure the economic burden of cerebral palsy (CP) in China is to provide information on CP's societal impacts to policy-makers. The economic burden of CP includes direct healthcare costs, direct non-healthcare costs, developmental costs and indirect costs such as productivity loss. The incidence approach is employed to estimate the lifetime economic burden of a new CP birth and that of all new cases in China in 2003. Caregivers of 319 CP patients were interviewed in specialty hospitals in five cities in 2004. Average expenditure and utilization rates for different services by age groups from this sample were obtained to estimate the economic burden of CP. Chinese CP patients' life expectancy and survival rate were simulated with reference to Australian data with Human Development Index adjustment. From the societal perspective, the average lifetime economic burden of a new CP case in China was US$ 67,044 in 2003, and the life-span total economic loss due to all new CP cases in 2003 amounted to US$ 2-4 billion. Indirect (productivity) costs are responsible for 93% of total economic loss, and direct healthcare and developmental costs make up 3% each. There are several factors which contribute to the extraordinarily high economic burden of CP, including productivity loss, reduced life expectancy, dependency, progressive deterioration of motor physical function, and recurrent use of rehabilitation services. The economic burden of CP in China is substantial for the family of a CP patient, as well as to society. Public provision and financing of necessary preventive and rehabilitative services is urgently needed to mitigate this heavy burden for patients and their families.

  11. Caregiver burden in atypical dementias: comparing frontotemporal dementia, Creutzfeldt-Jakob disease, and Alzheimer's disease.

    Science.gov (United States)

    Uflacker, Alice; Edmondson, Mary C; Onyike, Chiadi U; Appleby, Brian S

    2016-02-01

    Caregiver burden is a significant issue in the treatment of dementia and a known contributor to institutionalization of patients with dementia. Published data have documented increased caregiver burden in behavioral variant frontotemporal dementia (bvFTD) compared to Alzheimer's disease (AD). Another atypical dementia with high-perceived caregiver burden is sporadic Creutzfeldt-Jakob disease (sCJD), but no formal studies have assessed this perception. The aim of this study was to compare caregiver burden across atypical dementia etiologies. 76 adults with atypical dementia (young-onset AD [YOAD], bvFTD, language variant FTD [lvFTD], and sCJD) were administered an abbreviated version of the Zarit Burden Interview (ZBI), Neuropsychiatric Inventory (NPI-Q), and other assessment instruments during a five-year time period at Johns Hopkins Hospital (JHH). A Cox regression model examined differences between disease categories that impact mean ZBI scores. Mean ZBI scores were significantly different between dementia etiologies, with bvFTD and sCJD having the highest caregiver burden (p = 0.026). Mean NPI-Q caregiver distress scores were highest in bvFTD and sCJD (p = 0.002), with sCJD and bvFTD also having the highest number of endorsed symptom domains (p = 0.012). On regression analyses, an interactive variable combining final diagnosis category and NPI-Q total severity score demonstrated statistically significant differences in mean ZBI scores for sCJD and bvFTD. This study demonstrates that bvFTD and sCJD have increased levels of caregiver burden, NPI-Q caregiver distress, total severity scores, and number of endorsed symptom domains. These results suggest that higher caregiver burden in bvFTD and sCJD are disease specific and possibly related to neuropsychiatric symptoms.

  12. The economic burden of advanced gastric cancer in Taiwan.

    Science.gov (United States)

    Hong, Jihyung; Tsai, Yiling; Novick, Diego; Hsiao, Frank Chi-Huang; Cheng, Rebecca; Chen, Jen-Shi

    2017-09-16

    Gastric cancer is one of the leading causes of cancer-related deaths in both sexes worldwide, especially in Eastern Asia. This study aimed to estimate the economic burden of advanced gastric cancer (AGC) in Taiwan. The costs of AGC in 2013 were estimated using resource use data from a chart review study (n = 122 with AGC) and national statistics. Annual per-patient costs, where patients' follow-up periods were adjusted for, were estimated with 82 patients who had complete resource use data. The costs were composed of direct medical costs, direct non-medical costs (healthcare travel and caregiver costs), morbidity costs, and mortality costs. Relevant unit costs were retrieved mainly from literature and national statistics, and applied to the resource use data. A broad definition of morbidity and mortality costs was employed to value the productivity loss in patients with unpaid employment, economically inactive and unemployed as well as the life years after the age of retirement. Their narrow definitions were also used in sensitivity analyses, using age- and/or sex-specific employment rates. Forgone future earnings/productivity loss were discounted at 3%. Annual per-patient costs were projected to estimate the total costs of AGC at the national level with an estimated number of patients with AGC (N = 2611) in Taiwan in 2013. The mean age of the 82 patients was 59.3 (SD: 11.9) years, and 67.1% were male. Per-patient costs were US$26,431 for direct medical costs, US$4669 for direct non-medical costs, US$5758 for morbidity costs, and US$145,990 for mortality costs (per death). These per-patient costs were projected to incur total AGC costs of US$423 million at the national-level. Mortality costs accounted for 77.3% of the total costs, followed by direct medical costs (16.3%), morbidity costs (3.6%), and direct non-medical costs (2.9%). AGC was found to exert a significant economic burden in Taiwan, incurring US$423 million in 2013. This represents about 0.08% of

  13. Prospective study of the burden of rotavirus gastroenteritis in Danish children and their families

    DEFF Research Database (Denmark)

    Hoffmann, Thomas; Iturriza, Miren; Faaborg-Andersen, Jens

    2011-01-01

    This was the first study to characterize the total burden of rotavirus gastroenteritis (RVGE) at both hospital and general physician (GP) clinics in Denmark, and also the first to confirm rotavirus (RV) as the leading cause of acute gastroenteritis (GE) among children......This was the first study to characterize the total burden of rotavirus gastroenteritis (RVGE) at both hospital and general physician (GP) clinics in Denmark, and also the first to confirm rotavirus (RV) as the leading cause of acute gastroenteritis (GE) among children...

  14. Relative importance of dissolved and food pathways for lead contamination in shrimp

    International Nuclear Information System (INIS)

    Boisson, F.; Cotret, O.; Teyssie, J.-L.; El-Baradeie, M.; Fowler, S.W.

    2003-01-01

    The relative importance of dissolved and food pathways and the influence of food type in the bioaccumulation and retention of lead in the shrimp Palaemonetes varians were examined using a radiotracer method. Shrimp were exposed to 210 Pb-labelled seawater or fed two types of 210 Pb-labelled food, viz. mussels or worms. The amount of radiotracer accumulated by shrimp was examined over a 7-day period, followed by a 1-month and a 7-day depuration period for the dissolved and food source, respectively. Steady state in the uptake was reached after 2 days exposure to dissolved lead, with a resultant estimated concentration factor of 98 ± 3. Transfer factors following ingestion of contaminated mussels and worms were lower than unity for both food types, with lead transfer from worms being significantly higher than that from mussels. Accumulation of dissolved Pb by shrimp was found to occur mainly through adsorption on the exoskeleton with a minor accumulation in the internal tissues probably resulting from the intake of seawater for osmoregulation. In contrast, lead taken up from contaminated food was readily absorbed and bound in the internal tissues of P. varians. Although the transfer of lead to P. varians through the ingestion of contaminated food was low (TF < 1%), it still represented 4 to 8% of the lead content in the prey which is a significant additional contribution of lead to the shrimp body burden. Independent of food type, following ingestion of contaminated food, approximately 23-27% of total lead accumulated in shrimp was located in the edible parts (e.g. muscle). Therefore, the food pathway is suggested to be a significant contributor to the lead transfer to humans through ingestion of contaminated shrimp. After exposure to contaminated food, lead loss kinetics were described by a two-component model, whereas Pb loss following direct uptake from seawater was best described by a three-component model. The additional compartment representing 64% of total Pb

  15. Relative importance of dissolved and food pathways for lead contamination in shrimp

    Energy Technology Data Exchange (ETDEWEB)

    Boisson, F.; Cotret, O.; Teyssie, J.-L.; El-Baradeie, M.; Fowler, S.W

    2003-12-01

    The relative importance of dissolved and food pathways and the influence of food type in the bioaccumulation and retention of lead in the shrimp Palaemonetes varians were examined using a radiotracer method. Shrimp were exposed to {sup 210}Pb-labelled seawater or fed two types of {sup 210}Pb-labelled food, viz. mussels or worms. The amount of radiotracer accumulated by shrimp was examined over a 7-day period, followed by a 1-month and a 7-day depuration period for the dissolved and food source, respectively. Steady state in the uptake was reached after 2 days exposure to dissolved lead, with a resultant estimated concentration factor of 98 {+-} 3. Transfer factors following ingestion of contaminated mussels and worms were lower than unity for both food types, with lead transfer from worms being significantly higher than that from mussels. Accumulation of dissolved Pb by shrimp was found to occur mainly through adsorption on the exoskeleton with a minor accumulation in the internal tissues probably resulting from the intake of seawater for osmoregulation. In contrast, lead taken up from contaminated food was readily absorbed and bound in the internal tissues of P. varians. Although the transfer of lead to P. varians through the ingestion of contaminated food was low (TF < 1%), it still represented 4 to 8% of the lead content in the prey which is a significant additional contribution of lead to the shrimp body burden. Independent of food type, following ingestion of contaminated food, approximately 23-27% of total lead accumulated in shrimp was located in the edible parts (e.g. muscle). Therefore, the food pathway is suggested to be a significant contributor to the lead transfer to humans through ingestion of contaminated shrimp. After exposure to contaminated food, lead loss kinetics were described by a two-component model, whereas Pb loss following direct uptake from seawater was best described by a three-component model. The additional compartment representing 64

  16. The economic burden of cancer in Korea in 2009.

    Science.gov (United States)

    Kim, So Young; Park, Jong-Hyock; Kang, Kyoung Hee; Hwang, Inuk; Yang, Hyung Kook; Won, Young-Joo; Seo, Hong-Gwan; Lee, Dukhyoung; Yoon, Seok-Jun

    2015-01-01

    Cancer imposes a significant economic burden on individuals, families and society. The purpose of this study was to estimate the economic burden of cancer using the healthcare claims and cancer registry data in Korea in 2009. The economic burden of cancer was estimated using the prevalence data where patients were identified in the Korean Central Cancer Registry. We estimated the medical, non-medical, morbidity and mortality cost due to lost productivity. Medical costs were calculated using the healthcare claims data obtained from the Korean National Health Insurance (KNHI) Corporation. Non-medical costs included the cost of transportation to visit health providers, costs associated with caregiving for cancer patients, and costs for complementary and alternative medicine (CAM). Data acquired from the Korean National Statistics Office and Ministry of Labor were used to calculate the life expectancy at the time of death, age- and gender-specific wages on average, adjusted for unemployment and labor force participation rate. Sensitivity analysis was performed to derive the current value of foregone future earnings due to premature death, discounted at 3% and 5%. In 2009, estimated total economic cost of cancer amounted to $17.3 billion at a 3% discount rate. Medical care accounted for 28.3% of total costs, followed by non-medical (17.2%), morbidity (24.2%) and mortality (30.3%) costs. Given that the direct medical cost sharply increased over the last decade, we must strive to construct a sustainable health care system that provides better care while lowering the cost. In addition, a comprehensive cancer survivorship policy aimed at lower caregiving cost and higher rate of return to work has become more important than previously considered.

  17. Monitoring of airborne contamination during the handling of technetium-99m and radioiodine

    International Nuclear Information System (INIS)

    Eadie, A.S.; Horton, P.W.; Hilditch, T.E.

    1980-01-01

    Measurements have been made using an air sampler to measure airborne radioactivity produced during the routine handling of large activities of technetium-99m, iodine-125 and iodine-131. The results indicate that 99 Tcsup(m) can be safely handled in environments without direct exhaust of the ventilated air but that 125 I and 131 I should always be handled in a ventilated environment such as a fume cupboard or a down-draught work-station of the total-exhaust type. Monitoring of thyroid uptake proves to be the most reliable means of monitoring airborne contamination by these radionuclides, but burdens and radiation doses for typical procedures are well within the maximum permissible limits of the Code of Practice for the Protection of Persons from Ionizing Radiation arising from Medical and Dental Use. (author)

  18. Microbial contaminants in Pakistan: a review

    Directory of Open Access Journals (Sweden)

    Maida Kanwal

    2016-04-01

    Full Text Available Worldwide contamination of surface waters with microbial pathogens is of substantial health concern. These contaminants are usually transmitted by improper sanitation measures, unsafe waste disposal, excretions from patients, and physical contacts, i.e., sexual and nonsexual. Majority of these microbial pathogens have been categorized into three classes, i.e., bacteria, viruses and protozoa. Pakistan, being a developing country, is facing a noteworthy threat due to microbial contamination. In Pakistan, bacterial contaminants are reported extensively followed by viral and protozoa contaminants. The health issues associated with bacterial population includes dysentery, abdominal pain, headache, diarrhea etc.; and usually includes faecal and total coliforms, E. coli, Salmonella, Shigella and Campylobacter. The cases related to viral contamination are lesser but chronic and evidenced the presence of HCV, HAV, HEV viruses causing hepatitis, and other hepatic disorders. Lastly, the health impacts associated with protozoans are least reported; and a number of diseases such as giardia, cryptosporidium and toxoplasma have been linked with this class of contaminants. The current review compiles information of these biological contaminants along with their health issues in Pakistan. Moreover, potential sources and fate of microbial contaminants are also discussed.

  19. Exploring caregiver burden experienced by family caregivers of patients with End-Stage Renal Disease in Nigeria

    Directory of Open Access Journals (Sweden)

    Yemisi Okikiade Oyegbile

    Full Text Available Background: Family caregivers in many African countries bear the burden of caregiving alone, with the paucity of research, especially for caregivers of End-Stage Renal Disease patients, having concealed their needs. Aim: To explore the caregiver burden of family caregivers of End-Stage Renal Disease (ESRD patients in South-West Nigeria. Design: Following a complementary mixed method data collection strategy, the quantitative data was collected using the Zarit Burden Interview questionnaire to measure the burden of caregiving. Qualitative data was thereafter obtained through in-depth, individual interviews and was analysed using content analysis. Settings: The three research settings consisted of two state hospitals and one private hospital that provide renal care in South-West Nigeria. Result: The mean burden of caregiving for the sample was 50.18 thus indicating that family caregivers experienced moderate to severe burden, which is high compared to the other studies. The participants’ experiences of caregiving revealed the following categories: total dependence, acceptance of caregiving role, competing responsibilities, financial sacrifice and “not making mistakes”. Conclusion: Understanding the extent of caregiver burden, what constitutes burden to family caregivers in low/middle-income countries, and the difficulties associated with caregiving for care-recipients with ESRD, allows appropriate strategies and interventions to be developed. Keywords: End Stage Renal Disease, Family caregivers, Caregiver burden, Complementary mixed methods, Nigeria

  20. Effects of exogenous glutathione on arsenic burden and NO metabolism in brain of mice exposed to arsenite through drinking water.

    Science.gov (United States)

    Wang, Yan; Zhao, Fenghong; Jin, Yaping; Zhong, Yuan; Yu, Xiaoyun; Li, Gexin; Lv, Xiuqiang; Sun, Guifan

    2011-03-01

    Chronic exposure to inorganic arsenic (iAs) is associated with neurotoxicity. Studies to date have disclosed that methylation of ingested iAs is the main metabolic pathway, and it is a process relying on reduced glutathione (GSH). The aim of this study was to explore the effects of exogenous GSH on arsenic burden and metabolism of nitric oxide (NO) in the brain of mice exposed to arsenite via drinking water. Mice were exposed to sodium arsenite through drinking water contaminated with 50 mg/L arsenic for 4 weeks and treated intraperitoneally with saline solution, 200 mg/kg body weight (b.w), 400 mg/kg b.w, or 800 mg/kg b.w GSH, respectively, at the 4th week. Levels of iAs, monomethylarsenic acid, and dimethylarsenic acid (DMAs) in the liver, blood, and brain were determined by method of hydride generation coupled with atomic absorption spectrophotometry. Activities of nitric oxide synthase (NOS) and contents of NO in the brain were determined by colorimetric method. Compared with mice exposed to arsenite alone, administration of GSH increased dose-dependently the primary and secondary methylation ratio in the liver, which caused the decrease in percent iAs and increase in percent DMAs in the liver, as a consequence, resulted in significant decrease in iAs levels in the blood and total arsenic levels in both blood and brain. NOS activities and NO levels in the brain of mice in iAs group were significantly lower than those in control; however, administration of GSH could increase significantly activities of NOS and contents of NO. Findings from this study suggested that exogenous GSH could promote both primary and secondary arsenic methylation capacity in the liver, which might facilitate excretion of arsenicals, and consequently reduce arsenic burden in both blood and brain and furthermore ameliorate the effects of arsenicals on NO metabolism in the brain.

  1. The Global Burden of Potential Productivity Loss from Uncorrected Presbyopia.

    Science.gov (United States)

    Frick, Kevin D; Joy, Susan M; Wilson, David A; Naidoo, Kovin S; Holden, Brien A

    2015-08-01

    The onset of presbyopia in middle adulthood results in potential losses in productivity among otherwise healthy adults if uncorrected or undercorrected. The economic burden could be significant in lower-income countries, where up to 94% of cases may be uncorrected or undercorrected. This study estimates the global burden of potential productivity lost because of uncorrected functional presbyopia. Population data from the US Census Bureau were combined with the estimated presbyopia prevalence, age of onset, employment rate, gross domestic product (GDP) per capita in current US dollars, and near vision impairment disability weights from the Global Burden of Disease 2010 study to estimate the global loss of productivity from uncorrected and undercorrected presbyopia in each country in 2011. To allow comparison with earlier work, we also calculated the loss with the conservative assumption that the contribution to productivity extends only up to 50 years of age. The economic modeling did not require the use of subjects. We estimated the number of cases of uncorrected or undercorrected presbyopia in each country among the working-age population. The number of working-age cases was multiplied by the labor force participation rate, the employment rate, a disability weight, and the GDP per capita to estimate the potential loss of GDP due to presbyopia. The outcome being measured is the lost productivity in 2011 US dollars resulting from uncorrected or undercorrected presbyopia. There were an estimated 1.272 billion cases of presbyopia worldwide in 2011. A total of 244 million cases, uncorrected or undercorrected among people aged productivity loss of US $11.023 billion (0.016% of global GDP). If all those people aged productive, the potential productivity loss would be US $25.367 billion or 0.037% of global GDP. Correcting presbyopia to the level achieved in Europe would reduce the burden to US $1.390 billion (0.002% of global GDP). Even with conservative assumptions

  2. Incidental Findings in Imaging Research: Evaluating Incidence, Benefit and Burden

    Science.gov (United States)

    Orme, Nicholas M.; Fletcher, Joel G.; Siddiki, Hassan A.; Harmsen, W. Scott; O’Byrne, Megan M.; Port, John D.; Tremaine, William J.; Pitot, Henry C.; McFarland, Beth; Robinson, Marguerite E.; Koenig, Barabara A.; King, Bernard F.; Wolf, Susan M.

    2013-01-01

    Context Little information exists concerning the frequency of clinically significant incidental findings (IFs) identified in the course of imaging research across a broad spectrum of imaging modalities and body regions. Objective To estimate the frequency with which research imaging IFs generate further clinical action, and the medical benefit/burden of identifying these IFs. Design, Setting, and Participants Retrospective review of subjects undergoing a research imaging exam that was interpreted by a radiologist for IFs in the first quarter of 2004, with 3-year clinical follow-up. An expert panel reviewed IFs generating clinical action to determine medical benefit/burden based on predefined criteria. Main Outcome Measures Frequency of (1) IFs that generated further clinical action by modality, body part, age, gender, and (2) IFs resulting in clear medical benefit or burden. Results 1376 patients underwent 1426 research imaging studies. 40% (567/1426) of exams had at least one IF (1055 total). Risk of an IF increased significantly by age (OR=1.5; [1.4–1.7=95% C.I.] per decade increase). Abdominopelvic CT generated more IFs than other exams (OR=18.9 compared with ultrasound; 9.2% with subsequent clinical action), with CT Thorax and MR brain next (OR=11.9 and 5.9; 2.8% and 2.2% with action, respectively). Overall 6.2% of exams (35/567) with an IF generated clinical action, resulting in clear medical benefit in 1.1% (6/567) and clear medical burden in 0.5% (3/567). In most instances, medical benefit/burden was unclear (4.6%; 26/567). Conclusions The frequency of IFs in imaging research exams varies significantly by imaging modality, body region and age. Research imaging studies at high risk for generating IFs can be identified. Routine evaluation of research images by radiologists may result in identification of IFs in a substantial number of cases and subsequent clinical action to address them in much smaller number. Such clinical action can result in medical

  3. Psychometric properties of the Zarit Caregiver Burden Interview administered to caregivers to patients with Duchenne muscular dystrophy: a Rasch analysis.

    Science.gov (United States)

    Landfeldt, Erik; Mayhew, Anna; Straub, Volker; Bushby, Katharine; Lochmüller, Hanns; Lindgren, Peter

    2017-12-18

    To explore the psychometric properties of the full 22-item English (UK and US) version of the Zarit Caregiver Burden Interview administered to caregivers to patients with Duchenne muscular dystrophy. Caregivers to patients with Duchenne muscular dystrophy from the United Kingdom and the United States, recruited through the TREAT-NMD network, completed the Zarit Caregiver Burden Interview online. The psychometric properties of the Zarit Caregiver Burden Interview were examined using Rasch analysis. A total of 475 caregivers completed the Zarit Caregiver Burden Interview. Model misfit was identified for 9 of 22 items (mean item fit residual 0.061, SD: 2.736) and 13 of 22 items displayed disordered thresholds. The overall item-trait interaction chi-square value was 499 (198 degrees of freedom, p Interview fails to fully operationalize a quantitative conceptualization of caregiver burden among caregivers to patients with Duchenne muscular dystrophy from the United Kingdom and the United States. Further research is needed to understand the psychometric properties of the Zarit Caregiver Burden Interview in other populations and settings. Implications for Rehabilitation Duchenne muscular dystrophy is a terminal disease characterized by progressive muscle degeneration resulting in substantial disability and a significant burden on family caregivers. The Zarit Caregiver Burden Interview is one of the most widely applied measures of caregiver burden. Our Rasch analysis suggests that the Zarit Caregiver Burden Interview is not fit for purpose to measure burden in UK and US caregivers to patients with Duchenne muscular dystrophy. Clinicians and decision-makers should interpret Zarit Caregiver Burden Interview data from these populations with caution.

  4. Caregiver burden among primary caregivers of patients undergoing peripheral blood stem cell transplantation: a cross sectional study.

    Science.gov (United States)

    Akgul, Nur; Ozdemir, Leyla

    2014-08-01

    This study aimed to identify caregiver burden and influencing factors on the burden in primary caregivers of peripheral blood stem cell transplantation patients within 2-12 months following transplant, indicating early recovery period after discharge. This descriptive cross sectional study was carried out at hematopoietic stem cell transplantation outpatient units of three university hospitals in Turkey. A total of 55 patient and caregiver dyads were recruited and interviewed. The data were collected using questionnaires developed by the researchers and caregiver burden was measured with the Zarit Burden Interview. The mean score of Zarit Burden Interview was 28.41 (SD = 13.90). Patients' symptoms including nausea and self depreciation feeling were related to greater caregiver burden. Self-depreciation was referred to feeling undervalued. The mean score of the tool was significantly higher in caregivers who have not been educated beyond primary school and also caregivers who had lower income. Caregivers who supported their patients to fulfill physical needs and who did not receive help for meeting patients' psychological needs had statistically more elevated levels of burden. Moreover, the extent of care giving activities undertaken was positively correlated with caregiver burden scores. While positive impact of the care giving process on family relations decreased caregiver burden; negative effect increased the burden. This study suggests that caregiver burden of primary caregivers caring for peripheral blood stem cell transplantation patients varies by education, income status, and the extent of care giving activities undertaken. Changes in family ties and relations due to care giving effected caregiver burden. Copyright © 2014 Elsevier Ltd. All rights reserved.

  5. Care burden and its predictive factors in parents of newly diagnosed children with acute lymphoblastic leukemia in academic hospitals in China.

    Science.gov (United States)

    Wang, Jingting; Shen, Nanping; Zhang, Xiaoyan; Shen, Min; Xie, Anwei; Howell, Doris; Yuan, Changrong

    2017-12-01

    Caring for children with acute lymphoblastic leukemia (ALL) is a distressing experience for parents without medical training. The experience can lead to parents' care burden. This study explored care burden among parents of children with ALL and its related factors. A total of 130 parents were surveyed with the Zarit Burden Inventory (ZBI), Perceived Social Support Scale (PSSS), Zung's Self-rating Anxiety Scale (SAS), Zung's Self-rating Depression Scale (SDS), Medical Outcome Study Short Form 36 (SF-36), and a study specific demographic information questionnaire. Independent-samples T test, one-way ANOVA, Pearson correlation analysis and multivariate linear regression analysis (stepwise method), and binomial logistic regression were used in data analysis. The mean score of parents' care burden overall was 37.74 ± 16.57, 17 (13.08%) had little or no burden, 57 (43.85%) had mild-to-moderate burden, 44 (33.84%) had moderate-to-severe burden, and 12 (9.23%) had severe burden. Regression analyses indicated daily care time, anxiety, general health, average monthly family income, social support, and number of co-caregivers were factors associated with care burden. These variables accounted for 51% of the variance in care burden. Other demographic information of parents and children, depression, and other dimensions of SF-36 were not related to care burden. The severe burden level was associated the increase risk of emotional distress compared with little or no burden group (OR = 37.500, 95% CI = 4.515-311.348, P = 0.001). The results indicated that care burden in parents of children newly diagnosed with ALL is high. Parents with lower levels of care burden tend to have less daily care time, more co-caregivers, higher income, less anxiety, better general health, and social support. Strategies are needed to help reduce parents' care burden.

  6. Estimating the Burden of Serious Fungal Infections in Uruguay

    Directory of Open Access Journals (Sweden)

    Marina Macedo-Viñas

    2018-03-01

    Full Text Available We aimed to estimate for the first time the burden of fungal infections in Uruguay. Data on population characteristics and underlying conditions were extracted from the National Statistics Institute, the World Bank, national registries, and published articles. When no data existed, risk populations were used to estimate frequencies extrapolating from the literature. Population structure (inhabitants: total 3,444,006; 73% adults; 35% women younger than 50 years. Size of populations at risk (total cases per year: HIV infected 12,000; acute myeloid leukemia 126; hematopoietic stem cell transplantation 30; solid organ transplants 134; COPD 272,006; asthma in adults 223,431; cystic fibrosis in adults 48; tuberculosis 613; lung cancer 1400. Annual incidence estimations per 100,000: invasive aspergillosis, 22.4; candidemia, 16.4; Candida peritonitis, 3.7; Pneumocystis jirovecii pneumonia, 1.62; cryptococcosis, 0.75; severe asthma with fungal sensitization, 217; allergic bronchopulmonary aspergillosis, 165; recurrent Candida vaginitis, 6323; oral candidiasis, 74.5; and esophageal candidiasis, 25.7. Although some under and overestimations could have been made, we expect that at least 127,525 people suffer from serious fungal infections each year. Sporothrichosis, histoplasmosis, paracoccidioidomycosis, and dermatophytosis are known to be frequent but no data are available to make accurate estimations. Given the magnitude of the burden of fungal infections in Uruguay, efforts should be made to improve surveillance, strengthen laboratory diagnosis, and warrant access to first line antifungals.

  7. Metal accumulation in marine bivalves under various tributyltin burdens.

    Science.gov (United States)

    Tang, Chuan-Ho; Lin, Chan-Shing; Wang, Wei-Hsien

    2009-11-01

    In the present study, a field survey was conducted to measure the accumulation of butyltin, Cu, Zn, and Cd in green mussels (Perna viridis) and Pacific oysters (Crassostrea gigas) at the regions along a tributyltin pollution gradient. A negative correlation was found between the tributyltin/total butyltin ratio (0.87-0.31) and tributyltin content (114-5,817 ng/g as tin dry wt) in oysters, while the Cu content (44.2-381 mg/kg dry wt) was positively correlated with the logarithm of tributyltin content during the summer and winter. This suggests that as the tributyltin burden increases, the rates of tributyltin metabolism may be elevated, leading to enhanced Cu accumulation. A similar accumulation pattern for Zn was also found in oysters. In mussels, however, the tributyltin/total butyltin ratio and the Cu and Zn contents remained relatively constant (~ 0.7, 12, and 100 mg/kg dry wt, respectively) regardless of the tributyltin burden. Clearly, the butyltin and Cu/Zn accumulation processes in oysters differ from those in mussels under tributyltin pollution. These observations provide valuable information for those who evaluate or compare tributyltin and/or Cu/Zn pollution using oysters and mussels as bioindicators.

  8. Center for Contaminated Sediments

    Data.gov (United States)

    Federal Laboratory Consortium — The U.S. Army Corps of Engineers Center for Contaminated Sediments serves as a clearinghouse for technology and expertise concerned with contaminated sediments. The...

  9. Contaminated Sites in Iowa

    Data.gov (United States)

    Iowa State University GIS Support and Research Facility — Sites contaminated by hazardous materials or wastes. These sites are those administered by the Contaminated Sites Section of Iowa DNR. Many are sites which are...

  10. EDITORIAL Neglected Diseases: Burden and attention

    African Journals Online (AJOL)

    Preferred Customer

    Neglected diseases are largely infectious diseases that have burdened humanity for centuries, but currently receiving little attention. Infectious diseases in their long histories have resulted in considerable morbidities, disabilities and deformities, often subjecting to stigma. The magnitude of their impact on health and labor.

  11. Schizophrenia: management and family burden | Sebit | Central ...

    African Journals Online (AJOL)

    Schizophrenia: management and family burden. MB Sebit. Abstract. No Abstract. Full Text: EMAIL FULL TEXT EMAIL FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · http://dx.doi.org/10.4314/cajm.v53i9-12.62618 · AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians ...

  12. Tackling the high burden of blindness

    African Journals Online (AJOL)

    ... care delivery, and tackling the five major eye conditions that contribute to most blindness could reduce the current burden of blindness. This would open the window for addressing glaucoma, diabetic retinopathy, and macula degeneration which are the new emerging global consequences of non-communicable diseases.

  13. The Global Burden of Cancer 2013

    NARCIS (Netherlands)

    Fitzmaurice, C.; Geleijnse, J.M.; Naghavi, M.R.; et al.,

    2015-01-01

    Importance Cancer is among the leading causes of death worldwide. Current estimates of cancer burden in individual countries and regions are necessary to inform local cancer control strategies. Objective To estimate mortality, incidence, years lived with disability (YLDs), years of life lost (YLLs),

  14. The dual burden of malnutrition in Colombia.

    Science.gov (United States)

    Sarmiento, Olga L; Parra, Diana C; González, Silvia A; González-Casanova, Inés; Forero, Ana Y; Garcia, Johnattan

    2014-12-01

    Almost all nutrition policies in Colombia currently focus on either undernutrition or obesity, with the predominant emphasis on undernutrition. It is crucial to assess the prevalence of the dual burden of malnutrition in Colombia to better target programs and policies. The aim was to estimate the national prevalence of the dual burden of malnutrition in Colombia at the individual and household levels in children aged malnutrition was defined as the coexistence of overweight and stunting or anemia in the same person or household. In Colombia, low to high prevalences of overweight and obesity (3.4-51.2%) coexist with moderate to high prevalences of anemia (8.1-27.5%) and stunting (13.2%). The observed prevalence of the dual burden was lower than expected. Approximately 5% of households had at least one stunted child aged malnutrition in Colombia are lower than expected. Despite the independence of the occurrence of these conditions, the fact that the dual burden coexists at the national, household, and intraindividual levels suggests that public policies should address both conditions through multiple strategies. It is imperative to evaluate the current nutrition policies to inform malnutrition prevention efforts in Colombia and to share lessons with other countries at a similar stage of nutritional transition. © 2014 American Society for Nutrition.

  15. THE MALARIA BURDEN AND AGRICULTURAL OUTPUT IN ...

    African Journals Online (AJOL)

    iya beji

    on the physical, mental and social well being of the people as well as on the ... direct health burden of malaria by which its victims suffer physical and ..... Audibert, M. (1986), “Agricultural Non-wage Production and Health-Status – A Case.

  16. The Burden of Psychological Symptoms in Gynaecological ...

    African Journals Online (AJOL)

    The Burden of Psychological Symptoms in Gynaecological Conditions among Women in Uyo, Akwa Ibom State, Nigeria. ... Nigerian Journal of Psychiatry ... Background: There is an increasing evidence of significant psychological symptoms (anxiety and depression) among a large percentage of women with gynaecological ...

  17. Economic impacts assessment of pleuropneumonia burden and ...

    African Journals Online (AJOL)

    Contagious bovine pleuropneumonia (CBPP) is a trans-boundary infectious and contagious respiratory disease of cattle caused by Mycoplasma mycoides subsp. mycoides. It is a disease of high economic importance because of its ability to compromise food security. Information on its economic burden in pastoral cattle ...

  18. The burden of serious fungal diseases in Russia.

    Science.gov (United States)

    Klimko, N; Kozlova, Y; Khostelidi, S; Shadrivova, O; Borzova, Y; Burygina, E; Vasilieva, N; Denning, D W

    2015-10-01

    The incidence and prevalence of fungal infections in Russia is unknown. We estimated the burden of fungal infections in Russia according to the methodology of the LIFE program (www.LIFE-worldwide.org). The total number of patients with serious and chronic mycoses in Russia in 2011 was three million. Most of these patients (2,607,494) had superficial fungal infections (recurrent vulvovaginal candidiasis, oral and oesophageal candidiasis with HIV infection and tinea capitis). Invasive and chronic fungal infections (invasive candidiasis, invasive and chronic aspergillosis, cryptococcal meningitis, mucormycosis and Pneumocystis pneumonia) affected 69,331 patients. The total number of adults with allergic bronchopulmonary aspergillosis and severe asthma with fungal sensitisation was 406,082. © 2015 Blackwell Verlag GmbH.

  19. Restoration of contaminated soils

    International Nuclear Information System (INIS)

    Miranda J, Jose Eduardo

    2009-01-01

    A great variety of techniques are used for the restoration of contaminated soils. The contamination is present by both organic and inorganic pollutants. Environmental conditions and soil characteristics should take into account in order to implement a remedial technique. The bioremediation technologies are showed as help to remove a variety of soil contaminants. (author) [es

  20. Urban atmospheric contamination

    International Nuclear Information System (INIS)

    Baldasano Jose, M.

    1997-01-01

    The problems of contamination are not only limited to this century, pale pathology evidences of the effects of the contamination of the air exist in interiors in the health of the old ones; the article mention the elements that configure the problem of the atmospheric contamination, atmospheric pollutants and emission sources, orography condition and effects induced by the urbanization process

  1. Association of PCB, PBDE and PCDD/F body burdens with hormone levels for children in an e-waste dismantling area of Zhejiang Province, China

    Energy Technology Data Exchange (ETDEWEB)

    Xu, Peiwei, E-mail: pwxu@cdc.zj.cn; Lou, Xiaoming; Ding, Gangqiang; Shen, Haitao; Wu, Lizhi; Chen, Zhijian; Han, Jianlong; Han, Guangen; Wang, Xiaofeng, E-mail: zjcdcwxf@gmail.com

    2014-11-15

    Increased electronic waste (e-waste) has raised public concerns regarding exposure to numerous toxic contaminants, particularly polychlorinated biphenyls (PCBs), polybrominated diphenyl ethers (PBDEs) and polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs). In China, the body burdens of PCBs, PBDEs and PCDD/Fs are associated with thyroid hormones in populations from e-waste dismantling sites; however, it is unclear whether this association occurs in children. In this study, we determined the serum levels of PCBs, PBDEs and PCDD/Fs and the endocrine hormones including free triiodothyronine (FT3), total triiodothyronine (TT3), free thyroxine (FT4), total thyroxine (TT4), thyroid-stimulating hormone (TSH), adrenocorticotropic hormone (ACTH), cortisol and growth hormone (GH) in 21 children from an e-waste dismantling area and 24 children from a control area. The results showed that the mean levels of ∑ PCBs and ∑ PBDEs in the exposure group were significantly higher than in the control group (40.56 and 32.09 ng g{sup −1} lipid vs. 20.69 and 8.43 ng g{sup −1} lipid, respectively, p < 0.01 for each), and the mean level of ∑ PCDD/Fs in the exposure group was higher than in the control group, but the difference was not significant (206.17 vs. 160.27 pg g{sup −1} lipid, p > 0.05). For the endocrine hormones, we did not find significant differences between the exposed and control groups, although the mean levels of FT3, TT3, TT4, ACTH, cortisol and GH were higher, whereas the mean levels of FT4 and TSH were lower in the exposed group. The mean level of ∑ PBDEs was positively correlated with the mean levels of ∑ PCBs (r = 0.60, p < 0.05) and ∑ PCDD/Fs (r = 0.61, p < 0.05). Furthermore, the mean level of ∑ PBDEs was positively correlated with ACTH (r = 0.61, p < 0.05). In conclusion, our data suggested that exposure to e-waste dismantling environment increased the body burdens of PCBs and PBDEs in local children and that these contaminants

  2. Association of PCB, PBDE and PCDD/F body burdens with hormone levels for children in an e-waste dismantling area of Zhejiang Province, China

    International Nuclear Information System (INIS)

    Xu, Peiwei; Lou, Xiaoming; Ding, Gangqiang; Shen, Haitao; Wu, Lizhi; Chen, Zhijian; Han, Jianlong; Han, Guangen; Wang, Xiaofeng

    2014-01-01

    Increased electronic waste (e-waste) has raised public concerns regarding exposure to numerous toxic contaminants, particularly polychlorinated biphenyls (PCBs), polybrominated diphenyl ethers (PBDEs) and polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs). In China, the body burdens of PCBs, PBDEs and PCDD/Fs are associated with thyroid hormones in populations from e-waste dismantling sites; however, it is unclear whether this association occurs in children. In this study, we determined the serum levels of PCBs, PBDEs and PCDD/Fs and the endocrine hormones including free triiodothyronine (FT3), total triiodothyronine (TT3), free thyroxine (FT4), total thyroxine (TT4), thyroid-stimulating hormone (TSH), adrenocorticotropic hormone (ACTH), cortisol and growth hormone (GH) in 21 children from an e-waste dismantling area and 24 children from a control area. The results showed that the mean levels of ∑ PCBs and ∑ PBDEs in the exposure group were significantly higher than in the control group (40.56 and 32.09 ng g −1 lipid vs. 20.69 and 8.43 ng g −1 lipid, respectively, p < 0.01 for each), and the mean level of ∑ PCDD/Fs in the exposure group was higher than in the control group, but the difference was not significant (206.17 vs. 160.27 pg g −1 lipid, p > 0.05). For the endocrine hormones, we did not find significant differences between the exposed and control groups, although the mean levels of FT3, TT3, TT4, ACTH, cortisol and GH were higher, whereas the mean levels of FT4 and TSH were lower in the exposed group. The mean level of ∑ PBDEs was positively correlated with the mean levels of ∑ PCBs (r = 0.60, p < 0.05) and ∑ PCDD/Fs (r = 0.61, p < 0.05). Furthermore, the mean level of ∑ PBDEs was positively correlated with ACTH (r = 0.61, p < 0.05). In conclusion, our data suggested that exposure to e-waste dismantling environment increased the body burdens of PCBs and PBDEs in local children and that these contaminants released from the e

  3. Burden of musculoskeletal disorders in the Eastern Mediterranean Region, 1990–2013: findings from the Global Burden of Disease Study 2013

    Science.gov (United States)

    Forouzanfar, Mohammad H; Vollset, Stein Emil; El Bcheraoui, Charbel; Daoud, Farah; Afshin, Ashkan; Charara, Raghid; Khalil, Ibrahim; Higashi, Hideki; Abd El Razek, Mohamed Magdy; Kiadaliri, Aliasghar Ahmad; Alam, Khurshid; Akseer, Nadia; Al-Hamad, Nawal; Ali, Raghib; AlMazroa, Mohammad AbdulAziz; Alomari, Mahmoud A; Al-Rabeeah, Abdullah A; Alsharif, Ubai; Altirkawi, Khalid A; Atique, Suleman; Badawi, Alaa; Barrero, Lope H; Basulaiman, Mohammed; Bazargan-Hejazi, Shahrzad; Bedi, Neeraj; Bensenor, Isabela M; Buchbinder, Rachelle; Danawi, Hadi; Dharmaratne, Samath D; Zannad, Faiez; Farvid, Maryam S; Fereshtehnejad, Seyed-Mohammad; Farzadfar, Farshad; Fischer, Florian; Gupta, Rahul; Hamadeh, Randah Ribhi; Hamidi, Samer; Horino, Masako; Hoy, Damian G; Hsairi, Mohamed; Husseini, Abdullatif; Javanbakht, Mehdi; Jonas, Jost B; Kasaeian, Amir; Khan, Ejaz Ahmad; Khubchandani, Jagdish; Knudsen, Ann Kristin; Kopec, Jacek A; Lunevicius, Raimundas; Abd El Razek, Hassan Magdy; Majeed, Azeem; Malekzadeh, Reza; Mate, Kedar; Mehari, Alem; Meltzer, Michele; Memish, Ziad A; Mirarefin, Mojde; Mohammed, Shafiu; Naheed, Aliya; Obermeyer, Carla Makhlouf; Oh, In-Hwan; Park, Eun-Kee; Peprah, Emmanuel Kwame; Pourmalek, Farshad; Qorbani, Mostafa; Rafay, Anwar; Rahimi-Movaghar, Vafa; Shiri, Rahman; Rahman, Sajjad Ur; Rai, Rajesh Kumar; Rana, Saleem M; Sepanlou, Sadaf G; Shaikh, Masood Ali; Shiue, Ivy; Sibai, Abla Mehio; Silva, Diego Augusto Santos; Singh, Jasvinder A; Skogen, Jens Christoffer; Terkawi, Abdullah Sulieman; Ukwaja, Kingsley N; Westerman, Ronny; Yonemoto, Naohiro; Yoon, Seok-Jun; Younis, Mustafa Z; Zaidi, Zoubida; Zaki, Maysaa El Sayed; Lim, Stephen S; Wang, Haidong; Vos, Theo; Naghavi, Mohsen; Lopez, Alan D; Murray, Christopher J L; Mokdad, Ali H

    2017-01-01

    Objectives We used findings from the Global Burden of Disease Study 2013 to report the burden of musculoskeletal disorders in the Eastern Mediterranean Region (EMR). Methods The burden of musculoskeletal disorders was calculated for the EMR's 22 countries between 1990 and 2013. A systematic analysis was performed on mortality and morbidity data to estimate prevalence, death, years of live lost, years lived with disability and disability-adjusted life years (DALYs). Results For musculoskeletal disorders, the crude DALYs rate per 100 000 increased from 1297.1 (95% uncertainty interval (UI) 924.3–1703.4) in 1990 to 1606.0 (95% UI 1141.2–2130.4) in 2013. During 1990–2013, the total DALYs of musculoskeletal disorders increased by 105.2% in the EMR compared with a 58.0% increase in the rest of the world. The burden of musculoskeletal disorders as a proportion of total DALYs increased from 2.4% (95% UI 1.7–3.0) in 1990 to 4.7% (95% UI 3.6–5.8) in 2013. The range of point prevalence (per 1000) among the EMR countries was 28.2–136.0 for low back pain, 27.3–49.7 for neck pain, 9.7–37.3 for osteoarthritis (OA), 0.6–2.2 for rheumatoid arthritis and 0.1–0.8 for gout. Low back pain and neck pain had the highest burden in EMR countries. Conclusions This study shows a high burden of musculoskeletal disorders, with a faster increase in EMR compared with the rest of the world. The reasons for this faster increase need to be explored. Our findings call for incorporating prevention and control programmes that should include improving health data, addressing risk factors, providing evidence-based care and community programmes to increase awareness. PMID:28209629

  4. Adjustment of a direct method for the determination of man body burden in Pu-239 on by X-ray detection of U-235

    International Nuclear Information System (INIS)

    Boulay, P.

    1968-04-01

    The use of Pu-239 on a larger scale sets a problem about the contamination measurement by aerosol at lung level. A method of direct measurement of Pu-239 lung burden is possible, thanks to the use of a large area window proportional counter. A counter of such pattern, has been especially carried out for this purpose. The adjustment of the apparatus allows an adequate sensibility to detect a contamination at the maximum permissible body burden level. Besides, a method for individual 'internal calibration', with a plutonium mock: the protactinium-233, is reported. (author) [fr

  5. The burden of occupationally-related cutaneous malignant melanoma in Britain due to solar radiation.

    Science.gov (United States)

    Rushton, Lesley; J Hutchings, Sally

    2017-02-14

    Increasing evidence highlights the association of occupational exposure and cutaneous malignant melanoma (CMM). We estimated the burden of CMM and total skin cancer burden in Britain due to occupational solar radiation exposure. Attributable fractions (AF) and numbers were estimated for CMM mortality and incidence using risk estimates from the published literature and national data sources for proportions exposed. We extended existing methods to account for the exposed population age structure. The estimated total AF for CMM is 2.0% (95% CI: 1.4-2.7%), giving 48 (95% CI: 33-64) deaths in (2012) and 241 (95% CI: 168-325) registrations (in 2011) attributable to occupational exposure to solar radiation. Higher exposure and larger numbers exposed led to much higher numbers for men than women. Industries of concern are construction, agriculture, public administration and defence, and land transport. These results emphasise the urgent need to develop appropriate strategies to reduce this burden.

  6. Bacteria killing nanotechnology Bio-Kil effectively reduces bacterial burden in intensive care units.

    Science.gov (United States)

    Hsueh, P-R; Huang, H-C; Young, T-G; Su, C-Y; Liu, C-S; Yen, M-Y

    2014-04-01

    A contaminated hospital environment has been identified as an important reservoir of pathogens causing healthcare-associated infections. This study is to evaluate the efficacy of bacteria killing nanotechnology Bio-Kil on reducing bacterial counts in an intensive care unit (ICU). Two single-bed rooms (S-19 and S-20) in the ICU were selected from 7 April to 27 May 2011. Ten sets of new textiles (pillow cases, bed sheets, duvet cover, and patient clothing) used by patients in the two single-bed rooms were provided by the sponsors. In the room S-20, the 10 sets of new textiles were washed with Bio-Kil; the room walls, ceiling, and air-conditioning filters were treated with Bio-Kil; and the surfaces of instruments (respirator, telephone, and computer) were covered with Bio-Kil-embedded silicon pads. Room S-19 served as the control. We compared the bacterial count on textiles and environment surfaces as well as air samples between the two rooms. A total of 1,364 samples from 22 different sites in each room were collected. The mean bacterial count on textiles and environmental surfaces in room S-20 was significantly lower than that in room S-19 (10.4 vs 49.6 colony-forming units [CFU]/100 cm(2); P < 0.001). Room S-20 had lower bacterial counts in air samples than room S-19 (33.4-37.6 vs 21.6-25.7 CFU/hour/plate; P < 0.001). The density of microbial isolations was significantly greater among patients admitted to room S-19 than those to room S-20 (9.15 vs 5.88 isolates per 100 patient-days, P < 0.05). Bio-Kil can significantly reduce bacterial burden in the environment of the ICU.

  7. Implementation guide of internal contamination control

    International Nuclear Information System (INIS)

    Balter, Henia; Savio, Eduardo; Souto, Beatriz

    1994-01-01

    A review of current methods of contamination control for radioisotopes 131I, 125I and 99mTc, periodic control of personnel exposed to radiation.Maximum permissible body burden (Mpbb) for each radionuclide,radiotoxicity as danger of internal contamination directly related with Let, type of radiation,Ali values for various radionuclides and external irradiation as an opposed factor.Effective half life,examples, 99mTc in urine,iodine in thyroid caption, 99m Tc absorption by skin and mouth. Procedure of control and calculation by measurement of urine samples in a gamma spectrometer. Iodine thyroid caption by monitoring of thyroid with a solid NaI(TI)scintillator taking as background radiation the activity of upper leg muscle. Standard solutions are prepared to fill a thyroid phantoms.Results must not be higher than Mpbb of corresponding radionuclide.Bibliography

  8. Knowns and unknowns on burden of disease due to chemicals: a systematic review

    Directory of Open Access Journals (Sweden)

    Bertollini Roberto

    2011-01-01

    Full Text Available Abstract Background Continuous exposure to many chemicals, including through air, water, food, or other media and products results in health impacts which have been well assessed, however little is known about the total disease burden related to chemicals. This is important to know for overall policy actions and priorities. In this article the known burden related to selected chemicals or their mixtures, main data gaps, and the link to public health policy are reviewed. Methods A systematic review of the literature for global burden of disease estimates from chemicals was conducted. Global disease due to chemicals was estimated using standard methodology of the Global Burden of Disease. Results In total, 4.9 million deaths (8.3% of total and 86 million Disability-Adjusted Life Years (DALYs (5.7% of total were attributable to environmental exposure and management of selected chemicals in 2004. The largest contributors include indoor smoke from solid fuel use, outdoor air pollution and second-hand smoke, with 2.0, 1.2 and 0.6 million deaths annually. These are followed by occupational particulates, chemicals involved in acute poisonings, and pesticides involved in self-poisonings, with 375,000, 240,000 and 186,000 annual deaths, respectively. Conclusions The known burden due to chemicals is considerable. This information supports decision-making in programmes having a role to play in reducing human exposure to toxic chemicals. These figures present only a number of chemicals for which data are available, therefore, they are more likely an underestimate of the actual burden. Chemicals with known health effects, such as dioxins, cadmium, mercury or chronic exposure to pesticides could not be included in this article due to incomplete data and information. Effective public health interventions are known to manage chemicals and limit their public health impacts and should be implemented at national and international levels.

  9. Knowns and unknowns on burden of disease due to chemicals: a systematic review

    Science.gov (United States)

    2011-01-01

    Background Continuous exposure to many chemicals, including through air, water, food, or other media and products results in health impacts which have been well assessed, however little is known about the total disease burden related to chemicals. This is important to know for overall policy actions and priorities. In this article the known burden related to selected chemicals or their mixtures, main data gaps, and the link to public health policy are reviewed. Methods A systematic review of the literature for global burden of disease estimates from chemicals was conducted. Global disease due to chemicals was estimated using standard methodology of the Global Burden of Disease. Results In total, 4.9 million deaths (8.3% of total) and 86 million Disability-Adjusted Life Years (DALYs) (5.7% of total) were attributable to environmental exposure and management of selected chemicals in 2004. The largest contributors include indoor smoke from solid fuel use, outdoor air pollution and second-hand smoke, with 2.0, 1.2 and 0.6 million deaths annually. These are followed by occupational particulates, chemicals involved in acute poisonings, and pesticides involved in self-poisonings, with 375,000, 240,000 and 186,000 annual deaths, respectively. Conclusions The known burden due to chemicals is considerable. This information supports decision-making in programmes having a role to play in reducing human exposure to toxic chemicals. These figures present only a number of chemicals for which data are available, therefore, they are more likely an underestimate of the actual burden. Chemicals with known health effects, such as dioxins, cadmium, mercury or chronic exposure to pesticides could not be included in this article due to incomplete data and information. Effective public health interventions are known to manage chemicals and limit their public health impacts and should be implemented at national and international levels. PMID:21255392

  10. Burden of disease from toxic waste sites in India, Indonesia, and the Philippines in 2010.

    Science.gov (United States)

    Chatham-Stephens, Kevin; Caravanos, Jack; Ericson, Bret; Sunga-Amparo, Jennifer; Susilorini, Budi; Sharma, Promila; Landrigan, Philip J; Fuller, Richard

    2013-07-01

    Prior calculations of the burden of disease from toxic exposures have not included estimates of the burden from toxic waste sites due to the absence of exposure data. We developed a disability-adjusted life year (DALY)-based estimate of the disease burden attributable to toxic waste sites. We focused on three low- and middle-income countries (LMICs): India, Indonesia, and the Philippines. Sites were identified through the Blacksmith Institute's Toxic Sites Identification Program, a global effort to identify waste sites in LMICs. At least one of eight toxic chemicals was sampled in environmental media at each site, and the population at risk estimated. By combining estimates of disease incidence from these exposures with population data, we calculated the DALYs attributable to exposures at each site. We estimated that in 2010, 8,629,750 persons were at risk of exposure to industrial pollutants at 373 toxic waste sites in the three countries, and that these exposures resulted in 828,722 DALYs, with a range of 814,934-1,557,121 DALYs, depending on the weighting factor used. This disease burden is comparable to estimated burdens for outdoor air pollution (1,448,612 DALYs) and malaria (725,000 DALYs) in these countries. Lead and hexavalent chromium collectively accounted for 99.2% of the total DALYs for the chemicals evaluated. Toxic waste sites are responsible for a significant burden of disease in LMICs. Although some factors, such as unidentified and unscreened sites, may cause our estimate to be an underestimate of the actual burden of disease, other factors, such as extrapolation of environmental sampling to the entire exposed population, may result in an overestimate of the burden of disease attributable to these sites. Toxic waste sites are a major, and heretofore underrecognized, global health problem.

  11. Measuring Burden of Diseases in a Rapidly Developing Economy: State of Qatar

    Science.gov (United States)

    Bener, Abdulbari; Zirie, Mahmoud A.; Kim, Eun-Jung; Buz, Rama Al; Zaza, Mouayyad; Al-Nufal, Mohammed; Basha, Basma; Hillhouse, Edward W; Riboli, Elio

    2013-01-01

    Background: The Global Burden of Disease (GBD) study has provided a conceptual and methodological framework to quantify and compare the health of populations. Aim: The objective of the study was to assess the national burden of disease in the population of Qatar using the disability-adjusted life year (DALYs) as a measure of disability. Methods: We adapted the methodology described by the World Health Organization for conducting burden of disease to calculate years of life lost due to premature mortality (YLL), years lived with disability (YLD) and disability adjusted life years (DALYs). The study was conducted during the period from November 2011 to October 2012. Results:: The study findings revealed that ischemic heart disease (11.8%) and road traffic accidents (10.3%) were the two leading causes of burden of diseases in Qatar in 2010. The burden of diseases among men (222.04) was found three times more than of women's (71.85). Of the total DALYs, 72.7% was due to non fatal health outcomes and 27.3% was due to premature death. For men, chronic diseases like ischemic heart disease (15.7%) and road traffic accidents (13.7%) accounted great burden and an important source of lost years of healthy life. For women, birth asphyxia and birth trauma (12.6%) and abortion (4.6%) were the two leading causes of disease burden. Conclusion:: The results of the study have shown that the national health priority areas should cover cardiovascular diseases, road traffic accidents and mental health. The burden of diseases among men was three times of women's. PMID:23445701

  12. The Economic Burden Attributable to a Child’s Inpatient Admission for Diarrheal Disease in Rwanda

    Science.gov (United States)

    Ngabo, Fidele; Mvundura, Mercy; Gazley, Lauren; Gatera, Maurice; Rugambwa, Celse; Kayonga, Eugene; Tuyishime, Yvette; Niyibaho, Jeanne; Mwenda, Jason M.; Donnen, Philippe; Lepage, Philippe; Binagwaho, Agnes; Atherly, Deborah

    2016-01-01

    Background Diarrhea is one of the leading causes of childhood morbidity and mortality. Hospitalization for diarrhea can pose a significant burden to health systems and households. The objective of this study was to estimate the economic burden attributable to hospitalization for diarrhea among children less than five years old in Rwanda. These data can be used by decision-makers to assess the impact of interventions that reduce diarrhea morbidity, including rotavirus vaccine introduction. Methods This was a prospective costing study where medical records and hospital bills for children admitted with diarrhea at three hospitals were collected to estimate resource use and costs. Hospital length of stay was calculated from medical records. Costs incurred during the hospitalization were abstracted from the hospital bills. Interviews with the child’s caregivers provided data to estimate household costs which included transport costs and lost income. The portion of medical costs borne by insurance and household were reported separately. Annual economic burden before and after rotavirus vaccine introduction was estimated by multiplying the reported number of diarrhea hospitalizations in public health centers and district hospitals by the estimated economic burden per hospitalization. All costs are presented in 2014 US$. Results Costs for 203 children were analyzed. Approximately 93% of the children had health insurance coverage. Average hospital length of stay was 5.3 ± 3.9 days. Average medical costs for each child for the illness resulting in a hospitalization were $44.22 ± $23.74 and the total economic burden was $101, of which 65% was borne by the household. For households in the lowest income quintile, the household costs were 110% of their monthly income. The annual economic burden to Rwanda attributable to diarrhea hospitalizations ranged from $1.3 million to $1.7 million before rotavirus vaccine introduction. Conclusion Households often bear the largest share

  13. The Economic Burden Attributable to a Child's Inpatient Admission for Diarrheal Disease in Rwanda.

    Science.gov (United States)

    Ngabo, Fidele; Mvundura, Mercy; Gazley, Lauren; Gatera, Maurice; Rugambwa, Celse; Kayonga, Eugene; Tuyishime, Yvette; Niyibaho, Jeanne; Mwenda, Jason M; Donnen, Philippe; Lepage, Philippe; Binagwaho, Agnes; Atherly, Deborah

    2016-01-01

    Diarrhea is one of the leading causes of childhood morbidity and mortality. Hospitalization for diarrhea can pose a significant burden to health systems and households. The objective of this study was to estimate the economic burden attributable to hospitalization for diarrhea among children less than five years old in Rwanda. These data can be used by decision-makers to assess the impact of interventions that reduce diarrhea morbidity, including rotavirus vaccine introduction. This was a prospective costing study where medical records and hospital bills for children admitted with diarrhea at three hospitals were collected to estimate resource use and costs. Hospital length of stay was calculated from medical records. Costs incurred during the hospitalization were abstracted from the hospital bills. Interviews with the child's caregivers provided data to estimate household costs which included transport costs and lost income. The portion of medical costs borne by insurance and household were reported separately. Annual economic burden before and after rotavirus vaccine introduction was estimated by multiplying the reported number of diarrhea hospitalizations in public health centers and district hospitals by the estimated economic burden per hospitalization. All costs are presented in 2014 US$. Costs for 203 children were analyzed. Approximately 93% of the children had health insurance coverage. Average hospital length of stay was 5.3 ± 3.9 days. Average medical costs for each child for the illness resulting in a hospitalization were $44.22 ± $23.74 and the total economic burden was $101, of which 65% was borne by the household. For households in the lowest income quintile, the household costs were 110% of their monthly income. The annual economic burden to Rwanda attributable to diarrhea hospitalizations ranged from $1.3 million to $1.7 million before rotavirus vaccine introduction. Households often bear the largest share of the economic burden attributable to

  14. Measuring the burden of preventable diabetic hospitalisations in the Mexican Institute of Social Security (IMSS).

    Science.gov (United States)

    Lugo-Palacios, David G; Cairns, John; Masetto, Cynthia

    2016-08-02

    The prevalence of diabetes among adults in Mexico has increased markedly from 6.7 % in 1994 to 14.7 % in 2015. Although the main diabetic complications can be prevented or delayed with timely and effective primary care, a high percentage of diabetic patients have developed them imposing an important preventable burden on Mexican society and on the health system. This paper estimates the financial and health burden caused by potentially preventable hospitalisations due to diabetic complications in hospitals operated by the largest social security institution in Latin America, the Mexican Institute of Social Security (IMSS), in the period 2007-2014. Hospitalisations in IMSS hospitals whose main cause was a diabetic complication were identified. The financial burden was estimated using IMSS diagnostic-related groups. To estimate the health burden, DALYs were computed under the assumption that patients would not have experienced complications if they had received timely and effective primary care. A total of 322,977 hospitalisations due to five diabetic complications were identified during the period studied, of which hospitalisations due to kidney failure and diabetic foot represent 78 %. The financial burden increased by 8.4 % in real terms between 2007 and 2014. However, when measured as cost per IMSS affiliate, it decreased by 11.3 %. The health burden had an overall decrease of 13.6 % and the associated DALYs in 2014 reached 103,688. Resources used for the hospital treatment of diabetic complications are then not available for other health care interventions. In order to prevent these hospitalisations more resources might need to be invested in primary care; the first step could be to consider the financial burden of these hospitalisations as a potential target for switching resources from hospital care to primary care services. However, more evidence of the effectiveness of different primary care interventions is needed to know how much of the burden could

  15. The Economic Burden Attributable to a Child's Inpatient Admission for Diarrheal Disease in Rwanda.

    Directory of Open Access Journals (Sweden)

    Fidele Ngabo

    Full Text Available Diarrhea is one of the leading causes of childhood morbidity and mortality. Hospitalization for diarrhea can pose a significant burden to health systems and households. The objective of this study was to estimate the economic burden attributable to hospitalization for diarrhea among children less than five years old in Rwanda. These data can be used by decision-makers to assess the impact of interventions that reduce diarrhea morbidity, including rotavirus vaccine introduction.This was a prospective costing study where medical records and hospital bills for children admitted with diarrhea at three hospitals were collected to estimate resource use and costs. Hospital length of stay was calculated from medical records. Costs incurred during the hospitalization were abstracted from the hospital bills. Interviews with the child's caregivers provided data to estimate household costs which included transport costs and lost income. The portion of medical costs borne by insurance and household were reported separately. Annual economic burden before and after rotavirus vaccine introduction was estimated by multiplying the reported number of diarrhea hospitalizations in public health centers and district hospitals by the estimated economic burden per hospitalization. All costs are presented in 2014 US$.Costs for 203 children were analyzed. Approximately 93% of the children had health insurance coverage. Average hospital length of stay was 5.3 ± 3.9 days. Average medical costs for each child for the illness resulting in a hospitalization were $44.22 ± $23.74 and the total economic burden was $101, of which 65% was borne by the household. For households in the lowest income quintile, the household costs were 110% of their monthly income. The annual economic burden to Rwanda attributable to diarrhea hospitalizations ranged from $1.3 million to $1.7 million before rotavirus vaccine introduction.Households often bear the largest share of the economic burden

  16. Plant protection under conditions of radioactive contamination of agricultural lands

    International Nuclear Information System (INIS)

    Filipas, A.S.; Oulianenko, L.N.; Pimenov, E.P.

    1995-01-01

    Increasing influence of anthropogenic contaminants as well as substantiated risk of the action of ionizing radiation on agroecosystems suggest the necessity of studying both the state of separate components of cenosis and search for methods on retention of ecosystem stability as a whole. In this case it should be taken into account that by retention of resistance of living organisms to the action of stress agents not only genetically conditioned potential but induction of protective reactions at the expense of ecogene action is of deciding significance as well. Protection of agricultural plants on the territories subjected to radioactive contamination resulting from the ChNPP accident brings attention of research works to a series of problems, the main one being the minimization of pesticide use by the total ecologization of technological processes, in plant growing. But an ordinary discontinuance of conducting protective chemical measures leads to growth in the number of harmful organisms in crop sowings and as a consequence an increase of crop loss and decrease of its quality. It is possible to solve this problem by introduction of measures increasing the resistance of agricultural plants to the action of unfavorable factors of environment. Application of biologically active substances (BAS) of natural and synthetic nature for incrustation of seeds fits into these methods. For the territories with increased content of radionuclides and especially by their rehabilitation the methods of preventive treatments directed to retarding the development of harmful organisms in crop sowings and excluding subsequent technological operations on chemical protection of sowings takes on special significance as it is directly connected with the problem of radiation burden on workers of agroindustrial complex

  17. Melting of contaminated metallic waste

    International Nuclear Information System (INIS)

    Lee, Y.-S.; Cheng, S.-Y.; Kung, H.-T.; Lin, L.-F.

    2004-01-01

    Approximately 100 tons of contaminated metallic wastes were produced each year due to maintenance for each TPC's nuclear power reactor and it was roughly estimated that there will be 10,000 tons of metallic scraps resulted from decommissioning of each reactor in the future. One means of handling the contaminated metal is to melt it. Melting process owns not only volume reduction which saves the high cost of final disposal but also resource conservation and recycling benefits. Melting contaminated copper and aluminum scraps in the laboratory scale have been conducted at INER. A total of 546 kg copper condenser tubes with a specific activity of about 2.7 Bq/g was melted in a vacuum induction melting facility. Three types of products, ingot, slag and dust were derived from the melting process, with average activities of 0.10 Bq/g, 2.33 Bq/g and 84.3 Bq/g respectively. After the laboratory melting stage, a pilot plant with a 500 kg induction furnace is being designed to melt the increasingly produced contaminated metallic scraps from nuclear facilities and to investigate the behavior of different radionuclides during melting. (author)

  18. Metallic Burden of Deciduous Teeth and Childhood Behavioral Deficits

    Directory of Open Access Journals (Sweden)

    Tony J.H. Chan

    2015-06-01

    Full Text Available Attention Deficit/Hyperactivity Disorder (ADHD affects 5%–8% of children in the U.S. (10% of males and 4% of females. The contributions of multiple metal exposures to the childhood behavioral deficits are unclear, although particular metals have been implicated through their neurotoxicity. The objective of this study was to test the hypothesis that the body burden of Mn is positively correlated with ADHD symptoms. We also investigated the putative roles of Ca, Fe, Pb, and Hg. We collected shed molars from 266 children (138 boys and 128 girls who lost a tooth between 11 and 13 years of age. The molars were analyzed for metals using ICP-OES. The third grade teacher of each child completed the Teacher’s Disruptive Behavior Disorders Rating Scale (DBD to produce a score for “Total Disruptive Behavior” and subscale scores for “Attention Deficit Hyperactivity Disorder”, Hyperactivity/Impulsivity, Inattention, and Oppositional/Defiant. The mean Mn, Fe, Pb and Ca concentrations found in teeth was 6.1 ± 5.7 µg/g, 22.7 ± 24.1 µg/g, 0.9 ± 1.4 µg/g, and 6.0 × 105 ± 1.6 × 105 µg/g, respectively. Hg was not detected. No significant association was found between Mn and behavioral deficits. Ca was significantly negatively associated, and Pb showed a significant positive association with Hyperactivity/Impulsivity, Inattention, and Oppositional/Defiant Disorders. These findings call into question the putative independent association of manganese exposure and behavioral deficits in children, when the balance of other metallic burden, particularly Ca and Pb burdens play significant roles.

  19. Estimating Cryptosporidium and Giardia disease burdens for children drinking untreated groundwater in a rural population in India.

    Directory of Open Access Journals (Sweden)

    Miles E Daniels

    2018-01-01

    Full Text Available In many low-income settings, despite improvements in sanitation and hygiene, groundwater sources used for drinking may be contaminated with enteric pathogens such as Cryptosporidium and Giardia, which remain important causes of childhood morbidity. In this study, we examined the contribution of diarrhea caused by Cryptosporidium and Giardia found in groundwater sources used for drinking to the total burden of diarrheal disease among children < 5 in rural India.We studied a population of 3,385 children < 5 years of age in 100 communities of Puri District, Odisha, India. We developed a coupled quantitative microbial risk assessment (QMRA and susceptible-infected-recovered (SIR population model based on observed levels of Cryptosporidium and Giardia in improved groundwater sources used for drinking and compared the QMRA-SIR estimates with independently measured all-cause (i.e., all fecal-oral enteric pathogens and exposure pathways child diarrhea prevalence rates observed in the study population during two monsoon seasons (2012 and 2013. We used site specific and regional studies to inform assumptions about the human pathogenicity of the Cryptosporidium and Giardia species present in local groundwater. In all three human pathogenicity scenarios evaluated, the mean daily risk of Cryptosporidium or Giardia infection (0.06-1.53%, far exceeded the tolerable daily risk of infection from drinking water in the US (< 0.0001%. Depending on which protozoa species were present, median estimates of daily child diarrhea prevalence due to either Cryptosporidium or Giardia infection from drinking water was as high as 6.5% or as low as < 1% and accounted for at least 2.9% and as much as 65.8% of the all-cause diarrhea disease burden measured in children < 5 during the study period. Cryptosporidium tended to account for a greater share of estimated waterborne protozoa infections causing diarrhea than did Giardia. Diarrhea prevalence estimates for waterborne

  20. Global burden of human mycetoma: a systematic review and meta-analysis.

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    Wendy W J van de Sande

    2013-11-01

    Full Text Available Mycetoma is a chronic infectious disease of the subcutaneous tissue with a high morbidity. This disease has been reported from countries between 30°N and 15°S since 1840 but the exact burden of disease is not known. It is currently unknown what the incidence, prevalence and the number of reported cases per year per country is. In order to estimate what the global burden of mycetoma is, a meta-analysis was performed. In total 50 studies were included, which resulted in a total of 8763 mycetoma cases. Most cases were found in men between 11 and 40 years of age. The foot was most commonly affected. Most cases were reported from Mexico, Sudan and India. Madurella mycetomatis was the most prevalent causative agent world-wide, followed by Actinomadura madurae, Streptomyces somaliensis, Actinomadura pelletieri, Nocardia brasiliensis and Nocardia asteroides. Although this study represents a first indication of the global burden on mycetoma, the actual burden is probably much higher. In this study only cases reported to literature could be used and most of these cases were found by searching archives from a single hospital in a single city of that country. By erecting (international surveillance programs a more accurate estimation of the global burden on mycetoma can be obtained.

  1. Measuring the Environmental Burden of Disease in South Korea: A Population-Based Study

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    Seok-Jun Yoon

    2015-07-01

    Full Text Available Background: This study attempted to measure the environmental burden of disease by examining mortality and disability rates in South Korea, permitting international comparisons. Methods: Disability-adjusted life years (DALY was used to analyze data from public records. Years of life lost (YLL and years lost to disability (YLD were measured in terms of incidence rate and number of deaths. Attributable risks were based on those for WHO Western Pacific Regions. For air pollution, attributable risk was calculated using local PM10 levels and relative risk. Results: The total Korean environmental burden of disease was 17.98 per 1000 persons and the most serious risk factor was air pollution, at 6.89per1000 persons. Occupation was the second highest contributing factor, at 3.29 per 1000 persons, followed by indoor air pollution at 2.91 per 1000 persons. The DALY of air-pollution (indoor and outdoor was 9.80 per 1000 persons, accounting for more than half of the total environmental burden of disease. The burden of chronic obstructive pulmonary disease, lung cancer, and asthma were 4.07, 3.16, and 1.96 per 1000 persons, respectively. Conclusions: Respiratory illnesses comprised most of the disease burden, the majority of which was linked to air pollution. The present results are important as they could be used to make evidence-based decisions regarding the management of diseases and environmental-risk factors.

  2. [Ranking of radionuclides and pathways according to their contribution to the dose burden to the population resulting from NPP releases].

    Science.gov (United States)

    Spiridonov, S I; Karpenko, E I; Sharpan, L A

    2013-01-01

    Approaches are described towards estimating the consequences of radioactive contamination of ecosystems by nuclear fuel cycle enterprises with the rationale for the optimal specification level for nuclear power plants (NPP) operating in the normal mode. Calculations are made based on the initial data of the IAEA project, INPRO ENV, dealing with the ranking of radionuclides escaping to the environment from the operating NPPs. Influence of various factors on rankings of radionuclides and pathways of public exposure is demon- strated. An important factor is the controlled radionuclide composition of atmospheric NPP releases. It has been found that variation in the dose coefficients for some radionuclides leads to significant changes not only in the ranking results but also in the estimates of total dose burdens. Invariability is shown of the estimation concerning the greatest contribution of the peroral route to the population dose of irradiation in the situation considered. A conclusion was drawn on the need of taking into consideration uncertainties of different factors when comparing effects on the environment from enterprises of conventional and innovative nuclear fuel cycles.

  3. The relationship between burden and well-being among caregivers of Italian people diagnosed with severe neuromotor and cognitive disorders.

    Science.gov (United States)

    Fianco, Andrea; Sartori, Raffaela D G; Negri, Luca; Lorini, Saverio; Valle, Giovanni; Delle Fave, Antonella

    2015-04-01

    In studies on caregiving, high levels of perceived burden are commonly considered as synonymous with poor well-being. This study aimed at better disentangling the relationship between burden and well-being dimensions through their joint investigation. To this purpose, perceived well-being and social resources were evaluated among caregivers reporting different levels of burden. Participants were 91 caregivers (mean age=50.4; SD=9.6), parents of people diagnosed with severe neuromotor and cognitive disorders. Participants completed a semi-structured interview and a set of scaled questionnaires: Caregiver Burden Inventory (CBI), Satisfaction with Life Scale, Positive and Negative Affect Schedule, Depression Anxiety Stress Scale, Eudaimonic and Hedonic Happiness Investigation, Resilience Scale for Adults, and Multidimensional Scale of Perceived Social Support. Participants were divided into two groups according to their perceived burden level, assessed through CBI. In both groups, the subjective components of burden accounted for the major fraction of the total burden level. Participants perceiving high burden reported higher levels of depression related emotions, lower life satisfaction and lower resilience than participants perceiving low burden. No group difference emerged in perceived meaningfulness and social support. A regression analysis showed that the best predictor of perceived burden was life satisfaction, followed to a lesser extent by resilience, while depression related emotions did not provide significant contribution. Findings suggest that the joint assessment of burden and well-being dimensions, that are co-existing in caregivers' experience, allow for the identification of personal and relational resources that can be usefully included in interventions addressed to caregivers. Copyright © 2015 Elsevier Ltd. All rights reserved.

  4. Global Epidemiology and Burden of Schizophrenia

    DEFF Research Database (Denmark)

    Charlson, Fiona J; Ferrari, Alize J; Santomauro, Damian F

    2018-01-01

    countries. Method: We conducted a systematic review to identify studies reporting the prevalence, incidence, remission, and/or excess mortality associated with schizophrenia. Reported estimates which met our inclusion criteria were entered into a Bayesian meta-regression tool used in GBD 2016 to derive...... prevalence for 20 age groups, 7 super-regions, 21 regions, and 195 countries and territories. Burden of disease estimates were derived for acute and residual states of schizophrenia by multiplying the age-, sex-, year-, and location-specific prevalence by 2 disability weights representative of the disability......-standardized point prevalence rates did not vary widely across countries or regions. Globally, prevalent cases rose from 13.1 (95% UI: 11.6-14.8) million in 1990 to 20.9 (95% UI: 18.5-23.4) million cases in 2016. Schizophrenia contributes 13.4 (95% UI: 9.9-16.7) million years of life lived with disability to burden...

  5. Quantifying the Burden of Writing Research Articles in a Second Language: Data from Mexican Scientists

    Science.gov (United States)

    Hanauer, David I.; Englander, Karen

    2011-01-01

    This article provides quantitative data to establish the relative, perceived burden of writing research articles in English as a second language. Previous qualitative research has shown that scientists writing English in a second language face difficulties but has not established parameters for the degree of this difficulty. A total of 141…

  6. The global burden of alveolar echinococcosis.

    Directory of Open Access Journals (Sweden)

    Paul R Torgerson

    Full Text Available BACKGROUND: Human alveolar echinococcosis (AE is known to be common in certain rural communities in China whilst it is generally rare and sporadic elsewhere. The objective of this study was to provide a first estimate of the global incidence of this disease by country. The second objective was to estimate the global disease burden using age and gender stratified incidences and estimated life expectancy with the disease from previous results of survival analysis. Disability weights were suggested from previous burden studies on echinococcosis. METHODOLOGY/PRINCIPAL FINDINGS: We undertook a detailed review of published literature and data from other sources. We were unable to make a standardised systematic review as the quality of the data was highly variable from different countries and hence if we had used uniform inclusion criteria many endemic areas lacking data would not have been included. Therefore we used evidence based stochastic techniques to model uncertainty and other modelling and estimating techniques, particularly in regions where data quality was poor. We were able to make an estimate of the annual global incidence of disease and annual disease burden using standard techniques for calculation of DALYs. Our studies suggest that there are approximately 18,235 (CIs 11,900-28,200 new cases of AE per annum globally with 16,629 (91% occurring in China and 1,606 outside China. Most of these cases are in regions where there is little treatment available and therefore will be fatal cases. Based on using disability weights for hepatic carcinoma and estimated age and gender specific incidence we were able to calculate that AE results in a median of 666,434 DALYs per annum (CIs 331,000-1.3 million. CONCLUSIONS/SIGNIFICANCE: The global burden of AE is comparable to several diseases in the neglected tropical disease cluster and is likely to be one of the most important diseases in certain communities in rural China on the Tibetan plateau.

  7. Economic Burden of Diabetes in Urban Indians

    OpenAIRE

    Chandra, Pablo; Gogate, Bageshri; Gogate, Parikshit; Thite, Nilesh; Mutha, Abhay; Walimbe, Amit

    2014-01-01

    Purpose : To find out the average economic burden of medical care on a patient with diabetes in Pune, India Methods : A semi-open ended questionnaire followed by interview was conducted with patients attending diabetes and ophthalmic out-patient departments. They were asked regarding the duration of diabetes, methods undertaken for blood sugar control and the amount they spend on consultations, laboratory tests, medicines and procedures if any within past year. Expenditure was classified as d...

  8. Burden of arrhythmia in recreational marijuana users.

    Science.gov (United States)

    Desai, Rupak; Patel, Upenkumar; Deshmukh, Abhishek; Sachdeva, Rajesh; Kumar, Gautam

    2018-03-27

    Marijuana or Cannabis is extensively used as a recreational substance globally. Case reports have reported cardiac arrhythmias immediately following recreational marijuana use. However, the burden of arrhythmias in hospitalized marijuana users have not been evaluated through prospective or cross-sectional studies. Therefore, we planned to measure temporal trends of the frequency of arrhythmias in hospitalized marijuana users using National Inpatient Sample (NIS) database in the United States. Copyright © 2017 Elsevier B.V. All rights reserved.

  9. Prevalance of aflatoxin contamination in maize and groundnut in Ghana: Population structure, distribution, and toxigenicity of the causal agents

    Science.gov (United States)

    Aflatoxin contamination in maize and groundnut is perennial in Ghana with substantial health and economic burden on the population. The present study examined for the first time the prevalence of aflatoxin contamination in maize and groundnut in major producing regions across three agroecological zo...

  10. Spatial and temporal trends of contaminants in terrestrial biota from the Canadian Arctic

    Energy Technology Data Exchange (ETDEWEB)

    Gamberg, Mary [Gamberg Consulting, Box 10460, Whitehorse, YT, Y1A 7A1 (Canada)]. E-mail: mary.gamberg@northwestel.net; Braune, Birgit [Canadian Wildlife Service, Environment Canada, National Wildlife Research Centre, Carleton University, Raven Road, Ottawa, ON, K1A 0H3 (Canada); Davey, Eric [Athabasca Tribal Council, Environmental Affairs, 9206 McCormick Drive, Fort McMurray, AB, T9H 1C7 (Canada); Elkin, Brett [Northwest Territories Department of Resources, Wildlife and Economic Development, Yellowknife, NT X1A 3S8 (Canada); Hoekstra, Paul F. [Department of Environmental Biology, University of Guelph, Guelph, ON, N1G 2W1 (Canada); Kennedy, David [Northwest Territories Department of Resources, Wildlife and Economic Development, Yellowknife, NT X1A 3S8 (Canada); Macdonald, Colin [Northern Environmental Consulting, Pinawa, MB, R0E 1L0 (Canada); Muir, Derek [National Water Research Institute, Environment Canada, Burlington, ON, L7R 4A6 (Canada); Nirwal, Amar [Department of Chemistry and Chemical Engineering, Royal Military College of Canada, Box 17000, Stn Forces, Kingston, ON, K7K 7B4 (Canada); Wayland, Mark [Canadian Wildlife Service, Environment Canada, Prairie and Northern Region, 115 Perimeter Road, Saskatoon, SK, S7N 0X4 (Canada); Zeeb, Barbara [Department of Chemistry and Chemical Engineering, Royal Military College of Canada, Box 17000, Stn Forces, Kingston, ON, K7K 7B4 (Canada)

    2005-12-01

    Contaminants in the Canadian Arctic have been studied over the last twelve years under the guidance of the Northern Contaminants Program. This paper summarizes results from that program from 1998 to 2003 with respect to terrestrial animals in the Canadian Arctic. The arctic terrestrial environment has few significant contaminant issues, particularly when compared with freshwater and marine environments. Both current and historical industrial activities in the north may have a continuing effect on biota in the immediate area, but effects tend to be localized. An investigation of arctic ground squirrels at a site in the Northwest Territories that had historically received applications of DDT concluded that DDT in arctic ground squirrels livers was the result of contamination and that this is an indication of the continuing effect of a local point source of DDT. Arsenic concentrations were higher in berries collected from areas around gold mines in the Northwest Territories than from control sites, suggesting that gold mining may significantly affect arsenic levels in berries in the Yellowknives Dene traditional territory. Although moose and caribou from the Canadian Arctic generally carry relatively low contaminant burdens, Yukon moose had high renal selenium concentrations, and moose and some woodland caribou from the same area had high renal cadmium levels, which may put some animals at risk of toxicological effects. Low hepatic copper levels in some caribou herds may indicate a shortage of copper for metabolic demands, particularly for females. Similarities in patterns of temporal fluctuations in renal element concentrations for moose and caribou suggest that environmental factors may be a major cause of fluctuations in renal concentrations of some elements. Concentrations of persistent organochlorines and metals in beaver and muskrat from the Northwest Territories, and carnivores from across the Canadian Arctic were very low and considered normal for terrestrial

  11. Curbing the burden of lung cancer.

    Science.gov (United States)

    Urman, Alexandra; Hosgood, H Dean

    2016-06-01

    Lung cancer contributes substantially to the global burden of disease and healthcare costs. New screening modalities using low-dose computerized tomography are promising tools for early detection leading to curative surgery. However, the screening and follow-up diagnostic procedures of these techniques may be costly. Focusing on prevention is an important factor to reduce the burden of screening, treatment, and lung cancer deaths. The International Agency for Research on Cancer has identified several lung carcinogens, which we believe can be considered actionable when developing prevention strategies. To curb the societal burden of lung cancer, healthcare resources need to be focused on early detection and screening and on mitigating exposure(s) of a person to known lung carcinogens, such as active tobacco smoking, household air pollution (HAP), and outdoor air pollution. Evidence has also suggested that these known lung carcinogens may be associated with genetic predispositions, supporting the hypothesis that lung cancers attributed to differing exposures may have developed from unique underlying genetic mechanisms attributed to the exposure of interest. For instance, smokingattributed lung cancer involves novel genetic markers of risk compared with HAP-attributed lung cancer. Therefore, genetic risk markers may be used in risk stratification to identify subpopulations that are at a higher risk for developing lung cancer attributed to a given exposure. Such targeted prevention strategies suggest that precision prevention strategies may be possible in the future; however, much work is needed to determine whether these strategies will be viable.

  12. Plutonium-contaminated fragments at the Taranaki site at Maralinga

    International Nuclear Information System (INIS)

    Burns, P.A.; Cooper, M.B.; Duggleby, J.C.; Mika, J.F.; Williams, G.A.

    1986-07-01

    A detailed assessment is presented of the distribution of plutonium-contaminated fragments and sub-millimetre particles in the vicinity of the Taranaki site at the former U.K. Atomic Weapons Test Range at Maralinga in South Australia. The area which is contaminated with fragments has been divided into three general regions with the designations 'heavily contaminated', 'moderately contaminated' and 'plumes'. The average surface density, activity and estimated total number of fragments are presented for each region. Average surface densities of all fragments with americium-241 activities greater than 2 kBq are estimated to be 33, 7 and 2 m -2 for the 'heavily contaminated', 'moderately contaminated' and 'plumes' regions respectively. The total number of such fragments is estimated to be in excess of three million which accounts for a total plutonium activity of approximately 0.8 TBq. The implications of these results for a rehabilitation program are discussed

  13. Determination of the kalium-subtracted total beta in food

    International Nuclear Information System (INIS)

    Liu Guofan

    1985-01-01

    A procedure for measuring the kalium-subtracted total beta in food can be applied to estimating the contamination of beta nuclides except 40 K. The procedure, calculating formula, and some experiences in practice are described in this paper. The method is simple, rapid, and very useful to food contamination monitoring

  14. The Economic Burden of Violence against Children in South Africa

    Directory of Open Access Journals (Sweden)

    Xiangming Fang

    2017-11-01

    Full Text Available The purpose of this study was to estimate the economic burden of violence against children in South Africa. We assembled summative estimates of lifetime prevalence, calculated the magnitude of associations with negative outcomes, and thereby estimated the economic burden of violence against children. According to our calculations, 2.3 million and 84,287 disability-adjusted life-years (DALYs lost in South Africa in 2015 were attributable to nonfatal and fatal violence against children, respectively. The estimated economic value of DALYs lost to violence against children (including both fatal and nonfatal in South Africa in 2015 totalled ZAR173 billion (US $13.5 billion—or 4.3% of South Africa’s gross domestic product (GDP in 2015. In addition, the reduced earnings attributable to childhood physical violence and emotional violence in South Africa in 2015 were ZAR25.2 billion (US $2.0 billion and ZAR9.6 billion (US $750 million, respectively. In addition, South Africa spent ZAR1.6 billion (US $124 million on child care and protection in fiscal year 2015/2016, many of which costs are directly related to violence against children. This study confirms the importance of prioritising violence against children as a key social and economic concern for South Africa’s future.

  15. Dehydration in the Elderly: A Review Focused on Economic Burden.

    Science.gov (United States)

    Frangeskou, M; Lopez-Valcarcel, B; Serra-Majem, L

    2015-06-01

    Dehydration is the most common fluid and electrolyte problem among elderly patients. It is reported to be widely prevalent and costly to individuals and to the health care system. The purpose of this review is to summarize the literature on the economic burden of dehydration in the elderly. A comprehensive search of several databases from database inception to November 2013, only in English language, was conducted. The databases included Pubmed and ISI Web of Science. The search terms «dehydration» / "hyponaremia" / "hypernatremia" AND «cost» AND «elderly» were used to search for comparative studies of the economic burden of dehydration. A total of 15 papers were identified. Dehydration in the elderly is an independent factor of higher health care expenditures. It is directly associated with an increase in hospital mortality, as well as with an increase in the utilization of ICU, short and long term care facilities, readmission rates and hospital resources, especially among those with moderate to severe hyponatremia. Dehydration represents a potential target for intervention to reduce healthcare expenditures and improve patients' quality of life.

  16. Inpatient Financial Burden of Atopic Dermatitis in the United States

    DEFF Research Database (Denmark)

    Narla, Shanthi; Hsu, Derek Y; Thyssen, Jacob P

    2017-01-01

    Little is known about the inpatient burden of atopic dermatitis (AD). We sought to determine the risk factors and financial burden of hospitalizations for AD in the United States. Data were analyzed from the 2002-2012 National Inpatient Sample, including a 20% representative sample of all...... hospitalizations in the United States. Hospitalization rates for AD or eczema were highest in the northeast during the winter and south during the summer. Geometric mean cost of care (95% confidence interval) was lower for a primary diagnosis of AD or eczema versus no AD or eczema in adults ($3,502 [$3......,360-$3,651] vs. $6,849 [$6,775-$6,925]; P = 0.0004) and children ($2,716 [$2,542-$2,903] vs. $4,488 [$4,302-$4,682]; P = 0.0004). However, the high prevalence of hospitalization resulted in total inpatient costs of $8,288,083 per year for adults and $3,333,868 per year for children. In conclusion...

  17. The Economic Burden of Violence against Children in South Africa.

    Science.gov (United States)

    Fang, Xiangming; Zheng, Xiaodong; Fry, Deborah A; Ganz, Gary; Casey, Tabitha; Hsiao, Celia; Ward, Catherine L

    2017-11-22

    The purpose of this study was to estimate the economic burden of violence against children in South Africa. We assembled summative estimates of lifetime prevalence, calculated the magnitude of associations with negative outcomes, and thereby estimated the economic burden of violence against children. According to our calculations, 2.3 million and 84,287 disability-adjusted life-years (DALYs) lost in South Africa in 2015 were attributable to nonfatal and fatal violence against children, respectively. The estimated economic value of DALYs lost to violence against children (including both fatal and nonfatal) in South Africa in 2015 totalled ZAR173 billion (US $13.5 billion)-or 4.3% of South Africa's gross domestic product (GDP) in 2015. In addition, the reduced earnings attributable to childhood physical violence and emotional violence in South Africa in 2015 were ZAR25.2 billion (US $2.0 billion) and ZAR9.6 billion (US $750 million), respectively. In addition, South Africa spent ZAR1.6 billion (US $124 million) on child care and protection in fiscal year 2015/2016, many of which costs are directly related to violence against children. This study confirms the importance of prioritising violence against children as a key social and economic concern for South Africa's future.

  18. Comparative study of surrogate models for groundwater contamination source identification at DNAPL-contaminated sites

    Science.gov (United States)

    Hou, Zeyu; Lu, Wenxi

    2018-05-01

    Knowledge of groundwater contamination sources is critical for effectively protecting groundwater resources, estimating risks, mitigating disaster, and designing remediation strategies. Many methods for groundwater contamination source identification (GCSI) have been developed in recent years, including the simulation-optimization technique. This study proposes utilizing a support vector regression (SVR) model and a kernel extreme learning machine (KELM) model to enrich the content of the surrogate model. The surrogate model was itself key in replacing the simulation model, reducing the huge computational burden of iterations in the simulation-optimization technique to solve GCSI problems, especially in GCSI problems of aquifers contaminated by dense nonaqueous phase liquids (DNAPLs). A comparative study between the Kriging, SVR, and KELM models is reported. Additionally, there is analysis of the influence of parameter optimization and the structure of the training sample dataset on the approximation accuracy of the surrogate model. It was found that the KELM model was the most accurate surrogate model, and its performance was significantly improved after parameter optimization. The approximation accuracy of the surrogate model to the simulation model did not always improve with increasing numbers of training samples. Using the appropriate number of training samples was critical for improving the performance of the surrogate model and avoiding unnecessary computational workload. It was concluded that the KELM model developed in this work could reasonably predict system responses in given operation conditions. Replacing the simulation model with a KELM model considerably reduced the computational burden of the simulation-optimization process and also maintained high computation accuracy.

  19. The Tax Burden on Tobacco Volume 51, 1970-2016

    Data.gov (United States)

    U.S. Department of Health & Human Services — 1970-2016. Orzechowski and Walker. Tax Burden on Tobacco. Tax burden data was obtained from the annual compendium on tobacco revenue and industry statistics, The Tax...

  20. Prevalence and burden of Sickle Cell Disease among ...

    African Journals Online (AJOL)

    femi oloka

    the variables pain severity, monthly income, the psychological and ... 44% had significant psychological burden while 37.3% have socio-cultural burden. The ..... 6. Otis-Green S. Psychosocial Pain. Assessment Form. In Dow (Ed.), Nursing.

  1. Estimating the burden of disease attributable to indoor air pollution ...

    African Journals Online (AJOL)

    Estimating the burden of disease attributable to indoor air pollution from household ... To estimate the burden of respiratory ill health in South African children and adults in ... Mortality and disability-adjusted life years (DALYs) from acute lower ...

  2. Contamination analysis unit

    International Nuclear Information System (INIS)

    Gregg, H.R.; Meltzer, M.P.

    1996-01-01

    The portable Contamination Analysis Unit (CAU) measures trace quantities of surface contamination in real time. The detector head of the portable contamination analysis unit has an opening with an O-ring seal, one or more vacuum valves and a small mass spectrometer. With the valve closed, the mass spectrometer is evacuated with one or more pumps. The O-ring seal is placed against a surface to be tested and the vacuum valve is opened. Data is collected from the mass spectrometer and a portable computer provides contamination analysis. The CAU can be used to decontaminate and decommission hazardous and radioactive surfaces by measuring residual hazardous surface contamination, such as tritium and trace organics. It provides surface contamination data for research and development applications as well as real-time process control feedback for industrial cleaning operations and can be used to determine the readiness of a surface to accept bonding or coatings. 1 fig

  3. JPL Contamination Control Engineering

    Science.gov (United States)

    Blakkolb, Brian

    2013-01-01

    JPL has extensive expertise fielding contamination sensitive missions-in house and with our NASA/industry/academic partners.t Development and implementation of performance-driven cleanliness requirements for a wide range missions and payloads - UV-Vis-IR: GALEX, Dawn, Juno, WFPC-II, AIRS, TES, et al - Propulsion, thermal control, robotic sample acquisition systems. Contamination control engineering across the mission life cycle: - System and payload requirements derivation, analysis, and contamination control implementation plans - Hardware Design, Risk trades, Requirements V-V - Assembly, Integration & Test planning and implementation - Launch site operations and launch vehicle/payload integration - Flight ops center dot Personnel on staff have expertise with space materials development and flight experiments. JPL has capabilities and expertise to successfully address contamination issues presented by space and habitable environments. JPL has extensive experience fielding and managing contamination sensitive missions. Excellent working relationship with the aerospace contamination control engineering community/.

  4. Economic burden of underweight and overweight among adults in the Asia-Pacific region: a systematic review.

    Science.gov (United States)

    Hoque, Mohammad Enamul; Mannan, Munim; Long, Kurt Z; Al Mamun, Abdullah

    2016-04-01

    To assess the economic burden of underweight and overweight among adults in the Asia-Pacific region. Systematic review of articles published until March 2015. Seventeen suitable articles were found, of which 13 assess the economic burden of overweight/obesity and estimate that it accounts for 1.5-9.9% of a country's total healthcare expenditure. Four articles on the economic burden of underweight estimate it at 2.5-3.8% of the country's total GDP. Using hospital data, and compared to normal weight individuals, four articles estimated extra healthcare costs for overweight individuals of 7-9.8% and more, and extra healthcare costs for obese individuals of 17-22.3% and higher. Despite methodological diversity across the studies, there is a consensus that both underweight and overweight impose a substantial financial burden on healthcare systems in the Asia-Pacific region. © 2016 John Wiley & Sons Ltd.

  5. The global burden of viral hepatitis from 1990 to 2013: findings from the Global Burden of Disease Study 2013

    Science.gov (United States)

    Stanaway, Jeffrey D; Flaxman, Abraham D; Naghavi, Mohsen; Fitzmaurice, Christina; Vos, Theo; Abubakar, Ibrahim; Abu-Raddad, Laith J; Assadi, Reza; Bhala, Neeraj; Cowie, Benjamin; Forouzanfour, Mohammad H; Groeger, Justina; Hanafiah, Khayriyyah Mohd; Jacobsen, Kathryn H; James, Spencer L; MacLachlan, Jennifer; Malekzadeh, Reza; Martin, Natasha K; Mokdad, Ali A; Mokdad, Ali H; Murray, Christopher J L; Plass, Dietrich; Rana, Saleem; Rein, David B; Richardus, Jan Hendrik; Sanabria, Juan; Saylan, Mete; Shahraz, Saeid; So, Samuel; Vlassov, Vasiliy V; Weiderpass, Elisabete; Wiersma, Steven T; Younis, Mustafa; Yu, Chuanhua; Zaki, Maysaa El Sayed; Cooke, Graham S

    2016-01-01

    Summary Background With recent improvements in vaccines and treatments against viral hepatitis, an improved understanding of the burden of viral hepatitis is needed to inform global intervention strategies. We used data from the Global Burden of Disease (GBD) Study to estimate morbidity and mortality for acute viral hepatitis, and for cirrhosis and liver cancer caused by viral hepatitis, by age, sex, and country from 1990 to 2013. Methods We estimated mortality using natural history models for acute hepatitis infections and GBD’s cause-of-death ensemble model for cirrhosis and liver cancer. We used meta-regression to estimate total cirrhosis and total liver cancer prevalence, as well as the proportion of cirrhosis and liver cancer attributable to each cause. We then estimated cause-specific prevalence as the product of the total prevalence and the proportion attributable to a specific cause. Disability-adjusted life-years (DALYs) were calculated as the sum of years of life lost (YLLs) and years lived with disability (YLDs). Findings Between 1990 and 2013, global viral hepatitis deaths increased from 0·89 million (95% uncertainty interval [UI] 0·86–0·94) to 1·45 million (1·38–1·54); YLLs from 31·0 million (29·6–32·6) to 41·6 million (39·1–44·7); YLDs from 0·65 million (0·45–0·89) to 0·87 million (0·61–1·18); and DALYs from 31·7 million (30·2–33·3) to 42·5 million (39·9–45·6). In 2013, viral hepatitis was the seventh (95% UI seventh to eighth) leading cause of death worldwide, compared with tenth (tenth to 12th) in 1990. Interpretation Viral hepatitis is a leading cause of death and disability worldwide. Unlike most communicable diseases, the absolute burden and relative rank of viral hepatitis increased between 1990 and 2013. The enormous health loss attributable to viral hepatitis, and the availability of effective vaccines and treatments, suggests an important opportunity to improve public health. Funding Bill & Melinda

  6. Analysis of food contaminants

    National Research Council Canada - National Science Library

    Gilbert, John

    1984-01-01

    ... quantification methods used in the analysis of mycotoxins in foods - Confirmation and quantification of trace organic food contaminants by mass spectrometry-selected ion monitoring - Chemiluminescence...

  7. 12 CFR 508.10 - Burden of persuasion.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 5 2010-01-01 2010-01-01 false Burden of persuasion. 508.10 Section 508.10 Banks and Banking OFFICE OF THRIFT SUPERVISION, DEPARTMENT OF THE TREASURY REMOVALS, SUSPENSIONS, AND PROHIBITIONS WHERE A CRIME IS CHARGED OR PROVEN § 508.10 Burden of persuasion. The petitioner has the burden of...

  8. Double burden of disease in the slums of Kenya

    NARCIS (Netherlands)

    Oti, S.O.

    2015-01-01

    The goal of this thesis was to provide evidence of a double burden of disease in the slums of Nairobi and to make a case for an integrated health systems approach to tackling this situation. A double burden of disease refers to the coexistence of a high burden of communicable and non-communicable

  9. The burden experienced by family caregivers of patients with ...

    African Journals Online (AJOL)

    BACKGROUND: Caring for patients with chronic medical and psychiatric disorders is associated with significant burden. However little is known about the burden experience by caregivers of patients with epilepsy in Nigeria. The objective of this study, therefore, was to assess the level and correlates of burden among ...

  10. Financial burden of healthcare for cancer patients with social medical insurance: a multi-centered study in urban China

    OpenAIRE

    Mao, Wenhui; Tang, Shenglan; Zhu, Ying; Xie, Zening; Chen, Wen

    2017-01-01

    Background Cancer accounts for one-fifth of the total deaths in China and brings heavy financial burden to patients and their families. Chinese government has made strong commitment to develop three types of social medical insurance since 1997 and recently, more attempts were invested to provide better financial protection. To analyze health services utilization and financial burden of insured cancer patients, and identify the gaps of financial protection provided by insurance in urban China....

  11. The Energy Burden and Environmental Impact of Health Services

    Science.gov (United States)

    Buettner, Petra G.; Canyon, Deon V.

    2012-01-01

    Objectives. We reviewed the English-language literature on the energy burden and environmental impact of health services. Methods. We searched all years of the PubMed, CINAHL, and ScienceDirect databases for publications reporting energy consumption, greenhouse gas emissions, or the environmental impact of health-related activities. We extracted and tabulated data to enable cross-comparisons among different activities and services; where possible, we calculated per patient or per event emissions. Results. We identified 38 relevant publications. Per patient or per event, health-related energy consumption and greenhouse gas emissions are quite modest; in the aggregate, however, they are considerable. In England and the United States, health-related emissions account for 3% and 8% of total national emissions, respectively. Conclusions. Although reducing health-related energy consumption and emissions alone will not resolve all of the problems of energy scarcity and climate change, it could make a meaningful contribution. PMID:23078475

  12. Disease Burden of 32 Infectious Diseases in the Netherlands, 2007-2011.

    Science.gov (United States)

    van Lier, Alies; McDonald, Scott A; Bouwknegt, Martijn; Kretzschmar, Mirjam E; Havelaar, Arie H; Mangen, Marie-Josée J; Wallinga, Jacco; de Melker, Hester E

    2016-01-01

    Infectious disease burden estimates provided by a composite health measure give a balanced view of the true impact of a disease on a population, allowing the relative impact of diseases that differ in severity and mortality to be monitored over time. This article presents the first national disease burden estimates for a comprehensive set of 32 infectious diseases in the Netherlands. The average annual disease burden was computed for the period 2007-2011 for selected infectious diseases in the Netherlands using the disability-adjusted life years (DALY) measure. The pathogen- and incidence-based approach was adopted to quantify the burden due to both morbidity and premature mortality associated with all short and long-term consequences of infection. Natural history models, disease progression probabilities, disability weights, and other parameters were adapted from previous research. Annual incidence was obtained from statutory notification and other surveillance systems, which was corrected for under-ascertainment and under-reporting. The highest average annual disease burden was estimated for invasive pneumococcal disease (9444 DALYs/year; 95% uncertainty interval [UI]: 8911-9961) and influenza (8670 DALYs/year; 95% UI: 8468-8874), which represents 16% and 15% of the total burden of all 32 diseases, respectively. The remaining 30 diseases ranked by number of DALYs/year from high to low were: HIV infection, legionellosis, toxoplasmosis, chlamydia, campylobacteriosis, pertussis, tuberculosis, hepatitis C infection, Q fever, norovirus infection, salmonellosis, gonorrhoea, invasive meningococcal disease, hepatitis B infection, invasive Haemophilus influenzae infection, shigellosis, listeriosis, giardiasis, hepatitis A infection, infection with STEC O157, measles, cryptosporidiosis, syphilis, rabies, variant Creutzfeldt-Jakob disease, tetanus, mumps, rubella, diphtheria, and poliomyelitis. The very low burden for the latter five diseases can be attributed to the

  13. Disease Burden of 32 Infectious Diseases in the Netherlands, 2007-2011

    Science.gov (United States)

    Bouwknegt, Martijn; Kretzschmar, Mirjam E.; Mangen, Marie-Josée J.; Wallinga, Jacco; de Melker, Hester E.

    2016-01-01

    Background Infectious disease burden estimates provided by a composite health measure give a balanced view of the true impact of a disease on a population, allowing the relative impact of diseases that differ in severity and mortality to be monitored over time. This article presents the first national disease burden estimates for a comprehensive set of 32 infectious diseases in the Netherlands. Methods and Findings The average annual disease burden was computed for the period 2007–2011 for selected infectious diseases in the Netherlands using the disability-adjusted life years (DALY) measure. The pathogen- and incidence-based approach was adopted to quantify the burden due to both morbidity and premature mortality associated with all short and long-term consequences of infection. Natural history models, disease progression probabilities, disability weights, and other parameters were adapted from previous research. Annual incidence was obtained from statutory notification and other surveillance systems, which was corrected for under-ascertainment and under-reporting. The highest average annual disease burden was estimated for invasive pneumococcal disease (9444 DALYs/year; 95% uncertainty interval [UI]: 8911–9961) and influenza (8670 DALYs/year; 95% UI: 8468–8874), which represents 16% and 15% of the total burden of all 32 diseases, respectively. The remaining 30 diseases ranked by number of DALYs/year from high to low were: HIV infection, legionellosis, toxoplasmosis, chlamydia, campylobacteriosis, pertussis, tuberculosis, hepatitis C infection, Q fever, norovirus infection, salmonellosis, gonorrhoea, invasive meningococcal disease, hepatitis B infection, invasive Haemophilus influenzae infection, shigellosis, listeriosis, giardiasis, hepatitis A infection, infection with STEC O157, measles, cryptosporidiosis, syphilis, rabies, variant Creutzfeldt-Jakob disease, tetanus, mumps, rubella, diphtheria, and poliomyelitis. The very low burden for the latter five

  14. Disease Burden of 32 Infectious Diseases in the Netherlands, 2007-2011.

    Directory of Open Access Journals (Sweden)

    Alies van Lier

    Full Text Available Infectious disease burden estimates provided by a composite health measure give a balanced view of the true impact of a disease on a population, allowing the relative impact of diseases that differ in severity and mortality to be monitored over time. This article presents the first national disease burden estimates for a comprehensive set of 32 infectious diseases in the Netherlands.The average annual disease burden was computed for the period 2007-2011 for selected infectious diseases in the Netherlands using the disability-adjusted life years (DALY measure. The pathogen- and incidence-based approach was adopted to quantify the burden due to both morbidity and premature mortality associated with all short and long-term consequences of infection. Natural history models, disease progression probabilities, disability weights, and other parameters were adapted from previous research. Annual incidence was obtained from statutory notification and other surveillance systems, which was corrected for under-ascertainment and under-reporting. The highest average annual disease burden was estimated for invasive pneumococcal disease (9444 DALYs/year; 95% uncertainty interval [UI]: 8911-9961 and influenza (8670 DALYs/year; 95% UI: 8468-8874, which represents 16% and 15% of the total burden of all 32 diseases, respectively. The remaining 30 diseases ranked by number of DALYs/year from high to low were: HIV infection, legionellosis, toxoplasmosis, chlamydia, campylobacteriosis, pertussis, tuberculosis, hepatitis C infection, Q fever, norovirus infection, salmonellosis, gonorrhoea, invasive meningococcal disease, hepatitis B infection, invasive Haemophilus influenzae infection, shigellosis, listeriosis, giardiasis, hepatitis A infection, infection with STEC O157, measles, cryptosporidiosis, syphilis, rabies, variant Creutzfeldt-Jakob disease, tetanus, mumps, rubella, diphtheria, and poliomyelitis. The very low burden for the latter five diseases can be

  15. Global Burden of Leptospirosis: Estimated in Terms of Disability Adjusted Life Years.

    Directory of Open Access Journals (Sweden)

    Paul R Torgerson

    Full Text Available Leptospirosis, a spirochaetal zoonosis, occurs in diverse epidemiological settings and affects vulnerable populations, such as rural subsistence farmers and urban slum dwellers. Although leptospirosis can cause life-threatening disease, there is no global burden of disease estimate in terms of Disability Adjusted Life Years (DALYs available.We utilised the results of a parallel publication that reported global estimates of morbidity and mortality due to leptospirosis. We estimated Years of Life Lost (YLLs from age and gender stratified mortality rates. Years of Life with Disability (YLDs were developed from a simple disease model indicating likely sequelae. DALYs were estimated from the sum of YLLs and YLDs. The study suggested that globally approximately 2.90 million DALYs are lost per annum (UIs 1.25-4.54 million from the approximately annual 1.03 million cases reported previously. Males are predominantly affected with an estimated 2.33 million DALYs (UIs 0.98-3.69 or approximately 80% of the total burden. For comparison, this is over 70% of the global burden of cholera estimated by GBD 2010. Tropical regions of South and South-east Asia, Western Pacific, Central and South America, and Africa had the highest estimated leptospirosis disease burden.Leptospirosis imparts a significant health burden worldwide, which approach or exceed those encountered for a number of other zoonotic and neglected tropical diseases. The study findings indicate that highest burden estimates occur in resource-poor tropical countries, which include regions of Africa where the burden of leptospirosis has been under-appreciated and possibly misallocated to other febrile illnesses such as malaria.

  16. Plasma based markers of [11C] PiB-PET brain amyloid burden.

    Directory of Open Access Journals (Sweden)

    Steven John Kiddle

    Full Text Available Changes in brain amyloid burden have been shown to relate to Alzheimer's disease pathology, and are believed to precede the development of cognitive decline. There is thus a need for inexpensive and non-invasive screening methods that are able to accurately estimate brain amyloid burden as a marker of Alzheimer's disease. One potential method would involve using demographic information and measurements on plasma samples to establish biomarkers of brain amyloid burden; in this study data from the Alzheimer's Disease Neuroimaging Initiative was used to explore this possibility. Sixteen of the analytes on the Rules Based Medicine Human Discovery Multi-Analyte Profile 1.0 panel were found to associate with [(11C]-PiB PET measurements. Some of these markers of brain amyloid burden were also found to associate with other AD related phenotypes. Thirteen of these markers of brain amyloid burden--c-peptide, fibrinogen, alpha-1-antitrypsin, pancreatic polypeptide, complement C3, vitronectin, cortisol, AXL receptor kinase, interleukin-3, interleukin-13, matrix metalloproteinase-9 total, apolipoprotein E and immunoglobulin E--were used along with co-variates in multiple linear regression, and were shown by cross-validation to explain >30% of the variance of brain amyloid burden. When a threshold was used to classify subjects as PiB positive, the regression model was found to predict actual PiB positive individuals with a sensitivity of 0.918 and a specificity of 0.545. The number of APOE [Symbol: see text] 4 alleles and plasma apolipoprotein E level were found to contribute most to this model, and the relationship between these variables and brain amyloid burden was explored.

  17. Effects of frequent hemodialysis on perceived caregiver burden in the Frequent Hemodialysis Network trials.

    Science.gov (United States)

    Suri, Rita S; Larive, Brett; Hall, Yoshio; Kimmel, Paul L; Kliger, Alan S; Levin, Nathan; Tamura, Manjula Kurella; Chertow, Glenn M

    2014-05-01

    Patients receiving hemodialysis often perceive their caregivers are overburdened. We hypothesize that increasing hemodialysis frequency would result in higher patient perceptions of burden on their unpaid caregivers. In two separate trials, 245 patients were randomized to receive in-center daily hemodialysis (6 days/week) or conventional hemodialysis (3 days/week) while 87 patients were randomized to receive home nocturnal hemodialysis (6 nights/week) or home conventional hemodialysis for 12 months. Changes in overall mean scores over time in the 10-question Cousineau perceived burden scale were compared. In total, 173 of 245 (70%) and 80 of 87 (92%) randomized patients in the Daily and Nocturnal Trials, respectively, reported having an unpaid caregiver at baseline or during follow-up. Relative to in-center conventional dialysis, the 12-month change in mean perceived burden score with in-center daily hemodialysis was -2.1 (95% confidence interval, -9.4 to +5.3; P=0.58). Relative to home conventional dialysis, the 12-month change in mean perceived burden score with home nocturnal dialysis was +6.1 (95% confidence interval, -0.8 to +13.1; P=0.08). After multiple imputation for missing data in the Nocturnal Trial, the relative difference between home nocturnal and home conventional hemodialysis was +9.4 (95% confidence interval, +0.55 to +18.3; P=0.04). In the Nocturnal Trial, changes in perceived burden were inversely correlated with adherence to dialysis treatments (Pearson r=-0.35; P=0.02). Relative to conventional hemodialysis, in-center daily hemodialysis did not result in higher perceptions of caregiver burden. There was a trend to higher perceived caregiver burden among patients randomized to home nocturnal hemodialysis. These findings may have implications for the adoption of and adherence to frequent nocturnal hemodialysis.

  18. Subcutaneous mycoses in Peru: a systematic review and meta-analysis for the burden of disease.

    Science.gov (United States)

    Ramírez Soto, Max Carlos; Malaga, German

    2017-10-01

    There is a worrying lack of epidemiological data on the geographical distribution and burden of subcutaneous mycoses in Peru, hindering the implementation of surveillance and control programs. This study aimed to estimate the disease burden of subcutaneous mycoses in Peru and identify which fungal species were commonly associated with these mycoses. We performed a meta-analysis after a systematic review of the published literature in PubMed, LILACS, and SciELO to estimate the burden of subcutaneous mycoses in 25 regions in Peru. The disease burden was determined in terms of prevalence (number of cases per 100,000 inhabitants) and the number of reported cases per year per region. A total of 26 studies were eligible for inclusion. Results showed that sporotrichosis was the most common subcutaneous mycosis (99.7%), whereas lobomycosis, chromoblastomycosis, and subcutaneous phaeohyphomycosis were rare. Cases of eumycetoma and subcutaneous zygomycosis were not found. Of the 25 regions, the burden of sporotrichosis was estimated for four regions classified as endemic; in nine regions, only isolated cases were reported. The highest burden of sporotrichosis was in Apurimac (15 cases/100,000 inhabitants; 57 cases/year), followed by Cajamarca (3/100,000 inhabitants; 30/year), Cusco (0.5/100,000 inhabitants; 4/year), and La Libertad (0.2/100,000 inhabitants; 2/year). In two regions, the mycoses predominantly affected children. Sporotrichosis is the most common subcutaneous mycosis in Peru, with a high disease burden in Apurimac. Chromoblastomycosis, lobomycosis, and subcutaneous phaeohyphomycosis are rare mycoses in Peru. © 2017 The International Society of Dermatology.

  19. [Disease burden caused by violence in the Chinese population, in 1990 and 2013].

    Science.gov (United States)

    Yang, L; Gao, X; Jin, Y; Ye, P P; Er, Y L; Deng, X; Wang, Y; Duan, L L

    2017-10-10

    Objective: To analyze the disease burden of violence in the Chinese population, in 1990 and 2013. Methods: Indicators including mortality rate, years of life lost due to premature mortality (YLL), years lived with disability (YLD), and disability-adjusted of life years (DALY) related to violence, were extracted from the Global Burden of Disease 2013 and used to describe the burden of disease caused by violence in the Chinese population. Data related to corresponding parameters on disease burden of violence in 1990 and 2013 were described. Results: In 2013, a total of 20 500 people died of violent events, with the death rate as 1.44 per 100 000, in China. DALY caused by violence was 1.08 million person years in 2013. DALY caused by sharp violence was 0.47 million person years, with 0.09 million person years lost due to firearm violence. Disease burden caused by violence appeared higher in males than in females. When comparing with data from the 1990s, reductions were seen by 67.35 % on the standardized death rate of violence, by 68.07 % on the DALY attributable to violence, and by 70.47 % on the standardized DALY rate attributable to violence, respectively, in 2013. Disease burden of violence among young adults and elderly was among the highest. When comparing with data from the 1990, DALY in 2013 decreased among all the age groups except for the 70-year-old showed an increase of 9.36 % . The standardized DALY rate in 2013 showed a declining trend in all the age groups, mostly in the 0-4-year-old group. The standardized DALY rates caused by sharp violence or firearm decreased by75.11 % and 83.20 % in the 0-4-year-old group. Conclusion: In recent years, the disease burden caused by violence showed a decreasing trend but appeared higher in males however with the increase of DALY in the elder population.

  20. Lifetime Economic Burden of Rape Among U.S. Adults.

    Science.gov (United States)

    Peterson, Cora; DeGue, Sarah; Florence, Curtis; Lokey, Colby N

    2017-06-01

    This study estimated the per-victim U.S. lifetime cost of rape. Data from previous studies was combined with current administrative data and 2011 U.S. National Intimate Partner and Sexual Violence Survey data in a mathematical model. Rape was defined as any lifetime completed or attempted forced penetration or alcohol- or drug-facilitated penetration, measured among adults not currently institutionalized. Costs included attributable impaired health, lost productivity, and criminal justice costs from the societal perspective. Average age at first rape was assumed to be 18 years. Future costs were discounted by 3%. The main outcome measures were the average per-victim (female and male) and total population discounted lifetime cost of rape. Secondary outcome measures were marginal outcome probabilities among victims (e.g., suicide attempt) and perpetrators (e.g., incarceration) and associated costs. Analysis was conducted in 2016. The estimated lifetime cost of rape was $122,461 per victim, or a population economic burden of nearly $3.1 trillion (2014 U.S. dollars) over victims' lifetimes, based on data indicating >25 million U.S. adults have been raped. This estimate included $1.2 trillion (39% of total) in medical costs; $1.6 trillion (52%) in lost work productivity among victims and perpetrators; $234 billion (8%) in criminal justice activities; and $36 billion (1%) in other costs, including victim property loss or damage. Government sources pay an estimated $1 trillion (32%) of the lifetime economic burden. Preventing sexual violence could avoid substantial costs for victims, perpetrators, healthcare payers, employers, and government payers. These findings can inform evaluations of interventions to reduce sexual violence. Published by Elsevier Inc.

  1. Human leptospirosis in Seychelles: A prospective study confirms the heavy burden of the disease but suggests that rats are not the main reservoir.

    Science.gov (United States)

    Biscornet, Leon; Dellagi, Koussay; Pagès, Frédéric; Bibi, Jastin; de Comarmond, Jeanine; Mélade, Julien; Govinden, Graham; Tirant, Maria; Gomard, Yann; Guernier, Vanina; Lagadec, Erwan; Mélanie, Jimmy; Rocamora, Gérard; Le Minter, Gildas; Jaubert, Julien; Mavingui, Patrick; Tortosa, Pablo

    2017-08-01

    Leptospirosis is a bacterial zoonosis caused by pathogenic Leptospira for which rats are considered as the main reservoir. Disease incidence is higher in tropical countries, especially in insular ecosystems. Our objectives were to determine the current burden of leptospirosis in Seychelles, a country ranking first worldwide according to historical data, to establish epidemiological links between animal reservoirs and human disease, and to identify drivers of transmission. A total of 223 patients with acute febrile symptoms of unknown origin were enrolled in a 12-months prospective study and tested for leptospirosis through real-time PCR, IgM ELISA and MAT. In addition, 739 rats trapped throughout the main island were investigated for Leptospira renal carriage. All molecularly confirmed positive samples were further genotyped. A total of 51 patients fulfilled the biological criteria of acute leptospirosis, corresponding to an annual incidence of 54.6 (95% CI 40.7-71.8) per 100,000 inhabitants. Leptospira carriage in Rattus spp. was overall low (7.7%) but dramatically higher in Rattus norvegicus (52.9%) than in Rattus rattus (4.4%). Leptospira interrogans was the only detected species in both humans and rats, and was represented by three distinct Sequence Types (STs). Two were novel STs identified in two thirds of acute human cases while noteworthily absent from rats. This study shows that human leptospirosis still represents a heavy disease burden in Seychelles. Genotype data suggests that rats are actually not the main reservoir for human disease. We highlight a rather limited efficacy of preventive measures so far implemented in Seychelles. This could result from ineffective control measures of excreting animal populations, possibly due to a misidentification of the main contaminating reservoir(s). Altogether, presented data stimulate the exploration of alternative reservoir animal hosts.

  2. Human leptospirosis in Seychelles: A prospective study confirms the heavy burden of the disease but suggests that rats are not the main reservoir.

    Directory of Open Access Journals (Sweden)

    Leon Biscornet

    2017-08-01

    Full Text Available Leptospirosis is a bacterial zoonosis caused by pathogenic Leptospira for which rats are considered as the main reservoir. Disease incidence is higher in tropical countries, especially in insular ecosystems. Our objectives were to determine the current burden of leptospirosis in Seychelles, a country ranking first worldwide according to historical data, to establish epidemiological links between animal reservoirs and human disease, and to identify drivers of transmission.A total of 223 patients with acute febrile symptoms of unknown origin were enrolled in a 12-months prospective study and tested for leptospirosis through real-time PCR, IgM ELISA and MAT. In addition, 739 rats trapped throughout the main island were investigated for Leptospira renal carriage. All molecularly confirmed positive samples were further genotyped.A total of 51 patients fulfilled the biological criteria of acute leptospirosis, corresponding to an annual incidence of 54.6 (95% CI 40.7-71.8 per 100,000 inhabitants. Leptospira carriage in Rattus spp. was overall low (7.7% but dramatically higher in Rattus norvegicus (52.9% than in Rattus rattus (4.4%. Leptospira interrogans was the only detected species in both humans and rats, and was represented by three distinct Sequence Types (STs. Two were novel STs identified in two thirds of acute human cases while noteworthily absent from rats.This study shows that human leptospirosis still represents a heavy disease burden in Seychelles. Genotype data suggests that rats are actually not the main reservoir for human disease. We highlight a rather limited efficacy of preventive measures so far implemented in Seychelles. This could result from ineffective control measures of excreting animal populations, possibly due to a misidentification of the main contaminating reservoir(s. Altogether, presented data stimulate the exploration of alternative reservoir animal hosts.

  3. The financial and health burden of diabetic ambulatory care sensitive hospitalisations in Mexico.

    Science.gov (United States)

    Lugo-Palacios, David G; Cairns, John

    2016-01-01

    To estimate the financial and health burden of diabetic ambulatory care sensitive hospitalisations (ACSH) in Mexico during 2001-2011. We identified ACSH due to diabetic complications in general hospitals run by local health ministries and estimated their financial cost using diagnostic related groups. The health burden estimation assumes that patients would not have experienced complications if they had received appropriate primary care and computes the associated Disability-Adjusted Life Years (DALYs). The financial cost of diabetic ACSH increased by 125% in real terms and their health burden in 2010 accounted for 4.2% of total DALYs associated with diabetes in Mexico. Avoiding preventable hospitalisations could free resources within the health system for other health purposes. In addition, patients with ACSH suffer preventable losses of health that should be considered when assessing the performance of any primary care intervention.

  4. The financial and health burden of diabetic ambulatory care sensitive hospitalisations in Mexico

    Directory of Open Access Journals (Sweden)

    David G Lugo-Palacios

    2016-01-01

    Full Text Available Objective.To estimate the financial and health burden of diabetic ambulatory care sensitive hospitalisations (ACSH in Mexico during 2001-2011. Materials and methods. We identified ACSH due to diabetic complications in general hospitals run by local health ministries and estimated their financial cost using diagnostic related groups. The health burden estimation assumes that patients would not have experienced complications if they had received appropriate primary care and computes the associated DisabilityAdjusted Life Years (DALYs. Results. The financial cost of diabetic ACSH increased by 125% in real terms and their health burden in 2010 accounted for 4.2% of total DALYs associated with diabetes in Mexico. Conclusion. Avoiding preventable hospitalisations could free resources within the health system for other health purposes. In addition, patients with ACSH suffer preventable losses of health that should be considered when assessing the performance of any primary care intervention.

  5. Study of Burden Among Caregivers of Children with Cleft Lip and Palate

    Directory of Open Access Journals (Sweden)

    Ana Paula Ribeiro Razera

    Full Text Available Abstract: The psychological and physical health of caregivers of children with cleft lip and palate can be strongly influenced by the child’s condition and behavior, and care required by the treatment. This study’s objective was to identify overload levels among these caregivers. A total of 100 caregivers, whose children were in the perioperative period of cheiloplasty and/or palatoplasty, were interviewed using the Scale Burden Interview. The data were analyzed quantitatively. Moderate and moderate severe burden levels were identified in 43% of the sample. The mothers of children aged around 12 months presented significantly higher overload. The results indicate that children in this developmental stage present greater care demand because they seek autonomy in locomotion, explore objects in their surrounding environment, and continually request communicative and affective-social interaction with their reference to greater attachment (the caregiver, which may have contributed to higher burden.

  6. Burden of serious fungal infections in Guatemala.

    Science.gov (United States)

    Medina, N; Samayoa, B; Lau-Bonilla, D; Denning, D W; Herrera, R; Mercado, D; Guzmán, B; Pérez, J C; Arathoon, E

    2017-06-01

    Guatemala is a developing country in Central America with a high burden of HIV and endemic fungal infections; we attempted to estimate the burden of serious fungal infections for the country. A full literature search was done to identify epidemiology papers reporting fungal infections from Guatemala. We used specific populations at risk and fungal infection frequencies in the population to estimate national rates. The population of Guatemala in 2013 was 15.4 million; 40% were younger than 15 and 6.2% older than 60. There are an estimated 53,000 adults with HIV infection, in 2015, most presenting late. The estimated cases of opportunistic fungal infections were: 705 cases of disseminated histoplasmosis, 408 cases of cryptococcal meningitis, 816 cases of Pneumocystis pneumonia, 16,695 cases of oral candidiasis, and 4,505 cases of esophageal candidiasis. In the general population, an estimated 5,568 adult asthmatics have allergic bronchopulmonary aspergillosis (ABPA) based on a 2.42% prevalence of asthma and a 2.5% ABPA proportion. Amongst 2,452 pulmonary tuberculosis patients, we estimated a prevalence of 495 for chronic pulmonary aspergillosis in this group, and 1,484 for all conditions. An estimated 232,357 cases of recurrent vulvovaginal candidiasis is likely. Overall, 1.7% of the population are affected by these conditions. The true fungal infection burden in Guatemala is unknown. Tools and training for improved diagnosis are needed. Additional research on prevalence is needed to employ public health measures towards treatment and improving the reported data of fungal diseases.

  7. Monitoring of surface and airborne contamination

    Energy Technology Data Exchange (ETDEWEB)

    Pradeep Kumar, K S [Bhabha Atomic Research Centre, Bombay (India)

    1997-06-01

    Indian nuclear energy programme aims at total safety in all activities involved in the entire fuel cycle for the occupational workers, members of the public and the environment as a whole. Routine radiation monitoring with clearly laid out procedures are followed for ensuring the safety of workers and public. Radiation monitoring carried out for the nuclear installations comprises of process monitoring, monitoring of effluent releases and also of the radiation protection monitoring of the individuals, work place and environment. Regulations like banning of smoking and consumption of food and drink etc. reduces the risk of direct ingestion even if inadvertent spread of contamination takes place. Though limit of transportable surface contamination is prescribed, the health physicists always follow a ``clean on swipe`` philosophy which compensates any error in the measurement of surface contamination. In this paper, the following items are contained: Necessity of contamination monitoring, accuracy required in the calibration of surface contamination monitors, methodology for contamination monitoring, air monitoring, guidelines for unrestricted release of scrap materials, and problems in contamination monitoring. (G.K.)

  8. The humanistic burden of hereditary angioedema

    DEFF Research Database (Denmark)

    Caballero, Teresa; Aygören-Pürsün, Emel; Bygum, Anette

    2014-01-01

    and impact of HAE types I and II from the patient perspective. The HAE Burden of Illness Study in Europe was conducted in Spain, Germany, and Denmark to assess the real-world experience of HAE from the patient perspective via a one-time survey, which included items on clinical characteristics and physical......, traveling, and passing HAE to their children. Based on Hospital Anxiety and Depression Scale scores, 38 and 14% had clinically meaningful anxiety and depression, respectively. Despite standard of care, HAE patients still have frequent and painful attacks. Patients experience substantial impairment...

  9. The radium contamination in the southern Black Forest

    International Nuclear Information System (INIS)

    Schuttelkopf, H.; Kiefer, H.

    1980-01-01

    The high natural radium contamination in the Southern Black Forest was used to evaluate the extent of contamination in the environment, the mechanisms of radium transport to man, and the radiation burden of the population due to natural Ra-226. Ra-226 was measured in air, soil, sediment and rock samples. Spring, surface and drinking water were examined. The contamination of fish, milk and practically all foodstuffs produced in the Southern Black Forest was measured. Grass and hay samples and many wild plants were also analyzed for Ra-226. Since water and fish samples, grass and milk samples, soil and grass samples were collected jointly in every case, it was possible to calculate the following transfer factors: fish/water, grass/soil, milk/grass, water/sediments, foodstuffs/soil. The latter includes the transfer factors for wheat, barley, oat, eggs, beef and deer, potatoes and vegetables. The natural radiation burden was calculated on the basis of the consumption habits by the average member of the population. Measurement in the body counter of the Ra-226 body burden of 28 persons living in the area under consideration concluded the research program. The radio-ecological and health physics aspects of the results are discussed. (H.K.)

  10. Caregiver burden, productivity loss, and indirect costs associated with caring for patients with poststroke spasticity

    Science.gov (United States)

    Ganapathy, Vaidyanathan; Graham, Glenn D; DiBonaventura, Marco D; Gillard, Patrick J; Goren, Amir; Zorowitz, Richard D

    2015-01-01

    Objective Many stroke survivors experience poststroke spasticity and the related inability to perform basic activities, which necessitates patient management and treatment, and exerts a considerable burden on the informal caregiver. The current study aims to estimate burden, productivity loss, and indirect costs for caregivers of stroke survivors with spasticity. Methods Internet survey data were collected from 153 caregivers of stroke survivors with spasticity including caregiving time and difficulty (Oberst Caregiver Burden Scale), Work Productivity and Activity Impairment measures, and caregiver and patient characteristics. Fractional logit models examined predictors of work-related restriction, and work losses were monetized (2012 median US wages). Results Mean Oberst Caregiver Burden Scale time and difficulty scores were 46.1 and 32.4, respectively. Employed caregivers (n=71) had overall work restriction (32%), absenteeism (9%), and presenteeism (27%). Caregiver characteristics, lack of nursing home coverage, and stroke survivors’ disability predicted all work restriction outcomes. The mean total lost-productivity cost per employed caregiver was US$835 per month (>$10,000 per year; 72% attributable to presenteeism). Conclusion These findings demonstrate the substantial burden of caring for stroke survivors with spasticity illustrating the societal and economic impact of stroke that extends beyond the stroke survivor. PMID:26609225

  11. The burden of disease due to tuberculosis in the state of Santa Catarina, Brazil.

    Science.gov (United States)

    Ferrer, Glênio César Nunes; da Silva, Rosemeri Maurici; Ferrer, Kelian Tenfen; Traebert, Jefferson

    2014-01-01

    To estimate the burden of disease due to tuberculosis in the state of Santa Catarina, Brazil, in 2009. This was an epidemiological study with an ecological design. Data on tuberculosis incidence and mortality were collected from specific Brazilian National Ministry of Health databases. The burden of disease due to tuberculosis was based on the calculation of disability-adjusted life years (DALYs). The DALYs were estimated by adding the years of life lost (YLLs) and years lived with disability (YLDs). Absolute values were transformed into rates per 100,000 population. The rates were calculated by gender, age group, and health care macroregion. The burden of disease due to tuberculosis was 5,644.27 DALYs (92.25 DALYs/100,000 population), YLLs and YLDs respectively accounting for 78.77% and 21.23% of that total. The highest rates were found in males in the 30-44 and 45-59 year age brackets, although that was not true in every health care macroregion. Overall, the highest estimated burden was in the Planalto Norte macroregion (179.56 DALYs/100,000 population), followed by the Nordeste macroregion (167.07 DALYs/100,000 population). In the majority of the health care macroregions of Santa Catarina, the burden of disease due to tuberculosis was concentrated in adult males, the level of that concentration varying among the various macroregions.

  12. Factor analysis of the Zarit Burden Interview in family caregivers of patients with amyotrophic lateral sclerosis.

    Science.gov (United States)

    Oh, Juyeon; Kim, Jung A

    2018-02-01

    The Zarit Burden Interview has been used in many studies to assess caregiver burden in family caregivers of patients with amyotrophic lateral sclerosis, but the factor structure of the Zarit Burden Interview in the caregivers of amyotrophic lateral sclerosis patients is unknown. The aim of this study was to explore the factor structure of the Zarit Burden Interview in family caregivers of amyotrophic lateral sclerosis patients using exploratory factor analysis. The exploratory factor analysis was performed using generalized least squares with oblique rotation in a sample of 202 family caregivers. Three factors had an eigenvalue greater than 1 and accounted for 60.33% of the total variance. The three factors were named as follows: (factor 1) "Social restrictions" (items 2, 3, and 10-15); (factor 2) "Self-criticism" (items 20-21); and (factor 3) "Anger and frustration" (items 1, 4-6, 9, and 16-19). The correlation between factors 1 and 3 was much higher (r = 0.79) than that between factors 1 and 2 (r = 0.14) or factors 2 and 3 (r = 0.15). The findings of this study enriched our understanding of several meaningful dimensions of the caregiving burden in caregivers of an amyotrophic lateral sclerosis population and provided opportunities for future intervention.

  13. The burden of disease due to tuberculosis in the state of Santa Catarina, Brazil

    Directory of Open Access Journals (Sweden)

    Glenio Cesar Nunes Ferrer

    2014-01-01

    Full Text Available OBJECTIVE: To estimate the burden of disease due to tuberculosis in the state of Santa Catarina, Brazil, in 2009. METHODS: This was an epidemiological study with an ecological design. Data on tuberculosis incidence and mortality were collected from specific Brazilian National Ministry of Health databases. The burden of disease due to tuberculosis was based on the calculation of disability-adjusted life years (DALYs. The DALYs were estimated by adding the years of life lost (YLLs and years lived with disability (YLDs. Absolute values were transformed into rates per 100,000 population. The rates were calculated by gender, age group, and health care macroregion. RESULTS: The burden of disease due to tuberculosis was 5,644.27 DALYs (92.25 DALYs/100,000 population, YLLs and YLDs respectively accounting for 78.77% and 21.23% of that total. The highest rates were found in males in the 30-44 and 45-59 year age brackets, although that was not true in every health care macroregion. Overall, the highest estimated burden was in the Planalto Norte macroregion (179.56 DALYs/100,000 population, followed by the Nordeste macroregion (167.07 DALYs/100,000 population. CONCLUSIONS: In the majority of the health care macroregions of Santa Catarina, the burden of disease due to tuberculosis was concentrated in adult males, the level of that concentration varying among the various macroregions.

  14. Burden of road traffic accidents in Nepal by calculating disability-adjusted life years

    Directory of Open Access Journals (Sweden)

    Ling Huang

    2017-10-01

    Full Text Available Objective: To calculate the burden of road traffic accidents in Kathmandu Valley and then extrapolate this to the national level. Methods: A prospective study was performed to compute the burden of road traffic accidents by quantification of disability-adjusted life years (DALYs using the Global Burden of Disease Study method on the basis of 1-year data from nine hospitals in Nepal and the Department of Forensic Medicine and cross-checked with the Nepal Traffic Directorate. Multiple methods were applied to the extrapolated population metrics of the burden of road traffic accidents in Nepal. Results: The total number of years of life lived in disability, years of life lost, and DALYs in Nepal were 38,848±194, 119,935±1464, and 158,783±1658 (95% confidence interval respectively. The number of years lost because of morbidity and death was similar in Kathmandu Valley. Most (75% of the DALYs resulted from years of life lost in Nepal. Males accounted for 73% of DALYs. Almost half (44% of the DALYs were contributed by the group aged 15–29 years. Conclusion: This study is the first to calculate the burden of road traffic accidents in Nepal using Nepal’s own data. Nepal needs to develop and enhance its own system to identify significant public health issues so as to set national priorities for prevention of road traffic accidents.

  15. The global burden of conduct disorder and attention-deficit/hyperactivity disorder in 2010.

    Science.gov (United States)

    Erskine, Holly E; Ferrari, Alize J; Polanczyk, Guilherme V; Moffitt, Terrie E; Murray, Christopher J L; Vos, Theo; Whiteford, Harvey A; Scott, James G

    2014-04-01

    The Global Burden of Disease Study 2010 (GBD 2010) is the first to include conduct disorder (CD) and attention-deficit/hyperactivity disorder (ADHD) for burden quantification. A previous systematic review pooled the available epidemiological data for CD and ADHD, and predicted prevalence by country, region, age and sex for each disorder. Prevalence was then multiplied by a disability weight to calculate years lived with disability (YLDs). As no evidence of deaths resulting directly from either CD or ADHD was found, no years of life lost (YLLs) were calculated. Therefore, the number of disability-adjusted life years (DALYs) was equal to that of YLDs. Globally, CD was responsible for 5.75 million YLDs/DALYs with ADHD responsible for a further 491,500. Collectively, CD and ADHD accounted for 0.80% of total global YLDs and 0.25% of total global DALYs. In terms of global DALYs, CD was the 72nd leading contributor and among the 15 leading causes in children aged 5-19 years. Between 1990 and 2010, global DALYs attributable to CD and ADHD remained stable after accounting for population growth and ageing. The global burden of CD and ADHD is significant, particularly in male children. Appropriate allocation of resources to address the high morbidity associated with CD and ADHD is necessary to reduce global burden. However, burden estimation was limited by data lacking for all four epidemiological parameters and by methodological challenges in quantifying disability. Future studies need to address these limitations in order to increase the accuracy of burden quantification. © 2014 The Authors. Journal of Child Psychology and Psychiatry © 2014 Association for Child and Adolescent Mental Health.

  16. Contaminated soil concrete blocks

    NARCIS (Netherlands)

    de Korte, A.C.J.; Brouwers, Jos; Limbachiya, Mukesh C.; Kew, Hsein Y.

    2009-01-01

    According to Dutch law the contaminated soil needs to be remediated or immobilised. The main focus in this article is the design of concrete blocks, containing contaminated soil, that are suitable for large production, financial feasible and meets all technical and environmental requirements. In

  17. Surface soil contamination standards

    International Nuclear Information System (INIS)

    Boothe, G.F.

    1979-01-01

    The purpose of this document is to define surface soil contamination limits for radioactive materials below which posting, restrictions and environmental controls are not necessary in order to protect personnel and the environment. The standards can also be used to determine if solid waste or other material is contaminated relative to disposal requirements. The derivation of the standards is given

  18. Contamination Control Techniques

    Energy Technology Data Exchange (ETDEWEB)

    EBY, J.L.

    2000-05-16

    Welcome to a workshop on contamination Control techniques. This work shop is designed for about two hours. Attendee participation is encouraged during the workshop. We will address different topics within contamination control techniques; present processes, products and equipment used here at Hanford and then open the floor to you, the attendees for your input on the topics.

  19. Contamination Control Techniques

    International Nuclear Information System (INIS)

    EBY, J.L.

    2000-01-01

    Welcome to a workshop on contamination Control techniques. This work shop is designed for about two hours. Attendee participation is encouraged during the workshop. We will address different topics within contamination control techniques; present processes, products and equipment used here at Hanford and then open the floor to you, the attendees for your input on the topics

  20. Contaminated water treatment

    Science.gov (United States)

    Gormly, Sherwin J. (Inventor); Flynn, Michael T. (Inventor)

    2010-01-01

    Method and system for processing of a liquid ("contaminant liquid") containing water and containing urine and/or other contaminants in a two step process. Urine, or a contaminated liquid similar to and/or containing urine and thus having a relatively high salt and urea content is passed through an activated carbon filter to provide a resulting liquid, to remove most of the organic molecules. The resulting liquid is passed through a semipermeable membrane from a membrane first side to a membrane second side, where a fortified drink having a lower water concentration (higher osmotic potential) than the resulting liquid is positioned. Osmotic pressure differential causes the water, but not most of the remaining inorganic (salts) contaminant(s) to pass through the membrane to the fortified drink. Optionally, the resulting liquid is allowed to precipitate additional organic molecules before passage through the membrane.

  1. Bioremediation of contaminated soil

    International Nuclear Information System (INIS)

    Balba, M.T.; Ying, A.C.; McNeice, T.G.

    1992-01-01

    Microorganisms, especially bacteria, yeast and fungi are capable of degrading many kinds of xenobiotic compounds and toxic chemicals such as petroleum hydrocarbon compounds. These microorganisms are ubiquitous in nature and, despite their enormous versatility, there are numerous cases in which long-term contamination of soil and groundwater has been observed. The persistence of the contamination is usually caused by the inability of microorganisms to metabolize these compounds under the prevailing environmental condition. This paper reports on biological remediation of contaminated sites which can be accomplished by using naturally-occurring microorganisms to treat the contaminants. The development of a bioremediation program for a specific contaminated soil system usually includes: A thorough site/soil/waste characterization; Treatability studies

  2. Contamination sources, prevention, and research

    Science.gov (United States)

    Contamination is defined as anything other than cotton in cotton lint. Worldwide, contamination is on the rise and plastic contamination has increased at a faster rate than contamination overall. In the U.S., there are many sources of plastic contaminants, such as plastic trash that collects in cott...

  3. The economic burden of Clostridium difficile

    Science.gov (United States)

    McGlone, S. M.; Bailey, R. R.; Zimmer, S. M.; Popovich, M. J.; Tian, Y.; Ufberg, P.; Muder, R. R.; Lee, B. Y.

    2013-01-01

    Although Clostridium difficile (C. difficile) is the leading cause of infectious diarrhoea in hospitalized patients, the economic burden of this major nosocomial pathogen for hospitals, third-party payers and society remains unclear. We developed an economic computer simulation model to determine the costs attributable to healthcare-acquired C. difficile infection (CDI) from the hospital, third-party payer and societal perspectives. Sensitivity analyses explored the effects of varying the cost of hospitalization, C. difficile-attributable length of stay, and the probability of initial and secondary recurrences. The median cost of a case ranged from $9179 to $11 456 from the hospital perspective, $8932 to $11 679 from the third-party payor perspective, and $13 310 to $16 464 from the societal perspective. Most of the costs incurred were accrued during a patient’s primary CDI episode. Hospitals with an incidence of 4.1 CDI cases per 100 000 discharges would incur costs ≥$3.2 million (hospital perspective); an incidence of 10.5 would lead to costs ≥$30.6 million. Our model suggests that the annual US economic burden of CDI would be ≥$496 million (hospital perspective), ≥$547 million (third-party payer perspective) and ≥$796 million (societal perspective). Our results show that C. difficile infection is indeed costly, not only to third-party payers and the hospital, but to society as well. These results are consistent with current literature citing C. difficile as a costly disease. PMID:21668576

  4. Total parenteral nutrition - infants

    Science.gov (United States)

    ... medlineplus.gov/ency/article/007239.htm Total parenteral nutrition - infants To use the sharing features on this page, please enable JavaScript. Total parenteral nutrition (TPN) is a method of feeding that bypasses ...

  5. Total parenteral nutrition

    Science.gov (United States)

    ... medlineplus.gov/ency/patientinstructions/000177.htm Total parenteral nutrition To use the sharing features on this page, please enable JavaScript. Total parenteral nutrition (TPN) is a method of feeding that bypasses ...

  6. Technique of total thyroidectomy

    International Nuclear Information System (INIS)

    Rao, R.S.

    1999-01-01

    It is essential to define the various surgical procedures that are carried out for carcinoma of the thyroid gland. They are thyroid gland, subtotal lobectomy, total thyroidectomy and near total thyroidectomy

  7. Total iron binding capacity

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/003489.htm Total iron binding capacity To use the sharing features on this page, please enable JavaScript. Total iron binding capacity (TIBC) is a blood test to ...

  8. Burden and Cognitive Appraisal of Stroke Survivors' Informal Caregivers: An Assessment of Depression Model With Mediating and Moderating Effects.

    Science.gov (United States)

    Tsai, Yi-Chen; Pai, Hsiang-Chu

    2016-04-01

    This study proposes and evaluates a model of depression that concerns the role of burden and cognitive appraisal as mediators or moderators of outcomes among stroke survivor caregivers. A total of 105 informal caregivers of stroke survivor completed the self-report measures of Caregiver Burden Inventory, Center for Epidemiologic Studies Depression Scale, and Cognitive Impact of Appraisal Scale. The Glasgow Coma Scale and Barthel Index were used by the researcher to examine the physical functional status of the survivor. Partial least squares (PLS) path modeling was used to estimate the parameters of a depression model that included mediating or moderating effects. The model shows that burden and impact of cognitive appraisal have a significant direct and indirect impact on depression, while survivor physical functional status does not have a direct impact. The model also demonstrates that burden and impact of cognitive appraisal separately play a mediating role between survivor physical functional status and caregiver depression. In addition, cognitive appraisal has a moderating influence on the relationship between burden and depression. Overall, survivor physical functional status, burden, and cognitive appraisal were the predictors of caregiver depression, explaining 47.1% of the variance. This study has shown that burden and cognitive appraisal are mediators that more fully explain the relationship between patient severity and caregiver depression. Copyright © 2015 Elsevier Inc. All rights reserved.

  9. Socioeconomic burden of influenza in the Republic of Korea, 2007-2010.

    Directory of Open Access Journals (Sweden)

    Mina Suh

    Full Text Available BACKGROUND: Although the socioeconomic burden of 2009 pandemic influenza A (H1N1 was considerable, no reliable estimates have been reported. Our aim was to compared medical costs and socioeconomic burden resulting from pandemic influenza A (H1N1 2009 with that of previous seasonal influenza. METHODS: We estimated the medical costs and socioeconomic burden of influenza from May 2007 to April 2010. We used representative national data sources(data from the Health Insurance Review Agency, the National Health Insurance Corporation, the Korea Centers for Disease Control and Prevention, and the Korean National Statistics Office including medical utilization, prescription of antivirals, and vaccination. Uncertainty of data was explored through sensitivity analysis using Monte Carlo simulation. RESULTS: Compared with the seasonal influenza, total medical costs (US$291.7 million associated with pandemic (H1N1 2009 increased more than 37-fold. Compared with the 2007-2008 season, outpatient diagnostic costs (US$135.3 million were 773 times higher in the 2009-2010 season, and the mean diagnostic cost per outpatient visit was 58.8 times higher. Total socioeconomic burden of pandemic (H1N1 2009 was estimated at US$1581.3 million (10%-90%: US$1436.0-1808.3 million and those of seasonal influenza was estimated at US$44.7 million (10%-90%: US$32.4-57.9 million in 2007-2008 season and US$42.3 million (10%-90%: US$31.5-53.8 million in 2008-2009 season. Indirect costs accounted for 56.0% of total costs in pandemic (H1N1 2009, and 66.48-68.09% in seasonal influenza. The largest contributors to total burden were productivity losses of caregiver in pandemic (H1N1 2009, and productivity losses due to morbidity of outpatient in seasonal influenza. CONCLUSIONS: In the Republic of Korea, socioeconomic burden of pandemic (H1N1 2009 were considerably higher than burden of the previous two influenza seasons, primarily because of high diagnostic costs and longer sick leave.

  10. Fungal contamination in hospital environments.

    Science.gov (United States)

    Perdelli, F; Cristina, M L; Sartini, M; Spagnolo, A M; Dallera, M; Ottria, G; Lombardi, R; Grimaldi, M; Orlando, P

    2006-01-01

    To assess the degree of fungal contamination in hospital environments and to evaluate the ability of air conditioning systems to reduce such contamination. We monitored airborne microbial concentrations in various environments in 10 hospitals equipped with air conditioning. Sampling was performed with a portable Surface Air System impactor with replicate organism detection and counting plates containing a fungus-selective medium. The total fungal concentration was determined 72-120 hours after sampling. The genera most involved in infection were identified by macroscopic and microscopic observation. The mean concentration of airborne fungi in the set of environments examined was 19 +/- 19 colony-forming units (cfu) per cubic meter. Analysis of the fungal concentration in the different types of environments revealed different levels of contamination: the lowest mean values (12 +/- 14 cfu/m(3)) were recorded in operating theaters, and the highest (45 +/- 37 cfu/m(3)) were recorded in kitchens. Analyses revealed statistically significant differences between median values for the various environments. The fungal genus most commonly encountered was Penicillium, which, in kitchens, displayed the highest mean airborne concentration (8 +/- 2.4 cfu/m(3)). The percentage (35%) of Aspergillus documented in the wards was higher than that in any of the other environments monitored. The fungal concentrations recorded in the present study are comparable to those recorded in other studies conducted in hospital environments and are considerably lower than those seen in other indoor environments that are not air conditioned. These findings demonstrate the effectiveness of air-handling systems in reducing fungal contamination.

  11. Total well dominated trees

    DEFF Research Database (Denmark)

    Finbow, Arthur; Frendrup, Allan; Vestergaard, Preben D.

    cardinality then G is a total well dominated graph. In this paper we study composition and decomposition of total well dominated trees. By a reversible process we prove that any total well dominated tree can both be reduced to and constructed from a family of three small trees....

  12. Subsurface contaminants focus area

    International Nuclear Information System (INIS)

    1996-08-01

    The US Department of Enregy (DOE) Subsurface Contaminants Focus Area is developing technologies to address environmental problems associated with hazardous and radioactive contaminants in soil and groundwater that exist throughout the DOE complex, including radionuclides, heavy metals; and dense non-aqueous phase liquids (DNAPLs). More than 5,700 known DOE groundwater plumes have contaminated over 600 billion gallons of water and 200 million cubic meters of soil. Migration of these plumes threatens local and regional water sources, and in some cases has already adversely impacted off-site rsources. In addition, the Subsurface Contaminants Focus Area is responsible for supplying technologies for the remediation of numerous landfills at DOE facilities. These landfills are estimated to contain over 3 million cubic meters of radioactive and hazardous buried Technology developed within this specialty area will provide efective methods to contain contaminant plumes and new or alternative technologies for development of in situ technologies to minimize waste disposal costs and potential worker exposure by treating plumes in place. While addressing contaminant plumes emanating from DOE landfills, the Subsurface Contaminants Focus Area is also working to develop new or alternative technologies for the in situ stabilization, and nonintrusive characterization of these disposal sites

  13. Direct contamination - seasonality

    International Nuclear Information System (INIS)

    Aarkrog, A.

    1994-01-01

    Direct contamination is the primary pathway to terrestrial vegetation in the first period after an activity release to the atmosphere. All radionuclides are able to be transferred via this pathway. Deposition, interception and retention are the three processes involved in direct contamination of crops. Wet deposition is more important than dry deposition in temperature regions. Resuspension and rainsplash both belong to secondary direct deposition and became evident for e.g. radiocaesium after the Chernobyl accident. Seasonality is the varying response to radioactive contamination of crops according to the time of the year when the contamination occurs. Shortlived radionuclides (as 131 I) and those that mainly enter the foodchain by direct contamination (e.g. 137 Cs) are especially important in this connection. In particular, the contamination of cereal crops is influenced by seasonality. As a result of seasonality the impact of the Chernobyl accident on the radioactive contamination of human diet was for the same deposition density higher in southern than in northern Europe. (orig.)

  14. Subsurface contaminants focus area

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-08-01

    The US Department of Enregy (DOE) Subsurface Contaminants Focus Area is developing technologies to address environmental problems associated with hazardous and radioactive contaminants in soil and groundwater that exist throughout the DOE complex, including radionuclides, heavy metals; and dense non-aqueous phase liquids (DNAPLs). More than 5,700 known DOE groundwater plumes have contaminated over 600 billion gallons of water and 200 million cubic meters of soil. Migration of these plumes threatens local and regional water sources, and in some cases has already adversely impacted off-site rsources. In addition, the Subsurface Contaminants Focus Area is responsible for supplying technologies for the remediation of numerous landfills at DOE facilities. These landfills are estimated to contain over 3 million cubic meters of radioactive and hazardous buried Technology developed within this specialty area will provide efective methods to contain contaminant plumes and new or alternative technologies for development of in situ technologies to minimize waste disposal costs and potential worker exposure by treating plumes in place. While addressing contaminant plumes emanating from DOE landfills, the Subsurface Contaminants Focus Area is also working to develop new or alternative technologies for the in situ stabilization, and nonintrusive characterization of these disposal sites.

  15. Nosocomial infections among acute leukemia patients in China: An economic burden analysis.

    Science.gov (United States)

    Wu, Xiaohui; Yan, Tianyuan; Liu, Yunhong; Wang, Jingna; Li, Yingxia; Wang, Shuhui

    2016-10-01

    The economic burden associated nosocomial infections (NIs) in patients with acute leukemia (AL) in China was unclear. A prospective study was conducted to quantify the medical cost burden of NIs among AL patients. Nine hundred ninety-four patients diagnosed with AL between January 2011 and December 2013 were included. Relevant necessary information was extracted from the hospital information system and hospital infection surveillance system. The primary outcome was incidence of NIs and the secondary was economic burden results, including extra medical costs and prolonged length of stay (LOS). We estimated the total incremental cost of NIs by comparing all-cause health care costs in patients with versus without infections. Prolonged duration of stay was compared in patients with different infections. Of 994 patients with AL, 277 (27.9%) experienced NIs. NI was associated with a total incremental cost of $3,092 per patient ($5,227 vs $2,135; P economic burden on patients with AL. The study highlights the influence of NIs on LOS and health care costs and appeal to the establishment of prophylactic measures for NIs to reduce the unnecessary waste of medical resources in the long run. Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  16. The Burden of Mental Disorders in the Eastern Mediterranean Region, 1990-2013

    Science.gov (United States)

    Charara, Raghid; Forouzanfar, Mohammad; Naghavi, Mohsen; Moradi-Lakeh, Maziar; Afshin, Ashkan; Vos, Theo; Daoud, Farah; Wang, Haidong; El Bcheraoui, Charbel; Khalil, Ibrahim; Hamadeh, Randah R.; Khosravi, Ardeshir; Rahimi-Movaghar, Vafa; Khader, Yousef; Al-Hamad, Nawal; Makhlouf Obermeyer, Carla; Rafay, Anwar; Asghar, Rana; Rana, Saleem M.; Shaheen, Amira; Abu-Rmeileh, Niveen M. E.; Husseini, Abdullatif; Abu-Raddad, Laith J.; Khoja, Tawfik; Al Rayess, Zulfa A.; AlBuhairan, Fadia S.; Hsairi, Mohamed; Alomari, Mahmoud A.; Ali, Raghib; Roshandel, Gholamreza; Terkawi, Abdullah Sulieman; Hamidi, Samer; Refaat, Amany H.; Westerman, Ronny; Kiadaliri, Aliasghar Ahmad; Akanda, Ali S.; Ali, Syed Danish; Bacha, Umar; Badawi, Alaa; Bazargan-Hejazi, Shahrzad; Faghmous, Imad A. D.; Fereshtehnejad, Seyed-Mohammad; Fischer, Florian; Jonas, Jost B.; Kuate Defo, Barthelemy; Mehari, Alem; Omer, Saad B.; Pourmalek, Farshad; Uthman, Olalekan A.; Mokdad, Ali A.; Maalouf, Fadi T.; Abd-Allah, Foad; Akseer, Nadia; Arya, Dinesh; Borschmann, Rohan; Brazinova, Alexandra; Brugha, Traolach S.; Catalá-López, Ferrán; Degenhardt, Louisa; Ferrari, Alize; Haro, Josep Maria; Horino, Masako; Hornberger, John C.; Huang, Hsiang; Kieling, Christian; Kim, Daniel; Kim, Yunjin; Knudsen, Ann Kristin; Mitchell, Philip B.; Patton, George; Sagar, Rajesh; Satpathy, Maheswar; Savuon, Kim; Seedat, Soraya; Shiue, Ivy; Skogen, Jens Christoffer; Stein, Dan J.; Tabb, Karen M.; Whiteford, Harvey A.; Yip, Paul; Yonemoto, Naohiro; Murray, Christopher J. L.; Mokdad, Ali H.

    2017-01-01

    The Eastern Mediterranean Region (EMR) is witnessing an increase in chronic disorders, including mental illness. With ongoing unrest, this is expected to rise. This is the first study to quantify the burden of mental disorders in the EMR. We used data from the Global Burden of Disease study (GBD) 2013. DALYs (disability-adjusted life years) allow assessment of both premature mortality (years of life lost–YLLs) and nonfatal outcomes (years lived with disability–YLDs). DALYs are computed by adding YLLs and YLDs for each age-sex-country group. In 2013, mental disorders contributed to 5.6% of the total disease burden in the EMR (1894 DALYS/100,000 population): 2519 DALYS/100,000 (2590/100,000 males, 2426/100,000 females) in high-income countries, 1884 DALYS/100,000 (1618/100,000 males, 2157/100,000 females) in middle-income countries, 1607 DALYS/100,000 (1500/100,000 males, 1717/100,000 females) in low-income countries. Females had a greater proportion of burden due to mental disorders than did males of equivalent ages, except for those under 15 years of age. The highest proportion of DALYs occurred in the 25–49 age group, with a peak in the 35–39 years age group (5344 DALYs/100,000). The burden of mental disorders in EMR increased from 1726 DALYs/100,000 in 1990 to 1912 DALYs/100,000 in 2013 (10.8% increase). Within the mental disorders group in EMR, depressive disorders accounted for most DALYs, followed by anxiety disorders. Among EMR countries, Palestine had the largest burden of mental disorders. Nearly all EMR countries had a higher mental disorder burden compared to the global level. Our findings call for EMR ministries of health to increase provision of mental health services and to address the stigma of mental illness. Moreover, our results showing the accelerating burden of mental health are alarming as the region is seeing an increased level of instability. Indeed, mental health problems, if not properly addressed, will lead to an increased burden of

  17. A systematic review of patient-reported measures of burden of treatment in three chronic diseases

    Directory of Open Access Journals (Sweden)

    Eton DT

    2013-06-01

    Full Text Available David T Eton,1 Tarig A Elraiyah,2 Kathleen J Yost,3 Jennifer L Ridgeway,1 Anna Johnson,2 Jason S Egginton,1 Rebecca J Mullan,4 Mohammad Hassan Murad,2 Patricia J Erwin,2 Victor M Montori1,2 1Division of Heath Care Policy and Research, Department of Health Sciences Research, 2Knowledge and Evaluation Research Unit, 3Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA; 4University of Minnesota Medical School, Minneapolis, MN, USA Background: Burden of treatment refers to the workload of health care and its impact on patient functioning and well-being. There are a number of patient-reported measures that assess burden of treatment in single diseases or in specific treatment contexts. A review of such measures could help identify content for a general measure of treatment burden that could be used with patients dealing with multiple chronic conditions. We reviewed the content and psychometric properties of patient-reported measures that assess aspects of treatment burden in three chronic diseases, ie, diabetes, chronic kidney disease, and heart failure. Methods: We searched Ovid MEDLINE, Ovid EMBASE, Ovid PsycINFO, and EBSCO CINAHL through November 2011. Abstracts were independently reviewed by two people, with disagreements adjudicated by a third person. Retrieved articles were reviewed to confirm relevance, with patient-reported measures scrutinized to determine consistency with the definition of burden of treatment. Descriptive information and psychometric properties were extracted. Results: A total of 5686 abstracts were identified from the database searches. After abstract review, 359 full-text articles were retrieved, of which 76 met our inclusion criteria. An additional 22 articles were identified from the references of included articles. From the 98 studies, 57 patient-reported measures of treatment burden (full measures or components within measures were identified. Most were multi-item scales

  18. Caregiving burden and depression in paid caregivers of hospitalized patients: a pilot study in China

    Directory of Open Access Journals (Sweden)

    Yao-Dan Liang

    2017-07-01

    Full Text Available Abstract Background Caregiving burden and depression in family caregivers have been investigated, but little is known about how they affect paid caregivers. The aim of this study was to investigate caregiving burden and depression in paid caregivers of hospitalized patients. Methods A cross-sectional survey study was conducted in a tertiary referral hospital (Chengdu, China that enrolled 108 paid caregivers who worked in the inpatient department. The Caregiver Burden Inventory (CBI and the Center for Epidemiologic Studies Depression (CES-D scale were incorporated into a self-developed questionnaire to gather demographic information on the following four aspects: general, work, income, and family. Results The mean total CBI score was 29.7 ± 12.5. The time-dependence burden had the highest score of 15.3 ± 4.0, which was followed by the physical burden score of 6.5 ± 4.6, developmental burden score of 3.7 ± 4.0, social burden score of 3.2 ± 4.0, and emotional burden score of 2.4 ± 3.1. Multiple linear regression analysis showed that a higher CBI was associated with a longer time as a paid caregiver [β=7.041, 95% Confidence Interval (CI:1.935 to 12.974, p = 0.009], lower income satisfaction (β= − 6.573, 95% CI: -11.248 to −3.020, p = 0.001, and higher frequency of meeting with their relatives (β=7.125, 95% CI: 2.019 to 12.456, p = 0.006. The mean CES-D score was 11.9 ± 8.7, and significant depression was found in 28 (25.9% paid caregivers according to the CES-D score ≥ 16 cut-off. There was a moderate positive correlation between the CBI and CES-D scores (Pearson’s r = 0.452, p < 0.001. Conclusions A high caregiving burden was commonly observed in paid caregivers of hospitalized patients in China, as was a high prevalence of depression symptoms. Several associated factors were identified that could be areas for future interventions.

  19. Cancer risk assessments of Hong Kong soils contaminated by polycyclic aromatic hydrocarbons

    Energy Technology Data Exchange (ETDEWEB)

    Man, Yu Bon [School of Environmental and Resource Sciences, Zhejiang Agriculture and Forestry University, Lin’an, Zhejiang 311300 (China); State Key Laboratory in Marine Pollution - Croucher Institute for Environmental Sciences, Hong Kong Baptist University and City University of Hong Kong, Hong Kong SAR (China); Kang, Yuan [State Key Laboratory in Marine Pollution - Croucher Institute for Environmental Sciences, Hong Kong Baptist University and City University of Hong Kong, Hong Kong SAR (China); School of Chemistry and Environment, South China Normal University, Key Laboratory of Theoretical Chemistry of Environment, Ministry of Education, Higher Education Mega Center, Guangzhou 510006 (China); Wang, Hong Sheng [State Key Laboratory in Marine Pollution - Croucher Institute for Environmental Sciences, Hong Kong Baptist University and City University of Hong Kong, Hong Kong SAR (China); Department of Microbial and Biochemical Pharmacy, School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou 510006 (China); Lau, Winifred; Li, Hui; Sun, Xiao Lin [State Key Laboratory in Marine Pollution - Croucher Institute for Environmental Sciences, Hong Kong Baptist University and City University of Hong Kong, Hong Kong SAR (China); Giesy, John P. [Department of Biology and Chemistry and State Key Laboratory in Marine Pollution, City University of Hong Kong, Kowloon, Hong Kong, SAR (China); Chow, Ka Lai [State Key Laboratory in Marine Pollution - Croucher Institute for Environmental Sciences, Hong Kong Baptist University and City University of Hong Kong, Hong Kong SAR (China); Wong, Ming Hung, E-mail: mhwong@hkbu.edu.hk [School of Environmental and Resource Sciences, Zhejiang Agriculture and Forestry University, Lin’an, Zhejiang 311300 (China); State Key Laboratory in Marine Pollution - Croucher Institute for Environmental Sciences, Hong Kong Baptist University and City University of Hong Kong, Hong Kong SAR (China)

    2013-10-15

    Highlights: ► High levels of soil organic matter in soils render PAHs more resistant to degradation. ► Open burning site contain high concentrations of PAHs in Hong Kong. ► Car dismantling workshop can increase potential cancer risk on human. -- Abstract: The aim of this study was to evaluate soils from 12 different land use types on human cancer risks, with the main focus being on human cancer risks related to polycyclic aromatic hydrocarbons (PAHs). Fifty-five locations were selected to represent 12 different types of land use (electronic waste dismantling workshop (EW (DW)); open burning site (OBS); car dismantling workshop (CDW) etc.). The total concentrations of 16 PAHs in terms of total burden and their bioaccessibility were analysed using GC/MS. The PAHs concentrations were subsequently used to establish cancer risks in humans via three exposure pathways, namely, accident ingestion of soil, dermal contact soil and inhalation of soil particles. When the 95th centile values of total PAH concentrations were used to derive ingestion and dermal cancer risk probabilities on humans, the CDW land use type indicated a moderate potential for cancerous development (244 × 10{sup −6} and 209 × 10{sup −6}, respectively). Bioaccessible PAHs content in soil samples from CDW (3.60 × 10{sup −6}) were also classified as low cancer risk. CDW soil possessed a higher carcinogenic risk based on PAH concentrations. Bioremediation is recommended to treat the contaminated soil.

  20. Cancer risk assessments of Hong Kong soils contaminated by polycyclic aromatic hydrocarbons

    International Nuclear Information System (INIS)

    Man, Yu Bon; Kang, Yuan; Wang, Hong Sheng; Lau, Winifred; Li, Hui; Sun, Xiao Lin; Giesy, John P.; Chow, Ka Lai; Wong, Ming Hung

    2013-01-01

    Highlights: ► High levels of soil organic matter in soils render PAHs more resistant to degradation. ► Open burning site contain high concentrations of PAHs in Hong Kong. ► Car dismantling workshop can increase potential cancer risk on human. -- Abstract: The aim of this study was to evaluate soils from 12 different land use types on human cancer risks, with the main focus being on human cancer risks related to polycyclic aromatic hydrocarbons (PAHs). Fifty-five locations were selected to represent 12 different types of land use (electronic waste dismantling workshop (EW (DW)); open burning site (OBS); car dismantling workshop (CDW) etc.). The total concentrations of 16 PAHs in terms of total burden and their bioaccessibility were analysed using GC/MS. The PAHs concentrations were subsequently used to establish cancer risks in humans via three exposure pathways, namely, accident ingestion of soil, dermal contact soil and inhalation of soil particles. When the 95th centile values of total PAH concentrations were used to derive ingestion and dermal cancer risk probabilities on humans, the CDW land use type indicated a moderate potential for cancerous development (244 × 10 −6 and 209 × 10 −6 , respectively). Bioaccessible PAHs content in soil samples from CDW (3.60 × 10 −6 ) were also classified as low cancer risk. CDW soil possessed a higher carcinogenic risk based on PAH concentrations. Bioremediation is recommended to treat the contaminated soil

  1. A fifteen year experience of total thyroidectomy for the management ...

    African Journals Online (AJOL)

    Tracheostomy was required in 35 (5.8%) patients but none was permanent. Conclusion: Total thyroidectomy is a relatively safe treatment option for patients who have simple multinodular goitre. It provides a permanent cure with a low postoperative morbidity risk. The burden of replacement l-thyroxine needs to be discussed ...

  2. Burden of Self-reported Acute Gastrointestinal Illness in Cuba

    Science.gov (United States)

    Prieto, Pablo Aguiar; Finley, Rita L.; Guerin, Michele T.; Isaacs, Sandy; Domínguez, Arnaldo Castro; Marie, Gisele Coutín; Perez, Enrique

    2009-01-01

    Acute gastrointestinal illness is an important public-health issue worldwide. Burden-of-illness studies have not previously been conducted in Cuba. The objective of the study was to determine the magnitude, distribution, and burden of self-reported acute gastrointestinal illness in Cuba. A retrospective, cross-sectional survey was conducted in three sentinel sites during June-July 2005 (rainy season) and during November 2005–January 2006 (dry season). Households were randomly selected from a list maintained by the medical offices in each site. One individual per household was selected to complete a questionnaire in a face-to-face interview. The case definition was three or more bouts of loose stools in a 24-hour period within the last 30 days. In total, 97.3% of 6,576 interviews were completed. The overall prevalence of acute gastrointestinal illness was 10.6%. The risk of acute gastrointestinal illness was higher during the rainy season (odds ratio [OR]=3.85, 95% confidence interval [CI] 3.18-4.66) in children (OR=3.12, 95% CI 2.24-4.36) and teens (OR=2.27, 95% CI 1.51-3.41) compared to people aged 25-54 years, in males (OR=1.24, 95% CI 1.04-1.47), and in the municipality of Santiago de Cuba (OR=1.33, 95% CI 1.11-1.61). Of 680 cases, 17.1-38.1% visited a physician, depending on sentinel site. Of the cases who visited a physician, 33.3-53.9% were requested to submit a stool sample, and of those, 72.7-100.0% complied. Of the cases who sought medical care, 16.7- 61.5% and 0-31.6% were treated with antidiarrhoeals and antibiotics respectively. Acute gastrointestinal illness represented a substantial burden of health compared to developed countries. Targeting the identified risk factors when allocating resources for education, food safety, and infrastructure might lower the morbidity associated with acute gastrointestinal illness. PMID:19507750

  3. Use of National Burden to Define Operative Emergency General Surgery.

    Science.gov (United States)

    Scott, John W; Olufajo, Olubode A; Brat, Gabriel A; Rose, John A; Zogg, Cheryl K; Haider, Adil H; Salim, Ali; Havens, Joaquim M

    2016-06-15

    Emergency general surgery (EGS) represents 11% of surgical admissions and 50% of surgical mortality in the United States. However, there is currently no established definition of the EGS procedures. To define a set of procedures accounting for at least 80% of the national burden of operative EGS. A retrospective review was conducted using data from the 2008-2011 National Inpatient Sample. Adults (age, ≥18 years) with primary EGS diagnoses consistent with the American Association for the Surgery of Trauma definition, admitted urgently or emergently, who underwent an operative procedure within 2 days of admission were included in the analyses. Procedures were ranked to account for national mortality and complication burden. Among ranked procedures, contributions to total EGS frequency, mortality, and hospital costs were assessed. The data query and analysis were performed between November 15, 2015, and February 16, 2016. Overall procedure frequency, in-hospital mortality, major complications, and inpatient costs calculated per 3-digit International Classification of Diseases, Ninth Revision, Clinical Modification procedure codes. The study identified 421 476 patient encounters associated with operative EGS, weighted to represent 2.1 million nationally over the 4-year study period. The overall mortality rate was 1.23% (95% CI, 1.18%-1.28%), the complication rate was 15.0% (95% CI, 14.6%-15.3%), and mean cost per admission was $13 241 (95% CI, $12 957-$13 525). After ranking the 35 procedure groups by contribution to EGS mortality and morbidity burden, a final set of 7 operative EGS procedures were identified, which collectively accounted for 80.0% of procedures, 80.3% of deaths, 78.9% of complications, and 80.2% of inpatient costs nationwide. These 7 procedures included partial colectomy, small-bowel resection, cholecystectomy, operative management of peptic ulcer disease, lysis of peritoneal adhesions, appendectomy, and laparotomy. Only 7 procedures account

  4. Modeling the pH-mediated extraction of ionizable organic contaminants to improve the quality of municipal sewage sludge destined for land application

    International Nuclear Information System (INIS)

    Venkatesan, Arjun K.; Halden, Rolf U.

    2016-01-01

    A model was developed to assess the impact of adding acids and bases to processed municipal sewage sludge (MSS) to mobilize contaminants, facilitating their removal from sludge by flushing prior to land application. Among 312 organic contaminants documented to occur in U.S. MSS, 71 or 23% were identified as ionizable organic contaminants (IOCs), contributing a disproportionately large fraction of 82% of the total mass of sludge-borne contaminants. Detected IOCs included 57 pharmaceuticals and personal care products, 12 perfluorinated compounds, one surfactant and one pesticide. Annually, about 2000 t of IOCs were estimated to be released to U.S. soils via land-application of MSS. A partitioning model developed to assess the impact of pH on hydrophobic sorption revealed that between 36 and 85% of the mass of individual classes of IOCs potentially could be desorbed from MSS via pH adjustment and flushing. Thus, modeling results suggest that a sequential pH treatment [acidic (~ pH 2) followed by basic (~ pH 12) treatment] has the potential to reduce the burden of harmful IOCs in MSS applied on U.S. land by up to 40 ± 16 t annually. This approach may serve as a cost-effective treatment process that can be implemented easily in existing sludge treatment infrastructure in the U.S. and worldwide, serving to significantly improve the quality of MSS destined for land application. - Highlights: • Sorption model predicts the leachability of ionizable organics from sludge. • Ionic organics make up 82% of total contaminant mass in U.S. sludge. • 36–85% of ionic organic pollutants are removable by pH treatment. • Proposed sludge treatment promises cost-effective risk reduction.

  5. Modeling the pH-mediated extraction of ionizable organic contaminants to improve the quality of municipal sewage sludge destined for land application

    Energy Technology Data Exchange (ETDEWEB)

    Venkatesan, Arjun K.; Halden, Rolf U., E-mail: halden@asu.edu

    2016-04-15

    A model was developed to assess the impact of adding acids and bases to processed municipal sewage sludge (MSS) to mobilize contaminants, facilitating their removal from sludge by flushing prior to land application. Among 312 organic contaminants documented to occur in U.S. MSS, 71 or 23% were identified as ionizable organic contaminants (IOCs), contributing a disproportionately large fraction of 82% of the total mass of sludge-borne contaminants. Detected IOCs included 57 pharmaceuticals and personal care products, 12 perfluorinated compounds, one surfactant and one pesticide. Annually, about 2000 t of IOCs were estimated to be released to U.S. soils via land-application of MSS. A partitioning model developed to assess the impact of pH on hydrophobic sorption revealed that between 36 and 85% of the mass of individual classes of IOCs potentially could be desorbed from MSS via pH adjustment and flushing. Thus, modeling results suggest that a sequential pH treatment [acidic (~ pH 2) followed by basic (~ pH 12) treatment] has the potential to reduce the burden of harmful IOCs in MSS applied on U.S. land by up to 40 ± 16 t annually. This approach may serve as a cost-effective treatment process that can be implemented easily in existing sludge treatment infrastructure in the U.S. and worldwide, serving to significantly improve the quality of MSS destined for land application. - Highlights: • Sorption model predicts the leachability of ionizable organics from sludge. • Ionic organics make up 82% of total contaminant mass in U.S. sludge. • 36–85% of ionic organic pollutants are removable by pH treatment. • Proposed sludge treatment promises cost-effective risk reduction.

  6. Safety against radioactive contamination

    International Nuclear Information System (INIS)

    Anon.

    1983-01-01

    The ALWIT anticontamination suit is briefly described, consisting of lasting antistatic ''NDMEX III''. It was specially developed for the fire brigade who are exposed to a particular kind of contamination while carrying out radiation measurements during fire fighting, rescue and clearing up work. The ALWIT suit reliably prevents radioactive contamination of the surface of the body while wearing a breathing apparatus, independent of the ambient air. Tightly fitting cuffs on the neck, arms and legs together with zippers placed behind prevent contamination even with extreme movement. (P.F.K.)

  7. Family caregiver burden: the burden of caring for lung cancer patients according to the cancer stage and patient quality of life

    Directory of Open Access Journals (Sweden)

    Eliana Lourenço Borges

    Full Text Available ABSTRACT Objective: Patients with lung cancer experience different feelings and reactions, based on their family, social, cultural, and religious backgrounds, which are a source of great distress, not only for the patients but also for their family caregivers. This study aimed to evaluate the impact that lung cancer stage and quality of life (QoL of lung cancer patients have on caregiver burden. Methods: This was a prospective cross-sectional study. Consecutive patient-caregiver dyads were selected and asked to complete the Hospital Anxiety and Depression Scale and the Medical Outcomes Study 36-item ShortForm Health Survey (SF-36. Family caregivers also completed the Caregiver Burden Scale. Group-based modeling was used in order to identify patients with early- or advanced-stage cancer (IA to IIIA vs. IIIB to IV plus non-impaired or impaired QoL (SF36 total score > 50 vs. ≤ 50. Patient-caregiver dyads were stratified into four groups: early-stage cancer+non-impaired QoL; advanced-stage cancer+non-impaired QoL; early-stage cancer+impaired QoL; and advanced-stage cancer+impaired QoL. Results: We included 91 patient-caregiver dyads. The majority of the patients were male and heavy smokers. Family caregivers were younger and predominantly female. The burden, QoL, level of anxiety, and level of depression of caregivers were more affected by the QoL of the patients than by their lung cancer stage. The family caregivers of the patients with impaired QoL showed a higher median burden than did those of the patients with non-impaired QoL, regardless of disease stage. Conclusions: Caregiver burden is more affected by patient QoL than by lung cancer stage.

  8. Rationale, Design, and Methodological Aspects of the BUDAPEST-GLOBAL Study (Burden of Atherosclerotic Plaques Study in Twins-Genetic Loci and the Burden of Atherosclerotic Lesions).

    Science.gov (United States)

    Maurovich-Horvat, Pál; Tárnoki, Dávid L; Tárnoki, Ádám D; Horváth, Tamás; Jermendy, Ádám L; Kolossváry, Márton; Szilveszter, Bálint; Voros, Viktor; Kovács, Attila; Molnár, Andrea Á; Littvay, Levente; Lamb, Hildo J; Voros, Szilard; Jermendy, György; Merkely, Béla

    2015-12-01

    The heritability of coronary atherosclerotic plaque burden, coronary geometry, and phenotypes associated with increased cardiometabolic risk are largely unknown. The primary aim of the Burden of Atherosclerotic Plaques Study in Twins-Genetic Loci and the Burden of Atherosclerotic Lesions (BUDAPEST-GLOBAL) study is to evaluate the influence of genetic and environmental factors on the burden of coronary artery disease. By design this is a prospective, single-center, classical twin study. In total, 202 twins (61 monozygotic pairs, 40 dizygotic same-sex pairs) were enrolled from the Hungarian Twin Registry database. All twins underwent non-contrast-enhanced computed tomography (CT) for the detection and quantification of coronary artery calcium and for the measurement of epicardial fat volumes. In addition, a single non-contrast-enhanced image slice was acquired at the level of L3-L4 to assess abdominal fat distribution. Coronary CT angiography was used for the detection and quantification of plaque, stenosis, and overall coronary artery disease burden. For the primary analysis, we will assess the presence and volume of atherosclerotic plaques. Furthermore, the 3-dimensional coronary geometry will be assessed based on the coronary CT angiography datasets. Additional phenotypic analyses will include per-patient epicardial and abdominal fat quantity measurements. Measurements obtained from monozygotic and dizygotic twin pairs will be compared to evaluate the genetic or environmental effects of the given phenotype. The BUDAPEST-GLOBAL study provides a unique framework to shed some light on the genetic and environmental influences of cardiometabolic disorders. © 2015 Wiley Periodicals, Inc.

  9. Lesions in Broiler Chicks Following Experimental Contamination ...

    African Journals Online (AJOL)

    The objective of the present study was to investigate the effect of feed contamination with battery waste on the performance, organs weights as well as the histology of some internal organs of broiler chicks. A total of 120 1- d old broiler chicks were allotted to four dietary treatments in a completely randomized design.

  10. Microbial contamination associated with the processing of ...

    African Journals Online (AJOL)

    This study aimed to assess the microbiological contamination and quality of tchachanga, a roasted meat braised product processed at traditional scale in Benin, West Africa. A survey was performed to collect samples of tchachanga and data related to hygienic conditions of the roasted meat processing environment. A total ...

  11. Passive sampling methods for contaminated sediments

    DEFF Research Database (Denmark)

    Peijnenburg, Willie J.G.M.; Teasdale, Peter R.; Reible, Danny

    2014-01-01

    “Dissolved” concentrations of contaminants in sediment porewater (Cfree) provide a more relevant exposure metric for risk assessment than do total concentrations. Passive sampling methods (PSMs) for estimating Cfree offer the potential for cost-efficient and accurate in situ characterization...

  12. Burden of illness and treatment patterns for patients with fibromyalgia.

    Science.gov (United States)

    Robinson, Rebecca L; Kroenke, Kurt; Mease, Philip; Williams, David A; Chen, Yi; D'Souza, Deborah; Wohlreich, Madelaine; McCarberg, Bill

    2012-10-01

      This study was designed to describe burden of illness and treatment patterns, and to examine the patient, physician, and care factors associated with the treatment choices of individuals receiving new prescriptions for fibromyalgia (FM).   This is a baseline assessment of the Real-World Examination of Fibromyalgia: Longitudinal Evaluation of Costs and Treatments (REFLECTIONS), a prospective observational study. Baseline data (including a physician survey, a patient visit form, and computer-assisted telephone interviews) were collected from July 2008 through May 2010 in 58 care settings in the United States, including Puerto Rico.   Patients (N = 1,700) were mostly female (94.6%) and white (82.9%). Mean age was 50.4 years and mean duration of illness was 5.6 years. Mean Fibromyalgia Impact Questionnaire total score was 54.4 (range 0-80), and Brief Pain Inventory average pain severity level was 5.5 (range 0-10). Patients reported high annual health care use and numerous work limitations related to FM. Patients were taking 182 unique types of medications prescribed for FM, including duloxetine (26.8%), nonsteroidal anti-inflammatory drugs (26.6%), pregabalin (24.5%), opioids (24.2%), tramadol (15.3%), benzodiazepines (15.2%), cyclobenzaprine (12.9%), milnacipran (8.9%), and others. Most patients took more than one medication concurrently (77.8%). Type of current medications used was most strongly associated with medication history and physician specialty.   Burden of illness was high for patients with FM, and treatment patterns were highly variable. Importantly, the treatments with the most evidence to support their use were not always the most frequently chosen. Wiley Periodicals, Inc.

  13. Disease burden of chronic lymphocytic leukaemia within the European Union.

    Science.gov (United States)

    Watson, Louise; Wyld, Peter; Catovsky, Daniel

    2008-10-01

    Whilst Chronic lymphocytic leukaemia (CLL) is considered a rare disease, to our knowledge, the current prevalence of CLL within the European Union (EU) member states is not published. Understanding the number of individuals with CLL is vital to assess disease burden within the wider population. Using 2002 data from the International Agency for Research on Cancer, we estimated the number of individuals with CLL (ICD-10 C91.1) from those reported for all leukaemias (C91-95) and extrapolated the figures by the population increase within the EU between 2002 and 2006, the last year with fully updated community population estimates. One- and 5-yr partial prevalence estimates are reported (i.e. the number of individuals still living 1-5 yr post-diagnosis). We then applied proportional estimates from the literature to assess those requiring immediate treatment, those under observation and their likely progression rates. We found that within the 27 EU states plus Iceland, Norway and Lichtenstein, 1- and 5-yr CLL partial prevalence estimates totalled approximately 13,952 and 46,633 individuals respectively in 2006. By applying Binet staging to the 1-yr estimate, 40% of patients will be stage B/C and require immediate treatment. Thus, 5581 individuals may be treated within the first year of diagnosis. Of the 60% (8371) under observation, by 5 yr up to 33% (2763) may have more advanced disease with increased risk of mortality. Whilst CLL is a rare disease, the number of individuals burdened by the disease within the EU is considerable and thousands of patients require treatment and physician care, which has cost implications for member states.

  14. Liquid fructose supplementation in LDL-R−/− mice fed a western-type diet enhances lipid burden and atherosclerosis despite identical calorie consumption

    Directory of Open Access Journals (Sweden)

    Natalia Hutter

    2015-12-01

    Conclusions: SLF, without changing total calorie intake, increases atherosclerosis, visceral adipose tissue and cholesterol burden in a background of overweight LDL receptor knockout mice consuming an unhealthy, Western-type solid rodent chow.

  15. Neglected Tropical Diseases: Epidemiology and Global Burden

    Directory of Open Access Journals (Sweden)

    Amal K. Mitra

    2017-08-01

    Full Text Available More than a billion people—one-sixth of the world’s population, mostly in developing countries—are infected with one or more of the neglected tropical diseases (NTDs. Several national and international programs (e.g., the World Health Organization’s Global NTD Programs, the Centers for Disease Control and Prevention’s Global NTD Program, the United States Global Health Initiative, the United States Agency for International Development’s NTD Program, and others are focusing on NTDs, and fighting to control or eliminate them. This review identifies the risk factors of major NTDs, and describes the global burden of the diseases in terms of disability-adjusted life years (DALYs.

  16. The global burden of paediatric heart disease

    DEFF Research Database (Denmark)

    Musa, Ndidiamaka L; Hjortdal, Vibeke; Zheleva, Bistra

    2017-01-01

    An estimated 15 million children die or are crippled annually by treatable or preventable heart disease in low- and middle-income countries. Global efforts to reduce under-5 mortality have focused on reducing death from communicable diseases in low- and middle-income countries with little...... to no attention focusing on paediatric CHD and acquired heart disease. Lack of awareness of CHD and acquired heart disease, access to care, poor healthcare infrastructure, competing health priorities, and a critical shortage of specialists are important reasons why paediatric heart disease has not been addressed...... in low resourced settings. Non-governmental organisations have taken the lead to address these challenges. This review describes the global burden of paediatric heart disease and strategies to improve the quality of care for paediatric heart disease. These strategies would improve outcomes for children...

  17. Burden in family caregivers of the elderly: prevalence and association with characteristics of the elderly and the caregivers

    Directory of Open Access Journals (Sweden)

    Lara de Sa Neves Loureiro

    2013-10-01

    Full Text Available A cross-sectional, epidemiological study aimed to estimate the prevalence of burden among family caregivers of impaired elderly residents in the city of João Pessoa, and to identify associations between the mean burden and social and demographic characteristics of the elderly and the caregivers. A total number of 240 elderly residents in a previously drawn census tract participated in this research. The sample was composed of 52 elderly and their caregivers. For data collection, a questionnaire was applied with questions on social and demographic characteristics of elderly and caregivers, and the Burden Interview Scale was used. Results showed a high prevalence of burden among caregivers (84.6%, in which a statistically significant association was found with the following characteristics: retired elderly, elderly as head of family, spousal caregivers, and caregivers with less education. The findings of this study may contribute to the development of activities focused on formal and emotional support for the caregivers.

  18. Vermiremediation of soils contaminated with mixture of petroleum ...

    African Journals Online (AJOL)

    In this paper, vermiremediation, a biological technique was utilized in order to clean-up soil contaminated with gasoline, diesel and spent engine oil using an earthworm - Eisenia fetida. The contaminated soils were analyzed for the total petroleum hydrocarbon (TPH) level every 24 hours over a period of 120 hours using ...

  19. Contamination of herbal medicinal products marketed in Kaduna ...

    African Journals Online (AJOL)

    The study aimed to evaluate the bacterial contamination of powdered herbal medicinal preparations sourced from identified herbal retail outlets in different parts of Kaduna metropolis. The assessments of the contamination of the herbal products were carried out using standard procedures: total aerobic bacterial plate count, ...

  20. Heavy metals contamination of topsoil and dispersion in the ...

    African Journals Online (AJOL)

    Growing concern about reclamation of auto-repair workshop areas for residential and agricultural purposes makes risk assessment of heavy metal contamination of the study area imperative. In addition, the study is aimed at ascertaining the dispersion of contaminated Zn, Ni, Cr, Hg, and Pb within the soil profile. A total of 75 ...

  1. Contamination and decontamination of skin

    International Nuclear Information System (INIS)

    Severa, J.; Knajfl, J.

    1983-01-01

    In external contamination the beta radiation dose is the prevalent component of the total dose absorbed by the skin. There exist four types of radionUclide bonds to the skin: mechanical retention of solid particles or solution on the surface and in the pores, physical adsorption of nondissociated molecules or colloids, the ion exchange effect, and chemisorption. Radionuclides then penetrate the skin by transfollicular transfer. The total amount of radioactive substances absorbed into the skin depends on the condition of the skin. Skin is decontaminated by washing with lukewarm water and soap or with special decontamination solutions. The most widely used components of decontamination solutions are detergents, chelaton, sodium hexametaphosphate, oxalic acid, citric acid. The main principles of the decontamination of persons are given. (M.D.)

  2. Ten years' experience in determining internal contamination among plutonium laboratory workers

    International Nuclear Information System (INIS)

    Deworm, J.; Fieuw, G.

    1976-01-01

    Glove boxes in plutonium laboratories are fitted with ''sniffers'' (air samplers), which evaluate atmospheric contamination. The results of the measurements over a ten-year period of operation are available, and cases of detection in this way of air contamination exceeding the maximum permissible concentrations are exceptional. During contamination aerodynamic particle diameters of 1 - 4 μm were measured. The concentration and characteristics of the aerosol have made it possible to ascertain the inhalable fraction and to estimate the pulmonary and systemic burden in workers. The workers exposed in the laboratories undergo a urine test each month. The results obtained show that there is little risk of internal contamination without the person concerned being aware of an abnormal situation. In the majority of cases it is possible to take proper precautions and to collect the data necessary for evaluating the body burden. Three cases of specific contamination are examined in detail: contamination by plutonium and americium from a non-identified source, detected by routine urine analysis; contamination by inhalation of plutonium; an injury to the left forefinger, accompanied by plutonium contamination. (author)

  3. Economic Burden of Herpes Zoster ("culebrilla") in Latin America.

    Science.gov (United States)

    Rampakakis, Emmanouil; Pollock, Clare; Vujacich, Claudia; Toniolo Neto, Joao; Ortiz Covarrubias, Alejandro; Monsanto, Homero; Johnson, Kelly D

    2017-05-01

    Herpes zoster (HZ) is characterized by debilitating pain and blistering dermatomal rash. The most common complication of HZ is postherpetic neuralgia (PHN), a persistent pain that can substantially affect patients' quality of life. HZ has significant impact on patients' lives with considerable implications for healthcare systems and society. The purpose of this study was to evaluate the healthcare resource utilization (HCRU) and medical costs associated with HZ in Latin America. We conducted a pooled-analysis of three prospective cohort studies of HZ patients ≥50 years of age in Argentina (n=96); Brazil (n=145) and Mexico (n=142). Patients were recruited at different time-points during their HZ episode and were followed for six months. The incidence of PHN was defined as a worst ZBPI pain score of ≥3, persisting or appearing more than 90 days after the onset of rash. Work effectiveness was measured on a 100-point Likert scale where 100 was described as completely effective (able to work like before HZ began) and 0 as not effective at all. Direct costs included costs due to use of antiviral medications and all medical services used to treat HZ. Indirect cost was based on foregone earnings from patients due to work loss and presenteeism, and work loss by family caretakers. One-way sensitivity analysis was performed to assess the impact on total costs. All costs are reported in 2015 USD currency. 383 HZ patients were included and PHN incidence was 38.6%. The most commonly used resources were visits to the doctor's office (79.1% of patients), the emergency room (48.8%) and a specialist (37.9%); hospitalization was reported for 5.7% of patients. The overall direct cost per case was $763.19 USD, indirect cost was $701.40, for a total of $1,464.59 per HZ episode in Latin America. Total cost associated with HZ in patients with PHN was markedly higher compared to patients without PHN ($2,001.13 vs. $867.72, respectively) with indirect costs accounting for the most part

  4. Economic burden made celiac disease an expensive and challenging condition for Iranian patients.

    Science.gov (United States)

    Pourhoseingholi, Mohamad Amin; Rostami-Nejad, Mohammad; Barzegar, Farnoush; Rostami, Kamran; Volta, Umberto; Sadeghi, Amir; Honarkar, Zahra; Salehi, Niloofar; Asadzadeh-Aghdaei, Hamid; Baghestani, Ahmad Reza; Zali, Mohammad Reza

    2017-01-01

    The aim of this study was to estimate the economic burden of celiac disease (CD) in Iran. The assessment of burden of CD has become an important primary or secondary outcome measure in clinical and epidemiologic studies. Information regarding medical costs and gluten free diet (GFD) costs were gathered using questionnaire and checklists offered to the selected patients with CD. The data included the direct medical cost (including Doctor Visit, hospitalization, clinical test examinations, endoscopies, etc.), GFD cost and loss productivity cost (as the indirect cost) for CD patient were estimated. The factors used for cost estimation included frequency of health resource utilization and gluten free diet basket. Purchasing Power Parity Dollar (PPP$) was used in order to make inter-country comparisons. Total of 213 celiac patients entered to this study. The mean (standard deviation) of total cost per patient per year was 3377 (1853) PPP$. This total cost including direct medical cost, GFD costs and loss productivity cost per patients per year. Also the mean and standard deviation of medical cost and GFD cost were 195 (128) PPP$ and 932 (734) PPP$ respectively. The total costs of CD were significantly higher for male. Also GFD cost and total cost were higher for unmarried patients. In conclusion, our estimation of CD economic burden is indicating that CD patients face substantial expense that might not be affordable for a good number of these patients. The estimated economic burden may put these patients at high risk for dietary neglect resulting in increasing the risk of long term complications.

  5. The present and future disease burden of hepatitis C virus (HCV) infection with today's treatment paradigm

    DEFF Research Database (Denmark)

    Razavi, H; Waked, I; Sarrazin, C

    2014-01-01

    The disease burden of hepatitis C virus (HCV) is expected to increase as the infected population ages. A modelling approach was used to estimate the total number of viremic infections, diagnosed, treated and new infections in 2013. In addition, the model was used to estimate the change in the total...... number of HCV infections, the disease progression and mortality in 2013-2030. Finally, expert panel consensus was used to capture current treatment practices in each country. Using today's treatment paradigm, the total number of HCV infections is projected to decline or remain flat in all countries...

  6. Cleanup of contaminated areas

    International Nuclear Information System (INIS)

    Beone, G.; Carbone, A.I.; Zagaroli, M.

    1989-01-01

    The paper deals with the problem of contaminated areas cleanup, in order to eliminate every possible damage for man safety and environment and to site recovery for some utilization, The first step of cleanup operation is site characterization, that is followed by a pianificazion activity for a better definition of staff qualification, technology to be used, protection and prevention instruments for the risks due to contaminants handling. The second section describes the different remedial technologies for contaminated sites. Remedial technologies may be divided into on-site/off-site and in-situ treatments, according to whether materials (waste, soil, water) are moved to another location or not, respectively. Finally, it is outlined that contaminated areas cleanup is a typical multidisciplinary activity because very different competences are required. (author)

  7. Contaminant Candidate List 2

    Data.gov (United States)

    U.S. Environmental Protection Agency — CCL 2 is a list of contaminants that are currently not subject to any proposed or promulgated national primary drinking water regulations, that are known or...

  8. Contaminant Candidate List 3

    Data.gov (United States)

    U.S. Environmental Protection Agency — CCL 3 is a list of contaminants that are currently not subject to any proposed or promulgated national primary drinking water regulations, that are known or...

  9. Contaminant Candidate List 1

    Data.gov (United States)

    U.S. Environmental Protection Agency — CCL 1 is a list of contaminants that are currently not subject to any proposed or promulgated national primary drinking water regulations, that are known or...

  10. Tracers Detect Aquifer Contamination

    National Research Council Canada - National Science Library

    Enfield, Carl

    1995-01-01

    The EPA's National Laboratory (NRMRL) at Ada, OK, along with the University of Florida and the University of Texas, have developed a tracer procedure to detect the amount of contamination in aquifer formations...

  11. A petroleum contaminated soil bioremediation facility

    Energy Technology Data Exchange (ETDEWEB)

    Lombard, K.; Hazen, T.

    1994-06-01

    The amount of petroleum contaminated soil (PCS) at the Savannah River site (SRS) that has been identified, excavated and is currently in storage has increased several fold during the last few years. Several factors have contributed to this problem: (1) South Carolina Department of Health ad Environmental control (SCDHEC) lowered the sanitary landfill maximum concentration for total petroleum hydrocarbons (TPH) in the soil from 500 to 100 parts per million (ppm), (2) removal and replacement of underground storage tanks at several sites, (3) most recently SCDHEC disallowed aeration for treatment of contaminated soil, and (4) discovery of several very large contaminated areas of soil associated with leaking underground storage tanks (LUST), leaking pipes, disposal areas, and spills. Thus, SRS has an urgent need to remediate large quantities of contaminated soil that are currently stockpiled and the anticipated contaminated soils to be generated from accidental spills. As long as we utilize petroleum based compounds at the site, we will continue to generate contaminated soil that will require remediation.

  12. A petroleum contaminated soil bioremediation facility

    International Nuclear Information System (INIS)

    Lombard, K.; Hazen, T.

    1994-01-01

    The amount of petroleum contaminated soil (PCS) at the Savannah River site (SRS) that has been identified, excavated and is currently in storage has increased several fold during the last few years. Several factors have contributed to this problem: (1) South Carolina Department of Health ad Environmental control (SCDHEC) lowered the sanitary landfill maximum concentration for total petroleum hydrocarbons (TPH) in the soil from 500 to 100 parts per million (ppm), (2) removal and replacement of underground storage tanks at several sites, (3) most recently SCDHEC disallowed aeration for treatment of contaminated soil, and (4) discovery of several very large contaminated areas of soil associated with leaking underground storage tanks (LUST), leaking pipes, disposal areas, and spills. Thus, SRS has an urgent need to remediate large quantities of contaminated soil that are currently stockpiled and the anticipated contaminated soils to be generated from accidental spills. As long as we utilize petroleum based compounds at the site, we will continue to generate contaminated soil that will require remediation

  13. Modeling for Airborne Contamination

    International Nuclear Information System (INIS)

    F.R. Faillace; Y. Yuan

    2000-01-01

    The objective of Modeling for Airborne Contamination (referred to from now on as ''this report'') is to provide a documented methodology, along with supporting information, for estimating the release, transport, and assessment of dose to workers from airborne radioactive contaminants within the Monitored Geologic Repository (MGR) subsurface during the pre-closure period. Specifically, this report provides engineers and scientists with methodologies for estimating how concentrations of contaminants might be distributed in the air and on the drift surfaces if released from waste packages inside the repository. This report also provides dose conversion factors for inhalation, air submersion, and ground exposure pathways used to derive doses to potentially exposed subsurface workers. The scope of this report is limited to radiological contaminants (particulate, volatile and gaseous) resulting from waste package leaks (if any) and surface contamination and their transport processes. Neutron activation of air, dust in the air and the rock walls of the drift during the preclosure time is not considered within the scope of this report. Any neutrons causing such activation are not themselves considered to be ''contaminants'' released from the waste package. This report: (1) Documents mathematical models and model parameters for evaluating airborne contaminant transport within the MGR subsurface; and (2) Provides tables of dose conversion factors for inhalation, air submersion, and ground exposure pathways for important radionuclides. The dose conversion factors for air submersion and ground exposure pathways are further limited to drift diameters of 7.62 m and 5.5 m, corresponding to the main and emplacement drifts, respectively. If the final repository design significantly deviates from these drift dimensions, the results in this report may require revision. The dose conversion factors are further derived by using concrete of sufficient thickness to simulate the drift

  14. Economic Burden of Cardiovascular Disease in the Southwest of Iran

    Directory of Open Access Journals (Sweden)

    Sara Emamgholipour

    2018-03-01

    Full Text Available Background: CVDs are the first cause of death globally. About 50% of annual deaths are related to this group of diseases in Iran; however, the economic cost of CVD on Iranian society has not been conducted. Objectives: The aim of this study was to estimate the economic burden of CVDs in the southwest of Iran in 2016 from the social perspective. Materials and Methods: This study is a cross-sectional descriptive-analytic study conducted using the cost of illness (COI framework. The prevalence top-down method was used to quantify the annual cardiovascular costs. Productivity losses were estimated using the human capital approach and the friction cost method, with the discount rate of 3% to convert all future lifetime earnings into the present value. Results: In 2016, the average total cost per patient was $1881.4 and the total costs resulted in 1159.62 $million. Direct costs accounted for 60% and indirect costs for 40% of the total costs. The results were robust to a 20% change in the average unit price of all medical and non- medical direct costs and to discount rate of 2% and 10%. Conclusions: The total cardiovascular disease costs in 2016 represented approximately 6.7% of the Iran gross domestic product. The results of this study would be of special help for policymakers to evaluate the cost-effectiveness and outcomes of health care programs to allocate health care resources efficiently. Primordial Prevention of CVD including lifestyle modifications and dietary interventions resulted in substantial financial savings and is strongly recommended.

  15. Disease Burden from Hepatitis B Virus Infection in Guangdong Province, China

    Directory of Open Access Journals (Sweden)

    Jianpeng Xiao

    2015-11-01

    Full Text Available Objective: To estimate the disease burden and financial burden attributed to hepatitis B virus (HBV infection in Guangdong Province. Methods: Based on the data of incidence, mortality and healthcare cost of HBV-related diseases and other socio-economic data in Guangdong Province, we estimated deaths, disability-adjusted life-years (DALYs and economic cost for the three HBV-related diseases—hepatitis B, liver cirrhosis and liver cancer—in Guangdong following the procedures developed for the global burden of disease study. Then disease burden and economic cost attributed to HBV infection was estimated. Results: HBV infection was estimated to have caused 33,600 (95% confidence interval (CI: 29,300–37,800 premature deaths and the loss of 583,200 (95% CI: 495,200–671,100 DALYs in Guangdong in 2005. The greatest loss of deaths and DALYs were from liver cancer. The 45–59 years age group had the greatest burden attributable to HBV infection. The estimated total annual cost of HBV-related diseases in Guangdong was RMB 10.8 (95% CI: 8.7–13.0 billion,the direct and indirect cost were RMB 2.6 (95% CI: 2.1–3.2 and 8.2 (95% CI: 6.6–9.8 billion. Conclusions: HBV infection is a great medical challenge as well as a significant economic burden to Guangdong Province. The results suggest that substantial health benefits could be gained by extending effective public health and clinical interventions to reduce HBV infection in Guangdong Province.

  16. Estimation of the burden of chronic and allergic pulmonary aspergillosis in India.

    Directory of Open Access Journals (Sweden)

    Ritesh Agarwal

    Full Text Available It would be of considerable interest to clinicians if the burden of chronic pulmonary aspergillosis (CPA and allergic bronchopulmonary aspergillosis (ABPA in India were known. Herein, we estimate the burden of CPA following pulmonary tuberculosis (PTB, and ABPA (and severe asthma with fungal sensitization [SAFS] complicating asthma.We used the population estimates for India from the 2011 census data. The burden of asthma was estimated using three different methods (Global Initiative against Asthma [GINA] report statement, World Health Survey [WHS] estimates, Indian study on the epidemiology of asthma and chronic bronchitis [INSEARCH]. Global and India-specific figures were used for calculating the prevalence of ABPA and SAFS. The World Health Organization estimates were used for calculating PTB rates while the frequency of CPA was assessed from a previously published scoping review. Sensitivity analysis was performed to determine the burden in various scenarios.The total Indian population in 2011 was 1.2 billion. The asthma prevalence in adults was estimated at about 27.6 (range, 17-30 million. The burden of ABPA ranged from 0.12-6.09 million with different assumptions (best estimate, 1.38 [range, 0.86-1.52] million. The prevalence of SAFS was approximated at about 0.52-1.21 million (best estimate, 0.96 [range, 0.6-1.06] million. The incident TB cases were about 2.1 million while the annual incidence of CPA varied 27,000-0.17 million cases, with different estimates. If the mortality of CPA is estimated as 15% annually, the 5-year prevalence of CPA was placed at 290,147 cases with 5-year prevalence rate being 24 per 100,000.There is a significant burden of ABPA, SAFS and CPA in India. Prospective community-based studies are required to accurately determine the prevalence of these disorders.

  17. Caregiver burden, productivity loss, and indirect costs associated with caring for patients with poststroke spasticity

    Directory of Open Access Journals (Sweden)

    Ganapathy V

    2015-11-01

    Full Text Available Vaidyanathan Ganapathy,1 Glenn D Graham,2 Marco D DiBonaventura,3 Patrick J Gillard,1 Amir Goren,3 Richard D Zorowitz41Allergan, Irvine, CA, USA; 2Department of Veterans Affairs, San Francisco, CA, USA; 3Health Outcomes Practice, Kantar Health, New York, NY, USA; 4Johns Hopkins Bayview Medical Center, Baltimore, MD, USAObjective: Many stroke survivors experience poststroke spasticity and the related inability to perform basic activities, which necessitates patient management and treatment, and exerts a considerable burden on the informal caregiver. The current study aims to estimate burden, productivity loss, and indirect costs for caregivers of stroke survivors with spasticity.Methods: Internet survey data were collected from 153 caregivers of stroke survivors with spasticity including caregiving time and difficulty (Oberst Caregiver Burden Scale, Work Productivity and Activity Impairment measures, and caregiver and patient characteristics. Fractional logit models examined predictors of work-related restriction, and work losses were monetized (2012 median US wages.Results: Mean Oberst Caregiver Burden Scale time and difficulty scores were 46.1 and 32.4, respectively. Employed caregivers (n=71 had overall work restriction (32%, absenteeism (9%, and presenteeism (27%. Caregiver characteristics, lack of nursing home coverage, and stroke survivors’ disability predicted all work restriction outcomes. The mean total lost-productivity cost per employed caregiver was US$835 per month (>$10,000 per year; 72% attributable to presenteeism.Conclusion: These findings demonstrate the substantial burden of caring for stroke survivors with spasticity illustrating the societal and economic impact of stroke that extends beyond the stroke survivor.Keywords: burden, caregiver, productivity, spasticity, stroke

  18. The burden of acute respiratory infections in Ecuador 2011-2015.

    Science.gov (United States)

    Chicaiza-Ayala, Wilson; Henríquez-Trujillo, Aquiles R; Ortiz-Prado, Esteban; Douce, Richard W; Coral-Almeida, Marco

    2018-01-01

    Burden of disease studies intend to improve public health decision-making and to measure social and economic impact in population. The objective of this study was to describe the burden of acute respiratory infections (ARI) in Ecuador between 2011 and 2015. Five-year period morbidity and mortality data available from national agencies of statistics was analyzed to estimate the burden of disease attributable to acute respiratory infections. Cases and deaths registered were grouped according to their ICD-10 code into three diagnostic groups: Acute upper respiratory infections (J00-J06), Influenza and pneumonia (J09-J18), and Bronchitis and other acute lower respiratory infections (J20-J22, J85, J86). Disability-adjusted life years stratified by diagnostic and age group were calculated using the "DALY" package for R. The productivity loss in monetary terms was estimated using the human capital method. Over the 5-year period studied there were a total of 14.84 million cases of acute respiratory infections, with 17 757 deaths reported (0.12%). The yearly burden of disease ranged between 98 944 to 118 651 disability-adjusted life years, with an estimated average loss of productivity of US$152.16 million (±19.6) per year. Approximately 99% of the burden can be attributed to years life lost due to premature mortality in population under 5 years old and over 60 years-old. The burden of acute respiratory infections remained steady during the analyzed period. Evidence-based prevention and control policies to tackle acute respiratory infections in Ecuador should focus on the population at extreme ages of life.

  19. Methods for estimating the burden of antimicrobial resistance: a systematic literature review protocol

    Directory of Open Access Journals (Sweden)

    Nichola R. Naylor

    2016-11-01

    Full Text Available Abstract Background Estimates of the burden of antimicrobial resistance (AMR are needed to ascertain AMR impact, to evaluate interventions, and to allocate resources efficiently. Recent studies have estimated health, cost, and economic burden relating to AMR, with outcomes of interest ranging from drug-bug resistance impact on mortality in a hospital setting to total economic impact of AMR on the global economy. However, recent collation of this information has been largely informal, with no formal quality assessment of the current evidence base (e.g. with predefined checklists. This review therefore aims to establish what perspectives and resulting methodologies have been used in establishing the burden of AMR, whilst also ascertaining the quality of these studies. Methods The literature review will identify relevant literature using a systematic review methodology. MEDLINE, EMBASE, Scopus and EconLit will be searched utilising a predefined search string. Grey literature will be identified by searching within a predefined list of organisational websites. Independent screening of retrievals will be performed in a two-stage process (abstracts and full texts, utilising a pre-defined inclusion and exclusion criteria. Data will be extracted into a data extraction table and descriptive examination will be performed. Study quality will be assessed using the Newcastle-Ottawa scales and the Philips checklists where appropriate. A narrative synthesis of the results will be presented. Discussion This review will provide an overview of previous health, cost and economic definitions of burden and the resultant impact of these different definitions on the burden of AMR estimated. The review will also explore the methods that have been used to calculate this burden and discuss resulting study quality. This review can therefore act as a guide to methods for future research in this area. Systematic review registration PROSPERO CRD42016037510

  20. Approaches to Refining Estimates of Global Burden and Economics of Dengue

    Science.gov (United States)

    Shepard, Donald S.; Undurraga, Eduardo A.; Betancourt-Cravioto, Miguel; Guzmán, María G.; Halstead, Scott B.; Harris, Eva; Mudin, Rose Nani; Murray, Kristy O.; Tapia-Conyer, Roberto; Gubler, Duane J.

    2014-01-01

    Dengue presents a formidable and growing global economic and disease burden, with around half the world's population estimated to be at risk of infection. There is wide variation and substantial uncertainty in current estimates of dengue disease burden and, consequently, on economic burden estimates. Dengue disease varies across time, geography and persons affected. Variations in the transmission of four different viruses and interactions among vector density and host's immune status, age, pre-existing medical conditions, all contribute to the disease's complexity. This systematic review aims to identify and examine estimates of dengue disease burden and costs, discuss major sources of uncertainty, and suggest next steps to improve estimates. Economic analysis of dengue is mainly concerned with costs of illness, particularly in estimating total episodes of symptomatic dengue. However, national dengue disease reporting systems show a great diversity in design and implementation, hindering accurate global estimates of dengue episodes and country comparisons. A combination of immediate, short-, and long-term strategies could substantially improve estimates of disease and, consequently, of economic burden of dengue. Suggestions for immediate implementation include refining analysis of currently available data to adjust reported episodes and expanding data collection in empirical studies, such as documenting the number of ambulatory visits before and after hospitalization and including breakdowns by age. Short-term recommendations include merging multiple data sources, such as cohort and surveillance data to evaluate the accuracy of reporting rates (by health sector, treatment, severity, etc.), and using covariates to extrapolate dengue incidence to locations with no or limited reporting. Long-term efforts aim at strengthening capacity to document dengue transmission using serological methods to systematically analyze and relate to epidemiologic data. As promising tools

  1. Monitoring of transport contamination

    International Nuclear Information System (INIS)

    Turkin, N.F.

    1980-01-01

    Organization of monitoring of transport contamination is considered. A particularly thorough monitoring is recommended to be carried out in loading-unloading operations. The monitoring is performed when leaving loading-unloading site and zone under control and prior to preventive examination, technical service or repair. The method of monitoring of auto transport contamination with high-energy β-emitters by means of a special stand permitting the automation of the monitoring process is described [ru

  2. Measures against radioactive contamination due to Fukushima First Nuclear Power Plant accidents. Part 3. Removing and decontamination of contaminated soil

    International Nuclear Information System (INIS)

    Ishii, K.; Terakawa, A.; Matsuyama, S.

    2012-01-01

    We studied the structure of radioactive cesium distribution in soil and found the exponential dependence. This behavior could be explained theoretically. We developed a useful method to decontaminate the soil contaminated with radioactive cesium atoms. We applied our method to the contaminated school yards of elementary schools of Marumori town and decontaminated total area of about 7000 m"2. (author)

  3. HYDROCARBONS - TOTAL RESOLVED, CAS (CHEMICAL ABSTRACTS SERVICE) PARAMETER CODES and PCB, and other data from UNKNOWN in the New York Bight on 1901-01-01 (NODC Accession 8600271)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This submission contains the master data set assembled in a study called "Contaminant Body Burdens, Variability and Monitoring Implications for the New York Bight"....

  4. Moving beyond caregiver burden: identifying helpful interventions for family caregivers.

    Science.gov (United States)

    Sorrell, Jeanne M

    2014-03-01

    Family members serving as informal caregivers for loved ones often experience physical, psychological, emotional, social, and financial consequences that can be conceptualized as caregiver burden. As the number of older adults in our society continues to increase, there will be even more demand for family caregivers. It is important to move beyond a focus on the statistics and characteristics of caregiver burden and identify helpful interventions to reduce this burden. Interventions that decrease caregiver burden can enable family caregivers to delay placement of the individual in an institutional setting and improve quality of life for both the caregiver and care recipient. Copyright 2014, SLACK Incorporated.

  5. Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) Symptom Severity: Stress Management Skills are Related to Lower Illness Burden.

    Science.gov (United States)

    Lattie, Emily G; Antoni, Michael H; Fletcher, Mary Ann; Czaja, Sara; Perdomo, Dolores; Sala, Andreina; Nair, Sankaran; Fu, Shih Hua; Penedo, Frank J; Klimas, Nancy

    2013-01-01

    The onset of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) typically involves reductions in activities of daily living and social interactions (jointly referred to as "illness burden"). Emotional distress has been linked to increased reported symptoms, and stress management skills have been related to lower fatigue severity in CFS patients. Symptom severity and illness burden are highly correlated. The ability to manage stress may attenuate this relationship, allowing individuals to feel less burdened by the illness independent of the severity of their symptoms. This study aimed to evaluate if perceived stress management skills affect illness burden via emotional distress, independent of ME/CFS symptom severity. A total of 117 adults with ME/CFS completed measures of perceived stress management skills, emotional distress, ME/CFS symptom severity and illness burden. Regression analyses revealed that greater perceived stress management skills related to less social and fatigue-related illness burden, via lower emotional distress. This relationship existed independent of the association of symptom severity on illness burden, and was stronger among those not currently employed. Ability to manage stress is associated with a lower illness burden for individuals with ME/CFS. Future studies should evaluate the efficacy of psychosocial interventions in lowering illness burden by targeting stress management skills.

  6. Field Demonstration of Light Obscuration Particle Counting Technologies to Detect Fuel Contaminates

    Science.gov (United States)

    2016-12-01

    any other aspect of this collection of information, including suggestions for reducing this burden to Washington Headquarters Service, Directorate for...and automatic particle counters for monitoring contamination is frequently used in the hydraulics / hydraulic fluid industry. In 1999 ISO adopted ISO...11171 2 UNCLASSIFIED Hydraulic fluid power — Calibration of automatic particle counters for liquids (7), replacing ISO 4402, as an international

  7. Implementation of Department of Defense Survey Burden Action Plan - Reducing Survey Burden, Cost and Duplication

    Science.gov (United States)

    2017-08-23

    vulnerable populations (e.g., minors); or 3) sensitive topics (e.g., gender relations, discrimination , UCMJ violations) to improve tracking of survey...e.g., gender relations, discrimination , UCMJ violations) to improve tracking of survey burden. The applicable ISSCC-member Survey Office will...their families per year; or 2) vulnerable populations (e.g., minors); or 3) sensitive topics (e.g., gender relations, discrimination , UCMJ violations

  8. Measuring the burden of neglected tropical diseases: the global burden of disease framework.

    Directory of Open Access Journals (Sweden)

    Colin D Mathers

    2007-11-01

    Full Text Available Reliable, comparable information about the main causes of disease and injury in populations, and how these are changing, is a critical input for debates about priorities in the health sector. Traditional sources of information about the descriptive epidemiology of diseases, injuries, and risk factors are generally incomplete, fragmented, and of uncertain reliability and comparability. The Global Burden of Disease (GBD study has provided a conceptual and methodological framework to quantify and compare the health of populations using a summary measure of both mortality and disability, the disability-adjusted life year (DALY.This paper describes key features of the Global Burden of Disease analytic approach, which provides a standardized measurement framework to permit comparisons across diseases and injuries, as well as risk factors, and a systematic approach to the evaluation of data. The paper describes the evolution of the GBD, starting from the first study for the year 1990, summarizes the methodological improvements incorporated into GBD revisions for the years 2000-2004 carried out by the World Health Organization, and examines priorities and issues for the next major GBD study, funded by the Bill & Melinda Gates Foundation, and commencing in 2007.The paper presents an overview of summary results from the Global Burden of Disease study 2002, with a particular focus on the neglected tropical diseases, and also an overview of the comparative risk assessment for 26 global risk factors. Taken together, trypanosomiasis, Chagas disease, schistosomiasis, leishmaniasis, lymphatic filariasis, onchocerciasis, intestinal nematode infections, Japanese encephalitis, dengue, and leprosy accounted for an estimated 177,000 deaths worldwide in 2002, mostly in sub-Saharan Africa, and about 20 million DALYs, or 1.3% of the global burden of disease and injuries. Further research is currently underway to revise and update these estimates.

  9. Estimating the burden of disease attributable to diabetes in South Africa in 2000.

    Science.gov (United States)

    Bradshaw, Debbie; Norman, Rosana; Pieterse, Desiréé; Levitt, Naomi S

    2007-08-01

    To estimate the burden of disease attributable to diabetes by sex and age group in South Africa in 2000. The framework adopted for the most recent World Health Organization comparative risk assessment (CRA) methodology was followed. Small community studies used to derive the prevalence of diabetes by population group were weighted proportionately for a national estimate. Population-attributable fractions were calculated and applied to revised burden of disease estimates. Monte Carlo simulation-modelling techniques were used for uncertainty analysis. South Africa. Adults 30 years and older. Mortality and disability-adjusted life years (DALYs) for ischaemic heart disease (IHD), stroke, hypertensive disease and renal failure. Of South Africans aged >or= 30 years, 5.5% had diabetes which increased with age. Overall, about 14% of IHD, 10% of stroke, 12% of hypertensive disease and 12% of renal disease burden in adult males and females (30+ years) were attributable to diabetes. Diabetes was estimated to have caused 22,412 (95% uncertainty interval 20,755 - 24,872) or 4.3% (95% uncertainty interval 4.0 - 4.8%) of all deaths in South Africa in 2000. Since most of these occurred in middle or old age, the loss of healthy life years comprises a smaller proportion of the total 258,028 DALYs (95% uncertainty interval 236,856 - 290,849) in South Africa in 2000, accounting for 1.6% (95% uncertainty interval 1.5 - 1.8%) of the total burden. Diabetes is an important direct and indirect cause of burden in South Africa. Primary prevention of the disease through multi-level interventions and improved management at primary health care level are needed.

  10. Economic burden and cost determinants of coronary heart disease in rural southwest China: a multilevel analysis.

    Science.gov (United States)

    Le, C; Fang, Y; Linxiong, W; Shulan, Z; Golden, A R

    2015-01-01

    To estimate the economic burden of coronary heart disease (CHD) in a given year (2010), including direct and indirect costs, and examine the impact of contextual and individual socio-economic (SES) predictors on the costs of CHD among adults in rural southwest China. Cross-sectional community survey. In total, 4595 adults (aged ≥18 years) participated in this study. A prevalence-based cost-of-illness approach was used to estimate the economic burden of CHD. Information on demographic characteristics of the study population and the economic consequences of CHD was obtained using a standard questionnaire. Multilevel linear regression was used to model the variation in costs of CHD. In the study population, the overall prevalence of CHD was 2.9% (3.5% for males, 2.3% for females). The total cost of CHD was estimated to be US$17 million. Inpatient hospitalizations represented the main component of direct costs of CHD, and direct costs accounted for the greatest proportion of the economic burden of CHD. Males were more likely to have a higher economic burden of CHD than females. A positive association was found between the individual's level of education and the economic burden of CHD. Residence in a higher-income community was associated with higher costs related to CHD. This study found that both contextual and individual SES were closely associated with the costs of CHD. Future strategies for CHD interventions and improved access to affordable medications to treat and control CHD should focus on less-educated individuals and communities with lower SES. Copyright © 2014 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  11. Projections of the current and future disease burden of hepatitis C virus infection in Malaysia.

    Science.gov (United States)

    McDonald, Scott A; Dahlui, Maznah; Mohamed, Rosmawati; Naning, Herlianna; Shabaruddin, Fatiha Hana; Kamarulzaman, Adeeba

    2015-01-01

    The prevalence of hepatitis C virus (HCV) infection in Malaysia has been estimated at 2.5% of the adult population. Our objective, satisfying one of the directives of the WHO Framework for Global Action on Viral Hepatitis, was to forecast the HCV disease burden in Malaysia using modelling methods. An age-structured multi-state Markov model was developed to simulate the natural history of HCV infection. We tested three historical incidence scenarios that would give rise to the estimated prevalence in 2009, and calculated the incidence of cirrhosis, end-stage liver disease, and death, and disability-adjusted life-years (DALYs) under each scenario, to the year 2039. In the baseline scenario, current antiviral treatment levels were extended from 2014 to the end of the simulation period. To estimate the disease burden averted under current sustained virological response rates and treatment levels, the baseline scenario was compared to a counterfactual scenario in which no past or future treatment is assumed. In the baseline scenario, the projected disease burden for the year 2039 is 94,900 DALYs/year (95% credible interval (CrI): 77,100 to 124,500), with 2,002 (95% CrI: 1340 to 3040) and 540 (95% CrI: 251 to 1,030) individuals predicted to develop decompensated cirrhosis and hepatocellular carcinoma, respectively, in that year. Although current treatment practice is estimated to avert a cumulative total of 2,200 deaths from DC or HCC, a cumulative total of 63,900 HCV-related deaths is projected by 2039. The HCV-related disease burden is already high and is forecast to rise steeply over the coming decades under current levels of antiviral treatment. Increased governmental resources to improve HCV screening and treatment rates and to reduce transmission are essential to address the high projected HCV disease burden in Malaysia.

  12. Psychometric Properties of the Turkish Version of Caregiver Burden Index (CBI) for Parents of Children with Allergies.

    Science.gov (United States)

    Ekim, Ayfer; Hecan, Melis; Oren, Serkan

    Childhood chronic diseases have a great impact, including physiological, social and financial burdens, on parents. The concept of "caregiver burden" is gaining importance to understand the effects of allergic diseases and plan family-centered strategies. The purpose of this study was to examine the psychometric properties of the Caregiver Burden Index (CBI) in Turkish mothers of children with allergies. The participants of this methodological study were 213 mothers of children with allergies between 6 and 12years. Construct validity was evaluated through factor analysis and reliability was evaluated through internal consistency and item-total correlation. In reliability analysis, the overall Cronbach's alpha value (0.85) demonstrated a high level of reliability. The corrected item-total correlation varied between 0.63 and 0.84. In exploratory factor analysis, it was detected that 3 factors structure explained 73.6% of the total variance. This study indicated that the CBI is a valid and reliable tool to assess the caregiver burden of mothers of Turkish children with allergies. The results of this study contribute to the development and implementation of evidence based models of care that address the caregiver burden needs of parents whose children have allergies. Copyright © 2017 Elsevier Inc. All rights reserved.

  13. Total Quality Leadership

    Science.gov (United States)

    1991-01-01

    More than 750 NASA, government, contractor, and academic representatives attended the Seventh Annual NASA/Contractors Conference on Quality and Productivity. The panel presentations and Keynote speeches revolving around the theme of total quality leadership provided a solid base of understanding of the importance, benefits, and principles of total quality management (TQM). The presentations from the conference are summarized.

  14. Genoptraening efter total knaealloplastik

    DEFF Research Database (Denmark)

    Holm, Bente; Kehlet, Henrik

    2009-01-01

    The short- and long-term benefits of post-discharge physiotherapy regimens after total knee arthroplasty are debatable. A national survey including hospitals in Denmark that perform total knee arthroplasty showed a large variability in indication and regimen for post-knee arthroplasty...

  15. The Global Burden of Cancer 2013

    Science.gov (United States)

    2015-01-01

    IMPORTANCE Cancer is among the leading causes of death worldwide. Current estimates of cancer burden in individual countries and regions are necessary to inform local cancer control strategies. OBJECTIVE To estimate mortality, incidence, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs) for 28 cancers in 188 countries by sex from 1990 to 2013. EVIDENCE REVIEW The general methodology of the Global Burden of Disease (GBD) 2013 study was used. Cancer registries were the source for cancer incidence data as well as mortality incidence (MI) ratios. Sources for cause of death data include vital registration system data, verbal autopsy studies, and other sources. The MI ratios were used to transform incidence data to mortality estimates and cause of death estimates to incidence estimates. Cancer prevalence was estimated using MI ratios as surrogates for survival data; YLDs were calculated by multiplying prevalence estimates with disability weights, which were derived from population-based surveys; YLLs were computed by multiplying the number of estimated cancer deaths at each age with a reference life expectancy; and DALYs were calculated as the sum of YLDs and YLLs. FINDINGS In 2013 there were 14.9 million incident cancer cases, 8.2 million deaths, and 196.3 million DALYs. Prostate cancer was the leading cause for cancer incidence (1.4 million) for men and breast cancer for women (1.8 million). Tracheal, bronchus, and lung (TBL) cancer was the leading cause for cancer death in men and women, with 1.6 million deaths. For men, TBL cancer was the leading cause of DALYs (24.9 million). For women, breast cancer was the leading cause of DALYs (13.1 million). Age-standardized incidence rates (ASIRs) per 100 000 and age-standardized death rates (ASDRs) per 100 000 for both sexes in 2013 were higher in developing vs developed countries for stomach cancer (ASIR, 17 vs 14; ASDR, 15 vs 11), liver cancer (ASIR, 15 vs 7; ASDR, 16

  16. Burden of disease attributable to the Hebei Spirit oil spill in Taean, Korea

    Science.gov (United States)

    Kim, Young-Min; Park, Jae-Hyun; Choi, Kyusik; Noh, Su Ryeon; Choi, Young-Hyun; Cheong, Hae-Kwan

    2013-01-01

    Objectives We aimed to assess the burden of disease (BOD) of the residents living in contaminated coastal area with oil spill and also analysed the BOD attributable to the oil spill by disease, age, sex and subregion. Design Health impact assessment by measuring years lived with disability (YLD) due to an oil spill. Setting A whole population of a community affected by an anthropogenic environmental disaster and secondary health outcome data. Participants Based on the health outcome survey including 10 171 individuals (male 4354; female 5817), BOD of 66 473 populations (male 33 441; female 33 032) was measured. Interventions None. Observational study on the effect of a specific environmental health hazard. Primary and secondary outcome measures Using disability adjusted life year (DALY) method, BOD including physical and mental diseases was measured. For the BOD measurement, excess incidences of illnesses related to oil spill were estimated from the comparison of prevalence of the health outcomes between contaminated areas and reference area without contamination. Results YLD attributable to the oil spill were estimated to be 14 724 DALYs (male 7425 DALYs; female 7299 DALYs) for the year 2008. The YLD of mental diseases including post-traumatic stress disorder (PTSD) and depression for men were higher than that for women. The YLD for women was higher in asthma and allergies (rhinitis, dermatitis, conjunctivitis) than that for men. The effects of asthma and allergies were the greatest for people in their 40s, with the burden of mental illness being the greatest for those in their 20s. Proximity to the spill site was associated with increased BOD. Conclusions An oil spill near a coastline can cause substantial adverse health effects. As the health effects of hazardous pollutants from oil spills are long-lasting, close follow-up studies are required to identify chronic health effects. PMID:24056482

  17. Fluorescence Imaging Reveals Surface Contamination

    Science.gov (United States)

    Schirato, Richard; Polichar, Raulf

    1992-01-01

    In technique to detect surface contamination, object inspected illuminated by ultraviolet light to make contaminants fluoresce; low-light-level video camera views fluorescence. Image-processing techniques quantify distribution of contaminants. If fluorescence of material expected to contaminate surface is not intense, tagged with low concentration of dye.

  18. F29. HIGH-RISK SYMPTOMS FOR PSYCHOSIS IN ADOLESCENTS AND ITS RELATIONSHIP WITH FAMILY BURDEN

    Science.gov (United States)

    Puig-Navarro, Olga; De la Serna, Elena; Tor, Jordina; Sintes, Anna; Sugranyes, Gisela; Redondo, Marina; Pardo, Marta; Dolz, Montse; Baeza, Inmaculada

    2018-01-01

    Abstract Background High-risk symptoms for psychosis (HRS) and substantial functional impairment occurs early in the course of psychosis (Fusar-Poli et al., 2015). Many patients with HRS are adolescents who are still living at home and are highly reliant on their relatives for support. Objectives: (1) To compare the family burden of caregivers of adolescents with HRS with carers of an age and gender matched healthy control group (HC), (2) to examine the relationships between different family burden aspects and high-risk symptoms for psychosis in the HRS sample. Methods Sample: 68 HRS subjects (15.3 ± 1.7 years, 66% females) and 42 HC subjects (15.5 ± 1.5 years, 66% females) from a prospective longitudinal study including help-seeking subjects who met HRS criteria (Child and Adolescent Psychiatry and Psychology departments of Hospital Clínic and Sant Joan de Déu, Barcelona, Spain). Inclusion criteria: age 10–17 years, meeting criteria for 1) attenuated positive or negative symptoms in the previous 12-months, 2) brief intermittent psychotic symptoms, 3) first or second degree relative with schizophrenia or schizotypical disorder plus impairment of functioning. Exclusion criteria: IQ-9.35, p-5.59, p<0.001; T-Db: 6.36 ± 5.01 vs 1.02 ± 1.60, Db: 7.42 ± 6.51 vs 0.45 ± 1.23, Pb: 7.00 ± 6.13 vs 0.58 ± 1.80, Sb: 4.77 ± 4.66 vs 0.64 ± 1.95, Eb: 4.86 ± 4.64 vs 0.93 ± 2.66). Time-Dependence burden reported by caregivers of HRS patients was significantly correlated with the SOPS total score (r=0.303, p=0.014) and with the negative SOPS subscale score (r=0.308, p=0.012). The relationship between negative SOPS symptoms and time-dependence burden remained after controlling for affective symptoms (F=5.07, p0.028) and intelligence quotient (F=7.27, p=0.009). This factor represents objective aspects of burden arising from demands on the caregiver’s time. Discussion Caregivers of adolescents meeting criteria for HRS showed high perceived burden compared with

  19. The burden on informal caregivers of people with bipolar disorder.

    Science.gov (United States)

    Ogilvie, Alan D; Morant, Nicola; Goodwin, Guy M

    2005-01-01

    Caregivers of people with bipolar disorder may experience a different quality of burden than is seen with other illnesses. A better understanding of their concerns is necessary to improve the training of professionals working with this population. Conceptualizing caregiver burden in a conventional medical framework may not focus enough on issues important to caregivers, or on cultural and social issues. Perceptions of caregivers about bipolar disorder have important effects on levels of burden experienced. It is important to distinguish between caregivers' experience of this subjective burden and objective burden as externally appraised. Caregivers' previous experiences of health services may influence their beliefs about the illness. Caregiver burden is associated with depression, which affects patient recovery by adding stress to the living environment. The objective burden on caregivers of patients with bipolar disorder is significantly higher than for those with unipolar depression. Caregivers of bipolar patients have high levels of expressed emotion, including critical, hostile, or over-involved attitudes. Several measures have been developed to assess the care burden of patients with depressive disorders, but may be inappropriate for patients with bipolar disorder because of its cyclical nature and the stresses arising from manic and hypomanic episodes. Inter-episode symptoms pose another potential of burden in patients with bipolar disorder. Subsyndromal depressive symptoms are common in this phase of the illness, resulting in severe and widespread impairment of function. Despite the importance of assessing caregiver burden in bipolar disorder, relevant literature is scarce. The specific effects of mania and inter-episode symptoms have not been adequately addressed, and there is a lack of existing measures to assess burden adequately, causing uncertainty regarding how best to structure family interventions to optimally alleviate burden. The relatively few

  20. The economic burden of mental disorders in China, 2005-2013: implications for health policy.

    Science.gov (United States)

    Xu, Junfang; Wang, Jian; Wimo, Anders; Qiu, Chengxuan

    2016-05-11

    Mental disorders represent a major contributor to disease burden worldwide. We sought to quantify the national economic burden of mental disorders in China. We used a prevalence-based, bottom-up approach to estimate the economic costs of mental disorders in 2005-2013 in China. Prevalence data were derived from a national survey. Cost data were derived from the electronic health records of two psychiatric hospitals that consisted of 25,289 outpatients (10%) and inpatients (90%) who were diagnosed with a mental disorder. Cost items included direct medical costs, direct non-medical costs, and indirect costs. The total annual costs of mental disorders in China increased from $1,094.8 in 2005 to $3,665.4 in 2013 for individual patients, and from $21.0 billion to $88.8 billion for the whole society. The total costs of mental disorders in 2013 accounted for more than 15% of the total health expenditure in China, and 1.1% of China's gross domestic product. If the needs of the professional care for all patients with mental illnesses were fully met, the potential economic costs would have been almost five times higher than the actual estimated costs. Mental disorders imposed a huge economic burden on individuals and the society in China. A nation-wide strategic action plan for preventing mental disorders and promoting mental health and well-being is in urgent need to reduce the individual and societal costs of mental illnesses.

  1. Economic Burden of Pediatric Asthma: Annual Cost of Disease in Iran.

    Science.gov (United States)

    Sharifi, Laleh; Dashti, Raheleh; Pourpak, Zahra; Fazlollahi, Mohammad Reza; Movahedi, Masoud; Chavoshzadeh, Zahra; Soheili, Habib; Bokaie, Saied; Kazemnejad, Anoushiravan; Moin, Mostafa

    2018-02-01

    Asthma is the first cause of children hospitalization and need for emergency and impose high economic burden on the families and governments. We aimed to investigate the economic burden of pediatric asthma and its contribution to family health budget in Iran. Overall, 283 pediatric asthmatic patients, who referred to two tertiary pediatric referral centers in Tehran capital of Iran, included from 2010-2012. Direct and indirect asthma-related costs were recorded during one-year period. Data were statistically analyzed for finding association between the costs and factors that affect this cost (demographic variables, tobacco smoke exposure, control status of asthma and asthma concomitant diseases). Ninety-two (32.5%) females and 191(67.5%) males with the age range of 1-16 yr old were included. We found the annual total pediatrics asthma related costs were 367.97±23.06 USD. The highest cost belonged to the medications (69%) and the lowest one to the emergency (2%). We noticed a significant increasing in boys' total costs ( P =0.011), and 7-11 yr old age group ( P =0.018). In addition, we found significant association between total asthma costs and asthma control status ( P =0.011). The presence of an asthmatic child can consume nearly half of the health budget of a family. Our results emphasis on improving asthma management programs, which leads to successful control status of the disease and reduction in economic burden of pediatric asthma.

  2. Technogenic contamination of Bulgarian green leafy vegetation and its contribution to public exposure

    International Nuclear Information System (INIS)

    Pavlova, P.; Vasilev, G.

    2007-01-01

    Main sources of excessive background ionizing radiation exposure for the Bulgarian public are the following: medical radiation procedures; occupational radiation exposure; enhanced natural radiation exposure (uranium mining and milling, artificial fertilizers, non-radioactive sources of energy, building materials etc.); environmental technogenic radionuclide contamination from global fallouts (1950-1970) and Chernobyl accident depositions (1986-1996 and after). The green leafy vegetation, incl. forage plants used for feeding of farm animals (sheep and cows) as well as leafy vegetables (lettuce, dock, spinach, parsley etc.) are one of the main reservoirs of technogenic radionuclides. Bulgaria is situated in the middle northern latitude zone (40 north - 50 north) where the global radioactive fallout from nuclear experiments (1945-1962) were most intensive. Bulgaria is also one of the countries most affected by the Chernobyl NPP accident on 26 April 1986. Respectively, the Bulgarian population dose burden is high compared with the other European countries (excluding the population near the site, i.e. Ukraine, Russia and Byelorussian). Both the global and Chernobyl fallout (globally distributed) contaminated the green leafy vegetation with technogenic radionuclides of two groups: Short-lived, mainly Iodine-131; Long-lived, mainly Cesium-137 and partially Strontium- 90. The effects on the Bulgarian public from technogenic radionuclide contamination of green leafy vegetation were analyzed. The analyses show the following chain in motion of technogenic radionuclides (Iodine-131 and Cesium-137 are chosen as representative): 1) Iodine-131: (duration of transfer - less than 30 to 60 days since fallout); a) fallout - meadow grass - sheep and cows - milk and dairy products - person; b) fallout - leafy vegetables - person; 2) Cesium-137 (duration of transfer - several days) (based on Chernobyl experience); a) fallout - meadow grass - forage - sheep, cows, etc. - milk and dairy

  3. Laparoscopic total pancreatectomy

    Science.gov (United States)

    Wang, Xin; Li, Yongbin; Cai, Yunqiang; Liu, Xubao; Peng, Bing

    2017-01-01

    Abstract Rationale: Laparoscopic total pancreatectomy is a complicated surgical procedure and rarely been reported. This study was conducted to investigate the safety and feasibility of laparoscopic total pancreatectomy. Patients and Methods: Three patients underwent laparoscopic total pancreatectomy between May 2014 and August 2015. We reviewed their general demographic data, perioperative details, and short-term outcomes. General morbidity was assessed using Clavien–Dindo classification and delayed gastric emptying (DGE) was evaluated by International Study Group of Pancreatic Surgery (ISGPS) definition. Diagnosis and Outcomes: The indications for laparoscopic total pancreatectomy were intraductal papillary mucinous neoplasm (IPMN) (n = 2) and pancreatic neuroendocrine tumor (PNET) (n = 1). All patients underwent laparoscopic pylorus and spleen-preserving total pancreatectomy, the mean operative time was 490 minutes (range 450–540 minutes), the mean estimated blood loss was 266 mL (range 100–400 minutes); 2 patients suffered from postoperative complication. All the patients recovered uneventfully with conservative treatment and discharged with a mean hospital stay 18 days (range 8–24 days). The short-term (from 108 to 600 days) follow up demonstrated 3 patients had normal and consistent glycated hemoglobin (HbA1c) level with acceptable quality of life. Lessons: Laparoscopic total pancreatectomy is feasible and safe in selected patients and pylorus and spleen preserving technique should be considered. Further prospective randomized studies are needed to obtain a comprehensive understanding the role of laparoscopic technique in total pancreatectomy. PMID:28099344

  4. Economic burden to primary informal caregivers of hospitalized older adults in Mexico: a cohort study.

    Science.gov (United States)

    López-Ortega, Mariana; García-Peña, Carmen; Granados-García, Víctor; García-González, José Juan; Pérez-Zepeda, Mario Ulises

    2013-02-08

    The burden of out of pocket spending for the Mexican population is high compared to other countries. Even patients insured by social security institutions have to face the cost of health goods, services or nonmedical expenses related to their illness. Primary caregivers, in addition, experience losses in productivity by taking up responsibilities in care giving activities. This situation represents a mayor economic burden in an acute care setting for elderly population. There is evidence that specialized geriatric services could represent lower overall costs in these circumstances and could help reduce these burdens.The aim of this study was to investigate economic burden differences in caregivers of elderly patients comparing two acute care services (Geriatric and Internal Medicine). Specifically, economic costs associated with hospitalization of older adults in these two settings by evaluating health care related out of pocket expenditures (OOPE), non-medical OOPE and indirect costs. A comparative analysis of direct and indirect costs in hospitalised elderly patients (60-year or older) and their primary informal caregivers in two health care settings, using a prospective cohort was performed. Economic burden was measured by out of pocket expenses and indirect costs (productivity lost) due to care giving activities. The analysis included a two-part model, the first one allowing the estimation of the probability of observing any health care related and non-medical OOPE; and the second one, the positive observations or expenditures. A total of 210 subjects were followed during their hospital stay. Of the total number of subjects 95% reported at least one non-medical OOPE, being daily transportation the most common expense. Regarding medical OOPE, medicines were the most common expense, and the mean numbers of days without income were 4.12 days. Both OOPE and indirect costs were significantly different between type of services, with less overall economic burden to

  5. Estonian total ozone climatology

    Directory of Open Access Journals (Sweden)

    K. Eerme

    Full Text Available The climatological characteristics of total ozone over Estonia based on the Total Ozone Mapping Spectrometer (TOMS data are discussed. The mean annual cycle during 1979–2000 for the site at 58.3° N and 26.5° E is compiled. The available ground-level data interpolated before TOMS, have been used for trend detection. During the last two decades, the quasi-biennial oscillation (QBO corrected systematic decrease of total ozone from February–April was 3 ± 2.6% per decade. Before 1980, a spring decrease was not detectable. No decreasing trend was found in either the late autumn ozone minimum or in the summer total ozone. The QBO related signal in the spring total ozone has an amplitude of ± 20 DU and phase lag of 20 months. Between 1987–1992, the lagged covariance between the Singapore wind and the studied total ozone was weak. The spring (April–May and summer (June–August total ozone have the best correlation (coefficient 0.7 in the yearly cycle. The correlation between the May and August total ozone is higher than the one between the other summer months. Seasonal power spectra of the total ozone variance show preferred periods with an over 95% significance level. Since 1986, during the winter/spring, the contribution period of 32 days prevails instead of the earlier dominating 26 days. The spectral densities of the periods from 4 days to 2 weeks exhibit high interannual variability.

    Key words. Atmospheric composition and structure (middle atmosphere – composition and chemistry; volcanic effects – Meteorology and atmospheric dynamics (climatology

  6. Costs of groundwater contamination

    International Nuclear Information System (INIS)

    O'Neil, W.B.; Raucher, R.S.

    1990-01-01

    Two factors determine the cost of groundwater contamination: (1) the ways in which water was being used or was expected to be used in the future and (2) the physical characteristics of the setting that constrain the responses available to regain lost uses or to prevent related damages to human health and the environment. Most contamination incidents can be managed at a low enough cost that uses will not be foreclosed. It is important to take into account the following when considering costs: (1) natural cleansing through recharge and dilution can take many years; (2) it is difficult and costly to identify the exact area and expected path of a contamination plume; and (3) treatment or replacement of contaminated water often may represent the cost-effective strategy for managing the event. The costs of contamination include adverse health effects, containment and remediation, treatment and replacement costs. In comparing the costs and benefits of prevention programs with those of remediation, replacement or treatment, it is essential to adjust the cost/benefit numbers by the probability of their actual occurrence. Better forecasts of water demand are needed to predict more accurately the scarcity of new supply and the associated cost of replacement. This research should include estimates of the price elasticity of water demand and the possible effect on demand of more rational cost-based pricing structures. Research and development of techniques for in situ remediation should be encouraged

  7. The Humanistic and Economic Burden of Narcolepsy.

    Science.gov (United States)

    Flores, Natalia M; Villa, Kathleen F; Black, Jed; Chervin, Ronald D; Witt, Edward A

    2016-03-01

    To evaluate the burden of narcolepsy--with respect to psychiatric comorbidities, Health-Related Quality of Life (HRQoL), direct costs for healthcare resource utilization, and indirect costs for reported work loss-through comparison of patients to matched controls. This analysis was conducted on data from the 2011, 2012, and 2013 US National Health and Wellness Survey (NHWS; 2011 NHWS n = 75,000, 2012 NHWS n = 71,157, and 2013 NHWS n = 75,000). Patients who reported a narcolepsy diagnosis (n = 437) were matched 1:2 with controls (n = 874) on age, sex, race/ethnicity, marital status, education, household income, body mass index, smoking status, alcohol use, exercise, and physical comorbidity. Chi-square tests and one-way analyses of variance were used to assess whether the narcolepsy and control groups differed on psychiatric comorbidities, HRQoL, labor force participation, work productivity, and healthcare resource utilization. Patients with narcolepsy, in comparison to matched controls, reported substantially (two to four times) greater psychiatric comorbidity, HRQoL impairment, prevalence of long-term disability, absenteeism, and presenteeism, and greater resource use in the past 6 mo as indicated by higher mean number of hospitalizations, emergency department visits, traditional healthcare professional visits, neurologist visits, and psychiatrist visits (each p productivity through effective assessment and treatment of narcolepsy. © 2016 American Academy of Sleep Medicine.

  8. Burden of serious fungal infections in Mexico.

    Science.gov (United States)

    Corzo-León, D E; Armstrong-James, D; Denning, D W

    2015-10-01

    Serious fungal infections (SFIs) could be more frequent than are recognised. Estimates of the incidence and prevalence of SFIs are essential in order to identify public health problems. We estimated the rates of SFIs in Mexico, following a methodology similar to that used in prior studies. We obtained information about the general population and populations at risk. A systematic literature search was undertaken to identify epidemiological reports of SFIs in Mexico. When Mexican reports were unavailable, we based our estimates on international literature. The most prevalent SFIs in Mexico are recurrent vulvovaginal candidiasis (5999 per 100,000) followed by allergic bronchopulmonary aspergillosis (60 per 100,000), chronic pulmonary aspergillosis (15.9 per 100,000), fungal keratitis (10.4 per 100,000), invasive candidiasis (8.6 per 100,000) and SFIs in HIV (8.2 per 100,000); coccidioidomycosis (7.6 per 100,000), IA (4.56 per 100,000). These correspond to 2,749,159 people affected in any year (2.45% of the population), probably >10,000 deaths and 7000 blind eyes. SFIs affect immunocompromised and healthy populations. Most are associated with high morbidity and mortality rates. Validation of these estimates with epidemiological studies is required. The burdens indicate that an urgent need to improve medical skills, surveillance, diagnosis, and management of SFIs exists. © 2015 Blackwell Verlag GmbH.

  9. Global burden of disease attributable to mental and substance use disorders: findings from the Global Burden of Disease Study 2010.

    Science.gov (United States)

    Whiteford, Harvey A; Degenhardt, Louisa; Rehm, Jürgen; Baxter, Amanda J; Ferrari, Alize J; Erskine, Holly E; Charlson, Fiona J; Norman, Rosana E; Flaxman, Abraham D; Johns, Nicole; Burstein, Roy; Murray, Christopher J L; Vos, Theo

    2013-11-09

    We used data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2010 (GBD 2010) to estimate the burden of disease attributable to mental and substance use disorders in terms of disability-adjusted life years (DALYs), years of life lost to premature mortality (YLLs), and years lived with disability (YLDs). For each of the 20 mental and substance use disorders included in GBD 2010, we systematically reviewed epidemiological data and used a Bayesian meta-regression tool, DisMod-MR, to model prevalence by age, sex, country, region, and year. We obtained disability weights from representative community surveys and an internet-based survey to calculate YLDs. We calculated premature mortality as YLLs from cause of death estimates for 1980-2010 for 20 age groups, both sexes, and 187 countries. We derived DALYs from the sum of YLDs and YLLs. We adjusted burden estimates for comorbidity and present them with 95% uncertainty intervals. In 2010, mental and substance use disorders accounted for 183·9 million DALYs (95% UI 153·5 million-216·7 million), or 7·4% (6·2-8·6) of all DALYs worldwide. Such disorders accounted for 8·6 million YLLs (6·5 million-12·1 million; 0·5% [0·4-0·7] of all YLLs) and 175·3 million YLDs (144·5 million-207·8 million; 22·9% [18·6-27·2] of all YLDs). Mental and substance use disorders were the leading cause of YLDs worldwide. Depressive disorders accounted for 40·5% (31·7-49·2) of DALYs caused by mental and substance use disorders, with anxiety disorders accounting for 14·6% (11·2-18·4), illicit drug use disorders for 10·9% (8·9-13·2), alcohol use disorders for 9·6% (7·7-11·8), schizophrenia for 7·4% (5·0-9·8), bipolar disorder for 7·0% (4·4-10·3), pervasive developmental disorders for 4·2% (3·2-5·3), childhood behavioural disorders for 3·4% (2·2-4·7), and eating disorders for 1·2% (0·9-1·5). DALYs varied by age and sex, with the highest proportion of total DALYs occurring in people aged 10

  10. Plastic surgery and global health: how plastic surgery impacts the global burden of surgical disease.

    Science.gov (United States)

    Semer, Nadine B; Sullivan, Stephen R; Meara, John G

    2010-08-01

    The global burden of surgical disease is estimated as being 11% of the total global burden of disease. In this article we discuss the portion of this burden which could be ameliorated with plastic surgical expertise. Although not necessarily seen as a major player in issues related to global health, plastic surgeons are uniquely qualified to decrease the burden of surgical disease afflicting people in the developing world. Burns, traumatic injuries, and congenital anomalies are some of the areas where the presence of plastic surgical expertise can make a significant difference in patient outcomes and thereby decrease the years of life lost due to disability due to these highly treatable conditions. In light of the severe shortage of plastic surgeons throughout the developing world, it falls to those concentrated in the developed world to harness their skills and address the vast unmet needs of the developing world so as to enhance global health. Copyright 2009 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  11. Analysis of the economic burden of diagnosis and treatment of tuberculosis patients in rural China.

    Science.gov (United States)

    Pan, H-Q; Bele, S; Feng, Y; Qiu, S-S; Lü, J-Q; Tang, S-W; Shen, H-B; Wang, J-M; Zhu, L-M

    2013-12-01

    A county in Jiangsu Province, China. To estimate the costs of the diagnosis and treatment of tuberculosis (TB) from the patient's perspective and to identify determinants of the patient's financial burden. In a cross-sectional survey, we interviewed 316 patients diagnosed from January 2010 to May 2011 who had already completed their anti-tuberculosis treatment. The financial burden on TB patients included out-of-pocket costs and productivity losses. The average per capita total out-of-pocket cost was 3024.0 Chinese yuan (CNY), with a median cost of 1086 CNY (interquartile range [IQR] 480-2456). Mean out-of-pocket medical and non-medical costs were respectively 2565.7 CNY and 458.3 CNY. Productivity lost by patients and family members was 2615.2 CNY (median 500, IQR 250-2025). Factors associated with out-of-pocket costs and productivity losses included hospitalisation, adverse drug reactions, cost of drugs to 'protect' the liver, cost of second-line anti-tuberculosis drugs and diagnostic delay. Although the government of China has implemented a 'free TB service policy', the economic burden on patients is still heavy. More patient-centred interventions are essential to reduce the financial burden on patients.

  12. Environmental burden of acute respiratory infection and pneumonia due to indoor smoke in Dhading.

    Science.gov (United States)

    Dhimal, M; Dhakal, P; Shrestha, N; Baral, K; Maskey, M

    2010-04-01

    ARI and pneumonia is one of the major public health problems in Nepal which always ranks highest position among the top ten diseases. One of the risk factor of ARI and pneumonia is indoor smoke from kitchen where primary source of cooking is solid biomass fuel. This study was carried out in order to estimate the burden of ARI and pneumonia due to indoor smoke. ARI and pneumonia was chosen as it is one of the significant public health problem among under five children in Nepal and responsible for high number of premature deaths. A cross-sectional study was conducted in Dhading district. Multistage cluster sampling technique was used for data collection considering ward as a cluster. The environmental burden of ARI and pneumonia due to indoor smoke was calculated using the WHO Environmental Burden of Disease Series. About 87 percent of households were using solid biomass fuel as a primary source of fuel. The under five children exposed to solid fuel use was 41313. The total 1284 Disability Adjusted Life Years were lost due to ARI and pneumonia and about 50 percent of it was attributed by Indoor smoke in household. The solid biomass fuel was primary source of energy for cooking in Dhading district which is attributing about 50 percent of burden of ARI and pneumonia among under five children.

  13. Multiparameter analysis of fall-out plutonium burdens in human liver

    International Nuclear Information System (INIS)

    Griffith, W.C.; Guilmette, R.A.

    1991-01-01

    The effect of multiple factors on Pu liver burdens is estimated for a group of 310 people who were selected to have relative uniform exposure to fall-out plutonium ( 239 Pu plus 240 Pu), based on age in 1952, the start of atmospheric testing of thermonuclear weapons, and based on residence history in eastern Colorado, where they died between 1975 and 1979. The data were analysed using multiple linear regression of the logarithm of the total liver plutonium burden on other available covariates. The results of the regression indicated that the liver burden was increased by 34% in very heavy smokers (100 pack year history) compared to non-smokers, decreased by 27% in females compared to males, decreased by 24% in people with a neoplasm in the liver compared to those without a neoplasm, and decreased by 64% in people with cirrhosis compared to those without cirrhosis. However, all of those parameters accounted for only 26% of the variability in liver burdens observed among these people, indicating that there remains a large unexplained variation. (author)

  14. The impact of individual-level heterogeneity on estimated infectious disease burden: a simulation study.

    Science.gov (United States)

    McDonald, Scott A; Devleesschauwer, Brecht; Wallinga, Jacco

    2016-12-08

    Disease burden is not evenly distributed within a population; this uneven distribution can be due to individual heterogeneity in progression rates between disease stages. Composite measures of disease burden that are based on disease progression models, such as the disability-adjusted life year (DALY), are widely used to quantify the current and future burden of infectious diseases. Our goal was to investigate to what extent ignoring the presence of heterogeneity could bias DALY computation. Simulations using individual-based models for hypothetical infectious diseases with short and long natural histories were run assuming either "population-averaged" progression probabilities between disease stages, or progression probabilities that were influenced by an a priori defined individual-level frailty (i.e., heterogeneity in disease risk) distribution, and DALYs were calculated. Under the assumption of heterogeneity in transition rates and increasing frailty with age, the short natural history disease model predicted 14% fewer DALYs compared with the homogenous population assumption. Simulations of a long natural history disease indicated that assuming homogeneity in transition rates when heterogeneity was present could overestimate total DALYs, in the present case by 4% (95% quantile interval: 1-8%). The consequences of ignoring population heterogeneity should be considered when defining transition parameters for natural history models and when interpreting the resulting disease burden estimates.

  15. Total photon absorption

    International Nuclear Information System (INIS)

    Carlos, P.

    1985-06-01

    The present discussion is limited to a presentation of the most recent total photonuclear absorption experiments performed with real photons at intermediate energy, and more precisely in the region of nucleon resonances. The main sources of real photons are briefly reviewed and the experimental procedures used for total photonuclear absorption cross section measurements. The main results obtained below 140 MeV photon energy as well as above 2 GeV are recalled. The experimental study of total photonuclear absorption in the nuclear resonance region (140 MeV< E<2 GeV) is still at its beginning and some results are presented

  16. [Total artificial heart].

    Science.gov (United States)

    Antretter, H; Dumfarth, J; Höfer, D

    2015-09-01

    To date the CardioWest™ total artificial heart is the only clinically available implantable biventricular mechanical replacement for irreversible cardiac failure. This article presents the indications, contraindications, implantation procedere and postoperative treatment. In addition to a overview of the applications of the total artificial heart this article gives a brief presentation of the two patients treated in our department with the CardioWest™. The clinical course, postoperative rehabilitation, device-related complications and control mechanisms are presented. The total artificial heart is a reliable implant for treating critically ill patients with irreversible cardiogenic shock. A bridge to transplantation is feasible with excellent results.

  17. Contamination Control for Thermal Engineers

    Science.gov (United States)

    Rivera, Rachel B.

    2015-01-01

    The presentation will be given at the 26th Annual Thermal Fluids Analysis Workshop (TFAWS 2015) hosted by the Goddard Spaceflight Center (GSFC) Thermal Engineering Branch (Code 545). This course will cover the basics of Contamination Control, including contamination control related failures, the effects of contamination on Flight Hardware, what contamination requirements translate to, design methodology, and implementing contamination control into Integration, Testing and Launch.

  18. A case of internal contamination with plutonium oxide

    International Nuclear Information System (INIS)

    Breuer, F.; Clemente, G.F.; Strambi, E.; Testa, C.

    1980-01-01

    A case is described of internal contamination caused by the accidental explosion of a glove box, whereby a technician was wounded in his right cheek and inhaled insoluble PuO 2 . Immediate washing of the wound with a DTPA solution and the performance of a small surgical toilet reduced the wound contamination a hundred times. Intravenous injection of DPTA was started and continued for nine days. The ''in vivo'' determination of plutonium and Am-241 lung content was performed immediately after the accident and several other times thereafter. Plutonium was determined periodically in urine and fecal samples for five months. The large Esub(f)/Esub(u) ratio and the steep slope of the Esub(f) curve in the first days indicated that the inhaled material was very insoluble and that the suspended powder particles were large. This conclusion was confirmed by the lung clearance ''in vivo'' during the first few days. The initial lung burden, calculated by the fecal excretion of plutonium in the first five days, was in very good agreement with the direct measurement of the lung content; the residual lung burden and the systemic burden were derived respectively U by the fecal and urinary excretion 100 days after the intake. The committed doses to lungs, bone, liver and kidneys were calculated and were found to be considerably lower than the maximum permissible levels. (H.K.)

  19. Total 2004 results

    International Nuclear Information System (INIS)

    2005-02-01

    This document presents the 2004 results of Total Group: consolidated account, special items, number of shares, market environment, adjustment for amortization of Sanofi-Aventis merger-related intangibles, 4. quarter 2004 results (operating and net incomes, cash flow), upstream (results, production, reserves, recent highlights), downstream (results, refinery throughput, recent highlights), chemicals (results, recent highlights), Total's full year 2004 results (operating and net income, cash flow), 2005 sensitivities, Total SA parent company accounts and proposed dividend, adoption of IFRS accounting, summary and outlook, main operating information by segment for the 4. quarter and full year 2004: upstream (combined liquids and gas production by region, liquids production by region, gas production by region), downstream (refined product sales by region, chemicals), Total financial statements: consolidated statement of income, consolidated balance sheet (assets, liabilities and shareholder's equity), consolidated statements of cash flows, business segments information. (J.S.)

  20. Total synthesis of ciguatoxin.

    Science.gov (United States)

    Hamajima, Akinari; Isobe, Minoru

    2009-01-01

    Something fishy: Ciguatoxin (see structure) is one of the principal toxins involved in ciguatera poisoning and the target of a total synthesis involving the coupling of three segments. The key transformations in this synthesis feature acetylene-dicobalthexacarbonyl complexation.

  1. Total 2004 results

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2005-02-01

    This document presents the 2004 results of Total Group: consolidated account, special items, number of shares, market environment, adjustment for amortization of Sanofi-Aventis merger-related intangibles, 4. quarter 2004 results (operating and net incomes, cash flow), upstream (results, production, reserves, recent highlights), downstream (results, refinery throughput, recent highlights), chemicals (results, recent highlights), Total's full year 2004 results (operating and net income, cash flow), 2005 sensitivities, Total SA parent company accounts and proposed dividend, adoption of IFRS accounting, summary and outlook, main operating information by segment for the 4. quarter and full year 2004: upstream (combined liquids and gas production by region, liquids production by region, gas production by region), downstream (refined product sales by region, chemicals), Total financial statements: consolidated statement of income, consolidated balance sheet (assets, liabilities and shareholder's equity), consolidated statements of cash flows, business segments information. (J.S.)

  2. Genoptraening efter total knaealloplastik

    DEFF Research Database (Denmark)

    Holm, Bente; Kehlet, Henrik

    2009-01-01

    The short- and long-term benefits of post-discharge physiotherapy regimens after total knee arthroplasty are debatable. A national survey including hospitals in Denmark that perform total knee arthroplasty showed a large variability in indication and regimen for post-knee arthroplasty rehabilitat......The short- and long-term benefits of post-discharge physiotherapy regimens after total knee arthroplasty are debatable. A national survey including hospitals in Denmark that perform total knee arthroplasty showed a large variability in indication and regimen for post-knee arthroplasty...... rehabilitation. Since hospital stay duration has decreased considerably, the need for post-discharge physiotherapy may also have changed. Thus, the indication for and types of rehabilitation programmes need to be studied within the context of fast-track knee arthroplasty....

  3. Genoptraening efter total knaealloplastik

    DEFF Research Database (Denmark)

    Holm, Bente; Kehlet, Henrik

    2009-01-01

    The short- and long-term benefits of post-discharge physiotherapy regimens after total knee arthroplasty are debatable. A national survey including hospitals in Denmark that perform total knee arthroplasty showed a large variability in indication and regimen for post-knee arthroplasty rehabilitat......The short- and long-term benefits of post-discharge physiotherapy regimens after total knee arthroplasty are debatable. A national survey including hospitals in Denmark that perform total knee arthroplasty showed a large variability in indication and regimen for post-knee arthroplasty...... rehabilitation. Since hospital stay duration has decreased considerably, the need for post-discharge physiotherapy may also have changed. Thus, the indication for and types of rehabilitation programmes need to be studied within the context of fast-track knee arthroplasty. Udgivelsesdato: 2009-Feb-23...

  4. Assessment of sediment contamination in Casco Bay, Maine, USA

    Energy Technology Data Exchange (ETDEWEB)

    Wade, Terry L. [Geochemical and Environmental Research Group, Texas A and M University, 833 Graham Road, College Station, TX 77845 (United States); Sweet, Stephen T. [Geochemical and Environmental Research Group, Texas A and M University, 833 Graham Road, College Station, TX 77845 (United States)], E-mail: sweet@gerg.tamu.edu; Klein, Andrew G. [Geography Department, Texas A and M University, 814B Eller O and M Building, College Station, TX 77843 (United States)

    2008-04-15

    The current status of contaminant concentrations in Casco Bay, decadal trends of these contaminants and changes in their geographical distribution are assessed using sediment samples collected approximately 10 years apart. In general, regulated contaminants appeared to be decreasing in concentration. Total PAH and dioxins/furans concentrations did not significantly change over this period. Total organochlorine pesticides, 4,4-DDE, 4,4-DDD, total DDT, PCB, tributyltin and total butyltin decreased in concentration. Trace element concentrations in sediments decreased at the majority of the sampling sites for chromium, nickel, and selenium while arsenic, cadmium, copper, lead, mercury, silver, and zinc remained relatively constant. None of the contaminants measured has increased by more than a factor of 2. Selected sites located in the Inner Bay, where concentrations are higher and new inputs were more likely, showed increased concentrations of contaminants. Most contaminants were not found at concentrations expected to adversely affect sediment biota based on ERL/ERM guidelines. - Sediment studies indicate decadal decreases for many chemical contaminants in Casco Bay.

  5. Assessment of sediment contamination in Casco Bay, Maine, USA

    International Nuclear Information System (INIS)

    Wade, Terry L.; Sweet, Stephen T.; Klein, Andrew G.

    2008-01-01

    The current status of contaminant concentrations in Casco Bay, decadal trends of these contaminants and changes in their geographical distribution are assessed using sediment samples collected approximately 10 years apart. In general, regulated contaminants appeared to be decreasing in concentration. Total PAH and dioxins/furans concentrations did not significantly change over this period. Total organochlorine pesticides, 4,4-DDE, 4,4-DDD, total DDT, PCB, tributyltin and total butyltin decreased in concentration. Trace element concentrations in sediments decreased at the majority of the sampling sites for chromium, nickel, and selenium while arsenic, cadmium, copper, lead, mercury, silver, and zinc remained relatively constant. None of the contaminants measured has increased by more than a factor of 2. Selected sites located in the Inner Bay, where concentrations are higher and new inputs were more likely, showed increased concentrations of contaminants. Most contaminants were not found at concentrations expected to adversely affect sediment biota based on ERL/ERM guidelines. - Sediment studies indicate decadal decreases for many chemical contaminants in Casco Bay

  6. Strategies for sustainable woodland on contaminated soils.

    Science.gov (United States)

    Dickinson, N M

    2000-07-01

    Extensive in situ reclamation treatment technologies are appropriate for a large proportion of contaminated land in place of total removal or complete containment of soil. In this paper, initial results are presented of site descriptions, tree survival and metal uptake patterns from two field planting trials on a highly industrially contaminated site adjacent to a metal refinery and on old sanitary landfill sites. Survival rate was high in both trials but factors besides heavy metals were particularly significant. Uptake patterns of metals into foliage and woody tissues were variable, with substantial uptake in some species and clones supporting the findings of earlier pot experiments. It is argued that there is sufficient evidence to consider the use of trees in reclamation as part of a realistic, integrated, low-cost, ecologically-sound and sustainable reclamation strategy for contaminated land. This is an opportunity to bring a large number of brownfield sites into productive use, which otherwise would be prohibitively expensive to restore.

  7. Supravaginal eller total hysterektomi?

    DEFF Research Database (Denmark)

    Edvardsen, L; Madsen, E M

    1994-01-01

    There has been a decline in the rate of hysterectomies in Denmark in general over the last thirteen years, together with a rise in the number of supravaginal operations over the last two years. The literature concerning the relative merits of the supravaginal and the total abdominal operation is ...... indicate a reduced frequency of orgasm after the total hysterectomy compared with the supravaginal operation. When there are technical problems peroperatively with an increased urologic risk the supravaginal operation is recommended....

  8. Caregiver burden among relatives of patients with schizophrenia in ...

    African Journals Online (AJOL)

    both patients and their caregivers.1,2 Caregiver burden in mental illness can either be ... with chronic mental illness.9 Consequently, there is a need to study the burden of ..... References. 1. Kung W. The illness, stigma, culture or immigration?

  9. Burdens and Standards of Proof in Possession of Unexplained ...

    African Journals Online (AJOL)

    Cases such as Workineh Kenbato & Amelework Dalie demonstrate the confusion regarding who bears what burden, for which facts the burden would apply and the required standard of proof thereof. Despite efforts to use the prosecution of illicit enrichment as a weapon in the combat against corruption, there are concerns ...

  10. 34 CFR 34.14 - Burden of proof.

    Science.gov (United States)

    2010-07-01

    ... 34 Education 1 2010-07-01 2010-07-01 false Burden of proof. 34.14 Section 34.14 Education Office of the Secretary, Department of Education ADMINISTRATIVE WAGE GARNISHMENT § 34.14 Burden of proof. (a... those in § 34.24. (d)(1) If you object on the ground that applicable law bars us from collecting the...

  11. 6 CFR 27.325 - Burden of proof.

    Science.gov (United States)

    2010-01-01

    ... 6 Domestic Security 1 2010-01-01 2010-01-01 false Burden of proof. 27.325 Section 27.325 Domestic Security DEPARTMENT OF HOMELAND SECURITY, OFFICE OF THE SECRETARY CHEMICAL FACILITY ANTI-TERRORISM... burden of proving the facts necessary to support the challenged administrative action at every proceeding...

  12. The burden of disease attributable to sexually transmitted infections ...

    African Journals Online (AJOL)

    Years of life lost (YLL) and years lived with disability (YLD) were estimated using different approaches for HIV I AIDS, other STis and cervical cancer. Burden in respect of HIV I AIDS was estimated using the ASSA2002 model, and for the other diseases the revised national burden of disease estimates for 2000 based on ...

  13. Tuberculous Pericarditis is Multibacillary and Bacterial Burden Drives High Mortality

    Directory of Open Access Journals (Sweden)

    Jotam G. Pasipanodya

    2015-11-01

    Interpretation: Patients with culture confirmed tuberculous pericarditis have a high bacillary burden, and this bacterial burden drives mortality. Thus proven tuberculosis pericarditis is not a paucibacillary disease. Moreover, the severe immunosuppression suggests limited inflammation. There is a need for the design of a highly bactericidal regimen for this condition.

  14. Thailand's Student Loans Fund: Interest Rate Subsidies and Repayment Burdens

    Science.gov (United States)

    Chapman, Bruce; Lounkaew, Kiatanantha; Polsiri, Piruna; Sarachitti, Rangsit; Sitthipongpanich, Thitima

    2010-01-01

    Government student loan schemes typically have implicit interest rate subsidies which, while these are a cost to taxpayers, they have the benefit of diminishing repayment burdens for graduates. Our goal is to illustrate the extent of both interest rate subsidies and repayment burdens with respect to Thailand's Student Loans Fund (SLF), using…

  15. Caregiver burden among relatives of patients with schizophrenia in ...

    African Journals Online (AJOL)

    Background. Caring for patients with schizophrenia places an enormous burden on the caregivers. The magnitude of this problem remains largely unknown in sub-Saharan Africa. Objective. The objective of this study was to determine the nature of the burden reported by caregiving relatives of patients with schizophrenia.

  16. Estimating the burden of disease attributable to unsafe water and ...

    African Journals Online (AJOL)

    Objectives. To estimate the burden of disease attributable to unsafe water, sanitation and hygiene (WSH) by age group for South Africa in 2000. Design. World Health Organization comparative risk assessment methodology was used to estimate the disease burden attributable to an exposure by comparing the observed risk ...

  17. Caregiver burden and correlates among caregivers of children and ...

    African Journals Online (AJOL)

    Journal of Child and Adolescent Mental Health ... Data on socio-demographic factors, psychiatric morbidity among caregivers, and level of caregiver burden was collected using a researcher-designed socio-demographic questionnaire, Mini International Neuropsychiatric Interview, and Zarit burden interview, respectively.

  18. Household burden of chronic diseases in Ghana | Togoe | Ghana ...

    African Journals Online (AJOL)

    Conclusion: The relatively high direct cost of illness among households with person(s) living with NCDs and the associated high indirect burden of illness places undue stress on households. Research requires better measurement of the indirect burden with focus on the household. These findings suggest the necessity of ...

  19. The disease burden of congenital toxoplasmosis in Denmark, 2014

    DEFF Research Database (Denmark)

    Nissen, Ioanna; Jokelainen, Pikka; Stensvold, Christen Rune

    2017-01-01

    Congenital toxoplasmosis (CT) causes a substantial disease burden worldwide. The aim of this study was to estimate the disease burden of CT in Denmark, a developed country with free public healthcare and nationwide data available. Using data primarily from two public health surveillance programmes...

  20. Estimating the burden of disease attributable to unsafe water and ...

    African Journals Online (AJOL)

    Estimating the burden of disease attributable to unsafe water and lack of sanitation and hygiene in South Africa in 2000. ... Disease burden from diarrhoeal diseases, intestinal parasites and schistosomiasis, measured by deaths and disability-adjusted life years (DALYs). Results. 13 434 deaths were attributable to unsafe ...

  1. Caregiver burden in amyotrophic lateral sclerosis : A systematic review

    NARCIS (Netherlands)

    de Wit, Jessica; Bakker, Leonhard A; van Groenestijn, Annerieke C; van den Berg, Leonard H; Schröder, Carin D; Visser-Meily, Johanna Ma; Beelen, Anita

    BACKGROUND: Informal caregivers of patients with amyotrophic lateral sclerosis experience increased levels of caregiver burden as the disease progresses. Insight in the factors related to caregiver burden is needed in order to develop supportive interventions. AIM: To evaluate the evidence on

  2. Burden, genotype and phenotype profiles of adult patients with ...

    African Journals Online (AJOL)

    burden of SCD disease, with in excess of 300 000 new affected births annually ... child births globally.[3] In spite of the high burden of disease in SSA, SCD is often ..... supportive medication such as folic acid and patient clinic attendance.

  3. Burden and Stress among Psychiatry Residents and Psychiatric Healthcare Providers

    Science.gov (United States)

    Zuardi, Antonio Waldo; Ishara, Sergio; Bandeira, Marina

    2011-01-01

    Purpose: The authors compared the levels of job burden and stress in psychiatry residents with those of other healthcare professionals at inpatient and outpatient psychiatric hospitals in a medium-sized Brazilian city. Method: In this study, the levels of job burden and stress of 136 healthcare workers and 36 psychiatry residents from six various…

  4. The Contaminant Cobweb

    DEFF Research Database (Denmark)

    Bech Albertsen, Anita Nell

    2017-01-01

    This article maps out character complexity in Penny Dreadful by focusing on the intertextuality of monstrous female characters. The aim of this study is twofold. First, it seeks to examine show how mashup characters gain complexity through textual contamination as they are woven into an intertext......This article maps out character complexity in Penny Dreadful by focusing on the intertextuality of monstrous female characters. The aim of this study is twofold. First, it seeks to examine show how mashup characters gain complexity through textual contamination as they are woven...... into an intertextual cobweb of signification. Secondly, it aims at examining how monstrous complex characters like Vanessa Ives can be conceived as mashups contaminated by different manifestations of the monstrous-feminine as coined by Barbara Creed. An overarching hypothesis of this study is that interfigural...

  5. Phytovolatilization of Organic Contaminants.

    Science.gov (United States)

    Limmer, Matt; Burken, Joel

    2016-07-05

    Plants can interact with a variety of organic compounds, and thereby affect the fate and transport of many environmental contaminants. Volatile organic compounds may be volatilized from stems or leaves (direct phytovolatilization) or from soil due to plant root activities (indirect phytovolatilization). Fluxes of contaminants volatilizing from plants are important across scales ranging from local contaminant spills to global fluxes of methane emanating from ecosystems biochemically reducing organic carbon. In this article past studies are reviewed to clearly differentiate between direct- and indirect-phytovolatilization and we discuss the plant physiology driving phytovolatilization in different ecosystems. Current measurement techniques are also described, including common difficulties in experimental design. We also discuss reports of phytovolatilization in the literature, finding that compounds with low octanol-air partitioning coefficients are more likely to be phytovolatilized (log KOA < 5). Reports of direct phytovolatilization at field sites compare favorably to model predictions. Finally, future research needs are presented that could better quantify phytovolatilization fluxes at field scale.

  6. Total lymphoid irradiation

    International Nuclear Information System (INIS)

    Sutherland, D.E.; Ferguson, R.M.; Simmons, R.L.; Kim, T.H.; Slavin, S.; Najarian, J.S.

    1983-01-01

    Total lymphoid irradiation by itself can produce sufficient immunosuppression to prolong the survival of a variety of organ allografts in experimental animals. The degree of prolongation is dose-dependent and is limited by the toxicity that occurs with higher doses. Total lymphoid irradiation is more effective before transplantation than after, but when used after transplantation can be combined with pharmacologic immunosuppression to achieve a positive effect. In some animal models, total lymphoid irradiation induces an environment in which fully allogeneic bone marrow will engraft and induce permanent chimerism in the recipients who are then tolerant to organ allografts from the donor strain. If total lymphoid irradiation is ever to have clinical applicability on a large scale, it would seem that it would have to be under circumstances in which tolerance can be induced. However, in some animal models graft-versus-host disease occurs following bone marrow transplantation, and methods to obviate its occurrence probably will be needed if this approach is to be applied clinically. In recent years, patient and graft survival rates in renal allograft recipients treated with conventional immunosuppression have improved considerably, and thus the impetus to utilize total lymphoid irradiation for its immunosuppressive effect alone is less compelling. The future of total lymphoid irradiation probably lies in devising protocols in which maintenance immunosuppression can be eliminated, or nearly eliminated, altogether. Such protocols are effective in rodents. Whether they can be applied to clinical transplantation remains to be seen

  7. Totally optimal decision rules

    KAUST Repository

    Amin, Talha

    2017-11-22

    Optimality of decision rules (patterns) can be measured in many ways. One of these is referred to as length. Length signifies the number of terms in a decision rule and is optimally minimized. Another, coverage represents the width of a rule’s applicability and generality. As such, it is desirable to maximize coverage. A totally optimal decision rule is a decision rule that has the minimum possible length and the maximum possible coverage. This paper presents a method for determining the presence of totally optimal decision rules for “complete” decision tables (representations of total functions in which different variables can have domains of differing values). Depending on the cardinalities of the domains, we can either guarantee for each tuple of values of the function that totally optimal rules exist for each row of the table (as in the case of total Boolean functions where the cardinalities are equal to 2) or, for each row, we can find a tuple of values of the function for which totally optimal rules do not exist for this row.

  8. Totally optimal decision rules

    KAUST Repository

    Amin, Talha M.; Moshkov, Mikhail

    2017-01-01

    Optimality of decision rules (patterns) can be measured in many ways. One of these is referred to as length. Length signifies the number of terms in a decision rule and is optimally minimized. Another, coverage represents the width of a rule’s applicability and generality. As such, it is desirable to maximize coverage. A totally optimal decision rule is a decision rule that has the minimum possible length and the maximum possible coverage. This paper presents a method for determining the presence of totally optimal decision rules for “complete” decision tables (representations of total functions in which different variables can have domains of differing values). Depending on the cardinalities of the domains, we can either guarantee for each tuple of values of the function that totally optimal rules exist for each row of the table (as in the case of total Boolean functions where the cardinalities are equal to 2) or, for each row, we can find a tuple of values of the function for which totally optimal rules do not exist for this row.

  9. Statistical considerations in practical contamination monitoring

    International Nuclear Information System (INIS)

    Brodsky, A.; Gallaghar, R.G.

    1991-01-01

    This paper reports on an examination of smear survey practices which indicates that many radiation safety programs are lacking in important aspects of contamination monitoring. In order to satisfy regulatory and potential litigatory requirements, smear surveys should include the measurement and recording of the flowing data: area of each smear and smear procedure (by reference); total counts on smear and counting procedure; total counts on appropriate blanks and description of blank; total counts on standard and specifications of standard; and all counting times. The rationale for these smear survey requirements is obtained by examining the formulation of the minimum detectable amount (MDA) on a smear

  10. Response of microbial activities and diversity to PAHs contamination at coal tar contaminated land

    Science.gov (United States)

    Zhao, Xiaohui; Sun, Yujiao; Ding, Aizhong; Zhang, Dan; Zhang, Dayi

    2015-04-01

    Coal tar is one of the most hazardous and concerned organic pollutants and the main hazards are polycyclic aromatic hydrocarbons (PAHs). The indigenous microorganisms in soils are capable to degrade PAHs, with essential roles in biochemical process for PAHs natural attenuation. This study investigated 48 soil samples (from 8 depths of 6 boreholes) in Beijing coking and chemistry plant (China) and revealed the correlation between PAHs contamination, soil enzyme activities and microbial community structure, by 16S rRNA denaturing gradient gel electrophoresis (DGGE). At the site, the key contaminants were identified as naphthalene, acenaphthylene, acenaphthene, fluorene, phenanthrene and anthracene, and the total PAHs concentration ranged from 0.1 to 923.9 mg/kg dry soil. The total PAHs contamination level was positively correlated (pcatalase activities (0.554-6.230 mL 0.02 M KMnO4/g•h) and dehydrogenase activities (1.9-30.4 TF μg/g•h soil), showing the significant response of microbial population and degrading functions to the organic contamination in soils. The PAHs contamination stimulated the PAHs degrading microbes and promoted their biochemical roles in situ. The positive relationship between bacteria count and dehydrogenase activities (p<0.05) suggested the dominancy of PAHs degrading bacteria in the microbial community. More interestingly, the microbial community deterioration was uncovered via the decline of microbial biodiversity (richness from 16S rRNA DGGE) against total PAHs concentration (p<0.05). Our research described the spatial profiles of PAHs contamination and soil microbial functions at the PAHs heavily contaminated sites, offering deeper understanding on the roles of indigenous microbial community in natural attenuation process.

  11. Private prayer among Alzheimer's caregivers: mediating burden and resiliency.

    Science.gov (United States)

    Wilks, Scott E; Vonk, M Elizabeth

    2008-01-01

    This study examined whether the coping method of private prayer served as a protective factor of resiliency among a sample (N = 304) of Alzheimer's caregivers. Participants in caregiver support groups completed questionnaires that assessed a number of constructs, including caregiving burden; prayer frequency; use of private prayer as a means of coping; and perceived resiliency. The sample averaged a moderate level of burden and a great extent of prayer usage. Caregiving burden had positively affected the extent of prayer usage and negatively influenced perceived resiliency. Findings from hierarchical regression analysis showed that caregiving burden and private prayer significantly influenced variation in perceived resiliency scores. Results from a regression equation series and path analysis provided support for prayer as a mediator between burden and perceived resiliency. Implications for social work practice and education are discussed.

  12. [Burden, empathy, and resilience in dependent people caregivers].

    Science.gov (United States)

    Navarro-Abal, Yolanda; López-López, María José; Climent-Rodríguez, José Antonio; Gómez-Salgado, Juan

    2018-02-10

    To analyse the differences in perceived burden between family caregivers who are users of patient associations and those who are not; to assess the relationship between burden, resilience, and empathy levels. Retrospective ex post facto study of two groups, one of them quasi control. The sample was composed of 155 informal caregivers (28 men and 155 women); 109 of them were users of patient relatives' associations and 46 were not. Both descriptive and bivariate comparative analyses were carried out. Caregivers who were members of patient associations showed lower burden and empathy levels than those who were not. This highlighted that the higher their level of perceived burden, the lower their level of resilience. Belonging to carers' associations results in a lower level of perceived burden and a lower risk of developing compassion fatigue syndrome. Copyright © 2018 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

  13. Estimating the disease burden of methicillin-resistant Staphylococcus aureus in Japan: Retrospective database study of Japanese hospitals.

    Directory of Open Access Journals (Sweden)

    Hironori Uematsu

    Full Text Available The nationwide impact of antimicrobial-resistant infections on healthcare facilities throughout Japan has yet to be examined. This study aimed to estimate the disease burden of methicillin-resistant Staphylococcus aureus (MRSA infections in Japanese hospitals.Retrospective analysis of inpatients comparing outcomes between subjects with and without MRSA infection.A nationwide administrative claims database.1133 acute care hospitals throughout Japan.All surgical and non-surgical inpatients who were discharged between April 1, 2014 and March 31, 2015.Disease burden was assessed using hospitalization costs, length of stay, and in-hospital mortality. Using a unique method of infection identification, we categorized patients into an anti-MRSA drug group and a control group based on anti-MRSA drug utilization. To estimate the burden of MRSA infections, we calculated the differences in outcome measures between these two groups. The estimates were extrapolated to all 1584 acute care hospitals in Japan that have adopted a prospective payment system.We categorized 93 838 patients into the anti-MRSA drug group and 2 181 827 patients into the control group. The mean hospitalization costs, length of stay, and in-hospital mortality of the anti-MRSA drug group were US$33 548, 75.7 days, and 22.9%, respectively; these values were 3.43, 2.95, and 3.66 times that of the control group, respectively. When extrapolated to the 1584 hospitals, the total incremental burden of MRSA was estimated to be US$2 billion (3.41% of total hospitalization costs, 4.34 million days (3.02% of total length of stay, and 14.3 thousand deaths (3.62% of total mortality.This study quantified the approximate disease burden of MRSA infections in Japan. These findings can inform policymakers on the burden of antimicrobial-resistant infections and support the application of infection prevention programs.

  14. Disability-adjusted Life Years (DALYs) for Mental and Substance Use Disorders in the Korean Burden of Disease Study 2012.

    Science.gov (United States)

    Lim, Dohee; Lee, Won Kyung; Park, Hyesook

    2016-11-01

    The purpose of this study was to estimate the national burden of mental substance disorders on medical care utilization in Korea using National Health Insurance System (NHIS) data and updated disability weight, in terms of disability-adjusted life years (DALYs). For each of the 24 disorders, the incident years lived with disability (YLDs) was calculated, using NHIS data to estimate prevalence and incidence rates. The DisMod-II software program was used to model duration and remission. The years of life lost (YLLs) due to premature death were calculated from causes of death statistics. DALYs were computed as the sum of YLDs and YLLs, and time discounting and age weighting were applied. The year examined was 2012, and the subjects were divided into 9 groups according to age. In 2012, the Korean burden of mental and substance use disorders was 945,391 DALYs. More than 98% of DALYs were from YLDs, and the burden in females was greater than that in males, though the burden in males aged less than 19 years old was greater than that in females. Unipolar depressive disorders, schizophrenia, and anxiety disorders were found to be major diseases that accounted for more than 70% of the burden, and most DALYs occurred in their 30-59. Mental and substance use disorders accounted for 6.2% of the total burden of disease and were found to be the 7th greatest burden of disease. Therefore, mental and substance use disorders need to be embraced by mainstream health care with resources commensurate with the burden.

  15. Contamination Analysis Tools

    Science.gov (United States)

    Brieda, Lubos

    2015-01-01

    This talk presents 3 different tools developed recently for contamination analysis:HTML QCM analyzer: runs in a web browser, and allows for data analysis of QCM log filesJava RGA extractor: can load in multiple SRS.ana files and extract pressure vs. time dataC++ Contamination Simulation code: 3D particle tracing code for modeling transport of dust particulates and molecules. Uses residence time to determine if molecules stick. Particulates can be sampled from IEST-STD-1246 and be accelerated by aerodynamic forces.

  16. Some bioindicators of radioactive contamination

    International Nuclear Information System (INIS)

    Cosma, C.; Cozmuta, I.; Micu, C.

    1996-01-01

    The lessons that could be learned from the Chernobyl accident were numerous and encompassed all areas. One of those lead to the discovery of new monitoring methods which also supply to cost-effective solutions to control contaminant radioactive discharges in the environment. Through the measurements performed, we discovered that some samples, because of their radioactive content restrained also for long periods of time, can be used as bioindicators. Hen eggs between May 1-30 1986 were analysed (identification of radionuclides with a Ge(Li) detector and measuring of total gamma activity with NaI(T1)). Various aspects pursued revealed that eggs are precious witness of vegetable food contamination with fission products, especially Ba-140 and I-131, behaving as radionuclide separators (Ba-140 in egg shell -301 Bq/egg and I-131 in the content - 182 Bq/egg). Some of the most important pharmaceutical plants from Transylvania measured during 1986-1994 period presents high cesium radioactivity. The perennial plants (as Lichen Islandicus) for the same period accumulated a greater activity that the annual ones. Especially the lichen, because of the their slow decreasing activity are suitable as biological detectors also in retrospective measurements. Measuring the activity of some pollen samples was rediscovered. The pollen grains, during their transport in air by the bees, are acting like a filter for radionuclides so that we could use they to monitor the deliverance of these substances in air. (author)

  17. Bioremediation of oil contaminated soils

    International Nuclear Information System (INIS)

    Beeson, D.L.; Hogue, J.I.; Peterson, J.C.; Guerra, G.W.

    1994-01-01

    The Baldwin Waste Oil Site was an abandoned waste oil recycling facility located in Robstown, Nueces County, Texas. As part of their site assessment activities, the US Environmental Protection Agency (EPA) requested that the Ecology and Environment, Inc., Technical Assistance Team (TAT) investigate the feasibility of using in-situ bioremediation to remediate soils contaminated with oil and grease components, petroleum hydrocarbons, and volatile organic compounds. Bioremediation based on the land treatment concept was tested. The land treatment concept uses techniques to optimize indigenous microbial populations and bring them in contact with the contaminants. The study was designed to collect data upon which to base conclusions on the effectiveness of bioremediation, to demonstrate the effectiveness of bioremediation under field conditions, and to identify potential problems in implementing a full-scale project. Bioremediation effectiveness was monitored through total petroleum hydrocarbons (TPH) and Oil and Grease (O and G) analyses. Site specific treatment goals for the pilot project were concentrations of less than 1% for O and G and less than 10,000 mg/kg for TPH. Based on the reduction of TPH and O and G concentrations and the cost effectiveness of bioremediation based on the land treatment concept, full-scale in-situ bioremediation was initiated by the EPA at the Baldwin Waste Oil Site in February of 1993

  18. The mercury burden of the Czech population: An integrated approach.

    Science.gov (United States)

    Puklová, Vladimíra; Krsková, Andrea; Cerná, Milena; Cejchanová, Mája; Rehůrková, Irena; Ruprich, Jirí; Kratzer, Karel; Kubínová, Růzena; Zimová, Magdaléna

    2010-07-01

    In this paper an integrated approach in assessment of the population exposure from various sources of total mercury (THg) oral intake in the Czech Republic is presented. The information on total mercury levels in diet, drinking water, surface urban soil and body fluids and tissues stem from the Czech national Environmental Health Monitoring System (EHMS) operated since 1994. The THg concentration was determined by the special atomic absorption spectrophotometer AMA 254. The data on THg content in food from the sales network were collected in 12 cities. The estimated average dietary intake representing more than 95% of weight of usual diet composition ranged 1-2% of the JECFA/FAO WHO provisional tolerable weekly intake (PTWI) value for total mercury (5 microg/kg b.w./week). Data on drinking water quality stem from the nationwide monitoring database. The content of THg in drinking water is generally low; only 0.2% of the Czech population supplied with drinking water from the distribution networks (total of 92% of the population) has a mercury intake from drinking water higher than 1% PTWI and not exceeding 5% PTWI. The estimation of potential mercury intake by unintentional consumption of soil in small children was based on THg content in surface soil of a total of 324 nursery schools in 24 cities and towns. Median value was 0.16 mg/kg. Human biomonitoring was performed in 9 Czech cities. In 2007, the mercury median values in blood of adults (N=412) were 0.85 and 0.89 microg/l in males and in females, respectively; urine median value in adults was 1.10 microg/g creatinine. In 2008, the blood median value in children (N=324) amounted to 0.35 microg/l; urine median value is 0.16 microg/g creatinine. In children's hair the median THg value was 0.18 microg/g. The correlation between fish consumption and blood THg levels was observed in both adults and children. Also the biomonitoring outputs did not reveal a substantial burden of the population. Copyright 2010 Elsevier

  19. Validating a Cantonese short version of the Zarit Burden Interview (CZBI-Short) for dementia caregivers.

    Science.gov (United States)

    Tang, Jennifer Yee-Man; Ho, Andy Hau-Yan; Luo, Hao; Wong, Gloria Hoi-Yan; Lau, Bobo Hi-Po; Lum, Terry Yat-Sang; Cheung, Karen Siu-Lan

    2016-09-01

    The present study aimed to develop and validate a Cantonese short version of the Zarit Burden Interview (CZBI-Short) for Hong Kong Chinese dementia caregivers. The 12-item Zarit Burden Interview (ZBI) was translated into spoken Cantonese and back-translated by two bilingual research assistants and face validated by a panel of experts. Five hundred Chinese dementia caregivers showing signs of stress reported their burden using the translated ZBI and rated their depressive symptoms, overall health, and care recipients' physical functioning and behavioral problems. The factor structure of the translated scale was identified using principal component analysis and confirmatory factor analysis; internal consistency and item-total correlations were assessed; and concurrent validity was tested by correlating the ZBI with depressive symptoms, self-rated health, and care recipients' physical functioning and behavioral problems. The principal component analysis resulted in 11 items loading on a three-factor model comprised role strain, self-criticism, and negative emotion, which accounted for 59% of the variance. The confirmatory factor analysis supported the three-factor model (CZBI-Short) that explained 61% of the total variance. Cronbach's alpha (0.84) and item-total correlations (rho = 0.39-0.71) indicated CZBI-Short had good reliability. CZBI-Short showed correlations with depressive symptoms (r = 0.50), self-rated health (r = -0.26) and care recipients' physical functioning (r = 0.18-0.26) and disruptive behaviors (r = 0.36). The 12-item CZBI-Short is a concise, reliable, and valid instrument to assess burden in Chinese dementia caregivers in clinical and social care settings.

  20. The burden of insomnia in Japan

    Directory of Open Access Journals (Sweden)

    Mishima K

    2015-01-01

    Full Text Available Kazuo Mishima,1 Marco daCosta DiBonaventura,2 Hillary Gross2 1Department of Psychophysiology, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan; 2Kantar Health, New York, NY, USA Objectives: Several studies have suggested that patients who experience insomnia report a number of significant impairments. However, despite this literature, fewer studies have focused on the burden of insomnia among patients in Japan. The objective of the current study is to extend this work in Japan to further understand the effect of insomnia on health-related quality of life (hrQOL. Further, another objective is to understand general predictors of hrQOL among patients with insomnia. Methods: Data from the 2012 Japan National Health and Wellness Survey, an annual, cross-sectional study of adults aged 18 years or older, were used (N=30,000. All National Health and Wellness Survey respondents were categorized based on the incidence of self-reported insomnia diagnosis and prescription medication usage (clinical insomniacs under treatment versus [vs] good sleepers without insomnia or insomnia symptoms. Comparisons among different groups were made using multiple regression models controlling for demographics and health history. Results: Clinical insomniacs (n=1,018; 3.4% reported significantly worse hrQOL compared with good sleepers (n=20,542 (mental component summary: 34.2 vs 48.0; physical component summary: 48.0 vs 52.8; health utilities: 0.61 vs 0.76; all P<0.05. Health behaviors (smoking, exercise, alcohol use and comorbidities were the strongest predictors of health utilities for clinical insomniacs. For all three clinical insomniac subgroups of interest, those with a physical comorbidity but not a psychiatric one, those with a psychiatric comorbidity but not a physical one, and those without either a physical or psychiatric comorbidity, large decrements in health utilities were observed for respondents who did